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1.
J Prev Alzheimers Dis ; 11(3): 649-660, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38706281

RESUMO

BACKGROUND: Subjective hearing loss (SHL) refers to an individual's self-assessment of their hearing loss. The association and underlying mechanisms between SHL and cognitive impairment still necessitate elucidation. OBJECTIVES: To validate potential mechanisms between SHL and cognitive impairment. DESIGN: Cross-section. SETTING: Shanghai, China. PARTICIPANTS: A total of 2369 individuals from communities and the cognitive disorder clinic. MEASUREMENTS: All participants were subjected to a comprehensive neuropsychological assessment, encompassing the Hearing Handicap Inventory for the Elderly-Screening Version (HHIE-S). The participants' brain ß-amyloid (Aß) deposition status, plasma biomarkers associated with Alzheimer's disease (AD), and cardiovascular risk factors were also collected. RESULTS: In individuals with a heightened SHL, elevated HHIE-S score was linked to diminished cognitive and daily functioning as well as heightened levels of depressed mood. This correlation was observed in auditory memory performance but not in visual memory. The influence of SHL on cognitive function was mediated by depressed mood. SHL was associated with diabetes and smoking, whereas cognitive function was associated with hyperlipidemia and alcohol consumption. In individuals with positive brain Aß deposition, SHL demonstrated associations with cognitive function independent of plasma Aß42/40 ratio, P-tau181, neurofilament light chain, and APOE allele status. CONCLUSION: SHL has an independent effect on cognitive impairment. The findings do no provide evidence for the common cause mechanism. Instead, the findings support the presence of a cognitive resource mechanism and an impoverished environment mechanism, along with the potential for a pathological interaction mechanism.


Assuntos
Peptídeos beta-Amiloides , Disfunção Cognitiva , Perda Auditiva , Humanos , Masculino , Feminino , Perda Auditiva/psicologia , Idoso , Peptídeos beta-Amiloides/metabolismo , Peptídeos beta-Amiloides/sangue , Estudos Transversais , China , Testes Neuropsicológicos , Pessoa de Meia-Idade , Biomarcadores/sangue , Fatores de Risco , Autoavaliação Diagnóstica , Encéfalo/metabolismo , Depressão
3.
Zhonghua Yi Xue Za Zhi ; 103(24): 1830-1835, 2023 Jun 27.
Artigo em Chinês | MEDLINE | ID: mdl-37357188

RESUMO

Objective: To investigate the efficacy and safety of transcatheter aortic valve replacement (TAVR) in the treatment of severe aortic stenosis. Methods: The clinical data of patients with severe aortic stenosis who underwent TAVR at the People's Hospital of Xinjiang Uygur Autonomous Region between September 2016 and September 2022 were retrospectively analyzed. Changes in aortic transvalvular pressure gradients, valve orifice area, and activity tolerance of patients before and after the surgery were compared. Moreover, postoperative complications and follow-up results from 30 days to 6 years after the surgery were recorded. Results: A total of 76 patients were included in the study (50 males and 26 females), with an average age of (71.3±7.6) years, including 16 rheumatic valvular diseases, 60 senile degenerative diseases, 46 bicuspid valves and 30 tricuspid valves. The success rate of the operation was 96.1% (73/76). Compared with that before the operation, the mean aortic transvalvular pressure gradients decreased [(8.5±2.8) mmHg vs (68.5±19.2) mmHg (1 mmHg=0.133 kPa),P<0.001], but the valve orifice area increased [(1.91±0.31) cm2 vs (0.65±0.21) cm2, P<0.001]. Likewise, six-minute walking test (6MWT) showed that walking distance was longer after the surgery [(430±13) m vs (201±28) m, P<0.001]. There were 1 case of retroperitoneal hematoma, 1 case of stricture balloon dilatation after femoral artery suture concomitant with postoperative puncture site infection, 1 case of femoral artery surgical incision, 2 cases of valve-in-valve (ViV) and 5 cases of perivalvular leakage (4 cases were mild and 1 case was moderate) after the surgery, respectively. Moreover, acute left main artery occlusion during operation occurred in 1 case, ventricular rupture during operation occurred in 1 case and the patient was transferred to valve replacement surgery and finally dead, delayed coronary artery occlusion and death happened in 1 case, and all of the above-mentioned 3 cases were due to surgical failure. Postoperative pacemaker implantation due to third-degree atrioventricular block was performed in 5 cases. There were 1 case of pulmonary embolism, 1 case of transient right limb disorder, 1 case of gastrointestinal bleeding and 1 case of urethral bleeding after the surgery, respectively. The patients were followed up for (1.0±0.1) years (30 days to 6 years), and the results showed that 2 cases died, including 1 case died suddenly at home (the cause of death was unknown) and 1 case died of acute heart failure 8 months after the surgery. Chronic heart failure occurred repeatedly in 6 cases. The quality of life of other patients improved significantly. Conclusion: TAVR is effective and safe for patients with severe aortic stenosis.


