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1.
Article in Chinese | WPRIM | ID: wpr-907164

ABSTRACT

Objective To provide direction for the improvement of quality control of hospital preparations and ensure the safety for clinical use by analyzing the hospital preparation deviations in recent three years. Methods A retrospective analysis on 59 minor hospital preparation deviations from 2017 to 2019 was conducted. Brainstorming, fishbone drawing and, Minitab software were used to analyze the root causes of deviations from five aspects: personnel, machine, materials, methods and environment. The preventive and corrective measures were implemented. The results were evaluated. Results 1 significant deviation (1.7%), 24 major deviation (40.7%), and 34 minor deviation (57.6%) were identified among the 59 casses of preparation deviation. With the implementation of preventive and corrective measures, the total number of deviations in 2018 was significantly reduced compared to that in 2017. The total number of deviations in 2019 was about the same as that in 2018. The human factors need to be focused. Conclusion The pharmaceutical preparation deviations in our hospital have been reduced. The further quality improvements for pharmaceutical preparations will be carried out by following the regulations of pharmaceutical production quality management standards and pharmaceutical production supervision and administration measures.

2.
Article in Chinese | WPRIM | ID: wpr-923031

ABSTRACT

Objective To establish a high performance liquid chromatography(HPLC) method for simultaneous determination of the contents of 7 components of chlorogenic acid, caffeic acid, paeoniflorin, ammonium glycyrrhizinate, baicalin, baicalein, and wogonin in Piqin oral liquid. Methods A double-wavelength HPLC method was performed. The column was Agilent Zorbax SB-C18 (250 mm × 4.6 mm, 5 μm). The mobile phase was 0.02% phosphoric acid aqueous solution (A)-acetonitrile (B) gradient elution; Flow rate: 1.0 ml/min; Column temperature: 35℃; Injection volume: 20 μl; Detection wavelength: 0-18.0 min, 325 nm (detect chlorogenic acid, caffeic acid); 18.0-65.0 min, 280 nm (detect paeoniflorin, baicalin, baicalein, ammonium glycyrrhizinate, wogonin). Results The chlorogenic acid, caffeic acid, paeoniflorin, ammonium glycyrrhizinate, baicalin, baicalein and wogonin were completely separated. Seven components have a good linear relationship between the peak area and concentration, with the recoveries between 96.41% and 99.70%. Conclusion This method is simple, accurate and reproducible, and can be used for the quality control of Piqin oral liquid.

3.
Article in Chinese | WPRIM | ID: wpr-920785

ABSTRACT

Objective To determine the serum IgM and IgG antibody levels post-COVID-19 vaccination, and provide scientific evidence for COVID-19 antibody response after vaccination. Methods A total of 980 healthy persons were included in Kunming Third People’s Hospital from July through August, 2021, which had been vaccinated with COVID-19 vaccines and then tested for anti-SARS-CoV-2 IgM and IgG antibodies. Results After the COVID-19 vaccination, 469 persons (positive rate, 47.86%) were positive for anti-IgG antibody. Of them, 75 were males with (positive rate, 39.06%), and the average IgG level was 0.618 (0.180, 2.526) AU·mL-1[M(Q1,Q3)]; 394 were females (50.00%), and the IgG level was 0.999 (0.305, 3.334) AU·mL-1. In addition, 53 persons (5.41%) were anti-IgM antibody positive. Of them, 14 were males (positive rate, 7.29%), and the average IgM level was 0.057 (0.026, 0.195) AU·mL-1; 39 were females (4.95%), and the IgM level was 0.047 (0.027, 0.110) AU·mL-1. The positive rate of anti-IgG antibody was highest in those aged ≤30 years, which was 51.02% in male (n=25) and 55.88% in female (n=133). The anti-IgG response differed significantly by gender (χ2=7.401, D=0.135 1, P<0.05), whereas the anti-IgM response was not significantly different (χ2=1.656, P>0.05). Among the age groups, anti-IgG antibody level was higher in those aged ≤30 and 51-70 years, with 158 (55.05%) and 122 (52.36%) persons, respectively; the average antibody level was 1.209 (0.426, 4.386) AU·mL-1 and 1.074 (0.191, 7.670) AU·mL-1, respectively. The differences in the positive rates of IgG and IgM antibodies and the levels of IgG antibodies among different age groups were statistically significant (P<0.05). Using Kruskal-Wallis test and Spearman correlation analysis, it showed a high correlation between the IgG and IgM antibodies (r=0.836 4, H=64.82, 20.09, P<0.05). Conclusion The Anti-SARS-CoV-2 IgG antibody remains high six months post-COVID-19 vaccination, while anti-IgM antibody is low. The IgM and IgG response are higher in the young and elderly. The response differs by gender and age, demonstrating a correlation.

