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1.
Article in Chinese | WPRIM | ID: wpr-1017611

ABSTRACT

OBJECTIVE To analyze the relationship between LPR and common pharyngeal diseases and its risk factors.METHODS A total of 280 patients who were admitted to the Inpatient Department of Otolaryngology Head and Neck Surgery or Laryngoscopy Room of the First Affiliated Hospital of Harbin Medical University due to throat discomfort from September 2022 to May 2023 were selected as the study objects.All enrolled patients were required to complete the RSI and RFS scoring scales.According to the 2022 LPRD expert Consensus,RSI>13 and/or RFS>7 were classified as LPR group,and RSI≤13 and RFS≤7 are classified as non-LPR group.Chi-square test was used to analyze the differences in the incidence of common pharyngeal diseases such as upper respiratory tract papilloma,epiglottic cyst,vocal cord polyp,vocal cord leucoplakia,vocal cord cancer and hypopharyngeal cancer among different groups.Univariate Chi-square test analysis and multivariate binary logistic regression analysis were performed for gender,age,BMI,smoking and drinking history.All differences were statistically significant with P<0.05.RESULTS The prevalence of LPR in 280 patients with throat discomfort was 70.0%(196/280).There were statistically significant differences in the incidence of LPR group and non-LPR group in patients with vocal cord polyp(χ2=4.228,P<0.05),vocal cord leukoplakia(χ2=12.283,P<0.05),vocal cord cancer(χ2=4.103,P<0.05)and hypopharyngeal cancer(χ2=4.907,P<0.05),while there was no significant difference in the incidence of LPR group and non-LPR group in patients with papilloma of upper respiratory tract(χ2=0.183,P>0.05)and epiglottic cyst(χ2=0.556,P>0.05).Univariate analysis showed that there were significant differences in the incidence rates of smoking(χ2=20.403,P<0.05)and drinking(χ2=7.704,P<0.05)between the LPR group and the non-LPR group,while gender(χ2=0.01,P>0.05),age(χ2=8.147,P>0.05),BMI(χ2=2.060,P>0.05)had no significant difference.Multivariate logistic regression analysis showed that smoking(OR=3.390,95%CI:1.761-6.526,P<0.05)was an independent risk factor for LPR.CONCLUSION There is a high co-prevalence of LPR with vocal cord polyps,vocal cord leukoplakia,vocal cord cancer and hypopharyngeal cancer.Therefore,LPR should be evaluated when treating throat related diseases,and LPR should be actively treated if necessary.In addition,smoking and drinking are risk factors for LPR,so it is necessary to stop smoking and drinking alcohol when treating LPR.

2.
Article in Chinese | WPRIM | ID: wpr-1018839

ABSTRACT

Objective To investigate the clinical efficacy of CT-guided pulsed radiofrequency combined with continuous nerve block in the treatment of refractory postherpetic neuralgia(PHN).Methods A total of 208 patients with refractory PHN,who were admitted to the Hengshui Municipal People's Hospital of China between January 2021 and January 2023,were selected as the subjects of study.Using random number table method,the patients were divided into combination group and control group,with 104 patients in each group.The patients of control group received CT-guided pulsed radiofrequency therapy,and the patients of combination group received additional continuous nerve block therapy on the basis of the treatment of control group.The pain degree at different time point,clinical effective rate,number of analgesia remedy times,quality of sleep,and the levels of serum high mobility group box 1(HMGB1),interleukin-1 β(IL-1β)and interleukin-10(IL-10)were compared between the two groups.Results During the follow-up period,4 patients were lost in touch.Finally,103 patients were included in the combination group and 101 patients were included in the control group.The total treatment response rate in the combination group was 89.32%,which was significantly higher than 78.22%in the control group(P<0.05).There were statistically significant differences in visual analogue scale(V AS)scores and Athens insomnia scale(AIS)scores including the time effect,inter-group effect and time-group interaction effect,between the two groups(P<0.05).The postoperative one-week,2-week,4-week VAS scores and AIS scores in the combination group were remarkably lower than those in the control group(P<0.05).The number of analgesia remedy times in the combination group was smaller than that in the control group,and the used dosage of tramadol in the combination group was lower than that in the control group(P<0.05).Four weeks after treatment,the serum levels of HMGB1,IL-1β and IL-10 in the combination group were lower than those in the control group(P<0.05).Conclusion For the treatment of refractory PHN,CT-guided pulsed radiofrequency combined with continuous nerve block can effectively alleviate neural inflammatory damage,and improve pain symptoms and sleep quality,besides,its analgesic effect and clinical efficacy are superior to CT-guided pulsed radiofrequency alone.(J Intervent Radiol,2024,33:264-268)

