Objective To observe different effects of cyclic and continuous nutrition infusion on serum nutritional indicators, peripheral white blood cell counts (WBC), arterial partial pressure of oxygen (PaO2), arterial partial pressure of carbon dioxide (PaCO2) and acute physiology and chronic health evaluation Ⅲ (APACHE Ⅲ ) score in patients with mechanical ventilated respiratory failure (MVRF).Methods A cross-over and self-controlled trial was conducted in 48 patients with MVRF treated in a medical intensive care unit during December 2006 to June 2009, and continuous nutrition (group A) and cyclic nutrition (group B) were infused respectively for patients of the two groups.Serum levels of albumin (ALB), pre-albumin (PA), transferrin (TR), PaO2, PaCO2, WBC and APACHE Ⅲ score were measured for the patients with 24-hour continuous nutrition (group A) and 16-hour cyclic nutrition (group B)infusion.Effects of the two nutritional therapies were compared.Results After nutrition infusion, serum levels of ALB, PA and TR were (34±3)g/L, (196±28)mg/L and (2.1±0.3 ) g/L in group A, and (35 ±4) g/L, (198 ±25) mg/L and (2.0 ±0.4) g/L in group B, respectively; and PaO2 and PaCO2levels were (92 ± 12) mm Hg ( 1 mm Hg =0.133 kPa) and (42 ± 10) mm Hg in group A, and (91 ±9)mm Hg and (42 ± 10) mm Hg in group B, respectively.WBC and APACHE Ⅲ score were ( 11.8 ± 1.7) ×109/L and 38 ±7 in group A, and ( 12.6 ± 1.2) × 109/L and 40 ±6 in group B, respectively.Significant difference in serum levels of PA and TR was found between the two groups (PPA =0.019 and PTR =0.013),while there was no significant difference in other indictors between the two groups.Conclusions 24-hour continuous nutrition infusion for patients with MVRF can obviously improve their serum levels of PA and TR,but has no effect on serum level of ALB, PaO2, WBC and APACHE Ⅲ score in critical ill patients, as compared to those with 16-hour cyclic nutrition infusion.

Objective To explore the advantages of Argus method by comparing the accuracy and timeliness of Argus and artificial methods for measuring femoral head necrosis area in MRI scanning.Methods Totally 17 patients (31 hips) were measured with Argus and artificial methods respectively for the necrosis area, and then the measuring results and time were compared, and the correlation was investigated between the results and the patients' pain degree, along with that between the results and the extent of femoral head collapse.Results The necrosis area ratios determined by Argus and artificial methods were (33.5±4.08)%and (34.6±4.06)%respectively, with no statistical difference between the ratios (P>0.05). The time consumed by artificial method was (21.3 ±3.62)min, significantly longer than (7.89 ±1.03)min by Argus method, with P<0.001. Regression analysis proved that the necrosis areas were positively correlated with the patients' pain degree, and the correlation coefficient by Argus method was 0.807 8, more than 0.740 9 by artificial method. The femoral heads of 11 cases(16 hips) collapsed in the follow-up period, the necrosis areas were positively correlated with the patients collapse level, but the correlation coefficient by Argus method was 0.783 8, more than 0.726 7 by artificial method.Conclusion Argus method gains high accuracy and timeliness when used in MRI scanning of femoral head necrosis area, and thus is worth popularizing clinically.

Objective To understand the prevalence of depressive symptoms and associated sexual characteristics among men who have sex with men (MSM) in Foshan,Guangdong province.Methods Respondent-driven sampling method was used to recruit MSM who were 18 years and older,living in Foshan longer than 6 months.Scales of depression,demographical information,and characteristics of sexual behaviors were collected using a self-designed questionnaire.Respondent-Driven Sampling Analysis Tool and SAS were used to generate crude and estimated population proportion as well as 95％ confidence intervals (CI).Multivariate logistic regression was performed to explore potential factors associated with depressive symptoms.Results Among 249 respondents,the mean age (standard deviation) was 31.9 (8.5) years,with 43.5％ of them having had 7-9 years of education while 25.9％ had 10-12 years.49.7％ of the respondents were currently married.56.7％ of them had bisexual orientation.42.3％ of them met their sex partners in parks/toilets and 63.3％ of them had their first sex with a female.The estimated prevalence of depressive symptoms was 34.8％(28.2-42.3) among MSM in Foshan.Younger age,lower education levels,only had oral sex,and regularly meetingr sexual partners in parks were associated with depressive symptoms,with the adjusted odd ratio (95％ CI) as 3.31 (1.39-7.86),2.23 (1.01-4.93),3.09 (1.10-8.70) and 2.38(1.20-4.75),respectively.Conclusion Depression related symptoms might associate with the demographical and sexual characteristics of MSM in Foshan,suggesting that psychological interventions should involve components as demographical and sexual characteristics.

