Allicin as add-on therapy for Helicobacter pylori infection: A systematic review and meta-analysis

BACKGROUND Allicin(2-propene-1-sulfinothioic acid S-2-propenyl ester,diallyl thiosulfinate)extracted from garlic,has proven activity against Helicobacter pylori(H.Pylori)infection.In recent years,clinical trials have explored its utility as an add-on therapy with variable outcomes reported.AIM To perform a systemic review of allicin as an add-on treatment for H.Pylori infection and assess its efficacy in randomized controlled trials(RCTs).METHODS Electronic databases including MEDLINE,EMBASE,the Web of Science,the Cochrane Database,the China National Knowledge Infrastructure Database,Chinese VIP Information Databases,Chinese Medical Databases,and the Wan-Fang Database were searched for keywords including“allicin”,“Helicobacter pylori”,“randomized clinical trials”,and their synonyms.A meta-analysis was performed using the fixed-effects model for low heterogeneity and the randomeffects model for high heterogeneity with sensitivity analysis.Bias was evaluated using Egger’s tests.Trial sequential analysis(TSA)was used to evaluate information size and treatment benefits.The Grading of Recommendations Assessment,Development and Evaluation(GRADE)was used to assess the level of quality,and studies were classed as“high quality”,“moderate quality”,“low quality”,and“very low quality”.RESULTS A total of eight RCTs consisting of 867 participants(435 from the allicin group and 432 from the control group)were included.Eradication rate in the allicin group(93.33%,406/435)was significantly higher than that of the control group(83.56%,361/432)[I2=0%,odds ratio(OR)=2.75,95%confidence interval(CI):1.74-4.35,P<0.001].The healing rate of ulcers following H.pylori therapy in the allicin group(86.17%,349/405)was significantly higher than that of the control group(75.87%,305/402)[I2=0%,OR=2.05,95%CI:1.39-3.03,P<0.001].The total remission rate of peptic ulcers across all allicin groups was 95.99%,which was significantly higher than that of controls[95.99%(359/374)vs 89.25%(332/372),I2=0,heterogeneity P=0.84,OR=3.13,95%CI:1.51-6.51,P=0.002].No significant differences in side effects were observed.TSA suggested that the trials were of sufficient standard to draw reliable conclusions.The quality of outcomes including eradication rates and side effects was graded as“very low”due to downgrades for“risk of bias”and“indirectness”.Other outcomes such as ulcer healing rates and total ulcer remission rates were graded as"low"due to downgrades for“risk of bias”.CONCLUSION Allicin as an add-on therapy improves H.pylori eradication,healing of ulcers,and remission of symptoms.These results are suggested to be treated with caution due to limited quality.

mRNA profiles of cytokine receptors in unstimulated peripheral blood mononuclear cells from patients with chronic idiopathic urticaria

This present study was aimed to investigate the roles of the receptors of Th1/Th2 cytokines and chemokines in the pathogenesis of chronic idiopathic urticaria (CIU).Thirty patients with CIU,30 patients with dermographism and 30 healthy controls were randomly enrolled.Reverse transcription-PCR (RT-PCR) was used to analyze the mRNA of cytokine receptors in peripheral blood mononuclear cells (PBMCs).The mRNA levels of tumor necrosis factor receptor (TNFR),interferon-γ receptor (IFN-γR),and interleukin-10 receptor (IL-10R) were statistically increased in the CIU group (P < 0.05),while IL-2R,IL-4R,IL-6R,and IL-13R showed no significant differences between the CIU and other groups.The mRNA levels of CCR3 and CCR6 were statistically increased in the CIU group (P < 0.05).The toll-like receptor 2 (TLR2) mRNA level was significantly lower in the CIU group than the healthy control group (P < 0.05).These findings indicate that the regulation of mRNA of TNFR,IFN-γR,IL-10R,CCR3,CCR6 and TLR2 may be involved in the pathogenesis of CIU.