3.
Article in Chinese | WPRIM | ID: wpr-1026351

ABSTRACT

Purpose To observe the right ventricle and left ventricle blood pool T2 map in chronic thromboembolic pulmonary hypertension(CTEPH)and healthy controls,and to analyze the value of T2 mapping technique in evaluating CTEPH.Materials and Methods A total of 42 patients with CTEPH and 42 healthy volunteers had been prospectively recruited from January 2020 to January 2022 in China-Japan Friendship Hospital.All CTEPH patients underwent cardiac magnetic resonance with T2 mapping and right heart catheterization.Cardiac magnetic resonance was performed on healthy controls.Diastolic T2 mapping was performed in cardiac magnetic resonance,and then the ratio of right ventricular to left ventricular T2 values(RVT2/LVT2)between the CTEPH group and the healthy group was calculated and compared.Meanwhile,the correlation between RVT2/LVT2 and hemodynamic parameters in the CTEPH group was analyzed.Results RVT2/LVT2 in the CTEPH group was significantly lower than that in the healthy group(0.74±0.16 vs.0.86±0.12;t=3.673,P<0.001).RVT2/LVT2 in CTEPH group was negatively correlated with pulmonary vascular resistance(r=-0.534,P<0.001);while it was positively correlated with cardiac index,right atrium oxygen saturation,right ventricle oxygen saturation and pulmonary arteries oxygen saturation(r=0.600,0.603,0.648,0.582,P<0.001).Conclusion RVT2/LVT2 in the CTEPH group is positively correlated with right cardiac oxygen saturation and negatively correlated with pulmonary vascular resistance.T2 mapping may be a noninvasive evaluation of hemodynamics in CTEPH.

4.
Article in Chinese | WPRIM | ID: wpr-1027176

ABSTRACT

Objective:To investigate the values of two-dimensional and three-dimensional echocardiographic parameters in predicting pulmonary vascular resistance (PVR) in chronic pulmonary thromboembolic pulmonary hypertension (CTEPH).Methods:A total of 141 patients diagnosed with CTEPH in China-Japan Friendship Hospital from November 2015 to December 2022 were included. Two-dimensional echocardiographic indicators reflecting PVR were constructed according to the calculation formula of PVR: echocardiographic estimated systolic pulmonary artery pressure (sPAP Echo)/left ventricular end-diastolic diameter (LVIDd), echocardiographic estimated mean pulmonary artery pressure (mPAP Echo)/LVIDd. sPAP Echo/left ventricular end-diastolic volume (LVEDV), sPAP Echo/left ventricular cardiac output (LVCO) were measured by three-dimensional echocardiography. The correlations between two-dimensional and three-dimensional echocardiographic ratios and invasive PVR were then analyzed using the Spearman correlation method. Using receiver operating characteristic curve analysis, cut-off values for the ratios were generated to identify patients with PVR>1 000 dyn·s -1·cm -5. Pre- and postoperative hemodynamics and echocardiographic data were analyzed, as well as the correlation between the reduction rate of the echocardiographic index and PVR in 54 patients who underwent pulmonary endarterectomy (PEA). Results:sPAP Echo/LVIDd, sPAP Echo/LVEDV and sPAP Echo/LVCO were moderately correlated with PVR( rs=0.62, 0.52, 0.63, both P<0.001). The ratio of sPAP Echo to LVEDV, when greater than or equal to 1.41, had a sensitivity of 0.800 and a specificity of 0.930 for determining PVR >1 000 dyn·s -1·cm -5 (AUC=0.860, P<0.001). Similarly, the ratio of sPAP Echo to LVIDd, when greater than or equal to 2.14, had a sensitivity of 0.647 and a specificity of 0.861 for determining PVR >1000 dyn·s -1·cm -5 (AUC=0.830, P<0.001). The sPAP Echo/LVIDd and mPAP Echo/LVIDd significantly decreased after PEA (both P<0.001). The sPAP Echo/LVIDd and mPAP Echo/LVIDd reduction rate (ΔsPAP Echo/LVIDd and ΔmPAP Echo/LVIDd) were significantly correlated with PVR reduction rate (ΔPVR), respectively ( rs=0.61, 0.63, both P<0.05). Conclusions:Two-dimensional ratio sPAP Echo/LVIDd and three-dimensional ratio sPAP Echo/LVEDV can be used to noninvasively estimate PVR in CTEPH patients. The conventional ratio sPAP Echo/LVIDd is convenient and reproducibly suitable for monitoring the improvement of PVR before and after treatment, and its ratio of 2.14 can predict the significant increase of PVR in CTEPH patients (>1 000 dyn·s -1·cm -5).

