RESUMO
BACKGROUND: Cases of bilateral hip fractures are rare, and even more so are cases of bilateral intertrochanteric fractures. Common causes include trauma, internal diseases, and primary or secondary bone diseases. We report a case of bilateral intertrochanteric fractures in an elderly patient following a severe car accident, a scenario not extensively reported in existing literature. CASE PRESENTATION: We report on an 84-year-old male who suffered severe trauma from a car accident, resulting in multiple injuries and shock state, with pain and limited mobility in both hip joints. After examination and imaging studies, the patient was diagnosed with multiple injuries and bilateral intertrochanteric fractures. Following emergency resuscitation, he was admitted to the orthopedic ward. A pre-surgical multidisciplinary team (MDT) consultation was convened to optimize surgical conditions. The patient underwent successful one-stage bilateral intramedullary nailing. The patient was assisted to stand with a walker on the third day after surgery. Six months post-surgery, the patient resumed outdoor activities. CONCLUSION: Managing bilateral intertrochanteric fractures, particularly in the elderly with severe trauma, is notably challenging due to their rarity. However, a coordinated multidisciplinary approach and one-stage bilateral internal fixation can lead to effective treatment outcomes and favorable prognoses.
Assuntos
Acidentes de Trânsito , Fixação Intramedular de Fraturas , Fraturas do Quadril , Humanos , Masculino , Idoso de 80 Anos ou mais , Fraturas do Quadril/cirurgia , Fraturas do Quadril/diagnóstico por imagem , Fixação Intramedular de Fraturas/métodos , Resultado do Tratamento , Traumatismo Múltiplo/cirurgia , Traumatismo Múltiplo/diagnóstico por imagemRESUMO
Access to social support from one's social network can serve as a protective factor against HIV infection; however, research exploring the availability of support in diverse populations that include high proportions of people at increased risk for HIV and the characteristics of network members associated with access to such support is limited. Multi-level dyadic analyses of social network data collected from women at risk for HIV and their network members reveal which individual and relationship characteristics of network members are associated with providing emotional, material, and/or health informational support. Results indicate that access to all three types of support was associated with a network member being a friend, a member of a participant's 'core' group, someone whose opinion matters to the respondent, and the respondent trusting them. These findings have implications for interventions designed to increase access to support among individuals at risk for HIV.
Assuntos
Infecções por HIV , Humanos , Feminino , Infecções por HIV/epidemiologia , Infecções por HIV/prevenção & controle , Infecções por HIV/complicações , Apoio SocialRESUMO
BACKGROUND: Patients undergoing lung tumor surgery may experience various complications after discharge from the hospital. Using patient-reported outcomes (PROs), this study attempted to identify relevant indicators of postdischarge complications after lung tumor surgery and develop a predictive nomogram model to evaluate the risk for individual patients. METHODS: Patients who underwent lung tumor surgery between December 2021 and June 2022 were included in this study. PROs were assessed using the Perioperative Symptom Assessment for Lung Surgery scale and were assessed preoperatively at baseline, on postoperative day 1 (POD1) 1 to POD4, and then weekly until the fourth week. A random forest machine learning prediction model was built to rank the importance of each PRO score of patients on POD1 to POD4. We then selected the top 10 variables in terms of importance for the multivariable logistic regression analysis. Finally, a nomogram was developed. RESULTS: PROs, including coughing (POD3 and POD4), daily activity (POD1), and pain (POD1 and POD2), were associated with postdischarge complications in patients undergoing lung tumor surgery. The predictive model showed good performance in estimating the risk of postdischarge complications, with an area under the curve of 0.833 (95% confidence interval: 0.753-0.912), while maintaining good calibration and clinical value. CONCLUSION: We found that PRO scores on POD1 to POD4 were associated with postdischarge complications after lung tumor surgery, and we developed a helpful nomogram model to predict the risk of postdischarge complications.
