Objective To understand the delay factors of the treatment and diagnosis among pulmonary tuberculosis patients, and to provide scientific evidence for tuberculosis control.Methods A total of 128 pulmonary tuberculosis patients who was newly diagnosed and treated in Xiaoshan were enrolled in this study.The data of demography,medical history and tuberculosis knowledge were collected through questionnaires.Statistical method was used to analyze the current situation and delay factors of the treatment and diagnosis.Results The rate of treatment delay was 25.00%.Female patients without hemoptysis symptom,maintenance elderly,little knowledge of tuberculosis and low degree of education were relative to treatment delay among pulmonary tuberculosis patients (P <0.05 ).Multivariate logistic regression analysis showed that female(OR =6.39,95%CI:1.66 -24.61),was the delay factors of treatment.The rate of diagnosis delay was 50.78%.Multivariate logistic regression analysis showed that preliminary treatment in village or private clinics (OR =2.10,95%CI:1.00 -4.39),preliminary treatment without X ray (OR =3.91,95%CI:1.16 -13.19)and maintenance elderly (OR =57.43,95%CI:4.43 -744.30)were risk factors for delayed diagnosis.Conclusion The influencing factor for treatment and diagnosis delay are female,preliminary treatment in village or private clinics,preliminary treatment without X ray and maintenance elderly.

AIM: To investigate the value of ultrasonography in diabetic retinopathy ( DR) .?METHODS: Totally 103 cases ( 103 eyes ) of type 2 diabetes mellitus were selected from May 2015 to May 2017 in our hospital, there were 32 patients 32 eyes with non diabetic retinopathy ( NDR) , 40 patients 40 eyes with non proliferative diabetic retinopathy ( NPDR ) , and 31 patients 31 eyes with proliferative diabetic retinopathy (PDR), 40 healthy volunteers (40 eyes) were selected as control group, the maximum systolic blood flow velocity ( PSV ) , end diastolic velocity ( EDV ) and resistance index (RI) of the central retinal artery (CRA), posterior ciliary artery ( PCA ) and ophthalmic artery ( OA ) were detected by color Doppler ultrasound.?RESULTS:The difference of PSV, EDV and RI of CRA, PCA and OA in each group was statistically significant (P<0. 05). The PSV of CRA, PCA and OA in NDR group were 12. 38 ± 2. 10cm/s, 13. 36 ± 2. 55cm/s and 32. 04 ± 6. 07cm/s, significantly higher than that of NPDR group (9.70±1.67cm/s, 12.20±2.01cm/s and 27.40±4.32cm/s) and PDR group ( 7. 13 ± 1. 40cm/s, 10. 31 ± 1. 82cm/s and 22.10±3.51cm/s) (P<0. 05). EDV were 4. 67±1. 20cm/s, 5. 61 ± 1. 25cm/s and 8. 40 ± 1. 51cm/s, significantly higher than that of NPDR group (3. 52±1. 19cm/s, 5. 01±1. 30cm/s and 6.61±1. 67cm/s) and PDR group (2. 48±1. 02cm/s, 4. 11±1.04cm/s and 4. 01±1. 52cm/s) (P<0. 05). And RI were 0. 63 ± 0. 07, 0. 60 ± 0. 04 and 0. 77 ± 0. 05, was significantly lower than that of NPDR group (0. 72±0. 06, 0. 67±0. 05 and 0. 81 ± 0. 03) and PDR group (0. 80 ± 0. 09, 0. 74±0. 06 and 0. 86±0. 04) (P<0. 05).?CONCLUSION: Color Doppler ultrasound monitoring the hemodynamic changes of ocular blood vessels in diabetes can provide evidence for early detection of diabetic retinopathy.

