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AIM: To investigate the effect of adalimumab combined with dexamethasone intravitreal implant in the treatment of refractory non-infectious uveitis macular edema(UME).METHODS: A total of 92 cases(131 eyes)of refractory non-infectious UME patients admitted to our hospital from January 2020 to January 2022 were selected and randomly divided into control group, with 46 cases(63 eyes)treated with dexamethasone intravitreal implant and observation group, with 46 cases(68 eyes)treated with adalimumab subcutaneous injection combined with dexamethasone intravitreal implant. The best corrected visual acuity(BCVA), central retinal thickness(CRT), vitreous opacity and Th17/Treg cytokines were measured before and after treatment, and the occurrence of adverse reactions was recorded.RESULTS: Totally 3 cases(4 eyes)were lost to follow-up. After treatment for 1, 3, 6 and 12 mo, BCVA was improved in both groups compared with that before treatment, and CRT, vitreous opacity score, serum interleukin(IL)-17 and IL-22 levels were decreased compared with those before treatment, and serum transforming growth factor-β(TGF-β)and IL-10 levels were increased compared with those before treatment. BCVA in the observation group was better than that in the control group, and CRT, vitreous opacity score, serum IL-17 and IL-22 levels were lower than those in the control group, and serum TGF-β and IL-10 levels were higher than those in the control group(all P<0.05). During treatment and follow-up, no serious adverse reactions occurred in both groups.CONCLUSION: Adalimumab combined with dexamethasone intravitreal implants in the treatment of refractory non-infectious UME can significantly subside the macular edema, reduce vitreous opacity and improve visual acuity.
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Objective:To develop an evidence-based nursing program for a patient with oral complications of dysphagia due to cerebral infarction.Methods:According to the principle of PICO, and the problem of patients' clinical manifestations, using the method of combining subject words and free words, the database of Uptodate, NICE, SIGN. RNAO, medical pulse guide network, BMJ, Cochranc library, PubMed, EMbase, CINAHL, China National Knowledge Infrastructure were searched and collected the clinical guidelines, systematic evaluation and randomized controlled trial of oral complications in patients with dysphagia of cerebral infarction.Results:Totally 1 clinical decision, 5 clinical guidelines, 4 expert consensus, 2 systematic evaluations, 1 Meta-analysis, 3 randomized controlled trial (RCT) were included. Based on the search results and the patient′s condition and wishes, nurses performed swallowing function tests every two days according to the Standard Swallowing function rating Scale (SSA), raised the head of the bed 40°~45° and holded it for 1 hour. Three times a day, the teeth were brushed with chlorhexidine oral care solution under negative pressure. Sputum scab was removed by mechanical scrubbing. The back of tongue was scrubbed by 6x tongue scraping technique every night. After the infection was controlled, the teeth were washed twice a day with 0.9% sodium chloride solution. Oral condition and swallowing function were evaluated daily. High flow humidification oxygen therapy and mask spray atomization inhalation were used. Swallowing training was performed on the third day after admission. Seven days after the evidence was applied to clinical practice, the oral mucosa was moist without peculiar smell and sputum scab, and the swallowing function was changed from grade IV to grade II.Conclusion:Nursing cerebral infarction patients with dysphagia, nurses should timely assess the patient's oral cavity and swallowing function, the application of chlorhexidine and 0.9% sodium chloride solution oral care solution mechanical scrubbing method and negative pressure washing brushing method can effectively remove sputum scab, use 6x tongue scraping technology to scrub the back of tongue, can reduce micro organisms, reduce halitosis; the application of nasal mask high flow humidification oxygen therapy and spray atomization inhalation humidification effect is obvious Therefore, early swallowing training can reduce the incidence of oral complications.