Assuntos
Neoplasias Pulmonares , Alta do Paciente , Humanos , Assistência ao Convalescente , Resultado do Tratamento , Neoplasias Pulmonares/cirurgia , Neoplasias Pulmonares/complicações , Pulmão , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/etiologiaRESUMO
OBJECTIVE: To investigate the clinical effect of dumai (governor meridian) moxibustion combined with low-dose tadalafil in the treatment of ED with decline of vital gate fire. METHODS: We enrolled in this study 130 ED patients with decline of vital gate fire who met the inclusion criteria and equally randomized them into a control and an experimental group, the former treated with low-dose tadalafil tablets at 5 mg once a day while the latter by dumai moxibustion once a week in addition, all for 4 weeks. Of the total number of subjects, 62 in the control group and 63 in the experimental group completed the experiment. We recorded the scores on IIEF-5, Erection Quality Scale (EQS), Erection Hardness Scale (EHS), TCM symptoms and Treatment Satisfaction Scale (TSS) as well as the penile hemodynamic parameters peak systolic velocity (PSV), end diastolic velocity (EDV) and resistance index (RI) before and after treatment and compared them between the two groups. RESULTS: The total response rate was significantly higher in the experimental group than in the control (87.30% vs 66.13%, P < 0.05). IIEF-5, EQS, EHS and TSS scores, PSV and RI were markedly increased while TCM symptoms and EDV remarkably decreased in both groups after treatment (P < 0.05), even more significantly in the experimental than in the control group (P < 0.05). CONCLUSION: Dumai moxibustion combined with low-dose tadalafil can improve erectile function, increase penile blood flow velocity and alleviate clinical symptoms in ED patients with decline of vital gate fire, with definite clinical effect and safety.
Assuntos
Disfunção Erétil , Moxibustão , Masculino , Humanos , Disfunção Erétil/tratamento farmacológico , Disfunção Erétil/diagnóstico , Tadalafila/uso terapêutico , Tadalafila/farmacologia , Ereção Peniana , Pênis , Resultado do Tratamento , Carbolinas/uso terapêutico , Carbolinas/farmacologiaRESUMO
BACKGROUND: Tacrolimus has been widely used for immunosuppressive therapy in solid organ transplantation (SOT) and allo-geneic stem cell transplantation (allo-SCT) over the past 2 decades. Pancreatitis caused by tacrolimus was rarely reported in kidney transplantation previously. CASE PRESENTATION: Here we presented a case of a 45-year-old male who underwent kidney transplantation and received immunosuppressive therapy of tacrolimus, on day + 67 after transplantation he developed acute pancreatitis with extremely high blood concentration of tacrolimus. We excluded other possible causes and speculated tacrolimus was the probable inducer of pancreatitis. After tacrolimus was discontinued and alternated with cyclosporine, he gradually recovered and was discharged home with no relapse. CONCLUSION: Tacrolimus can be a probable cause of pancreatitis after kidney transplantation. We recommended clinicians to be aware of the possibility of tacrolimus-induced pancreatitis during tacrolimus treatment.
Assuntos
Ciclosporina/administração & dosagem , Falência Renal Crônica/cirurgia , Transplante de Rim , Pancreatite , Complicações Pós-Operatórias , Tacrolimo , Monitoramento de Medicamentos/métodos , Substituição de Medicamentos/métodos , Humanos , Imunossupressores/administração & dosagem , Imunossupressores/efeitos adversos , Imunossupressores/sangue , Transplante de Rim/efeitos adversos , Transplante de Rim/métodos , Masculino , Pessoa de Meia-Idade , Pancreatite/sangue , Pancreatite/induzido quimicamente , Pancreatite/diagnóstico , Complicações Pós-Operatórias/sangue , Complicações Pós-Operatórias/induzido quimicamente , Complicações Pós-Operatórias/diagnóstico , Tacrolimo/administração & dosagem , Tacrolimo/efeitos adversos , Tacrolimo/sangue , Resultado do TratamentoRESUMO
OBJECTIVE: To investigate the efficacy and safety of regular oral use of sildenafil in the treatment of ED. METHODS: We randomly divided 334 ED patients into three groups to be treated orally with sildenafil tablets at 50 mg qd (sildenafil regular), sildenafil tablets at 100 mg 30 minutes before intercourse (sildenafil on-demand), and tadalafil tablets at 10 mg qd (tadalafil regular), all for 3 months. Then we recorded the IIEF-5 score and penile erection hardness score (EHS) and adverse reactions and compared them among the three groups of patients. RESULTS: There were no statistically significant differences among the three groups of patients in age, body mass index, education, ED duration, or baseline IIEF-5 and EHS (P > 0.05). After 3-month medication, both IIEF-5 score and EHS were significantly improved in the three groups of patients as compared with the baseline (P < 0.05), with no statistically significant difference in the IIEF-5 score among the sildenafil regular, sildenafil on-demand and tadalafil regular groups (15.15 ± 2.05 vs 15.55 ± 2.36 vs 15.54 ± 2.27, P > 0.05), but the EHS markedly higher in the sildenafil on-demand than in the sildenafil regular group (3.48 ± 1.80 vs 3.12 ± 1.52, P < 0.05). The effectiveness rates in the sildenafil regular, sildenafil on-demand and tadalafil regular groups were 76.2%, 62.4% and 80.8%, respectively, significantly lower in the sildenafil on-demand than in the other two groups (P < 0.05). Adverse reactions were mild and showed no statistically significant difference in the incidence rate among the three groups (P > 0.05). CONCLUSIONS: Regular use of sildenafil has a therapeutic effect similar to that of tadalafil but better than that of sildenafil on-demand, without more adverse effects.
