中国临床实用医学最新文献

{"title":"Risk factors of hemorrhage transformation after ischemic stroke and its prediction model","authors":"Liqun Yu, Sheng-liang Shi, Ye Zhang, Haifang Zhu","doi":"10.3760/CMA.J.ISSN.1673-8799.2017.04.009","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-8799.2017.04.009","url":null,"abstract":"Objective \u0000To establish a prediction model by analyzing the related risk factors of hemorrhage transformation (HT) after ischemic stroke. \u0000 \u0000 \u0000Methods \u0000A retrospective study was performed on 327 cases of patients with ischemic stroke who were admitted from January 2015 to September 2016.The pathogenesis,clinical manifestation and general data of patients were retrospectively analyzed.The risk factors of HT were selected by logistic regression analysis and other methods,a new prediction model was established,and the evaluation boundary value of the ROC curve was obtained,which was greater than the evaluation boundary value was in HT high risk group. \u0000 \u0000 \u0000Results \u0000Atrial fibrillation ( OR=4.940,95%CI: 1.879~12.988,P<0.05 ),systolic blood pressure higher than 160 mmHg ( OR=2.762,95%CI: 1.175~6.494,P<0.05,1 mmHg=0.133 kPa ),massive cerebral infarction ( OR=3.796,95%CI: 1.495~9.635,P<0.05),NIHSS score more than 10 points ( OR=5.665,95%CI: 2.289~14.021,P<0.05),thrombolytic treatment ( OR=3.086,95%CI: 4.981~96.257,P<0.05) were independent risk factors for HT.Prediction model: Logit P=-3.588+ 1.579×X1+ 1.016×X2+ 1.334×X3+ 1.734×X4+ 3.086×X5.The AUC was 0.912 (95%CI: 0.873~0.950,P<0.001). When the boundary value was-2,the sensitivity was 88.33%,specificity is 82.02%. \u0000 \u0000 \u0000Conclusion \u0000Atrial fibrillation history,systolic blood pressure which is higher than 160 mmHg,massive cerebral infarction,NIHSS score is more than 10 point,and thrombolytic treatment are independent risk factors for HT.The patient will have a higher risk of HT,when the boundary value is greater than-2. \u0000 \u0000 \u0000Key words: \u0000Ischemic stroke; Hemorrhage transformation; Risk factor; Prediction model","PeriodicalId":64135,"journal":{"name":"中国临床实用医学","volume":"8 1","pages":"35-39"},"PeriodicalIF":0.0,"publicationDate":"2017-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43514293","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of prognostic factors on ultrasound guided radiofrequency ablation in the treatment of primary hepatic carcinoma","authors":"Chong Zhao, T. Han, Siqi Ji, Youfa Fang, Peng Liu, Chuan Deng, Junqiang Guo","doi":"10.3760/CMA.J.ISSN.1673-8799.2017.04.002","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-8799.2017.04.002","url":null,"abstract":"Objective \u0000To explore the clinical efficacy and related factors on ultrasound guided radiofrequency ablation in the treatment of primary liver cancer. \u0000 \u0000 \u0000Methods \u0000This retrospective study involed the patients admitted between December 2012 and July 2015.A total of 130 patients who underwent radiofrequency ablation.111 of 130 patients were followed up.The clinical efficacy was summarized and the prognostic factors was analyzed. \u0000 \u0000 \u0000Results \u0000The survival rate of less than 2 years was 35.1%,the survival rate of more than 2 years was 64.9%.By the single factor analysis,gender,age,hepatitis history,splenomegaly or hypersplenism,preoperative aspertate aminotransferase,preoperative alanine aminotransferase,preoperative total bilirubin and preoperative prothrombin time were not obvious influence on survival,there was no statistically significant difference(P>0.05). Child grading,lcirrhosis of liver,liver function,serum albumin,alphafetoprotein,tumor number,a single tumor diameter and the total diameter of the largest influence on patient survival was statistically significant(P<0.05). By the multifactor analysis,the maximum diameter of single tumor and serum albumin were independent prognostic factors of radiofrequency ablation. \u0000 \u0000 \u0000Conclusion \u0000Radiofrequency ablation is an effective treatment for liver cancer,the treatment effect is influenced by many factors.Through the analysis of related factors,it is helpful to select a better indications for clinical treatment and improve the prognosis of hepatic carcinoma. \u0000 \u0000 \u0000Key words: \u0000Radiofrequency ablation; Primary hepatic carcinoma; Prognosis; Related factors","PeriodicalId":64135,"journal":{"name":"中国临床实用医学","volume":"8 1","pages":"3-6"},"PeriodicalIF":0.0,"publicationDate":"2017-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49140025","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The risk factors and bacterial susceptibility analysis of in severe acute pancreatitis complicated with intra-abdominal infections","authors":"Yisen Huang, Yaqiong Zhuang, Zijian Su","doi":"10.3760/CMA.J.ISSN.1673-8799.2017.04.007","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-8799.2017.04.007","url":null,"abstract":"Objective