4.
Article in Chinese | WPRIM | ID: wpr-912865

ABSTRACT

Objective: To systematically evaluate the effects of different forms of traditional Chinese health-preservation exercises on osteoporosis (OP) using network meta-analysis.Methods: A systematic search on Excerpta Medica Database (EMBASE), Springer Link, Allied and Complementary Medicine Database (AMED), PubMed, Cochrane Library, China National Knowledge Infrastructure (CNKI), Wanfang Academic Journal Full-text Database (Wanfang) and Chongqing VIP Database (CQVIP) targeted the randomized controlled trials (RCTs) studying traditional Chinese exercises for OP published up to January 2020. Cochrane handbook was adopted to estimate the publication bias in the included studies, and statistical analysis was performed using Stata 14.0 and GeMTC 0.14.3 when data were extracted. Results: Fifty RCTs were included in the network meta-analysis, comprising a total of 4505 OP patients. The network meta-analysis showed that in terms of visual analog scale (VAS) for pain, Tai Ji Quan (Tai Chi) was the most efficacious, followed by Yi Jin Jing (Sinew-transforming Qigong Exercises), Ba Duan Jin (Eight-sectioned Exercise), Wu Qin Xi (Five-animal Exercises), sports training, drug and blank control; in terms of bone mineral density (BMD) of femoral neck, Yi Jin Jing was the most efficacious, followed by Wu Qin Xi, Ba Duan Jin, Tai Ji Quan, sports training, blank control and drug; regarding the lumbar BMD, it was Yi Jin Jing, Tai Ji Quan, Ba Duan Jin, Wu Qin Xi, sports training, blank control and drug in the descending order of efficacy; in terms of serum alkaline phosphatase, it was Yi Jin Jing, Tai Ji Quan, sports training, Wu Qin Xi, Ba Duan Jin, drug and blank control in the descending order of efficacy. Conclusion: The evidence to date suggests that the first choice for OP amongst the traditional Chinese exercises should be Yi Jin Jing, which can not only reduce the subjective pain, but also promote bone formation and increase BMD, though this conclusion requires more high-quality large-scale RCTs for further proof.

5.
Article in Chinese | WPRIM | ID: wpr-912416

ABSTRACT

Objective:To identify the causative genes of the posterior microphthalmia-retinal pigment degeneration family.Methods:A retrospective clinical study. One child (proband) and 3 family members of a family with posterior microphthalmia-retinitis pigmentosa diagnosed by clinical and genetic examination at Henan Provincial People's Hospital in July 2019 were included in the study. Medical history and family history, and draw pedigree of the patients was collected. Visual acuity, visual field, fundus color photography, optical coherence tomography and electroretinogram (ERG) were examined. The peripheral venous blood of the proband, his parents and sister, and extract the whole genome DNA was collected. Whole-exome sequencing was used to detect genetic variations, the suspected pathogenic variations were verified by Sanger sequencing, and the pathogenicity was determined by bioinformatics analysis.Results:The parents discovered the proband was poor vision at the age of 10 months. At the age of 3, the best corrected visual acuity of the right eye and the left eye were 0.3 and 0.4, respectively. No abnormality was found in anterior segment. Extremely high hyperopia in both eyes. The axial length was 14.47 mm and 15.78 mm, respectively. The optic disc of both eyes was relatively small and flushed, retinal folds can be observed in macular area, and no obvious pigment deposition was found. ERG examination showed that the rod system response and the maximal combined response of both eyes decreased slightly to moderately, and the single-flash cone response and the 30 Hz flicker response decreased moderately to severely. Genetic analysis revealed two novel mutations in the membrane frizzled-related protein ( MFRP) gene in the proband: c.363delC/p.Thr121Thrfs*16, c.1627C>T/p.Gln543Stop,37 in exon 4 and 13, the former was a frameshift mutation, encoding 16 amino acids and then terminated, and the latter was an nonsense mutation, truncated 37 amino acids, both which were predicted to be pathogenic and segregate with disease. The mother and sister carried c.363delC, and the father carried c.1627C>T. Conclusion:MFRP gene c.363delC/p.Thr121Thrfs*16, c.1627C >T/p.Gln543Stop, 37 compound heterozygous mutation may be the pathogenic gene of this family.

