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1.
Zhonghua Yu Fang Yi Xue Za Zhi ; 58(6): 924-930, 2024 Jun 06.
Artigo em Chinês | MEDLINE | ID: mdl-38955743

RESUMO

Public health and social measures (PHSMs) are one of the most important measures in the prevention and control of COVID-19 and have also been effective in suppressing the spread of influenza viruses, but their effectiveness has not been fully investigated. This study aimed to review the progress of research on the impact of PHSMs on influenza during the COVID-19 pandemic based on the latest evidence of the effectiveness of various PHSMs in controlling transmission of influenza viruses, to provide scientific evidence for optimizing influenza prevention and control strategies.


Assuntos
COVID-19 , Influenza Humana , Pandemias , Saúde Pública , Humanos , COVID-19/epidemiologia , COVID-19/prevenção & controle , Influenza Humana/epidemiologia , Influenza Humana/prevenção & controle
2.
Zhonghua Wai Ke Za Zhi ; 62(4): 331-337, 2024 Apr 01.
Artigo em Chinês | MEDLINE | ID: mdl-38432675

RESUMO

Intrahepatic cholangiocarcinoma (ICC) is a type of primary liver cancer, which has shown an increasing trend in incidence and mortality in recent years, with a poor prognosis. The clinical diagnosis and treatment of ICC currently face the challenges of low detection rate, high mortality rate, poor treatment outcome, and urgently need more in-depth research to promote the improvement of clinical diagnosis and treatment level. In recent years, ICC diagnosis and treatment related research has made new progress in many aspects, and the knowledge about these new clinical diagnosis and treatment advances should be updated in a timely manner. This article reviewed the latest research results in recent years, summarized some new views on ICC typing, prevention and diagnosis staging that have been proposed recently, as well as the new progress made in surgical treatment and systemic treatment, and briefly discussed the potential of ICC individualized precision treatment and the occurrence of rare complications caused by combined treatment.


Assuntos
Neoplasias dos Ductos Biliares , Colangiocarcinoma , Humanos , Neoplasias dos Ductos Biliares/diagnóstico , Neoplasias dos Ductos Biliares/terapia , Neoplasias dos Ductos Biliares/patologia , Colangiocarcinoma/diagnóstico , Colangiocarcinoma/terapia , Colangiocarcinoma/patologia , Resultado do Tratamento , Terapia Combinada , Ductos Biliares Intra-Hepáticos/patologia , Prognóstico
3.
Zhonghua Nei Ke Za Zhi ; 62(5): 480-493, 2023 May 01.
Artigo em Chinês | MEDLINE | ID: mdl-37096274

RESUMO

We wished to establish an expert consensus on late stage of critical care (CC) management. The panel comprised 13 experts in CC medicine. Each statement was assessed based on the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) principle. Then, the Delphi method was adopted by 17 experts to reassess the following 28 statements. (1) ESCAPE has evolved from a strategy of delirium management to a strategy of late stage of CC management. (2) The new version of ESCAPE is a strategy for optimizing treatment and comprehensive care of critically ill patients (CIPs) after the rescue period, including early mobilization, early rehabilitation, nutritional support, sleep management, mental assessment, cognitive-function training, emotional support, and optimizing sedation and analgesia. (3) Disease assessment to determine the starting point of early mobilization, early rehabilitation, and early enteral nutrition. (4) Early mobilization has synergistic effects upon the recovery of organ function. (5) Early functional exercise and rehabilitation are important means to promote CIP recovery, and gives them a sense of future prospects. (6) Timely start of enteral nutrition is conducive to early mobilization and early rehabilitation. (7) The spontaneous breathing test should be started as soon as possible, and a weaning plan should be selected step-by-step. (8) The waking process of CIPs should be realized in a planned and purposeful way. (9) Establishment of a sleep-wake rhythm is the key to sleep management in post-CC management. (10) The spontaneous awakening trial, spontaneous breathing trial, and sleep management should be carried out together. (11) The depth of sedation should be adjusted dynamically in the late stage of CC period. (12) Standardized sedation assessment is the premise of rational sedation. (13) Appropriate sedative drugs should be selected according to the objectives of sedation and drug characteristics. (14) A goal-directed minimization strategy for sedation should be implemented. (15) The principle of analgesia must be mastered first. (16) Subjective assessment is preferred for analgesia assessment. (17) Opioid-based analgesic strategies should be selected step-by-step according to the characteristics of different drugs. (18) There must be rational use of non-opioid analgesics and non-drug-based analgesic measures. (19) Pay attention to evaluation of the psychological status of CIPs. (20) Cognitive function in CIPs cannot be ignored. (21) Delirium management should be based on non-drug-based measures and rational use of drugs. (22) Reset treatment can be considered for severe delirium. (23) Psychological assessment should be conducted as early as possible to screen-out high-risk groups with post-traumatic stress disorder. (24) Emotional support, flexible visiting, and environment management are important components of humanistic management in the intensive care unit (ICU). (25) Emotional support from medical teams and families should be promoted through"ICU diaries"and other forms. (26) Environmental management should be carried out by enriching environmental content, limiting environmental interference, and optimizing the environmental atmosphere. (27) Reasonable promotion of flexible visitation should be done on the basis of prevention of nosocomial infection. (28) ESCAPE is an excellent project for late stage of CC management.


