Humans ; Thyroid Cancer, Papillary ; Carcinoma, Papillary/surgery* ; Thyroid Neoplasms/surgery*

Objective: Several COVID-19 patients have overlapping comorbidities. The independent role of each component contributing to the risk of COVID-19 is unknown, and how some non-cardiometabolic comorbidities affect the risk of COVID-19 remains unclear. Methods: A retrospective follow-up design was adopted. A total of 1,160 laboratory-confirmed patients were enrolled from nine provinces in China. Data on comorbidities were obtained from the patients' medical records. Multivariable logistic regression models were used to estimate the odds ratio ( Results: Overall, 158 (13.6%) patients were diagnosed with severe illness and 32 (2.7%) had unfavorable outcomes. Hypertension (2.87, 1.30-6.32), type 2 diabetes (T2DM) (3.57, 2.32-5.49), cardiovascular disease (CVD) (3.78, 1.81-7.89), fatty liver disease (7.53, 1.96-28.96), hyperlipidemia (2.15, 1.26-3.67), other lung diseases (6.00, 3.01-11.96), and electrolyte imbalance (10.40, 3.00-26.10) were independently linked to increased odds of being severely ill. T2DM (6.07, 2.89-12.75), CVD (8.47, 6.03-11.89), and electrolyte imbalance (19.44, 11.47-32.96) were also strong predictors of unfavorable outcomes. Women with comorbidities were more likely to have severe disease on admission (5.46, 3.25-9.19), while men with comorbidities were more likely to have unfavorable treatment outcomes (6.58, 1.46-29.64) within two weeks. Conclusion Besides hypertension, diabetes, and CVD, fatty liver disease, hyperlipidemia, other lung diseases, and electrolyte imbalance were independent risk factors for COVID-19 severity and poor treatment outcome. Women with comorbidities were more likely to have severe disease, while men with comorbidities were more likely to have unfavorable treatment outcomes.
Adult ; Aged ; COVID-19/virology* ; China/epidemiology* ; Comorbidity ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Severity of Illness Index ; Treatment Outcome

OBJECTIVE: To compare the clinical effect differences among different acupoint selection methods for primary insomnia. METHODS: A total of 333 patients with primary insomnia were recruited from 3 study centers and randomly divided into a group A (111 cases, 7 cases dropped off), a group B (111 cases, 5 cases dropped off) and a group C (111 cases, 2 cases dropped off). The patients in the group A were treated with acupuncture at Shenmen (HT 7) and Baihui (GV 20), the patients in the group B were treated with acupuncture at Sanyinjiao (SP 6) and Baihui (GV 20), and the patients in the group C were treated with acupuncture at non-acupoint and Baihui (GV 20). All the treatment was given once a day, 30 min each time; 5 treatments were taken as a course and 5 courses of treatment were given. The Pittsburgh sleep quality index (PSQI) and Athens insomnia scale (AIS) scores were evaluated before and after treatment as well as 4 weeks after treatment. The encephalofluctuograph technology (ET) was observed before and after treatment. RESULTS: Compared before treatment, the PSQI scores after treatment and at follow-up were significantly decreased in three groups (<0.01), and the decrease in the group A and the group B was greater than that in the group C (<0.01). Compared before treatment, the AIS scores after treatment and at follow-up was significantly decreased in three groups (<0.01), and the decrease in the group A was greater than that in the group C (<0.05). The interclass and between-groups ET before and after treatment had no significant difference (>0.05). CONCLUSION The acupuncture at acupoints along the meridians could improve the sleep quality in patients with primary insomnia, and the therapeutic effect of acupoint along the meridians is better than that of non-acupoint.
Acupuncture Points ; Acupuncture Therapy ; Humans ; Meridians ; Sleep Initiation and Maintenance Disorders ; therapy ; Treatment Outcome