Assuntos
Estenose da Valva Aórtica , Implante de Prótese de Valva Cardíaca , Próteses Valvulares Cardíacas , Substituição da Valva Aórtica Transcateter , Masculino , Feminino , Humanos , Pessoa de Meia-Idade , Idoso , Substituição da Valva Aórtica Transcateter/métodos , Valva Aórtica/cirurgia , Estenose da Valva Aórtica/cirurgia , Estudos Retrospectivos , Qualidade de Vida , Resultado do Tratamento , Complicações Pós-Operatórias , Fatores de Risco
4.
Clin Radiol ; 78(5): e393-e400, 2023 05.
Artigo em Inglês | MEDLINE | ID: mdl-36822980

RESUMO

AIM: To compare the accuracy of hand-held ultrasonography (US), mammography (MG), magnetic resonance imaging (MRI), and automated breast volume scanning (ABVS) in defining residual breast cancer tumour size after neoadjuvant therapy (NAT). MATERIALS AND METHODS: Patients diagnosed breast cancer and who received NAT at the Breast Center, Peking University People's Hospital, were enrolled prospectively. Imaging was performed after the last cycle of NAT. The residual tumour size, intraclass correlation coefficients (ICCs), and receiver operating characteristic (ROC) to predict pathological complete response (pCR) were analysed. RESULTS: A total of 156 patients with 159 tumours were analysed. ABVS had a moderate correlation with histopathology residual tumour size (ICC = 0.666), and showed high agreement among triple-positive tumours (ICC = 0.797). With 5 mm as the threshold, the coincidence rate reached 64.7% between ABVS and pathological size, which was significantly higher than that between US, MG, MRI, and pathological size (50%, 45.1%, 41.4%; p=0.009, p=0.001, p<0.001, respectively). For ROC analysis, ABVS demonstrated a higher area under the ROC curve, but with no statistical difference, except for MG (0.855, 0.816, 0.819, and 0.788, respectively; p=0.183 for US, p=0.044 for MG, and p=0.397 for MRI, with ABVS as the reference). CONCLUSIONS: The longest tumour diameter on ABVS had a moderate correlation with pathological residual invasive tumour size. ABVS was shown to have good ability to predict pCR and would appear to be a potential useful tool for the assessment after NAT for breast cancer.


Assuntos
Neoplasias da Mama , Feminino , Humanos , Neoplasias da Mama/diagnóstico por imagem , Neoplasias da Mama/terapia , Neoplasias da Mama/patologia , Neoplasia Residual/diagnóstico por imagem , Neoplasia Residual/patologia , Terapia Neoadjuvante/métodos , Ultrassonografia Mamária/métodos , Interpretação de Imagem Assistida por Computador/métodos , Mama/diagnóstico por imagem , Mama/patologia , Mamografia/métodos , Ultrassonografia/métodos , Imageamento por Ressonância Magnética/métodos
6.
Artigo em Chinês | MEDLINE | ID: mdl-36058665

RESUMO

Objective: To analyze the characteristics of trigeminal event-related potentials (tERPs) in different kinds of olfactory disorders (OD), and to evaluate the importance of tERPs for the patients with olfactory dysfunction. Methods: Clinical data of 314 patients with olfactory dysfunction from the Smell and Taste Clinics in Beijing Anzhen Hospital from 2015 to 2021 were retrospectively reviewed, including 158 males and 156 females, aging from 6 to 78 years. The control group consisted of healthy people from medical examination center, who were gender and age matched. The clinical characteristics of OD were analyzed using Sniffin' Sticks test, olfactory event-related potentials (oERPs), tERPs and acoustic rhinometry test. SPSS 17.0 software was used to compare the difference of tERPs between the two groups, and to analyze the related factors affecting trigeminal function. Results: The ratio of tERPs presence was different in OD caused by different reasons: head traumatic OD (54.9%), post-virus infection OD (63.6%), sinonasal inflammatory OD (68.4%) and OD due to other causes (56.9%). Compared with controls, tERPs signals in OD patients showed a significant lower amplitude in the N1 wave (all P<0.001), and lower amplitude in the P2 wave in most OD patients (head trauma t=-4.11, P<0.001; sinonasal inflammation t=-2.04, P=0.046; others t=-2.40, P=0.020) except in OD by post-virus infection (t=-1.98, P=0.052). tERPs signals in OD patients by sinonasal inflammation showed longer latency in the N1 wave (t=2.15, P=0.036), but this difference was not observed in other OD patients (all P>0.05). tERPs signals were significantly correlated with the Sniffin' Sticks score, deficiency of oERPs and nasal minimum cross-sectional area (all P<0.05). Conclusions: OD patients show neurophysiologic deficits in trigeminal function. The absence of tERPs or lower amplitude in N1 waves are the important characteristics of patients with OD.