5.
Chinese Journal of Surgery ; (12): 41-47, 2023.
Article in Chinese | WPRIM | ID: wpr-970171

ABSTRACT

Objective: To establish and validate a nomogram model for predicting the risk of microvascular invasion(MVI) in hepatocellular carcinoma. Methods: The clinical data of 210 patients with hepatocellular carcinoma who underwent hepatectomy at Department of Hepatobiliary and Pancreatic Surgery,the Affiliated Hospital of Qingdao University from January 2013 to October 2021 were retrospectively analyzed. There were 169 males and 41 females, aged(M(IQR)) 57(12)years(range:30 to 80 years). The patients were divided into model group(the first 170 cases) and validation group(the last 40 cases) according to visit time. Based on the clinical data of the model group,rank-sum test and multivariate Logistic regression analysis were used to screen out the independent related factors of MVI. R software was used to establish a nomogram model to predict the preoperative MVI risk of hepatocellular carcinoma,and the validation group data were used for external validation. Results: Based on the modeling group data,the receiver operating characteristic curve was used to determine that cut-off value of DeRitis ratio,γ-glutamyltransferase(GGT) concentration,the inverse number of activated peripheral blood T cell ratio (-aPBTLR) and the maximum tumor diameter for predicting MVI, which was 0.95((area under curve, AUC)=0.634, 95%CI: 0.549 to 0.719), 38.2 U/L(AUC=0.604, 95%CI: 0.518 to 0.689),-6.05%(AUC=0.660, 95%CI: 0.578 to 0.742),4 cm(AUC=0.618, 95%CI: 0.533 to 0.703), respectively. Univariate and multivariate Logistic regression analysis showed that DeRitis≥0.95,GGT concentration ≥38.2 U/L,-aPBTLR>-6.05% and the maximum tumor diameter ≥4 cm were independent related factors for MVI in hepatocellular carcinoma patients(all P<0.05). The nomogram prediction model based on the above four factors established by R software has good prediction efficiency. The C-index was 0.758 and 0.751 in the model group and the validation group,respectively. Decision curve analysis and clinical impact curve showed that the nomogram model had good clinical benefits. Conclusions: DeRitis ratio,serum GGT concentration,-aPBTLR and the maximum tumor diameter are valuable factors for preoperative prediction of hepatocellular carcinoma with MVI. A relatively reliable nomogram prediction model could be established on them.


Subject(s)
Female , Humans , Male , Adult , Middle Aged , Aged , Aged, 80 and over , Carcinoma, Hepatocellular/pathology , Liver Neoplasms/pathology , Neoplasm Invasiveness , Nomograms , Retrospective Studies , Risk Factors
6.
Article in Chinese | WPRIM | ID: wpr-991354

ABSTRACT

Objective:To investigate the effect of flipped classroom model in the theory teaching of psychiatry for medical undergraduates.Methods:A total of 121 students from grade 2014 were randomly divided into observation group and control group. The observation group was given flipped classroom teaching and the control group was given traditional teaching. In order to evaluate the teaching effect of flipped classroom, the students in the observation group were evaluated by comparing the test scores of the two groups in class and using the self-made questionnaire. SPSS 18.0 was used to conduct t-test. Results:The results showed that the average score of the observation group was significantly higher than that of the control group ( P < 0.05). The results of teaching effect showed that there were 60 students in the observation group, among which 96.7% (58 students) believed that flipped classroom teaching was beneficial to promoting pre-class preview, improving teamwork ability, autonomous learning ability and teacher-student communication; 95.0% (57 students) thought they were satisfied with flipped classroom teaching, which was conducive to linking theory with practice; 93.3% (56 students) thought that they could arouse their interest in learning, improve their attention, and improve their ability to analyze and solve problems; 90.0% (54 students) thought flipped classroom was superior to traditional classroom and helpful to their future study; 86.7% (52 students) did not think their study burden was increased. Conclusion:The flipped classroom model can stimulate students' interest and attention, and promote the combination of independent learning and interactive learning, which has a better effect than the traditional teaching model in the theory teaching of psychiatry and is easily accepted by students. Therefore, it holds promise for application.

