Acupuncture Points ; Acupuncture Therapy ; Chronic Disease ; therapy ; Diarrhea ; therapy ; Female ; Humans ; Middle Aged

Objective To investigate the molecular epidemiology of 114C. albicans strains isolated from the vaginal discharge of female patients treated in three obstetrics and gynecology hospitals in Shanghai by analyzing the relationship between the main genotypes and resistance proifle, and the relationship between genetic diversity and cluster ofC. albicans.Methods A total of 114 strains ofC. albicans were collected from the Obstetrics & Gynecology Hospital of Fudan University, Shanghai First Maternity and Infant Hospital Corporation and the International Peace Maternity & Child Health Hospital of China welfare institute. Phylogenetic analysis of strains were carried out by eBURST.C. albicans strains were also analyzed by multilocus sequence typing (MLST). The susceptibility of theC. albicans strains was tested by ATB FUNGUS 3.Results A total of 47 diploid strain types (DSTs) were identiifed from the 114 strains, 30 of which were known types. DST 79 and DST 435 were the main types. Of the 114C. albicans strains, 96.5% were susceptible to lfucytosine, 100% to amphotericin B, 85.1% to lfuconazole, 55.2% to itraconazole and 84.3% to voriconazole.Conclusions The pathogenicC. albicans strains isolated from different obstetrics and gynecology hospitals in Shanghai were originated from multiple clones, the main type of which was DST 79 and DST 435 with certain degree of antifungal resistance. MLST typing suggests that genetic diversity is present in theC. albicans strains isolated in Shanghai area. The clustering analysis ofC. albicans strains is consistent with its genotypes.

Objective To compare the effect of target controlled infusion (TCI) and man controlled infusion (MCI) of propofol in pain-free endoscopic ultrasonography.Methods Sixty patients undergoing pain-free endoscopic ultrasonography were divided into TCI group and MCI group by random digits table method,each group 30 patients.Operation time,dose of propofol,time to loss consciousness and recovery time were recorded.The level of mean artery pressure (MAP) and heart rate (HR) were recorded before induction (T0),before operation (T1),5 min afteroperafion (T2) and 5 min afterawake (T3).Cases with bucking,aspiration,laryngeal spasm,pulse oxygen saturation (SpO2) lower than 0.90,MAP lower than 50 mmHg (1 mmHg =0.133 kPa) and HR lower than 50 bpm were recorded.Results Dose of propofol was higher in MCI group than that in TCI group,time to loss consciousness was shorter in MCI group than that in TCI group,recovery time was shorter in TCI group than that in MCI group,there was significant difference (P ＜ 0.01).The level of MAP and HR on T1 were significantly lower than those on T0 between two groups (P ＜ 0.05).The level of MAP and HR on T1 in TCI group were signifcantly higher than those in MCI group (P ＜ 0.05).The rate of bucking between two groups had no significant difference (x2 =0.37,P ＞ 0.05).The rate of anoxemia in TCI group was 10.0％ (3/30),in MCI group was 66.7％ (20/30),there was significant difference (x2 =20.38,P ＜ 0.01).The rate ofMAP lower than 50 mmHg in TCI group was 6.7％ (2/30),in MCI group was 30.0％ (9/30),there was significant difference (x2 =5.46,P ＜ 0.05).The rate of HR lower than 50 bpm between two groups had no significant difference (x2 =3.35,P ＞ 0.05).Conclusion Compared with MCI,patients induced by TCI mode are more stable in blood pressure,and more safe.

Objective To explore the association between waist-to-height ratio (WHtR) and dyslipidemia in Chinese adults and to find out an optimal threshold of WHtR for predicting dyslipidemia.Methods A total of 221 270 adults from 4 health checkup centers nationwide were selected by using cluster random sampling method.Height,body weight,waist circumference (WC),total cholesterol (TC),triglyceride (TG),high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol(LDL-C) were measured.Body mass index (BMI) and WHtR were then calculated.The area under the receiver operating characteristic curve(AUC) was analyzed and optimal cutoffs were estimated by maximizing the sums of sensitivity and specificity.Results WHtR showed the largest AUCs in the participants with higher TC,TG and LDL-C,followed by increased WC and BMI.In male and female,the optimal thresholds of WHtR,WC and BMI for predicting dyslipidemia were 0.49-0.50 and 0.47-0.49,83-85and 73-76 cm,and 24-25 and 22-23 kg/m2,respectively.Conclusion WHtR may be superior to WC and BMI for predicting dyslipidemia,and an unisex cutoff of 0.5 should be recommended.

