Objective: To investigate the effects of myocardial enzyme, immune function and inflammatory response by ursodeoxycholic acid combined with bifidobacterium quadruple preparations on hyperbilirubinemia neonatal. Method...Objective: To investigate the effects of myocardial enzyme, immune function and inflammatory response by ursodeoxycholic acid combined with bifidobacterium quadruple preparations on hyperbilirubinemia neonatal. Methods: A total of 100 cases of neonatal hyperbilirubinemia in our hospital from June 2016 to May-2017 were selected and divided into control group and observation group by random number table, 50 cases in each group. Two groups of neonatal were given routine symptomatic treatment. The control group was treated with ursodeoxycholic acid and the observation group was treated with Bifidobacterium tetralogy of live bacteria on the basis of the control group. The two groups of neonatal were both treated for 7 d. The serum levels of CK-MB, CK, LDH, AST, CD3+, CD4+, CD4+/CD8+, CD8+, CRP and TNF-α were measured before and after the treatment of the two groups. Results: Before treatment, there was no significant difference in serum CK-MB, CK, LDH, AST, CD3+, CD4+, CD4+/CD8+, CD8+, CRP and TNF-α levels between the 2 groups. After treatment: 2 groups of serum CK-MB, CK, LDH, AST, CD8+, CRP, TNF-α levels significantly decreased compared with the group before treatment, CD3+, CD4+ and CD4+/CD8+ levels were significantly increased after treatment, and the observation group with serum CK-MB, CK, LDH, AST, CD8 +, CRP, TNF-α levels were significantly lower than the control group, CD3+, CD4+ and CD4+/CD8+ levels were significantly higher than the control group, the differences were statistically significant. Conclusion: Ursodeoxycholic acid combined with Bifidobacterium quadruple viable tablets can can reduce the activity of myocardial enzyme, improve the state of spectrum index of neonatal hyperbilirubinemia.展开更多
Antenatal administration of magnesium sulfate is an important part of the neuroprotective strategy for preterm infants. Strong evidence from five randomized controlled trials and five meta-analyses has demonstrated th...Antenatal administration of magnesium sulfate is an important part of the neuroprotective strategy for preterm infants. Strong evidence from five randomized controlled trials and five meta-analyses has demonstrated that magnesium sulfate, when administered before preterm delivery, significantly reduces the risk of cerebral palsy at two years. Through secondary analyses of randomized controlled trials and other original clinical studies, this state-of-the-art review highlights the absence of serious adverse effects in both pregnant women and neonates, as well as the impact of maternal body mass index and preeclamptic status on the maternal and neonatal magnesium levels, which could influence the magnitude of the neuroprotective effect. Although antenatal magnesium sulfate is a cost-effective strategy, some practice surveys have demonstrated that the use of magnesium sulfate is not sufficient and that its use is heterogeneous, differing among different maternity wards. Since 2010, an increasing number of obstetrical societies have recommended its use to improve the neurological outcomes of preterm infants, especially the International Federation of Gynecology and Obstetrics and World Health Organization in 2015, and France in 2017. Considering the neuroprotective impact of magnesium sulfate when administered before delivery, postnatal administration should be considered, and its effects should be assessed using randomized controlled trials.展开更多
BACKGROUND Acute cardiorenal syndrome type 1(CRS-1)is defined by a rapid cardiac dysfunction leading to acute kidney injury(AKI).Neutrophil gelatinaseassociated lipocalin(NGAL)is expressed on the surface of human neut...BACKGROUND Acute cardiorenal syndrome type 1(CRS-1)is defined by a rapid cardiac dysfunction leading to acute kidney injury(AKI).Neutrophil gelatinaseassociated lipocalin(NGAL)is expressed on the surface of human neutrophils and epithelial cells,such as renal tubule cells,and its serum(sNGAL)and urinary have been used to predict AKI in different clinical settings.AIM To characterize CRS-1 in a cohort of patients with acute heart diseases,evaluating the potentiality of sNGAL as an early marker of CRS-1.METHODS We performed a retrospective cohort,multi-centre study.From January 2010 to December 2011,we recruited 202 adult patients admitted to the coronary intensive care unit(CICU)with a diagnosis of acute heart failure or acute coronary syndrome.We monitored the