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AIM: To observe changes in fundus microcirculation of myopic adolescents after wearing orthokeratology by applying optical coherence tomography angiography(OCTA).METHODS: Prospective study. A total of 40 cases(40 eyes)of adolescents with low to moderate myopia who chose orthokeratology to correct visual acuity at our hospital from April 2021 to June 2022 were collected. The uncorrected distant visual acuity and axial length were evaluated at 1, 3 and 6mo before and after wearing orthokeratology, respectively. Furthermore, the changes in superficial vessel density(SVD), deep vessel density(DVD), central retinal thickness(CRT), foveal avascular zone area(FAZ-A), foveal avascular zone perimeter(FAZ-P), retinal nerve fiber layer(RNFL)thickness and radial peripapillary capillaries density(RPCD)were observed by applying OCTA.RESULTS: The uncorrected distant visual acuity was significantly improved at 1, 3 and 6mo after wearing orthokeratology(P<0.001). There was no statistically significant difference in axial length before and after wearing orthokeratology(P>0.05). Moreover, there were significant differences in both SVD of fovea quadrant and DVD of fovea and lower quadrant(P<0.01), but there were no differences in CRT, FAZ-A and FAZ-P, RNFL thickness and RPCD(P>0.05).CONCLUSION: Wearing orthokeratology can significantly improve visual acuity and increase local retinal vessel density in the macula in adolescents with low to moderate myopia.
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OBJECTIVE: To analyze the experience of diagnosis and treatment of a case of brodifacoum poisoning. METHODS: The clinical data of a case of unexplained brodifacoum poisoning was retrospectively analyzed. RESULTS: The patient went to the doctor for unexplained bleeding. The bleeding symptoms included nasal o blood ozing, blood in saliva and skin ecchymosis. Blood anticoagulative rodenticide test showed positive with brodifacoum. The results of coagulative function tests showed that the indexes of partial prothrombin time, prothrombin time and fibrinogen were increased. The patient was diagnosed as brodifacoum poisoning based on the clinical symptoms and laboratory test results. The combined use of 40 mg/d of vitamin K_1 and frozen plasma improved the clotting time and quickly alleviated the bleeding symptoms of the patient. However, the patient′s bleeding symptoms recurred when vitamin K_1 was discontinued. The patient was hospitalized for 62 days and then discharged. With follow-up one month after discharge, the patient showed no bleeding symptoms, but brodifacoum could still be detected in the blood. CONCLUSION: The symptoms of brodifacoum poisoning may relapse and the treatment course is long. Vitamin K_1 could be used as the first-choice medicine for the treatment of brodifacoum poisoning, but its usage needs to be optimized.
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OBJECTIVE: To analyze the correlation between vascular endothelia injury factors and occupational hand-arm vibration disease( HAVD). METHODS: A judge sampling method was used to select 23 male patients with HAVD as the HAVD group,61 male workers who exposed to hand-arm vibration without HAVD as the vibration exposure group,64 male workers without hand-arm vibration exposure as the control group. The plasma levels of myosin light chain 2( MLC2),endothelin-1( ET-1) and vinculin( VCL) were detected by enzyme-linked immunosorbent assay. Logistic regression analysis was used to analyze the related indicators of HAVD for building the new multivariable model index Y. The indicators of HAVD were screened and judged by receiver operating characteristic( ROC) curves. RESULTS: There was significant difference in plasma levels of MLC2 among the three groups( P < 0. 05). The levels from high to low was as follows: HAVD group > vibration exposure group > control group. The plasma level of ET-1 in HAVD group was lower than that in the control group( P < 0. 05),but there was no significant difference between vibration exposure group and HAVD group( P > 0. 05). There was no significant difference among the three groups in the plasma level of VCL( P > 0. 05).The logistic regression analysis results showed that after adjusting confounding factors such as age,length of service,smoking,alcohol drinking and subjective symptoms,the higher MLC2 plasma level,the higher risk of HAVD( P < 0. 01),and the lower ET-1 plasma level,the higher risk of HAVD( P < 0. 05). According to ROC curve analysis,the area under the ROC curve( A_Z) value of the plasma levels of MLC2 and ET-1 were 0. 820 and 0. 524,respectively( P < 0. 01). The predictive probability index Y built with MLC2 and ET-1 by logistic regression model was used to judge the A_Z value of HAVD to be 0. 799( P < 0. 01). The A_Z values from high to low was as follows: MLC2 > Y> ET-1( P < 0. 01).CONCLUSION: The plasma levels of MLC2 and ET-1 are correlated with HAVD. The efficacy of MLC2 as a biomarker for screening HAVD is better than that of ET-1. No association was found between VCL and HAVD.
