الملخص
AIM: To explore the clinical features, diagnosis and treatment experience and the distribution characteristics of pathogenic microorganisms of primary canaliculitis, and provide reference for its diagnosis and treatment. METHODS: Retrospective clinical study. A total of 119 cases(120 eyes)diagnosed as primary canaliculitis in the department of ophthalmology of Wuxi No.2 People's Hospital from June 2019 to February 2023 were included. The treatment methods were mainly divided into conservative treatment(removing canaliculus stones through lacrimal punctum combined with injecting antibiotic eye ointment into the tube)and surgical treatment. The inspection methods of pathogenic microorganisms included secretion smear microscopy and microbial culture.RESULTS: Primary canaliculitis was more common in middle-aged and older female, mainly manifested by long-term red eye and increased secretion; however, the majority was not accompanied by tearing. Totally, 118 cases(99.2%)had monocular disease, while 63 cases(63 eyes; 52.5%)had inferior lacrimal canaliculus disease. Laboratory examination: Among 119 cases(120 eyes), 4 cases(4 eyes)did not undergo laboratory examination, and the other 115 cases(116 eyes)were as follows: Gram staining microscopy of secretion smear showed that Actinomyces were detected in 102 cases(103 eyes; 88.8%), while no fungus was detected; Microbial culture: 85 cases(86 eyes; 74.1%)were positive for bacterial culture. A total of 111 bacterial strains were cultured, which contained 26 types of bacteria. Among them, 32 strains were aerobic(28.8%); 26 strains were anaerobic(23.4%); and 53 strains were facultative anaerobic(47.7%). The most common bacteria were streptococcus(20 strains), staphylococcus(13 strains), Propionibacterium(10 strains), and capnocytophaga(10 strains). Only 4 cases(4 eyes; 3.4%)of microbial cultures were positive for Actinomyces. Fungus was negative in all microbial cultures. Treatment: Of the 119 cases(120 eyes), 114 cases(115 eyes; 95.8%)were cured by conservative treatment of removing lacrimal canaliculus stones through lacrimal punctum and intracanalicular ointment infiltration(IOI), while 5 cases(5 eyes)were not effective in conservative treatment; however, all of them were cured after surgical treatment, and the cure rate for primary canaliculitis was 100.0%.CONCLUSION: The incidence of primary canaliculitis is low, and it is prevalent in middle-aged and older female. Single lacrimal canaliculus is more common, which could be missed and misdiagnosed in clinic. Actinomyces is the major pathogen observed mostly in mixed infections, with heterogeneous strains, mainly anaerobic or facultative anaerobic bacteria. Streptococcus and Staphylococcus are the most common whereas fungal canaliculitis is rare. The cure rate of primary canaliculitis is high after diagnosis, and IOI method is recommended as the initial treatment of canaliculitis.
الملخص
Fluorescence-guided surgery (FGS) with tumor-targeted imaging agents, particularly those using the near-infrared wavelength, has emerged as a real-time technique to highlight the tumor location and margins during a surgical procedure. For accurate visualization of prostate cancer (PCa) boundary and lymphatic metastasis, we developed a new approach involving an efficient self-quenched near-infrared fluorescence probe, Cy-KUE-OA, with dual PCa-membrane affinity. Cy-KUE-OA specifically targeted the prostate-specific membrane antigen (PSMA), anchored into the phospholipids of the cell membrane of PCa cells and consequently showed a strong Cy7-de-quenching effect. This dual-membrane-targeting probe allowed us to detect PSMA-expressing PCa cells both in vitro and in vivo and enabled clear visualization of the tumor boundary during fluorescence-guided laparoscopic surgery in PCa mouse models. Furthermore, the high PCa preference of Cy-KUE-OA was confirmed on surgically resected patient specimens of healthy tissues, PCa, and lymph node metastases. Taken together, our results serve as a bridge between preclinical and clinical research in FGS of PCa and lay a solid foundation for further clinical research.