renal function to evaluate CRS-1 development and measured sNGAL levels within 24 h and after 72 h of CICU admission.RESULTS Overall,enrolled patients were hemodynamically stable with a mean arterial pressure of 92(82-107)mmHg,55/202(27.2%)of the patients developed CRS-1,but none of them required dialysis.Neither the NGAL delta value(AUC 0.40,95%CI:0.25-0.55)nor the NGAL peak(AUC 0.45,95%CI:0.36-0.54)or NGAL cutoff(≥140 ng/mL)values were statistically significant between the two groups(CRS-1 vs no-CRS1 patients).The area under the ROC curve for the prediction of CRS-1 was 0.40(95%CI:0.25-0.55)for the delta NGAL value and 0.45(95%CI:0.36-0.54)for the NGAL peak value.Finally,in multivariate analysis,the risk of developing CRS-1 was correlated with age>60 years,urea nitrogen at admission and 24 h-urine output(AUC 0.83,SE=60.5%SP=93%),while sNGAL was not significantly correlated.CONCLUSION In our population,sNGAL does not predict CRS-1,probably as a consequence of the mild renal injury and the low severity of heart disease.So,these data might suggest that patient selection should be taken into account when considering the utility of NGAL measurement as a biomarker of kidney damage.展开更多
Objective:To determine the effect of physical activity by using the teach-back educational method on hemodialysis patients’quality of life(QOL)and physical ability.Methods:This is a single-blind clinical trial study ...Objective:To determine the effect of physical activity by using the teach-back educational method on hemodialysis patients’quality of life(QOL)and physical ability.Methods:This is a single-blind clinical trial study involving a control group.A total of 90 patients who admitted to the dialysis centers of Beheshti and Besat hospitals in Hamadan were selected using a convenience sampling method and were randomly assigned to intervention(n=45)and control(n=45)groups.Data were collected using a demographic information checklist,a kidney disease QOL questionnaire,and a 6-minute-walk distance(6MWD)checklist.The patients’QOL questionnaire was completed,and the 6MWD was recorded before and at the end of the 2nd,4th,6th,8th,and 12th weeks of the intervention.In the intervention group,the patients were taught to perform physical activities with Pilates stretches in different resistances using the teach-back educational method during dialysis sessions for 12 weeks.Data were analyzed by using the independent t-test and chi-square test using SPSS-22 software.Results:Before the intervention,no differences were observed between the experimental and control groups in terms of demographic characteristics,QOL,and physical ability(P>0.05).The physical ability and QOL levels of patients exercising in the test group were higher than those in the control group after the intervention(P<0.05).Based on the results,the 2 groups significantly differed with regard to the scores of various dimensions of QOL and physical ability after the intervention(P<0.05).Conclusions:Physical activity by using the teach-back method can effectively increase physical ability and improve QOL of hemodialysis patients.Therefore,the recommendations and inclusion of exercise in the dialysis care plan can effectively promote patients’health.展开更多
OBJECTIVE: To determine if the rates of pregnancy complications, preterm birth, small for gestational age, perinatal mortality, and serious neonatal morbidity are higher among mothers aged 35- 39 years or 40 years or ...OBJECTIVE: To determine if the rates of pregnancy complications, preterm birth, small for gestational age, perinatal mortality, and serious neonatal morbidity are higher among mothers aged 35- 39 years or 40 years or older, compared with mothers 20- 24 years. METHODS: We performed a population- based study of all women in Nova Scotia, Canada, who delivered a singleton fetus between 1988 and 2002 (N = 157,445). Family income of women who delivered between 1988 and 1995 was obtained through a confidential linkage with tax records (n = 76,300). The primary outcome was perinatal death (excluding congenital anomalies) or serious neonatal morbidity. Analysis was based on logistic models. RESULTS: Older women were more likely to be married, affluent, weigh 70 kg or more, attend prenatal classes, and have a bad obstetric history but less likely to be nulliparous and to smoke. They were more likely to have hypertension, diabetes mellitus, placental abruption, or placenta previa. Preterm birth and small- for- gestational age rates were also higher; compared with women aged 20- 24 years, adjusted rate ratios for preterm birth among women aged 35- 39 years and 40 years or older were 1.61 (95% confidence interval [CI] 1.42- 1.82; P < .001) and 1.80 (95% CI 1.37- 2.36; P < .001), respectively. Adjusted rate ratios for perinatal mortality/morbidity were 1.46 (95% CI 1.11- 1.92; P = .007) among women 35- 39 years and 1.95 (95% CI 1.13- 3.35; P = .02) among women 40 years or older. Perinatal mortality rates were low at all ages, especially in recent years. CONCLUSION: Older maternal age is associated with relatively higher risks of perinatal mortality/morbidity, although the absolute rate of such outcomes is low.展开更多