7.
Article in Chinese | WPRIM | ID: wpr-992251

ABSTRACT

Objective:To assess the prognostic accuracy of five scoring systems for mortality in elderly patients (≥80 years old) with sepsis.Methods:A retrospective study was conducted on elderly patients with sepsis (≥80 years old, meeting Sepsis 3.0 diagnostic criteria) in Medical Information Mart for Intensive Care Ⅳ (MIMIC-Ⅳ). The participants were divided into survival and death group according to the 28-day mortality. The baseline data of patients was collected based on the peak of vital signs and laboratory test results within 24 hours after admission to intensive care unit (ICU). Systemic Inflammatory Response Syndrome (SIRS) score, quick Sequential Organ Failure Assessment (qSOFA), Sequential Organ Failure Assessment (SOFA), National Early Warning Score (NEWS) and Oxford Acute Severity of Illness Score (OASIS) were calculated and prognosis was recorded. The accuracy of the above scoring systems in predicting 28-day mortality was calculated, the receiver operating characteristic (ROC) curve was plotted, and the area under the ROC curve (AUC) was calculated and compared.Results:A total of 42 037 hospital records were screened, and 956 sepsis patients (456 males, 47.70%) who were aged ≥80 years and met the Sepsis 3.0 diagnostic criteria within 24 hours of admission to ICU were included. There were 696 patients (72.8%) in the survival group and 260 patients (27.2%) in the death group. There were no significant difference in age, gender, Charlson Comorbidity Index, length of stay before admission to ICU and length of stay in ICU between 2 groups (all P>0.05). The proportion of patients receiving mechanical ventilation and septic shock in the death group were higher comparing with those in the survival group (both P<0.001), and the total length of hospital stay in the survival group was longer than that in the death group ( P<0.001). The proportion of SOFA score≥7, qSOFA score≥2, SIRS score≥2, NEWS score≥8, OASIS score≥42 in the death group was higher than that in the survival group (all P<0.05). The AUC of qSOFA, SOFA, SIRS, NEWS and OASIS in predicting the mortality of elderly sepsis patients were 0.587 (95% CI: 0.556-0.617), 0.694 (95% CI: 0.655-0.732), 0.591 (95% CI: 0.555-0.627), 0.684 (95% CI: 0.646-0.721) and 0.718 (95% CI: 0.681-0.755), respectively. Conclusions:OASIS was superior than qSOFA, SOFA, SIRS and NEWS scores in predicting the mortality of elderly patients with sepsis, but the prognostic accuracy of all above scoring systems for elderly patients with sepsis was insufficient.

8.
Journal of Chinese Physician ; (12): 1170-1175, 2023.
Article in Chinese | WPRIM | ID: wpr-992438

ABSTRACT

Objective:To investigate the clinical efficacy of Yunkang oral liquid combined with dexamethasone and low-molecular-weight heparin in the treatment of recurrent spontaneous abortion (RSA) complicated with pre thrombotic state (PTS), and its effects on thromboelastogram and serum progesterone, β-human chorionic gonadotropin (β- hCG), and helper T cell (Th) 1/Th2 cytokine levels in patients with recurrent spontaneous abortion (RSA).Methods:A prospective selection of 94 RSA patients with PTS admitted to the Baoding Second Central Hospital from January 2015 to December 2020 was conducted. They were randomly divided into two groups using a random number table method, with 47 patients in each group. The control group was treated with dexamethasone combined with low molecular weight heparin, while the observation group was treated with Yunkang oral liquid in addition to the control group. Continuously treat until 12 weeks of pregnancy to evaluate the efficacy of both groups and observe the adverse reactions in both groups. Two sets of thromboelastogram parameters were compared before and after treatment, including clot formation time (K value), clot reaction time (R value), and clot formation rate (α angle), maximum clot strength (MA value), and coagulation comprehensive index (CI), as well as serum progesterone β- hCG, Th1/Th2 cytokine levels. The pregnancy outcomes of the two groups were followed up.Results:The total effective rate of the observation group [95.7%(45/47)] was significantly higher than that of the control group [83.0%(39/47), P<0.05]. After treatment, the K and R values of both groups were significantly prolonged compared to before treatment (all P<0.05), the angle α, MA value, and CI value were significantly reduced compared to those before treatment (all P<0.05); After treatment, the K and R values in the observation group were significantly longer than those in the control group (al P<0.05), The angleα, MA value, and CI value were significantly lower than those of the control group (all P<0.05). After treatment, the levels of β- hCG serum progesterone of the two groups were significantly higher than those before treatment (all P<0.05), and The β-hCG levels of the serum progesterone were all higher than those in the control group (all P<0.05). After treatment, The levels serum Th1 cytokines [interferon-γ (INF- γ), tumor necrosis factor- α (TNF- α)] of both groups were significantly decreased compared to those before treatment (all P<0.05), and the levels of serum Th2 cytokines [interleukin-4, IL-10] were significantly increased compared to those before treatment (all P<0.05); After treatment, the observation group's serum IFN- γ, TNF- α were significantly lower than those of the control group (all P<0.05), and The levels of serum IL-4 and IL-10 were significantly higher than those of the control group all P<0.05). The live birth rate of the observation group was 87.2%(41/47), which was higher than that of the control group [70.2%(33/47)] ( P<0.05). There was no statistically significant difference in the adverse reaction rate between the observation group [6.4%(3/47)] and the control group [4.3%(2/47)] ( P>0.05). Conclusions:The treatment of RSA combined with PTS with Yunkang oral liquid, dexmedroxyprogesterone, and low molecular weight heparin can significantly alleviate blood hypercoagulability, increase reproductive endocrine hormone levels, regulate Th1/Th2 cytokine balance, improve live birth rate and clinical efficacy, and is safe and reliable.