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Objective@#This study aims to explore the influence of birth order and age difference on the emotional and behavioral problems among children from two-child family, so as to provide advice on parenting.@*Methods@#A total of 482 students in grades 2 to 5 from the 5 primary schools in Guangzhou were selected, all of whom came from two-child families (excluding twin children). Emotional and behavioral problems were investigated by using the Conner’s Parental Symptom Questionnaire (PSQ).@*Results@#Among children from two-child families, higher prevalence of behavioral problems, learning problems, impulsive hyperactivity and hyperactivity index in older compared with younger children (β=-0.09，-0.16，-0.09，-0.10,P<0.05). The scores of behavioral problems and hyperactivity index were significantly higher among those of children who were 6-9 years older than young siblings, compared to those who were 0-3 years older than younger siblings(β=0.20,0.21,P<0.05). No similar pattern was found among the younger siblings(P>0.05).@*Conclusion@#Among school-age children from two-child families, emotional and behavioral problems of the elder ones were more serious than the younger ones’. Age difference between siblings shows impact on the emotional and behavioral development among elder children, however no significant impact is noticed among the younger ones.
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Objective@#To systematic evaluate the real experience of patients after falling during hospitalization and qualitative research on the cognition and demand for fall prevention will provide theoretical basis for patients, their families, medical staff and medical institutions to better carry out fall prevention.@*Methods@#English databases such as PsycINFO, Medline, Embase, CINAHL, Cochrane, PubMed, and Chinese databases such as Chinese biomedical literature database, CNKI, Wanang database were retrieved by computer. Included qualitative studies on the emotional experience of fall of inpatients and their cognition and needs for fall prevention. The retrieval time limit was until November 1, 2018.The literature was evaluated using the quality evaluation criteria for qualitative research (2016) of the JBI evidence-based health care center, and the results were integrated using a pooled integration method.@*Results@#A total of 8 studies were included, and 33 clear research results were extracted. Similar results were summarized and combined to form 7 new categories, which were integrated into 4 results. Results 1: psychological experience of hospitalized patients after falling down. Integration results 2: the causes of falls from the perspective of inpatients. Integration results 3: hospital fall prevention measures and evaluation from the perspective of inpatients. Integration result 4: inpatients expected to receive care from their families and help from medical staff.@*Conclusion@#Fall events seriously affect the mental health of patients; Patients′ cognition of falling is affected and changed by many factors. Fall prevention should shift from clinical focus to patient-centered and attach importance to the participation of family members.
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Aim To study the apoptotic inducing effects of deguelin on SH-SY5Y cells.Methods SH-SY5Y cells were treated with 0,0.625,1.25,2.5,5,10 and 20 μmol·L-1 deguelin for different time(24,48,72 h);cell viability was detected by CCK-8 assay.SH-SY5Y cells were treated with 0,8,20,50 μmol·L-1 deguelin for 24 h;light microscope and AO/EB double stained method were employed for observing the morphology and apoptotic morphology of treated cells.Apoptotic rate of treated cells was determined by flow cytometry.Cells were stained by DCFH-DA,and the whole reactive oxygen species(ROS)was determined by flow cytometry.Spectrophotometry was employed to determine the activation degree of caspase-3.Results Deguelin inhibited cell growth in a time-and dose-dependent manner,and the IC50 value of deguelin was(26.07±2.18),(18.33±0.94),(12.5±1.49)μmol·L-1 when treated with 24,48,72 h respectively.After treated with 8,20,50 μmol·L-1 deguelin for 24 h,cell apoptotic rate,ROS and activation rate of caspase-3 increased markedly(P<0.05),all of which performed a dose related effect.Conclusion Deguelin can inhibit SH-SY5Y cell proliferation and induce cell apoptosis,and the mechanism may be concerned with the elevated ROS and activated caspase-3.
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OBJECTIVE To analyze the correlation between number of tissue eosinophils(Eos) and blood Eos levels in patients with chronic rhinosinusitis with nasal polyps(CRSwNP), and to investigate if tissue and blood eosinophilia predicts disease severity and prognosis in CRSwNP. METHODS A retrospective analysis of 102 patients, who diagnosed with CRSwNP was carried out in this study. Surgical specimens were evaluated for degree of tissue Eos, which was compared with blood Eos. Patients were divided into two groups according to the results of endoscopy one year after surgery: recurrent and non-recurrent group. Statistical analysis was performed to compare tissue and blood Eos and CT Lund-Mackay scores. RESULTS Blood and tissue Eos in recurrent group was significantly higher than that in non-recurrent group(P=0.032, 0.033, 0.017). There was not a statistical difference of CT scores between two groups(P =0.089). There was a significant correlation between tissue Eos and absolute number of blood Eos(r=0.637, P=0.000) as well as between tissue Eos and percentage of blood Eos(r=0.542, P=0.000). However Eos and CT scores were not correlated statistically(P>0.05). CONCLUSION Blood Eos levels can predict the degree of Eos infiltration in nasal polyps. Blood and tissue Eos correlate with prognosis.
