Retrospective analysis of 35 burn patients in different stages of pregnancy / 中华烧伤杂志

Objective: To summarize the clinical outcomes of burn patients in different stages of pregnancy and explore a rational therapeutic scheme for burns during pregnancy. Methods: A retrospective observational study was conducted. From June 2010 to June 2020, 21 patients who met the inclusion criteria were admitted to the Department of Burns of Wuhan Third Hospital and 14 patients who met the inclusion criteria were admitted to the Department of Burns of the First Affiliated Hospital of Nanchang University. Based on the pregnancy period when patients suffered burns, the 35 patients were divided into early pregnancy group with 18 patients (aged (26±4) years, with 8 (4, 11) weeks of gestation), middle pregnancy group with 10 patients (aged (26±3) years, with 21 (14, 27) weeks of gestation), and late pregnancy group with 7 patients (aged (30±5) years, with 32 (29, 35) weeks of gestation). All the patients received treatment including fluid resuscitation, anti-infection, wound treatment, and multidisciplinary comprehensive managements. The burn-related complications during the treatment, maternal outcomes, fetal outcomes, fetal delivery mode, gestational weeks at delivery, and newborn weight of patients in the 3 groups were recorded. Data were statistically analyzed with one-way analysis of variance, Kruskal-Wallis test, and Fisher's exact probability test. Results: During the treatment, there were 4, 4, and 2 patients who suffered wound infections and 1, 3, and 2 patients who developed shock symptoms, respectively, in early pregnancy group, middle pregnancy group, and late pregnancy group. There were no statistically significant differences in them among the 3 groups (P>0.05). One patient in late pregnancy group developed into multiple organ dysfunction syndrome after debridement. At last, all the pregnant women survived, and no statistically significant difference existed among the 3 groups (P>0.05). In early pregnancy group, middle pregnancy group, and late pregnancy group, the survived fetus cases were 9, 8, and 6, respectively, and the differences between them were not statistically significant (P>0.05). Variables including stillbirth and full-term birth were close in patients in the 3 groups (P>0.05), while the preterm birth and miscarriage in patients in the 3 groups were statistically different (P<0.05 or P<0.01), with the early pregnancy group having the most miscarriage cases and the fewest preterm birth cases. There were no statistically significant differences in fetal delivery mode, gestational weeks at delivery, and newborn weight among the patients with survived fetus in 3 groups (P>0.05). Conclusions: For patients suffering burns during early, middle, and late pregnancy, superior rates of maternal and fetal survival can be achieved after timely and adequate treatments including fluid resuscitation, anti-infection, wound treatment, and multidisciplinary comprehensive managements.

Correlation analysis of one-year postoperative mortality,preoperative serum indexes and postoperative nutrition guidance in elderly hip fracture patients / 中国骨伤

OBJECTIVE@#To analyze the influence of preoperative serum nutritional indexes and postoperative nutritional guidance on 1-year mortality in elderly patients with hip fracture.@*METHODS@#From January 2015 to December 2017, 396 elderly patients with hip fracture were included in the study, including 267 females and 129 males, aged 68 to 80(75.48±2.62) years; the course of disease was 2 to 10 (6.12±1.35) days;all patients were followed up for 1-year, and were divided into death group and survival group according to whether the patients died or not. Multivariate logistic regression model was used to analyze the influencing factors of 1 year mortality.@*RESULTS@#Duringthe follow-up, 4 patients lost contact and were treated as shedding, among which 67 patients died and 325 patients survived. The age, male patients, patients with more than three basic diseases, American Society of Anesthesiologists grade Ⅲ-Ⅳ and patients with postoperative complications in the death group were significantly higher than those in the survival group (all @*CONCLUSION@#Advanced age, male and multiple underlying diseases were independent risk factors for 1-year mortality in elderly patients with hip fracture, while higher preoperative nutritional level and routine nutritional guidance were protective factors.

