Total-and lipid-associated sialic acid in serum and thrombocytes in patients with chronic heart failure

ObjectivesTo investigate and discuss the total-, lipid-associated, and thrombocyte-sialic acid levels in chronic heart failure (CHF) patients.Design and methodsThirty-one chronic heart failure patients and 38 healthy controls were included in the study. Serum total sialic acid (TSA), lipid associated sialic acid (LASA), thrombocyte sialic acid (TrSA) were determined together with the traditional inflammation and prognostic markers.ResultsSerum TSA levels were significantly higher in patient group (3.08 ± 0.33 mmol/L) than control group (2.60 ± 0.17 mmol/L). Serum LASA, homocysteine, high-sensitivity CRP, brain natriuretic peptide and erythrocyte sedimentation rate were also significantly higher in patient group. TrSA levels were not significant between the groups.ConclusionTSA and LASA levels increase in CHF, independent from coronary artery disease. TrSA levels were not found to be a prognostic or valuable marker for CHF patients. Acute phase response and lipid associated portions of SA are thought to be responsible for SA rise in CHF.     

Pediatric urolithiasis with renal failure: Siut experience

PurposePediatric urolithiasis is endemic in Pakistan and constitutes about 13% of all urolithiasis cases. Urolithiasis associated with renal failure is one of the most important cause of pediatric ESRD in Pakistan.Material and methodsRetrospective analysis of 402 children with urolithiasis and associated renal failure. Ultrasound was the mainstay of radiological diagnosis and assessment.Results402 patients, age ranged between 9 months to 14 years with male female ratio of 2:1. More than 50% had a positive family history of stone disease. Apart from obstruction and infection, poor socioeconomic status (89%), rural residence (66%), neglect and delay in acquiring treatment led to renal failure in these patients. The most common signs and symptoms were fever (56.7%), flank pain (55.2%), shortness of breath (38%) and vomiting (38.3%). 105 (26%) were anuric at presentation and 297 (74%) non-anuric. More than 60% of these patients had bilateral stones and associated urinary tract infection. The initial management of these patients required dialysis mostly peritoneal dialysis in small children. Percutaneous nephrostomy with or with out dialysis was also the main stay of initial management especiallyfor those presenting with a pyonephrosis. In some “Double J” stents were also placed to relieve obstruction. Details of operative procedures for definitive treatment and type of stones will be provided in presentation.ConclusionsAbout 70% of the patients had good recovery of renal function. These good results were achieved because of the provision of free high technological treatment to all our patients under one roof with close co-operation of pediatric urology, nephrology and intensive care teams.     

营养不良的胃癌患者术后肠内营养与肠外营养效果比较

目的:观察肠内营养(EN)与肠外营养(PN)对营养不良的胃癌患者术后临床恢复的影响.方法:选取经主观综合性营养评估法(SGA)评价为中、重度营养不良的胃癌患者58例,随机分为EN组和PN组各29例,共治疗7 d.观察治疗期间感染发生情况,记录患者肛门排气时间和术后留院时间.手术前后均测量体质量指数(BMI),同时抽取静脉血检测前白蛋白(PA)、血红蛋白(HG)和白蛋白(AL).结果:2组感染率差异无统计学意义(P＞0.05),EN组肛门排气时间提前(P＜0.05),术后留院时间明显缩短(P＜0.05).EN组术后BMI和PA明显高于PN组(P＜0.05).结论:EN治疗营养不良的胃癌患者术后临床恢复多个方面均优于PN治疗.     

某医院泌尿道医院感染的分布与长期趋势分析

目的：研究某医院1993年至2000年住院患者泌尿道医院感染的分布及其发病率变动趋势.方法：采用前瞻性调查的方法监测某医院1993年至2000年的所有住院患者泌尿道医院感染发生情况.结果：1993年至2000年该医院住院手术患者共126 665例,其中377例发生泌尿道医院感染,感染发病率为0.30%.1993年至2000年各年份泌尿道医院感染发病率分别为0.63%、0.44%、0.29%、0.41%、0.23%、0.21%、0.21%、0.13%,呈逐年下降趋势.泌尿外科、其他外科、内科、妇科、产科、儿科、五官科各科室的泌尿道医院感染发病率分别为1.79%、0.43%、0.29%、0.62%、0.11%、0.11%、0.02%.1993年至2000年产科、五官科、儿科泌尿道医院感染发病率无明显下降趋势,泌尿外科、妇科、内科、其他外科泌尿道医院感染发病率呈下降趋势.男性、女性泌尿道医院感染发病率分别为：0.29%、0.31%.1993年至2000年男性、女性泌尿道医院感染发病率呈下降趋势.婴儿、幼儿、少年、成年、老年组的泌尿道医院感染发病率分别为0.00%、0.18%、0.15%、0.25%、0.47%,老年组显著高于其他组.除婴儿组各年泌尿道医院感染发病率均为0.00%、幼儿组发病率变化差异无统计学意义,其他各组泌尿道医院感染发病率呈明显下降趋势.春、夏、秋、冬4季的泌尿道医院感染发病率分别为：0.45%、0.60%、0.36%、0.32%,夏季的发病率明显高于其他季节.4个季节的泌尿道医院感染发病率均呈显著下降趋势.结论：不同亚人群泌尿道感染发病率明显不同.总泌尿道医院感染发病率呈下降趋势.总泌尿道医院感染发病率逐渐下降趋势归因于大多数亚人群泌尿道医院感染发病率的下降.系统的医院感染监测可有效降低泌尿道医院感染率.     

