ObjectiveTo investigate the effects of retention enema with Huangling Jiedu Xiezhuo granules（HJXG） on Nod-like receptor protein 3（NLRP3）， intestinal flora， and short-term prognosis in patients with gout. MethodsA total of 60 patients with gout admitted to the hospital from January 2021 to December 2023 were selected and divided into a control group and an observation group according to the random number table method， with 30 cases in each group. The control group was treated with febuxostat， and the observation group was treated with retention enema with HJXG on the basis of the control group. After 14 days of continuous treatment， the clinical efficacy， traditional Chinese medicine （TCM） syndrome score， and visual analogue scale （VAS） pain index of the two groups were compared， and serum creatinine（SCr）， blood urea nitrogen（BUN）， uric acid（UA）， cystatin C（CysC）， β₂- microglobulin（β₂-MG）， glomerular filtration rate test（GFR）， creatinine clearance rate （Ccr）， erythrocyte sedimentation rate（ESR）， hypersensitive C-reactive protein，（hs-CRP）， interleukin 6（IL-6）， interleukin-1β（IL-1β）， interleukin-18 （IL-18）， NLRP3 inflammasome levels， and the number of intestinal flora were detected in the two groups. The prognosis of patients was followed up within 12 weeks. COX regression analysis was used to analyze the effect of short-term prognosis. ResultsAfter treatment， TCM syndrome scores and VAS pain index in both groups were reduced （P<0.05）， and TCM syndrome scores in the observation group were significantly lower than those in the control group. After treatment， ESR， hs-CRP， IL-6， NLRP3， IL-18， and IL-1β were significantly decreased in both groups （P<0.01）， and the levels of IL-6， ESR， NLRP3， and IL-18 were significantly improved in the observation group compared with the control group （P<0.05）. BUN， SCr， UA， β₂-MG， GFR indexes in both groups were significantly lower after treatment， Ccr indexes in both groups were significantly higher after treatment， and the levels of SCr， UA， CysC， and Ccr in the observation group were significantly better than those in the control group （P<0.05）. After treatment， the intestinal flora in both groups was improved， and the observation group was significantly improved compared with the control group in terms of Lactobacillus， Proteus， Bacteroides， and Escherichia coli （P<0.05）. COX regression analysis showed that retention enema with HJXG could reduce the risk of poor short-term prognosis in patients with gout compared with Western medicine alone. ConclusionThe retention enema with HJXG can improve the curative effect of patients with gout， improve the TCM syndromes， reduce inflammation， and enhance renal function， intestinal flora， and short-term prognosis.

ObjectiveTo investigate the effects of Xinfeng capsules combined with chronic disease management of traditional Chinese medicine （TCM） on rapid disease control and short-term prognosis of patients with rheumatoid arthritis （RA）. MethodsA total of 80 RA patients hospitalized in the Department of Rheumatology of The First Affiliated Hospital of Anhui University of Chinese Medicine from January 2022 to March 2024 were enrolled and randomly divided into an observation group （40 cases） and a control group （40 cases）. The control group was treated with conventional methotrexate combined with standard chronic disease management， while the observation group was additionally treated with Xinfeng Capsules combined with TCM chronic disease management. The treatment course lasted 24 weeks. The outcomes were compared between two groups， including disease activity ［28-joint disease activity score （DAS28）， clinical disease activity index （CDAI）， simplified disease activity index （SDAI）］， visual analogue scale （VAS） for pain， TCM syndrome score， tender joint count （TJC）， swollen joint count （SJC）， morning stiffness duration， Health Assessment Questionnaire （HAQ）， Self-Rating Anxiety Scale （SAS）， Self-Rating Depression Scale （SDS）， American College of Rheumatology （ACR） 20%， 50% and 70% response rates （ACR20/50/70）， erythrocyte sedimentation rate （ESR）， high-sensitivity C-reactive protein （hs-CRP）， rheumatoid factor （RF）， anti-cyclic citrullinated peptide antibody （CCP-Ab）， interleukin （IL）-6， IL-1β， tumor necrosis factor-α （TNF-α）， and serum immunoglobulin G （IgG）. The Chronic Disease Self-Management Scale （CDSMS） was used to evaluate patients’ self-management ability， self-care ability， and nursing satisfaction. Patients were followed up for 12 weeks to assess prognosis， and COX regression analysis was performed to determine the impact on short-term prognosis. ResultsAfter treatment， TJC， SJC， morning stiffness duration， DAS28， CDAI， SDAI， VAS， TCM syndrome score， ESR， hs-CRP， RF， CCP-Ab， IL-6， IL-1β， TNF-α， IgG， HAQ， SAS， SDS， chronic disease self-management behavior， self-efficacy， and self-care ability all improved significantly in both groups compared with baseline （P<0.05，P<0.01）. Compared with the control group， the observation group showed more significant improvements in TJC， SJC， morning stiffness duration， DAS28， CDAI， SDAI， VAS， TCM syndrome score， ESR， IL-1β， IgG， HAQ， SAS， SDS， self-care ability， chronic disease self-management behavior， and self-efficacy （P<0.05 or P<0.01）. The ACR70 response rate and nursing satisfaction were significantly higher in the observation group than in the control group （P<0.01）. COX regression analysis showed that Xinfeng capsules combined with TCM chronic disease management reduced the risk of poor short-term prognosis in RA patients. ConclusionXinfeng capsules combined with TCM chronic disease management facilitates rapid disease control in RA patients， effectively improves short-term prognosis， and plays an important role in the treatment of the disease.