OBJECTIVETo investigate the effects of ulinastatin on gut mucosal apoptosis and bacterium translocation in a rat model of sepsis.

METHODSFifty rats were randomly assigned into 4 groups, namely the control (n=5, no operation or drugs), ulinastatin pretreatment (n=15, treated with 25,000 U/kg ulinastatin 2 h before operation), ulinastatin treatment (n=15, treated with 25,000 U/kg ulinastatin 2 h after operation) and sepsis model (n=15, without drug treatment) groups. The rats in the later 3 groups were subjected to cecal ligation and puncture (CLP). At 3, 6 and 12 h after CLP, the rats were sacrificed and the ileum was removed to examine the pathology and apoptosis of the mucosa. The DNA of Bacillus coli in the whole blood was detected using PCR.

RESULTSSepsis caused of epithelial cell loss in the ileal villi, ulceration and blebbing of the lamina propria. Ulinastatin treatment administered before and after the operation both significantly alleviated these morphological anomalies. The sepsis rats showed significantly increased intestinal mucosal apoptotic index as compared with the other 3 groups (P<0.05). Ulinastatin pretreatment, in comparison ulinastatin treatment 12 h after CLP, significantly increased the intestinal mucosal apoptotic index (P<0.05). Bacillus coli DNA was positive in sepsis and postoperative ulinastatin treatment groups but negative in the control and pretreated groups.

CONCLUSIONIncreased intestinal musocal apoptosis and gut bacterial translocation occur in rats following sepsis, and ulinastatin can effectively decrease intestinal mucosal apoptosis and inhibit bacterial translocation.

Animals ; Apoptosis ; drug effects ; Bacterial Translocation ; drug effects ; Female ; Glycoproteins ; pharmacology ; therapeutic use ; Ileum ; drug effects ; microbiology ; pathology ; Intestinal Mucosa ; drug effects ; microbiology ; pathology ; Male ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Sepsis ; drug therapy ; Trypsin Inhibitors ; pharmacology ; therapeutic use

Objective To explore the self-face recognition and its relationship to empathy in patients with schizophrenia.Methods Sixty-two schizophrenic patients and fifty -four healthy subjects were assessed with the self-face recognition task (SFRT) and the interpersonal reactivity index-C (IRI-C).Results The SFRT reaction time in the patients group( (2188 ± 1138) ms) was significantly longer than that in the control group( ( 1152 ± 326) ms) (P ＜ 0.01 ) ;the accuracy in the patients group ( (80 ± 16) ％ ) was significantly lower than that in the control group ( (88 ± 6) ％ ) (P ＜ 0.01 ).The IRI-C total scores,the subscores in perspective taking,the subscores in fantasy and empathic concern of IRI-C were significantly lower in the patients group(respectively(44.82 ± 10.50),(8.98 ± 3.56),( 11.87 ± 4.38 ),( 14.73 ± 4.00) ) than those in the control group ( respectively (49.85 ± 10.28),( 10.78 ± 3.86),( 14.98 ± 6.12),( 17.39 ± 4.56) ) ; the subscore in personal distress of IRI-C in the patients group(9.37 ± 5.12) was significantly higher than those in the control group(6.52 ± 3.89) ( P＜ 0.01 ).There was significant positive correlation between the accuracy for self-face recognition in SFRT and the subscore in fantasy of IRI-C ( r =0.322,P ＜ 0.05 ),the reaction time of SFRT had significantly positive correlation with the subscore in personal distress.Conclusion Schizophren patients have general impairments of self-face recognition and empathic abilities,and the self-face recognition is related to the empathic abilities.