6.
Article in Chinese | WPRIM | ID: wpr-912107

ABSTRACT

With the appearance of the disadvantages of traditional tumor treatment, immunotherapy has entered people′s horizons as modern emerging treatment strategies, among which plant polysaccharides have received much more attention due to their antitumor activity and significant immunomodulatory effects. Tumor-associated macrophages (TAMs), as a component of tumor microenvironment, are important factors affecting tumors, and the regulation of TAMs by plant polysaccharides is one of the effective immunotherapy to treat tumor. In this review, we mainly described the regulation of TAMs by plant polysaccharides and the underlying mechanisms, and then gave an outlook on the research interests and the development of plant polysaccharides as immune adjuvants, aiming to provide reference for the study of plant polysaccharides in the immunotherapy for tumors.

7.
Article in Chinese | WPRIM | ID: wpr-911988

ABSTRACT

Objective:To investigate the effects of gestational weight gain (GWG) at different stages on pregnancy complications such as preeclampsia, gestational hypertension, gestational diabetes mellitus(GDM), small for gestational age (SGA), and large for gestational age (LGA).Methods:This was a prospective longitudinal cohort study. Singleton pregnancies at 11-13 +6 weeks of gestation in the Affiliated Drum Tower Hospital, Medical School of Nanjing University from January 2017 to November 2019 were recruited. The maternal height, weight, blood pressure, and fetal ultrasonic parameters were measured at 19-23 +6, 29-34 +6, and 35-40 +6 weeks of gestation by face-to-face interview and the pregnancy outcomes were followed up. All participants were grouped by body mass index (BMI) in the first trimester, with <18.50 kg/m 2 as underweight group, 18.50-23.99 kg/m 2 as normal group, ≥24.00 kg/m 2 as overweight/obesity group. Chi-square test and rank-sum test were adopted for comparison among groups. Weekly weight gain was converted into Z scores, and insufficient, appropriate, and excessive weight gain were respectively defined when Z<-1, -1≤ Z≤1, and Z>1. The effect of weekly weight gain at different gestational trimesters on pregnancy complications was analyzed by binary logistic regression. Results:Totally, 4 143 pregnant women entered the cohort. After excluding 327 cases, 3 816 were finally included in the analysis, with 394 in underweight group, 2 668 in normal group, and 754 in overweight/obesity group. Excessive weekly weight gain in the early second trimester was a risk factor for LGA( aOR=1.78, 95% CI:1.31-2.42, P<0.001), and in the later second trimester it was associated with preterm preeclampsia ( aOR=3.00, 95% CI: 1.26-7.10, P=0.013), gestational hypertension ( aOR=2.38, 95% CI: 1.44-3.94, P=0.001), and LGA ( aOR=1.59, 95% CI: 1.15-2.22, P=0.005). In the third trimester, excessive weekly weight gain was associated with higher risks of term preeclampsia ( aOR=2.70, 95% CI: 1.61-4.54, P<0.001) and gestational hypertension ( aOR=1.84, 95% CI: 1.05-3.21, P=0.033); while insufficient weekly weight gain was a risk factor for SGA ( aOR=1.58, 95% CI: 1.01-2.48, P=0.045), but a protective factor for term preeclampsia ( aOR=0.37, 95% CI: 0.14-0.97, P=0.041). Insufficient and excessive weekly weight gain in the early second trimester were not related to GDM (both P>0.05). Conclusions:GWG at different stages has different effects on pregnancy complications. A more relaxed control of GWG in the early second trimester combined with strict control in both the later second trimester and the third trimester may be a reasonable strategy to reduce the risk of preeclampsia without increasing the risk of SGA.

8.
Article in Chinese | WPRIM | ID: wpr-911971

ABSTRACT

RhD-negative pregnant women with an RhD-positive fetus are at risk of hemolytic disease of the fetus and newborn (HDFN), which may lead to fetal/neonatal death. While these would not affect those RhD-negative fetuses. With the advancement of technology in genetics, the administration of anti-D immunoglobulin to women with an RhD-positive fetus could reduce the risk of HDFN. Therefore, non-invasive prenatal testing on fetal RHD genotype plays an important role in the management of RhD-negative pregnant women. Selective usage of anti-D immunoglobulin is important in perinatal management in these women. The non-invasive prenatal screening for fetal RHD gene which has been carried out in Caucasian is not applicable to Asians because of the difference in RHD genotype. In addition to complete or partial RHD gene deletion, point mutations are also common RHD genotypes among Asians. This enlightens us to establish a non-invasive prenatal screening method for Asians. This article reviews the progress of fetal RHD screening in Asian RhD-negative pregnant women.