الملخص
Traumatic cerebrospinal fluid leakage commonly presents in traumatic brain injury patients, and it may lead to complications such as meningitis, ventriculitis, brain abscess, subdural hematoma or tension pneumocephalus. When misdiagnosed or inappropriately treated, traumatic cerebrospinal fluid leakage may result in severe complications and may be life-threatening. Some traumatic cerebrospinal fluid leakage has concealed manifestations and is prone to misdiagnosis. Due to different sites and mechanisms of trauma and degree of cerebrospinal fluid leak, treatments for traumatic cerebrospinal fluid leakage varies greatly. Hence, the Craniocerebral Trauma Professional Group of Neurosurgery Branch of Chinese Medical Association and the Neurological Injury Professional Group of Trauma Branch of Chinese Medical Association organized relevant experts to formulate the " Chinese expert consensus on the diagnosis and treatment of traumatic cerebrospinal fluid leakage in adults ( version 2023)" based on existing clinical evidence and experience. The consensus consisted of 16 recommendations, covering the leakage diagnosis, localization, treatments, and intracranial infection prevention, so as to standardize the diagnosis and treatment of traumatic cerebrospinal fluid leakage and improve the overall prognosis of the patients.
الملخص
Objective:To explore the clinical application of portable head and neck magnetic resonance imaging (MRI) device in neurosurgery.Methods:A total of 213 patients with brain diseases who were scanned by portable head and neck MRI device in Center of Neurosurgery, Zhujiang Hospital, Southern Medical University from June to September 2022 were selected. The portable head and neck MRI images and 3.0T conventional MRI images of 10 randomly selected patients were compared; the differences in signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) of different sequences were analyzed. Thirty-one patients accepted tracheal intubation/tracheotomy, or ventilator-assisted breathing were selected as special patient group, and another 30 patients were as general patient group; the differences in comprehensive diagnostic scores of portable head and neck MRI images were compared. Noise intensity differences in different sequences between 3.0T conventional MRI and portable head and neck MRI were statistically compared. Twenty hospitalized volunteers with normal hearing in our center from July to August 2022 were selected, conventional 3.0T MRI and portable head and neck MRI were performed successively, and the noise intensity of different sequences in them was evaluated by using a 5-point system.Results:Compared with those in 3.0T conventional MRI images, the SNR and CNR of T1WI, T2WI, and Liquid attenuated reverse recovery sequence (FLAIR) sequences in portable head and neck MRI images were significantly lower ( P<0.05). No significant difference was noted in the comprehensive diagnostic scores of portable head and neck MRI images between special patients and general patients ( P>0.05). Compared with that in the 3.0T conventional MRI, the noise intensity of different sequences in portable head and neck MRI was significantly reduced ( P<0.05). These volunteers had significantly reduced noise intensity scores of different sequences in portable head and neck MRI compared with that in conventional 3.0T MRI ( P<0.05). Conclusion:Portable head and neck MRI device is easy to use, enjoying high safety, imaging quality and suitability, which meets the clinical needs for neurosurgery patients.
الملخص
Objective:To investigate the effects of metformin (MF) and vibration intervention on the improvement of bone mineral density (BMD) and glucose metabolism in diabetic rats with osteoporosis (DOP) .Methods:In this study, 125 rats were purchased, 100 rat models of diabetic osteoporosis were selected according to the random number table sampling method, and 100 rats were tested for modeling. According to the principle of random grouping, the rats successfully modeled were divided into model control groups (group MC) , metformin group (group MF) , vibration group (group V) , metformin + vibration group (group MV) . Normally fed 25 rats were blank control group (group C) . Rats in each group were treated for 20 weeks of intervention according to their own protocols. After the intervention, various samples were collected from rats in each group for BMD testing and HOME-IR testing.Results:Compared with the pre-measured BMD value of group C, the pre-measured BMD of group MC, group MF, group V and group MV were significantly reduced, respectively 0.21±0.03, 0.20±0.04, 0.20±0.03, 0.19±0.05 (g/cm 2) , P<0.05, indicating that the DOP model was successfully constructed. After 20 weeks of intervention, the BMD values of group MF, group V, and group MV were respectively 0.23±0.07, 0.24±0.05, 0.27±0.01 (g/cm 2) , significantly higher than the pre-measured value and the post-measured value of group MC, P<0.05. Comparing the changes in bone metabolism after the intervention of the patients, it was found that HOP of group MF, group V, and group MV after the intervention were 17.07±2.33, 16.95±4.22, and 15.43±3.75 (mg/g) respectively; DPD of group MF, group V and group MV were 3.26±0.09, 3.13±0.10, 2.95±0.10 (mmol/L) , respectively; The TRACP of the MF group, the V group and the MV group were 152.51±10.89, 149.67±11.05, and 143.90±10.67 (μg/L) respectively; The bone metabolism indexes of the patients were significantly lower than the pre-measured values and the post-measured values of the MC group, P<0.05. Comparing the glucose metabolism and insulin sensitivity of the patients after the intervention, it was found that FPG of group MF, group V, and group MV after the intervention were 15.32±4.98, 16.34±5.76, 19.76±5.71 (mmol/L) respectively. The FINS of group MF, group V and group MV were 25.46±6.21, 27.92±5.33, 29.85±7.22 (mmol/L) respectively. The HOME-IR of group MF, group V, and group MV were 17.39±1.37, 20.27±1.36, 26.81±1.83 (mmol/L) respectively, and all the indexes were significantly lower than those of group MC, P<0.05. Conclusion:This study believes that metformin and vibration intervention can significantly reduce blood glucose and relieve symptoms in diabetic rats with osteoporosis Insulin sensitivity, reduce bone loss, increase bone density.
