Objective To investigate the influence of Chinese medicine ( CM) treatment on life span of middle-late primary hepatic carcinoma (PHC) patients. Results A multicenter retrospective cohort study was carried out in 489 PHC patients at the stages of Ⅱb, Ⅲa and Ⅲb collected from 15 domestic hospitals. With CM treatment as the exposure factor, the enrolled patients were divided into CM group, western medicine (WM) group and the CM-WM combination group. The main outcomes included median survival time (MST) and survival rate, and the effects of CM treatment and minimally invasive therapy on MST were observed. Results Half-a-year survival rate, one-year survival rate and two-year survival rate were 50%, 9%, 1% in CM group, 70%, 30%, 6% in CM-WM combination group, and 50%, 10%, 0% in WM group, respectively. The survival rates in CM-WM combination group differed from those in CM group and WM group (P<0.01), but the differences of survival rates between CM group and WM group were insignificant (P>0.05) . MST at the stages of Ⅱb, Ⅲa, Ⅲb in CM-WM group was obviously prolonged as compared with the other two groups (P<0.01), and MST at the stages of Ⅲa, Ⅲb in CM group was also obviously prolonged as compared with WM group (P<0.05) . The difference of MST at the stage of Ⅱb was insignificant between CM group and WM group ( P>0.05) . CM treatment and minimally invasive therapy were effective on prolonging the survival time of PHC patients ( P<0.01) . The results of COX regressionanalysis showed that Karnofsky scores, CM treatment and minimally invasive therapy were the preventive factors for the prognosis. Conclusion CM-WM combination group has the best long -term therapeutic effect. CM -WM combination treatment is effective on increasing MST and long-term survival rate, in particular for PHC patients at the stages ofⅡb, Ⅲa and Ⅲb. CM treatment and minimally invasive therapy are helpful for the prolongation of the survival time of PHC patients.

Objective:To explore the application effect of video education combined with Teach-back in the treatment of patients with chronic periodontitis.Methods:Using non-simultaneous experimental research methods, From January to August in 2019, 41 patients with chronic periodontitis who underwent implant restoration in Shanghai Tenth People′s Hospital was selected by convenience sampling method as the control group, and implemented routine oral health education. From September 2019 to May 2020, 42 patients with chronic periodontitis who underwent implant restoration in Shanghai Tenth People′s Hospital were the observation group, and implemented video education combined with Teach-back. Compare the two groups of oral health care self-efficacy, periodontal clinical indicators, and the incidence of peri-implant mucositis.Results:Comparing 6 months and 12 months after implant restoration, the total scores of oral health self-efficacy and regular oral visits, correct brushing, and balanced diet in the observation group were 66.31 ± 4.32 and 67.19 ± 4.65, 22.04 ± 1.35 and 21.69 ± 1.82, 21.73 ± 1.65 and 22.64 ± 1.82, 22.54 ± 1.62 and 22.86 ± 1.74 respectively, which were higher than the control group 53.93 ± 4.78 and 54.09 ± 5.67, 17.02 ± 2.58 and 17.43 ± 2.16, 17.65 ± 1.74 and 18.54 ± 2.36, 19.14 ± 2.13 and 18.12 ± 2.58, the difference between the two groups at the two time points were statistically significant ( t values were 6.52-12.39, all P<0.05). And the PLI, mSBI, and PIS scores of the observation group were 0.80 ± 0.17 and 0.75 ± 0.14, 0.79 ± 0.19 and 0.81 ± 0.18, 2.08 ± 0.45 and 2.10 ± 0.53, respectively, which were lower than the control group 0.92 ± 0.19 and 0.99 ± 0.21, 1.03 ± 0.17 and 1.16 ± 0.21, 2.45 ± 0.68 and 2.62 ± 0.61, the difference between the two groups at the two time points were statistically significant ( t values were 2.93-8.16, all P<0.05). 12 months after, the incidence of mucositis around implants in the observation group was 7.14%(3/42), which was lower than 26.83%(11/41)in the control group ( χ2=5.73, P<0.05). Conclusions:Video education combined with Teach-back can improve the self-efficacy of oral health care during implant restoration treatment in patients with chronic periodontitis, improve oral health care behavior, thereby improving the periodontal condition around the implant and reducing the incidence of mucositis.

OBJECTIVEHuman leukocyte antigen (HLA) class II genes, especially HLA-DQ genes, which are highly polymorphic, have been thought to be candidate loci for the etiology of asthma, and shown to be involved in antigenic presentation. This study was conducted to investigate whether susceptibility or resistance to asthma is associated with HLA-DQA1 and DQB1 genes polymorphism.

METHODSVenous blood samples were collected from northern Chinese population with Han ethnic. (1) One hundred and twenty-five unrelated asthmatic individuals and 52 subjects from 12 asthmatic pedigrees. (2) Ninety-six healthy controls without asthma and atopy with the same ethnic. Genomic DNA was extracted using standard phenol-chloroform method. The second exon of HLA-DQA1 and DQB1 genes were amplified by sequence-specific primer-polymerase chain reaction (SSP-PCR) method. All asthmatics had their serum IgE (total and specific) antibody or skin-prick test measured, bronchial reactivity to methacholine (Mch) and bronchial reversibility by beta(2)-agonist evaluated.