Assuntos
Disfunção Erétil/tratamento farmacológico , Citrato de Sildenafila/uso terapêutico , Humanos , Masculino , Ereção Peniana/efeitos dos fármacos , Comprimidos , Tadalafila/uso terapêutico , Resultado do TratamentoRESUMO
Surface water pollution has become a hot issue in recent years in that deterioration of surface water quality has hampered the sustainable development of China's economy. Previous studies have analyzed regional changes of water pollutants, but very few have studied at a national scale. By analyzing 9 water quality parameters recorded at 422 sampling stations nationwide, this studies summarized the spatial and temporal variations of surface water quality in China in "11th Five-Year Plan" period. Research showed that China's surface water quality is improving. But, further deterioration in several areas cannot be ignored. Human activities including over-urbanization and farming exerted a negative impact on surface water quality. Though the water quality in the upstream of major rivers located in northwest China was relatively better than that of other areas, deterioration of surface water quality has begun to emerge in the area. Additionally, the surface water quality in southern China was better than that of northern China. But some studies indicated that surface water quality was likely to worsen at a high speed. It was also found that different water quality parameters are characterized by spatial and temporal variations. These studies pointed out, the government should pay more attention to in the areas where the water quality parameters significantly exceeded the national standards. These studies provides theoretical basis for the decision-making and implementation of macro-scale water quality control policies.
Assuntos
Rios/química , Poluição da Água/análise , Qualidade da Água , China , Conservação dos Recursos Naturais/métodos , Monitoramento Ambiental , Humanos , Planejamento Social , Urbanização , Poluentes da Água/análise , Poluição da Água/prevenção & controle , Poluição da Água/estatística & dados numéricosRESUMO
PURPOSE: Symptom assessment based on patient-reported outcome (PRO) can correlate with disease severity, making it a potential tool for threshold alerts of postoperative complications. This study aimed to determine whether shortness of breath (SOB) scores on the day of discharge could predict the development of post-discharge complications in patients who underwent lung cancer surgery. METHODS: Patients were from a study of a dynamic perioperative rehabilitation cohort of lung cancer patients focusing on patient-reported outcomes. Patients were assessed using the Perioperative Symptom Assessment Scale for Lung surgery (PSA-Lung). Logistic regression model was used to examine the potential association between SOB on the day of discharge and complications within 3 months after discharge. The post-discharge complications were taken as the anchor variable to determine the optimal cutpoint for SOB on the day of discharge. RESULTS: Complications within 3 months post-discharge occurred in 71 (10.84%) of 655 patients. Logistic regression analysis revealed that being female (OR 1.764, 95% CI 1.006-3.092, P < 0.05) and having two chest tubes (OR 2.026, 95% CI 1.107-3.710, P < 0.05) were significantly associated with post-discharge complications. Additionally, the SOB score on the day of discharge (OR 1.125, 95% CI 1.012-1.250, P < 0.05) was a significant predictor. The optimal SOB cutpoint was 5 (on a scale of 0-10). Patients with an SOB score ≥ 5 at discharge experienced a lower quality of life 1 month later compared to those with SOB score<5 at discharge (73 [50-86] vs. 81 [65-91], P < 0.05). CONCLUSION: SOB on the day of discharge may serve as an early warning sign for the timely detection of 3 month post-discharge complications.