Objective: To ascertain the role of serum potassium levels in predicting clinical outcomes in diarrhea-associated hemolytic uremic syndrome (HUS D+). Methods: We reviewed clinical and laboratory data from HUS D+ patie...Objective: To ascertain the role of serum potassium levels in predicting clinical outcomes in diarrhea-associated hemolytic uremic syndrome (HUS D+). Methods: We reviewed clinical and laboratory data from HUS D+ patients at our tertiary care institution from 2001 to 2008. Serum potassium concentration at presentation and during the acute phase of acute renal failure were recorded and related to laboratory parameters and clinical outcomes. Results: 15 HUS D+ cases were identified. E. coli 0157:H7 was found in 9/15 cases (70%). Potassium levels were not predictive of clinical outcomes. Normal serum potassium levels were found in the majority of patients. Potassium levels <3.6 mmol/L were evident at presentation in 3/15 patients (23%), and no patient manifested hyperkalemia even when creatinine levels were concurrently increase. Conclusions: This study suggests the presence of vigorous compensatory mechanisms in the homoestasis of serum potassium levels during HUS D+ disease since neither the increase stool volumes associated with diarrhea nor the presence of renal failure resulted in clinically significant changes in serum potassium levels.展开更多
Objective:To investigate the effects of Gongliuxiao Capsule on inflammatory factors, tumor markers, sex hormones and vascular endothelial function in patients with uterine fibroids. Methods:130 patients with uterine f...Objective:To investigate the effects of Gongliuxiao Capsule on inflammatory factors, tumor markers, sex hormones and vascular endothelial function in patients with uterine fibroids. Methods:130 patients with uterine fibroids admitted to our hospital from October 2015 to March 2017 were enrolled. According to the treatment, they were divided into single treatment group and combined medication group, with 65 cases in each group. The changes of inflammatory factors, tumor markers, sex hormones and vascular endothelial function were compared before and after treatment in the two groups.Results: There were no significant differences in the levels of sex hormones, inflammatory factors, tumor markers and vascular endothelial function between the two groups (P>0.05). The levels of sex hormones E2, P, FSH and LH, the levels of inflammatory factors TNF-α, MMP-9 and IGF-1, tumor markers CA125, CA19-9 and vascular endothelial function VEGF and b-FGF were significantly lower in the two groups (P<0.05). The levels of E2, P, FSH and LH in the combined drug groupswere (154.12±16.20) pmol/L, (9.12±1.02) μg/L, (13.84±1.42) U/L and (12.77±1.36) U/L, respectively,which were significantly lower than the single drug group level (P<0.05). The levels of CA125 and CA19-9 in the combined drug group were (27.89±2.88) U/mL and (28.09±3.04) U/mL, respectively, which were significantly lower than the single drug group (P<0.05). The levels of TNF-α, MMP-9 and IGF-1 in the combined drug group were (24.16±2.63) ng/L, (159.22±16.82) μg/L and (69.75±7.09) μg/L, respectively, which were significantly lower than the single drug group(P<0.05). The levels of VEGF and b-FGF in the combination group were (138.29±14.32) μg/L and (98.59±10.02) μg/L, respectively, which were significantly lower than the single drug group (P<0.05).Conclusion:Mifepristone combined with Gongliuxiao Capsule can alleviate endocrine disorders, relieve inflammatory stress response and improve vascular endothelial function in patients with uterine fibroids. It is worthy of clinical application.展开更多
