Humans ; Inflammatory Bowel Diseases/drug therapy* ; Interleukin-6/therapeutic use*

Background/Aims: Crohn’s disease (CD) primarily affects young female adults of reproductive age. Few studies have been conducted on this population’s ovarian reserve status. The aim of study was to investigate potential risk factors associated with low ovarian reserve, as reflected by serum anti-Müllerian hormone (AMH) in women of reproductive age with CD. Methods: This was a case-control study. Cases included 87 patients with established CD, and healthy controls were matched by age, height and weight in a 1:1 ratio. Serum AMH levels were measured by enzyme-linked immunosorbent assay. Results: The average serum AMH level was significantly lower in CD patients than in control group (2.47±2.08 ng/mL vs. 3.87±1.96 ng/mL, respectively, P<0.001). Serum AMH levels were comparable between CD patients and control group under 25 years of age (4.41±1.52 ng/mL vs. 3.49±2.10 ng/mL, P=0.06), however, serum AMH levels were significantly lower in CD patients over 25 years of age compared to control group (P<0.05). Multivariable analysis showed that an age greater than 25 (odds ratio [OR], 10.03; 95% confidence interval [CI], 1.90–52.93, P=0.007), active disease state (OR, 27.99; 95% CI, 6.13–127.95, P<0.001) and thalidomide use (OR, 15.66; 95% CI, 2.22–110.65, P=0.006) were independent risk factors associated with low ovarian reserve (serum AMH levels <2 ng/mL) in CD patients. Conclusions Ovarian reserve is impaired in young women of reproductive age with CD. Age over 25 and an active disease state were both independently associated with low ovarian reserve. Thalidomide use could result in impaired ovarian reserve.

Objective: To analyze the correlation between plasma trough level of generic imatinib and its metabolism and clinical outcomes in Chinese patients with chronic myeloid leukemia in chronic phase (CML-CP) . Methods: The 21 patients with CML-CP who enrolled in a clinical trial YMTN 1.0 from Oct 11^th, 2012 to May 8^th, 2013 and received generic imatinib were as study subjects. The correlation between steady plasma trough levels of imatinib and its metabolism with clinical response, age, weight and body surface area (BSA) were evaluated. Results: ①The mean steady plasma trough level of generic imatinib and its metabolism was (1 185.07±417.91) μg/L and (251.53±76.50) μg/L, respectively. ②Age, weight and BSA has no significant effects on plasma trough level of generic imatinib and its metabolism (P>0.05) . ③Patients with steady plasma trough level of generic imatinib more than 1 000 μg/L are possible to have higher major molecular response (MMR) /complete molecular response (CMR) rate than those below 1 000 μg/L (42% vs 0, P<0.05) . Conclusion Plasma trough levels of generic imatinib varied in CML patients. The steady plasma trough levels of generic imatinib is maybe related to molecular response in CML patients.

Objective To investigate postoperative psychological experiences of patients underwent kidney transplant donated by his/her parent,and to discover mental signs and psychological journey in individual growth.Methods Semi-structured in-depth interviews were conducted among 17 patients underwent kidney transplant donated by his/her parent,and Giorgi analysis method was used to analyze data.Results The postoperative psychological experiences of patients mainly contained 4 aspects:posttraumatic growth,rebuilding meaning of life,being grateful for experience,coexisting of hope and challenge.Conclusion The patients have complex psychological experiences,having positive aspects derived from rehabilitation and improved quality of life,as well as negative aspects derived from concerning health of the donor,fear for complication and rejection,and lack of sound supporting system.Medical staff should guide patients to adjust cognitive and behavioral patterns and face life events directly,integrate medical/social support resources and enhance patients' psychological capital to face future life.

