Objective To analyze the present situation and reasons of short-term unplanned extubation after peripherally inserted central venous catheters (PICC)surgery in cancer patients. Methods A total of 2 458 cancer patients underwent PICC surgery were collected,and patients experienced short-term unplanned extubation were screened out to analyze the general information, catheter situation and reasons of unplanned extubation.Results Totally 2 431 cases (98.90%, 2431 /2458)were successfully followed-up and 103 patients (4.24%,103 /2431)experienced short-term unplanned extubation.Among them,the proportion of patients received primary PICC,pa-tients over 65 years old and patients with catheter located in median cubital vein were 96.12%(99 /103),59.22% (61 /103)and 46.60% (48 /103)respectively.The incidence of unplanned extubation were related to age,vascular choose and whether the primary PICC.Subjective will (61.17%,63 /103)of patients was the main reason for short-term unplanned extubation and the objective reasons were catheter prolapse (10.67%,11 /103),local thrombosis (7.77%,8 /103) and puncture site exudation /phlebitis(6.80%,7 /103),catheter-related infections (5.83%,6 /103)and so on.Conclusion Effective maintenance during the entire process after PICC such as adequate doctor-patient communication,positive patient education,strengthening outside hospital PICC maintenance training as well as establishment of good follow up system can reduce the inci-dence rate of short-term unplanned extubation.

Objective To analyze the present situation and reasons of short-term unplanned extubation after peripherally inserted central venous catheters (PICC)surgery in cancer patients. Methods A total of 2 458 cancer patients underwent PICC surgery were collected,and patients experienced short-term unplanned extubation were screened out to analyze the general information, catheter situation and reasons of unplanned extubation.Results Totally 2 431 cases (98.90%, 2431 /2458)were successfully followed-up and 103 patients (4.24%,103 /2431)experienced short-term unplanned extubation.Among them,the proportion of patients received primary PICC,pa-tients over 65 years old and patients with catheter located in median cubital vein were 96.12%(99 /103),59.22% (61 /103)and 46.60% (48 /103)respectively.The incidence of unplanned extubation were related to age,vascular choose and whether the primary PICC.Subjective will (61.17%,63 /103)of patients was the main reason for short-term unplanned extubation and the objective reasons were catheter prolapse (10.67%,11 /103),local thrombosis (7.77%,8 /103) and puncture site exudation /phlebitis(6.80%,7 /103),catheter-related infections (5.83%,6 /103)and so on.Conclusion Effective maintenance during the entire process after PICC such as adequate doctor-patient communication,positive patient education,strengthening outside hospital PICC maintenance training as well as establishment of good follow up system can reduce the inci-dence rate of short-term unplanned extubation.

OBJECTIVETo observe the effect of Yuquan Pill (YP) on proinflammatory cytokines in patients with type 2 diabetes mellitus (DM2).

METHODSNinety patients with DM2 were randomly divided into the treated group and the control group by the ratio of 2:1. Both groups were treated with Glucobay on the base of dietary and exercise therapy for 3 months, with YP, given to the treated group additionally 6 g four times a day. And the changes of proinflammatory cytokines, including C-reactive protein (CRP), tumor necrosis factor-alpha (TNF-alpha) and interleukin-6 (IL-6), etc. were observed.

RESULTSThe levels of serum CRP,TNF-alpha and IL-6 significantly lowered after treatment in both groups (P<0.01), and the improvement in the treated group was superior to that in the control group (P<0.01).

CONCLUSIONYP could reduce the levels of the increased proinflammatory cytokines in patients with DM2.

Acarbose ; therapeutic use ; Adult ; Aged ; C-Reactive Protein ; metabolism ; Diabetes Mellitus, Type 2 ; blood ; drug therapy ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Hypoglycemic Agents ; therapeutic use ; Interleukin-6 ; blood ; Male ; Middle Aged ; Phytotherapy ; Tumor Necrosis Factor-alpha ; blood

OBJECTIVETo assess the clinical utility of liver fibrosis indexes determination in patients with nonalcoholic fatty liver disease.

METHODSLiver fibrosis indexes of 79 patients with fatty liver, diagnosed by B ultrasonic echography, 37 patients with posthepatitic cirrhosis patients and 32 healthy subjects were determined.

RESULTSThe level of procollagen III(PC III), hyaluronic acid (HA), collagen IV(C IV), laminin (LN) in the fatty liver cases were significantly higher than those of healthy subjects (P<0.05 - 0.01), but lower than those in the liver cirrhosis cases (P<0.01). The difference of PC III, C IV, LN between the severe and early fatty liver cases was significant (P<0.05 - 0.01). Positive rate of these indexes was higher in severe cases.