Changes in the Cytokine Profiles of Patients with Chronic Hepatitis B during Antiviral Therapy

Objective To investigate the changes in the cytokine profiles of chronic hepatitis B(CHB)patients undergoing antiviral treatment.Methods Hepatitis B e antigen(HBeAg)-positive patients were treated with Pegylated interferon(PEGIFN)and entecavir(ETV).Clinical biochemistry and cytokines were detected at baseline and every 3 months.Results In all,200 patients completed 48 weeks of treatment,100 in the PEG-IFN group and 100 in the ETV group.During 3–6 months of treatment,compared with baseline,the PEG-IFN group showed a significant decrease in interferon-gamma(IFN-γ),interleukin-17 A(IL-17 A),interleukin-6(IL-6),interleukin-10(IL-10),and transforming growth factor beta(TGF-β)(P<0.001)and a significant increase in interferon-alpha 2(IFN-α2)(P<0.001).In the ETV group,IL-10 and TGF-β1 decreased significantly(P<0.001).After 3 months,the levels of IFN-α2,IL-17 A,and tumor necrosis factor-alpha(TNF-α)in the PEGIFN group were significantly higher than those in the ETV group(P<0.01).The levels of IL-6 and TGF-β3 were significantly lower than those in the ETV group(P<0.01).After 6 months,the levels of IFN-α2,IFN-γ,and TNF-αin the PEG-IFN group were significantly higher than those in the ETV group(P<0.01),while the levels of IL-6 and TGF-β3 were significantly lower than those in the ETV group(P<0.01).Compared with ETV,PEG-IFN had higher HBeAg and HBsAg disappearance rates.Conclusion During antiviral therapy,a change in the cytokine profile occurred;in the aspect of immune control and functional cure,PEG-IFN was significantly better than ETV.

Hypoxia in acute cardiac injury of coronavirus disease 2019:lesson learned from pathological studies

Coronavirus disease 2019(COVID-19)is an infectious respiratory disease caused by the severe acute respiratory syndrome coronavirus 2(SARS-CoV-2),which has infected 972,303 people and caused 50,322 deaths all over the world according to the latest WHO report.[1]As a highly contagious disease,COVID-19 has killed more people than severe acute respiratory syndrome(SARS)and middle east respiratory syndrome(MERS)combined,despite an relatively low case-fatality rate.[2,3]Although it mainly attacks respiratory system,other systems including cardiovascular system are also influenced by COVID-19.Acute cardiac injury(ACI)is also one of the noteworthy issues which researchers have noticed in several studies.[4–7] .

The Predictive Value of On-treatment Virological Response for Sustained Virological Response in Patients with Chronic Hepatitis C Receiving a Personalized Treatment Program

To investigate the effects of individualised treatment with peginterferon alpha-2a(40 kD)plus ribavirin in Chinese patients with CHC.Methods Total of 297 consecutive Chinese patients were enrolled,including 250 nave cases and 47 cases who were previously treated.Treatment duration was determined according to viral genotypes,prior treatment history and viral responses at week 4,12 and 24.Results Totally,235 patients(79.1%)completed treatment and 186(87.3%)achieved SVR.And 219 out of 289(75.8%)patients achieved HCV RNA negative at week 4(RVR)and 259 of 276(93.8%)at week 12.Among the 164 patients with RVR who completed follow-up,158(96.3%)achieved SVR.Patients with RVR had lower baseline viral loads than patients without RVR(P=0.034).The positive predictive value(PPV)of RVR for SVR was 90.7%(OR 2.10 vs.non-RVR,95%CI:0.50-8.7).Similar outcomes were observed among patients with HCV undetectable at week 12.Conclusions Viral suppression by week 4 is associated with a high rate of treatment success in treatment nave and experienced patients receiving individualized CHC therapy.

An Insight of the First Community Infected COVID-19 Patient in Beijing by Imported Case: Role of Deep Learning-Assisted CT Diagnosis

In the era of coronavirus disease 2019(COVID-19)pandemic,imported COVID-19 cases pose great challenges to many countries.Chest CT examination is considered to be complementary to nucleic acid test for COVID-19 detection and diagnosis.Wie report the first community infected COVID-19 patient by an imported case in Beijing,which manifested as nodular lesions on chest CT imaging at the early stage.Deep Learning(DL)-based diagnostic systems quantitatively monitored the progress of pulmonary lesions in 6 days and timely made alert for suspected pneumonia,so that prompt medical isolation was taken.The patient was confirmed as COVID-19 case after nucleic acid test,for which the community transmission was prevented timely.The roles of DL-assisted diagnosis in helping radiologists screening suspected COVID cases were discussed.