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OBJECTIVE: To evaluate the efficacy and safety of sodium dimercaptopropane sulfonate( DMPS) in the treatment of patients with increased urinary mercury. METHODS: By random sampling method,68 patients with elevated urinary mercury were chosen as study subjects. Among them,61 cases were observation subjects working with mercury and 7 cases were chronic occupational mild mercury poisoning. DMPS was used to eliminate mercury by intramuscular injection. The changes of urinary mercury level were observed before and after treatment,and the curative effect was analyzed. RESULTS: The median( the 25 th and 75 th percentiles) of natural voiding urinary mercury was 36. 6( 28. 4,55. 6) μmol / mol creatinine and 24 hours total urine mercury amount was 1 074. 7( 608. 0,1 646. 3) μg / d in the first course of treatment.After 1 to 8 courses of mercury expulsion,the 24 hours total urine mercury amount in 68 patients were lower than the normal reference level( 45. 0 μg / d). The median( the 25 th and 75 th percentiles) of one-time morning urinary mercury level before hospital discharge was 2. 7( 1. 8,4. 0) μmol / mol creatinin,which was lower than the level of natural voiding urinary mercury( P < 0. 05). The first and second course of treatment resulted in the highest decline in urinary mercury,followed by a gradually decreased in urinary mercury in later courses. The number of treatment courses in observation subjects working with mercury was less than that in patients with chronic mild mercury poisoning [( 4. 0 ± 1. 3) vs( 5. 6 ±1. 1) times,P < 0. 05]. There was a positive correlation between the number of treatment courses and the level of natural voiding urinary mercury or 24 hours total urine mercury amount in the first course of treatment( P < 0. 01). The number of courses of mercury expulsion was not related to gender,length of service and age( P > 0. 05). One patient had dizziness and pale after intramuscular injection of DMPS,the symptom was disappeared with symptomatic treatment; 68 patients after treatment have no other adverse reactions. CONCLUSION: Using DMPS as mercury displacement treatment was effective and relatively safe. The change of urinary mercury after DMPS treatment can be used as a basis for establishing clinical standard for patients with increased urinary mercury.
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OBJECTIVE: To collect,analyze and summarize the clinical characteristics of occupational chronic n-hexane poisoning cases reported in the literatures published in domestic open public periodicals in order to provide evidence for the revision of GBZ 84 Diagnostic Criteria of Occupational Chronic n-Hexane Poisoning. METHODS: By the bibliometrics method,the databases of CNKI,VIP and WANFANG were used to retrieve literatures on the occupational chronic n-hexane poisoning published from 1990 to 2014. The literatures with detailed clinical data were screened and selected for summary and analysis. RESULTS: A total of 68 reference literatures meeting the inclusion criteria were chosen in 25 years of domestic publication. These literatures reported 1 027 cases of occupational n-hexane poisoning,including 165 males and 862 females. The median of age was 28. 3( 13. 0-59. 0) years. Most of the cases had a disease incubation period of 2. 0-10. 0months. The diagnostic classification was made in 817 cases( 79. 6%),with mild,moderate and severe chronic n-hexane poisoning in 418,241 and 158 cases,respectively. The n-hexane levels in workplace air were reported in 736 cases( 71. 7%),91. 8%( 676 /736) of which had exceeded the national occupational exposure limit. Chronic n-hexane poisoning was mainly characterized by peripheral nerve damage,626 cases( 61. 0%) had feeling and movement disorders,256 cases( 24. 9%) had movement disorder and 145 cases( 14. 1%) had feeling disorders. The clinical characteristics of these disorders were bilaterally symmetric feeling or movement disorders in distal limbs. The nerve-electromyography examination showed the neurogenic damage,which was parallel with the severity of patients' condition and could be detected at early stage of illness. The gas chromatography was used to detect the 2,5-hexanedione level of 156 cases( 15. 2%) of patients and the positive detection rate was 50. 6%( 70 /156). Currently,there was no specific medication or other therapy for treatment of chronic n-hexane poisoning. The comprehensive therapy which mainly include nerve restoration was the general therapy method. Addition of mouse nerve growth factor to the conventional therapy had significant treatment effects. The therapeutic effect was reported in 954 cases with the recovery rate of 83. 6%( 798 /954),and the complication in nervous system was observed in 156 cases who were not cured. CONCLUSION: The main clinical manifestation of chronic n-hexane poisoning is peripheral neuropathy. The nerve-electromyography is the most important diagnostic method. Currently,comprehensive therapy is used with good prognosis in the patients.