This study was purposed to investigate the significance of using (FCM) flow cytometry for detection bone marrow involvement by lymphoma cells in untreated patients with B cell non-Hodgkin's lymphoma (B-NHL). Bone marrow samples of 54 patients with B-NHL were analyzed by flow cytometry, morphological method and molecular biology technique. Bone marrow involvement was diagnosed based on the results of morphology, FCM and molecular biology. The results indicated that the positive ratios of bone marrow involvement were different detected by three methods, the most sensitive method was FCM (positive rate was 27.5%), the moderately sensitive method was molecular biology (positive rate was 22.2%), the inferior method was morphology method (positive rate was 5.6%). Combined with three methods, the positive rate increased to 38.9%. The monoclonal B lymphocytes were detected by FCM in fourteen patients, the ratios of kappa light chain/lambda light chain were far beyond the diagnostic threshold. Even in patients with early stage, lymphoma cells still could be detected by FCM in involved bone marrow. Monoclonal B lymphocytes were detected by FCM in three patients who were diagnosed bone marrow involvement by morphological method. The concordance between FCM and molecular biology was relatively high (70.4%, p=0.14). It is concluded that the detection of monoclonal B lymphocytes by using FCM has high sensitivity and accuracy in patients with B-NHL. Evaluation whether the bone marrow has been involved by lymphoma cells should be recommend to every patient with B-NHL before chemotherapy and every disease stages. Combined application of FCM and molecular biology method would enhance diagnostic efficacy.
Adult ; Aged ; Bone Marrow ; pathology ; Clone Cells ; pathology ; Female ; Flow Cytometry ; Humans ; Lymphoma, B-Cell ; diagnosis ; pathology ; Male ; Middle Aged ; Neoplasm Staging ; Young Adult

OBJECTIVETo study the clinical significance of abnormal protein bands (APB) in multiple myeloma (MM) patients treated with bortezomib-based induction regimen and autologous stem cell transplantation (ASCT).

METHODSSixty-eight MM patients submitted to bortezomib-based induction therapy and ASCT from January 2007 to July 2012 were retrospectively studied. Monoclonal protein was detected by immunofixation electrophoresis (IFE).

RESULTSOf all 68 patients, 33 (48.5%) patients had APB. At the first emergence of an APB, two patients with light chain type achieved CR and before transplantation, and thirty-one patients were after transplantation with median time of 104 (ranged 33-404) days. The median duration of APB appearance was 105 (ranged 35-801) days. Patients who developed APB compared with those without APB, had a significantly higher CR plus very good partial response (VGPR) rates (100.0% vs 85.7%%, P=0.017) and CR rates (87.9% vs 62.9%) (P=0.03). There were no significant differences in gender, age, HGB, ALB, β2-microglobulin, M protein type, Durie-Salmon and ISS stages, the case number of first line or second line treatment, induction courses of bortezomib-based regimen, and the mode of ASCT. With a median follow-up of 33.4 (ranged 7.0-71.7) months, patients with APB tended to have a longer overall survival (OS) versus non-APB patients, although no significant difference obtained (P＞0.05). Among APB patients, OS was longer in patients whose appearance of APB occurred ＜6 months after transplantation than those ≥ 6 months, but the significant difference was not obtained yet (P＞0.05).

CONCLUSIONSPatients who developed APB had a significantly better response to bortezomib-based induction regimen followed ASCT. APB emergence has a good prognostic significance.

Adult ; Aged ; Boronic Acids ; therapeutic use ; Bortezomib ; Female ; Hematopoietic Stem Cell Transplantation ; Humans ; Male ; Middle Aged ; Multiple Myeloma ; metabolism ; therapy ; Myeloma Proteins ; metabolism ; Prognosis ; Pyrazines ; therapeutic use ; Retrospective Studies ; Transplantation, Autologous

OBJECTIVESTo evaluate the value of the metastatic to examined lymph nodes (rN) ratio in gastric cancer patients who underwent radical resection.

METHODSIn this retrospective study, data were collected from the medical records of 710 patients who underwent radical gastrectomy (R0) for gastric cancer from 1980 to 2006 in the Department of Surgical Oncology at the First Affiliated Hospital of China Medical University. The patients were divided into 2 groups according to the number of examined lymph nodes: Group 1 consisted of 327 patients with <15 examined lymph nodes and Group 2 consisted of 383 patients with ≥15 lymph nodes. rN categories staging and pN categories were divided separately according to the metastatic lymph node ratio and the examined lymph nodes. The prognostic factors were analyzed by univariate (Log-rank) and multivariate (Cox model) analysis methods.

RESULTSThe median survival time was 74 months (95% CI:55.6-92.4 months) in Group 1 and 96 months (95% CI:77.8-119.2 months) in Group 2, and the difference was not statistically significant (P>0.05). On multivariate analysis, the N ratio remained as an independent prognostic factor in both Group 1 (P<0.01, RR=1.225, 95% CI:1.102-1.362) and Group 2 (P<0.01, RR=1.421, 95% CI:1.269-1.592). However, pN stage was an independent prognostic factor only in Group 1. When the rN ratio classification was applied, there were no significant differences between each categories (P>0.05). However, the overall survival of patients with pN1 disease in Group 1 was significantly shorter than that in Group 2 according to the pN stage classification (P<0.01).