Assuntos
Transtornos do Olfato , Viroses , Potenciais Evocados/fisiologia , Feminino , Humanos , Inflamação , Masculino , Transtornos do Olfato/etiologia , Estudos Retrospectivos , Olfato/fisiologia , Viroses/complicações
7.
Zhonghua Liu Xing Bing Xue Za Zhi ; 43(7): 1140-1146, 2022 Jul 10.
Artigo em Chinês | MEDLINE | ID: mdl-35856212

RESUMO

Objective: To assess the cost-effectiveness of influenza vaccination among people aged 60 years and older in Shenzhen. Methods: A Markov state transition model was constructed to evaluate the cost-effectiveness of annual influenza vaccination for preventing influenza infection compared with no vaccination among the elderly from the social perspective. Allowing seasonal variation of influenza activity, the model followed a five-year cohort using weekly cycles. We employed once the Chinese gross domestic product (GDP) per capita in 2019 (70 892 yuan) as the willingness-to-pay (WTP) threshold and calculated the net monetary benefit (NMB) with costs and quality-adjusted life-years (QALYs) discounted at 5% annually. The impact of parameter uncertainty on the results was examined using one-way and probabilistic sensitivity analyses (PSA). Results: The base case amounted to approximately 35 yuan of cost-saving and a net gain of 0.007 QALYs. Correspondingly, the NMB was 529 yuan per vaccinated person. One-way sensitivity analyses showed that the NMB was relatively sensitive to changes in the attack rate of influenza and vaccine effectiveness. Based on the results of PSA with 1 000 Monte Carlo simulations, influenza vaccination had a probability of being cost-effective in 100% of the repetitions. Conclusions: The present study provides evidence that influenza vaccination is a cost-saving disease prevention strategy for people aged 60 years and older in Shenzhen.


Assuntos
Vacinas contra Influenza , Influenza Humana , Idoso , Análise Custo-Benefício , Humanos , Vacinas contra Influenza/uso terapêutico , Influenza Humana/prevenção & controle , Cadeias de Markov , Pessoa de Meia-Idade , Anos de Vida Ajustados por Qualidade de Vida , Vacinação/métodos
8.
Zhonghua Yu Fang Yi Xue Za Zhi ; 56(3): 302-311, 2022 Mar 06.
Artigo em Chinês | MEDLINE | ID: mdl-35381651

RESUMO

Objective: To investigate the germline mutation status of related genes in breast cancer patients and high-risk individuals by next-generation sequencing. To analyze the correlations between homologous recombination repair (HR) pathway gene mutation status and clinicopathological characteristics of breast cancer patients. To supplement the database of breast cancer related gene mutations in Chinese population. Methods: This study is a cross-sectional study. From October 2020 to September 2021, whole blood samples were collected from 350 breast cancer patients and 49 high-risk individuals, admitted to Peking University People's Hospital and accepted genetic testing voluntarily. Germline mutations in 32 breast cancer related genes were detected by NGS. The clinicopathological characteristics, including age at the onset, family history, unilateral/bilateral tumor, Luminal typing (Luminal A subtype, Luminal B subtype, HER2-enriched subtype and triple negative breast cancer), tumor size and metastasis, were analyzed, and the correlations between HR pathway gene mutation status and clinicopathological characteristics were analyzed by Chi-squared test and Fisher's exact probability test. Results: Among 350 breast cancer patients, 64 (18.3%) cases carried gene pathogenic mutations (including pathogenic and likely pathogenic mutations), including 47 (13.4%) in BRCA1/2, 16 (4.6%) in non-BRCA1/2 genes, 1 (0.3%) in BRCA2 and FANCL. Among 49 high-risk individuals, 7 (14.3%) cases carried gene pathogenic mutations, including 6 (12.3%) in BRCA1/2 and 1 (2%) in ATM genes. BRCA1/2 pathogenic mutations were associated with age at the onset (18%, 8.7%, χ²=6.346, P=0.012), and the BRCA1/2 pathogenic mutation frequency was higher in patients diagnosed at age ≤45 years. HR pathway gene mutations (including pathogenic, likely pathogenic and uncertain significance mutations) were correlated with unilateral/bilateral tumor (49.5%, 68.4%, χ²=4.841, P=0.028) and Luminal typing (45.7%, 62.2%, 32%, 60%, χ²=12.004, P=0.007), and the HR mutation frequencies were higher in patients with bilateral tumor, Luminal B breast cancer and triple negative breast cancer (TNBC). Conclusion: The BRCA1/2 pathogenic mutation frequency in high-risk individuals is similar to that in breast cancer patients, and BRCA1/2 testing is helpful to guide breast cancer screening and prevention in high-risk individuals. Patients with early onset breast cancer, bilateral breast cancer, Luminal B breast cancer and TNBC have higher mutation frequencies of HR pathway genes, and HR pathway genes testing should be conducted as soon as possible to provide laboratory evidence for diagnosis, treatment, prognosis and risk evaluation of breast cancer.