Denaturing high-performance liquid chromatography to diagnose cerebral autosomal dominant arteriopathy in Chinese patients with subcortical infarcts and leukoencephalopathy

BACKGROUND: Notch3 mutations are the molecular genetic foundation for cerebral autosomal dominantarteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL). Of all currently available detec-tion methods, direct sequencing or restriction enzymes are frequently used, but the cost is relatively high,because the Notch3 gene is composed of many exons and mutational sites are widely distributed. Denaturinghigh-performance liquid chromatography (DHPLC) exhibits high efficiency and specificity and has been ap-plied to gene detection. To date, there has no report regarding DHPLC in gene detection of large-scale CA-DASIL families in China. OBJECTIVE: To explore the application and value of DHPLC in the diagnosis of CADASIL by a mutationscreening for Notch3 gene in CADASIL probands and their family members. DESIGN, TIME AND SETTING: A comparative observation was performed at the Genetic DiagnosisLaboratory of Institute of Geriatrics, Xuanwu Hospital of Capital Medical University and the Key Laboratoryfor Neurodegenerative Disease of the Ministry of Education between August 2003 and May 2004. PARTICIPANTS: Fourteen CADASIL patients and their family members, comprising eight males and sixfemales, aged 38-62 years, were included. Their key features included recurrent sub-cortical ischemic eventsand vascular dementia. In addition, 100 healthy physical examinees were selected as controls, including 52males and 48 females, aged 56-72 years, who had no neurodegenerative disease or psychosis, and no historyor high risk for cerebrovascular disease. METHODS: DNA was extracted from white blood cells. Ten hotspots of the Notch3 gene for sequencevariation were first amplified by PCR, and the products were detected using DHPLC. Exons exhibiting avariant in the DHPLC profile underwent another PCR amplification, followed by DNA sequencing to iden-tify the mutation type. In addition, patients with normal DHPLC peak profiles underwent PCR amplificationfor the remaining 13 exons. DNA sequencing was performed for the exons, exhibiting a variation in theDHPLC profile to identify the mutation type. At the same time, Notch3 gene detection was undertaken in 100healthy controls. MAIN OUTCOME MEASURES: Peak profile changes of PCR products under different column tempera-tures during DHPLC detection; Notch3 pathogenic mutations and polymorphisms. RESULTS: Three heterozygous missense mutations at exon3 and exon4, as well as 15 polymorphisms, weredetected in DHPLC patients and their family members. Of the three heterozygous missense mutations,Cys134Tyr, a novel mutation, had not been previously reported in China. None of these mutations was foundin 200 chromosomes of the controls. In addition, DHPLC did not exhibit noticeable changes after a 1 ℃temperature adjustment, while 3 ℃ was too great and might result in DNA melting and indiscernible peakprofile, so 2 ℃ was determined to be appropriate. CONCLUSION: DHPLC technique exhibits efficiency, sensitivity, and specificity in screening for Notch3gene mutations. The optimal column temperature allows for two degrees of fluctuation based on the tem-perature recommended by applied software and peak alterations during screening.

EXPERIENCE OF MINIMALLY INVASIVE TREATMENT IN 520 PATIENTS WITH INTRACR ANIALANEURYSMS

Objective.To summarize the experience of minim ally invasive treatment in 520patie nts with intracranial aneurysms on a retrospective study.Methods.The measures used in the treatment of520patients were reviewed in terms o f timing of surgery,induced-hypotensive anesthesia,b rain protection combined with temporal occlusion of the feeding artery,exter-nal drainage of CSF,dynamic monitoring of intracranial pressure,blood flow velocity,serum osmolality and CT scanning,anti-vasospasm therapy a s well as selected interventional en dovascular embolization of aneurysms.Results.Of the 520patients,485were treated with either direct clipping or endov ascular embolization and35patients were treated non-surgic ally.In 449patients undergoing dir ect clipping and 36undergoing endov ascu-lar embolization,intraoperative r upture of aneurysm occurred in 27(6.0%)and 0%,respectively.Death oc-curred in 13(2.6%),hemiplegia in 8(1.6%),and vegetative state in 2(0.4%).The operative mortality of direct clipping was 3.8%in 210patie nts before 1990and 1.8%in 275patien ts after 1990(36patients undergo-ing endovascular embolization,the operative mortality was 0%).Conclusion.The outcome of patients with intracranial aneurysms can be markedly impr oved and the opera-tive mortality can be lowered by mini mally invasive treatment.