الملخص
Objective:To identify the clinical significance of CDK5 in colon cancer tissues.Methods:Two hundred colon cancer tissues were tested for CDK5 expression by immunohistochemistry on tissue microarrays. The correlation between CDK5 expression and clinicopathological features, prognosis and peripheral inflammation-related cells was analyzed.Results:CDK5 was low expressed in 100 cases (50.0%), and high in another 100 cases (50.0%). Longer time to tumor progression ( P=0.026) and overall survival ( P=0.035) were observed in patients with high CDK5 expression. By multivariate analysis , the expression of CDK5 was an independent risk factor for poor prognosis ( HR=0.45,95% CI: 0.21-0.99, P=0.049). The expression of CDK5 was not related to the counts of white blood cells and neutrophils ( P>0.05). Prognosis of patients with a positive lymph node ratio less than 0.15 was significantly better than that of patients with a higher lymph node ratio ( P<0.001). Conclusions:Patients with low CDK5 expression have poor prognosis, and CDK5 expression is not related to the counts of peripheral white blood cells and neutrophils.
الملخص
The outbreak of coronavirus disease 2019 (COVID-19) was declared a global public health emergency on 31 January 2020. Emergency medicine procedures in Emergency Department should be optimized to cope with the current COVID-19 pandemic by providing subspecialty services, reducing the spread of nosocomial infections, and promoting its capabilities to handle emerging diseases. Thus, the Chinese Society of Emergency Medicine and Wuhan Society of Emergency Medicine drafted this consensus together to address concerns of medical staffs who work in Emergency Department. Based on in-depth review of COVID-19 diagnosis and treatment plans, literatures, as well as management approval, this consensus proposes recommendations for improving the rationalization and efficiency of emergency processes, reducing the risk of nosocomial infections, preventing hospital viral transmission, and ensuring patient safety.
الملخص
Objective:To investigate the effect of treadmill training on spasticity and the expression of potassium chloride co-transporter 2 (KCC2) after blocking BDNF-TrkB signaling pathway in rats with incomplete spinal cord injury (SCI).Methods:Forty female Sprague-Dawley rats were randomly divided into a sham-operation group (Sham group), an SCI+ phosphate-buffered saline group (SCI/PBS group), an SCI-treadmill training+ PBS group (SCI-TT/PBS group), an SCI/TrkB-IgG group and an SCI-TT/TrkB-IgG group. All of the rats underwent 1 week of intrathecal catheterization, and then T 10 incomplete SCI was induced. In the Sham group the spinal cord was only exposed. Seven days later, BDNF-TrkB signaling was blocked in the SCI/TrkB-IgG and SCI-TT/TrkB-IgG groups using the TrkB-IgG. The remaining three groups were controls treated with PBS. The SCI-TT/PBS and SCI-TT/TrkB-IgG groups began exercising 7 days after the SCI and continued for 4 weeks. The spasticity in their hind limbs was assessed using the Asworth assessment and H reflex (H-max/M-max ratio). The expression of KCC2 in the distal spinal cord was detected using western blotting and immunohistochemistry. Results:After the SCI the average Ashworth spasticity grades of the four SCI groups increased significantly compared with the Sham group. The average Ashworth spasticity grade of the SCI-TT/PBS group was significantly lower than those of the SCI/PBS and SCI/TrkB-IgG groups in the 3rd through the 5th week, and the SCI-TT/PBS group′s average grade was significantly less than that of the SCI-TT/TrkB-IgG group after 4 weeks. Within 5 weeks the average H-max/M-max ratio of the Sham group remained unchanged, significantly lower than the other 4 groups′ averages. There was no significant difference in the H-max/M-max ratio among the 4 groups of injured rats within 2 weeks after the SCI, but after 3-5 weeks the average H-max/M-max ratio of the SCI-TT/PBS group was significantly lower than those of the SCI/PBS, SCI/TrkB-IgG and SCI-TT/TrkB-IgG groups. At the 4th and 5th week the average H-max/M-max ratio in the SCI-TT/TrkB-IgG group was significantly lower than that in the SCITrkB-IgG group. And after 5 weeks the average expression of KCC2 in the anterior horn of the injured spinal cord was significantly lower in the 4 SCI groups than in the Sham group. Exercise significantly increased the expression of KCC2 in the SCI-TT/PBS group, and its immune intensity and relative optical density were significantly higher than those in the SCI/PBS, SCI/TrkB-IgG and SCI-TT/TrkB-IgG groups. However, there was no significant difference between the SCI/TrkB-IgG group and the SCI-TT/TrkB-IgG group.Conclusions:Treadmill training can improve spasticity after incomplete SCI and the expression of KCC2 in the distal spinal cord, at least in rats.