Background Children and adolescents with chronic physical conditions have an increased probability of mental health problems,which may be partly attributed to the variations in play behavior.This study explores the as...Background Children and adolescents with chronic physical conditions have an increased probability of mental health problems,which may be partly attributed to the variations in play behavior.This study explores the associations between having a chronic physical condition,play behavior,and having mental health problems.Methods Data from the Generation R Study were analyzed,a population-based,prospective cohort in the Netherlands.Chronic physical conditions were typically identified before six years of age.Play behavior was assessed at ages 6 and 10.Mental health problems were measured with the Child Behavior Checklist at 14 years of age.Logistic,ranked-order,and linear regression analyses were used to examine direct associations,and mediation analyses were used to investigate indirect paths.P values were false discovery rate adjusted.Results Of the 4043 included participants,691(17%)had a chronic physical condition.Having a chronic physical condition was associated with more mental health problems and limited activity at the age of six years.Playing sports and engaging in social interactions at age 10 were related to fewer mental health problems at age 14.Limited activity mediated the relationship between having a chronic physical condition and mental health problems(social:mediated_(proportion)=8.33%,95%CI=2.02%;15.7%,P_(adj)<0.001;physical:mediated_(proportion)=7.72%,95%CI=1.73%;19.1%,P_(adj)=0.040).Conclusions Health-related limitations in social and physical activities mediate the relationship between having a chronic physical condition and mental health problems in children.Participation in social and physical activities early in life may be crucial for the mental well-being of children with a chronic physical condition.展开更多
Background Respiratory dysfunctions are an important cause of morbidity and death in cerebral palsy(CP)populations.Respiratory exercises in addition to conventional rehabilitation have been suggested to improve respir...Background Respiratory dysfunctions are an important cause of morbidity and death in cerebral palsy(CP)populations.Respiratory exercises in addition to conventional rehabilitation have been suggested to improve respiratory status in CP patients.The objective of this systematic review and meta-analysis was to verify the effects of the addition of respiratory exercises to conventional rehabilitation on pulmonary function,functional capacity,respiratory muscle strength,gross motor function and quality of life in children and adolescents with CP.Methods We searched for randomized controlled clinical trials in PubMed/Medline,Lilacs,SciELO,EMBASE and Physi-otheraphy Evidence(PEDro)from their inception until July 2022 without language restrictions.Studies that included respiratory exercises(breathing exercise program;feedback respiratory training;incentive spirometer exercise;inspiratory muscle training;and combination of respiratory exercises+incentive spirometer exercise)in combination with conventional rehabilitation for children and adolescents with CP were evaluated by two independent reviewers.The mean difference(MD)and 95%confidence interval(CI)were estimated by random effect models.Results Ten studies met the eligibility criteria,including 324 children aged from 6 to 16 years.The meta-analysis showed an improvement in inspiratory muscle strength of 22.96 cmH2O(18.63-27.27,n=55)and pulmonary function of 0.60(0.38-0.82,n=98)for forced vital capacity(L);0.22(0.06-0.39,n=98)for forced expiratory volume at 1 second(L);and 0.50(0.05-0.04,n=98)for peak expiratory flow(L/min).Functional skills in daily living activities improved in the intervention group.Caregivers'assistance of daily living activities,functional capacity,gross motor function and expiratory muscle strength showed a nonsignificant improvement.Social well-being and acceptance and functioning domains improved in only one study.Conclusions Emerging data show significant enhancements in inspiratory muscle strength and pulmonary function in CP patients after respiratory training in addition to conventional rehabilitation.There is no consensus on the frequency,type or intensity of respiratory exercises for children with and adolescents with CP.展开更多
Adevelopmentally normal,15-year-old boy presented with complaint of gait abnormalities since 8 years of age.The child complained of difficulty in climbing stairs and running.He could not climb stairs without the suppo...Adevelopmentally normal,15-year-old boy presented with complaint of gait abnormalities since 8 years of age.The child complained of difficulty in climbing stairs and running.He could not climb stairs without the support of railing.There was no problem with rising from sitting or lying down position.展开更多
基金Guangxi Natural Science Foundation Funding Project(No.2011GXNSFA018285).