Assuntos
Cuidados Críticos , Delírio , Humanos , Consenso , Cuidados Críticos/métodos , Unidades de Terapia Intensiva , Dor/tratamento farmacológico , Analgésicos/uso terapêutico , Delírio/terapia , Estado Terminal
4.
Zhonghua Yi Xue Za Zhi ; 103(20): 1563-1567, 2023 May 30.
Artigo em Chinês | MEDLINE | ID: mdl-37246007

RESUMO

Objective: To evaluate the learning curve of the "Double Grooves-Double Rings" (DGDR) technique of transurethral Thulium laser enucleation of the prostate (ThuLEP) for benign prostatic hyperplasia (BPH) by a single surgeon. From June 2021 to July 2022, 84 patients mean age (69.0±8.0) years,preoperative prostate volume (90.9±40.3)ml with BPH underwent ThuLEP in the Department of Urology, Peking University First Hospital.Performed by a single surgeon who had no experience of transurethral resection of prostate (TURP) and any laser surgeries. The case scatter plots with the best fitting line were drawn to analyze the learning curve. According to the date of the surgeries, the patients were equally divided into three learning stages (28 patients for each group). The T-PSA,prostate volume,operative time,enucleation time, enucleation efficiency,catheter indwelling time, hemoglobin drop and perioperative complications (including re-TURP, blood transfusion, stress incontinence≥3 months and urethral stricture) were compared among the groups. The learning curve was divided into three stages, and the cutting point was shown on the 14th case. Except the prostate volume [stage1 (75.7±30.7) ml, stage2 (93.40±39.6)ml, stage3 (103.5±46.2) ml, P<0.05], there was no significant difference of the baseline data between three groups (P>0.05). Compared with those of stage 1(100.6±24.7) min,(0.55±0.22) g/min, a statistically significant improvement was observed in both of the operative time and the enucleation efficiency among stage 2[(84.5±36.6) min, (0.87±0.33) g/min and stage 3 (71.2±26.3) min, (1.27±0.45) g/min, P<0.05]. The learning curve of the DGDR technique for ThuLEP can be divided into three stages. A ThuLEP beginner can preliminarily master this technique after completing 14 cases.


Assuntos
Terapia a Laser , Lasers de Estado Sólido , Hiperplasia Prostática , Cirurgiões , Ressecção Transuretral da Próstata , Idoso , Humanos , Masculino , Pessoa de Meia-Idade , Lasers , Curva de Aprendizado , Próstata , Hiperplasia Prostática/cirurgia , Túlio , Ressecção Transuretral da Próstata/métodos , Resultado do Tratamento
5.
Zhonghua Wai Ke Za Zhi ; 61(6): 481-485, 2023 Jun 01.
Artigo em Chinês | MEDLINE | ID: mdl-37088480

RESUMO

Objective: To examine the preliminary effect of laparoscopic extraperitoneal colostomy anterior to posterior sheath of rectus abdominis-transversus abdominis for the prevention of parastomal hernia after abdominoperineal resection for rectal cancer. Methods: This study is a prospective case series study. From June 2021 to June 2022, patients with low rectal cancer underwent laparoscopic abdominoperineal resection combined with extraperitoneal colostomy anterior to posterior sheath of rectus abdominis-transversus abdominis at the First Department of General Surgery, Shaanxi Provincial People's Hospital were enrolled. The clinical data and postoperative CT images of patients were collected to analyze the incidence of surgical complication and parastomal hernia. Results: Totally 6 cases of patient were enrolled, including 3 males and 3 females, aging 72.5 (19.5) years (M(IQR)) (range: 55 to 79 years). The operation time was 250 (48) minutes (range: 190 to 275 minutes), the stoma operation time was 27.5 (10.7) minutes (range: 21 to 37 minutes), the bleeding volume was 30 (35) ml (range: 15 to 80 ml). All patients were cured and discharged without surgery-related complications. The follow-up time was 136 (105) days (range: 98 to 279 days). After physical examination and abdominal CT follow-up, no parastomal hernia occurred in the 6 patients up to this article. Conclusions: A method of laparoscopic extraperitoneal colostomy anterior to posterior sheath of rectus abdominis-transversus abdominis is established. Permanent stoma can be completed with this method safely. It may have a preventive effect on the occurrence of parastomal hernia, which is worthy of further study.


