AIM:To evaluate the efficacy and safety of tenofovir disoproxil fumarate(TDF) for chronic hepatitis B(CHB) patients after multiple failures.METHODS:A total of 29 CHB patients who had a suboptimal response or developed...AIM:To evaluate the efficacy and safety of tenofovir disoproxil fumarate(TDF) for chronic hepatitis B(CHB) patients after multiple failures.METHODS:A total of 29 CHB patients who had a suboptimal response or developed resistance to two or more previous nucleoside/nucleotide analogue(NA) treatments were included.Study subjects were treated with TDF alone(n = 13) or in combination with lamivudine(LAM,n = 12) or entecavir(ETV,n = 4) for ≥ 6 mo.Complete virologic response(CVR) was defined as an achievement of serum hepatitis B virus(HBV) DNA level ≤ 60 IU/mL by real-time polymerase chain reaction method during treatment.Safety assessment was based on serum creatinine and phosphorus level.Eleven patients had histories of LAM and adefovir dipivoxil(ADV) treatment and 18 patients were exposed to LAM,ADV,and ETV.Twenty-seven patients(93.1%) were hepatitis B e antigen(HBeAg) positive and the mean value of the baseline serum HBV DNA level was 5.5 log IU/mL ± 1.7 log IU/mL.The median treatment duration was 16 mo(range 7 to 29 mo).RESULTS:All the patients had been treated with LAM and developed genotypic and phenotypic resistance to it.Resistance to ADV was present in 7 patients and 10 subjects had a resistance to ETV.One patient had a resistance to both ADV and ETV.The cumulative probabilities of CVR at 12 and 24 mo of TDF containing treatment regimen calculated by the Kaplan Meier method were 86.2% and 96.6%,respectively.Although one patient failed to achieve CVR,serum HBV DNA level decreased by 3.9 log IU/mL from the baseline and the last serum HBV DNA level during treatment was 85 IU/mL,achieving near CVR.No patients in this study showed viral breakthrough or primary non-response during the follow-up period.The cumulative probability of HBeAg clearance in the 27 HBeAg positive patients was 7.4%,12%,and 27% at 6,12,and 18 mo of treatment,respectively.Treatment efficacy of TDF containing regimen was not statistically different according to the presence of specific HBV mutations.History of prior exposure to specific antiviral agents did not make a difference to treatment outcome.Treatment efficacy of TDF was not affected by combination therapy with LAM or ETV.No patient developed renal toxicity and no cases of hypophosphatemia associated with TDF therapy were observed.There were no other adverse events related to TDF therapy observed in the study subjects.CONCLUSION:TDF can be an effective and safe rescue therapy in CHB patients after multiple NA therapy failures.展开更多
Purpose： To analyze the influence of psychological nursing to the treatment and recovery of elderly patients. Method： It conducts different care methods according to different psychological problems and disease type...Purpose： To analyze the influence of psychological nursing to the treatment and recovery of elderly patients. Method： It conducts different care methods according to different psychological problems and disease types. Result： Through effective psychological care, it can promote the recovery of patients＇ diseases. Conclusion： Implementing effective psychological care to the patients is good for the treatment and recovery of diseases, which shortens the time of effectively controlling diseases.展开更多
Purpose： Ocular trauma is the third leading cause of hospitalization in ophthalmology patients, imposing direct and indirect physical and psychological costs on society. This study aims to investigate the status of o...Purpose： Ocular trauma is the third leading cause of hospitalization in ophthalmology patients, imposing direct and indirect physical and psychological costs on society. This study aims to investigate the status of ocular trauma in hospitalized patients in the industrialized city of Kashan in 2011. Methods： This cross-sectional descriptive applied study was conducted in 2012 on patients hospitalized for ocular trauma. Data, including age, gender, occupation, education, timing of admission following accident, location of accident, type of injury, damaging instrument, and type of trauma, were collected using a questionnaire designed by a trained nurse, and analyzed using SPSS-lfi software by means of means _＋ standard deviation, frequency, and percentage for descriptive data and t-test, one-way analysis of variance, Chi-square and Fisher exact test for analysis at