肛管直肠恶性黑色素瘤：42例诊断与治疗

目的：肛管直肠恶性黑色素瘤（AMM的）是一种罕见的和积极的恶性肿瘤，其治疗仍controversial.This调查研究和总结我们的经验诊断，治疗和AMM.Methods误诊：从1980年8月至十二月2009,42与AMM的患者在我们hospital.The这些患者治疗的临床资料进行回顾性分析，包括主要症状，治疗和prognosis.Further免疫抗体分析使用的S - 100蛋白，液压集成块- 45抗原和波形蛋白活性进行了22 specimens.Results：在42例的投诉主要是便血（四十二分之二十三，55.0％），（42分之12，28.6％），肛门群众，改变大便性状（4 / 42，9.5％），和或肛门里急后重疼痛（3 / 42，7.1％）。误诊率是62％（42分之26），最常见的误诊痔（9 / 26，34.6％）组成，息肉（11/26，42.3％）和直肠癌（6 / 26，23.1％）.28例腹会阴切除术，10例行局部广泛切除，3例行姑息性手术，手术和没有operation.After 1，15例患者进行放疗，化疗和21日进行了8个与这两个治疗。 22例1年内死亡，11在2年，5起3年内，并在四余年的平均存活时间为11个月，1 45 months.The的免疫组化结果最长，显示的S - 100蛋白存在于所有22例（100％），液压集成块- 45是在22染色（95.5％）21 22（86.4％）和波形蛋白19。结论：AMM的是一个贫穷的预后和资质的罕见疾病被误诊。便血是最常见的symptom.Immunohistochemical染色利于AMM.Operation诊断是主要治疗，操作类型应该是个性化。

Paraneoplastic Syndromes of Hypercalcemia and Leukocytosis Associated with Colonic Metastases from Squamous Cell Carcinoma of the Lung: a Case Report

Lung cancer is the most common cancer-related death in both men and women in the world. Approximately 25% of all cancer deaths are attributable to lung carcinoma. Moreover, about one-half of patients with lung cancer have metastases at the time of initial diagnosis, most frequently of lymph nodes, adrenals, liver, bone and brain.

Application of Oral Fluid in Measles IgG Antibody Detection for Medical Staff

Measles is an acute,highly contagious,and severe respiratory disease caused by the measles virus.Infected patients can develop fever,maculopapular rashes,pneumonia,encephalitis,and other complications,including death;.A measles epidemic has persisted in China for years.Crosscontamination can easily occur in hospitals,and medical staff is at high risk for cross-infection.

Anatomy and clinical application of suprascapular nerve to accessory nerve transfer

BACKGROUND Loss of motor function in the trapezius muscle is one complication of radical neck dissection after cutting the accessory nerve(AN) during surgery.Nerve repair is an effective method to restore trapezius muscle function,and includes neurolysis,direct suture,and nerve grafting.The suprascapular nerve(SCN) and AN are next to each other in position.The function of the AN and SCN in shoulder elevation and abduction movement is synergistic.SCN might be considered by surgeons for AN reanimation.AIM To obtain anatomical and clinical data for partial suprascapular nerve-to-AN transfer.METHODS Ten sides of cadavers perfused with formalin were obtained from the Department of Human Anatomy,Histology and Embryology,Peking University Health Science Center.The SCN(n = 10) and AN(n = 10) were carefully dissected in the posterior triangle of the neck,and the trapezius muscle was dissected to fully display the accessory nerve.The length of the SCN from the origin of the brachial plexus(a point) to the scapular notch(b point) and the distance of the SCN from the origin point(a point) to the point(c point) where the AN entered the border of the trapezius muscle were measured.The length and branches of the AN in the trapezius muscle were measured.A female patient aged 55 years underwent surgery for partial SCN to AN transfer at Department of Oral and Maxillofacial Surgery,Peking University School and Hospital of Stomatology.The patient suffered from recurrent upper gingival cancer.Radical neck dissection was performed on the right side,and the right AN was removed at the intersection between the nerve and the posterior border of the SCM muscle.One-third of the diameter of the SCN was cut off,and combined epineurial and perineurial sutures were applied between the distal end of the cut-off fascicles of the SCN and the proximal end of the AN without tension.Both subjective and objective evaluations were performed before,three months after,and nine months after surgery.For the subjective evaluation,the questionnaire included the Neck Dissection Impairment Index(NDII) and the Constant Shoulder Scale.Electromyography was used for the objective examination.Data were analyzed using t tests with SPSS 19.0 software to determine the relationship between the length of the SCN and the linear distance.A P value of < 0.05 was considered as statistically significant.RESULTS The whole length of the AN in the trapezius muscle was 16.89 cm.The average numbers of branches distributed in the descending,horizontal and ascending portions were 3.8,2.6 and 2.2,respectively.The diameter of the AN was 1.94 mm at the anterior border of the trapezius.The length of the suprascapular nerve from the origin of the brachial plexus to the scapular notch was longer than the distance of the suprascapular nerve from the origin point to the point where the accessory nerve entered the upper edge of the trapezius muscle.The amplitude of trapezius muscle electromyography indicated that both the horizontal and ascending portions of the trapezius muscle on the right side had better function than the left side nine months after surgery.The results showed that the right-sided supraspinatus and infraspinatus muscles did not lose more function than the left side.CONCLUSION Based on anatomical data and clinical application,partial suprascapular nerve-to-AN transfer could be achieved and may improve innervation of the affected trapezius muscle after radical neck dissection.