Systematic Review and Meta-Analysis of Antibiotic-Impregnated Shunt Catheters on Anti-Infective Effect of Hydrocephalus Shunt

Objective@#: Shunt infection is a common complication while treating hydrocephalus. The antibiotic-impregnated shunt catheter (AISC) was designed to reduce shunt infection rate. A meta-analysis was conducted to study the effectiveness of AISCs in reduction of shunt infection in terms of age, follow-up time and high-risk patient population. @*Methods@#: This study reviewed literature from three databases including PubMed, EMBASE, and Cochrane Library (from 2000 to March 2019). Clinical studies from controlled trials for shunt operation were included in this analysis. A subgroup analysis was performed based on the patient’s age, follow-up time and high-risk population. The fixed effect in RevMan 5.3 software (Cochrane Collaboration) was used for this meta-analysis. @*Results@#: This study included 19 controlled clinical trials including 10105 operations. The analysis demonstrated that AISC could reduce the infection rate in shunt surgery compared to standard shunt catheter (non-AISC) from 8.13% to 4.09% (odds ratio [OR], 0.48; 95% confidence interval [CI], 0.40–0.58; p=0.01; I2=46%). Subgroup analysis of different age groups showed that AISC had significant antimicrobial effects in all three groups (adult, infant, and adolescent). Follow-up time analysis showed that AISC was effective in preventing early shunt infections (within 6 months after implant). AISC is more effective in high-risk population (OR, 0.24; 95% CI, 0.14–0.40; p=0.60; I2=0%) than in general patient population. @*Conclusion@#: The results of meta-analysis indicated that AISC is an effective method for reducing shunt infection. We recommend that AISC should be considered for use in infants and high-risk groups. For adult patients, the choice for AISC could be determined based on the treatment cost.

Technical elements and clinical application of umbilical refining of heat-sensitive moxibustion / 中国针灸

Under the guidance of the theory and technique of arrival of of heat-sensitive moxibustion, the technical elements of umbilical refining of moxibustion proposed in by were analyzed. It is believed that the parameters of moxibustion temperature and time are the key points. The standard of "quantitative moxa" is established to achieve the appropriate moxibustion temperature and moxibustion time. The umbilical refining of heat-sensitive moxibustion is established to reappear the magic effect of 's umbilical refining of moxibustion. The umbilical refining of heat-sensitive moxibustion is recommended for stomachache, diarrhea, constipation, dysmenorrhea, impotence, etc. with significant curative effect.

Study on clinical efficacy and mechanism of Qingying Tang for treating psoriatic blood-heat syndrome based on IL-23/Th17 / 中国中药杂志

To observe the clinical curative effect of Qingying Tang in the treatment of psoriatic blood-heat syndrome and explore its intrinsic mechanism.In this study,we collected 72 patients with blood-heat syndrome psoriasis admitted to our dermatology clinic from January 2016 to December 2017 and divided into control group and observation group according to the random number table method,36 cases in each group.The patients in control group were given with Acitretin Capsules orally,10 mg/time,twice a day.The patients in observation group were given with Qingying Tang orally,150 mL/time,twice a day.The treatment period was 12 weeks in both groups.The traditional Chinese medicine(TCM) syndrome scores before and after treatment,psoriasis area and severity index(PASI) score,dermatology life quality index(DLQI) score,and the clinical efficacy of the two groups were compared between the two groups;flow cytometry was used to detect peripheral blood Th17 cell percentages before and after treatment in both groups;serum interleukin(IL)-17,IL-23,IL-22,and IL-21 levels in both groups before and after treatment were measured by ELISA;the expression levels of STAT3 and RORγt before and after treatment in patients were measured by using skin lesion immunohistochemical method.The results showed that the TCM symptoms were improved significantly in both groups(P<0.05),and the effect in observation group was significantly better than that in the control group(P<0.05).PASI and DLQI scores were decreased significantly after treatment in both groups(P<0.05),and the scores in observation group were significantly lower than those in the control group(P<0.05).The curative effect of the observation group was significantly higher than that of the control group(P<0.05).After treatment,the percentage of Th17 cells,as well as IL-17,IL-23,IL-22 and IL-21 levels in peripheral blood were significantly decreased in both groups(P<0.05),and the levels in observation group were significantly lower than those in the control group(P<0.05).The expression levels of STAT3 and RORγt in both groups were significantly lower than those before treatment(P<0.01),and the levels in observation group were significantly lower than those in the control group(P<0.05).All of the results indicted that Qingying Tang can effectively improve the skin lesions and TCM syndrome in patients with psoriasis and blood-heat syndrome,and improve patient health quality,which may be related to regulation of peripheral blood IL-23/Th17.