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Mai is the important concept in TCM and this term has been found in the early classic work of TCM. With the development and perfection of TCM theory, the original meaning of mai is "blood vessels entirely distrusted in the body". In five dynasties, the meaning of it was supplemented as "distribution of qi and blood in five zang and six fu organs to the four extremities", in which, not only blood but also qi has been included. With the constant understanding on mai, qi and blood, the unique concept of meridian and collateral is gradually generated. In terms of the modern study on the original meaning of mai and the academic evolution of meridian and collateral, it is discovered that qi is predominated and distributed in meridian and collateral as compared with blood. It is very significant to study the original meaning and academic evolution of mai, as well as the origin of the concept of meridian and collateral and to provide the reference support for the terminology standardization and basic study.
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Humans , Acupuncture , History , China , History, Ancient , Medicine in Literature , Medicine, Chinese Traditional , History , Meridians , Qi , History , Terminology as TopicABSTRACT
Objective To evaluate the speech recognition ability in noise enviroment in older adults with age-related hearing loss and to discuss the influences of age ,hearing loss and cognitive function on the ability of speech recognition in noise enviroment .Methods A total of 90 older adults aged over 60 years at the hearing clinic of Xinhua hospital were divided into three groups according to the age ,which were 60~69 y group (88 ears) ,70~79 y group (64 ears) ,> 79 y group (28 ears) .All the participants completed pure tone audiometry ,the Mandarin hearing in noise test (MHINT) and the mini-mental state examination (MMSE) .The pure tone average hearing threshold (PTA) ,signal-to -noise ratio (SNR) of MHINT and MMSE scores were obtained .We used the statis_tical software SPSS 17 .0 to analyze the correlations among age ,PTA ,adaptive SNR and MMSE scores .ResuIts ①PTA and SNR increased with the age .The difference of PTA and SNR for different age groups was statistically sig_nificant (P<0 .01) .②The difference SNR among different PTA groups were significant (P<0 .01) ,and when the influence of MMSE scores was controlled the difference was still significant .There was a significant linear correlation between PTA and SNR (r=0 .326 ,P<0 .01) .MMSE scores decreased with the increasing of PTA ,and there was also a linear correlation between PTA and MMSE scores (-0 .187 ,P<0 .05) .③Adaptive SNR and MMSE scores were correlated (r= -0 .201 ,P<0 .01) ,but there was no significant linear relationship .Besides ,SNR of the cog_nitive function impairment group (<27 points) was significantly greater than that of the normal cognitive function group (27~30 points) (P<0 .01) .However ,among the three PTA groups ,the differences were not statistically significant .ConcIusion The hearing in noise test reflects the ability of speech recognition in noise enviroment in ol_der adults ,and can be used to assess the hearing functions in elder .Speech recognition in noise ,peripheral hearing loss and cognitive functions are relevant .Cognitive functions have an influence on the evaluation of the hearing func_tion for older adults .
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Objective To investigate the allergen of asthma in children in order to instruct family management and improve the quality of life of children with asthma. Methods Skin prick was used to detect the allergen of asthma in children. Family management program was designed for patients with posi-tive results and implemented under supervision. Controlled study of patients adopting family management program and patients without this program was performed for 1 year. Results 78 cases of 104 children (75.0%) with asthma were positive for allergen. Among 78 cases, 58 cases were positive for der-matophagoides culinae, and 49 cases were positive for dermatophagoides pteronyssinus, which were two main allergens. The one- year follow- up research results showed: 14 cases once suffered emergency treat-ment, 6 needed hospitalization, 12 absent from classes and the average economic cost reached 1840.5 yuan per patient per year among 52 patients who received family management program.While in 26 patients who did not adopt family management program, 15 cases once suffered emergency treatment, 10 needed hospi-talization, 14 absent from classes and the average economic cost reached 3267.3 yuan per patient per year. The difference was significant. Conclusions Family management guide can improve the quality of life in asthma children positive for allergen.