Objective To analyse the quality of life in patients with severe acute respiratory syndrome (SARS) for 10 years. Methods Twenty-five SARS patients were collected as SARS group and 25 healthy persons were used as control group. There were no significant differences in general clinical data between two groups. The quality of life of the respondents was evaluated by the MOS item short form health survey (SF-36) including physiological function, physical pain, general health condition, energy, social function, emotional function and mental health. The pulmonary function indicators including forced vital capacity (FVC), one second forced expiratory volume (FEV1), one second rate (FEV1/FVC), total lung capacity (TLC), residual volume (RV), corrected breath diffusing capacity (TLCOc SB) and corrected dispersion rate TLCOc/VA were also compared between two groups. The correlation between each dimension score of pulmonary function indexes and quality of life were analyzed in SARS group. Data of hip and femoral head necrosis were detected by MRI scan in SARS group of patients. Results Total quality of life score was poor in 23 cases (92.0%), and moderate quality of life score in 2 cases (8.0%). The quality of life score was lower in SARS group than that of control group (P<0.01). Data of TLCOc SB was lower in SARS group than that of control group. The score of physiological function was positively correlated with FEV1 and FEV1/FVC. The score of physical pain was positively correlated with FEV1/FVC (P<0.05). There were no significant differences between quality of life score and pulmonary function indicators. There were 11 cases (44%) of avascular necrosis of femoral head, and 14 cases (56%) of non-avascular necrosis of femoral head in SARS group. The score of physiological function was lower in femoral head necrosis group than that of non necrosis group (P<0.05). ConclusionThe lower quality of life in patients with SARS is not only related with psychological factors but also related with physical factors. The damage of pulmonary function and (or) necrosis of femoral head affect the quality of life in patients with SARS, especially the physiological function.

ObjectiveTo explore the relationship of single nucleotide polymorphism (SNPs) of the bone morphogenetic protein-4 (BMP-4) gene with the morbidity and severity of the ossification of posterior longitudinal ligament (OPLL) of the spine in Chinese patients. MethodsThe venous blood samples of 200 OPLL patients and 200 non-OPLL controls were measured with the DNA sequences in four locus of BMP-4 gene with polymerase chain reaction(PCR). ResultsThere was a significant association between the rs17563，rs2855532 polymorphism and the occurrence of OPLL （P＜0.05）. The ''T'' allele in these 2 SNPs promotes the extent of OPLL (P<0.05). However, no significant association in morbidity and severity was found between the other 2 SNPs (rs1957860, rs2071047). ConclusionSNPs in rs17563，rs2855532 associates with the morbidity and severity of the ossification of posterior longitudinal ligament of the spine in Chinese patients.

Objective To investigate the distribution of androgen receptor (AR) gene CAGrepeats in the Chinese Han nationality and its application in genetic diagnosis for Kennedy's disease (KD). MethodsRT-PCR,denaturing polyacrylamide gel electrophoresis (DPAGE) and gene sequencing were conducted for AR gene CAG repetition among 100 healthy controls and 28 patients diagnosed as motorneuron diseases,and the number of the repetition was counted. Results The healthy controls had a range of 15-31 times of CAG repetition,with an average of (23 ± 3) times.Among patients with motoneuron disease,3 cases with CAG repetition for more than 40 times (namely,46,47 and 47 times) were diagnosed as KD.The main clinical manifestations included slow progress of limb weakness,primarily in the proximal lower limbs,fatigue accompanied by myalgia,muscle jumping,muscle atrophy,elevated serum creatine kinase (CK) levels,neurogenic damage revealed by electromyogram (EMG) and androgen insensitivity.Conclusions The incidence of KDmay be underestimated in the Chinese population.Performing genetic diagnosis in patients with motor neuron disease for AR gene can improve clinical diagnosis and avoid misdiagnosis.

