PURPOSE: Details of patients hospitalized for asthma exacerbation in mainland China are lacking. To improve disease control and reduce economic burden, a large sample survey among this patient population is indispensable. This study aimed to investigate the clinical characteristics and outcomes of such patients.METHODS: A retrospective study was conducted on patients hospitalized for asthma exacerbation in 29 hospitals of 29 regions in mainland China during the period 2013 to 2014. Demographic features, pre-admission conditions, exacerbation details, and outcomes were summarized. Risk factors for exacerbation severity were analyzed.RESULTS: There were 3,240 asthmatic patients included in this study (57.7% females, 42.3% males). Only 28.0% used daily controller medications; 1,287 (39.7%) patients were not currently on inhaled corticosteroids. Acute upper airway infection was the most common trigger of exacerbation (42.3%). Patients with severe to life-threatening exacerbation tended to have a longer disease course, a smoking history, and had comorbidities such as hypertension, chronic obstructive pulmonary disease (COPD), and food allergy. The multivariate analysis showed that smoking history, comorbidities of hypertension, COPD, and food allergy were independent risk factors for more severe exacerbation. The number of patients hospitalized for asthma exacerbation varied with seasons, peaking in March and September. Eight patients died during the study period (mortality 0.25%).CONCLUSIONS: Despite enhanced education on asthma self-management in China during recent years, few patients were using daily controller medications before the onset of their exacerbation, indicating that more educational efforts and considerations are needed. The findings of this study may improve our understanding of hospital admission for asthma exacerbation in mainland China and provide evidence for decision-making.
Adrenal Cortex Hormones ; Asthma ; China ; Comorbidity ; Disease Progression ; Education ; Female ; Food Hypersensitivity ; Hospitalization ; Humans ; Hypertension ; Inpatients ; Medication Adherence ; Mortality ; Multivariate Analysis ; Pulmonary Disease, Chronic Obstructive ; Retrospective Studies ; Risk Factors ; Seasons ; Self Care ; Smoke ; Smoking

Objective To explore the clinical values of the modified thoracic drainage devices that were applied in treatment of primary spontaneous pneumothorax patients who underwent single-port video-assisted thoracoscopic surgery. Methods Clinical data of 82 primary spontaneous pneumothorax patients who underwent single-port video-assisted thoracoscopic lung wedge resection and pleurodesis from January 1st, 2015 to August 31st, 2016 was analyzed retrospectively. These patients, according to the thoracic drainage devices, were divided into traditional group (Group A, n = 42) or modified group (Group B, n = 40). These statistical data, including duration of thoracic drainage, lengths of hospital stay, duration of using antibiotic, amounts of pleural drainage, scales of pain, and complications of the two groups of patients in postoperative stage, were compared. Results There was no significant differences (P > 0.05) in volumes of thoracic drainage while there were significant differences (P < 0.05) in duration of thoracic drainage, lengths of hospital stay, duration of using antibiotic, scales of pain, and complications in postoperative stage between the two groups. And patients in group B had shorter time of thoracic drainage, hospital stay, and using antibiotic, lower scales of pain and rates of complications when compared with group A. Conclusion There are some clinical values of application of modified thoracic drainage devices in treatment of primary spontaneous pneumothorax underwent single-port video-assisted thoracoscopic surgery, because of it could give the patients fast recovery and made the operations simpler.

Objective To investigate the level and correlation between Thioredoxin (Trx) and Thioredoxin interacting protein (Txnip) in aqueous humor of cortical cataract patients with type 2 diabetes.Methods The Txnip and Trx levels were determined by Elisa in aqueous humor of 60 cataract patients with type 2 diabetes,which were divided into group A (control group,HbA1c ＜5.5％),group B (5.5％ ≤HbA1c ＜6.5％) and group C (HbA1c＞6.5％),and each group contains 20 patients.Results The level of Txnip in group B was higher than that in group A,while that in group C was the highest,there were statistical differences (all P ＜ 0.05).Compared with group A,the level of Trx in group B was increased,while that in group C was the lowest,there were statistical differences (all P ＜ 0.05).The level of Trx was positive correlated with Txnip in group A (r =0.810,P =0.000),but negative correlated with Txnip in group C (r =-0.809,P =0.000) and degree of cataract in group C (r =-0.727,P =0.001).Logistic regression analysis revealed that Txnip and HbAl c were risk factors of cortical cataract.Conclusion Trx and Txnip may play an important role in the development of diabetic cataract.