文摘Objective: To investigate the effects of myocardial enzyme, immune function and inflammatory response by ursodeoxycholic acid combined with bifidobacterium quadruple preparations on hyperbilirubinemia neonatal. Methods: A total of 100 cases of neonatal hyperbilirubinemia in our hospital from June 2016 to May-2017 were selected and divided into control group and observation group by random number table, 50 cases in each group. Two groups of neonatal were given routine symptomatic treatment. The control group was treated with ursodeoxycholic acid and the observation group was treated with Bifidobacterium tetralogy of live bacteria on the basis of the control group. The two groups of neonatal were both treated for 7 d. The serum levels of CK-MB, CK, LDH, AST, CD3+, CD4+, CD4+/CD8+, CD8+, CRP and TNF-α were measured before and after the treatment of the two groups. Results: Before treatment, there was no significant difference in serum CK-MB, CK, LDH, AST, CD3+, CD4+, CD4+/CD8+, CD8+, CRP and TNF-α levels between the 2 groups. After treatment: 2 groups of serum CK-MB, CK, LDH, AST, CD8+, CRP, TNF-α levels significantly decreased compared with the group before treatment, CD3+, CD4+ and CD4+/CD8+ levels were significantly increased after treatment, and the observation group with serum CK-MB, CK, LDH, AST, CD8 +, CRP, TNF-α levels were significantly lower than the control group, CD3+, CD4+ and CD4+/CD8+ levels were significantly higher than the control group, the differences were statistically significant. Conclusion: Ursodeoxycholic acid combined with Bifidobacterium quadruple viable tablets can can reduce the activity of myocardial enzyme, improve the state of spectrum index of neonatal hyperbilirubinemia.
文摘Antenatal administration of magnesium sulfate is an important part of the neuroprotective strategy for preterm infants. Strong evidence from five randomized controlled trials and five meta-analyses has demonstrated that magnesium sulfate, when administered before preterm delivery, significantly reduces the risk of cerebral palsy at two years. Through secondary analyses of randomized controlled trials and other original clinical studies, this state-of-the-art review highlights the absence of serious adverse effects in both pregnant women and neonates, as well as the impact of maternal body mass index and preeclamptic status on the maternal and neonatal magnesium levels, which could influence the magnitude of the neuroprotective effect. Although antenatal magnesium sulfate is a cost-effective strategy, some practice surveys have demonstrated that the use of magnesium sulfate is not sufficient and that its use is heterogeneous, differing among different maternity wards. Since 2010, an increasing number of obstetrical societies have recommended its use to improve the neurological outcomes of preterm infants, especially the International Federation of Gynecology and Obstetrics and World Health Organization in 2015, and France in 2017. Considering the neuroprotective impact of magnesium sulfate when administered before delivery, postnatal administration should be considered, and its effects should be assessed using randomized controlled trials.