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OBJECTIVE: To analyze the correlation between four vessel regulate factors and vibration-induced white finger( VWF) evaluating in workers exposed to hand-arm vibration,and discuss the value of regulate factors for VWF screening.METHODS: Using typical sampling method,77 male workers exposed to hand-arm vibration with more than 1 year of polish work from a metalwork factory were selected as the study subjects. Based on the workers' self-report,they were divided into VWF group( 43 workers) and non-VWF group( 34 workers). The venous blood from center elbow was collected and plasma was separated. The plasma level of endothelin( ET) was detected by radioimmunoassay. The plasma levels of transforming growth factor beta( TGF-β),soluble intercellular adhesion molecule-1( s ICAM-1) and 5-hydroxytryptamine( 5-HT) were detected by enzyme-linked immunosorbent assay. The regulate factors for evaluating VWF were screened and the new multivariable model index
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<p><b>OBJECTIVE</b>To investigate the efficacy of mouse nerve growth factor (mNGF) in treating occupational hand-arm vibration disease (HAVD).</p><p><b>METHODS</b>Sixty-four patients with HAVD were equally and randomly divided into treatment group and control group. The control group was given Salvia miltiorrhiza Bunge and deproteinized extract of calf blood to improve circulation, and also given methylcobalamin tablets and vitamin B6 for neurotrophic treatment. In addition to the above treatments for the control group, the treatment group was also given 30 µg/d mNGF by intramuscular injection for two courses (4 weeks for each course) with a 15-day interval.</p><p><b>RESULTS</b>Both the treatment group and the control group showed significant improvements in clinical symptoms and signs (hand numbness and pain, and reduced senses of touch, pain, and vibration), cold water loading test (CWLT), and electroneuromyography (ENMG) after treatments (P < 0.05). And the treatment group had significantly more improvements than the control group (P < 0.05).</p><p><b>CONCLUSION</b>mNGF can significantly improve hand numbness and pain, reduced senses of touch, pain, and vibration, CWLT, and ENMG, so it has better clinical effect and safety in treating HAVD. Early diagnosis and treatment can improve the outcome of patients with HAVD.</p>
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Animals , Humans , Mice , Hand-Arm Vibration Syndrome , Drug Therapy , Nerve Growth Factor , Pharmacology , Occupational Diseases , Treatment Outcome , VibrationABSTRACT
Objective To study the curative effect of mesenchymal stem cells(MSC)transplantation on occupational chronic benzene poisoning and summarize the nursing measures.Methods The clinical data of 5 patients with occupational chronic benzene poisoning treated with MSC transplantation for 48 times totally were retrospectively reviewed for the purpose of investigating the curative effects and summing up the nursing measures.Results After transplantation,the levels of white blood cells,hemoglobin and neutrophil,platelet were all increased significantly.The differences in white blood cells and neutrophil were significant between pre-and post-transplantation(P<0.05).Bone marrow hyperplasia was active after treatment.No adverse reactions were observed in all of the patients.Conclusion MSC is safe and effective in treating occupational chronic benzene poisoning.Observing patient’s conditions closely,implementing protective isolation and psychological nursing strictly and doing predictive nursing measures are of significance for success of MSC transplantation and improvement of the curative effect.