Objective:Analyze the cancer screening status of the cancer screening program in urban areas in Shaanxi province in 2019-2020.Methods:The early diagnosis and early treatment project for urban cancers carried out high-risk population screening for 5 types of high-incidence malignant tumors (breast cancer, lung cancer, upper gastrointestinal cancer, liver cancer, and colorectal cancer) in urban areas. Three prefecture-level cities in Shaanxi province with a population of over 1 million (Xi'an, Baoji, and Shangluo) were selected, and 4 communities with a relatively good working foundation were selected in each city. The general population aged 45-74 years was surveyed on the principles of informed consent and voluntariness, and high-risk groups identified through the questionnaire were further subjected to free endoscopy, ultrasound, CT, and other clinical screenings. The high-risk rates, screening compliance rates, and positive detection rates of the above 5 types of malignant tumors were analyzed.Results:A total of 19 632 people completed the survey effectively, with the proportion of male participants (40.0%) lower than that of females (60.0%). A total of 10 102 high-risk groups were identified, with an initial screening high-risk rate of 51.5%, and the high-risk rates for the 5 types of cancers were 24.1% for breast cancer, 28.6% for lung cancer, 9.1% for upper gastrointestinal cancer, 4.0% for liver cancer, and 20.0% for colorectal cancer. Among the 14 960 person-time initially assessed as high-risk, 5 129 person-time received clinical screening, with a screening compliance rate of 34.3%. The number of people receiving clinical screening and the screening compliance rates for the 5 types of cancers were 1 192 (41.9%) for breast cancer, 2 081 (37.1%) for lung cancer, 574 (32.0%) for upper gastrointestinal cancer, 404 (51.3%) for liver cancer, and 878 (22.3%) for colorectal cancer, with positive detection numbers and rates of 179 (15.0%) for breast, 289 (13.9%) for lung, 9 (1.6%) for upper gastrointestinal, 14 (3.5%) for suspected liver, and 67 (7.6%) for colorectal, respectively.Conclusion:The cancer screening status of the cancer screening program in urban areas in Shaanxi province is beneficial for the detection of precancerous lesions and early cancer patients, and improving the early diagnosis and treatment rate of patients, but the public participation rate is not high, and the project management model and technical plan need to be further improved.