9.
Article in Chinese | WPRIM | ID: wpr-910867

ABSTRACT

Objective:To explore the influence of group combined Internet+personalized health management mode on physiological indexes and self-management ability of physical examination population with chronic disease.Methods:A total of 88 people with abnormal chronic disease associated indicators who underwent physical examination in the Health Management Department of the First Hospital of Shanxi Medical University from May 2019 to December 2019 were recruited as the research subjects by purposive sampling. They were randomly divided into the control group and experimental group according to the random envelope method, with 44 patients in each group. The control group was treated with routine health return visit management, while the experimental group was treated with group combined Internet+personalized health management for 6 months, once a month. The differences of physiological indexes and self-management ability scores before and after the intervention were analyzed and compared between the two groups.Results:Comparison of physiological indicators: after intervention, systolic blood pressure, diastolic blood pressure, triglyceride, total cholesterol, low density lipoprotein and fasting blood glucose in experimental group were significantly lower than those in control group[(138.5±16.7) vs (147.2±16.1) mmHg (1 mmHg=0.133 kPa), (82.3±9.4) vs (86.4±9.4) mmHg, (2.14±0.99) vs (2.96±2.43) mmol/L, (5.27±0.83) vs (6.09±1.02) mmol/L, (3.40±0.66) vs (3.96±0.72) mmol/L, (7.37±2.03) vs (8.67±2.90) mmol/L]( t=2.476, 2.046, 2.072, 4.132, 3.814, 2.437, all P<0.05). Comparison of self-management ability score: all scores and total scores of self-management ability in two groups after intervention were higher than those before intervention (all P<0.05 in experimental group, but all P>0.05 in control group), and all scores and total scores of self-management ability in experimental group were significantly higher than those in control group after intervention (all P<0.05). Conclusion:The application of group combined Internet+personalized health management mode in physical examination population with chronic disease is conducive to improving their physiological indicators of chronic diseases and enhancing their ability of self-management.

10.
Chinese Journal of Orthopaedics ; (12): 815-824, 2021.
Article in Chinese | WPRIM | ID: wpr-910663

ABSTRACT

Objective:To analyze the natural history and outcomes of major neurological complications in spinal deformity correction surgery and to determine the risk factors for no neurological recovery.Methods:All of 7 851 patients with spinal deformity who underwent deformity correction from January 2000 to December 2017 were reviewed. Major neurological complication featured by complete or incomplete paralysis of single or both lower extremities was identified in 59 patients, including 28 males and 31 females with an average age of 25.0±16.3 (range 6 to 71 years old). Among these cases, 6 were adolescent idiopathic scoliosis, 22 were congenital scoliosis, 10 were neuromuscular scoliosis, 5 were neurofibromatosis type 1, and 16 were other types. 5 patients had complete paraplegia of the lower limbs, 17 patients had incomplete paralysis of the lower limbs, and 37 patients had incomplete paraplegia of unilateral lower limb. Treatment included implant removal, debridement of hematoma, loosening the fixation and decompression by laminectomy for mechanical injury, as well as transfusion and press agent for ischemic injury. The neurological function was determined by the American Spinal Injury Association (ASIA) grading system.Fisher exact test and univariate logistics regression were used to determine the association between clinical, surgical parameters and no recovery of neurological function. For the identified factors with P value<0.10, multiple logistics regression was used to determine the independent risk factor for no recovery. Results:The incidence of major neurological complications was 0.75%(59/7851). At final follow-up, 42 patients (71.2%) had complete recovery and 10 patients (16.9%) had partial recovery, and 44 cases (74.6%) had recovery within 6 months. There were 7 cases had no recovery, including 3 with type I neurofibromatosis(ASIA: 1 grade A, 2 grade C), 1 with Scheuermann's disease (ASIA: grade C), 1 with arthrogryposis multiplex congenital (ASIA: grade B), 1 with poliomyelitis related scoliosis (ASIA:grade C), and 1 with idiopathic scoliosis (ASIA: grade A). Fisher test showed the distribution of etiology was statistically different between recovery and no recovery groups. Univariate logistics regression showed diagnosis as NF-1 ( OR=18.750, P=0.005), Cobb angle of the main curve >90° ( OR=4.444, P=0.073), preoperative deficit ( OR=5.750, P=0.046) and complete neurological injury ( OR=6.533, P=0.067) were potential risk factors for no recovery. Multivariate logistics regression showed that diagnosis with NF-I ( OR=35.477, P=0.005) was the risk factor for no recovery. Conclusion:For patients who underwent deformity correction that develops major neurological complications after surgery, 88.1% of patients were able to recover during follow-up, and 71.2% of patients achieved complete recovery. The first 3-6 month is the time window for neurological recovery. Patients with type I neurofibromatosis is the risk factor for no recovery.

