简介：Humanimmunodeficiencyvirus(HIV)hashadaninsightfulimpactaboutthestateofhealthinessofhumanimmunesystem.Duetogreatimprovementindrugtherapy,HIVinfectionshavebeenreducedby17%overthepasteightyears.IthasbeenprovedthatmosteffectivetreatmentHAART(HighlyActiveAntiRetroviralTherapy)mainlycontrolsthediseasesprogressionbutitdoesnoteradicatethediseasescompletely.ReverseTranscriptaseInhibitordrugsspeciallyassociatedwithvirusspecificCytotoxicT-Lymphocyte(CTL)thatdeclineswithdiseaseprogression.CTLresponsesagainstAIDSpathogenesiscouldbepotentialinthedynamicsofvirusreplication,recognitionandclearanceofinfectedcells.InthisresearcharticleamathematicalmodelhasbeenproposedonthebasisofCTLresponsesuppressioninthechronicphaseofinfectionduetopresenceofvirus.WealsoconsiderthegrowthoftheviruspopulationfromtheinfectedCD4~+Tcellsbuddingprocessandfromtheotherinfectedcellslikemacrophagesandthymocytes.Ouranalyticalandnumericalstudiesareconsistentwithexistingobservationsfromalliedareas.

简介：Chroniccolitisbelongstothecategoryof"Xiexie"(diarrhea),manifestedmainlyasloosestoolswithundigestedfood,mucusandsmallamountofpusandblood,abdominalpain,beinglong-lastingandlingeringinthecourseofdisease.Generally,thetherapeuticeffectwaspoor.Inrecentyears,theauthorofthepresentpaperhastreated28casesofthisdiseaseandachievedsatisfactoryresults.Hereisthesummary.

简介：AbstractObjective:This study aims to describe presenting characteristics of patients diagnosed with non-invasive chronic rhinosinusitis (CRS) following liver or kidney transplant and determine factors associated with disease-related complications, selection of endoscopic sinus surgery (ESS), and disease resolution in this population.Study design:Retrospective chart review.Setting:An academic tertiary care center (Mayo Clinic, Rochester, Minnesota).Subjects and methods:Liver and kidney transplant recipients evaluated by Mayo Clinic otolaryngologists for CRS between 1998 and 2018 were identified. Univariate and multivariate logistic regression analyses were used to determine patient factors and treatment modalities associated with developing complications, selection of ESS, and disease resolution.Results:Fifty-seven patients met inclusion criteria. No patients developed intraorbital or intracranial complications of their CRS. Multivariate modeling demonstrated that the presence of polyps (P = 0.036) was associated with undergoing ESS within one year of presentation. A higher Lund-Mackay (LM) computed tomography score (P = 0.023) and older age (P = 0.018) were significantly associated with decreased disease resolution. No other factors were significantly associated with the use of endoscopic sinus surgery within one year of otolaryngology presentation or resolution of CRS in this cohort.Conclusion:The risk of developing CRS-related intraorbital or intracranial complications in this immunecompromised patient cohort may be lower than originally thought. For liver- and kidney-recipients stable on immunosuppressive medication for many years, prognostic factors for CRS may mirror those for immunocompetent patients.

简介：AbstractAim:Toassesstheefficacyandsafetyofanalsubmucosalinjection(ASI)ofamikacininchronicbacterialprostatitis(CBP).Methods:FiftymaleoutpatientswithCBPwererandomlydiidedintotwogroups.ThirtycasesofASIgroupweregivenamikacin400mgdailybyASIfortentimesandtheothertwentycasesofintramuscularinjection(IM)groupweregiventhesamedrugdailybyIM,AllpatientswereevaluatedwithNIH-Chronicprostatitissymptomindex(NIH-CPSI),thebacteriacultureoftheexpressedprostatesecretion(EPS),proctoscopicexamination,rectalbiopsyandtheclinicalmanifestationwerecheckedatpretreatmentandonday7and90aftercessationoftherapy,Results:Thecurerate,apparenteffectiverateandeffectiverateofASIgroupandIMgroupwere33.3%vs5%(P<0.050,43.3%vs10%(P<0.05)and16.7%vs20%(P>0.05).respectively.ThescoreofNIH-CPSIinbothofASIgroupandIMgroupdecreasedsignificantly7daysaftercessationoftherapy,bothASIandIMofamikacincouldrelievesymptomswithinashorttime,However,3monthsaftercessationoftherapythescoreofNIH-CPSIinASIgroupcontinuedowninspiteofnosignificantdifferencescomparedwith7daysaftercessationoftheragy,butthescoreofIMgroupwasreboundnearlycolsedtolevelofpretreatmentat23.8±8.5andsignificantlyhigherthanthatofASIgroup.Theamountofwhitebloodcell(WBC)ofEPSinASIgroupincreasedslightlyat7daysaftercessationoftherapywithoutsignificantdifferencewithpretreatment(P>0.050,butitsignificantlydecreasedat3monthsaftercessationoftherapy,theamountofWBCofEPSinASIgroupwaslowerthanthatofIMgroupat3monthsaftercessationoftherapy(P<0.05).ProctoscopicexaminationofanalcanalwerenormalafterASItherapyandtherectumbiopsyshowednoobvioushistopathologicabnormalityatthesiteofinjectionexceptmildfocalsubmucosalinfiltrationoflymphocytesandplasmacellsat7daysaftercessationoftherapywhichdisappearedon3monthsaftercessationoftherapy.Allpatientshadnoevidentcomplicat