文摘BACKGROUND Acute cardiorenal syndrome type 1(CRS-1)is defined by a rapid cardiac dysfunction leading to acute kidney injury(AKI).Neutrophil gelatinaseassociated lipocalin(NGAL)is expressed on the surface of human neutrophils and epithelial cells,such as renal tubule cells,and its serum(sNGAL)and urinary have been used to predict AKI in different clinical settings.AIM To characterize CRS-1 in a cohort of patients with acute heart diseases,evaluating the potentiality of sNGAL as an early marker of CRS-1.METHODS We performed a retrospective cohort,multi-centre study.From January 2010 to December 2011,we recruited 202 adult patients admitted to the coronary intensive care unit(CICU)with a diagnosis of acute heart failure or acute coronary syndrome.We monitored the renal function to evaluate CRS-1 development and measured sNGAL levels within 24 h and after 72 h of CICU admission.RESULTS Overall,enrolled patients were hemodynamically stable with a mean arterial pressure of 92(82-107)mmHg,55/202(27.2%)of the patients developed CRS-1,but none of them required dialysis.Neither the NGAL delta value(AUC 0.40,95%CI:0.25-0.55)nor the NGAL peak(AUC 0.45,95%CI:0.36-0.54)or NGAL cutoff(≥140 ng/mL)values were statistically significant between the two groups(CRS-1 vs no-CRS1 patients).The area under the ROC curve for the prediction of CRS-1 was 0.40(95%CI:0.25-0.55)for the delta NGAL value and 0.45(95%CI:0.36-0.54)for the NGAL peak value.Finally,in multivariate analysis,the risk of developing CRS-1 was correlated with age>60 years,urea nitrogen at admission and 24 h-urine output(AUC 0.83,SE=60.5%SP=93%),while sNGAL was not significantly correlated.CONCLUSION In our population,sNGAL does not predict CRS-1,probably as a consequence of the mild renal injury and the low severity of heart disease.So,these data might suggest that patient selection should be taken into account when considering the utility of NGAL measurement as a biomarker of kidney damage.
基金supported by Hamadan University of Medical Sciences(No.9712218009).
文摘Objective:To determine the effect of physical activity by using the teach-back educational method on hemodialysis patients’quality of life(QOL)and physical ability.Methods:This is a single-blind clinical trial study involving a control group.A total of 90 patients who admitted to the dialysis centers of Beheshti and Besat hospitals in Hamadan were selected using a convenience sampling method and were randomly assigned to intervention(n=45)and control(n=45)groups.Data were collected using a demographic information checklist,a kidney disease QOL questionnaire,and a 6-minute-walk distance(6MWD)checklist.The patients’QOL questionnaire was completed,and the 6MWD was recorded before and at the end of the 2nd,4th,6th,8th,and 12th weeks of the intervention.In the intervention group,the patients were taught to perform physical activities with Pilates stretches in different resistances using the teach-back educational method during dialysis sessions for 12 weeks.Data were analyzed by using the independent t-test and chi-square test using SPSS-22 software.Results:Before the intervention,no differences were observed between the experimental and control groups in terms of demographic characteristics,QOL,and physical ability(P>0.05).The physical ability and QOL levels of patients exercising in the test group were higher than those in the control group after the intervention(P<0.05).Based on the results,the 2 groups significantly differed with regard to the scores of various dimensions of QOL and physical ability after the intervention(P<0.05).Conclusions:Physical activity by using the teach-back method can effectively increase physical ability and improve QOL of hemodialysis patients.Therefore,the recommendations and inclusion of exercise in the dialysis care plan can effectively promote patients’health.
