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Objective To explore the risk factors and clinical features of systemic lupus erythematosus (SLE) patients with venous thromboembolic disorders (VTE). Methods Twenty SLE patients with VTE (VTE group) and 40 SLE cases without VTE (control group) were retrospectively analyzed for clinical and laboratory features. T test, Mann-Whitney U rank sum test, χ2 test, Logistic regression analysis were used for statistical analysis. Results The prevalence of VTE in SLE patients was 1.5%(20/1 326). Renal involvement, increased blood pressure, history of lower extremity deep vein catheter, merging with antiphospholipid antibody syndrome (APS) could be seen more frequently in VTE group than control group ( χ2=5.508, 7.033, 5.208, 7.882, respectively), and the difference were statistically significant (both P<0.05). Hydroxychloroquine dosage used in the VTE group (133±119) mg/d was lower than that of the control group (211±126) mg/d (t=2.156, P=0.034), antiplatelet drug use rate was lower than the control group too, the difference were statistically significant ( χ2=7.080, P=0.008). Logistic regressions showed that renal involvement [OR=5.5, 95%CI (3.6, 12.7), P=0.003], lower C3 level [OR=2.3, 95%CI (1.8, 5.2), P=0.005], SLEDAI activity score [OR=8.13, 95%CI (5.2, 7.3), P=0.001] were independent risk factors for VTE in SLE. Conclusion SLE patients with renal involvement, increased blood pressure, history of lower extremity deep vein catheterization or complicated with APS were risk factors for VTE, while hydroxylchloroquine, antiplatelet drugs may help prevent VTE.
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Objective To investigate the clinical features of rheumatoid arthritis (RA) associated with thyroid function abnormalities.Methods Serum thyroid function,anti-thyroglobulin antibodies (TGAb) and anti-thyroid peroxidase antibodies (TPOAb) were detected in 186 RA patients.Clinical data were then analyzed.Comparison of continuous data between groups was made by t test,while comparison of categorical data was made by x2 test.The non-normal distribution of the data was analyzed by Mann-Whitney U rank sum test.Results Fifty-six RA cases (30％) had abnormal thyroid function,including 25 low T3 syndrome cases,16 subclinical hypothyroidism cases,10 hypothyroidism cases and 5 Graves' disease cases.Among them 23 cases were diagnosed as Hashimoto's thyroiditis.The positive rate in the hypothyroidism group with chills (45 cases,80.3％,x2=99.94),lazy words (14 cases,25.0％;x2=7.896),lethargy (24 cases,42.9％;x2=7.433) and abdominal distension (21 cases,37.5％;x2=7.15) was higher than that in the group with normal thyroid function (all P＜0.05).Level of serum high density lipoprotein was decreased in hypothyroid group [(1.0±0.5) mmol/L vs (1.4±0.6) mmol/L,t=4.087,P＜0.05].Patients with abnormal thyroid function had higher positive rate of ANA [(10 cases,7.7％) vs (25 cases,44.5％),x2=34.98],anti-SSA [(3 cases,2.3％) vs (23 cases,41.1％),x2=48.91],anti-SSB [(2 cases,1.5％) vs (12 cases,21.4％),x2=22.25],TGAb [(20 cases,15.4％) vs (43 cases,76.7％),x2=65.88] and TPOAb [(13 cases,10.0％) vs (27 cases,48.2％),x2=35.90] than those with normal thyroid function (all P＜O.05).Conclusion Rheumatoid arthritis is often accompanied by thyroid disease.The positive rate of auto-antibodies in RA with abnormal thyroid function is higher than those with normal thyroid function and has no relationship with the disease activity.
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Objective Implanting surgical meshes to support breast in periareoler mammaplasty shows an excellent prospect.But shrinking of the mesh and the adhesion formation affected the postoperative shape and palpation of the breast.The aim of this study was to compare biocompatible properties of four different polypropylene meshes (Prolene(R) ; Vypro Ⅱ(R) ; Premilene Mesh (R) and Premilene Mesh LP(R)) and to discuss the inclusion criteria of meshes in this technique.Methods The study was carried out in pigs.Four different polypropylene meshes were implanted subcutaneously in belly.90 days after implantation the mesh samples were explanted,and complications,foreign-body reaction,collagen fiber and elastic fiber formation were observed,as well as ultrastructures for the biocompatible properties.Results The biocompatible properties of each mesh were different.The foreign-body reactions determined the biocompatible properties,and affected the postoperative shape greatly.Conclusions Premilene Mesh LP o as a newer low-weight polypropylene mesh,has superior properties to the others.
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Objective To summarize the clinical manifestations and treatment of Churg-Strauss syndrome (CSS) involving large and medium-sized arteries. Method Six cases were investigated retrospec-tively and literature were reviewed. Results The pathological category of large-and medium-sized arteries involved in CSS included occlusion, stenosis, thrombesis, dissection, aneurysm, arteritis, and periarterifis. The involved arteries included coronary artery, central retinal artery, mesenteric artery, vertebral artery, basilar artery, carotid artery, aorta, and arteries of extremities. The large-and medium-sized arteries involvement in patients with CSS might not associated with age, duration of disease, and the titer of perinuclear-antineutrophil cytoplasmic antibodies. Treatment with corticosteroid and immunosuppressive agents combined with surgical interventions or anticoagulation if needed might improve the prognosis in the early stage. It was particularly hazardous for coronary involvement in patients with CSS. Conclusion CSS can involve many kinds of large-and medium-sized arteries. The pathological category of large and medium-sized arteries involved in CSS is diverse. More attention should be paid to large and medium-sized arteries involvement in patients with CSS.
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@#Objective To observe the effect of scalp-acupuncture combined with physical therapy on spastic cerebral palsy.Methods 80 children with spastic cerebral palsy were randomly divided into observation group and a control group,40 cases in each group.The observation group was treated with scalp-acupuncture combined with physical therapy,and the control group with physical therapy only.They were assessed with the Functional Independence Measure for children(WeeFIM) and the Gross Motor Function Measure(GMFM) before and 3 months after treatment.Results No side-effect was observed during the treatment.The scores of WeeFIM and GMFM of the observation group were significantly superior to the control group(P<0.05).Conclusion The scalp-acupuncture can improve the efficiency of physical therapy on motor function in the children with spastic cerebral palsy.
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Objective To evaluate the method of vulvar reconstruction after extended vulvectomy. Methods Retrospectively, fourteen cases of vulva carcinoma were treated by radical wide local excision, and the defects were repaired with anterolateral thigh flap and inferior pedicle rectus abdominal myocutaneous flap. After the flap was harvested, it was put on the defect through the tunnel between the donor and the recipient site and the vulvae was reconstructed. Results All the flaps were survived except 1 anterolateral thigh flap with partial necrosis. One patient was infected at the groin incision but the flap and the grafted skin were survived. The patients were treated with change of the dressing and recovered after skin grafting. All other incisions were healed with first intention. The partial necrosis area was about 4 cm?6 cm, it healed at 36 postoperative days after free skin grafting. The reconstructed vulvae were plump and elastic. It appeared like the normal vulvae and there was no contraction of the vagina. Conclusions Vulvar reconstruction with the anterolateral thigh flap and rectus abdominal flaps after the radical vulvectomy could make the patients recover easily. It produces almost normal appearance and function of the vulvae, reduces the time of would healing. The patient could have the next therapy more quickly and the quality of life improves. It has wide application value in clinics.