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Los objetivos fueron determinar la percepción de la calidad de atención de enfermería, a los pacientes sometidos a quimioterapia ambulatoria en el Hospital Nacional Cayetano Heredia, e Identificar la percepción de la calidad de atención de enfermería según la dimensión humana, oportuna, segura y continua. Material y Método. El estudio fue de nivel aplicativo, tipo cuantitativo, método descriptivo de corte transversal. La población estuvo constituida por 32 pacientes. La técnica fue la entrevista y el instrumento una escala modificada tipo Lickert. Considerando el consentimiento informado. Resultados; Del 100 por ciento (32) 53 por ciento (17) tienen una percepción medianamente favorable, 31 por ciento (10) favorable, 16 por ciento (5) desfavorable. En cuanto a la dimensión humana 47 por ciento (15) tienen una percepción favorable, 19 por ciento (6) medianamente favorable y 19 por ciento (11) desfavorable. En la dimensión oportuna 34 por ciento (19) tienen percepción favorable, 16 por ciento (5) medianamente favorable y 25 por ciento (8) desfavorable; en la dimensión segura 44 por ciento (14) presentan percepción favorable, 37 por ciento (12) favorable y 19 por ciento (6) desfavorable y en la dimensión continua, 63 por ciento (20) favorable, 6 por ciento (2) medianamente favorable, 31 por ciento (10) desfavorable. Conclusión. Un porcentaje considerable (69 por ciento) de los pacientes oncológicos tienen una percepción medianamente favorable a desfavorable, que está dado por que la enfermera debe entender los problemas y necesidades, dedicarle tiempo, brindar orientación sobre los cuidados a seguir después de la quimioterapia lo desfavorable esta dado cuando la enfermera no se presenta con su nombre, no le explica los procedimientos a realizar, ni le brinda apoyo emocional permanente. Y un porcentaje mínimo significativo (34 por ciento) favorable referido a que se dirige la enfermera con tono de voz adecuado, lo atiende de manera personalizada, se muestra amable, le orienta sobre el efecto del tratamiento, le brinda confianza y le atiende ante cualquier efecto secundario del medicamento.
The objectives were to determine the perceived quality of nursing care to patients undergoing outpatient chemotherapy at the National Hospital Cayetano Heredia, and identify the perception of the quality of nursing care as the human dimension, timely, secure and continuous. Material and Methods. The study was application level, quantitative, cross sectional method. The population consisted of 32 patients. The technique was the interview and the instrument Lickert scale. Whereas informed consent. Results, 100 per cent (32) 53 per cent (17) have a fairly favorable perception, 31 per cent (10) favorable, 16 per cent (5) unfavorable. As for the human dimension 47 per cent (15) have a favorable, 19 per cent (6) moderately favorable and 19 per cent (11) unfavorable. In the appropriate size 34 per cent (19) have a favorable perception, 16 per cent (5) moderately favorable and 25 per cent (8) unfavorable safe in the dimension 44 per cent (14) have a favorable perception, 37 per cent (12) and 19 per cent favorable (6) adverse and continuous dimension, 63 per cent (20) deal, 6 per cent (2) moderately favorable, 31 per cent (10) unfavorable. Conclusión. A significant percentage (69 per cent) of cancer patients have a moderately favorable to unfavorable perception, which is given by the nurse must understand the problems and needs, spend time, provide guidance on the care to continue after chemotherapy is the unfavorable given when the nurse does not appear with his name, explains the procedures to be performed, and provides ongoing emotional support. And a significant minimum percentage (34 per cent) favorable referred to the nurse goes right tone of voice, treats in a personalized manner, is amiable, he focuses on the effect of treatment, confidence and gives addresses for any purpose medication side.