The aim of the study was to find out the risk factors of the severe acute pancreatitis(SAP)complicated with intra-abdominal infections according to the retrospective analysis of the clinical data of 280 patients with SAP in Quanzhou First Hospital of Fujian Medical University,and to analyze the bacterial spectrum,drug sensitivity in patients with intra-abdominal infections for clinical diagnosis and treatment. Methods Collected the clinical data of 280 patients,the relationship between the factors which have significant difference in patients complicated with intra-abdominal infections and no intra-abdominal infections patients was explored according to the Logistic regression analysis,and analysized the predisposing factor of SAP complicated with the intra-abdominal infections.The ascite specimens and the necrotic tissues of SAP patients complicated with the intra-abdominal infections were harvested for bacterial culture and drug sensitivity analysis. Results The Multiple organ dysfunction syndrome,seroperitoneum,Ca and intestinal dysfunction were the risk factors of SAP with the intra-abdominal infections,the main pathogenic bacteria was gram-negative bacteria.The top two gram-negative bacteria were Escherichia coli,pseudomonas aeruginosa,and the top two gram-positive bacterium were enterococcus,staphylococcus aureus.They were generally not sensitive to common antibiotics. Conclusion The early therapy of SAP complicated with the intra-abdominal infections should be basd on the risk factors,bacterial spectrum,and drug sensitivity,in order to increase the clinical therapeutic effect. Key words: Severe acute pancreatitis; Intra-abdominal infections; Logistic regression analysis; Bacterial susceptibility testing","PeriodicalId":64135,"journal":{"name":"中国临床实用医学","volume":"8 1","pages":"26-30"},"PeriodicalIF":0.0,"publicationDate":"2017-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44819290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exenatide improving antioxidant ability of nonalcoholic fatty liver disease of rats","authors":"Xiaobo Li","doi":"10.3760/CMA.J.ISSN.1673-8799.2017.04.022","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-8799.2017.04.022","url":null,"abstract":"Objective \u0000To investigate the exenatide effect on fat-induced nonalcoholic fatty liver disease(NAFLD) of rat. \u0000 \u0000 \u0000Methods \u0000NAFLD models were established after 12 weeks of high fat diet feeding,a total of 120 SD rats were randomly divided into control group(CON group),model group(HFD group),exenatide low,medium,high dose group(ELD group,EMD group,EHD group) and polyene phosphatidylcholine treatment group(PDC group),with 20 rats in each group.After given appropriate treatment,half of the rats were sacrificed after 4 and 8 weeks.HE staining of liver slices,antioxidant factors were performed. \u0000 \u0000 \u0000Results \u0000With the dose of exenatide became larger,and the time got longer,the liver fat and the inflammatory response were significantly reduced and the fat particles were significantly reduced; serum and liver total antioxidant capacity was significantly improved. \u0000 \u0000 \u0000Conclusion \u0000Exenatide improves antioxidant ability of NAFLD of rats. \u0000 \u0000 \u0000Key words: \u0000Non-alcoholic fatty liver disease; Exenatide; Antioxidant ability","PeriodicalId":64135,"journal":{"name":"中国临床实用医学","volume":"8 1","pages":"74-78"},"PeriodicalIF":0.0,"publicationDate":"2017-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43173309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of autologous serum and fetal bovine serum on the proliferation of menstrual blood mesenchymal stem cells","authors":"Xi Wang","doi":"10.3760/CMA.J.ISSN.1673-8799.2017.04.006","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-8799.2017.04.006","url":null,"abstract":"Objective \u0000To investigate the feasibility of culturing menstrual blood mesenchymal stem cells in autologous serum system and provide individualized treatment. \u0000 \u0000 \u0000Methods \u0000Collecting the menstrual blood of healthy and child-bearing women of 20-30 years old.Isolated the menstrual blood mesenchymal stem cells through ficoll-hypaque density gradient centrifugation,and suspended them separately,even in DMEM-F12 medium which supplemented with 10% fetal bovine serum and with 10% autologous serum.Supervise the morphology and proliferation of the cultured cell,and draw the growth curves with CCK-8 assay.Compare their osteogenic and adipogenic potential. \u0000 \u0000 \u0000Results \u0000The menstrual blood mesenchymal stem cells cultured in the two systems both showed to be typical spindle shaped and can form colony,and their proliferation ability was similar,with CCK-8 assay,the absorbance value of both system had no significant difference(P>0.05). \u0000 \u0000 \u0000Conclusion \u0000Both of the training systems