Assuntos
Dispneia , Neoplasias Pulmonares , Alta do Paciente , Complicações Pós-Operatórias , Humanos , Feminino , Masculino , Neoplasias Pulmonares/cirurgia , Dispneia/etiologia , Idoso , Pessoa de Meia-Idade , Pneumonectomia/efeitos adversosRESUMO
OBJECTIVE: To compare the clinical effect between heat-sensitive moxibustion and mild moxibustion for migraine without aura. METHODS: A total of 54 patients with migraine without aura were randomized into an observation group (27 cases, 2 cases dropped off) and a control group (27 cases, 2 cases dropped off). The basic western medication treatment was adopted in the two groups. In the control group, mild moxibustion was applied at Shuaigu (GB 8), Fengchi (GB 20) and Yanglingquan (GB 34) on the affected side. In the observation group, the frequent acupoint areas of the affected side i.e. Shuaigu (GB 8), Fengchi (GB 20), Taiyang (EX-HN 5), Taichong (LR 3), Yanglingquan (GB 34) were determined, 3 acupoints with strong heat-sensitive sensation were selected each time and mild moxibustion was adopted. The treatment was given once a day, 5 times of treatment was as one course and 2 courses were required in the two groups. Before and after treatment, the scores of migraine symptom, visual analogue scale (VAS), migraine specific quality of life questionnaire (MSQ) were observed, and the clinical efficacy was evaluated after treatment in the two groups. RESULTS: After treatment, the scores of migraine symptom and VAS were decreased compared with those before treatment (P<0.01), while the MSQ scores were increased compared with those before treatment (P<0.01) in the two groups. After treatment, the scores of migraine symptom and VAS in the observation group were lower than those in the control group (P<0.05), while the MSQ score in the observation group was higher than that in the control group (P<0.01). The total effective rate was 92.0% (23/25) in the observation group, which was superior to 72.0% (18/25) in the control group (P<0.05). CONCLUSION: Both heat-sensitive moxibustion and mild moxibustion can effectively alleviate the clinical symptoms, improve the headache degree and life quality in patients with migraine without aura, the clinical efficacy of heat-sensitive moxibustion is superior to that of mild moxibustion.
Assuntos
Terapia por Acupuntura , Enxaqueca sem Aura , Moxibustão , Humanos , Enxaqueca sem Aura/terapia , Temperatura Alta , Qualidade de Vida , Pontos de Acupuntura , Resultado do TratamentoRESUMO
BACKGROUND: Acupotomy as well as Juanbi decoction has been used in the treatment of lumbar disc herniation. However, there is no study on ultrasound-guided acupotomy combined with Juanbi decoction in the treatment of lumbar disc herniation. METHOD: This study was supported by the Sichuan Provincial Administration of Traditional Chinese Medicine [grant number: 2020LC0163] and the Science and Technology Department of Sichuan Province [grant number: 2022YFS0418]. This study was 3 center, open, randomized, controlled trial, and was carried out from December 2020 to December 2022. A total of 60 eligible patients with LDH were split into group A and group B at random. The group B received Juanbi Decoction 3 times daily for 2 weeks along with an acupotomy assisted by ultrasound. The acupotomy was administered once a week. The same protocol was used with the group A, but the Juanbi Decoction was replaced with normal saline. OBSERVATION INDEX: Visual analogue scale (VAS) score on 1 day and 1 week after treatment, VAS score, Japanese orthopedic association low back pain score(JOA) rate, Oswestry Disability Index (ODI), and low back outcome scale (LBOS) at 1, 3, 6, and 12 months after treatment in 2 groups. RESULTS: There were no significant differences in general information, VAS score before treatment, JOA, ODI, and LBOS between the 2 groups (P > .05). Intra-group comparison: VAS score, JOA rate, ODI, and LBOS were compared before and after treatment in both groups, and the differences were statistically significant (P < .05). There were significant differences in VAS and LBOS between the 2 groups at 3 and 6 months after treatment, and there were statistically significant differences in ODI and JOA rates at 3, 6, and 12 months after treatment between the 2 groups. CONCLUSION: Acupotomy aided by ultrasound combined with Juanbi Decoction significantly relieves lumbar pain and can improve lumbar function in patients with LDH, and the clinical efficacy lasts for about 6 months.