11.
Article in Chinese | WPRIM | ID: wpr-910412

ABSTRACT

Objective:To evaluate biological dose and retrospective biodosimetry of a case of large area back skin injury caused by suspected interventional procedure.Methods:Peripheral blood from the patient was collected at about 7 months after interventional procedure, and the chromosomal aberrations in peripheral blood cells were analyzed to evaluate the retrospective biodosimetry using the correction factor of dose estimation, Dolphin′s model and Qdr method, respectively. Results:Based on the amounts of semi-automated dic and manually detected dic plus ring, the whole-body average absorbed dose of the victim was estimated to be 0.68-0.95 Gy by four different dose response curves. Over dispersion of dic or dic plus ring was also detected, and the efficiency of dose assessment was obviously increased using dic semi-automatic detection. Based on three different retrospective biodosimetry models, the estimated average absorbed dose was further corrected to be between 1.80-2.86 Gy, which was consistent with clinical diagnosis of degree Ⅳ radiation skin injury.Conclusions:A case of suspected radiation skin injury was confirmed by chromosomal aberration analysis and it’s biodosimetry was reconstructed, suggesting that the unstable chromosomal aberration analysis may be applicable to assess the retrospective biodosimetry of non-uniform local radiation exposure.

12.
Article in Chinese | WPRIM | ID: wpr-910384

ABSTRACT

Objective:To investigate the influence of low-dose ionizing radiation on the expression level of serum insulin-like growth factor binding protein-3 (IGFBP-3) in radiation workers in hospitals.Methods:183 radiation workers were randomly selected and grouped by work type including interventional radiology ( n=37), nuclear medicine ( n=43), radiotherapy ( n=48), and diagnostic radiology ( n=55). The content of IGFBP-3 in the serum of radiation workers was detected by ELISA assay. Results:It was observed that the expression level of serum IGFBP-3 in the four groups had significant differences ( F=6.056, P<0.05), and the content of serum IGFBP-3 in the interventional radiology group was significantly higher than that of nuclear medicine, radiotherapy, and diagnostic radiology groups ( t= 2.815, 3.611, 3.936, P<0.05). The concentration of IGFBP-3 in the serum of radiation workers among different annual effective dose groups was statistically different ( F=8.380, P<0.05), which gradually increased with the increase of annual effective dose and length of service ( rs=0.202, 0.151, P<0.05). Conclusions:The expression level of serum IGFBP-3 has the potential to be used as a biomarker to reflect the cumulative exposure of long-term chronic low-dose ionizing radiation.

13.
Article in Chinese | WPRIM | ID: wpr-910381

ABSTRACT

The application of chromosome translocation to retrospective biodosimetry for A-bomb survivors, the victims previously exposed to nuclear/ radiation accident has experienced nearly 40 years of development. Retrospective biodosimetry was internationally paid close attention to radiation workers, exposed atomic veterans and medical exposure subjects, respectively, along with the development of molecular cytogenetic technology such as mFISH and cGH. And the remarkable breakthrough and progress have been made in recent years. This paper reviews the progress of translocation indicator as retrospective biodosimetry for the subjects, in order to provide a reference for retrospective dose estimation based on translocation analysis.

14.
Chinese Journal of Radiology ; (12): 1082-1085, 2021.
Article in Chinese | WPRIM | ID: wpr-910272

ABSTRACT

Objective:To investigate the clinical efficacy of superior hypogastric nerve block (SHNB) in relieving pelvic pain after uterine artery embolization (UAE).Methods:Totally 50 patients of UAE before the curettage of uterine incision pregnancy were selected in Affiliated Zhenjiang Fourth People′s Hospital,Jiangsu University from February 2019 to December 2020 and were randomly divided into SHNB group( n=22) and control group( n=28) using random number table. The SHNB group underwent fluoroscopy-guided SHNB before UAE, and the control group received dizocine 10 mg intramuscularly before embolization. Both groups were treated with curettage 24 h after UAE. The pain scores were evaluated by using a numerical rating scale (NRS) to compare the pain scores between the two groups atthe time period A1 (from the beginning of UAE to immediate postoperative period) and at the time period A2 (from leaving the interventional operating room to the time before curettage). Data was recorded and compared between the two groups at the time period from the beginning of UAE surgery to the time before curettage for the doses of opioids used.The differences inage and weight between the two groups were compared by independent sample t test, and the NRS score and morphine dose were compared by Mann-whitney U test. Results:All patients completed SHNB and UAE without serious complications.There was no significant difference in age and weight between the two groups ( P>0.05).The maximum pain scores in the SHNB group were lower than those in the control group at both the A1 and A2 time periods[0(0, 0.25) vs. 3.00 (2.00, 4.00), and 2.50 (0.75, 5.50) vs. 4.00 (3.25, 7.00); Z=-4.932, -2.351, P<0.05]. The equivalent dose of morphine required in the SHNB group was lower than that of the control group [0(0, 10.00) vs. 10.00 (5.00, 15.00)mg, Z=-2.247, P=0.025]. Conclusion:Fluoroscopic-guided SHNB is a safe, effective, and minimally invasive way to reduce pain and the opiate dose after UAE.