Assuntos
Proteína BRCA1 , Proteína BRCA2 , Neoplasias da Mama , Reparo de DNA por Recombinação , Neoplasias de Mama Triplo Negativas , Proteína BRCA1/genética , Proteína BRCA2/genética , Neoplasias da Mama/genética , Neoplasias da Mama/patologia , Estudos Transversais , Feminino , Predisposição Genética para Doença , Mutação em Linhagem Germinativa , Sequenciamento de Nucleotídeos em Larga Escala , Humanos , Pessoa de Meia-Idade , Mutação , Neoplasias de Mama Triplo Negativas/genética , Neoplasias de Mama Triplo Negativas/patologia
9.
Ann R Coll Surg Engl ; 103(6): 438-443, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33852371

RESUMO

INTRODUCTION: Lingual thyroglossal duct cysts (LTGDC) are a rare kind of thyroglossal duct cyst. However, Sistrunk surgery is not very suitable for this type of cyst. This study aimed to explore the efficacy of transoral excision of LTGDC by plasma coblation. METHODS: The present study reviewed 11 patients, comprising seven males and four females, who had been diagnosed with LTGDC preoperatively by computed tomography (CT) and fibre-optic electronic laryngoscopy. Of those patients, two had recurrence after surgery of epiglottic cysts. All these patients underwent transoral excision by plasma coblation. Then, we collected preoperative data of the patients, observed the effect of surgery, and analysed factors relevant to LTGDC, including the estimated bleeding amount, postoperative hospitalisation, complications and recurrence rates. RESULTS: The connection between LTGDC and hyoid was tapered on sagittal images of CT, which was vital evidence for the diagnosis of LTGDC. Surgery was performed successfully for all 11 patients, and all recovered without complication. There was no evidence of recurrence after surgery, during follow up for 3-43 months. CONCLUSIONS: Transoral surgery for LTGDC can be performed successfully by plasma coblation, which is an effective and safe surgical treatment. Fibre-optic electronic laryngoscopy and CT are essential to the diagnosis of LTGDC in order to avoid missing detection and misdiagnosis.


Assuntos
Eletrocirurgia/métodos , Cisto Tireoglosso/cirurgia , Adolescente , Adulto , Perda Sanguínea Cirúrgica , Eletrocirurgia/efeitos adversos , Feminino , Humanos , Laringoscopia/métodos , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Boca , Recidiva , Cisto Tireoglosso/diagnóstico por imagem
10.
Zhonghua Wai Ke Za Zhi ; 59(2): 109-115, 2021 Feb 01.
Artigo em Chinês | MEDLINE | ID: mdl-33378802