Assuntos
Hérnia Ventral , Hérnia Incisional , Laparoscopia , Neoplasias Retais , Masculino , Feminino , Humanos , Colostomia/efeitos adversos , Colostomia/métodos , Reto do Abdome , Laparoscopia/métodos , Hérnia Incisional/prevenção & controle , Hérnia Incisional/cirurgia , Neoplasias Retais/cirurgia , Hérnia Ventral/diagnóstico , Hérnia Ventral/etiologia , Hérnia Ventral/cirurgia , Telas Cirúrgicas/efeitos adversos
6.
Beijing Da Xue Xue Bao Yi Xue Ban ; 54(2): 283-288, 2022 Apr 18.
Artigo em Chinês | MEDLINE | ID: mdl-35435193

RESUMO

OBJECTIVE: To evaluate the efficacy and safety of 585 nm Q-switched laser in the treatment of acne inflammatory lesions and postinflammatory erythema. METHODS: A total of 25 patients with moderate facial acne, symmetrical distribution of inflammatory lesions and postinflammatory erythema on both sides of the face, were enrolled. Among the 25 patients, 22 patients completed all the treatment and evaluation, and 3 patients were lost to follow-up. 585 nm Q-switched laser was used on a randomly selected side of the face for three times of treatment at a 2 week interval. The evaluations were made before each treatment, 2 and 4 weeks after the last treatment, therefore the evaluation time points were before the treatment, weeks 2, 4, 6, and 8, respectively, for a total of 5 times. Acne severity was assessed using the investigator' s global assessment (IGA) score, and erythema severity was assessed using the investigator' s subjective erythema score and narrow-spectrum reflectance spectrophotometer at each follow-up. RESULTS: After 3 times of treatment, there was statistically significant difference between the IGA score in week 8 and before treatment on both sides(Z=2.64, P < 0.01; Z=2.67, P < 0.01). There was no significant difference in IGA score between the treatment side and the control side before treatment and in week 8 (P=0.59, P=0.26). There was statistically significant difference between the investiga-tor' s subjective erythema score in week 8 and before treatment on the treatment side(Z=4.24, P < 0.01), while no significant difference was showed on the control side(Z=1.73, P=0.08). In week 8, the investigator's subjective erythema score of the treatment side was lower than that of the control side (Z=3.61, P < 0.01). The erythema index of the treatment side was significantly decreased at 5 time points (P < 0.01), and the index decreased significantly in week 8 compared with the index before treatment (P < 0.01), while the erythema index of the control side was not significantly different at 5 time points. The treatment related adverse events included erythema and edema after treatment and pain during treatment, the severity was mild to moderate, which resolved spontaneously within 1 to 3 days. Nine patients were very satisfied with the treatment, 7 patients were satisfied, and 6 patients considered average. CONCLUSION: 585 nm Q-switched laser has some effect in the treatment of postinflammatory erythema, and it ensures good tolerance and safety. There was no statistically significant difference between the treatment side and the control side on the improvement of acne inflammatory lesions.


Assuntos
Acne Vulgar , Acne Vulgar/complicações , Acne Vulgar/patologia , Acne Vulgar/terapia , Eritema/etiologia , Face , Humanos , Imunoglobulina A , Resultado do Tratamento
7.
Zhonghua Yu Fang Yi Xue Za Zhi ; 56(8): 1127-1135, 2022 Aug 06.
Artigo em Chinês | MEDLINE | ID: mdl-35922243

RESUMO

The COVID-19 outbreak at the end of 2019 has accelerated the development and research for COVID-19 vaccines worldwide. Among the COVID-19 vaccines in clinical trials developed via different platforms, recombinant virus vector-based vaccines have shown excellent immunogenicity and efficacy. However, at the same time, there are serious issues such as vaccine safety and pre-existing antibodies against vectors. This article summarizes the design concept and development history of recombinant virus vector-based vaccines, and focuses on the progress in the clinical studies of vector-based COVID-19 vaccines as well as the challenges, in order to provide reference for the research of recombinant vector-based vaccines.


Assuntos
COVID-19 , Vacinas Virais , COVID-19/prevenção & controle , Vacinas contra COVID-19 , Vetores Genéticos , Humanos , Vacinas Sintéticas
8.
Zhonghua Yu Fang Yi Xue Za Zhi ; 56(2): 146-150, 2022 Feb 06.
Artigo em Chinês | MEDLINE | ID: mdl-35184442

RESUMO

As a serious disease of death and disability, stroke constitutes a serious threat to human health. Because of stroke patients often have high-risk factors of malnutrition such as dysphagia and autonomic eating disorder, the hospitalization time, mortality and disability rate of stroke patients increases. Nutritional therapy can effectively improve the malnutrition of patients, which are of great significance for the treatment and rehabilitation of stroke and the prevention of its complications. Nutrients are important components of nutrition therapy, and different ways of nutrition therapy directly affect the effect of treatment. This article summarizes effects of nutrients and different nutritional treatments on stroke prevention, morbidity and treatment, and provides a theoretical basis and new thinking for further reducing the incidence rate of stroke, improving the quality of life in patients and reducing the financial burden of society and family.