Assuntos
Terapia por Acupuntura , Deslocamento do Disco Intervertebral , Dor Lombar , Humanos , Deslocamento do Disco Intervertebral/diagnóstico por imagem , Deslocamento do Disco Intervertebral/terapia , Vértebras Lombares/diagnóstico por imagem , Resultado do Tratamento , Ultrassonografia de IntervençãoRESUMO
Coastal erosion will aggravate the loss of shorelines and threaten the safety of coastal engineering facilities. Mangrove is often considered as an efficient coastal guard; however the mechanisms involved in anti-scouribility ascribed to mangrove are still poorly understood. Thus, two artificial mangrove forests (including exotic Sonneratia apetala and native Kandelia obovata) and an unvegetated mudflat control were selected to explore the potential function of microbial extracellular polymeric substance (EPS) on the anti-scouribility of the sediments. A cohesive strength meter was used for the analysis of anti-scouribility, while a sequential extraction and 16S high-throughput sequencing were employed to evaluate the changes in EPS and microbial community driven by mangrove restoration. Principal component, redundancy, and two-matrix correlation heatmap analyses were performed for the analyses of the correlations among shear stress, EPS, microbes, and soil properties. The results showed an obvious enhancement of anti-scouribility after mangrove restoration. Compared to those of unvegetated mudflat, shear stress increased from 1.94 N/m2 to 3.26 and 4.93 N/m2 in the sediments of S. apetala and K. obovata stands, respectively. Mangrove restoration also promoted EPS content in the sediments, irrespective of EPS components and sub-fractions. Both extracellular protein and polysaccharide were found to be positively correlated with anti-scouribility. Coinciding with increased anti-scouribility and EPS, increased bacterial abundances were also detected in the sediments after mangrove restoration (especially K. obovata), whereas Proteobacteria and Bacteroides may be important and influential for EPS secretion and anti-scouribility promotion. Nevertheless, increased total organic carbon, total nitrogen and total phosphorus induced by mangrove restoration may also partially contribute to improvement of anti-scouribility. In conclusion, this is the first study to provide evidence for a link between mangrove restoration and increased EPS which improve resistance to scouring. The present study provides a novel perspective on the revealing of the function of mangrove on erosion mitigation.
Assuntos
Microbiota , Rhizophoraceae , Matriz Extracelular de Substâncias Poliméricas , Solo , Áreas AlagadasRESUMO
Objective: To investigate the short-term effectiveness of TiRobot combined with O-arm navigation system in the minimally invasive treatment of hindfoot fracture. Methods: Between March 2019 and March 2021, 25 patients with hindfoot fractures were admitted. There were 14 males and 11 females, with an average age of 51.7 years (range, 19-76 years). The causes of injuries included falling from height in 17 cases and traffic accident in 8 cases. The interval between injury and operation was 1-3 days (mean, 2.1 days). There were 16 cases of calcaneus fracture, 7 cases of talus fracture, and 2 cases of calcaneus and talus fractures. According to Sanders classification criteria, the calcaneus fractures were classified as type â ¡ in 10 cases and type â ¢ in 8 cases; according to the Hawkins classification criteria, the talus fractures were classified as type â ¡ in 4 cases and type â ¢ in 5 cases. Preoperative American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score was 48.1±9.1. During operation, the fractures were fixed with the percutaneous cannulated screws with the assistance of the TiRobot combined with the O-arm navigation system. The operation time, hospital stay, and the occurrence of related complications were recorded. X-ray films were reviewed to evaluate the fracture healing and the occurrence of talus osteonecrosis, and the width, length, height, Böhler's angle, and Gissane's angle of the calcaneus were measured; AOFAS ankle-hindfoot score was used to evaluated the foot function. Results: The operation time ranged from 47 to 71 minutes (mean, 60.5 minutes). The length of hospital stay ranged from 2 to 5 days (mean, 3.4 days). All incisions healed by first intention. All patients were followed up 12-24 months (mean, 17.3 months). One patient demonstrated hypoesthesia on the lateral side of foot after operation and recovered after symptomatic treatment. All fractures healed confirmed by X-ray films and the healing time ranged from 10 to 16 weeks (mean, 11.8 weeks). No talus osteonecrosis occurred during follow-up. There were significant differences in the width, length, height, Böhler's angle, and Gissane's angle of the calcaneus between pre-operation and at last follow -up ( P<0.05). At last follow-up, AOFAS ankle-hindfoot score was 91.2±5.0, the difference was significant when compared with preoperative score ( t=22.169, P<0.001). The results were excellent in 16 cases and good in 9 cases, with an excellent and good rate of 100%. Conclusion: TiRobot combined with O-arm navigation system for minimally invasive treatment of hindfoot fractures can obtain the satisfactory short-term effectiveness, with the advantages of less surgical trauma, precise fixation, and fewer complications.