Objective:Analyze the cancer screening status of the cancer screening program in urban areas in Shaanxi province in 2019-2020.Methods:The early diagnosis and early treatment project for urban cancers carried out high-risk population screening for 5 types of high-incidence malignant tumors (breast cancer, lung cancer, upper gastrointestinal cancer, liver cancer, and colorectal cancer) in urban areas. Three prefecture-level cities in Shaanxi province with a population of over 1 million (Xi'an, Baoji, and Shangluo) were selected, and 4 communities with a relatively good working foundation were selected in each city. The general population aged 45-74 years was surveyed on the principles of informed consent and voluntariness, and high-risk groups identified through the questionnaire were further subjected to free endoscopy, ultrasound, CT, and other clinical screenings. The high-risk rates, screening compliance rates, and positive detection rates of the above 5 types of malignant tumors were analyzed.Results:A total of 19 632 people completed the survey effectively, with the proportion of male participants (40.0%) lower than that of females (60.0%). A total of 10 102 high-risk groups were identified, with an initial screening high-risk rate of 51.5%, and the high-risk rates for the 5 types of cancers were 24.1% for breast cancer, 28.6% for lung cancer, 9.1% for upper gastrointestinal cancer, 4.0% for liver cancer, and 20.0% for colorectal cancer. Among the 14 960 person-time initially assessed as high-risk, 5 129 person-time received clinical screening, with a screening compliance rate of 34.3%. The number of people receiving clinical screening and the screening compliance rates for the 5 types of cancers were 1 192 (41.9%) for breast cancer, 2 081 (37.1%) for lung cancer, 574 (32.0%) for upper gastrointestinal cancer, 404 (51.3%) for liver cancer, and 878 (22.3%) for colorectal cancer, with positive detection numbers and rates of 179 (15.0%) for breast, 289 (13.9%) for lung, 9 (1.6%) for upper gastrointestinal, 14 (3.5%) for suspected liver, and 67 (7.6%) for colorectal, respectively.Conclusion:The cancer screening status of the cancer screening program in urban areas in Shaanxi province is beneficial for the detection of precancerous lesions and early cancer patients, and improving the early diagnosis and treatment rate of patients, but the public participation rate is not high, and the project management model and technical plan need to be further improved.

Objective:To study the expression and significance of ADMA/NOS/NO/cGMP pathway in the maternal-fetal interface of patients with preeclampsia. Methods: 60 patients were selected and divided into severe preeclampsia group, mild preeclampsia group and gestational hypertensive group according to the disease condition, meanwhile 20 healthy pregnant women of singleton receiving cesarean section were chosen as control group. Levels of NO and cGMP in placenta of the four groups were detected and compared,and activities of total NOS in placenta were measured and compared. The expression of eNOS and iNOS in placental tissue was detected by immunohistochemistry SP method. High-performance liquid chromatography was used to detect the level of ADMA in HUVECs. Results:The levels of NO in placenta of severe and mild preclampsia groups were (7. 6±3. 6) and (11. 4±4. 3) μmol/g, which were statistically significantly lower than that in control group(P<0. 05). The levels of cGMP in placenta of severe and mild pre-clampsia groups were ( 3. 26 ± 0. 31 ) and ( 4. 53 ± 0. 42 ) pmol/g, which were aslo significantly lower than that in control group ( P<0. 05). In the four groups,the level of cGMP in placenta was positively correlated with the level of NO in placenta(r=0. 672). The activities of total NOS in placenta of severe and mild preeclampsia groups were (10. 4±3. 0)and (14. 8±1. 6)U/mg protein,which were statistically significantly lower than that in control group ( P<0. 05 ) . In placenta of the four groups, the activity of total NOS was positively correlated with the level of NO(r=0. 785). The expression of eNOS in placenta of severe and mild preeclampsia groups was statistically significantly lower than that in control group ( P<0. 05 ) , the expression of iNOS in severe preeclampsia group was significantly higher than that in the control group(P<0. 05). The levels of ADMA in HUVECs of severe preeclampsia group,mild pre-eclampsia group and gestational hypertensive group were statistically significantly higher than that in the control group(P<0. 05). The level of ADMA in HUVECs was negatively correlated with the level of NO in placenta of the four groups ( r=-0. 582 ) . Conclusion:ADMA/NOS/NO/cGMP pathway may play an important role in the pathogenesis of preeclampsia.