الملخص
Objective@#To explore the association between polycyclic aromatic hydrocarbons (PAHs) exposure and cytochrome P450 CYP1A1 expression at gene and enzyme activity levels in the peripheral blood monocyte cells in coke oven workers, and to provide a certain basis for the biological monitoring of health damage in coke oven workers.@*Methods@#We surveyed 118 coke oven workers and 63 controls (energy power workers in the same company) using self-designed questionnaire, determined their post-shift urinary 1-hydroxypyrene (1-OH-Py) concentration using high performance liquid chromatography (HPLC)-fluorescence detector method. We also isolated the peripheral blood mononuclear cell (PBMC) from fasting venous blood, and detected DNA damage using comet assay, CYP1A1 mRNA level using the real-time fluorescent quantitative PCR (FQ-PCR), and EROD activity using spectrophotometry. Statistical analyses including one-way analysis of variance and multiple linear regressions were used to analyze the association of urinary 1-OH-Py and CYP1A1 mRNA level and EROD activity.@*Results@#Compared to the control group, the urinary 1-OH-Py concentration and PBMC DNA tail moment were significantly increased in coke oven workers (P<0.05), and CYP1A1 gene level and EROD activity in PBMC were significantly decreased (P<0.05). Multiple linear regression showed that a ten-fold increase of urinary 1-OH-Pycon centration was associated with a decrease of 0.77 (95%CI: -1.33--0.21) in CYP1A1 gene level, and a decline of 0.15 (95%CI: -0.76--0.16) in EROD activity of PBMC in coke oven workers (P<0.05).@*Conclusion@#Occupational PAHs exposure induced DNA damage, which was associated with the decreased level in CYP1A1 gene cavel and EROD activity in PBMC of coke oven workers.
الملخص
Objective To investigate the relationship between lipoprotein[a] (Lp[a]) level and risk of onset of spontaneous subarachnoid hemorrhage (SSAH).Methods Thirty-four patients with SSAH,admitted to our hospital from November 2014 to December 2015,were chosen as patient group,and another 40 healthy volunteers were collected as control group.Morning fasting venous blood was collected,and levels of plasma Lp (a),total cholesterol (TC),glycerol triester (TG),high-density lipoprotein cholesterol (HDL-C),low-density lipoprotein cholesterol (LDL-C),apolipoprotein AI (ApoAI) and apolipoprotein B (ApoB) were detected.Pearson correlation analysis was used to analyze the correlations of Lp (a) with various lipid components.Results As compared with control group (84.28±57.96 mg/L),patient group had significantly higher Lp(a) level ([170.50±144.58] mg/L,P＜0.05);TC,HDL-C,LDL-C,ApoAI and ApoB levels showed no significant differences between the two groups (P＞0.05).Pearson correlation analysis indicated that Lp(a) level did not correlate to TC,HDL-C,LDL-C,ApoAI and ApoB levels (P＞0.05).Conclusion Plasma Lp (a) level is a risk factor for the onset of SSAH.
