Child ; Evidence-Based Medicine ; Humans ; Lupus Nephritis ; diagnosis ; therapy ; Practice Guidelines as Topic

Thyroid hormones and the related antibodies have some function in the natural process of breast cancer development.The possible mechanisms include:iodine complex can inhibit breast cell proliferation and can induce apoptosis; thyroid hormone can affect breast cancer cell proliferation and apoptosis; the imbalance of thyroid hormone and estrogen hormone promotes breast cells cancerous; hypothyroidism may affect the proliferation and invasiveness of breast tumors; lymphocytic infiltration or abnormal local immune response in thyroid disease.

Objective:To observe the clinical effect of liver-regulating and blood-tonifying acupuncture in the treatment of cervical spondylosis of vertebral artery type. Methods:A total of 60 cases meeting the inclusion criteria were randomized into an observation group and a control group, 30 cases in each group. Cases in the observation group received liver-regulating and blood-tonifying acupuncture, in which Jiaji (EX-B 2) points of C3-C7, Ganshu (BL 18) and Geshu (BL 17) were used; cases in the control group received routine acupuncture treatment in which jiaji (EX-B2) points of C3-C7 were used. Both groups received 5 times of treatment in a week with a 2-day rest, symptoms evaluation was done after 4 weeks of treatment, and then therapeutical effect was evaluated. Results:The total effective rate was 90.0% in the observation group, 73.3% in the control group, and inter-group comparison showed a statistical significance (P<0.05). After treatment, the symptoms and signs scores in both groups all substantially dropped, showing statistical significances (both P<0.05); inter-group comparison showed that the improvements in subscales of dizziness, pressing pain along vertebrae and revolve-cervix test in the observation group were superior than those in the control group, showing statistical significances (all P<0.05), while the inter-group comparisons of subscales of headache and vomiting and nause didn't show any statistical significances after treatment (both P>0.05). Conclusion: Liver-regulating and blood-tonifying acupuncture is effective in treating cervical spondylosis of vertebral artery type, and it can significantly improve patients' symptoms and signs.

Objective To detect the expression of telomerase catalytic subunit (TERT),telomerase in human ovarian luteinized granulosa cells and to investigate the relationship between telomerase expression and the ovarian fecundity Methods Ovarian luteinized granulosa cells were recovered from 22 women with regular menses who underwent in vitro fertilization/ intracytoplasmic sperm injection programme.We carried out in situ hybridization histochemistry on luteinized granulosa cells to detect TERT mRNA expression,and telomeric repeat amplification protocol to detect telomerase activity Results TERT mRNA were present in luteinized granulosa cells.The expression of TERT mRNA and telomerase activity in ovarian luteinized granulosa cells decreased with increase of age,basal serum follicle stimulating hormone levels Conclusions These results suggest that telomerase may play an active role in ovarian function.A reduced telomerase activity of granulosa cells may be one of the important mechanisms involved in decreased ovarian function in women.