9.
Journal of Chinese Physician ; (12): 1181-1186, 2023.
Article in Chinese | WPRIM | ID: wpr-992440

ABSTRACT

Objective:To investigate the clinical efficacy of vitamin D drops combined with insulin aspart in the treatment of gestational diabetes mellitus (GDM), and the effect of vitamin D drops on the serum levels of 1, 25 dihydroxyvitamin D 3 [1, 25(OH) 2D 3] and retinol binding protein 4 (RBP4). Methods:A total of 94 GDM patients admitted to the Baoding Second Central Hospital from March 2019 to March 2021 were selected and randomly divided into an observation group and a control group with 47 cases each using a random number table method. The control group received subcutaneous injection of insulin aspartate for treatment, while the observation group received oral vitamin D drops for treatment. After 4 weeks of continuous treatment, the blood glucose control effect and adverse reactions were observed in both groups. The glucose metabolism indicators of the two groups were compared before and after treatment, including fasting blood glucose (FPG), 2-hour postprandial blood glucose (2-hour PG), insulin resistance index (HOMA-IR), and pancreatic islets β Cell Function Index (HOMA-β) and serum levels of 1, 25(OH) 2D 3, RBP4, lipoprotein related phospholipase A2 (Lp-PLA2), and vascular cell adhesion molecule-1 (VCAM-1). All patients were followed up until the end of pregnancy, and Statistical analysis was conducted on the adverse outcomes of two groups of mothers and infants. Results:The time to reach the standard for FPG and 2-hour PG in the observation group, as well as the time for both to reach the standard were significantly shorter than those in the control group (all P<0.05). There was no statistically significant difference in the incidence of dawn phenomenon and hypoglycemia between the observation group and the control group (all P>0.05). After treatment, FPG and 2-hour PG in both groups were significantly reduced compared to those before treatment (all P<0.05); However, after treatment, there was no statistically significant difference between the groups (all P>0.05). Compared with before treatment, HOMA-IR in both groups significantly decreased (all P<0.05), All HOMA- β significantly increased (all P<0.05); And the improvement was more significant in the observation group (all P<0.05). After treatment, the serum levels of 1, 25(OH) 2D 3 in the observation group significantly increased compared to that before treatment ( P<0.05), but there was no significant change in the control group before and after treatment ( P>0.05). After treatment, the levels of serum RBP4, Lp-PLA2, and VCAM-1 in both groups significantly decreased compared to those before treatment (all P<0.05); After treatment, the serum levels of RBP4, Lp-PLA2, and VCAM-1 in the observation group were lower than those in the control group (all P<0.05). The incidence of adverse maternal and neonatal outcomes in the observation group was 14.9%(7/47) and 10.6%(5/47), respectively, which were lower than those in the control group [34.0%(16/47) and 27.7%(13/47)] (all P<0.05). There were 8 cases of hypoglycemia in 94 patients (3 in the observation group and 5 in the control group), and no other adverse events occurred. Conclusions:The combination of vitamin D drops and insulin aspartate in the treatment of GDM can safely, effectively, quickly, and steadily control patients′ blood sugar, improve IR and pancreatic islets β The effect of cell function on reducing the incidence of adverse maternal and fetal outcomes may be related to increasing serum 1, 25(OH) 2D 3 levels and down-regulating the expression levels of serum RBP4, Lp-PLA2, and VCAM-1.