have the osteogenic and adipogenic potential.The menstrual blood mesenchymal stem cells are cultured in the two systems both have typical spindle shape and colonic growth,and their proliferation abilities are similar,maintaining the menstrual blood of basic biological characteristics,which can replace fetal bovine serum stromal stem cells being used in menstrual blood amplification culture,as the same kind of serum cultivation system,for a large number of amplification menstrual blood source sex stromal stem cells being used in clinical treatment and provides a relatively safe choice. \u0000 \u0000 \u0000Key words: \u0000Menstrual blood mesenchymal stem cells; Autologous serum; Fetal bovine serum system; Cell proliferation; Biosafety","PeriodicalId":64135,"journal":{"name":"中国临床实用医学","volume":"8 1","pages":"19-25"},"PeriodicalIF":0.0,"publicationDate":"2017-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49248905","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Significance and expression of Shp2 in liver cancer stem cell","authors":"Yuting Luan, T. Han, Zehua Qi, Ran Liu, Xiaodan Yang, Zhendong Zheng","doi":"10.3760/CMA.J.ISSN.1673-8799.2017.04.003","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-8799.2017.04.003","url":null,"abstract":"Objective \u0000To study the expression of Shp2 in liver cancer stem cells and the significance of liver stem cells regulation,and then clarify the molecular mechanism of Shp2 in regulating the liver cancer stem cells,explore its feasibility as a therapeutic target for liver cancer and liver cancer biomarkers for individualized treatment. \u0000 \u0000 \u0000Methods \u0000Real-time PCR was used to detect the expression of Shp2 in chemotherapy resistant in HCC cells xenografts.In addition,the expression of Shp2 was detected by real-time PCR technique in stem cell enriched HCC cells using a variety of sorting techniques.The interfering Shp2 cell line was used to define the possible regulation mechanism of Shp2 on liver cancer stem cells by Western blot method. \u0000 \u0000 \u0000Results \u0000In vivo experiments showed that Shp2 expression increased in chemotherapy resistant liver cancer xenografts.What′s more,in vitro experiments,the expression of Shp2 was elevated in the liver cancer stem cells.The expression of Shp2 is closely related to the b-catenin in the interfering Shp2 HCC cell lines,suggesting that Shp2 may promote the formation of liver cancer stem cells through the Wnt/b-catenin pathway. \u0000 \u0000 \u0000Conclusion \u0000In this study,we found that the activation of Wnt/b-catenin signaling pathway by Shp2 in HCC cells promotes cancer stem cell expansion,which suggesting that Shp2 maybe as a biomarker of liver cancer stem cells,and provide a new molecular target and clinical basis for clinical transformation study. \u0000 \u0000 \u0000Key words: \u0000Hepatocellular carcinoma; Shp2; Liver cancer stem cells; Chemotherapy resistance","PeriodicalId":64135,"journal":{"name":"中国临床实用医学","volume":"8 1","pages":"7-10"},"PeriodicalIF":0.0,"publicationDate":"2017-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49312221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multiple imaging contribute to diagnosis and surgical strategies of hepatocellular carcinoma combined with cholangiocarcinoma","authors":"Siqi Ji, Chong Zhao, Youfa Fang, Peng Liu, Chuan Deng, Junqiang Guo, T. Han","doi":"10.3760/CMA.J.ISSN.1673-8799.2017.04.005","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-8799.2017.04.005","url":null,"abstract":"Objective \u0000To explore the multiple imagingcontribute to diagnosis and surgical strategies of hepatocellular carcinoma combinedwith cholangiocarcinoma(HCC-CC). \u0000 \u0000 \u0000Methods \u0000Six patients with liver cancer from Janurary2015 to June 2017 were included in the General Hospital of Shenyang Military.CombineCT,MRI and three-dimensional imaging,All the patients were determined if theywere HCC-CC,and suggested tumor staging and metastasis,assessed whether the patient could undergo the surgery. \u0000 \u0000 \u0000Results \u0000Six patients were HCC-CC throughpathological examination.4 of them underwent radical R0 resection and theother patients underwent routine palliative surgery.All patients were satisfiedwith the result. \u0000 \u0000 \u0000Conclusion \u0000Comboinedmultiple Imaging can help todiagnose HCC-CC,there is a positive effect on the patient′s surgical andsurgical strategies. \u0000 \u0000 \u0000Key words: \u0000Combinedhepatocellular carcinoma and cholangiocarcinoma; Liver cancer; Imaging diagnose; Surgicalstrategies","PeriodicalId":64135,"journal":{"name":"中国临床实用医学","volume":"8 1","pages":"15-18"},"PeriodicalIF":0.0,"publicationDate":"2017-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43117703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Research progress of total hip arthroplasty through direct approach by lateral