The efficacy of freehand respiratory training for alleviating dysphagia after stroke / 中华物理医学与康复杂志

Objective@#To observe any curative effect on dysphagia of freehand respiratory training applied to hemiplegic stroke survivors.@*Methods@#Forty-eight hospitalized, hemiplegic stroke survivors were randomly divided into an observation group and a control group, each of 24. Both groups received routine stroke rehabilitation, including motor function training, exercise training, physical therapy and swallowing training. The observation group was additionally provided with barehanded breathing function training, mainly consisting of cough glottis exercise, lip constriction aspiration exercise, chest movement exercise, abdominal muscle contraction and relaxation exercise, as well as abdominal aspiration training. The intervention lasted for 6 weeks for both groups. Before and after the intervention the maximum breathing time, first and second forced volume (FEV1), forced vital capacity (FVC), maximum inspiratory pressure (PImax), standardized swallowing assessment (SSA), Kubota drinking water test (KDWT) and functional dysphagia scale (FDS) scoring were quantified for both groups.@*Results@#There was no significant difference between the two groups′ averages on any of the measurements before the intervention. Afterward, however, the average maximal breathing time, FEV1, FVC, and PImax of the observation group were all significantly higher than before the intervention and significantly higher than those of the control group. After treatment, the observation group′s average KDWT efficiency was not, however, significantly better than that of the control group. Moreover, after the treatment the average SSA and FDS of the observation group were significantly lower than those of the control group, as well as significantly better than before the treatment.@*Conclusion@#Barehanded breathing function training can supplement routine rehabilitation to significantly improve the breathing of stroke survivors.

The efficacy of freehand respiratory training for alleviating dysphagia after stroke / 中华物理医学与康复杂志

Objective To observe any curative effect on dysphagia of freehand respiratory training applied to hemiplegic stroke survivors. Methods Forty-eight hospitalized, hemiplegic stroke survivors were randomly divid-ed into an observation group and a control group, each of 24. Both groups received routine stroke rehabilitation, in-cluding motor function training, exercise training, physical therapy and swallowing training. The observation group was additionally provided with barehanded breathing function training, mainly consisting of cough glottis exercise, lip constriction aspiration exercise, chest movement exercise, abdominal muscle contraction and relaxation exercise, as well as abdominal aspiration training. The intervention lasted for 6 weeks for both groups. Before and after the inter-vention the maximum breathing time, first and second forced volume ( FEV1 ) , forced vital capacity ( FVC) , maxi-mum inspiratory pressure ( PImax ) , standardized swallowing assessment ( SSA ) , Kubota drinking water test (KDWT) and functional dysphagia scale (FDS) scoring were quantified for both groups. Results There was no significant difference between the two groups' averages on any of the measurements before the intervention. Afterward, however, the average maximal breathing time, FEV1 , FVC, and PImax of the observation group were all significantly higher than before the intervention and significantly higher than those of the control group. After treatment, the obser-vation group's average KDWT efficiency was not, however, significantly better than that of the control group. Moreo-ver, after the treatment the average SSA and FDS of the observation group were significantly lower than those of the control group, as well as significantly better than before the treatment. Conclusion Barehanded breathing function training can supplement routine rehabilitation to significantly improve the breathing of stroke survivors.