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Humans , Male , Adult , Female , Nursing Care , Quality of Health Care , Drug Therapy , Evaluation Studies as Topic , Cross-Sectional StudiesABSTRACT
This study was purposed to establish a real-time quantitative reverse transcription polymerase chain reaction (RT-PCR) for detection of PML/RARa fusion gene in patients with acute promyelocytic leukemia (APL) and to explore the relationship between the expression level of PML/RARa fusion gene transcript and the clinical status or efficacy of the therapy in APL. The conventional RT-PCR was used to amplify PML/RARa gene from cultured NB4 cells. Standard curves were constructed by modified real-time PCR on standard template after 10-fold serial dilutions of cDNA of 1 microg NB4 cells. The sensitivity, stability and repeatability of this method was determined. The PML/RARa gene transcripts of bone marrows in 4 APL patients before and after treatment and in 1 APL patient relapsed after complete remission were dynamically detected by modified real-time quantitative RT-PCR. The results indicated that the sensitivity of real-time quantitative RT-PCR for detecting PML/RARa fusion gene was about 10(-5) microg cDNA from NB4 cells, the repeatability and reproducibility of this method were satisfactory, intra-and inter-assay coefficients of variation were 2.1% and 3.8%. The copy numbers of PML/RARa transcripte reflecting PML/RARa fusion gene expression level in 4 newly diagnosed patients with APL were 1884, 5533, 1803, 4677 and the median was 3 475. After ATRA + chemotherapy copy numbers of PML/RARa transcript decreased to 40, 135, 79, 29, and mean was 121. Another patient's PML/RARa gene copy number was 8600 at diagnosis, the gene copy number was 730 after therapy for 4 months, although he was in complete remission, but copy number increased to 11 000 when APL relapsed 3 months later. The copy number efficiently reduced to 1200 after ATRA + chemotherapy. It is concluded that the established real-time quantitative RT-PCR method is sensitive, reliable, accurate and repeatable. The efficiency of method was finally tested for patient samples, showing a PML/RARa transcript copy number in APL patients significantly decrease after therapy, and increase at the time of relapse which indicate that changes of fusion gene expression levels coincide with clinical progress of disease. This method can be used to detect the minimal residual disease, assess response to treatment and evaluate prognosis of disease.
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Adolescent , Adult , Female , Humans , Male , Young Adult , Leukemia, Promyelocytic, Acute , Genetics , Metabolism , Oncogene Proteins, Fusion , Genetics , RNA, Messenger , Genetics , Reverse Transcriptase Polymerase Chain Reaction , Methods , Sensitivity and Specificity , Tumor Cells, CulturedABSTRACT
<p><b>OBJECTIVE</b>To summarize the experience in performing reoperation of valve dysfunction after congenital heart disease procedure.</p><p><b>METHODS</b>From 1994 to 2001 we reviewed the data of 13 patients with valve dysfunction after congenital heart disease operation, in which 8 patients after ventricular septal defect, 3 after atrioventricular canal and 2 after respectively tetralogy of Fallot and atrial septal defect were corrected. Before the first operation, 6 patients had presented the mild to moderate mitral regurgitation, 1 had aortic regurgitation. Other 6 patients had valves dysfunction occurring after the first operation, among them, 2 suffered from respectively residual shunt of the ventricular septal defect, 2 had anterior chordae rupture of tricuspid valve, one had an operative injured aortic valve and one had surviving of right ventricular outlet obstruction. Thirteen patients were reoperated, including mitral valve replacement in 6, tricuspid valve replacement in 2, aortic valve replacement in one, aortic valve replacement consists with mitral valve repair and tricuspid valve repair in one and tricuspid valve repair in 3. Concomitant procedures were performed.</p><p><b>RESULTS</b>Low cardiac output occurred in 3 cases and there were 2 early deaths, due to cerebral air-embolism, respiratory and circulatory failure respectively. Other 11 cases discharged and were followed up well.</p><p><b>CONCLUSIONS</b>It is important to safeguard and repair the valvular construction and function during the operation in congenital heart disease. Reoperation should be performed timely for obtaining recurrent and a good results.</p>