OBJECTIVE:To investigate the effectiveness and economics of 10 mg/d rosuvastatin and 20 mg/d atorvastatin in the treatment of hyperlipidemia (HLP). METHODS:The information of 180 HLP patients selected from Tianmen Municipal First People's Hospital during Mar. 2015-Feb. 2016 were divided into group A and B according to medication regimen,with 90 cases in each group. Group A was given Atorvastatin calcium tablet 20 mg,qd;group B was given Rosuvastatin calcium tablet 10 mg,qd. Treatment course of 2 groups lasted for 8 weeks. Blood lipid indexes before and after treatment,lipid-lowering efficacy,the rate of qualified blood lipid and the occurrence of ADR after treatment were compared between 2 groups. Cost-effectiveness analysis was adopted for economic evaluation. RESULTS:Before treatment,there was no statistical significance in the levels of blood lipid in-dexes between 2 groups (P>0.05). After treatment,TC and LDL-C levels of 2 groups were significantly lower than before treat-ment,and those of group B were significantly lower than those of group A,with statistical significance(P<0.05). Total response rate of lipid-lowering in group B(97.78％)was significantly higher than group A(86.67％),and the rate of qualified blood lipid (66.67％)was also significantly higher than group A(51.11％),with statistical significance(P<0.05). There was no statistical significance in the incidence of ADR between 2 groups (P>0.05). The costs of group A and B were 488.32,436.24 yuan,and cost-effectiveness ratios were 5.63,4.46;incremental cost-effectiveness ratio was -4.69. The plan of group B had cost-effective-ness advantage. The results of cost-effectiveness analysis were supported by sensitivity analysis. CONCLUSIONS:In the view of short-term efficacy,10 mg/d rosuvastatin plan is better than 20 mg/d atorvastatin plan in lowering lipid and has cost-effectiveness advantage,and both have similar safety.

BACKGROUND/AIMS: The past decades have seen increasing incidence and prevalence of inflammatory bowel disease (IBD) in China. This article aimed to summarize the current status and characteristics of surgical management for IBD in China. METHODS: We searched PubMed, Embase, and Chinese databases from January 1, 1990 to July 1, 2014 for all relevant studies on the surgical treatment IBD in China. Eligible studies with sufficient defined variables were further reviewed for primary and secondary outcome measures. RESULTS: A total of 74 studies comprising 2,007 subjects with Crohn's disease (CD) and 1,085 subjects with ulcerative colitis (UC) were included. The percentage of CD patients misdiagnosed before surgery, including misdiagnosis as appendicitis or UC, was 50.8%±30.9% (578/1,268). The overall postoperative complication rate was 22.3%±13.0% (267/1,501). For studies of UC, the overall postoperative complication rate was 22.2%±27.9% (176/725). In large research centers (n>50 surgical cases), the rates of emergency operations for CD (P=0.032) and in-hospital mortalities resulting from both CD and UC were much lower than those in smaller research centers (n≤50 surgical cases) (P=0.026 and P <0.001, respectively). Regarding the changes in CD and UC surgery over time, postoperative complications (P=0.045 for CD; P=0.020 for UC) and postoperative in-hospital mortality (P=0.0002 for CD; P=0.0160 for UC) both significantly improved after the year 2010. CONCLUSIONS: The surgical management of IBD in China has improved over time. However, the rates of misdiagnosis and postoperative complications over the past two decades have remained high. Large research centers were found to have relatively better capacity for surgical management than the smaller ones. Higher quality prospective studies are needed in China.
Appendicitis ; Asian Continental Ancestry Group ; China* ; Colitis, Ulcerative ; Crohn Disease ; Diagnostic Errors ; Emergencies ; Hospital Mortality ; Humans ; Incidence ; Inflammatory Bowel Diseases* ; Outcome Assessment (Health Care) ; Postoperative Complications ; Prevalence ; Prospective Studies