Assuntos
Desnutrição , Acidente Vascular Cerebral , Nutrição Enteral/efeitos adversos , Humanos , Desnutrição/prevenção & controle , Estado Nutricional , Apoio Nutricional/efeitos adversos , Qualidade de Vida , Acidente Vascular Cerebral/complicações , Acidente Vascular Cerebral/prevenção & controle
9.
Zhonghua Yu Fang Yi Xue Za Zhi ; 56(8): 1095-1100, 2022 Aug 06.
Artigo em Chinês | MEDLINE | ID: mdl-35922237

RESUMO

Objective: To determine IgG antibody levels of measles, rubella, mumps in healthy population in Shanghai from 2010 to 2020 and analyze the trend of antibody changes in different age groups. Methods: 10 828 healthy people without measles, rubella and mumps in Shanghai were included in the study from 2010 to 2020. Serum samples were collected from 12 age groups, and the serum IgG antibody of measles, rubella and mumps were detected by ELISA. The difference of antibody positive rates and antibody levels were analyzed. Results: The median age M (Q1, Q3) of 10 828 objects were 8 years old (9 months old, 20 years old). Males accounted for 48.34% (5 234/10 828) and females accounted for 50.92% (5 514/10 828). Unknown gender information accounted for 0.74% (80/10 828), and 27.03% (2 927/10 828) of participants had unknown MMR immunization history. The total positive rates of measles, rubella and mumps IgG antibody were 76.78%, 64.46% and 64.29% and their GMCs were 541.45 mIU/ml, 31.76 IU/ml and 133.73 U/ml respectively. There were significant differences in serum IgG antibody GMC of measles, rubella and mumps in each year (Fmeasles=180.74, P<0.001; Frubella=189.95, P<0.001; Fmumps=122.40, P<0.001). The positive rate of measles antibody was higher than that of rubella and mumps, and the difference was statistically significant (χ²=518.09, P<0.001). Conclusion: The level of measles IgG antibody in healthy people in Shanghai is higher, while the level of rubella and mumps IgG antibody is slightly lower.


Assuntos
Sarampo , Caxumba , Rubéola (Sarampo Alemão) , Adulto , Anticorpos Antivirais , Criança , China/epidemiologia , Feminino , Humanos , Imunoglobulina G , Lactente , Masculino , Sarampo/prevenção & controle , Vacina contra Sarampo-Caxumba-Rubéola , Caxumba/epidemiologia , Caxumba/prevenção & controle , Vírus da Caxumba , Rubéola (Sarampo Alemão)/epidemiologia , Rubéola (Sarampo Alemão)/prevenção & controle , Adulto Jovem
10.
Tech Coloproctol ; 25(5): 495-504, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33759066

RESUMO

BACKGROUND: Crohn's disease (CD) is a chronic idiopathic inflammatory intestinal disorder associated with fecal dysbiosis. Fecal microbiota transplantation (FMT) is an emerging treatment approach for CD. But its efficacy and safety remain controversial. We performed a systematic review and meta-analysis to evaluate the efficacy and safety of FMT in CD patients. METHODS: Electronic databases were searched for studies that reported efficacy and/or safety of FMT for CD. Clinical remission was established as the primary outcome. Secondary outcome was clinical response. Odds ratios with 95% confidence intervals (CIs) were reported. RESULTS: In all, 12 trials were included in our study. Pooled analysis showed that 0.62 (95% CI 0.48, 0.81) of CD patients achieved clinical remission and 0.79 (95% CI 0.71, 0.89) of CD patients achieved clinical response post-FMT. Sub-analyses suggested the rate of clinical remission with fresh stool FMT was higher than with frozen stool FMT (73% vs 43%; p < 0.05). Most adverse events were minor and self-resolving and no major FMT-related adverse event has been reported so far. CONCLUSIONS: The evidence showed that FMT is an effective and safe therapy for CD. FMT may be successful because it increases the overall diversity of enteric microbiome. Additional randomized controlled studies are needed.


Assuntos
Doença de Crohn , Doenças Inflamatórias Intestinais , Doença de Crohn/terapia , Transplante de Microbiota Fecal , Fezes , Humanos , Intestinos , Resultado do Tratamento
11.
Beijing Da Xue Xue Bao Yi Xue Ban ; 53(3): 530-535, 2021 Jun 18.
Artigo em Chinês | MEDLINE | ID: mdl-34145856