Assuntos
Fraturas do Tornozelo , Traumatismos do Tornozelo , Calcâneo , Traumatismos do Pé , Fraturas Ósseas , Traumatismos do Joelho , Procedimentos Cirúrgicos Minimamente Invasivos , Osteonecrose , Cirurgia Assistida por Computador , Calcâneo/lesões , Feminino , Traumatismos do Pé/cirurgia , Fixação Interna de Fraturas/métodos , Fraturas Ósseas/cirurgia , Humanos , Imageamento Tridimensional , Traumatismos do Joelho/cirurgia , Masculino , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios X , Resultado do TratamentoRESUMO
The study explored the clinical efficacy of a type 5 phosphodiesterase inhibitor (PDE5i) combined with Ziyin Baihuo granules in the treatment of patients suffering from erectile dysfunction (ED) with yin deficiency and fire-hyperactivity syndrome. A total of 163 patients with erectile dysfunction were divided into observation and control groups. The observation group took tadalafil (Cialis) and Ziyin Baihuo granules orally, and the control group took only tadalafil orally, for 12 weeks. An additional 40 healthy people were selected as a normal group for comparison of the sex hormone levels before and after treatment of the participants in the erectile dysfunction group. After treatment, the symptoms of dry throat and tongue, tidal fever and night sweats, liking cold and avoiding heat, and waist pain showed significant improvement in the observation group (p < .05). Compared with before treatment, the clinical indexes of erectile function in the control group and the observation group were improved after treatment (p < .05). After treatment, Ziyin Baihuo granules combined with tadalafil restored the abnormal indexes of blood (p < .05) in the observation group. Our research shows that PDE5i combined with Ziyin Baihuo granules could effectively improve erectile function.
Assuntos
Disfunção Erétil , Masculino , Humanos , Disfunção Erétil/tratamento farmacológico , Inibidores de Fosfodiesterase , Tadalafila/uso terapêutico , Resultado do Tratamento , EmoçõesRESUMO
OBJECTIVE: To observe the clinical results of different concentration NaCl solution in hemorrhagic shock resuscitation. METHODS: The 75 cases with hemorrhagic shock were divided into five groups by means of random number table. Treat the cases with 0.9% (control group), 3%, 4.5%, 6% and 7.5% NaCl solution, respectively. Observe the changes of BP, HR, blood gas, renal function, electrolyte concentration of plasma, before and after treatment. RESULTS: After transfusion, compared with groups of 0.9% NS, the mean BP of patients in other four groups rise more quickly but only the group of 4.5% can last 30 minutes (P < 0.05), and K(+) of plasma in groups of 6%, 7.5% NS decline more obviously (P < 0.05), the group of 4.5% maintain the best lever. CONCLUSION: The mean BP of patients rise quickly and continue for a long time, in the group of 4.5%. Meanwhile the internal environment of the body maintain relatively stable in the group of 4.5%.