CONCLUSIONSThe metastatic lymph node ratio is an independent prognostic factor of the prognosis of gastric cancer. The staging system based on metastatic lymph node ratio (rN) is more reliable than the system based on the number of metastatic lymph nodes in the prediction of the prognosis of gastric cancer.

Adult ; Aged ; Aged, 80 and over ; Female ; Follow-Up Studies ; Humans ; Lymph Nodes ; pathology ; Lymphatic Metastasis ; Male ; Middle Aged ; Prognosis ; Retrospective Studies ; Stomach Neoplasms ; diagnosis ; pathology ; surgery

OBJECTIVETo understand the aortic pulse wave velocity (PWV) in mid-aged and elderly populations and to study the correlation between gender and PWV and the tendency of PWV on different age groups.

METHODSAccording to the clinical trial guideline, we selected 545 healthy subjects (age, 31-85 years, 395 men and 150 women), and measured carotid-femoral PWV, using Complior.

RESULTSThe average value of PWV in Chinese healthy subjects was 11.62 +/- 2.97 m/s. There was no significant difference in the PWV values between males and females who were older than 40 years, but the values of PWV were lower in females than in males in the 30-39 year-old group. PWV was positively correlated with age. In the present study, the reference values of PWV were established in the different age groups, based on the regression equations between PWV and age.

CONCLUSIONAortic pulse wave velocity seemed to be influenced by age but hardly influenced by gender in healthy subjects, so that the reference value of PWV should be established according to the different age groups. When aorta got stiffer, the value PWV got larger accordingly when age was increasing.

Adult ; Age Factors ; Aged ; Aged, 80 and over ; Aorta ; physiology ; Female ; Humans ; Male ; Middle Aged ; Pulsatile Flow ; Reference Values ; Sex Factors

Objective To study the clinical characteristics of syndrome types of laryngeal cough ,in order to provide an epidemiology basis for classification diagnosis. Methods Medical history,clinical signs and symp-toms of patients with laryngeal cough were collected. And questionnaire survey was carried out. Results (1)Of the 4 syndrome types,compared with wind evil invading lung type laryngeal cough incidence,the insecure defen-sive exterior and intrinsic special type showed no statistical difference(P>0.05). And the comparative differences between the rest 2 groups are of statistical differences(P < 0.05).(2)The onset time was analyzed. The results show laryngeal cough incidence from yin deficiency type and fire hyperactivity type showed no statistical difference (P > 0.05). The rest are all of statistical difference(P < 0.05).(3)The clinical course was analyzed. No differ-ence was found between spleen deficient phlegm type ,yin deficiency and fire hyperactivity type laryngeal cough (P>0.05). Differences of the rest 2 groups showed statistical difference(P<0.05).(4)The state of illness was analyzed. The results showed statistical difference between spleen phlegm type and yin deficiency and fire hyperac-tivity type(P<0.05). No statistical difference can be found between the rest 2 groups(P>0.05).(5)The cross-tab chi-square test was carried out on the 4 groups of syndromes on the nasal allergy eye and allergy concomitant incidence. The results showed that there was no significant difference between the 4 groups(P>0.05).(6)On the phlegm part,the results showed difference between wind evil invading lung type and yin deficiency and fire hyper- activity type laryngeal cough(P>0.05). Differences between the rest 2 groups are of statistical significance(P<0.05).(7)Foreign body sensation was analyzed. The results showed no difference between insecure defensive exte-rior and intrinsic special type and wind evil invading lung type ,deficient spleen phlegm type and yin deficiency and fire hyperactivity type(P>0.05). Differences between the rest 2 groups are all of statistical significance(P<0.05). Conclusions The 4 groups of syndrome types,insecure defensive exterior and intrinsic special type and wind evil invading lung type are the most common. Deficient spleen phlegm type is middle ,yin deficiency and fire hyperactivity type come next. Cough caused by wind invading lung mainly occurs in the evening. Its duration is usually within 1 month. It may be accompanied by phlegm with or without occasional pharyngeal paraesthesia. The daily life is usually unaffected or slightly affected. Cough caused by deficiency of vital energy and specific intrinsic quality mainly occurs in the morning. Its duration is usually 3 months to 1 year. It may be accompanied by less phlegm or no phlegm without or with occasional pharyngeal paraesthesia. The daily life is unaffected or slightly affected. Cough caused by Yin deficiency and fire hyperactivity occurs from time to time. It duration is more than 1 year. It may be accompanied by phlegm with pharyngeal paraesthesia. The daily life is unaffected or seriously affected. Cough caused by spleen deficiency and phlegm turbidity mainly occurs in the morning. Its duration is more than 1 year. It may be accompanied by more phlegm with pharyngeal paraesthesia. The daily life is seriously affected.