Objective To observe the clinical effect of thrombus removal of external hemorrhoid combined with procedure for prolapse and hemorrhoids(PPH) in the treatment of circumferential mixed hemorrhoid with incarceration.Methods A total of 118 cases of circumferential mixed hemorrhoid with incarceration were divided into two groups:experimental group of 60 cases was treated by thrombus removal combined with PPH;control group of 58 cases was treated by Milligan-Morgan.We observed the differences of postoperative visual analogue scale (VAS)score,edema,bleeding,residual skin tag,wound healing time,anal stenosis,fecal incontinence,anorectal manometry and satisfaction in the two groups.Results There was significant difference between the experimental group and the control group in postoperative edema,bleeding and residual skin tag(χ2=6.63,4.19,6.64,P<0.05),but postoperative anal stenosis and fecal incontinence weren′t statistically significant different(χ2=0.38,1.11,P>0.05).Postoperative VAS score,wound healing time,satisfaction,anal resting and anal maximal squeeze pressure between the two groups were all statistically different(P<0.01).Conclusion The operation of thrombus removal of external hemorrhoid combined with PPH can effectively reduce the postoperative complications and promote recovery.

Objective To observe the Lactulose Oral Solution's influence in PPH postoperative complications and patients′ satisfactory rate for constipation and to find more intervention measures for reducing the complications. Methods A hundred and twenty cases of hemorrhoids with constipation were randomly divided into the two groups: the experimental group, the control group in 60 cases in each group. All patients’ postoperative bleeding, anal edema, stool impaction and satisfaction were observed and compared within 30 days. Results In the control group, the postoperative bleeding’ cases were of 23, anal edema’s were of 20 and stool impaction‘s were of 8. The incidence was 38.3%, 33.3% and 13.3% severally. The satisfactory patients were of 49 and the degree of satisfaction was of 81.7%. In the experimental group, the postoperative bleeding’ cases were of 12, anal edema’s were of 8 and stool impaction's was of 1. The incidence was 20%, 13.3% and 1.7% respectively. The cases who were satisfactory were of 58 and the degree of satisfaction was 96.7%. The postoperative bleeding , anal edema , stool impaction and satisfaction were different statistically in the two groups above (P < 0.05). Conclusion It can reduce PPH postoperative complications and increase patients′satisfaction by using Lactulose Oral Solution in patients with constipation and it will have a certain clinical value if these patients take this oral solution routinely.

OBJECTIVETo verify the reliability of real-time PCR for the detection of genetic mutations underlying spinal muscular atrophy (SMA) and establish quality control for clinical testing.

METHODSThirty-five patients, 61 first-degree relatives, 61 healthy controls and 7 prenatal cases which were previously genotyped by multiplex ligation-dependent probe amplification (MLPA) were tested with Roche LightCycler 480 and Bio-Rad CFX96 (TM) real-time PCR machines for relative quantification of copy number of SMN1 exon 7.

RESULTSGenotyping detected by relative quantitative real-time PCR were consistent with the results of MLPA. Both types of real-time PCR machines could accurately distinguish different SMN1 copy numbers despite certain systematic differences between the two platforms.

CONCLUSIONThe reliability of real-time PCR assay for detecting SMA depends on quality control. Standard database generated with known SMN1 copy number variations should be established for different instruments.

OBJECTIVE: To assess the left ventricular (LV) longitudinal systolic and diastolic function in patients treated by epirubicin by velocity vector imaging (VVI) and to discuss the important clinical value of VVI in quantitatively evaluating the regional longitudinal function. METHODS: Thirty patients with breast cancer treated with epirubicin chemotherapy and 30 normal controls were included in the study. Dynamic images of apical long axis, four-chamber and two chamber view were obtained in all subjects, and the longitudinal systolic and diatolic parameters were measured in all subjects, including systolic maximum velocity (Vs), systolic maximum strain (SS), systolic maximum strain rate (SSR), diastolic maximum velocity (Vd), and diastolic maximum strain rate (DSR). The parameters were compared between the 2 groups. The conventional echcardiographic parameters were also obtained. RESULTS: There was no significant change in all baseline parameters before the chemotherapy in 30 breast cancer patients compared with the normal controls (P>0.05). After the second chemotherapy cycle, DSR was lower in every segment, Vd was lower in the free wall, mainly the lateral, anterior and inferior wall (P<0.05), while Vd didn't change significantly in the septum wall (P>0.05). After the third chemotherapy cycle, Vd, DSR and SSR decreased significantly in all segments (P<0.05). Vs and SS didn't change significantly (P>0.05). CONCLUSION VVI can monitor the epirubicin cardiotoxicity early and is more sensitive than echocardiograph.
Adult ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Blood Flow Velocity ; Breast Neoplasms ; drug therapy ; Carcinoma, Ductal, Breast ; drug therapy ; Cardiac Volume ; Case-Control Studies ; Echocardiography ; Elasticity Imaging Techniques ; Epirubicin ; administration & dosage ; adverse effects ; Female ; Humans ; Middle Aged ; Ventricular Dysfunction, Left ; chemically induced ; diagnostic imaging