Objective To observe the effects of acupuncture in acupoints at different meridians on 5-HT, DA, NE in the peripheral serum of insomnia rats; To explore the mechanism of action of acupuncture for the treatment of insomnia. Methods Sixty SD rats were randomly divided into blank group, model group, Baihui+Shenmen group, Baihui+Sanyinjiao group, and Baihui+non-acupoint group, with 12 rats in each group. Injection of PCPA suspension of rats was used to establish insomnia model. Each acupuncture group received corresponding acupoints, 30 min each time, for 7 days. The levels of 5-HT, DA and NE in serum were measured by ELISA. Results Compared with the blank group, the levels of 5-HT, DA and NE in the model group were significantly higher than those in the blank group (P<0.01). Compared with the model group, the contents of DA and NE in the acupuncture groups were significantly lower than those in the model group (P<0.05, P<0.01), and the 5-HT in Baihui+Sanyinjiao group was significantly lower than those in the model group (P<0.05). Among all acupuncture groups, overall efficacy of Baihui+Shenmen group was better than Baihui+Sanyinjiao group and Baihui+non-acupoint group. Conclusion Acupuncture can improve sleep structure in rats may be related to serum monoamine neurotransmitters. Acupuncture in acupoints at different meridians may be one of the influencing factors of acupoint compatibility effects.

AIM: To investigate the effect of scleral slap invagination and trabeculectomy combined with amniotic membrane implantation in the treatment of glaucoma.?METHODS:From May 2013 to June 2017, 98 cases (116 eyes ) with glaucoma were treated in our hospital. According to the random number table method, the patients were divided into two groups: the observation group of 45 cases (58 eyes) with scleral slap invagination surgery combined with amniotic membrane transplantation into operation, the control group of 53 cases ( 58 eyes ) with trabeculectomy combined with amniotic membrane implantation. Postoperatively patients were followed up for 3mo to observe IOP control;using MEN-C90 type blood rheology analyzer to detect the whole blood viscosity, plasma viscosity, hematocrit and blood viscosity changes, using the Doppler flow imaging ( CDFI) technique for the detection of ophthalmic artery end diastolic velocity ( EDV ) , RI, and the peak systolic velocity ( PSV ) and other hemodynamic parameters change.?RESULTS:One week and 3mo after the surgery, mean IOP of the observation group was 12. 18 ± 0. 98mmHg, 12. 23 ± 0. 94mmHg, the control group was 14. 49 ±1. 64mmHg, 14. 62 ± 1. 59mmHg, the difference was statistically significant (P<0. 05); IOP successful-control rate of observation group after operation was 81. 0％, more than that of the control group ( 61. 3％), the difference was statistically significant (P<0. 05). At 1wk and 3mo after operation high blood viscosity, plasma viscosity, hematocrit and blood viscosity of two groups decreased significantly compared with the preoperative (P<0. 05); those of the observation group were better than those of the control group (P<0. 05). At 1wk and 3mo after operation, EDV and PSV of the two groups increased significantly, RI decreased significantly, compared with the preoperative differences were statistically significant ( P < 0. 05 ), those of the observation group were better than those of the control group (P<0. 05).? CONCLUSION: The combination of scleral slap invagination and amniotic membrane implantation has a significant effect on glaucoma patients, the effect of intraocular pressure control is good, the postoperative complications are low, and the safety of the patients is high.

Objective To observe the effects of acupuncture treatment on the levels of HPA axis related hormones and acupoint compatibility in insomnia rats; To discuss the mechanism of action for acupuncture treatment. Methods Chlorophenylalanine suspension was under intraperitoneal injection to establish insomnia model rats. Sixty SD rats were randomly divided into blank group, model group, Baihui+Shenmen group, Baihui+Sanyinjiao group, Baihui+non-acupoint group, with 12 rats in each group. Each treatment group received acupuncture in relevant acupoints, 30 min each time, for 7 d. ELISA was used to measure the levels of CRH, ACTH and CORT. Results Compared with the model group, the levels of CRH, ACTH and CORT of the acupuncture groups decreased to some extent. In the three acupuncture groups, the efficacy of Baihui+Shenmen group was better than that of Baihui+Sanyinjiao group and Baihui+non-non-acupoint group. Conclusion Acupuncture treatment may calm and soothe the nerves to release the insomnia through regulating HPA axis related hormones. Acupuncture acupoints at different meridians may be one of the factors that cause the difference of acupoints compatibility effect.