15.
Chinese Journal of Radiology ; (12): 910-916, 2021.
Article in Chinese | WPRIM | ID: wpr-910251

ABSTRACT

Objective:To evaluate spectral CT metal artifacts reduction (MAR) technique in reducing metal artifacts of spinal implants in a phantom.Methods:Ovine spines were chosen as anthropomorphic phantom. The phantom including the pedicle screws, 3D-printed vertebral body (VB) and mesh cage were examined using spectral CT. Postoperative CT images were reconstructed at 70—140 keV with 10 keV interval of MAR and non-MAR. Artifact index (AI) and signal-to-noise ratio (SNR) were evaluated by CT and SD values in ROIs around the implants. Visibility of bony structures, the artifacts of pedicle screw, 3D-printed VB and mesh cage were subjectively evaluated. Plotting curves of AI and SNR with the increasing keV were drawn. The AI and SNR were compared at lower (70 keV), medium (100 keV) and high (130 keV) level between MAR and non-MAR images using the paired t-test, and the subjective scores were compared using Wilcoxon signed rank-sum test. Results:The AI values around pedicle screws (anterior, posterior and lateral), 3D-printed VB and mesh cage decreased with the increase of keV, while SNR improved in MAR and non-MAR images. The AI values in the anterior, lateral and posterior pedicle screws and lateral titanium implants were significantly lower in MAR than those in non-MAR ( P<0.05). The AI value in posterior 3D-printed vertebral was lower in MAR than that of non-MAR only at 70 keV ( P<0.001). The SNR values in the anterior and posterior pedicle screws, 3D-printed VB increased with the increase of keV, but decreased in other ROIs. In the subjective evaluation, the image scores of MAR were higher than those of non-MAR ( P<0.05). Conclusion:Spectral CT using the MAR reconstruction can effectively reduce metal artifacts of spinal implants. The effect is better in pedicle screw and mesh cage than 3D-printed VB.

16.
Chinese Journal of Trauma ; (12): 236-242, 2021.
Article in Chinese | WPRIM | ID: wpr-909860

ABSTRACT

Objective:To compare the mid-term clinical efficacy of total hip replacement (THR) and closed reduction and external fixation (CREF) in treatment of intertrochanteric fractures in the elderly.Methods:A retrospective case-control study was conducted to analyze the clinical data of 155 elderly patients with unilateral intertrochanteric fractures admitted to Second Affiliated Hospital of Army Medical University from June 2011 to June 2019, including 63 males and 92 females, aged 70-98 years [(80.1±7.0)years]. According to Jensen-Evans classification, the type of fracture was type I in 2 patients, type II in 21, type III in 24, type IV in 36, type V in 67, and type R in 5. A total of 85 patients were treated by THR (THR Group) and 70 patients by CREF (CREF group). The operation time, intraoperative blood loss, blood transfusion rate, length of hospital stay, postoperative complication rate, Harris hip score at postoperative 1 year, excellent and good rate of hip joint function, and 12-item short form health survey (SF-12) physical component summary score (SF-12PCS) of postoperative quality of life, mortality rate within 1 year and survival rate were compared between the two groups.Results:The follow-up time was 1.0-9.5 years [(3.9±2.4)years]. A total of, 140 patients were followed up for more than one year, 2 patients were lost, 13 patients died within 1 year after surgery. The operation time [77(60, 100)minutes] and intraoperative blood loss [(290.6±182.3)ml] in THR group were significantly longer or more than those in CREF Group [55(50, 70)minutes, (30.5±25.0)ml] ( P<0.05). The blood transfusion rate [78%(66/85)] in THR group was significantly higher than that in CREF Group [21%(15/70)] ( P<0.05). The length of hospital stay and incidence of postoperative complications were similar between the two groups ( P>0.05). One year after operation, the Harris hip score [(84.4±15.1)points], excellent and good rate of hip joint function [76%(63/83)] and SF-12 PCS score [(16.2±1.0)points] in THR group were significantly higher than those in CREF group [(69.0±21.6)points, 43%(27/63), (14.1±2.2)points] ( P<0.05). The mortality within 1 year after operation was similar between the two groups ( P>0.05). The survival curve analysis showed that the survival status in THR group was better than that in CREF group ( P<0.05). Conclusion:Compared with CREF, THR has better joint function and quality of life, as well as a higher overall survival rate when applied to treat intertrochanteric fractures in the elderly patients.