中国北京地区部分医院患者疼痛现状调查(英文)

Objective:This study aimed to survey the characteristics and treatments of cancer pain in Beijing hospitals,China.Methods:At 20:00 on December 22,2009,there conducted a questionnaire survey in 2238 patients with malignant tumors of 26 hospitals in Beijing,and the survey results were statistically analyzed.Results:The 531 cases in 2238 patients had pained and 121 cases (22.79%) had outbreak pain with one week.At 20:00 on December 22,2009,199 cases (38%) in the above-mentioned 531 pain patients suffered the moderate to severe pain (pain scores ≥ 4).The number of pain (pain scores ≥ 4) patients in the consecutive three days from December 20 to December 22 were 150.Conclusion:In the 531 cancer pain patients of the surveyed hospitals,38% of the patients were not satisfied with the pain control.Doctors believed that the main reason for pain not controlled was the non-standard treatment,but patients considered to be afraid of addiction.

Advances in the application of auxiliary imaging techniques in parathyroid diseases

Hypoparathyroidism is one of the main complications after total thyroidectomy,severely affecting patients’quality of life.How to effectively protect parathyroid function after surgery and reduce the incidence of hypoparathyroidism has always been a key research area in thyroid surgery.Therefore,precise localization of parathyroid glands during surgery,effective imaging,and accurate surgical resection have become hot topics of concern for thyroid surgeons.In response to this clinical phenomenon,this study compared several different imaging methods for parathyroid surgery,including nanocarbon,indocyanine green,near-infrared imaging techniques,and technetium-99m methoxyisobutylisonitrile combined with gamma probe imaging technology.The advantages and disadvantages of each method were analyzed,providing scientific recommendations for future parathyroid imaging.In recent years,some related basic and clinical research has also been conducted in thyroid surgery.This article reviewed relevant literature and provided an overview of the practical application progress of various imaging techniques in parathyroid surgery.