position","authors":"Jingdong Zhang","doi":"10.3760/CMA.J.ISSN.1673-8799.2017.03.001","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-8799.2017.03.001","url":null,"abstract":"","PeriodicalId":64135,"journal":{"name":"中国临床实用医学","volume":"8 1","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2017-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49313324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of VKORC1 and CYP2C9 gene polymorphisms on the stable dosage of warfarin and anticoagulation in patients with hypertrophic cardiomyopathy complicated with atrial fibrillation","authors":"Tian-Lei Liu, Yong Wang, Yangeng Yu","doi":"10.3760/CMA.J.ISSN.1673-8799.2017.03.007","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-8799.2017.03.007","url":null,"abstract":"Objective \u0000To investigate the gene polymorphisms and clinical features of vitamin K epoxide reductase complex 1(VKORC1) and cytochrome P450 2C9(CYP2C9), and their correlation with stable dosage of warfarin, the risk of hemorrhage and over anticoagulation for patients with hypertrophic cardiomyopathy. \u0000 \u0000 \u0000Methods \u0000A retrospective study was performed on 60 patients with hypertrophic cardiomyopathy(HCM) combined with atrial fibrillation(AF) who were admitted and regularly took oral warfarin as anticoagulation from January 2011 to December 2016.The clinical data such as age, body height, body weight, stable warfarin dosage and the situation of hemorrhage and over anticoagulation were recorded.Genotypes of CYP2C9 and VKORC1 were detected with fluorescence PCR-capillary electrophoresis sequencing and the relationship between the genotype and clinical features and the stable dose of warfarin, hemorrhage and over anticoagulation were analyzed by statistical methods. \u0000 \u0000 \u0000Results \u0000Among the 60 patients, VKORC1-1639G>A detection showed that 50 patients were AA type, 9 patients were AG type, 1 patient was GG type, the stabledosage of AA type patients were significant lower than that of AG type patients(P 0.05); CYP2C9 detection showed that 51 patients were *1/*1 type, 6 patients were *1/*3 type, 3 patients were *3/*3 type, *2 allele was not found, the stable dosage of patients who carry the *3 mutation were significant lower than that of *1/*1 type patients, and the more *3 mutation they own, the lower dosage they require(P 0.05). The incidence of hemorrhage and anticoagulation was significantly higher in patients aged 65 years or older than those who were younger than 65 years(P<0.05). \u0000 \u0000 \u0000Conclusion \u0000Stable warfarin dosage has relationship with different genotypes of VKORC1 and CYP2C9 in HCM patients, age may be a factor of warfarin over anticoagulation and hemorrhage. \u0000 \u0000 \u0000Key words: \u0000Hypertrophic cardiomyopathy; Atrial fibrillation; Warfarin; Vitamin K epoxide reductase complex 1; cytochrome P450 2C9; Gene polymorphisms; Hemorrhage; Over anticoagulation","PeriodicalId":64135,"journal":{"name":"中国临床实用医学","volume":"8 1","pages":"34-40"},"PeriodicalIF":0.0,"publicationDate":"2017-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44130714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Shuanghuang burn ointment in vitro antibacterial activity of common fungi infectious","authors":"Haifeng Sun, Yang Wang, R. Zhai","doi":"10.3760/CMA.J.ISSN.1673-8799.2017.03.024","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-8799.2017.03.024","url":null,"abstract":"Objective \u0000To evaluate the antibacterial activity of fungal infection about Shuanghuang burn ointment in vitro. \u0000 \u0000 \u0000Methods \u0000The clinical isolates of candida albicans, candida tropicalis, candida albicans, candida albicans, aspergillus fumigatus, aspergillus niger, aspergillus flavus and rhizopus were produced with agar plates containing bacteria.Application of modified agar diffusion method with Shuanghuang burn ointment and clotrimazole and ketoconazole were cultured.The growth status of the strain was observed and the diameter of bacteriostatic circle was determined. \u0000 \u0000 \u0000Results \u0000Shuanghuang burn ointment form obvious bacteriostatic ring in the culture medium of Rhizopus.Compared with clotrimazole and ketoconazole, there was significant difference(P<0.05). In the experiments of aspergillus and candida culturesm, Shuanghuang burn ointment could not form obvious bacteriostatic ring. \u0000 \u0000 \u0000Conclusion \u0000Shuanghuang burn ointment has certain inhibitory effect on rhizopus in vitro.There is no obvious effect on candida and aspergillus. \u0000 \u0000 \u0000Key words: \u0000Fungi; Burns; Traditional Chinese medicine; Shuanghuang burn ointment","PeriodicalId":64135,"journal":{"name":"中国临床实用医学","volume":"8 1","pages":"90-93"},"PeriodicalIF":0.0,"publicationDate":"2017-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41376726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}