17.
Clinical Medicine of China ; (12): 444-447, 2021.
Article in Chinese | WPRIM | ID: wpr-909774

ABSTRACT

Objective:To investigate the clinical effect of minimally invasive treatment of supracondylar fracture of humerus with nerve injury and the need for surgical exploration of nerve.Methods:From August 2017 to September 2020, 34 cases of children with supracondylar fracture of humerus with nerve injury in the Department of orthopedics of Shanxi Children′s Hospital were selected for retrospective analysis.Closed reduction, Kirschner wire fixation and small incision surgery were used to explore the injured nerve.The follow-up period ranged from 6 months to 3 years, with a follow-up time of (2.15±0.49) years.The elbow function, radial nerve, median nerve and ulnar nerve function were evaluated according to the trial standard of upper limb peripheral nerve function evaluation of Hand Surgery Society of Chinese Medical Association.Results:The elbow function of children in this group: excellent 31 cases, good 2 cases, fair 1 cases, poor 0 cases, excellent 33 cases.Three patients failed to take early functional rehabilitation exercise.Two patients recovered after 2.5 months of treatment by professional orthopedic rehabilitation therapists and physical therapy.One of them did not cooperate with functional rehabilitation training.After 3.5 months of treatment by orthopedic rehabilitation therapists, elbow and finger functions were not affected.Two weeks after nerve injury: radial nerve function evaluation: excellent in 15 cases, good in 3 cases, fair in 4 cases, poor in 0 cases, excellent in 18 cases.Median nerve function evaluation: excellent in 5 cases, good in 2 cases, fair in 6 cases, poor in 0 cases, excellent in 7 cases.Ulnar nerve function evaluation: excellent 5 cases, good 0 cases, fair 1 cases, poor 0 cases, excellent 5 cases.At 3 months after injury, the excellent and good rate of radial nerve, median nerve and ulnar nerve was 100%.Conclusion:The supracondylar fracture of humerus with nerve injury is treated by minimally invasive surgery, and the nerve exploration is still a few.The recovery of nerve injury after surgery is smooth, and the clinical effect is good.

18.
Clinical Medicine of China ; (12): 368-369, 2021.
Article in Chinese | WPRIM | ID: wpr-909759

ABSTRACT

POEMS syndrome is a rare clinical disease associated with plasma cell diseases.Classic pentalogy includes: multiple peripheral neuropathy, organ enlargement, endocrine disorders, M-proteinemia and skin lesions.Due to its rarity, multiple system involvement and high clinical heterogeneity, the missed diagnosis rate and misdiagnosis rate are high.This paper reports a case of M protein negative POEMS syndrome with ascites as the prominent manifestation.

19.
Article in Chinese | WPRIM | ID: wpr-909478

ABSTRACT

Objective:To investigate the brain characteristics of chronic schizophrenia by voxel-mirrored homotopic connectivity (VMHC).Methods:Forty seven patients with chronic schizophrenia from Tianjin Anding Hospital and 31 healthy controls from nearby communities were included in the study. The MRI data of the subjects were collected by Siemens Skyra 3.0 T MRI.Positive and negative symptoms scale (PANSS) was used to assess the illness severity of patients with chronic schizophrenia.SPM12 was used to process the collected MRI data. DPARSF was used to calculate the VMHC values of subjects in the two groups. The independent sample t test based on SPM12 was used to compare the VMHC values of the two groups. The significant brain regions in VMHC were regarded as regions of interest (ROI), and VBM8 was used to further analyze the gray matter volume of the ROI of the two groups. Results:Compared with healthy controls, the patients with chronic schizophrenia demonstrated decreased VMHC mainly located in lingual gyrus(voxel=208, T=4.98), occipital middle occipital gyrus(voxel=156, T=3.75) and postcentral gyrus(voxel=237, T=4.36) (FDR correction, q=0.05). Compared with healthy controls, the gray matter volumes in bilateral lingual gyrus(left(0.0034±0.0008), (0.0028±0.0013), t=-2.141, P=0.037; right(0.0025±0.0006), (0.0020±0.0011), t=2.268, P=0.028) and postcentral gyrus((0.0432±0.0051), (0.0372±0.0162), t=-2.070, P=0.045) increased, but non-significant change in postcentral gyrus of the patients with chronic schizophrenia. Conclusion:The abnormal VMHC mainly locate in lingual gyrus, middle occipital gyrus and postcentral gyrus in patients with chronic schizophrenia.