significance level ofp 〈 0.05. Results： In total, 82 patients were hospitalized due to ocular traumas. The majority of patients were male （65 patients, 79.3%）. Their mean age was （25.4 ± 21.4） years, with an age range of 20-40 years （30 patients, 36.6%）. Hyphema was the most common injury （26 patients, 25.5%）, home was the most frequent incident location （32 patients, 39%）, and knife or other cutting tools were mostly responsible for injuries （18 patients, 21.9%）. Patients were hospitalized for 1-6 days, and the average length of stay in hospital was 2.63 days. Frequency distribution of injuries based on whether or not ruptures differed significantly among different age groups. Conclusion： The majority of ocular trauma occurred in young males. Knife was the principle culprit for eye injuries, followed by vehicles. To reduce such incidents, it is recommended that people be trained to avoid high-risk behaviors when using knives and to better heed driving rules and regulations.展开更多
OBJECTIVE: Symptom patterns are an important diagnostic concept in terms of Traditional Chinese Medicine. Although symptom patterns and healthrelated quality of life(HRQOL) are common diagnostic measures for cancer pa...OBJECTIVE: Symptom patterns are an important diagnostic concept in terms of Traditional Chinese Medicine. Although symptom patterns and healthrelated quality of life(HRQOL) are common diagnostic measures for cancer patients, the association between them has not been studied. This study aimed to describe the changes in the pattern of symptoms of Yang-deficiency, Yin-deficiency, blood stasis, and HRQOL before and after chemotherapy,and to examine the association between the patterns and the cancer patients' HRQOL.METHODS: A panel study was undertaken with 123 cancer patients who were about to begin their first course of chemotherapy at four teaching hospitals in Taiwan. A structured questionnaire was used before and after chemotherapy. HRQOL was assessed using the Medical Outcomes Survey Short-Form 36. The Traditional Chinese Medical Constitutional Scale was used to measure Yang-deficiency, Yin-deficiency, and blood stasis patterns,with higher scores indicating a larger deficiency.RESULTS: The patients had significantly worse scores for Yang-deficient pattern, Yin-deficiency pattern, blood stasis pattern, and the physical components of HRQOL after chemotherapy compared with before chemotherapy. The HRQOL scores correlated significantly with Yang-deficiency, Yin-deficiency, and the blood stasis pattern scores. A generalized estimating equation model showed that the HRQOL scores were significantly worse after chemotherapy compared with before chemotherapy for the physical component, but not for the mental component. Blood stasis pattern was significantly associated with a decreased HRQOL in both the physical and mental components. A hemoglobin level < 12 g/d L was associated with a worse physical component of HRQOL.CONCLUSION: The Yang-deficiency, Yin-deficiency,and blood stasis patterns were all associated with lower HRQOLincancerpatientsafterchemotherapy.展开更多
Objective:To probe into the relation between magnetic resonance imaging(MRI) signal classifications and TCM syndromes in femoral head necrosis patients,so as to provide reference for TCM diagnosis of this disease.Meth...Objective:To probe into the relation between magnetic resonance imaging(MRI) signal classifications and TCM syndromes in femoral head necrosis patients,so as to provide reference for TCM diagnosis of this disease.Methods:Refering to the criteria for TCM syndrome types of necrosis of the femoral head described in "The Guiding Principles of Clinical Studies of New Chinese Drugs" and Shimizu and Mitchell's MRI signal classifications,MRI signal classifications between different TCM syndrome types were compared.Results:The Shimizu signal classification of different TCM syndrome types had statistically significant difference(P=0.04);Both T2WI+fs and Mitchell signal classifications of different TCM syndrome types had no statistical by significant differences(P=0.42 or P=0.15).Conclusion:There is a certain correlativity of TCM syndrome types of necrosis of the femoral head with T1WI signal classification of MRI.MRI signal classification may contribute to objectivity in TCM syndrome typing of this disease.展开更多