Antibiotic resistance characteristic and genes analysis of a marine water sourced Klebsiella pneumoniae

Objective:Both antibiotic resistant bacteria (ARBs) and antibiotic resistant genes (ARGs) are considered as one of the most dangerous environmental pollutants in the 21st century by the WHO. This study aims to understand the ARGs of Klebsiella pneumoniae (K. pneumoniae) with multiple drug resistance bacterium from the marine water collected from a beach at Sanya Bay, and to explore the antibiotic resistance mechanism of the K. pneumoniae, providing a basis for exploring the transfer of drug resistance genes of beach, and preventing and controlling the health risk of entertainment population.Methods:The sample of marine water were collected and screened by Mcconkey plate. The drug sensitive test was detected by Merieux VITEK2, The DNA was extracted and one strain of 16srDNA was sequenced and identified as K. pneumoniae. Whole-genome resequencing was performed using Illumina HiseqXten platform, and the obtained sequences were compared with NCBI blasting. The reference bacterium were multi-resistant K. pneumoniae HS11286. Plasmids were extracted and the resistant genes were identified.Results:The ARGs encoding protein was 117/4801 (identity > 40%) and the carrying rate was 2.436 9%. The identity of following ARGs of OKPB, sul1, rpoB, ef-tu, phoP, sul2, AAC(6’)-ib-cr, QnrB, floR, aadA16 were more than 99%. The strain showed resistance to ampicillin, ticacillin/clavulanic acid and chloramphenicol, and was intermediate to ampicillin/sulbactam, compound sulfamethoxazole, ciprofloxacin, minocycline. Preliminary positioning showed that Qnrs, sul1, tetA, cat, QacE were carried on plasmid.Conclusion:The multiple drug resistant bacteria strain has a variety of different resistant phenotypes, some ARGs can be easily spread by plasmid. It probably will bring exposure risk to people for entertainment. Sensibility of some antibiotics were on the brink of resistance, It is necessary to tracking corresponding antibiotics pollution and strengthening monitoring of ARBs and mobile resistant elements of bacteria.

Curative effect and safety of L-carnitine combined with alprostadil for patients with diabetic nephropathy / 药物评价研究

Objective To explore the curative effect and safety of L-carnitine combined with alprostadil for patients with diabetic nephropathy.Methods 102 patients with diabetic nephropathy were enrolled in hospital of Inner Mongolia normal university from August 2013 to December 2016,of which patients divided into two groups randomly,control group (n =50) accepted alprostadil treatment,and combined group (n =52) adopted L-camitine based on the patients in control group.The blood glucose and renal functions were detected respectively after treatment.And the curative effect was evaluated and compared between two groups;The adverse reactions were recorded and analyzed in the period of treatment.Results After treatment,the FBP,2 h BG,24 h uPro,BUN,Scr and β2-MG of patients in two groups were decreased significantly (P ＜ 0.05),and the change of combined group was higher than those control group significantly (P ＜ 0.05).After treatment,the total efficiency of combined group was higher than that patients in control group (P ＜ 0.05).The incidence of adverse reactions of control group in the period of treatment was 20.0％ (10/50),and combined group was 5.8％ (3/52),and which difference from two groups was no significance.Conclusions L-carnitine combined with alprostadil for patients with diabetic nephropathy deserved popularization in clinic,and which not only possessed remarkable curative effect,but also well controlled the blood glucose level,improved the renal function,decreased the incidence of adverse reactions certainly.

Clinical effect of orthokeratology for juvenile with myopia astigmatism and its effects on corneal endothelial cells / 国际眼科杂志(Guoji Yanke Zazhi)