RESUMO

Objective: To compare the population characteristics, the positive rate of screening, the detection rate of breast cancer, early diagnosis rate and the cost between the mass screening group and opportunistic screening group of breast cancer. Methods: This study is a prospective multicenter cohort study conducted from January 1, 2014 to December 31, 2016. The participants were enrolled for mass screening or opportunistic screening of breast cancer. After completing the questionnaire, all the participants received breast physical examination and breast ultrasound examination every year for 3 rounds by year. The participants' characteristics and screening results of the two groups were compared by χ2 test, Fisher exact test or Wilcoxon rank-sum test. Results: A total of 20 080 subjects were enrolled. In the mass screening group, 9 434 (100%), 8 111 (85.98%) and 3 940 (41.76%) cases completed the 3 rounds of screening, and 10 646 (100%), 6 209 (58.32%) and 2 988 (28.07%) cases in the opportunistic screening group, respectively. In the opportunistic screening group, the proportions of less than 3 months lactation (1 275/9 796 vs. 1 061/8 860, χ²=4.597, P=0.032), non-fertility (850/10 646 vs. 574/9 434, χ²=27.400, P<0.01), abortion history (6 384/10 646 vs. 5 062/9 434, χ²=81.232, P<0.01), postmenopausal (2 776/10 646 vs. 2 217/9 434, χ²=17.757, P<0.01), long-term oral contraceptives(>6 months) (171/10 646 vs. 77/9 434, χ²=25.593, P<0.01) and family history of breast cancer in first-degree relatives (464/10 646 vs. 236/9 434, χ²=51.257, P<0.01) were significantly higher than those in mass screening group. The positive rate of screening (514/10 646 vs. 128/9 434, χ²=194.736, P<0.01), the detection rate of breast cancer (158/10 646 vs. 13/9 434, χ²=107.374, P<0.01), and positive rate of biopsy (158/452 vs. 13/87, χ²=13.491, P<0.01) in the opportunistic screening group were significantly higher than those of the mass screening group. The early diagnosis rate of the mass screening group was significantly higher than the opportunistic screening group (10/12 vs. 66/141, χ²=5.902, P=0.015). The average cost for detecting each breast cancer case of the mass screening group was 215 038 CNY, which was 13.6 times of the opportunistic screening group (15 799 CNY/case). In the opportunistic screening group, the positive rate of biopsy in primary hospitals was significantly lower than that in large-volume hospitals (79/267 vs. 79/185, χ²=8.267, P=0.004), but there was no significant difference in the mass screening group (6/37 vs. 7/50, χ²=0.082, P=0.774). Conclusions: Breast cancer screening can improve early detection rate. Compared with the mass screening mode, the opportunistic screening mode has the advantages of higher proportion of high-risk factors, higher positive rate of screening, higher detection rate of breast cancer, higher positive rate of biopsy, and lower cost of screening. However, the early diagnosis rate of breast cancer of opportunistic screening is lower than that of mass screening. The positive rate of opportunistic screening in primary hospitals is lower than that of large-volume hospitals. The two screening modes have their own advantages and should be chosen according to local conditions of different regions in China.


Assuntos
Neoplasias da Mama , Detecção Precoce de Câncer , Programas de Rastreamento , Neoplasias da Mama/diagnóstico , China/epidemiologia , Feminino , Humanos , Mamografia , Estudos Prospectivos
11.
Zhonghua Wai Ke Za Zhi ; 59(2): 116-120, 2021 Feb 01.
Artigo em Chinês | MEDLINE | ID: mdl-33378803

RESUMO

Objective: To examine treatment outcomes of breast phyllodes tumors and the prognosis factors of local recurrence. Methods: This retrospective cohort study included 276 patients who underwent surgical resection at Breast Center, Peking University People's Hospital from January 2011 to December 2019. Tumor subtype and histopathological features were determined from pathology reports, and the deadline of follow-up was September 30th, 2020. All 276 patients underwent open surgery, including 17 patients of mastectomy, and 259 patients of lumpectomy. The enrolled patients were all female, with age of (41.5±11.3) years (rang: 11 to 76 years), and tumor diameter of 35(28) mm (M(QR)). The Kaplan-Meier method and Log-rank test were used for survival analysis. The multivariate analysis was implemented using the Cox proportional hazard model. Results: According the pathologic test, there were 191 patients of benign phyllodes tumor, 67 patients of borderline tumor and 18 patients of malignant tumor. There were 249 patients with a follow-up of more than 6 months, and 14.1% (35/249) had local recurrence. The time-to-recurrence was (28.6±22.2) months (range: 2 to 96 months), (29.1±18.1) months (range: 2 to 80 months), (32.1±30.1) months (range: 5 to 96 months) and (12.0±6.9) months (range: 8 to 20 months) for benign, borderline and malignant phyllodes tumors. Tumor diameter (≥100 mm vs.<50 mm, HR=3.968, 95%CI: 1.550 to 10.158, P=0.004) and malignant heterologous element (yes vs. no, HR=26.933, 95%CI: 3.105 to 233.600, P=0.003) were prognosis factors of local recurrence. One death from malignant phyllodes occurred after distant metastasis. The 3-year disease-free survival rates of benign, borderline and malignant phyllodes tumor were 88.2%, 81.7% and 81.4% (P=0.300). Conclusion: Phyllodes tumors have a considerable local recurrence rate, which may be associated with tumor diameter and malignant heterologous element.