Objective To investigate relationships of polymorphisms in six genes （ GHR, IGF-1, IGF-1R, IGFBP-3, JAK2, and STAT5b） in the growth hormone （GH）/insulin-like growth factor-1 （IGF-1） axis with idiopathic short st...Objective To investigate relationships of polymorphisms in six genes （ GHR, IGF-1, IGF-1R, IGFBP-3, JAK2, and STAT5b） in the growth hormone （GH）/insulin-like growth factor-1 （IGF-1） axis with idiopathic short stature （ISS） in the Chinese Han population. Methods A case- control study was carried out on a cohort of 198 ISS patients and 306 healthy controls. A total of 106 tagging single nucleotide polymorphisms （tagSNPs） from the six genes were selected from the HapMap （haplotype map of the human genome ） Han Chinese in the Beijing subset. Results of genotyping conducted by high- throughput lllumina GoldenGateTM Assay were analyzed by statistical software. Results Both individual tagSNPs and haplotypes showed an association with 1SS in the Han Chinese population （ P 〈 O. 05 ）. For each single test, both allele and genotype were tested. By allele frequency analysis, six positive SNP sites （ rsNo. 1, rsNo. 2, rsNo. 3, rsNo. 4, rsNo. 5, and rsNo. 6） of 3 genes （ JAK2, 1GF-1R, and GHR） were found having associations with ISS. By genotype frequency analysis, there were significant differences between the patient and control groups in the following SNP sites： 4 sites in JAK2 gene （ rsNo. 1, rsNo. 2, rsNo. 3, and rsNo. 4） and 1 site in GHR gene （ rsNo. 6）. The risk which affected ISS was found related to the JAK2 gene in 4 sites （ increase in rsNo. 1 and decrease in rsNo. 2, rsNo. 3, and rsNo. 4 ） and to the GHR gene in 1 site （decrease in rsNo. 6）. They were four haplotypes in gene of IGF-1R as ＂TGC＂, ＂CGCT＂, ＂TA＂, and ＂ CA＂, one haplotype in IGFBP-3 as ＂TA＂, and one haplotype in JAK2 as ＂CTG＂, which revealed high significance for risks of affecting ISS. At last, multivariate logistic regression analysis of specific site rsNo. 6 of the GHR gene revealed that the serum IGF-1 was related to genotypes AA and AC, with genotype CC as the reference （ P =0. 015）. Conclusion Genetic variances in six genes within the GH/IGF-1 axis may be important etiological factors for ISS in the Chinese Han population.展开更多
文摘AIM:To evaluate the efficacy and safety of tenofovir disoproxil fumarate(TDF) for chronic hepatitis B(CHB) patients after multiple failures.METHODS:A total of 29 CHB patients who had a suboptimal response or developed resistance to two or more previous nucleoside/nucleotide analogue(NA) treatments were included.Study subjects were treated with TDF alone(n = 13) or in combination with lamivudine(LAM,n = 12) or entecavir(ETV,n = 4) for ≥ 6 mo.Complete virologic response(CVR) was defined as an achievement of serum hepatitis B virus(HBV) DNA level ≤ 60 IU/mL by real-time polymerase chain reaction method during treatment.Safety assessment was based on serum creatinine and phosphorus level.Eleven patients had histories of LAM and adefovir dipivoxil(ADV) treatment and 18 patients were exposed to LAM,ADV,and ETV.Twenty-seven patients(93.1%) were hepatitis B e antigen(HBeAg) positive and the mean value of the baseline serum HBV DNA level was 5.5 log IU/mL ± 1.7 log IU/mL.The median treatment duration was 16 mo(range 7 to 29 mo).RESULTS:All the patients had been treated with LAM and developed genotypic and phenotypic resistance to it.Resistance to ADV was present in 7 patients and 10 subjects had a resistance to ETV.One patient had a resistance to both ADV and ETV.The cumulative probabilities of CVR at 12 and 24 mo of TDF containing treatment regimen calculated by the Kaplan Meier method were 86.2% and 96.6%,respectively.Although one patient failed to achieve CVR,serum HBV DNA level decreased by 3.9 log IU/mL from the baseline and the last serum HBV DNA level during treatment was 85 IU/mL,achieving near CVR.No patients in this study showed viral breakthrough or primary non-response during the follow-up period.The cumulative probability of HBeAg clearance in the 27 HBeAg positive patients was 7.4%,12%,and 27% at 6,12,and 18 mo of treatment,respectively.Treatment efficacy of TDF containing regimen was not statistically different according to the presence of specific HBV mutations.History of prior exposure to specific antiviral agents did not make a difference to treatment outcome.Treatment efficacy of TDF was not affected by combination therapy with LAM or ETV.No patient developed renal toxicity and no cases of hypophosphatemia associated with TDF therapy were observed.There were no other adverse events related to TDF therapy observed in the study subjects.CONCLUSION:TDF can be an effective and safe rescue therapy in CHB patients after multiple NA therapy failures.