Prognosis of traumatic spinal cord injury in children:Follow-up of 86 patients

Purpose:The long-term situation of children with spinal cord injury(SCI)was investigated,and suggestions for helping them better return to the society were provided.Methods:SCI patients less than 18 years old hospitalized in Beijing Boai Hospital from January 2011 to December 2020 were retrospectively analyzed.Information including motor function,complications,characteristic changes,self-care abilities,school attendance and social participation were collected by telephone interview and electronic questionnaire.All the answers were statistically analyzed.Results:A total of 86 cases were enrolled,77 girls and 9 boys,with a median injury age of 6 years and 2 months.The follow-up time was 3-130 months.The main cause of trauma in these children was sport injury(66.3%),the thoracic spinal cord was involved the most(91.9%),and complete SCIs accounted for the majority(76.7%).In terms of complications,children with complete SCIs were more likely to have urinary incontinence,constipation and characteristic changes(p<0.05);whereas the incomplete SCIs often have spasticity(p<0.05).As to the daily living abilities,children with incomplete lumbar SCIs were more capable to accomplish personal hygiene,transfer,and bathing independently than those with complete injuries,or cervical/thoracic SCIs,respectively(p<0.05).Moreover,children older than 9 years care more able to dress and transfer independently than the youngers(p<0.05).Wheelchair users accounted for 84.9%and more than half of them were able to propel wheelchair independently,and those who move passively in wheelchairs were mostly introverted kids(p<0.05).Almost all(93.8%)children with incomplete injuries were able to walk independently.Most(79.1%)children continued to attending school,and 41.9%participated in interest classes.Unfortunately,67.4%of the children spent less time playing with their peers than before the injury.Conclusion:SCIs impair physical structures and function of children,affect their independence in daily living,and restrict school attendance and social interaction.Comprehensive rehabilitation after injury is a systematic work.Medical staff and caregivers should not only pay attention to neurological function,but also help them improve self-care abilities.It is also important to balance rehabilitation training and school work and social participation.

Angioarchitecture and prognosis of pediatric intracranial pial arteriovenous fistula

Objective Pial arteriovenous fistulas(PAVFs)are rare and mostly observed in children.However,the overall angioarchitecture,clinical features,treatments and long-term prognosis for pediatric patients remain unclear.Methods Clinical data of consecutive 42 pediatric PAVFs were documented and analysed.According to the differences of age distribution and clinical features,they were split into a younger group(≤3 years old;20 cases)and an older group(3-14 years old;22 cases).Results Their mean age was 4.9±3.9 years,and the mean preoperative modified Rankin Scale(mRS)score was 1.64±1.57.Fourteen patients(33.3%)were asymptomatic,followed by epilepsy(21.4%),intracranial haemorrhage(16.7%),hydrocephalus(9.5%),developmental delay(7.1%),intermittent headache(7.1%)and congestive heart failure(4.8%).Annual bleeding rate and rebleeding rate before treatment reached 3.86%and 3.17%.Poor venous drainage including sinus dynamic obstruction(21 cases,50.0%)and sinus occlusion(17 cases,40.48%)were found with high frequency among these patients.Finally,33 cases were cured(78.57%),and 4 cases faced surgery-related complications(9.52%).During 24-140 months’follow-up,the mean mRS score reduced to 0.57±0.40.However,only 22 cases(52.38%)recovered to absolutely normal,and poor venous drainage was the risk factor for patients’incomplete recovery(p=0.028,Exp(B)=14.692,95%CI 1.346 to 160.392).Compared with the older group,younger group showed more chronic symptoms,more secondary pathological changes,more times treatment and worse prognosis(p=0.013,0.002,0.000 and 0.032,respectively).Conclusions Pediatric PAVF has different angioarchitectures,clinical features and prognoses in different age groups.Poor venous drainage is an important factor leading to poor prognosis,and it accounts for incomplete recovery in nearly half of patients.

连续性肾脏替代疗法对老年难治性心衰患者多器官的保护作用

目的观察连续性肾脏替代疗法（CRRT）对改善老年难治性心力衰竭（心衰）患者心功能的疗效,以及对肝、肾、肺、脑等多个脏器是否存在保护作用。方法收集我院2009-2014年老年难治性心衰患者（≥60岁）共188例,其中108例仅接受传统治疗,80例接受传统疗法联合CRRT治疗。传统联合CRRT治疗组在CRRT前（当天）及CRRT后1周分别评估患者心功能、胸部X线、脑电图,以及检验血清天门冬氨酸氨基转移酶（AST）、丙氨酸氨基转移酶（ALT）、血肌酐（SCr）。传统组在相应时间同时行同样评估。结果传统联合CRRT组NYHA心功能分级（P=0.007）、AST（P=0.004）、ALT（P=0.024）、SCr（P=0.046）水平以及脑电异常活动发生率（P=0.037）均较CRRT前下降,而射血分数（EF）值（P=0.019）较CRRT前上升;与传统组比较,其NYHA分级明显改善（P〈0.001）,EF值上升（P=0.018）,AST（P=0.004）、ALT（P=0.039）、SCr（P=0.032）水平均有所下降,且传统联合CRRT组肺炎（P〈0.001）、脑电活动好转率（P=0.034）均显著高于传统组。结论 CRRT可改善老年难治性心衰患者心功能,并可减少或改善肝、肾、肺、脑等多个器官并发症的出现或损伤程度,对多个器官具有保护作用。