الملخص
α-cells, which synthesize glucagon, also support β-cell survival and have the capacity to transdifferentiate into β-cells. However, the role of α-cells in pathological conditions and their putative clinical applications remain elusive due in large part to the lack of mature α-cells. Here, we present a new technique to generate functional α-like cells. α-like cells (iAlpha cells) were generated from mouse fibroblasts by transduction of transcription factors, including Hhex, Foxa3, Gata4, Pdx1 and Pax4, which induce α-cell-specific gene expression and glucagon secretion in response to KCl and Arg stimulation. The cell functions in vivo and in vitro were evaluated. Lineage-specific and functional-related gene expression was tested by realtime PCR, insulin tolerance test (ITT), glucose tolerance test (GTT), Ki67 and glucagon immunohistochemistry analysis were done in iAlpha cells transplanted nude mice. iAlpha cells possess α-cell function in vitro and alter blood glucose levels in vivo. Transplantation of iAlpha cells into nude mice resulted in insulin resistance and increased β-cell proliferation. Taken together, we present a novel strategy to generate functional α-like cells for the purposes of disease modeling and regenerative medicine.
الموضوعات
Animals , Mice , Blood Glucose , Fibroblasts , Gene Expression , Glucagon , Glucose Tolerance Test , Immunohistochemistry , In Vitro Techniques , Insulin , Insulin Resistance , Mice, Nude , Polymerase Chain Reaction , Regenerative Medicine , Transcription Factorsالملخص
To investigate the expression of hypoxia-inducible factor 1α (HIF-1α) and CD133 in predicting pathologic remission and survival of patients with locally advanced rectal cancer undergoing neoadjuvant chemoradiotherapy.One hundred and fourteen patients with locally advanced rectal cancer undergoing neoadjuvant chemoradiotherapy from January 2010 to December 2015 in Jinhua Municipal Central Hospital were enrolled in the study. RT-PCR and immunohistochemistry methods were used to detect the mRNA and protein expression of HIF-1α and CD133 before and after chemoradiotherapy. Spearman rank correlation was used to analyze the correlation between HIF-1α and CD133 mRNA expression. Univariate and logistic multivariate analyses were used to determine the factors related to pathological complete response (pCR). Logistic regression analysis and Cox's proportional hazard model were used to determine factors related to overall survival and recurrence-free survival.The expression of HIF-1α and CD133 mRNA was correlated with pT, ypTNM, pCR, recurrence and metastasis of rectal cancer, while not correlated with sex, age and BMI of patients. HIF-1α mRNA expression was positively correlated with CD133 mRNA expression (=0.579,=0.000). Immunohistochemistry analysis showed that residual cancer cells strongly expressing HIF-1α also expressed CD133 strongly. Univariate analysis showed that HIF-1α mRNA and CD133 mRNA were significantly correlated with pCR (=0.001,=0.022, respectively). Multivariate analysis showed that HIF-1α and CD133 mRNA expression were independent prognostic factors of pCR (=0.012,=0.047, respectively). Cox regression analysis showed that the expression of HIF-1α mRNA and CD133 mRNA were independent predictors of recurrence-free survival and overall survival (=0.025,=0.033, respectively).The study indicates that HIF-1α and CD133 can predict pathological complete remission and survival of patients with locally advanced rectal cancer.
الموضوعات
Female , Humans , Male , AC133 Antigen , Genetics , Biomarkers, Tumor , Chemoradiotherapy , Disease-Free Survival , Hypoxia-Inducible Factor 1, alpha Subunit , Genetics , Neoadjuvant Therapy , Neoplasm Grading , Neoplasm Metastasis , Diagnosis , Neoplasm Recurrence, Local , Epidemiology , Genetics , Neoplasm, Residual , Genetics , Prognosis , Proportional Hazards Models , Rectal Neoplasms , Chemistry , Epidemiology , Genetics , Therapeutics , Survival Rateالملخص
Objective To investigate the efficacy and safety of capecitabine in the treatment of colorectal cancer. Methods Totally 160 elderly patients with stageⅣcolorectal cancer were enrolled in this study. After first-line combined chemotherapy,80 patients were treated with capecitabine monotherapy(maintenance group)and another 80 cases were not(control group). The survival rate was analyzed by Kaplan-Meier curve and the efficiency and incidence of adverse events were compared. Results (1) The Kaplan-Meier curve suggested that the difference between two groups was statistically significant(P<0.05).(2)The response rate of maintenance group was significantly higher than that of control group (P < 0.05). (3)The incidence of adverse events during capecitabine monotherapy was lower than that during combined chemotherapy(P < 0.05).(4)The incidence of adverse reactions during capecitabine monotherapy was similar to that of control group(P > 0.05). Conclusion Capecitabine monotherapy in patients with stage Ⅳ colorectal cancer after combined chemotherapy has a longer median PFS than those without maintenance but similar adverse reactions ,which was worthy of clinical promotion.