文摘Purpose： To analyze the influence of psychological nursing to the treatment and recovery of elderly patients. Method： It conducts different care methods according to different psychological problems and disease types. Result： Through effective psychological care, it can promote the recovery of patients＇ diseases. Conclusion： Implementing effective psychological care to the patients is good for the treatment and recovery of diseases, which shortens the time of effectively controlling diseases.
文摘Purpose： Ocular trauma is the third leading cause of hospitalization in ophthalmology patients, imposing direct and indirect physical and psychological costs on society. This study aims to investigate the status of ocular trauma in hospitalized patients in the industrialized city of Kashan in 2011. Methods： This cross-sectional descriptive applied study was conducted in 2012 on patients hospitalized for ocular trauma. Data, including age, gender, occupation, education, timing of admission following accident, location of accident, type of injury, damaging instrument, and type of trauma, were collected using a questionnaire designed by a trained nurse, and analyzed using SPSS-lfi software by means of means _＋ standard deviation, frequency, and percentage for descriptive data and t-test, one-way analysis of variance, Chi-square and Fisher exact test for analysis at significance level ofp 〈 0.05. Results： In total, 82 patients were hospitalized due to ocular traumas. The majority of patients were male （65 patients, 79.3%）. Their mean age was （25.4 ± 21.4） years, with an age range of 20-40 years （30 patients, 36.6%）. Hyphema was the most common injury （26 patients, 25.5%）, home was the most frequent incident location （32 patients, 39%）, and knife or other cutting tools were mostly responsible for injuries （18 patients, 21.9%）. Patients were hospitalized for 1-6 days, and the average length of stay in hospital was 2.63 days. Frequency distribution of injuries based on whether or not ruptures differed significantly among different age groups. Conclusion： The majority of ocular trauma occurred in young males. Knife was the principle culprit for eye injuries, followed by vehicles. To reduce such incidents, it is recommended that people be trained to avoid high-risk behaviors when using knives and to better heed driving rules and regulations.
基金the Committee on Chinese Medicine and Pharmacy,Ministry of Health and Welfare,Taiwan Traditional Chinese Medicine Diagnosis of Patients with Cancer Receiving Chemotherapy:Based on Meridian Energy Results(First Year),No.CCMP98-RD-034Traditional Chinese Medicine Diagnosis of Patients With Cancer Receiving Chemotherapy:Based on Meridian Energy Results(Second Year),No.CCMP99-RD-106Construction of Care Model of Integrative Medicine for Patients With Cancer,No.CCMP100-RD-026
文摘OBJECTIVE: Symptom patterns are an important diagnostic concept in terms of Traditional Chinese Medicine. Although symptom patterns and healthrelated quality of life(HRQOL) are common diagnostic measures for cancer patients, the association between them has not been studied. This study aimed to describe the changes in the pattern of symptoms of Yang-deficiency, Yin-deficiency, blood stasis, and HRQOL before and after chemotherapy,and to examine the association between the patterns and the cancer patients' HRQOL.METHODS: A panel study was undertaken with 123 cancer patients who were about to begin their first course of chemotherapy at four teaching hospitals in Taiwan. A structured questionnaire was used before and after chemotherapy. HRQOL was assessed using the Medical Outcomes Survey Short-Form 36. The Traditional Chinese Medical Constitutional Scale was used to measure Yang-deficiency, Yin-deficiency, and blood stasis patterns,with higher scores indicating a larger deficiency.RESULTS: The patients had significantly worse scores for Yang-deficient pattern, Yin-deficiency pattern, blood stasis pattern, and the physical components of HRQOL after chemotherapy compared with before chemotherapy. The HRQOL scores correlated significantly with Yang-deficiency, Yin-deficiency, and the blood stasis pattern scores. A generalized estimating equation model showed that the HRQOL scores were significantly worse after chemotherapy compared with before chemotherapy for the physical component, but not for the mental component. Blood stasis pattern was significantly associated with a decreased HRQOL in both the physical and mental components. A hemoglobin level < 12 g/d L was associated with a worse physical component of HRQOL.CONCLUSION: The Yang-deficiency, Yin-deficiency,and blood stasis patterns were all associated with lower HRQOLincancerpatientsafterchemotherapy.