Assuntos
Choque Hemorrágico/terapia , Cloreto de Sódio/administração & dosagem , Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Solução Salina Hipertônica/administração & dosagem , Resultado do Tratamento , Adulto JovemRESUMO
OBJECTIVE: To investigate the clinical effect of thunder-fire moxibustion combined with electroacupuncture in the treatment of cold-dampness knee osteoarthritis. METHODS: A total of 72 patients with cold-dampness knee osteoarthritis were randomly divided into observation group and control group according to the random numbers generated by computer software, with 36 patients in each group. For the observation group, electroacupuncture was performed at the main acupoints of Dubi (ST35), Neixiyan (EX-LE4), Zusanli (ST36), Yanglingquan (GB34), Yinlingquan (SP9), Xuehai (SP10), Liangqiu (ST34), and Heding (EX-LE2) once a day, with a needle retaining time of 30 min, and thunder-fire moxibustion was performed at Shenque (CV8) and Guanyuan (CV4) in the form of suspended moxibustion once a day, with 30 min each time. The patients in the control group were given oral administration of diclofenac sodium double-release enteric-coated capsules, 75 mg each time, once a day, and Fugui Gutong capsules, 6 capsules a time and 3 times a day. Each course of treatment was 14 days, and both groups were treated for 2 courses, with an interval of 2 days between the two courses. Visual Analogue Scale (VAS) score, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, and Lequesne index were observed before the treatment, immediately after the treatment, and at 4 months after the treatment, and the outcome of traditional Chinese medicine (TCM) syndrome was compared between the two groups after treatment. RESULTS: Both groups had significant reductions in VAS score, WOMAC score, and Lequesne index immediately and at 4 months after the treatment (P<0.05). Compared with the control group, the observation group had significant reductions in VAS score, Lequesne index, and WOMAC score (scores of pain, function and total score) immediately and at 4 months after the treatment (P<0.05). The effective rate was 97.1% (34/35) in the observation group, and was 78.8% (26/33) in the control group. The effective rate of the observation group was obviously higher than that of the control group (P<0.05). CONCLUSION: Thunder-fire moxibustion combined with electroacupuncture has a better, more durable clinical effect and fewer adverse reactions than the drugs in the treatment of cold-dampness knee osteoarthritis.
Assuntos
Eletroacupuntura , Moxibustão , Osteoartrite do Joelho , Pontos de Acupuntura , Humanos , Resultado do TratamentoRESUMO
To analyze the distribution pattern concerning multi-nozzle interference spray particle granularity between hydraulic supports, the present study conducts atomization interference experimental characterization for three types of nozzles used in coal mines based on a Doppler laser interference spray dust suppression simulation experimental system. The results indicate that for single-nozzle atomization, the impact of spray pressure on spray droplet size is gradually subdued, and a spray pressure of 8 MPa yields the best result; compared with single-nozzle spray, the multi-nozzle atomization interference effect can downsize the spray field overlapping zone, leading to an improved uniformity of overall spray particle distribution. As the spray field overlapping coefficient k increases, the particle size of the interference spray field decreases first and then increases. As the spray field overlapping coefficient reaches 0.4, the distribution of spray droplet size is most concentrated, corresponding to the optimal atomized dust suppression effect. Practical testing indicates that the optimal spray field overlapping coefficient measured at a fully mechanized mining face agrees well with the experimental result. Under the optimal parameters, the average total dust and respirable dust suppression rates measured at various measuring points on the downwind side during support relocation reach 78.93% and 80.53%, respectively.
Assuntos
Minas de Carvão , Poeira , Poluição Ambiental/prevenção & controle , Tamanho da Partícula , PressãoRESUMO
BACKGROUND: Coil embolization of intracranial aneurysms is being increasingly used; however, thromboembolic events have become a major periprocedural complication. OBJECTIVE: To determine the safety and efficacy of prophylactic tirofiban in patients with ruptured intracranial aneurysms. METHODS: Tirofiban was administered as an intravenous bolus (8.0â µg/kg over 3â min) followed by a maintenance infusion (0.10â µg/kg/min) before stent deployment or after completion of single coiling. Dual oral antiplatelet therapy (loading doses) was overlapped with half the tirofiban dose 2â h before cessation of the tirofiban infusion. Cases of intracranial hemorrhage or thromboembolism were recorded. RESULTS: Tirofiban was prophylactically used in 221 patients, including 175 (79.19%) who underwent stent-assisted coiling and 46 (20.81%) who underwent single coiling, all in the setting of aneurysmal subarachnoid hemorrhage. Six (2.71%) cases of intracranial hemorrhage occurred, including four (1.81%) tirofiban-related cases and two (0.90%) antiplatelet therapy-related cases. There were two (0.90%) cases of fatal hemorrhage, one related to tirofiban and the other related to dual antiplatelet therapy. Thromboembolic events occurred in seven (3.17%) patients (6 stent-assisted embolization, 1 single coiling), of which one (0.45%) event occurred during stenting and six (2.72%) occurred during intravenous tirofiban maintenance. No thromboembolic events related to dual antiplatelet therapy were found. CONCLUSIONS: Tirofiban bolus over 3â min followed by maintenance infusion appears to be a safe and efficient prophylactic protocol for the endovascular treatment of ruptured intracranial aneurysms and may be an alternative to intraoperative oral antiplatelet therapy, especially in the case of stent-assisted embolization.