RESULTSHLA-DQA1 * 0104 allele and HLA-DQB1 * 0201 allele were significantly higher in asthmatics than those in healthy controls (0.408 vs 0.177, P < 0.01; 0.568 vs 0.198, P < 0.01). Odds ratios (ORs) were 3.203 (95% CI 1.699 - 6.037), 5.328 (95% CI 2.883 - 9.849) respectively. Conversely, HLA-DQA1 * 0301 allele and HLA-DQB1 * 0301 were significantly decreased in asthmatics compared to healthy controls (0.296 vs 0.50, P < 0.01; 0.4 vs 0.563, P < 0.05); Logistic regression analysis showed that HLA-DQA1 * 0104 allele was associated independently with asthma etiology, OR [represented by Exp(B)] was 5.0942 with 95% CI 2.2520 - 21.1813; Spearman's analysis showed that HLA-DQA1 * 0104 allele and HLA-DQB1 * 0201 allele were positively associated with atopy, the correlation coefficient were 0.183 and 0.289 respectively, P < 0.01. By contrast, HLA-DQA1 * 0301 allele was negatively related to atopy, the correlation coefficient was -0.168, P < 0.05; linkage analysis did not support the view that HLA-DQA1/DQB1 genes were linked to asthma with LOD value being 0.72.

CONCLUSIONSHLA-DQA1 * 0104 allele and HLA-DQB1 * 0201 allele were implicated in susceptibility to asthma and atopy, HLA-DQA1 * 0301 allele and HLA-DQB1 * 0301 might be protective factor against asthma. Asthma and atopy are multifactorial disorders, HLA-DQA1 and DQB1 genes are involved in the regulation of immune specific response to common allergen.

Adult ; Asian Continental Ancestry Group ; genetics ; Asthma ; genetics ; China ; Disease Susceptibility ; Female ; HLA-DQ Antigens ; genetics ; HLA-DQ alpha-Chains ; HLA-DQ beta-Chains ; Humans ; Male ; Polymorphism, Genetic

Objective:To evaluate the effect of esketamine combined with ultrasound-guided dorsal penile nerve block (DPNB) on negative postoperative behavioral changes (NPOBCs) in pediatric patients undergoing circumcision under general anesthesia.Methods:One-hundred and ninety-five pediatric patients, aged 4-8 yr, with body mass index of 10-35 kg, of American Society of Anesthesiologists Physical Status classificationⅠ or Ⅱ, undergoing elective circumcision under general anesthesia, were selected and divided into 3 groups ( n=65 each) using a random number table method: esketamine group (group E), DPNB group (group D) and esketamine combined with DPNB group (group ED). Propofol 1.5 mg/kg was intravenously injected, and the patients were admitted to the operating room after consciousness disappeared in the 3 groups. Esketamine 0.5 mg/kg was intravenously injected in E and ED groups, and the equal volume of normal saline was given in group D. D and ED groups underwent bilateral DPNB with 0.25 % ropivacaine 0.15 ml/kg under ultrasound guidance, with the maximum total amount of the drug not exceeding 10 ml. Fentanyl 1.0 μg/kg and propofol 2.0 mg/kg were intravenously injected prior to the skin incision in the three groups. If intraoperative body movement occurred, propofol 10 mg was added, which could be repeated. The occurrence of intraoperative body movement, respiratory depression and amount of propofol added was recorded. When postoperative pain (FLACC score >4) occurred, flurbiprofen 1 mg/kg was intravenously injected for analgesia, and the usage of flurbiprofen was recorded. When emergence agitation(PEAD score>10) occurred, propofol 1 mg/kg was intravenously injected for sedation, and the occurrence of emergence agitation was recorded. Parents were followed up by telephone at 1, 7 and 30 days postoperatively to assess the occurrence of NPOBCs using the PHBQ scale. Results:Fifty-six patients in group E and 59 patients in D and ED groups finally completed the study.Compared with group E, the incidence of intraoperative body movement was significantly decreased, the amount of additional propofol was reduced, the emergence agitation score, incidence of emergence agitation and severe agitation and usage rate of postoperative flurbiprofen were decreased, and the incidence of separation anxiety at 7 and 30 days postoperatively was decreased in D and ED groups, and the incidence of intraoperative respiratory depression was significantly decreased, and the incidence of NPOBCs at 7 and 30 days postoperatively was decreased in group ED ( P<0.05). Compared with group D, the incidence of intraoperative respiratory depression was significantly decreased, the amount of additional propofol was decreased, the usage rate of postoperative flurbiprofen and incidence of sleep anxiety at 1 day postoperatively were decreased ( P<0.05), and no significant change was found in the incidence of NPOBCs at each time point after operation in group ED ( P>0.05). Conclusions:Esketamine combined with ultrasound-guided DPNB can reduce the occurrence of NPOBCs in pediatric patients undergoing circumcision under general anesthesia.