OBJECTIVE: To determine the value of contrast-enhanced ultrasound in the diagnosis of benign and malignant hepatic tumors. METHODS: A total of 83 patients with 123 focal liver lesions (FLLs) underwent contrast enhanced ultrasound (CEUS) examination. The contrast enhanced characterization of FLLs were compared. RESULTS: All the 103 lesions in hepatocallular carcinoma improved quickly in the arterial phase or portal phase. Altogether 98 lesions (95%) washed out during the late phase but the rest 5 lesions (5%) did not. Of the 69 lesions of hepatocellular carcinoma, 53(77%) enhanced global in the arterial phase or portal phase, and the rest 16 (23%) showed inhomogeneous enhancement but no enhancement in the central area during arterial phase or portal phase. A total of 66(96%) presented wash-out during the late phase, and 3(4%) had no wash-out. Of the 34 lesions of metastatic hepatic carcinoma, 24(71%)presented inhomogeneous enhancement in the arterial phase or portal phase, 10(29%) enhanced globally in the arterial phase or portal phase, 32 (94%) presented wash-out during the late phase, and 2(6%) had no wash-out in the late phase. Of the 20 lesions of benign hepatic tumor, 18(90%) presented inhomogeneous enhancement slowly in the arterial phase or portal phase, 14 (70%) slightly enhanced, and 20 (100%) presented no wash-out in the the late phase. CONCLUSION CEUS can improve the accuracy of diagnosis of benign and malignant hepatic tumors.
Adult ; Aged ; Aged, 80 and over ; Carcinoma, Hepatocellular ; diagnostic imaging ; pathology ; Contrast Media ; Diagnosis, Differential ; Female ; Hemangioma ; diagnostic imaging ; pathology ; Humans ; Image Enhancement ; Liver Neoplasms ; diagnostic imaging ; pathology ; secondary ; Male ; Middle Aged ; Ultrasonography

Objective To investigate the role of muhiplex ligation-dependent probe amplification(MLPA) in identifying fetal aneuploidy of chromosomes 13,18,21,X,and Y. Methods From June 2007 to December 2008,263 samples(prenatal diagnosis group),including amniotic or umbilical cord blood from pregnant women who required prenatal diagnosis,were processed in parallel by MLPA and conventional karyotype to detect fetal aneuploidy.Another 26 samples(fetal death group).ineluding retained abortion and fetal death,were also processed bv MLPA. Results Five cases of 21-trisomy,4 eases of 18-trisomy,1 case of 13-trisomy and 3 cases of 45,X were identified among the prenatal diagnosis group by MLPA,and the results were consistent with karyotype.Two cases of 45,X and 1 case of 18-trisomy were identified among the retained abortion and fetal death group. Conclusions MLPA is a rapid,efficient,simple,reliable and economical technique in detecting most common chromosomal aneuploidies and have important clinical value.

Objective To assess the left ventricular(LV)segmental function by velocity vector imaging(VVI)in uremic patients with diffferent quantity of parathyroid hormone(PTH).Methods Sixty patients with uremia were divided into 2 groups according to the value of PTH:group A with PTH less than 3 times of upper normal limit,group B with PTH more than 3 times of upper normal limit.Normal control group was 30 healthy subj ects.All people were evaluated by VVI.The parameters,including the longitudinal systolic strain rate(SSR),diastolic strain rate(DSR),were analysed among the three groups.Results Compared with normal group,in group A and B,SSR,DSR in all segments were lower.Compared with group A,in group B,DSR were all significantly lower(P＜0.05),SSR in apex of laternal wall,medium of anterior septum wall,posterior wall,medium and apex of posterior septum wall and superior wall,base,medium and apex of anterior wall were significantly lower(P＜0.05).There was no statistically significant difference of left ventricular ejection fraction between the two groups(P＞0.05).Conclusions VVI is a viable objective tool to quantitatively assess LV segmental function damaged by different quantity of PTH.