Assuntos
Aneurisma Roto/terapia , Procedimentos Endovasculares/métodos , Aneurisma Intracraniano/terapia , Cuidados Intraoperatórios/métodos , Profilaxia Pré-Exposição/métodos , Tirosina/análogos & derivados , Administração Intravenosa , Administração Oral , Adulto , Idoso , Aneurisma Roto/diagnóstico por imagem , Embolização Terapêutica/efeitos adversos , Embolização Terapêutica/métodos , Procedimentos Endovasculares/efeitos adversos , Feminino , Humanos , Injeções Intravenosas , Aneurisma Intracraniano/diagnóstico por imagem , Cuidados Intraoperatórios/efeitos adversos , Masculino , Pessoa de Meia-Idade , Inibidores da Agregação Plaquetária/administração & dosagem , Stents , Tirofibana , Resultado do Tratamento , Tirosina/administração & dosagemRESUMO
Cattle dung, firewood, and crop straw have being used as survival necessities by farmers and herdsmen for thousands of years in Tibet. Until recently such biotic energy source still constitutes more than 92 per cent of total rural energy consumption due to lack of petroleum, coal and new alternative energy sources. As a result, environmental degradation such as land desertification, soil erosion, grassland degradation and soil fertility reduction is increasingly aggravated, the area of desertified land has increased 1467.5 km2 from 1991 to 1997. Degraded area of grassland has reached 2.60 x 10(7) hm2, increased by 116.1% from 1987 to 1996. To prevent further deterioration of eco-environment in Tibet great efforts should be made to make full use of ample solar energy, wind energy and other biotic energy of the Qinghai-Tibet Plateau. The solar cooking stoves and solar hothouse, expand forest area and replace existing abiotic energy sources with firewood forest should be popularized. This is an urgent task to protect the eco-environment of Tibet today.
Assuntos
Conservação dos Recursos Naturais , Poluentes Ambientais/análise , Poluição Ambiental/prevenção & controle , Animais , Culinária , Monitoramento Ambiental , Humanos , Esterco , População Rural , Energia Solar , Tibet , Árvores , MadeiraRESUMO
Resveratrol (3,4',5-trihydroxystilbene) is a naturally derived phytoalexin stilbene isolated from grapes and other plants, playing an important role in human health and is well known for its extensive bioactivities, such as antioxidation, anti-inflammatory, anticancer. In addition to resveratrol, scientists also pay attention to resveratrol oligomers, derivatives of resveratrol, which are characterized by the polymerization of two to eight, or even more resveratrol units, and are the largest group of oligomeric stilbenes. Resveratrol oligomers have multiple beneficial properties, of which some are superior in activity, stability, and selectivity compared with resveratrol. The complicated structures and diverse biological activities are of significant interest for drug research and development and may provide promising prospects as cancer preventive and therapeutical agents. This review presents an overview on preventive or anticancer properties of resveratrol oligomers.
Assuntos
Antineoplásicos Fitogênicos/uso terapêutico , Neoplasias/tratamento farmacológico , Polímeros/química , Estilbenos/química , Estilbenos/uso terapêutico , Antineoplásicos Fitogênicos/farmacologia , Apoptose/efeitos dos fármacos , Pontos de Checagem do Ciclo Celular/efeitos dos fármacos , Humanos , Neoplasias/prevenção & controle , Resveratrol , Estilbenos/farmacologiaRESUMO
Specificity of acupoints is one of the basic theories of the acupuncture and moxibustion sciences and is a very important basis to guide the clinical treatment of acupuncture and moxibustion. However, the scientific foundation of specificity of acupoints is still unclear, which has greatly restricted to the clinical effect improvement of acupuncture and moxibustion and has influenced to academic status of acupuncture and moxibustion sciences both in China and abroad. In this paper, the recent related researches are reviewed and then the key effects and mechanism that the tissue structure of acupoints can decide and affect specificity of acupoints-organs effects are analyzed and explored. It is held that acupuncture at the different tissue structure of the different depth in the different or the same acupoints will cause changes of varying qualities or degrees of visceral function because of stimulation of the different receptors in the different tissues followed by excitation of varying afferent nerve fibers.