RESUMO

OBJECTIVE: To explore the personality portraits of patients with type 2 diabetes mellitus (T2DM), its relationship with medication adherence and the influencing factors of medication adherence. METHODS: T2DM patients from 22 community health service stations of 4 community health service centers in Tongzhou district and Shunyi district in Beijing were selected as the research objects. A self-designed questionnaire was used to collect demographic information. The short version of Big Five personality scale was used to collect personality information, and latent profile analysis was used to explore their personality portraits. The medication adherence was evaluated by medication adherence scale, and the difference of medication adherence among the different personality portraits was explored by analysis of variance. The influencing factors of medication adherence were explored by the ordinal Logistic regression model. RESULTS: In the study, 751 T2DM patients were included. Latent profile analysis showed that the T2DM patients in this study could be divided into four types of personality portraits, including introverted and stable type (42.7%), negative type (12.7%), anxiety type (15.3%) and active and responsible type (29.3%). Among them, 75 patients said that they did not use medicine or insulin, 5 patients were lack of data, and finally 671 patients with T2DM were included in the analysis about medication adherence. The analysis of variance showed that there was no significant difference in medication adherence between anxiety type (5.55±1.65) and negative type (5.94±1.53, P=0.089), but the medication adherence score of anxiety type was significantly lower than that of introverted and stable type (6.17±1.46, P=0.001) and active and responsible type (6.09±1.65, P=0.004). Anxiety type and negative type were seen as a whole in the ordinal Logistic regression model named anxiety and negative type. The results showed that compared with anxiety and negative type, the active and responsible type or introverted and stable type was the protective factor for good medication adherence (OR=1.567, 95%CI: 1.096-2.237; OR=1.774, 95%CI: 1.214-2.591), and the education level also affected the medication adherence. CONCLUSION: T2DM can be classified into four types of personality portraits based on Big Five personality theory. The anxiety and negative type after the combination of anxiety type and negative type is the independent risk factor for poor medication adherence. In addition, education level is also the influencing factor of medication compliance.


Assuntos
Diabetes Mellitus Tipo 2 , Ansiedade/epidemiologia , Pequim , Diabetes Mellitus Tipo 2/tratamento farmacológico , Humanos , Adesão à Medicação , Personalidade
12.
Beijing Da Xue Xue Bao Yi Xue Ban ; 53(6): 1144-1151, 2021 Dec 18.
Artigo em Chinês | MEDLINE | ID: mdl-34916696

RESUMO

OBJECTIVE: The key point of anesthesia management in carotid endarterectomy (CEA) is to maintain adequate cerebral perfusion during carotid artery occlusion. Placement of shunt is one of the common surgical methods. This study analyzed the effects of different shunt strategies on cerebral infarction after carotid endarterectomy. METHODS: A total of 443 patients who underwent CEA under general anesthesia within 2 years were divided into imaging group (based on preoperative imaging data as the basis for shunt) and stump pressure group (based on intraoperative stump pressure as the basis for shunt). The preoperative demographic data, past medical history, degree of cervical vascular stenosis, blood pressure at each time point during the perioperative period, vascular blocking time, whether to place the shunt, postoperative hospital stay, cerebral infarction during hospitalization, and other adverse events were collected and compared between the two groups. On this basis, the preoperative and intraoperative conditions with significant differences were matched with propensity scores, and the influence of different shunt strategies on postoperative cerebral infarction was analyzed. RESULTS: In the study, 268 patients in the imaging group and 175 patients in the stump pressure group underwent CEA under general anesthesia. There were statistically significant differences in basic conditions and blood pressure at each time point between the two groups. After matching the propensity scores, 105 patients in each of the two groups were matched. The basic conditions of the patients before surgery and the difference in blood pressure of the two groups at each time point were not statistically significant. There was no significant diffe-rence in the incidence of postoperative cerebral infarction between the two groups (1.9% vs. 1.0%, P>0.999). The intraoperative shunt rate in the imaging group was lower than that in the stump pressure group (0 vs. 22.9%, P < 0.001). The postoperative hospital stay in the imaging group was 8 (7, 8) days, which was longer than the stump pressure group 5 (4, 6) days (P < 0.001). CONCLUSION: The rate of the shunt was lower according to preoperative imaging examination than that according to the residual pressure in our hospital. There is no significant difference in the incidence of cerebral infarction during the postoperative hospital stay. The effect of different shunt strategies on cerebral infarction needs further study.


Assuntos
Endarterectomia das Carótidas , Anestesia Geral , Pressão Sanguínea , Infarto Cerebral/epidemiologia , Infarto Cerebral/etiologia , Infarto Cerebral/prevenção & controle , Endarterectomia das Carótidas/efeitos adversos , Humanos , Próteses e Implantes
13.
Zhonghua Yi Xue Za Zhi ; 101(39): 3232-3237, 2021 Oct 26.
Artigo em Chinês | MEDLINE | ID: mdl-34689536