Assuntos
Neoplasias da Mama , Recidiva Local de Neoplasia/diagnóstico , Tumor Filoide , Adulto , Neoplasias da Mama/cirurgia , Feminino , Humanos , Mastectomia , Pessoa de Meia-Idade , Tumor Filoide/cirurgia , Prognóstico , Estudos Retrospectivos
12.
Zhonghua Wai Ke Za Zhi ; 59(2): 121-126, 2021 Feb 01.
Artigo em Chinês | MEDLINE | ID: mdl-33378804

RESUMO

Objective: To examine the clinical application value of single-port inflatable endoscopic nipple sparing mastectomy with immediate reconstruction using prosthesis implantation in the treatment of early breast cancer. Methods: From February 2014 to July 2019, the clinic-pathological data of 34 early breast cancer patients received single-port inflatable endoscopic nipple sparing mastectomy with immediate reconstruction using prosthesis implantation at Department of General Surgery, Beijing Friendship Hospital, Capital Medical University were retrospectively analyzed and followed up. All the patients were female, with an age of 46(11) years (M(QR)) (range: 26 to 64 years). The radical cure degree of operation, cosmetic effect after operation were evaluated. The satisfaction to operation and personal quality of life after operation was accessed by BREAST-Q scale. Results: All surgical procedures were successfully completed. The operation time was (313.4±11.7) minutes (range: 200 to 485 minutes). The blooding-liquid was (33.8±3.3) ml (range: 10 to 100 ml). There were 5 cases (14.7%) of nipple areola necrosis after operation, of which 1 patient received taking the prosthesis out because of prosthesis exposure. There was no capsular contracture or postoperative bleeding case. The follow-up time was 35(17) months (range: 12 to 77 months), and there was one case suffering local recurrence and metastasis, and another suffering metastasis. The scores of postoperative breast satisfaction, psychosocial status, chest wall status and sexual health were 78.32±2.57 (range: 55 to 100), 89.12±2.30 (range: 82 to 100), 91.47±1.33 (range: 43 to 100), and 78.50±2.68 (range: 39 to 100). Conclusion: Single-port inflatable endoscopic nipple sparing mastectomy with immediate reconstruction using prosthesis implantation in the treatment of early breast cancer can achieve provided curative and cosmetic effect on patients with breast cancer, with good patients' postoperative quality of life and satisfaction.


Assuntos
Neoplasias da Mama , Mamoplastia , Mastectomia/métodos , Adulto , Neoplasias da Mama/cirurgia , Feminino , Humanos , Pessoa de Meia-Idade , Mamilos , Implantação de Prótese , Qualidade de Vida , Estudos Retrospectivos
13.
Int J Oral Maxillofac Surg ; 50(3): 335-340, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32814655

RESUMO

The aim of this study was to compare postoperative complications and facial nerve (FN) recovery rates between conventional superficial parotidectomy (CSP) and partial superficial parotidectomy (PSP) as surgical treatment for benign parotid tumours. A prospective study was conducted on 55 consecutive patients who underwent either CSP (n=35) or PSP (n=20) for benign parotid tumours. The primary outcomes were FN injury, FN recovery rates, and Frey syndrome. Secondary outcomes were operative time, hospital stay, sialocele, haematoma, and auricular numbness. The degree of FN injury was evaluated at 1 week, 1, 3, 6, and 12 months postoperative using the House-Brackmann grading system. Frey syndrome was assessed using a subjective clinical questionnaire and objective Minor starch-iodine test. No patient in either group experienced permanent FN paralysis. There was a significantly higher incidence of temporary FN weakness in the CSP group (P=0.007). The respective FN recovery rates at 1, 3, 6, and 12 months were 60%, 88.6%, 94.3%, and 100% in the CSP group and 90%, 95%, 100%, and 100% in the PSP group. No significant difference was observed between the groups regarding the incidence of Frey syndrome, sialocele, and haematoma. The operative time and hospital stay were both shorter in the PSP group. Although the PSP is a more conservative procedure with significantly reduced FN injury, operative time, and hospital stay compared to CSP, the CSP procedure shows a comparable FN recovery rate to the PSP.


Assuntos
Paralisia Facial , Neoplasias Parotídeas , Nervo Facial , Humanos , Glândula Parótida/cirurgia , Neoplasias Parotídeas/cirurgia , Complicações Pós-Operatórias/epidemiologia , Estudos Prospectivos , Estudos Retrospectivos
14.
Zhonghua Yan Ke Za Zhi ; 56(7): 544-548, 2020 Jul 11.
Artigo em Chinês | MEDLINE | ID: mdl-32842339

RESUMO

Crouzon syndrome is an autosomal dominant disorder characterized by acrocephaly, exophthalmos, hypertelorism, strabismus, parrot-beaked nose, and hypoplastic maxilla. It is usually caused by a pathogenic mutation in the fibroblast growth factor receptor 2 gene and premature fusion of the sutures of the cranium and the base of the skull. This article documents the ophthalmic complications in patients with Crouzon syndrome before and after the influence of craniofacial surgery with particular emphasis on the different mechanisms and treatments involved. It is important to perform timely decompressive surgery before the presence of optic atrophy and corneal defects, and make early detection and adequate management of amblyopia, ptosis and strabismus. (Chin J Ophthalmol, 2020, 56: 544-548).