文摘OBJECTIVE: To determine if the rates of pregnancy complications, preterm birth, small for gestational age, perinatal mortality, and serious neonatal morbidity are higher among mothers aged 35- 39 years or 40 years or older, compared with mothers 20- 24 years. METHODS: We performed a population- based study of all women in Nova Scotia, Canada, who delivered a singleton fetus between 1988 and 2002 (N = 157,445). Family income of women who delivered between 1988 and 1995 was obtained through a confidential linkage with tax records (n = 76,300). The primary outcome was perinatal death (excluding congenital anomalies) or serious neonatal morbidity. Analysis was based on logistic models. RESULTS: Older women were more likely to be married, affluent, weigh 70 kg or more, attend prenatal classes, and have a bad obstetric history but less likely to be nulliparous and to smoke. They were more likely to have hypertension, diabetes mellitus, placental abruption, or placenta previa. Preterm birth and small- for- gestational age rates were also higher; compared with women aged 20- 24 years, adjusted rate ratios for preterm birth among women aged 35- 39 years and 40 years or older were 1.61 (95% confidence interval [CI] 1.42- 1.82; P < .001) and 1.80 (95% CI 1.37- 2.36; P < .001), respectively. Adjusted rate ratios for perinatal mortality/morbidity were 1.46 (95% CI 1.11- 1.92; P = .007) among women 35- 39 years and 1.95 (95% CI 1.13- 3.35; P = .02) among women 40 years or older. Perinatal mortality rates were low at all ages, especially in recent years. CONCLUSION: Older maternal age is associated with relatively higher risks of perinatal mortality/morbidity, although the absolute rate of such outcomes is low.
文摘Objective: To ascertain the role of serum potassium levels in predicting clinical outcomes in diarrhea-associated hemolytic uremic syndrome (HUS D+). Methods: We reviewed clinical and laboratory data from HUS D+ patients at our tertiary care institution from 2001 to 2008. Serum potassium concentration at presentation and during the acute phase of acute renal failure were recorded and related to laboratory parameters and clinical outcomes. Results: 15 HUS D+ cases were identified. E. coli 0157:H7 was found in 9/15 cases (70%). Potassium levels were not predictive of clinical outcomes. Normal serum potassium levels were found in the majority of patients. Potassium levels <3.6 mmol/L were evident at presentation in 3/15 patients (23%), and no patient manifested hyperkalemia even when creatinine levels were concurrently increase. Conclusions: This study suggests the presence of vigorous compensatory mechanisms in the homoestasis of serum potassium levels during HUS D+ disease since neither the increase stool volumes associated with diarrhea nor the presence of renal failure resulted in clinically significant changes in serum potassium levels.
文摘Objective:To investigate the effects of Gongliuxiao Capsule on inflammatory factors, tumor markers, sex hormones and vascular endothelial function in patients with uterine fibroids. Methods:130 patients with uterine fibroids admitted to our hospital from October 2015 to March 2017 were enrolled. According to the treatment, they were divided into single treatment group and combined medication group, with 65 cases in each group. The changes of inflammatory factors, tumor markers, sex hormones and vascular endothelial function were compared before and after treatment in the two groups.Results: There were no significant differences in the levels of sex hormones, inflammatory factors, tumor markers and vascular endothelial function between the two groups (P>0.05). The levels of sex hormones E2, P, FSH and LH, the levels of inflammatory factors TNF-α, MMP-9 and IGF-1, tumor markers CA125, CA19-9 and vascular endothelial function VEGF and b-FGF were significantly lower in the two groups (P<0.05). The levels of E2, P, FSH and LH in the combined drug groupswere (154.12±16.20) pmol/L, (9.12±1.02) μg/L, (13.84±1.42) U/L and (12.77±1.36) U/L, respectively,which were significantly lower than the single drug group level (P<0.05). The levels of CA125 and CA19-9 in the combined drug group were (27.89±2.88) U/mL and (28.09±3.04) U/mL, respectively, which were significantly lower than the single drug group (P<0.05). The levels of TNF-α, MMP-9 and IGF-1 in the combined drug group were (24.16±2.63) ng/L, (159.22±16.82) μg/L and (69.75±7.09) μg/L, respectively, which were significantly lower than the single drug group(P<0.05). The levels of VEGF and b-FGF in the combination group were (138.29±14.32) μg/L and (98.59±10.02) μg/L, respectively, which were significantly lower than the single drug group (P<0.05).Conclusion:Mifepristone combined with Gongliuxiao Capsule can alleviate endocrine disorders, relieve inflammatory stress response and improve vascular endothelial function in patients with uterine fibroids. It is worthy of clinical application.