OBJECTIVETo investigate the effect of Xuezhikang (, XZK) on renal cell apoptosis in diabetic rats and the possible mechanism.

METHODSSixty-six rats were randomly divided into 3 groups: the normal, model and XZK groups. In each group, the rats were further randomly divided into 3-month and 6-month subgroups, respectively. Diabetes of rats was induced by a single intraperitoneal injection of 1% streptozocin at 60 mg/kg body weight. Rats in the XZK group received gastric perfusion of XZK (1200 mg/kg body weight) everyday for 3 or 6 months, while rats in the normal and model groups received equal volume of saline. Twenty-four hours' urine was collected for urinary albumin excretion (UAE) measurement. Periodic acid-Schiff (PAS) and Masson's trichrome staining were used for saccharides and collagen detection. Cell apoptosis of renal cortex was investigated by TdT-mediated dUTP nick end labeling (TUNEL) staining. Bax and Bcl-2 expressions were detected by immunohistochemistry and Western blot, respectively. Cytochrome C (Cyt C) and caspase-9 concentration were detected by Western blot.

RESULTSCompared with the model group, XZK treatment could significantly decrease the kidney hypertrophy index, 24 h UAE, renal cell apoptosis, cytoplasmic Cyt C level and active caspase-9 level, as well as suppress the increment of Bax and up-regulate the expression of Bcl-2, leading to the suppression of Bax/Bcl-2 ratio at 3 and 6 months (P<0.05 or P<0.01). Moreover, XZK treatment could alleviate the deposition of PAS-stained saccharides and Masson's trichromestained collagen to different extent.

CONCLUSIONSRenal cell apoptosis was observed in diabetic kidney, in which mitochondrial apoptotic pathway might be involved. XZK treatment could attenuate pathological changes in diabetic kidney and reduce renal cell apoptosis, probably via the suppression of Bax/Bcl-2 ratio, which lead to inhibition of Cyt C release and following caspase-9 activation.

Albuminuria ; blood ; complications ; Animals ; Apoptosis ; drug effects ; Blood Glucose ; metabolism ; Caspase 9 ; metabolism ; Cytochromes c ; metabolism ; Diabetes Mellitus, Experimental ; blood ; drug therapy ; metabolism ; pathology ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Hypertrophy ; In Situ Nick-End Labeling ; Kidney ; drug effects ; pathology ; Kidney Glomerulus ; pathology ; Lipids ; blood ; Male ; Mesangial Cells ; drug effects ; pathology ; Proto-Oncogene Proteins c-bcl-2 ; metabolism ; Rats, Sprague-Dawley ; Streptozocin ; bcl-2-Associated X Protein ; metabolism

OBJECTIVETo determine whether patients infected with chronic hepatitis C (CHC) show a differential distribution profile of IL-28B polymorphisms according to the presence of concomitant cryoglobulinemia.

METHODSSixty-two consecutive CHC patients were enrolled in the study between December 2008 and December 2010. All patients received combination therapy of pegylated interferon alpha-2a (weekly, 180 g, subcutaneous injection) plus ribavirin (daily, 10to15 mg/kg body weight, oral) for 48 weeks, with individualized dosage adjustments according to the patient's clinical situation. Cryoglobulins were detected visibly by separation of cryoprecipitates in patient serum samples. Three IL-28B SNPs (rs8099917, rs12979860, and rs12980275) were detected by sequencing. Response to treatment was assessed by measuring serum levels of HCV RNA by quantitative PCR at baseline (prior to treatment initiation), during treatment (4 and 12 weeks after treatment initiation), end of therapy (48 weeks after treatment initiation), and post-treatment (24 weeks after end of therapy). The significance of between-group differences were assessed by the Chi-square and Fisher's exact tests.