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Chinese Critical Care Medicine ; (12): 702-707, 2021.
Article in Chinese | WPRIM | ID: wpr-909388

ABSTRACT

Objective:To explore the value of bedside lung ultrasound in the early diagnosis and severity assessment of ventilator-associated pneumonia (VAP).Methods:A prospective observational study was conducted in 60 patients with VAP (VAP group) and 62 patients without VAP (control group) who were admitted to department of intensive care unit of General Hospital of Ningxia Medical University from September 2018 to July 2020. The gender, age and underlying diseases of non-VAP group were matched with VAP group. The general clinical data such as gender, age, underlying diseases, department source of the patient, acute physiology and chronic health evaluationⅡ(APACHEⅡ) score, sequential organ failure assessment (SOFA) score were recorded. The body temperature, white blood cell count (WBC), procalcitonin (PCT), oxygenation index (PaO 2/FiO 2), alveolar artery oxygen differential pressure (P A-aDO 2) were recorded. During mechanical ventilation, the patient's body temperature, WBC, sputum characteristics, and the change of the lung ultrasound were dynamically observed. With or without dynamic air bronchogram, lung ultrasound was considered to be positive as long as there were small subpleural consolidation or tissue-like sign. Ventilator-associated pneumonia lung ultrasound score (VPLUS) and lung ultrasound score (LUSS) were performed, and chest CT scan was completed on the same day. Use positive chest CT scan as the standard to evaluate the diagnostic efficacy of lung ultrasound, VPLUS score, and the combination of the two with PCT for VAP. LUSS was used to assess the severity of disease in patients with VAP. The correlation between LUSS and PaO 2/FiO 2, P A-aDO 2, APACHEⅡscore and SOFA score were analyzed. Results:① General information: compared with non-VAP group, VAP group had more emergency surgery patients [51.7% (31/60) vs. 33.9% (21/62), P = 0.047], APACHEⅡ score and SOFA score were significantly higher (APACHEⅡscore: 15.4±5.7 vs. 13.4±3.4, P = 0.021; SOFA score: 8.8±4.2 vs. 6.3±3.3, P < 0.001), body temperature tended to rise (℃: 38.3±0.8 vs. 38.0±0.9, P = 0.054), more patients had airway purulent secretions [65.0% (39/60) vs. 41.9% (26/62), P = 0.011], and mechanical ventilation time and length of ICU stay were longer [mechanical ventilation time (days): 10.5 (6.6, 15.0) vs. 4.3 (3.0, 6.0), P < 0.001; length of ICU stay (days): 14.8 (9.0, 18.0) vs. 6.0 (4.0, 9.1), P < 0.001], 28-day mortality rate was higher [31.7% (19/60) vs. 9.7% (6/62), P = 0.003].② Diagnostic efficacy evaluation: when lung ultrasound was positive, VPLUS≥3 and PCT > 0.5 μg/L were used separately for the diagnosis of VAP, the sensitivity was 73.3%, 75.0%, 61.7%, respectively; the specificity was 80.6%, 58.1% and 59.7%, respectively; the 95% confidence interval (95% CI) was 0.685-0.842, 0.574-0.748, 0.514-0.694, respectively, all P < 0.05, positive lung ultrasound had good sensitivity and specificity. When positive lung ultrasound or VPLUS≥3 were combined with PCT > 0.5 μg/L for tandem test, the specificity of VAP diagnosis was increased to 95.2% and 83.9%, respectively; but the specificity of VAP diagnosis of positive lung ultrasound combined with PCT > 0.5 μg/L was higher than VPLUS ≥3 combined with PCT > 0.5 μg/L (95.2% vs. 83.9%, P < 0.05).③ Correlation analysis: LUSS showed a significant positive correlation with APACHEⅡ and SOFA score ( r values were 0.407, 0.399, P values were 0.001, 0.002, respectively), LUSS had no relation with PaO 2/FiO 2 and P A-aDO 2 ( r values were 0.189, -0.064, P values were 0.629, 0.149, respectively). Conclusions:Lung ultrasound can early detect VAP , and its diagnostic specificity is significantly improved when combined with PCT > 0.5 μg/L. LUSS is closely related to the severity of disease in VAP patients, therefore, lung ultrasound may be an effective method for early diagnosis and efficacy evaluation of VAP patients.

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