الملخص
Objective To investigate the efficacy and safety of capecitabine in the treatment of colorectal cancer. Methods Totally 160 elderly patients with stageⅣcolorectal cancer were enrolled in this study. After first-line combined chemotherapy,80 patients were treated with capecitabine monotherapy(maintenance group)and another 80 cases were not(control group). The survival rate was analyzed by Kaplan-Meier curve and the efficiency and incidence of adverse events were compared. Results (1) The Kaplan-Meier curve suggested that the difference between two groups was statistically significant(P<0.05).(2)The response rate of maintenance group was significantly higher than that of control group (P < 0.05). (3)The incidence of adverse events during capecitabine monotherapy was lower than that during combined chemotherapy(P < 0.05).(4)The incidence of adverse reactions during capecitabine monotherapy was similar to that of control group(P > 0.05). Conclusion Capecitabine monotherapy in patients with stage Ⅳ colorectal cancer after combined chemotherapy has a longer median PFS than those without maintenance but similar adverse reactions ,which was worthy of clinical promotion.
الملخص
Objective To observed the impact of selenium supplementation therapy on the thyroid perioxidase antibody(TPO-Ab) levels and serum oxidative stress[malondialdehyde(MDA, glutathione peroxidase(GPx), and superoxide dismutase(SOD)] in patients with Hashimoto′s thyroiditis. Methods 79 patients with Hashimoto′s thyroiditis were randomly divided into trial group(n=44) and placebo group(n=35) .The double-blind treatment was for 24 weeks. The thyroid hormone levels, serum TPO-Ab levels, and oxidative stress indexes(MDA, GPx, and SOD) of both groups were detected before and after treatment. Results (1)There was no change of thyroid hormone levels either before or after treatments of both groups(P>0.05). (2)TPO-Ab of the trial group decreased significantly after the treatment(P<0.05). While the placebo group has little change. Group with TPO-Ab≤200 IU/ml and the course≤1 year manifested the most obvious declines by 29.98% and 26.63% respectively. (3)The oxidative stress level of trial group significantly decreased after 24 weeks. There was significantly positive correlation between the oxidative stress indexes and TPO-Ab. However the placebo group was with little change. Conclusion Selenium supplementation may reduce the level of TPO-Ab titers and oxidative stress in patients with Hashimoto′s thyroiditis, especially for those with lower antibody titers and short course.
الملخص
Objective To analyze the effect of Ginkgo biloba extract on ischemic stroke and its influence on serum superoxide dismutase(SOD) and malondialdehyde(MDA). Methods 146 patients with ischemic stroke were divided into two groups. The two groups were treated routinely and one group plus Ginkgo biloba extract. Results After treatment,the clinical efficacy,SOD,MDA and ET-1 level,hemorheology,NIHSS scores and Barthel index of observation group was better than that in the control group(P<0.05).Difference of adverse reactions were not statistically significant. Conclusion Ginkgo biloba extract can improve the therapeutic effect of ischemic stroke and adjust the level of related factors.
الملخص
Objective To investigate the effect of postoperative analgesia by using loxoprofen sodium on dental implant patients at different time points. Methods A total of 400 patients with dental implant treatment were divided into two groups by random number table method. The experimental group was firstly given loxoprofen sodium tablets (60 mg) in 30 minutes preoperatively, and the control group was firstly given on three hours after surgery (60 mg). Local anesthesia was used to all dental implant surgery. Using the Wong-Baker Smile Assessment method in operation and Numerical Rating Scale (NRS) in postoperative respectively to assess pain level in surgery and 3 h, 6 h, 12 h and 24 h after surgery. Results The percentages of painless patients of the experimental group and the control group in operation were 99%(198/200) and 97%(194/200), and there was no significant difference between them (χ2=2.041, P>0.05); the percentages of painless patients of the experimental group at 3 h, 6 h, 12 h after surgery were 60.5%(121/200), 79.0%(158/200), 83.5%(167/200), and the control group were 47.0%(94/200), 64.5%(129/200), 71.5%(143/200), and there was significant difference between the control group and the experimental group (χ2=14.255,15.447, 11.165, P=0.007, 0.004, 0.011); however, in the two groups, there was no significant difference at 24 h after surgery, the experimental group was 93.0% (186/200), the control group was 89.5% (179/200) (χ2=2.468, P>0.05). Conclusions Preoperative administration with loxoprofen sodium tablets can significantly reduce the risk of postoperative pain, and could be used as a conventional implant surgery analgesic program.