Economic analysis in admitted patients with acute exacerbation of chronic obstructive pulmonary disease

背景：在北京的长期的妨碍的肺的疾病(AECOPD ) 的尖锐恶化的社会经济的负担充分没被理解。学习与 AECOPD 和联系因素在病人调查了住院费用。方法：一个多中心，回顾的学习包括二所水平 III 医院和二所水平 II 医院在北京在四所医院里被进行。有 AECOPD 的病人承认了到在 1 月之间的医院，在 2006 的 12 月被注册。住院花费了，它与疾病严厉和治疗的关系被分析。结果：完全， 439 个病人与 294 个人(67.0%) 和吝啬的年龄一起被注册 73.4 年。吝啬的医院停留是 20.7 天。204 个病人(46.5%) 的一个总数有呼吸衰竭， 153 (34.9%) 与肺性心病， 123 (28.0%) 与冠的动脉疾病， 231 (52.6%) 与高血压， 70 (15.9%) 与脑血管的疾病并且 32 (7.3%) 与肾衰竭。到全部的费用的药费用的百分比是最高(71.2%) ，由实验室费用(16.7%) 列在后面，治疗费用(9.7%) ，氧费用(7.3%) ，辐射学费用(4.5%) ，考试费用(4.5%) ，床费用(4.1%) 。关联分析证明费用断然与年龄被相关，住院天，合作病态象呼吸衰竭和肺性心病那样，高血压。321 个病人进一步被分析。住院费用与非侵略的通风在病人增加了(P 【 0.01 ) ，侵略机械通风(P 【 0.01 ) ， ICU 停留(P 【 0.01 ) ，抗菌素(P 【 0.05 ) ，全身的类固醇(P 【 0.01 ) ，并且差的预后(P 【 0.05 ) 。关联分析证明住院费用否定地与百分比被相关在 1 秒( FEV ( 1 )%)的强迫的吐气的体积( r =-0.149, P 【 0.05 )， pH ( r =-0.258, P 【 0.01 )，并且 PaO ( 2 )( r =-0.131, P 【 0.05 )，断然与 PaCO ( 2 )相关( r = 0.319 ， P 【 0.01 )，非侵略的正压通风( r = 0.375 ， P 【 0.01 )并且持续时间( r = 0.463 ， P 【 0.01 )，侵略机械通风( r = 0.416 ， P 【 0.01 )并且持续时间( r = 0.511 ， P 【 0.01 )， ICU 留下来( r 0.390 ， P 【 0.01 )并且持续时间( r 【 0.05 )并且全身的类固醇( r = 0.202 ， P 【 0.01 )。结论：AECOPD 在保健资源利用上有大影响。疾病严厉，非侵略或侵略的通风的使用， ICU 停留和抗菌素和全身的类固醇的用法是住院费用的主要决定因素。针对减少尖锐恶化愿望的频率的长期的常规处理降低长期的妨碍的肺的疾病(COPD ) 的社会、经济的负担。

Deep inferior epigastric perforator flap for breast reconstruction:experience with 43 flaps

在过去的十年的背景，在那里在乳房切除术以后一直在增加胸重建。为一个乳房的重建的理想的材料是脂肪和皮肤。横向的权利 abdominis myocutaneous (电车) 拍动直到最近是为胸重建的标准答案。腹的墙功能是为在有电车拍动的胸重建的整形外科医生的一颗主要担心。免费拍动给整个权利 abdominis 肌肉，仅仅包括皮和脂肪，因此保存足够的腹的墙胜任的深劣等的腹上部的穿孔机(DIEP ) 。这研究的目的是与在2000年3月和2005年8月之间的 DIEP flap.Methods 在胸重建总结我们的经验， 43 胸重建的一个总数被我们的外科医生用 DIEP 拍动在 40 个病人上执行( 3 个病人有双边的过程)，他们中的 14 个是立即的手术， 26 被推迟。腹的功能，对施主地点的满足和重建的胸，和感觉恢复在病人的吝啬的年龄是的 follow-up.Results 期间分别地被估计 38.6 年(范围， 28-50 ) 。拍动的尺寸是 11