RESUMO

Objective: To explore the efficacy of endovenous microwave ablation in treating primary varicose veins of the lower extremities. Methods: A total of 214 patients with primary varicose veins of the lower extremities in the First Affiliated Hospital of Sun Yat-sen University from January 2017 to November 2019 were included and divided into microwave ablation group (n=128) and high ligation with microwave ablation group (n=86) according to surgical approach. Further subgroups including subgroup S (diameter<10 mm) and subgroup L (diameter≥10 mm) were established. The surgical success rate, postoperative incidence and recovery of local skin numbness and ecchymosis, and the postoperative recovery of active skin ulcer were compared between the two groups and subgroups. Results: The surgical success rate was 96% (136/141) in microwave ablation group, 100% in subgroup S (116/116), and 80% in subgroup L (20/25), respectively. In addition, the surgical success rate in high ligation with microwave ablation group, subgroup S, and subgroup L was all 100% (90/90, 73/73, and 17/17). In subgroup L of microwave ablation group, the diameter of 5 great saphenous veins in patients who failed the microwave ablation was 13.0-17.1 mm. The mean follow-up time was (24±4) months in microwave ablation group and (36±6) months in high ligation with microwave ablation group, respectively. In the microwave ablation group and high ligation with microwave ablation group, the incidence of postoperative skin numbness was 15.6% and 14.4%, respectively, and the incidence of skin ecchymosis was 5.7% and 3.3%, respectively, with no statistically significant difference between the two groups (both P>0.05). The rate of active skin ulcer in the two groups was 6.4% and 15.6%, respectively, and the difference was statistically significant (P=0.020). Local skin ecchymosis in the two groups recovered within 1 month after operation. Local skin numbness in both groups recovered within the maximum 2 years of follow-up, and active skin ulcer in both groups recovered within the maximum 1 years of follow-up. Conclusion: The endovenous microwave ablation is safe and effective, especially combining with high ligation of great saphenous vein. Good follow-up results can be achieved for great saphenous vein with diameter smaller than 10 mm. However, for those with diameter greater than 10 mm, the surgical success rate of endovenous microwave ablation decreases.


Assuntos
Terapia a Laser , Varizes , Veia Femoral , Humanos , Extremidade Inferior , Micro-Ondas , Veia Safena , Resultado do Tratamento , Varizes/cirurgia
14.
Zhonghua Wai Ke Za Zhi ; 59(6): 550-554, 2021 Jun 01.
Artigo em Chinês | MEDLINE | ID: mdl-34102741

RESUMO

Unicompartmental knee arthroplasty(UKA) is an important surgical technique for the treatment of end-stage knee osteoarthritis, which has high requirement for the position and angle of the prosthesis. The application of three-dimensional(3D) printed in UKA reflects several characteristics such as accuracy,efficiency and safety,but the current research results show that there is still lack of consistency in the design of 3D printed guides and the standard of prosthetic position parameters. This article reviews the history, manufacturing requirements and process of 3D printed guides during UKA surgery, as well as the results of current clinical research. Whether 3D printed guides can safely and effectively improve the placement accuracy of inexperienced doctors during UKA surgery,and whether the long-term results are worthy of clinical promotion need further verification.


Assuntos
Artroplastia do Joelho , Prótese do Joelho , Osteoartrite do Joelho , Humanos , Articulação do Joelho/cirurgia , Osteoartrite do Joelho/cirurgia , Resultado do Tratamento
15.
Beijing Da Xue Xue Bao Yi Xue Ban ; 52(3): 506-513, 2020 Jun 18.
Artigo em Chinês | MEDLINE | ID: mdl-32541985

RESUMO

OBJECTIVE: To explore the correlation between different personality characteristics and self-management attitude such as medication, exercise and diet in patients with type 2 diabetes mellitus. METHODS: The patients with type 2 diabetes mellitus from 4 Community Healthcare Services and 22 affiliated community stations of Tongzhou District and Shunyi District of Beijing were selected as subjects. The Chinese big five personality inventory and the self-designed scale including the attitudes of medication, exercise and diet were used in the study. RESULTS: In this study, 642 subjects were finally included, among whom the sex ratio of male and female was basically the same, 61.21% were over 61 years old. In this study, different genders had differences in neurotic personality (P<0.05), different age groups had differences in agreeableness and openness (P<0.05), different education levels had differences in openness and extraversion (P<0.05), and different income levels had differences in agreeableness, openness and extraversion (P<0.05). The linear correlation analysis of the five-factor moldel of personality traits with medication, exercise and diet attitude showed that three items of perceived disorders of medication were positively correlated with neuroticism (r=0.125, 0.187, 0.151, P<0.05), four items of perceived disorders of exercise were positively correlated with neurotic personality (r=0.163, 0.129, 0.119, 0.104, P<0.05), and perceived benefits of exercise were positively correlated with conscientiousness (five items, r=0.156, 0.111, 0.131, 0.104, 0.131, P<0.05), agreeableness (two items, r=0.092, 0.078, P<0.05) and extraversion (four items, r=0.079, 0.122, 0.115, 0.123, P<0.05), three items of perceived disorders of diet were positively correlated with neuroticism (r=0.115, 0.137, 0.108, P<0.05), and two items of were negatively correlated with conscientiousness (r=-0.126, -0.161, P<0.05) and agreeableness (r=-0.103, -0.115, P<0.05). In the canonical correlation analysis, according to the formula combination of three groups of typical variables and canonical structure diagrams, neuroticism and agreeableness played major roles in personality traits, and items that represented "obstacles" in medication, exercise, and dietary attitudes played a major role. CONCLUSION: All the five personality traits were correlated with the self-management attitude of type 2 diabetes patients, and different personality traits have an impact on the self-management of patients with type 2 diabetes mellitus. In particular, it is of great significance to understand neuroticism for improving the mental health and quality of life of patients with type 2 diabetes mellitus. Therefore, attention should be paid to the influence of psychological factors in community management of type 2 diabetes and disease self-management, and the personalized care and health education should be carried out according to the personality traits of patients.