基金supporting the well-being of chronically ill children’project of the eHealth Junior consortium[NWA.1292.19.226]of the NWA research program'Research on Routes by Consortia(ORC)'funded by the Netherlands Organization for Scientific Research(NWO)+2 种基金funded by the European Union's Horizon 2020 research and innovation programme(EUCAN-Connect grant agreement No 824989ATHLETE,grant agreement No 874583ENDOMIX grant agreement No 101136566).
文摘Background Children and adolescents with chronic physical conditions have an increased probability of mental health problems,which may be partly attributed to the variations in play behavior.This study explores the associations between having a chronic physical condition,play behavior,and having mental health problems.Methods Data from the Generation R Study were analyzed,a population-based,prospective cohort in the Netherlands.Chronic physical conditions were typically identified before six years of age.Play behavior was assessed at ages 6 and 10.Mental health problems were measured with the Child Behavior Checklist at 14 years of age.Logistic,ranked-order,and linear regression analyses were used to examine direct associations,and mediation analyses were used to investigate indirect paths.P values were false discovery rate adjusted.Results Of the 4043 included participants,691(17%)had a chronic physical condition.Having a chronic physical condition was associated with more mental health problems and limited activity at the age of six years.Playing sports and engaging in social interactions at age 10 were related to fewer mental health problems at age 14.Limited activity mediated the relationship between having a chronic physical condition and mental health problems(social:mediated_(proportion)=8.33%,95%CI=2.02%;15.7%,P_(adj)<0.001;physical:mediated_(proportion)=7.72%,95%CI=1.73%;19.1%,P_(adj)=0.040).Conclusions Health-related limitations in social and physical activities mediate the relationship between having a chronic physical condition and mental health problems in children.Participation in social and physical activities early in life may be crucial for the mental well-being of children with a chronic physical condition.
文摘Background Respiratory dysfunctions are an important cause of morbidity and death in cerebral palsy(CP)populations.Respiratory exercises in addition to conventional rehabilitation have been suggested to improve respiratory status in CP patients.The objective of this systematic review and meta-analysis was to verify the effects of the addition of respiratory exercises to conventional rehabilitation on pulmonary function,functional capacity,respiratory muscle strength,gross motor function and quality of life in children and adolescents with CP.Methods We searched for randomized controlled clinical trials in PubMed/Medline,Lilacs,SciELO,EMBASE and Physi-otheraphy Evidence(PEDro)from their inception until July 2022 without language restrictions.Studies that included respiratory exercises(breathing exercise program;feedback respiratory training;incentive spirometer exercise;inspiratory muscle training;and combination of respiratory exercises+incentive spirometer exercise)in combination with conventional rehabilitation for children and adolescents with CP were evaluated by two independent reviewers.The mean difference(MD)and 95%confidence interval(CI)were estimated by random effect models.Results Ten studies met the eligibility criteria,including 324 children aged from 6 to 16 years.The meta-analysis showed an improvement in inspiratory muscle strength of 22.96 cmH2O(18.63-27.27,n=55)and pulmonary function of 0.60(0.38-0.82,n=98)for forced vital capacity(L);0.22(0.06-0.39,n=98)for forced expiratory volume at 1 second(L);and 0.50(0.05-0.04,n=98)for peak expiratory flow(L/min).Functional skills in daily living activities improved in the intervention group.Caregivers'assistance of daily living activities,functional capacity,gross motor function and expiratory muscle strength showed a nonsignificant improvement.Social well-being and acceptance and functioning domains improved in only one study.Conclusions Emerging data show significant enhancements in inspiratory muscle strength and pulmonary function in CP patients after respiratory training in addition to conventional rehabilitation.There is no consensus on the frequency,type or intensity of respiratory exercises for children with and adolescents with CP.
文摘Adevelopmentally normal,15-year-old boy presented with complaint of gait abnormalities since 8 years of age.The child complained of difficulty in climbing stairs and running.He could not climb stairs without the support of railing.There was no problem with rising from sitting or lying down position.