Assuntos
Ambliopia , Disostose Craniofacial/genética , Disostose Craniofacial/cirurgia , Craniossinostoses , Atrofia Óptica , Estrabismo , Humanos
15.
Osteoarthritis Cartilage ; 28(7): 917-923, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32305527

RESUMO

OBJECTIVE: Flavocoxid is a prescription medical food used to manage osteoarthritis (OA) symptoms. Safety concerns based on case reports raised an association with acute liver injury and hypersensitivity pneumonitis. We determined incidence rates (IR) of these safety events in a cohort of new users of flavocoxid and prescription non-steroidal anti-inflammatory drugs (NSAIDs). METHOD: MarketScan® claims data (2006-2017) was used to identify patients initiating flavocoxid or NSAIDs. Propensity score matching (1:2 ratio) was used to balance patient characteristics. Outcomes included hospitalization for hypersensitivity pneumonitis, liver injury, gastrointestinal bleeding, myocardial infarction, and acute kidney injury. Poisson regression was used to calculate IRs and Cox regression for calculating adjusted hazard ratios (aHR). RESULTS: 3,337 flavocoxid and 6,674 NSAID users met eligibility criteria. Before matching, flavocoxid users were older (mean 57 vs 51 years), had more polypharmacy (68% vs 29% taking ≥11 medications). After matching, characteristics were well balanced. The rate of hypersensitivity pneumonitis was 1.1 (95% CI 0.0-5.9) per 1,000 PY for flavocoxid and 0.0 (95% CI 0.0-2.2) for NSAIDs. For hospitalized liver injury, it was 3.2 (95% CI 0.7-9.3) for flavocoxid and 2.4 (95% CI 0.7-6.1) for NSAIDs, aHR = 1.16, 95% CI 0.23-6.01. A lower rate of GI bleed was observed, IR: 5.3 (1.7-12.3) for flavocoxid and 10.2 (5.9-16.3) for NSAIDs, aHR 0.49 (0.18-1.68). There were no significant differences for MI or AKI. CONCLUSION: The rate of hypersensitivity pneumonitis and liver injury associated with flavocoxid was low and minimally elevated compared to NSAIDs. Flavocoxid users had a significantly lower risk for hospitalized GI bleeding. The risk-benefit profile of flavocoxid may warrant reevaluation in light of these findings.


Assuntos
Injúria Renal Aguda/epidemiologia , Alveolite Alérgica Extrínseca/epidemiologia , Anti-Inflamatórios não Esteroides/uso terapêutico , Catequina/uso terapêutico , Doença Hepática Induzida por Substâncias e Drogas/epidemiologia , Hemorragia Gastrointestinal/epidemiologia , Infarto do Miocárdio/epidemiologia , Osteoartrite/tratamento farmacológico , Injúria Renal Aguda/induzido quimicamente , Adulto , Idoso , Alveolite Alérgica Extrínseca/induzido quimicamente , Doença Hepática Induzida por Substâncias e Drogas/etiologia , Combinação de Medicamentos , Feminino , Hemorragia Gastrointestinal/induzido quimicamente , Hospitalização/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/induzido quimicamente , Polimedicação , Modelos de Riscos Proporcionais
16.
Eur Rev Med Pharmacol Sci ; 24(6): 3245-3253, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32271441

RESUMO

OBJECTIVE: This study aimed to investigate the effect of miR-126 on intracranial aneurysm (IA) and its predictive value for aneurysm rupture. PATIENTS AND METHODS: Altogether 102 patients (patient group) with IA diagnosed in the Jinhua Municipal Central Hospital from July 2016 to April 2018, and 80 healthy people (normal group) who underwent physical examination during the same period were collected. QRT-PCR was used to detect the expression of miR-126 in serum, analyze the expression of miR-126 in IA, and explore the predictive value on IA rupture. Potential target genes of miR-126 were analyzed by target gene prediction website, and David was used to analyze the enrichment of miR-126 target gene GO and KEGG. RESULTS: The expression of miR-126 in serum of patient group was significantly higher than that of normal group (p < 0.05), ROC curve area was 0.966. The high expressions of miR-126 were directly related to the possibility of large lesions (p < 0.05). Multivariate analysis showed that lesion size and miR-126 expression were independent risk factors for rupture of IA patients. ROC curve showed that lesion size and miR-126 expression area under the curve were 0.707 and 0.827. Altogether 520 potential target sites were found by Venn diagram of Targetscan, miRDB, and Starbase online miR-126 prediction website. GO enrichment and KEGG analysis by David online software found that miR-126 target genes were mainly enriched in 169 biological processes, such as nucleus, transcription, DNA-templated, transcription factor activity, sequence-specific DNA binding, protein binding, and phosphatidylinositol phosphorylation. KEGG analysis found that miR-126 target genes were significantly enriched in MAPK signaling pathway, pathways in cancer, ErbB signaling pathway, MicroRNAs in cancer, and Thyroid hormone signaling pathway. CONCLUSIONS: MiR-126 can be used as a potential diagnostic and predictive indicator for IA occurrence and IA rupture.