CONCLUSIONThere is a trend of liver fibrosis in severe fatty liver patients. Combined determination of liver fibrosis indexes may help the diagnosis of liver fibrosis in the fatty liver patients.

Adult ; Alanine Transaminase ; blood ; Collagen Type III ; blood ; Collagen Type IV ; blood ; Fatty Liver ; blood ; diagnostic imaging ; pathology ; Female ; Humans ; Hyaluronic Acid ; blood ; Laminin ; blood ; Liver Cirrhosis ; blood ; diagnosis ; Male ; Middle Aged ; Ultrasonography

OBJECTIVETo explore the relationship between phlegm-stasis syndrome (PSS) and the fibrinolytic status in patients with non-alcoholic fatty liver (NAFL).

METHODSSeventy patients with NAFL were divided into the PSS group and non-PSS group according to TCM Syndrome typing, and a control group consisted of 28 healthy subjects was set up. Levels of plasminogen (PLG), tissue plasminogen activator (t-PA), plasminogen activator inhibitor-1 (PAI-1) and D-dimer were determined and compared.

RESULTSThe activity of t-PA in NAFL patients was significantly lower than that in the control group (P<0.05), and PLG and PAI-1 were significantly higher than those in the control group (P<0.05). In respect to the TCM Syndrome typing, in patients of PSS, t-PA was significantly lower and PLG, PAI-1 were significantly higher than those in patients of non-PSS (P<0.05 or P<0.01), while D-dimer was insignificantly different between patients of the two Syndrome types (P>0.05).

CONCLUSIONNAFL patients of PSS type shows significant lower of fibrinolytic activity, indicating that there is certain degree of microcirculatory disturbance and hyper viscosity state, so the application of dissolving phlegm and dispelling stasis principle in treating NAFL is significant.

Adult ; Aged ; Diagnosis, Differential ; Fatty Liver ; blood ; diagnosis ; Female ; Fibrinolysis ; Humans ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Plasminogen ; metabolism ; Plasminogen Activator Inhibitor 1 ; blood ; Tissue Plasminogen Activator ; blood

OBJECTIVETo explore the correlation of nonalcoholic fatty liver (NAFL) with insulin resistance and the intervention of it by Gankangyin(GKY).

METHODSNinety-six patients with NAFL were randomly assigned into the treated group and the control group. They were treated with GKY and Silymarin for 3 months respectively. Oral glucose tolerance test (OGTT) and insulin release test (IRT) were conducted and insulin sensitivity indexes were determined before and after treatment. And 32 healthy nonalcoholic persons were enrolled and used as the healthy control group.

RESULTSBefore treatment, the levels of blood glucose and insulin at different time points in OGTT test, and the insulin resistance index (IRI) were significantly higher (P < 0.05 or P < 0.01) while insulin sensitivity index (ISI) and insulin active index (IAI) were lower (P < 0.05 or P < 0.01) in the NAFL patients than those in the healthy persons. After treatment, the above-mentioned raised criteria were significantly lowered (P < 0.05, P < 0.01) and the lowered criteria were significantly increased (P < 0.01) in the treated group, while in the control group all the criteria were insignificantly changed (P > 0.05).

CONCLUSIONEvident insulin resistance exists in NAFL patients. GKY could increase the insulin sensitivity, thus improving the state of insulin resistance in NAFL patients.

Adipose Tissue ; metabolism ; Adult ; Aged ; Alanine Transaminase ; blood ; Antioxidants ; administration & dosage ; Blood Glucose ; drug effects ; Body Mass Index ; Cholesterol ; blood ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; administration & dosage ; Fatty Liver ; drug therapy ; metabolism ; Female ; Glucose Tolerance Test ; Humans ; Insulin ; blood ; Insulin Resistance ; Male ; Middle Aged ; Silymarin ; administration & dosage ; Triglycerides ; blood

OBJECTIVETo study the effect of Xuesaitong soft capsule (XST) on liver fibrosis criteria in patients with post-hepatitis fibrosis.

METHODSSixty-four patients with such fibrosis were randomly divided into the treated group and control group. They were treated with XST and Dahuang Zhechong pill (NFDA1) for 3 months respectively. Their liver fibrosis criteria were examined before and after treatment.

RESULTSThe levels of serum procollagen III, hyaluronic acid, collagen IV, laminin in the two groups were significantly lower (P < 0.01) than those before treatment. The differences between the two groups were insignificant (P > 0.05).