Assuntos
Diabetes Mellitus Tipo 2 , Autogestão , Atitude , Pequim , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Personalidade , Inventário de Personalidade , Qualidade de Vida
16.
Zhonghua Yu Fang Yi Xue Za Zhi ; 54(6): 685-690, 2020 06 06.
Artigo em Chinês | MEDLINE | ID: mdl-32842287

RESUMO

Objective: The study intends to identify gap in HIV/AIDS awareness dissemination between the official channel delivery and the needs of adolescents. Methods: We crawled all the HIV/AIDS queries from "Baidu zhidao" till June 11st, 2018. "Baidu zhidao" inquiry and information form official public service announcement (abbreviated for "official delivery" hereafter) were the data source for comparative analysis. We categorized the text data into four kinds, "prevention", "testing and treatment", "symptoms and infection" and "legalization and policies" according to official categorization. Word segmentation was used for text mining and word frequency statistics, as well word cloud was used for word frequency visualization (all based on a comparison after removing the useless words). Results: Of the official delivery, the proportion of prevention category accounted for 32.3% (n=162) (ranks 1st), and the proportion of legalization and policies category was 14.1% (n=71). While among the "Baidu zhidao" inquiry information, the proportion of testing and treatment category accounted for 51.7% (n=51 264), and the proportion of prevention category accounted for 11.4% (n=11 272). The frequencies of same terms/ repeated terms of two channels accounted for 60% (59.3%-63.9%) of each category among the official delivery, of which, the proportion of interest terms comparatively less and more diverse in "Baidu zhidao" inquiries. The proportion of the terms frequency of each category was about 45% in "prevention, testing and treatment", 34.3% (n=14 781) in "symptoms and infection" and 17.0% (n=5 744) in "legalization and policies", respectively. Conclusion: A big gap was identified between the available official source and inquiries' term, especially word frequency discrepancy between "legalization and policies" and "prevention" categories. It underscore the necessity for the official channel to address the needs and interests of adolescents in the future.


Assuntos
Síndrome da Imunodeficiência Adquirida/prevenção & controle , Adolescente , Mineração de Dados , Humanos , Disseminação de Informação
17.
Zhonghua Wai Ke Za Zhi ; 58(6): 441-446, 2020 Jun 01.
Artigo em Chinês | MEDLINE | ID: mdl-32498483

RESUMO

Objective: To explore the influence of lateral patellofemoral joint degeneration on the treatment of anteromedial osteoarthritis of knee joint by Oxford medial unicompartmental knee arthroplasty. Methods: The clinical data of 73 patients (73 knees) with knee osteoarthritis underwent unicompartmental knee arthroplasty at Department of Orthopaedic Surgery, Xuanwu Hospital, Capital Medical University from March 2016 to December 2017 were analysed respectively.There were 18 males and 55 females, aged (68.6±7.5) years(range: 53 to 89 years).The lateral patellofemoral joints of patients were evaluated by Ahlback grading system. Patients with Ahlback 0 andⅠ were in the non degenerative group (37 cases), and those with Ahlback Ⅱ and above were in the degenerative group (36 cases). Hospital for special surgery knee score(HSS) and the Western Ontario and McMaster Universities(WOMAC) osteoarthritis index, as well as the condition of kneeling, sit to stand movement, up stair and down stair were recorded. The data before and after operation were compared by paired sample t test, and the data between groups were compared by independent sample t test. χ(2) test was used for counting data. Pearson correlation analysis was used to compare the correlation between ahlback score, HSS and WOMAC osteoarthritis index. Results: The follow-up time was (35.1±6.6) months (range: 25 to 47 months).The knee function of the patients improved significantly after operation.The HSS score increased from 57.7±11.8 preoperative to 81.8±7.8 postoperative (t=16.64, P=0.00) and WOMAC osteoarthritis index decreased from 48.9±13.4 preoperative to 15.6±8.8 postoperative (t=20.48, P=0.00). There was no statistical difference in the change of HSS between the degenerative group and the non-degenerative group before and after surgery(27.5±12.2 vs. 22.5±12.3, t=-1.65, P=0.10) as well as the change of WOMAC osteoarthritis index(31.8±14.0 vs. 36.4±13.7, t=-1.35, P=0.18), but the lateral patellofemoral joint degeneration was related to inability to complete squats (χ(2)=5.17, P=0.04) and sitting up (χ(2)=7.22, P=0.01). Conclusion: The degeneration of lateral patellofemoral joint has no effect on the early functional recovery of patients with anteromedial knee osteoarthritis after Oxford medial unicompartmental knee arthroplasty.