Objective To compare the efficacy of different doses of esomeprazole based quadruple therapy on Helicobacter pylori(H.pylori) eradication in Uygur population, and to study the relationship between H.pylori eradication and dyspepsia symptoms in H.pylori caused gastritis.Methods From August 2015 to May 2016, Uygur patients diagnosed with H.pylori positive superficial gastritis in Xinjiang Uygur Autonomous Region Kashgar Prefecture were recruited.According to random number table, patients were divided into single-dose group, standard-dose group and high-dose group.In single-dose group patients received esomeprazole 40 mg, once per day;in standard-dose group patients received esomeprazole 20 mg, twice per day;and in high-dose group patients received esomeprazole 40 mg, twice per day;besides esomeprazole the treatment of three groups were all combination of amoxicillin, clarithromycin and bismuth, magnesium compound granules.The treatment course of all three groups was 14 days.The H.pylori eradication rate, clinical efficacy, symptom score and adverse drug reaction were compared.The H.pylori eradication rate was evaluated with intention to treat analysis (ITT) and per-protocol sets (PP).Chi square test, t test and one-way analysis of vaiance were used for statistical comparison.Results A total of 248 patients were enrolled,82 cases in single-dose group, 83 cases in standard-dose group and 83 cases in high-dose group.There were five, five and six cases lose to follow-up or dropped out respectively in single-dose, standard-dose and high-dose group.The results of ITT analysis showed that the eradication rates of H.pylori in single-dose group, standard-dose group and high-dose group were 62.2%(51/82),77.1%(64/83) and 89.2%(74/83),respectively;the differences between each two groups were statistically significant (x2=4.34,16.33 and 4.30, all P<0.05).The results of PP analysis showed that H.pylori eradication rates of single-dose group, standard-dose group and high dose group were 66.2%(51/77),82.1%(64/78) and 96.1%(74/77),respectively;the differences between each two groups were statistically significant (x2=5.06, 22.47 and 7.84, all P<0.05).After four weeks of eradication therapy, the total dyspepsia symptom scores of single-dose group, standard-dose group and high dose group were all significantly lower than those before treatment (52.3±27.1 vs 99.4±44.1, 38.2±25.4 vs 101.0±48.9 and 28.8±16.1 vs 99.9±46.6), and the differences were statistically significant(t=5.88, 8.79 and 9.11, all P<0.01).After treatment, the total dyspepsia symptom scores of standard-dose group and high-dose group were both lower than that of single-dose group, and the differences were statistically significant (t=2.78 and 2.91, both P<0.01).The score of upper abdominal pain, epigastric burning, abdominal distention and symptom total score of high-dose group were all lower than those of standard dose group (4.8±3.9 vs 8.1±3.5, 3.1±2.5 vs 5.8±4.1, 7.9±6.8 vs 10.5±9.6 and 28.8±16.1 vs 38.2±25.4), and the differences were statistically significant (t=1.52,1.08,1.23 and 1.96, all P<0.01).After four weeks of treatment, the total efficacy rates of single-dose, standard-dose and high-dose group were 45.5%(35/77), 74.4%(58/78) and 87.0%(67/77),respectively.There were statistically significant differences between each two groups of three groups (x2=13.49, 29.73 and 3.98, all P<0.05).The incidences of adverse drug reaction of single-dose, standard-dose and high-dose group were 6.5%(5/77), 7.7%(6/78) and 7.8%(6/77),respectively;there was no statistically significant difference among the three groups (all P>0.05).Conclusions High dose of esomeprazole based quadruple therapy can increase the eradication rate of H.pylori in Uygur population, and H.pylori eradication therapy can significantly improve the dyspepsia symptoms of H.pylori caused gastritis in Uygur.High dose of esomeprazole may improve the clinical efficacy of H.pylori caused gastritis with dyspeptic symptoms in Uygur with safety.

Objective To assessthe association of polymorphism in angiotensin converting enzyme insertion/deletion (ACE I/D) gene with curative effect of hypotensive drugs.Methods The studies concerning association of ACE I/D with curative effect of hypotensive drugs were retrieved by searching data base,and then screened according to inclusive and exclusive criteria.Meta-analysis was performed by review manager 5.3 software.WMD and OR were used to assess difference of levels or effective rate of blood pressure degression among DD,DI and Ⅱ gcnotype.Results Totally 12 articles with 2 528 patients were included in this study.For all patients,WMD (95％ CI) with DD:Ⅱ genotype reflecting degression level of systolic pressure (SP) and diastolic pressure (DP) were respectively 5.92(4.09～7.75) and 1.70(1.03～ 2.38),and OR (95％CI) reflecting effective rate of blood pressure degression was 2.49 (1.44～ 4.31),with statistical significance (P＜ 0.05).For subgroup analysis according to hypotensive drugs,using angiotensin Ⅱ receptor blocker (ARB),WMD (95 ％CI) of SP and DP were respectively 9.16(6.51～11.82) and 1.84(0.10～3.57) in DD:Ⅱ,or 6.75(4.21～9.28) and 3.38(0.16～6.61) in DI ∶ Ⅱ genotype,all with P＜0.05.There were no statistical significance for diuretic in DD ∶ Ⅱ,DD ∶ DI and DI ∶ Ⅱ.Using angiotensin converting enzyme inhibitor (ACEI),OR (95％CI) were respectively 3.79(1.80～8.01) and 2.97(1.34～6.55) in DD:Ⅱ and DD:DI,with P＜0.05.Conclusion Compared with I allele in patient,ACEI and ARB were more effective for D allele,while there were no difference for curative effect of diuretic between I allele and D allele.