Assuntos
Aneurisma Roto/genética , Aneurisma Intracraniano/genética , MicroRNAs/genética , Aneurisma Roto/diagnóstico , Aneurisma Roto/metabolismo , Biologia Computacional , Feminino , Humanos , Aneurisma Intracraniano/diagnóstico , Aneurisma Intracraniano/metabolismo , Sistema de Sinalização das MAP Quinases , Masculino , MicroRNAs/metabolismo , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Fatores de Risco
19.
Br J Oral Maxillofac Surg ; 57(8): 729-733, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31266651

RESUMO

Neck masses in children are a common clinical concern but there is a paucity of published information about them. We organised this retrospective study to analyse their prevalence and treatment in Northwest China. The records of 207 children who presented with neck masses between 2008 and 2017 were retrieved from the Department of Oral and Maxillofacial Surgery, Lanzhou University Second Hospital, and age, sex, clinical presentation, preoperative investigation, surgical procedure, histopathological diagnosis, and complications were recorded. Their mean (range) age was 10 years (6 months to 21 years), and the male:female ratio was 1.23:1. In total 128 patients (62%) had congenital lesions, 35 (17%) had inflammatory lesions, and 44 (21%) had neoplastic lesions. The most common mass was a thyroglossal cyst (31%), followed by plunging ranula (17%) and lymphangioma (16%). Temporary injury to the facial nerve and wound infection were the major complications of surgical treatment. The types of neck masses in Northwest China differ from those previously reported, which may be attributed to genetic alterations in people of this race. The present report adds to the knowledge of diagnosis and treatment of neck masses in children in Northwest China, and brings out the demographic differences between races.


Assuntos
Linfangioma , Cisto Tireoglosso , Adolescente , Criança , Pré-Escolar , China/epidemiologia , Feminino , Humanos , Lactente , Linfangioma/epidemiologia , Masculino , Pescoço , Prevalência , Estudos Retrospectivos , Cisto Tireoglosso/epidemiologia , Adulto Jovem
20.
Zhonghua Liu Xing Bing Xue Za Zhi ; 40(6): 666-669, 2019 Jun 10.
Artigo em Chinês | MEDLINE | ID: mdl-31238616

RESUMO

Objective: To analyze the prevalence and risk factors of hypertension combined with diabetes in the middle to elder population in the Nan'an district of Chongqing, and to provide evidence for formulating relevant prevention and control strategies. Methods: Middle or elder adults were enrolled by a Stratified multistage cluster sampling method. Questionnaire survey and the related measurements were conducted. The epidemiology of hypertension combined with diabetes was analyzed descriptively, and the risk or protective factors were analyzed by logistic regression method. Results: A total of 24 792 people were surveyed, with 1 547 patients identified as having hypertension combined with diabetes. The overall prevalence rate appeared as 6.2%, of which 6.0% in males and 6.4% in females, respectively. The prevalence of hypertension combined with diabetes in the general population was increasing with age (χ(2)=343.766, P<0.001). Factors as age, education, smoking, marital status, exercise, BMI, triglyceride, total cholesterol, high density lipoprotein cholesterol and low density lipoprotein cholesterol were related to the prevalence of hypertension and diabetes. High density lipoprotein cholesterol appeared as a protective factor for hypertension combined with diabetes (OR=0.817, 95%CI: 0.715-0.934). Age, education, low density lipoprotein cholesterol and lack of exercise all appeared as risk factors for hypertension combined with diabetes (P<0.05), respectively. Conclusions: The prevalence rate of hypertension combined with diabetes in the middle or elder adults in Nan'an of Chongqing seemed high. Attention should be paid to the health status of people being elderly, overweight or obese, low cultural level, smoking, triglyceride abnormality, total cholesterol abnormality and high low density lipoprotein cholesterol, so as to reduce the risk on hypertension combined with diabetes.


Assuntos
Diabetes Mellitus/epidemiologia , Hipertensão/epidemiologia , Idoso , China/epidemiologia , Diabetes Mellitus/etnologia , Feminino , Humanos , Hipertensão/etnologia , Masculino , Pessoa de Meia-Idade , Obesidade , Prevalência , Fatores de Risco
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