Objective To evaluate the predictive effect of baseline hepatitis B surface antigen (HBsAg)on virological response in HBeAg -positive chronic hepatitis B patients treated with pegylated interferon (PEG -IFN ) α-2b. Methods The retrospective analysis compared the treatment efficacy of PEG -IFN α-2b in 55 cases of HBeAg -positive chronic hepatitis B patients with different baseline HBsAg levels.Serum HBV DNA load was measured at baseline and after 1 2,24,and 48 weeks of the therapy.Virological response was defined as HBV DNA <1 000 IU /ml.Serum HBsAg titers were quantitatively assayed at baseline,1 2 and 24 weeks.Results 1 8 patients had baseline HBsAg levels greater than 20 000 IU /ml(Group A),26 patients had baseline HBsAg levels between 1 500 and 20 000 IU /ml(Group B)and 1 1 patients had baseline HBsAg levels less than 1 500 IU /ml(Group C)after 48 weeks treatment with PEG -IFNα-2b.The achieved virological response rates of the three groups were 1 6.67%,42.31 % and 63.64% respectively with a statistically significant difference between group A and C (P <0.05).1 3 patients had HBsAg levels declined greater than 0.5 log1 0 and 30 patients had HBsAg levels declined less than 0.5 log1 0 at week 1 2 and the achieved virological response rates were 1 6.67%,46.2% and 33.3% respectively without statistically significant difference (P >0.05).1 6 patients with HBsAg
levels greater than 20 000 IU /ml after treatment of 24 weeks did not achieve virological response after treatment of 48 weeks.Conclusion Baseline HBsAg levels in combination with HBV DNA quantitative value may become an effective predictor for guiding optimal therapy with PEG -IFN α-2b against HBeAg -positive chronic hepatitis B.

Objective: To investigate the effects of the active ingredients combined therapy on inflammatory factors interleukin 1 beta (IL-1β) and neuropeptide Y (NPY) based on pharmacodynamics in rats. Methods: The animal model was built by transient middle cerebral artery occlusion (MCAO). The method for evaluating the concentrations of the FA-Pr-Al components in rat plasma was established by using HPLC and the expression levels of IL-1β and NPY were determined by ELISA. A new mathematics method of the trend of percentage rate of change (PRC) was used to assess the correlation between pharmacokinetics (PK) and pharmacodynamics (PD). Results: FA-Pr-Al in combination reduced neurological deficits, decreased infarct volume and inhibited the expression levels of IL-1β and NPY (all P<0.05) compared with the model group. FA, Pr and Al all displayed two compartment open models in rats. Clockwise hysteresis loops were obtained by time-concentration-effect curves. IL-1β and NPY level changes in the plasma followed an opposite trend to the plasma concentration tendency after Cmax was reached. Astragaloside's PRC value was significantly higher than those of FA and puerarin between 120 to 180 min. Conclusions: The pharmacokinetics of FA-Pr-Al in combination were closely related its pharmacodynamics in treating ischemia/reperfusion injury, and the components of FA-Pr-Al may have a synergistic pharmacological effect. Astragaloside may play a more pronounced role in regulating IL-1βand NPY levels compared with puerarin or FA.

BACKGROUNDData on the epidemiology of hypertension in Chinese non-dialysis chronic kidney disease (CKD) patients are limited. The aim of the present study was to investigate the prevalence, awareness, treatment, and control of hypertension in the non-dialysis CKD patients through a nationwide, multicenter study in China.

METHODSThe survey was performed in 61 tertiary hospitals in 31 provinces, municipalities, and autonomous regions in China (except Hong Kong, Macao, and Taiwan). Trained physicians collected demographic and clinical data and measured blood pressure (BP) using a standardized protocol. Hypertension was defined as systolic BP &ge; 140 mmHg and/or diastolic BP &ge; 90 mmHg, and/or use of antihypertensive medications. BP < 140/90 mmHg and < 130/80 mmHg were used as the 2 thresholds of hypertension control. In multivariate logistic regression with adjustment for sex and age, we analyzed the association between CKD stages and uncontrolled hypertension in non-dialysis CKD patients.

RESULTSThe analysis included 8927 non-dialysis CKD patients. The prevalence, awareness, and treatment of hypertension in non-dialysis CKD patients were 67.3%, 85.8%, and 81.0%, respectively. Of hypertensive CKD patients, 33.1% and 14.1% had controlled BP to < 140/90 mmHg and < 130/80 mmHg, respectively. With successive CKD stages, the prevalence of hypertension in non-dialysis CKD patients increased, but the control of hypertension decreased (P < 0.001). When the threshold of BP < 130/80 mmHg was considered, the risk of uncontrolled hypertension in CKD 2, 3a, 3b, 4, and 5 stages increased 1.3, 1.4, 1.4, 2.5, and 4.0 times compared with CKD 1 stage, respectively (P < 0.05). Using the threshold of < 140/90 mmHg, the risk of uncontrolled hypertension increased in advanced stages (P < 0.05).

CONCLUSIONSThe prevalence of hypertension Chinese non-dialysis CKD patients was high, and the hypertension control was suboptimal. With successive CKD stages, the risk of uncontrolled hypertension increased.

Adult ; Aged ; Awareness ; Female ; Humans ; Hypertension ; complications ; epidemiology ; therapy ; Male ; Middle Aged ; Prevalence ; Renal Insufficiency, Chronic ; complications