Nutritional Risk Assessment by Scored Patient-Generated Subjective Global Assessment Associated with Demographic Characteristics in 23,904 Common Malignant Tumors Patients

Malnutrition is a problem affecting tumor patients greatly. This study aims to investigate whether demographic characteristics are related to the malnutrition of cancer patients. Twenty-three thousand nine hundred and four (23,904) patients with 16 common malignant tumors were enrolled in the study. Patient Generated Subjective Global Assessment (PG-SGA) was used as a screening tool to assess the nutritional risk of patients and analysis of variance was used to compare PG-SGA scores of patients. Correlations between PG-SGA scores and demographic characteristics were evaluated by correlation analysis. We observed that 57.88% tumor patients had some degree of malnutrition (score ≥4) and only 20.61% were well-nourished (score 0–1). Screening scores were higher among older patients for most of the tumors. PG-SGA scores showed the significant difference between females and males in some tumors. In addition, the PG-SGA scores of some tumors were significantly different in various types of medical insurances, education levels, occupations, regions, and nationalities. Correlation analysis indicated the existence of associations between PG-SGA scores and demographic characteristics. Understanding the distribution of nutritional risk of tumor patients and the correlations between the PG-SGA scores and demographic characteristics could help identify subgroups who may benefit from targeted interventions to improve the effect of clinical treatment and the quality of life for oncology patients.     

Valproic acid induced liver injury: An insight into molecular toxicological mechanism

Valproic acid (VPA) is an anti-seizure drug that causes idiosyncratic liver injury. 2-propyl-4-pentenoic acid (Δ⁴VPA), a metabolite of VPA, has been implicated in VPA-induced hepatotoxicity. This review summarizes the pathogenesis involved in VPA-induced liver injury. The VPA induce liver injury mainly by i) liberation of Δ⁴VPA metabolites; ii) decrease in glutathione stores and antioxidants, resulting in oxidative stress; iii) inhibition of fatty acid β-oxidation, inducing mitochondrial DNA depletion and hypermethylation; a decrease in proton leak; oxidative phosphorylation impairment and ATP synthesis decrease; iv) induction of fatty liver via inhibition of carnitine palmitoyltransferase I, enhancing nuclear receptor peroxisome proliferator-activated receptor-gamma and acyl-CoA thioesterase 1, and inducing long-chain fatty acid uptake and triglyceride synthesis. VPA administration aggravates liver injury in individuals with metabolic syndromes. Therapeutic drug monitoring, routine serum levels of transaminases, ammonia, and lipid parameters during VPA therapy may thus be beneficial in improving the safety profile or preventing the progression of DILI.     

双氯芬酸胆碱滴眼液对兔眼炎症模型抗炎效果观察

目的；观察双氯芬酸胆碱滴眼液的抗炎效果。方法：新西兰大白兔36只，随机分为3组，分别用辣椒酊、斑蝥酊和电烫伤刺激兔眼致炎症模型，1.0g/L双氯芬酸胆碱滴眼滴眼，以醋酸可的松滴眼液和生理盐水为对照，观察其对角膜、虹膜、结膜炎的治疗效果。结果：1.0g/L双氯芬酸胆碱滴眼液可显著减轻刺激引起的兔眼前节炎症反应的强度，消除炎症反应积分与醋酸可的松滴眼液相似。结论：双氯芬酸胆碱滴眼液可作为一种新的非甾体抗炎滴眼药进行开发应用。     

Impact of neoadjuvant chemotherapy on the postoperative pathology of locally advanced cervical squamous cell carcinomas: 1:1 propensity score matching analysis

ObjectiveTo assess the impact of neoadjuvant chemotherapy on postoperative pathology for stage IB2 and IIA2 cervical squamous cell carcinoma.MethodsPostoperative pathology was compared between patients who received neoadjuvant chemotherapy followed by radical hysterectomy (NACT group) and patients who received upfront radical hysterectomy (URH group). Then, patients in the NACT group were divided into a chemotherapy-sensitive group and a chemotherapy-insensitive group according to their response to chemotherapy.ResultsAfter 1:1 propensity score matching (PSM), the positive rates of lymphovascular space invasion (LVSI) (7.9% vs 17.7%, P = 0.001) and cervical deep stromal invasion (60.4% vs 76.2%, P < 0.001) in the NACT group were significantly lower than those in the URH group, while the positive rates of parametrial invasion, lymph node metastasis, and vaginal margin invasion were not significantly different between the two groups. The rate of positive lymph node metastasis in the chemotherapy-sensitive group was significantly lower than that in the URH group (18.1% vs 26.5%, P = 0.037).ConclusionAmong patients with stage IB2 and IIA2 cervical squamous cell carcinomas, NACT can reduce the positive rate of intermediate-risk factors, such as deep cervical stromal invasion and LVSI, but cannot reduce the positive rate of high-risk factors. For patients who are chemotherapy sensitive, NACT can reduce the positive rate of lymph node metastasis.