A Review The elastin has been investigated since the 1950 s, and it has been found that elastin relates to the vascular diseases in recent years. In this review, the elastin gene structure, distribution and its role in the pathogenesis of vascular diseases and aging are summarized.

Objective To investigate the changes in pulmonary gas exchange and intrapulmonary shunting during orthotopic liver transplantation (OLT) without veno-venous bypass. Methods Sixteen ASA III-IV patients with end-stage liver diseases were studied. Anesthesia was induced with midazolam 0.1 mg ? kg-1 , fentanyl 10 ?g kg -1 , scopolamine 0.6 mg, and vecuronium 0.1 mg ? kg-1 and maintained with isoflurane and propofol infusion (2-3 mg? kg-1h-1 ) supplemented with intermittent iv boluses of midazolam, fentanyl and vecuronium. The patients were intubated and mechanically ventilated with 100% O2 Swan-Ganz catheter was inserted via right internal jugular vein. Radial artery was cannulated. MAP, HR, ECG, CVP, SpO2 and PET CO2 were continuously monitored. Body temperature was maintained at≥35.5℃ during operation. Blood samples were taken from radial and pulmonary artery for blood gas analysis. P(A-a) O2 and Qs/Qt were calculated immediately before operation (T1 ), cross-clamping (T2) and unclamping of inferior vena cava and portal vein (T3 ) , 5 min (T4) and 90 min (T5 ) after graft reperfusion and at the end of operation (T6). Results P(A-a) O2 and Qs/Qt were both higher than normal value at T1 . PaCO2, P(A-a) O2 and Qs/Qt increased significantly at T3 and T4 as compared with those at T2 P(A-a)O2 and Qs/Qt were significantly decreased at T5 and T6 as compared with those at T3 and T4 Qs/Qt was positively correlated with P(a-A) O2 and PAP. Conclusion There is a certain degree of intrapulmonary shunt before and during orthotopic liver transplantation without veno-venous bypass. The amount of fluid infused should be strictly controlled during anhepatic phase.

Objective To evaluate the association between genetic polymorphisms in promoter regions of matrix metalloprotein‐ase‐1 (MMP‐1)‐1607bp1G/2G ,matrix metalloproteinase‐7 (MM P‐7)‐181‐bpA /G and susceptibility of cervical cancer using Meta‐analysis .Methods Relevant studies that had relationships of the polymorphism in promoter regions of matrix metalloproteinase‐1 (MM P‐1)‐1607bp1G/2G ,matrix metalloproteinase‐7 (MMP‐7)‐181‐bpA /G and susceptibility of cervical cancer were collected as case‐control groups .RevMan5 .0 software was applied to analyze the odds ratios (OR) and 95% confidence intervals(CI) of the as‐sociation between polymorphisms and susceptibility of cervical cancer .Results Finally ,6 studies were selected ,containing 4 studies of MMP‐1 and 2 studies of MMP‐7 .For MMP‐1‐1607bp1G/2G ,OR was 0 .76 (95% CI = 0 .51 - 1 .13 ,P= 0 .17) under 1G/1G +1G/2G ∶ 2G/2G model ,OR was 0 .72 (95% CI = 0 .42 - 1 .23 ,P = 0 .42) under 1G/1G ∶ 2G/2G model ,OR was 0 .79(95% CI =0 .57 - 1 .09 ,P= 0 .15) under 1G ∶ 2G model ,it was concluded that there was no statistical significance between them .For MM P‐7‐181bpA /G ,OR was 0 .47 (95% CI = 0 .30 - 0 .74 ,P= 0 .001) under AA + AG ∶ GG model ,OR was 0 .43 (95% CI = 0 .26 - 0 .74 , P= 0 .002) under AA ∶ GG model ,OR was 0 .77(95% CI = 0 .62 - 0 .94 ,P= 0 .02) under A ∶ G model ,there were statistical signifi‐cance differences under all models .Conclusion Polymorphisms in promoter of MMP‐7‐118bpA/G are associated with the suscepti‐bility of cervical cancer and an allele is a protective factor .It is still not confirmed that significant association between the MM P‐1‐1607bp1G/2G and susceptibility to cervical cancer exists in current literature .