文摘Objective:To probe into the relation between magnetic resonance imaging(MRI) signal classifications and TCM syndromes in femoral head necrosis patients,so as to provide reference for TCM diagnosis of this disease.Methods:Refering to the criteria for TCM syndrome types of necrosis of the femoral head described in "The Guiding Principles of Clinical Studies of New Chinese Drugs" and Shimizu and Mitchell's MRI signal classifications,MRI signal classifications between different TCM syndrome types were compared.Results:The Shimizu signal classification of different TCM syndrome types had statistically significant difference(P=0.04);Both T2WI+fs and Mitchell signal classifications of different TCM syndrome types had no statistical by significant differences(P=0.42 or P=0.15).Conclusion:There is a certain correlativity of TCM syndrome types of necrosis of the femoral head with T1WI signal classification of MRI.MRI signal classification may contribute to objectivity in TCM syndrome typing of this disease.
基金Supported by National Natural Science Foundation of China(30771029)
文摘Objective To investigate relationships of polymorphisms in six genes （ GHR, IGF-1, IGF-1R, IGFBP-3, JAK2, and STAT5b） in the growth hormone （GH）/insulin-like growth factor-1 （IGF-1） axis with idiopathic short stature （ISS） in the Chinese Han population. Methods A case- control study was carried out on a cohort of 198 ISS patients and 306 healthy controls. A total of 106 tagging single nucleotide polymorphisms （tagSNPs） from the six genes were selected from the HapMap （haplotype map of the human genome ） Han Chinese in the Beijing subset. Results of genotyping conducted by high- throughput lllumina GoldenGateTM Assay were analyzed by statistical software. Results Both individual tagSNPs and haplotypes showed an association with 1SS in the Han Chinese population （ P 〈 O. 05 ）. For each single test, both allele and genotype were tested. By allele frequency analysis, six positive SNP sites （ rsNo. 1, rsNo. 2, rsNo. 3, rsNo. 4, rsNo. 5, and rsNo. 6） of 3 genes （ JAK2, 1GF-1R, and GHR） were found having associations with ISS. By genotype frequency analysis, there were significant differences between the patient and control groups in the following SNP sites： 4 sites in JAK2 gene （ rsNo. 1, rsNo. 2, rsNo. 3, and rsNo. 4） and 1 site in GHR gene （ rsNo. 6）. The risk which affected ISS was found related to the JAK2 gene in 4 sites （ increase in rsNo. 1 and decrease in rsNo. 2, rsNo. 3, and rsNo. 4 ） and to the GHR gene in 1 site （decrease in rsNo. 6）. They were four haplotypes in gene of IGF-1R as ＂TGC＂, ＂CGCT＂, ＂TA＂, and ＂ CA＂, one haplotype in IGFBP-3 as ＂TA＂, and one haplotype in JAK2 as ＂CTG＂, which revealed high significance for risks of affecting ISS. At last, multivariate logistic regression analysis of specific site rsNo. 6 of the GHR gene revealed that the serum IGF-1 was related to genotypes AA and AC, with genotype CC as the reference （ P =0. 015）. Conclusion Genetic variances in six genes within the GH/IGF-1 axis may be important etiological factors for ISS in the Chinese Han population.