Objective To evaluate the prevalence and risk factors of progressive liver fibrosis in patients with non-alcoholic fatty liver disease (NAFLD).Methods A total of 2 054 subjects who underwent health check up and were diagnosed as NAFLD in 9 institutions were included in the study.Blood routine and biochemical findings were collected to calculate aspartate aminotransferase-to-platelet ratio index (APRI).Subjects were divided into three groups according to diagnostic threshold of liver fibrosis:APRI ＜0.43 group,APRI 0.43-0.53 group and APRI ≥ 0.54 group.The correlation between APRI and biochemical variables was analyzed,and the risk factors of progressive fibrosis were also analyzed.Results Among 2 054 subjects (male/female 1 598/456) there were 61 cases with APRI ≥ 0.98 (2.97％,progressive fibrosis),318 with APRI ≥0.54 (15.48％),1 475 with APRI ＜ 0.43 (71.81％),261 with APRI 0.43-0.53 (12.71％).Logistic stepwise regression analysis showed that TG (P =0.002,OR =1.095,95％CI:1.033-1.161),2 hPG(P =0.000,OR =1.103,95％ CI:1.058-1.151,BUN(P =0.034,OR =1.215,95 ％ CI:1.014-1.454) were risk factors,and H DL-C (P =0.034,OR =0.353,95 ％ CI:O.135-0.924) was a protective factor for the progression of fibrosis.Conclusion The progressive fibrosis in patients with NAFLD is closely associated to blood glucose and lipid metabolism disorder.

Neurofibromatosis 1 (NF1) is an autosomal dominant genetic disease first manifesting in childhood, which affects multiple organs, childhood development and neurocognitive status. These patients have a high predisposition to develop both benign and malignant tumors. On September 30, 2018, a rare case of NF1 with B-lineage acute lymphocytic leukemia (ALL) was treated in the Department of Pediatrics, Third Xiangya Hospital, Central South University. The child presented with café au lait macules (CALM) since the date of birth. And the diagnosis of B-lineage ALL was made by bone marrow cytomorphologic examination and immunological phenotype detection. ETV6/RUNX1 fusion gene was positive. Also, a de novo mutation of c. 2773delT (p. Leu925Ter) was found in the exon of NF1 gene by gene sequencing, which was a nonsense mutation and led to the premature termination of peptide synthesis. Molecular genetic testing is recommended to confirm NF1, particularly in children with only pigmentary features of the diagnostic criteria. NF1-affected individuals should be referred to a specialist of NF1 clinical network for long-term follow-up and surveillance.

Objective:To explore the clinical value of antegrade transabdominal nasobiliary duct placement in the treatment of fine diameter choledocholithiasis in the elderly.Methods:From June 2021 to June 2022, 60 elderly patients with fine diameter common bile duct stones who were treatment in the Shandong Chengwu County People′s Hospital were enrolled. All patients underwent laparoscopic common bile duct exploration (LCBDE), 28 patients in the experimental group were underwent antegrade transabdominal placement of nasal bile ducts, 32 patients in the control group were treated with T-tube drainage. The operative index, postoperative complications and total medical expenses, postoperative patient satisfaction were compared between the two groups.Results:The operation was successful in both groups, and no conversion to laparotomy or death occurred. The indwelling time of common bile duct drainage, postoperative hospital stay in the experimental group were shorter than those in the control group, the incidence of postoperative pain was lower than that in the control group, the postoperative patient satisfaction was higher than that in the control group: (6.46 ± 1.04) d vs. (33.63 ± 1.19) d, (8.11 ± 0.74) d vs. (10.38 ± 1.54) d, 3.6%(1/28) vs. 21.9%(7/32), (9.21 ± 0.83) scores vs. (7.56 ± 0.62) scores, there were statistical differences ( P<0.05). The surgical time, postoperative activity time, gastrointestinal function recovery time and total medical expenses between the two groups had no statistical differences( P>0.05). The postoperative complications between the two groups had no statistical differences ( P>0.05). Conclusions:Anterior transabdominal nasobiliary duct placement can shorten the retention time and hospitalization time of the common bile duct drainage tube, reduce the incidence of postoperative complications, and promote rapid recovery. It is a safe and effective surgical method.