RESULTSCryoglobulinemia was detected in 43.5% (27/62) of the CHC patients and showed a female bias (59.3% vs. males: 34.3%, P = 0.05). Compared to CHC patients without cryoglobulinemia, the CHC patients with cryoglobulinemia showed significantly higher levels of HCV RNA at baseline (5.64+/-1.20 vs. 6.37+/-0.67, P less than 0.05) but lower frequencies of the IL28B rs8099917 TT genotype (94.3% vs. 63.0%, P = 0.002), rs8099917 T allele (97.1% vs. 81.5%, P = 0.003), and rs12979860 C allele (94.3% vs. 83.3%, P = 0.048). CHC patients with cryoglobulinemia and having the rs8099917 TT, rs12979860 CC, or rs12980275 AA genotype achieved a higher rate of sustained virological response.

CONCLUSIONCryoglobulinemia in CHC patients is associated with a differential distribution of IL-28B polymorphisms, and certain polymorphisms may be related to anti-viral treatment response.

Adult ; Alleles ; Antiviral Agents ; therapeutic use ; Cryoglobulinemia ; blood ; complications ; Female ; Genotype ; Hepatitis C, Chronic ; blood ; complications ; drug therapy ; genetics ; Humans ; Interleukins ; genetics ; Male ; Middle Aged ; Polymorphism, Single Nucleotide ; RNA, Viral ; blood

Objective To explore the changes and significance of plasma cardiotrophin-1 (CT-1) in children with heart failure.Methods Forty children with heart failure (NYHA Ⅱ,n =14;NYHA Ⅲ,n =16;NYHA Ⅳ,n =10)were chosen as observation group,and 20 healthy children without heart failure were taken as healthy control group.Plasma CT-1 was measured by a double antibody sandwich enzyme-linked immunosorbent assay (ELISA).N terminal probrain natriuretic peptide(NT-pro BNP) concentration was tested by Pu Rui fluorescent dry quantitative analyzer.Left ventricular ejection fraction(LVEF) was evaluated by GE Vivid 7 doppler echocardiography and cardiac function assessed by modified ROSS score.Plasma CT-1 level,NT-pro BNP and LVEF were compared between the 2 groups.The correlation of plasma CT-1 level with NT-pro BNP and LVEF were analyzed in patients with different degrees of heart failure.Results Plasma levels of CT-1 and NT-pro BNP were significantly higher in children with heart failure than those in healthy control group (P ＜ 0.01),and with progression of heart failure,the levels of CT-1 and NT-pro B NP progressively increased in heart failure children.Plasma CT-1 level in different NYHA had statistical significance (F =55.5,P ＜0.01).Plasma CT-1 level was positive correlated with NT-pro BNP and modified ROSS score(r =0.787,0.848,all P ＜ 0.01),and negative associated with LVEF (r =-0.66,P ＜ 0.01),respectively,in heart failure children.Conclusions Plasma CT-1 level is significantly elevated in heart failure children.There are good correlation among CT-1,NT-pro BNP and LVEF.Plasma CT-1 is a reliable marker of reflecting the severity of heart failure,combined with NT-pro BNP detection helps to improve the diagnostic accuracy of heart failure in children.

Objective To study the value of the reflux symptom index (RSI) and reflux finding score (RFS) in laryngopharyngeal reflux disease(LPRD). Methods Twenty-five patients with RSI scores > 13 or RFS scores > 7 and sixteen patients with RSI scores > 13 and RFS scores > 7 were suspected as LPRD. Forty one patients with the RSI scores > 13 and/or RFS scores > 7 were suspected as LPRD, 15 patients with the RSI scores ≤ 13 and RFS scores ≤ 7 were regarded as control group. All the patients had 24-hour dual probe pH monitoring. Twenty-five patients with positive pH monitoring hand received anti-reflux treatment with omeprazole for 3 months, and then the RSI and RFS was estimated gain. Results The RSI and RFS scoring had high consistent with the results of pH monitoring (Kappa=0.43, u=3.48, P < 0.01),especially if RSI scores > 13 and RFS scores >7 (Kappa=0.55, u=3.06, P<0.01). There was a significant decreasing in RSI and RFS scoring in patients after anti-acid treatment for 3 months (tRSl=8.838, PRSl=0.000;tRFS=5.695, PRFS=0.000). Conclusions The RSI and RFS can be used as screening tool for laryngopharyngeal reflux diseases and as a simple method for evaluating the effectiveness of treatment.