Objective To assess the value of one-stage hybrid technique for treatment of pernicious placenta previa. Methods 12 patients with pernicious placenta previa who had received simultaneously Cesarean section and temporary balloon occlusion of abdominal aorta or internal iliac artery in the hybrid operation room were included in this study. 12 patients with pernicious placenta previa who had preserved balloon ducts in internal iliac artery before Cesarean section were chosen as a control group. Balloons were filled to control hemorrhage during the procedure. The hemodynamic parameters including blood pressure and heart rate were monitored during the opera-tion. Surgical duration ,amount of blood loss ,amount of blood transfusion ,volume of infusion ,urine volume during the procedure,postoperative volume of blood loss within 24 hours,uterine hysterectomy rate and neonatal conditions were compared between the two groups. Results During the operation,the blood pressure and heart rate in hybrid group were more stable. The mean surgical duration was(72 ± 8)min,the intraoperative mean amount of blood loss was(620 ± 95)mL,the mean amount of blood transfusion was(550 ± 40)mL,the mean volume of infusion was(1850 ± 160)mL,the mean amount of blood loss in 24 h after the operation was(75 ± 9) mL in the hybrid group,which were significantly lower than those in the control group(P<0.05 for all comparisons). No serious complications occurred in any of the two groups after the operation. There were no significant differences in neonatal conditions between the two groups. Conclusions One-stage hybrid technique has an obvious effect in the control of intraoperative bleeding in patients with pernicious placenta previa. It is worth popularizing in the hospital whose conditions are permitted.

AIM: To evaluate the pulmonary function in patients with type 2 diabetes mellitus in order to identify whether the lung is a target organ of chronic pathologic changes in diabetes mellitus. METHODS: Pulmonary ventilation function and diffusion capacity were studied in 107 patients with type 2 diabetes mellitus and 61 healthy subjects matched for age and sex. Glycosylated hemoglobin (HbA1c), urine albumin excretion rate (AER), fundus examination and nerve conduction velocity were included as parameters of glycemic control and diabetic microangiopathies. RESULTS: Pulmonary ventilation function was similar in type 2 diabetic group and the control. Compared with the control, carbon monoxide diffusion capacity (DLCO) and DLCO corrected by alveolar volume (DLCO/VA) were significantly lower in type 2 diabetic group (P<0.05). DLCO and DLCO/VA were inversely correlated with microangiopathy score (r: -0.291, -0.324, respectively, P<0.01). Furthermore, DLCO/VA was negatively correlated with age and duration of diabetes mellitus (r: -0.269, -0.236, respectively, P<0.05). CONCLUSIONS: Pulmonary ventilation function is normal in patients with type 2 diabetes mellitus, but their diffusion capacity is impaired. It suggests that the lung may also be the target organ of the chronic pathologic changes of diabetes mellitus.

OBJECTIVETo identify valid measures for preventing outbreaks of severe acute respiratory syndrome (SARS) among protected healthcare workers in isolation units.

METHODSArchitectural factors, admitted SARS cases and infection of healthcare workers in different isolation wards between January 30 and March 30, 2003 were analyzed.

RESULTSFour types of isolation wards were analyzed, including the ward where the thirty-first bed was located on the twelfth floor, the laminar flow ward in the Intensive Care Unit where the tenth bed was located on the fifteenth floor, the ward where the twenty-seventh bed was located on the thirteenth floor of the Lingnan Building, and thirty wards on the fourteenth to eighteenth floors of the Zhongshan Building. The ratios (m(2)/m(3)) of the area of the ventilation windows to the volume of the rooms were 0, 0, 1:95 and 1:40, respectively. Numbers of SARS cases in the wards mentioned above were 1, 1, 1 and 96, respectively. Total times of hospitalization were 43, 168, 110 and 1272 hours, respectively. The infection rates of the healthcare workers in the areas mentioned above were 73.2%, 32.1%, 27.5% and 1.7%, respectively. The difference in the infection rates was of statistical significance.

CONCLUSIONSIsolating SARS cases in wards with good ventilation could reduce the viral load of the ward and might be the key to preventing outbreaks of SARS among healthcare workers along with strict personal protection measures in isolation units.

Adult ; Disease Outbreaks ; prevention & control ; Facility Design and Construction ; Female ; Hospital Units ; Humans ; Infectious Disease Transmission, Patient-to-Professional ; prevention & control ; Male ; Middle Aged ; Patient Isolation ; Severe Acute Respiratory Syndrome ; prevention & control ; Ventilation

OBJECTIVETo explore digestive system manifestations in patients with severe acute respiratory syndrome (SARS).