BACKGROUND/AIMS: The past decades have seen increasing incidence and prevalence of inflammatory bowel disease (IBD) in China. This article aimed to summarize the current status and characteristics of surgical management for IBD in China. METHODS: We searched PubMed, Embase, and Chinese databases from January 1, 1990 to July 1, 2014 for all relevant studies on the surgical treatment IBD in China. Eligible studies with sufficient defined variables were further reviewed for primary and secondary outcome measures. RESULTS: A total of 74 studies comprising 2,007 subjects with Crohn's disease (CD) and 1,085 subjects with ulcerative colitis (UC) were included. The percentage of CD patients misdiagnosed before surgery, including misdiagnosis as appendicitis or UC, was 50.8%±30.9% (578/1,268). The overall postoperative complication rate was 22.3%±13.0% (267/1,501). For studies of UC, the overall postoperative complication rate was 22.2%±27.9% (176/725). In large research centers (n>50 surgical cases), the rates of emergency operations for CD (P=0.032) and in-hospital mortalities resulting from both CD and UC were much lower than those in smaller research centers (n≤50 surgical cases) (P=0.026 and P <0.001, respectively). Regarding the changes in CD and UC surgery over time, postoperative complications (P=0.045 for CD; P=0.020 for UC) and postoperative in-hospital mortality (P=0.0002 for CD; P=0.0160 for UC) both significantly improved after the year 2010. CONCLUSIONS: The surgical management of IBD in China has improved over time. However, the rates of misdiagnosis and postoperative complications over the past two decades have remained high. Large research centers were found to have relatively better capacity for surgical management than the smaller ones. Higher quality prospective studies are needed in China.
Appendicitis ; Asian Continental Ancestry Group ; China* ; Colitis, Ulcerative ; Crohn Disease ; Diagnostic Errors ; Emergencies ; Hospital Mortality ; Humans ; Incidence ; Inflammatory Bowel Diseases* ; Outcome Assessment (Health Care) ; Postoperative Complications ; Prevalence ; Prospective Studies

Capsules ; China ; Drugs, Generic ; Humans ; Imatinib Mesylate ; Leukemia, Myeloid, Chronic-Phase

Objective To study the affecting factors of the activities of daily living in patients after abdominal surgery.Methods Using survey methodology,95 abdominal surgery patients were investigated br general condition questionnaire and Barthel index scales.The data were analyzed using descriptive analysis,t test,variance analysis and multiple regression analysis.Results The total number of valid return was 91.and the valid usable return rate was 95.8% .The affecting factors of recovery to ADL2 of abdominal surgery patients after operation were gender,age,education level,economic condition,type of illness,postoperation complications,operation times,nutrition risk scores and activities of daily living of preoperation,and the differences were significant.The affecting factors of recovery to ADL1 of abdominal surgery patients after operation were age,education level economic condition,marital status,type of illness,postoperation complications,nutrition risk scores and activities of daily living of preoperation,the differences wen significant.Conclusions The affecting factors of ADL of abdominal surgery patients after operation were gender,age,education level economic level,type of illness,postoperation complications,marital status,operation times,nutrition risk scores and activities of daily living of preoperation.

Objective: To observe the clinical effect and infra-red thermogram changes for acute lumbar sprain. Methods: All 295 cases with acute lumbar sprain were randomly divided into an electroacupuncture group (147 cases) and medication group (148 cases). The cases in electroacupuncture group were treated by needling Houxi (SI 3), whereas those in the medication group were treated with Meloxicam tablet. The infra-red thermogram was observed before and after treatment. Results: The recovery and effective rates in the electroacupuncture group were 71.4% and 93.9%, whereas the rates in the medication groups were 42.6% and 87.2% (P＜0.01). The temperature differences via the thermogram in the electroacupuncture and medication groups were 2.52℃ and 0.80℃ (P＜0.01), indicating a significant difference.Conclusion: Both electroacupuncture and medication could obtain significant effect for acute lumbar sprain; however, electroacupuncture obtained a better overall effect and a more substantial temperature-raising effect in the thermogram than medication.