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简介：ObjectivesToexploretheeffectoflosartanoncardiacandrenalfunctioninpatientswithchronicheartfailure(CHF).MethodsSixty-fivepatientswithCHFweredividedintotwogroupsusingarandomized,controlandsingleblindmethod:losartangroup(n=30)andconventiongroup(n=35),withatreatmentcourseof8weeksforbothgroups.TheconcentrationsofcystatinC(cysC)inserum,microamountalbumin(MA)inurineweremeasuredbyimmunoturbidimetry.Theconcentrationofaquaporin-2(AQP-2)wasdeterminedbyenzyme-linked-immunosorbentassay(ELISA)andtheheartcontractilefunctionwasmeasuredbyechocardiographybeforeandaftertreatmentrespectively.ResultsComparingwithroutinetreatmentgroup,leftventricularend-diastolicdimension(LVEDd)decreasedsignificantly,whileleftventricularejectionfraction(LVEF)andleftventricularfractionalshortening(LVFS)increasedsignificantlyinlosartangroup.ThelevelsofcysCinserumandMA,AQP-2inurineweresignificantlylowerinlosartangroupthaninroutinetreatmentgroup.ConclusionLosartancanimprovecardiacandrenalfunctioninpatientswithCHF.

简介：目的：观察针药结合治疗陧性盆腔炎的临床疗效。方法：将符合纳入标准的88例慢性盆腔炎患者随机分入治疗组或对照组，治疗组45例，采用针刺配合中药治疗；对照组43例，口服妇科千金胶囊治疗。结果：治疗3个月经周期后，治疗组痊愈28例，显效9例，有效4例，无效4例，总有效率91．1％；对照组痊愈7例，显效8例，有效15例，无效13例，总有效率69．8％，两组比较，差异有统计学意义（P〈0．05），治疗组疗效优于对照组。半年后随访，治疗组复发率明显低于对照组（P〈0．01）。结论：针药结合治疗浸性盆腔炎疗效好，不易复发。

简介：Tianshu(ST25),Zhongwan(CV12),Qihai(CV6),Zusanli(ST36)andetcwereselectedtotreatchronicdiarrhea.Thecurativeeffectbetweengingermoxibustionandacupuncturewascompared.Theeffectiverateoftwogroupswasrespectively93%and82%.

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简介：AbstractIn 2009, China strengthened its public health service system. Since then, the country has made remarkable achievements in community-based chronic disease prevention and control; however, certain groups still have unmet needs. During 2019 to 2029, China will consolidate the top-level design of its medical health system. During this period, the coordination of department policies, improvement of service delivery mechanisms, building an integrated health service system, and other issues will be highlighted. This study will provide a basis for designing China's chronic disease prevention and control system during the next stage of development. We will consider the unmet needs of patients with chronic diseases as an indicator for remodeling the prediction system in combination with the elements and structural theories of complex health systems. In this article, we first introduce the definition and measurement methods of unmet needs. Second, we identify the existing unmet needs found among patients with chronic diseases with reference to the chronic disease prevention and control policies of China as well as current service items. Finally, we propose the design of community chronic disease service package for the next development stage based on unmet needs of patients with chronic diseases. We also provide suggestions for how to improve China's chronic care delivery system.