METHODThe clinical data of 96 cases with SARS admitted into our hospital from February 6, 2003 to March 28, 2003 were retrospectively analyzed.

RESULTSAmong the 96 cases, 26 cases (27%) had diarrhea, 17 (18%) had nausea, 6 (6%) had vomiting, 16 (17%) had bellyache, and 8 (8%) had ALT elevation.

CONCLUSIONSPatients with SARS may have digestive system manifestations; diarrhea is the most common symptom.

Adolescent ; Adult ; Diarrhea ; etiology ; Digestive System Diseases ; etiology ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Severe Acute Respiratory Syndrome ; complications

OBJECTIVETo describe a hospital outbreak of severe acute respiratory syndrome (SARS) and summarize its clinical features and therapeutic approaches.

METHODSThe outbreak started with a SARS patient from the community, and a total of 96 people (76 women and 20 men, mean age (29.5 +/- 10.3) years, 93.8% of whom were health care workers) who had exposure to this source patient became infected in a short time. Clinical data in this cohort were collected prospectively as they were identified.

RESULTS(1) The incubation period ranged from 1 to 20 (mean: 5.9 +/- 3.5) days. The duration of hospitalization was (17.2 +/- 8.0) days. (2) The initial temperature was (38.3 +/- 0.6) degrees C, while the highest was (39.2 +/- 0.6) degrees C (P < 0.001), with fever duration of (9.0 +/- 4.2) days. (3) Other most common symptoms included fatigue (93.8%), cough (85.4%), mild sputum production (66.7%), chills (55.2%), headache (39.6%), general malaise (35.4%) and myalgia (21.9%). (4) The radiographic changes were predominantly bilateral in the middle or lower lung zones. The number of affected lung fields was 1.2 +/- 0.8 on presentation, which increased to 2.9 +/- 1.4 after admission (P < 0.001). The interval from the beginning of fever to the onset of abnormal chest radiographs was (3.5 +/- 2.3) days, which increased in size, extent, and severity to the maximum (6.7 +/- 3.5) days later. The time before the lung opacities were basically absorbed was (14.9 +/- 7.8) days. (5) Leukopenia was observed in 67.7% of this cohort. The time between the onset of fever and leukopenia was (4.4 +/- 2.3) days, with the lowest white blood cell count of (2.80 +/- 0.72) x 10(9)/L. (6) The lowest arterial oxygen saturation was (94.8 +/- 3.1)% with supplementary oxygen. (7) Antibiotical therapies included tetracyclines (91.0%), aminoglycosides (83.3%), quinolones (79.2%); 18.8% of the patients received a combination of tetracyclines and aminoglycosides, while 11.5% received a combination of tetracyclines and quinolones, and 63.5% received a combination of tetracyclines, aminoglycosides and quinolones. Vancomycin was used in 13.5% of the patients. (8) 68.8% of the patients were treated with methylprednisolones for a mean interval of (4.9 +/- 2.4) days. The initial dose was (67.3 +/- 28.2) mg/d and the maximal dose was (82.4 +/- 30.5) mg/d. (9) Human gamma-globulin, interferon-alpha, antiviral drugs (oral ribavirin or oseltamivir) were used respectively in 68.6%, 46.9% and 92.7% of the patients. (10) Ninety-five patients (99.0%) had a complete clinical recovery, and only 1 patient (1.0%) died.

CONCLUSIONSSARS appears to be quickly infectious and potentially lethal among health care workers, characterized by acute onset and rapid progression, and mostly bilateral lung involvement on chest radiographs. Proper administration of glucocorticosteroids seems to be of some benefits. Antibiotics, human gamma-globulin, interferon-alpha, and antiviral drugs, although empirically, might be useful to shorten the clinical course.

Adult ; China ; epidemiology ; Cross Infection ; diagnosis ; epidemiology ; therapy ; Disease Outbreaks ; Female ; Humans ; Male ; Severe Acute Respiratory Syndrome ; diagnosis ; epidemiology ; therapy