CONCLUSIONXST could recover liver dysfunction and had anti-liver fibrosis function.

Adult ; Capsules ; Drugs, Chinese Herbal ; administration & dosage ; adverse effects ; therapeutic use ; Female ; Hepatitis B, Chronic ; complications ; Humans ; Liver ; physiopathology ; Liver Cirrhosis ; drug therapy ; pathology ; physiopathology ; virology ; Male ; Middle Aged ; Treatment Outcome

This study was aimed to detect the methylation status of FHIT gene promoter region in the DNA from plasma of patients with myelodysplastic syndrome (MDS), and to investigate the demethylating effect of decitabine. Methylation-specific PCR method was used to detect the methylation status of FHIT gene promoter region in the DNA from plasma of 4 patients with MDS before and after treatment with decitabine plus semis CAG therapy (among them, 1 case of newly diagnosed MDS, 3 cases progressed into acute leukemia). The results indicated that 3 cases were found to have an increased methylation in the promoter region. After treatment with decitabine plus semis CAG, increased methylation was reversed in 2 cases. In 4 cases, 2 cases displayed clinical response. It is concluded that FHIT gene hypermethylation is associated with MDS pathogenesis. Decitabine has demethylating effect on the FHIT gene hypermethylation of plasma from MDS patients. Detecting the methylation status of FHIT gene in DNA from plasma may play a role in MDS auxiliary diagnosis or prognosis.
Acid Anhydride Hydrolases ; genetics ; Adult ; Aged ; Azacitidine ; analogs & derivatives ; therapeutic use ; DNA ; blood ; DNA Methylation ; Female ; Humans ; Male ; Middle Aged ; Myelodysplastic Syndromes ; blood ; drug therapy ; Neoplasm Proteins ; genetics ; Promoter Regions, Genetic

A case of 3-hydroxyisobutyryl-CoA hydrolase deficiency was reported, and its clinical features, gene mutation characteristics, and diagnosis and treatment were analyzed with reference to related literature. The patient aged 1 year and 6 months had developmental regression and paroxysmal dystonia after pyrexia and diarrhea, and head MRI showed symmetrical lesions in the bilateral basal ganglia. No pathogenic mutation was found in the full-length detection of mitochondrial genome. Nuclear gene detection of mitochondrial-related diseases found new compound heterozygous mutations in the HIBCH gene, i.e., c.439-2A>G and c.958A>G (p.K320E), which were inherited from his father and mother, respectively. The boy was given cocktail therapy, dietary valine restriction, and symptomatic treatment. After 2 weeks of treatment, there were improvements in dystonia and motor and intellectual development.

OBJECTIVETo supply evidence for establishing the standard for Chinese medicine (CM) syndrome differentiation by investigating the distribution and characteristics of CM syndromes in patients with nonalcoholic fatty liver disease (NAFLD).

METHODS928 NAFLD patients' symptoms, signs, tongue and pulse parameters were studied by clinical epidemiologic survey. And the results were analyzed by the cluster analysis and factor analysis.

RESULTSThe results of cluster analysis showed that the CM syndrome typings of fatty liver patients were mainly classified as dampness heat accumulation, Pi deficiency with dampness phlegm, Gan-qi stagnation and Pi deficiency, phlegm stasis accumulation, and Gan-Shen insufficiency, which were in accordance with clinical practice. The results of factor analysis indicated that overweight/obesity, abdominal distension, hypochondriac pain, discomfort in the hepatic region were common "condition factors" of fatty liver patients. The 5 "syndrome factors" such as dampness heat accumulation, Pi deficiency with dampness phlegm, Gan-qi stagnation and Pi deficiency, phlegm stasis accumulation, and Gan-Shen insufficiency showed identification significance in syndrome typing.

CONCLUSIONSThe basic CM syndrome typings of NAFLD were dampness heat accumulation, Pi deficiency with dampness phlegm, Gan-qi stagnation and Pi deficiency, phlegm stasis accumulation, and Gan-Shen insufficiency. The four parameters of fatty liver patients could be classified by statistical analysis as condition factors and syndrome factors (which could reflect CM syndrome characteristics), which could provide certain evidence for establishing CM syndrome differentiation standards.

Adult ; Aged ; Cluster Analysis ; Factor Analysis, Statistical ; Fatty Liver ; diagnosis ; epidemiology ; Female ; Humans ; Male ; Medicine, Chinese Traditional ; methods ; Middle Aged ; Non-alcoholic Fatty Liver Disease