简介：AbstractBackground:Previously, dihydroceramide (d18:0/24:0) (dhCer (d18:0/24:0)) was reported to be a potential biomarker for acute-onchronic liver failure (ACLF) prognosis. In this study, we further explored the role of dhCer (d18:0/24:0) in the progression of ACLF to validate the biomarker using ACLF rat model.Methods:ACLF rats were sacrificed at 4 and 8 h post-D-galactosamine (D-gal)/lipopolysaccharide (LPS) administration to investigate the liver biochemical markers, prothrombin time and liver histopathology. Change in dhCer and other sphingolipids levels were investigated by high-performance liquid chromatography coupled to tandem mass spectrometry (HPLC-MS/MS). Rats were treated with N-(4-hydroxyphenyl) retinamide (4-HPR) to examine the mortality rate and its role in improving ACLF.Results:LPS/D-gal administration resulted in significant elevation in alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels. Prothrombin time was prolonged and histopathological examination showed abnormality. HPLC-MS/MS results showed total dhCer levels in ACLF group (64.10 ± 8.90 pmol/100 μL, 64.22 ± 6.78 pmol/100 μL for 4 and 8 h, respectively) were decreased significantly compared with control group (121.61 ± 23.09 pmol/100 μL) (P < 0.05). In particular, dhCer (d18:0/24:0), dhCer (d18:0/20:0), and dhCer (d18:0/22:0) levels were decreased. Treatment with 4-HPR significantly increased the levels of dhCers, including dhCer (d18:0/24:0) compared with ACLF group, for the level of dhCer (d18:0/24:0) in 4-HPR group was 20.10 ± 8.60 pmol/100 μL and the level of dhCer (d18:0/24:0) in ACLF group was 9.74 ± 2.99 pmol/100 μL (P < 0.05). This was associated with reduced mortality rate and prolonged survival time. The ALT and AST in 4-HPR group were significantly decreased compared with ACLF group. The prothrombin time of 4-HPR group (41.49 s) was significantly lower than the prothrombin time of ACLF group (57.96 s) (P < 0.05). 4-HPR also decreased plasma ammonia levels slightly, as the plasma ammonia levels in 4-HPR group and ACLF group were 207.37 ± 60.43, 209.15 ± 60.43 μmol/L, respectively. Further, 4-HPR treatment improved histopathological parameters.Conclusions:DhCer, especially dhCer (d18:0/24:0), is involved in the progression of ACLF. Increasing the levels of dhCer can reduce the mortality rate of ACLF rats and alleviate liver injury.

简介：Objective:EvaluatingtheauditoryfunctioninpatientswithchronichepatitisCtreatedwithsofosbuvirandribavirin.Methods:Thisstudyinvolved80patientswithchronichepatitisCwhoagreedtoreceivesofosbuvirandribavirin.Allparticipantsweresubjectedtobaselineotologicalandaudiologicalassessmentjustbeforetreatment.Theaudiologicalassessmentincludedstandardpuretoneaudiometry,extendedhighfrequencyaudiometry,immitancemetryandotoacousticemissions(OAEs)(transientanddistortionproduct).Accordingtobaselinehearingthresholdmeasurements,thestudypopulationwasdividedinto2groups.Group1included42patientswithnormalhearingsensitivity(250e8000Hz),andGroup2included38patientswithsensorineuralhearingloss.After24weeksoftherapy,otologicalandaudiologicalassessmentswererepeatedandcomparedbetweenthetwogroupsandbeforeandaftertherapy.Results:Post-treatmenthearingthresholdevaluationshowednosignificantdifferencefrompretreatmentevaluationatalltestedfrequencies.Therewasnostatisticallysignificantdifferencebetweenpreandpost-treatmentotoacousticemissionsresults.Conclusion:TherapywithsofosbuvirandribavirininchronichepatitisChasnonoticeableeffectsoncochlearfunctions.

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简介：Theclinicalexploitationofelectricallystimulatedskeletalmusclecirculationas-sistant(SMCA)isanewtechnologyinlater80’s.Itismainlyusedforadvancedstageheartfailureandprogressiveheartdiseases.Thiskindofheartdiseaseshasahigherincidenceanditsdeathrateoccupiesfirstplaceinallkindsofheartdiseases.Thetreatmentsuchashearttransplantingisrestrictedbycertaincircumstances,soitcannotbeusedingeneral.ThewayofSMCAcanavoidmanydisadvantagessuchasex-

简介：[摘要] 目的：探讨个性化护理干预在慢性心衰护理中的效果。方法：从2020年1月至2021年3月，来我院治疗的102例慢性心衰患者。根据入院编号奇偶性分组：奇数编号的51例进入对照组，实施心内科护理常规；偶数编号的51例进入试验组，进行个性化护理干预。比较护理依从性和生活质量。结果：试验组依从性优良率更高（96.08%vs84.31%）；两组患者干预后的QOL均明显增高，且试验组评分结果较对照组更高，经检验有统计学差异（P＜0.05）。结论：对慢性心衰患者进行个性化护理干预，能提高护理依从性，有助于改善生活质量。