Abstract?AIM:To investigate the clinical effect of orthokeratology for 400 juvenile with myopia astigmatism and its effects on corneal endothelial cells.?METHODS:Four hundred patients(800 eyes), of whom the average age was 11.5 ±2.3 years old, 239 male, 161 female, were divided into two groups: orthokeratology group and spectacles group. Parameters including efficacy data ( uncorrected visual acuity, corneal curvature, axial length and diopter ) and corneal endothelial cell data ( count of endothelial cell, endothelial cell density, fluorescein staining and central corneal thickness) were observed at 1d, 1, 6, 12 and 24mo after wearing.? RESULTS: The visual acuity of spectacles group recovered to normal after wearing, that of orthokeratology group recovered to normal at 1mo after wearing.At 2a after wearing, the corneal curvature, diopter of orthokeratology group decreased significantly (40.09 ±0.31D, 0.23 ±0.06D respectively); while those of spectacles group increased, the differences between the two groups were significant (P0.05 ) compared to those before wearing. At 2a after wearing, the axial length of the two groups were 23.96 ± 0.38mm, 26.49±0.88mm respectively (P0.05).The count of endothelial cell and endothelial cell density both decreased after wearing without significant differences (P>0.05).?CONCLUSION: Orthokeratology has less effect on the corneal endothelial cells, no obvious adverse reactions and can control the prognosis of myopia.

The effect of naloxone on heme oxygenase-1 expression in focal cerebral ischemia-reperfusion in rats / 中国脑血管病杂志

Objective: To discuss the expression of heme oxygenase-1 (HO-1) protein around ischemic focus after focal cerebral ischemia-reperfusion in rats and the effect after naloxone intervention. Methods: Forty-five Sprague-Dawley rats were randomly allocated into three groups (n = 15, each): sham operation group, ischemia-reperfusion group, and naloxone group. A focal cerebral ischemia-reperfusion model was built by the suture method for middle cerebral artery occlusion (MCAO) in rats. After the successful reperfusion by inserting and withdrawing sutures, naloxone (3 mg/kg) was injected intraperitoneally into the rats of naloxone group, and isotonic saline was injected intraperitoneally into the rats of sham operation group and ischemia-reperfusion group. The expression of HO-1 was assayed by immunohistochemistry. In situ terminal deoxynucleotidyl transferase (TUNEL) assay was used to observe the numbers of brain apoptosis. Results: The numbers of HO-1 positive cell in the ischemia-reperfusion group were significantly higher than those in the sham operation group with an average of 51.6 ± 10.8 vs 9.8 ± 2.8/high-power field (HP) (P < 0.05). The numbers of HO-1 positive cell around the ischemic foci in the naloxone group were higher than those in the ischemia-reperfusion group averaged 63.5 ± 10.0 vs 51.6 ± 10.8/HP (P < 0.05). The numbers of TUNEL positive cell in the naloxone group were significantly lower than those in the ischemia-reperfusion group (20.5 ± 3.5 vs 29.8 ± 4.0/ HP,), but were higher than those in the sham operation group (4.2 ± 2.0/ HP), and there were significant differences between the groups (P < 0.05). Conclusion: Naloxone may reduce neuronal apoptosis caused by focal cerebral ischemia-reperfusion injury after MCAO, and its mechanism may be associated with the increase of naloxone-induced HO-1 expression.

Analysis of coronary arteriographic and fluorescence fundus angiographic characteristics in type 2 diabetic patients with coronary heart disease / 中华内分泌代谢杂志

Objective To study the relationship between coronary arteriographic and fluorescence fundus angiographic characteristics in type 2 diabetic patients with coronary heart disease.Methods The study was carried out by the analysis of the data from coronary arteriography and fluorescence fundus angiography in 203 type 2 diabetic patients with coronary heart disease in different groups divided according to age or total cholesterol level. Logisitic regression analysis was applied to explore various risk factors to angiographic characteristics.Results With advancing age,there were more involvement of 3 coronary vessels or the left main branch along with stageⅢretinopathy,but less single vessel diseases in the coronary arteries and less stageⅠretinopathy.The difference in coronary angiographic and fluorescence fundus angiographic characteristics between groups with different total cholesterol levels was not significant.Logistic regression analysis suggested that coronary artery diaease was related to age,sex and blood glucose and triglyceride levels while diabetic retinopathy was related to blood glucose level and age.Conclusion There is great difference in coronary arteriography and fluorescence fundus angiography among different age groups.Aging may aggravate the lesions both in the coronary arteries and fundal vessels in type 2 diabetic patients with coronary heart diseease.