الملخص
Objective To explore the application of new neuronavigation in microsurgery for intracranial tumors. Methods Thirty-six patients with intracranial tumors, admitted to our hospital from November 2016 to April 2017, were treated with brain LAB KICK neuronavigational system-assisted micro-neurosurgery. Preoperative MRI or CT thin-layer scanning were performed, and the images were input to the Brain LAB Vector Vision neural system for three-dimensional reconstruction. The tumors and the important structures were marked. Intraoperative guidance in the neuronavigation system was performed to find the important nerves, vascular and bone signs and other structures. The clinical data and therapeutic effect of these patients were retrospectively analyzed. Results All the 36 patients were successfully guided by neuronavigation to reach the tumor sites, with the registration error of 0.10-0.25 mm. Total resection was achieved in 31 patients, subtotal resection in 3, and most resection in 2. Symptoms improved significantly in 34 patients after the surgery. No surgical complications caused by neuronavigation errors were found, and no asymptomatic deterioration or death were noted. Conclusion Brain LAB neuronavigation system in neurosurgery is accurate and safe, enjoying high total resection rate and minimized operation complications.
الملخص
OBJECTIVE:To improve high-alert medication management in our hospital. METHODS:According to assessment criteria of JCI,referring to the problems of high-alert medication management in our hospital,PDCA(plan,do,check,action)cy-cle method,reverse fishbone diagram and other methods were adopted to formulate and implement relevant countermeasures. Com-pliance rate of 29 departments was evaluated within 12 months after the implementation of countermeasures. RESULTS:Relevant emergency measures were formulated for 2 negative factors by reverse fishbone diagram;whole-course and orderly quality control of high-alert medication was conducted through establishing high-alert medication management institutions,formulating high-alert medication management system and quality measurement criteria,strengthening staff training and education,improving hospital in-formation system,etc. The compliance rate of departments increased from 53% in Jan. to 100% in Jun.(P<0.05),and kept sta-ble until Dec. CONCLUSIONS:PDCA cycle improves the systemization and standardization of high-alert medication management and multiple department cooperation,and contributes to the safety of drug use.
الملخص
BACKGROUND:Detecting the serum levels of biochemical markers to assess bone fractures is simple, mini-invasive and specific. Thereafter, to predict bone nonunion by choosing an appropriate marker has become a hotspot. OBJECTIVE:To establish an animal model of bone nonunion and explore the changing rules of the biochemical markers during the process of nonunion. METHODS:Twenty New Zealand white rabbits aged 5-6 months were enrol ed and divided into two groups. In bone defect group, a 15-mm length of bone (including the periosteum) was removed from the left mid-radius, and the medul ary cavities were closed with bone wax. In bone fracture group, the mid-radius was fractured. X-ray examination was taken and blood samples were extracted preoperatively and at 2, 3, 4, 5, 6, 7, 8, 10, and 12 weeks after surgery. The serum levels of osteocalcin and bone-specific alkaline phosphatase (BSAP) as markers of bone formation, and C-terminal telopeptide of type I col agen (CTX), N-terminal telopeptide of type I col agen (NTX), and tartrate-resistant acid phosphatase 5b (TRACP 5b) as markers of bone resorption, were measured using biotin double-antibody sandwich ELISA. RESULTS AND CONCLUSION:In the bone defect group, the bone metabolism was at a high level, suggesting that the early diagnosis of bone nonunion depends on several biochemical indicators. In the bone defect group, the serum level of CTX peaked at 5 weeks, and the serum levels of osteocalcin, BSAP and NTX decreased obviously at 4 or 5 weeks, while the serum TRACP 5b concentration did not change significantly, indicating that al above markers except TRACP 5b sensitively reflect the bone turnover in vivo. Further studies are needed to determine whether systematic monitoring of the biochemical markers can reflect the bone turnover effectively and can be used for the early diagnosis of nonunion in the rabbit model.