Assuntos
Artroplastia do Joelho/métodos , Osteoartrite do Joelho/cirurgia , Articulação Patelofemoral , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Articulação do Joelho/cirurgia , Prótese do Joelho , Masculino , Pessoa de Meia-Idade , Amplitude de Movimento Articular , Recuperação de Função Fisiológica , Resultado do Tratamento
18.
Zhonghua Yi Xue Za Zhi ; 99(15): 1152-1155, 2019 Apr 16.
Artigo em Chinês | MEDLINE | ID: mdl-31006218

RESUMO

Objective: To investigate the feasibility and safety of magnetic resonance guided focused ultrasound surgery (MRgFUS) ablation treatment for uterine fibroids and adenomyosis. Methods: From February 2017 to July 2018, a total of 61 women in Foshan Hospital of Traditional Chinese Medicine with uterine fibroids or adenomyosis (36 cases of fibroids and 25 cases of adenomyosis) were included for treatment of MRgFUS, mean age was 27-48 (39±5) years. The treatment status, treatment effect and complications were recorded, and the differences between myoma and adenomyosis were compared. Results: Thirty-two (88.9%) patients of fibroid group and twenty-one (84.0%) patients of adenomyosis group were completed MRgFUS treatment respectively (P>0.05). The spot energy of adenomyosis group was 1 039-5 698(2 852±991) J, which was higher than 600-6 466(2 485±1 137) J of fibroid group (P<0.01). There was no significant statistical difference in mean temperature of spot and ablation time between the two groups (P>0.05).The non-perfusion volume ratio (NPVR) of the fibroid and adenomyosis group was 54%-99%(84%±15%) and 60%-98%(82%±12%) and there was no significant statistical difference (P>0.05), but the ablation efficiencies of adenomyosis group was less than fibroid group (0.8-4.3(2.1±0.9) cm(3)/min vs 1.3-7.8(3.6±1.5)cm(3)/min, P<0.01).The incidence of complications of adenomyosis group was 47.6%(10/21), it was higher than fibroid group 18.8%(6/32) (P<0.05). Conclusions: MRgFUS is a non-invasive, safe and effective treatment for both uterine fibroids and adenomyosis. Compared with uterine fibroids, MRgFUS treatment of adenomyosis has some disadvantages such as higher energy, lower ablation efficiency and more adverse reactions, and further optimization is needed.


Assuntos
Adenomiose , Ablação por Ultrassom Focalizado de Alta Intensidade , Neoplasias Uterinas , Adenomiose/cirurgia , Adulto , Feminino , Humanos , Leiomioma , Imageamento por Ressonância Magnética , Pessoa de Meia-Idade , Resultado do Tratamento , Neoplasias Uterinas/cirurgia
19.
Zhonghua Gan Zang Bing Za Zhi ; 27(2): 102-105, 2019 Feb 20.
Artigo em Chinês | MEDLINE | ID: mdl-30818913

RESUMO

The China Foundation of Hepatitis Prevention and Control (CFHPC) initiated a project named, "getting to zero mother-to-child transmission of Hepatitis B," in July 2015, which aims to further reduce the incidence of mother-to-child transmission through standardized follow-up management of pregnant women and their infants with chronic hepatitis B virus infection by means of mobile medical application. Over the past three years, the project has established a nationwide collaborative network for interruption of mother-to-child transmission of hepatitis B virus, with 123 hospitals as project members. In addition, it has formulated a technical guidance document (Clinical Management Algorithm for Interrupting Mother-to-Child Transmission of HBV), which is designed and developed as a mobile medical application (SHIELD APP), and was released in an international conference on the theme to eliminate viral hepatitis. Following the measures mentioned above, the public's awareness rate of hepatitis B have been raised, and a good social atmosphere has been formed, which has played a positive role in promoting the prevention and control of viral hepatitis in China.


Assuntos
Antivirais/uso terapêutico , Vírus da Hepatite B , Hepatite B/prevenção & controle , Transmissão Vertical de Doenças Infecciosas/prevenção & controle , Complicações Infecciosas na Gravidez/tratamento farmacológico , Complicações Infecciosas na Gravidez/virologia , Criança , China/epidemiologia , Feminino , Hepatite B/epidemiologia , Antígenos de Superfície da Hepatite B , Vacinas contra Hepatite B/administração & dosagem , Vacinas contra Hepatite B/imunologia , Antígenos E da Hepatite B , Humanos , Lactente , Gravidez , Complicações Infecciosas na Gravidez/epidemiologia
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