10.
Article in Chinese | WPRIM | ID: wpr-1030036

ABSTRACT

The incidence and prevention of chronic non-communicable respiratory diseases represented by chronic obstructive pulmonary disease, bronchial asthma, and lung cancer, as well asrespiratory communicable diseases such as viral pneumonia and tuberculosis, are becoming increasingly severe and complex.Only by constructing the modern respiratory discipline system of pulmonary and critical care medicine (PCCM) and developing the standardized management of PCCM departments in the hospital, could we achieve the goal of establishing overall specialized capacity for respiratory diseases and improving the ability of disease prevention and treatment in China. This article introducedthe project design and practice exploration based on the standardized construction of PCCM department in hospital, in the context of the new pattern of modern respiratory discipline.It focused on project initiation and management, formulation of evaluation standards, identification process and grading, and phased effectiveness.It also discussed and analyzed the experience, enlightenment, existing problems and suggestions, which could provide reference and advance experience for innovation, governance and improvement of capacity building of respiratory specialty and high-quality development of other medical disciplines and specialties in China.

11.
Article in Chinese | WPRIM | ID: wpr-997056

ABSTRACT

@#Objective    To systematically evaluate the risk factors for postoperative pulmonary infection in patients with esophageal cancer. Methods    CNKI, Wangfang Data, VIP, CBM, PubMed, EMbase, The Cochrane Library were searched from inception to January 2021 to collect case-control studies, cohort studies and cross-sectional studies about risk factors for postoperative pulmonary infection in patients with esophageal cancer. Two researchers independently conducted literature screening, data extraction and quality assessment. RevMan 5.3 software and Stata 15.0 software were used for meta-analysis. Results    A total of 20 articles were included, covering 5 409 patients of esophageal cancer. The quality score of included studies was 6-8 points. Meta-analysis results showed that age (MD=1.99, 95%CI 0.10 to 3.88, P=0.04), age≥60 years (OR=2.68, 95%CI 1.46 to 4.91, P=0.001), smoking history (OR=2.41, 95%CI 1.77 to 3.28, P<0.001), diabetes (OR=2.30, 95%CI 1.90 to 2.77, P<0.001), chronic obstructive pulmonary disease (OR=3.69, 95%CI 2.09 to 6.52, P<0.001), pulmonary disease (OR=2.22, 95%CI 1.16 to 4.26, P=0.02), thoracotomy (OR=1.77, 95%CI 1.32 to 2.37, P<0.001), operation time (MD=14.08, 95%CI 9.64 to 18.52, P<0.001), operation time>4 h (OR=3.09, 95%CI 1.46 to 6.55, P=0.003), single lung ventilation (OR=3.46, 95%CI 1.61 to 7.44, P=0.001), recurrent laryngeal nerve injury (OR=5.66, 95%CI 1.63 to 19.71, P=0.006), and no use of patient-controlled epidural analgesia (PCEA) (OR=2.81, 95%CI 1.71 to 4.61, P<0.001) were risk factors for postoperative pulmonary infection in patients with esophageal cancer. Conclusion    The existing evidence shows that age, age≥60 years, smoking history, diabetes, chronic obstructive pulmonary disease, pulmonary disease, thoracotomy, operation time, operation time>4 h, single lung ventilation, recurrent laryngeal nerve injury, and no use of PCEA are risk factors for postoperative pulmonary infection in patients with esophageal cancer. Due to the limitation of the quantity and quality of included literature, the conclusion of this study still needs to be confirmed by more high-quality studies.

12.
Article in Chinese | WPRIM | ID: wpr-1011047

ABSTRACT

Objective:To study the application value of narrow-band imaging in the diagnosis of laryngopharyngeal reflux. Methods:A total of 275 patients admitted to the inpatient department or laryngoscopy room of the Otolaryngology Head and Neck Surgery Department of the First Affiliated Hospital of Harbin Medical University from September 2022 to April 2023 due to throat discomfort were selected as the research subjects. All of them completed RSI, RFS scoring scales and electronic laryngoscopy(including ordinary white light and NBI). According to the expert consensus of LPRD in 2022, RSI and RFS scoring scale were used as diagnostic criteria to divide them into LPR group and non-LPR group. Chi-square test was used to analyze the differences of positive rates of characteristic manifestations under NBI among different groups. The consistency of NBI and scale diagnostic methods was analyzed by Kappa, and RSI and RFS scoring were used as diagnostic criteria, The diagnostic efficiency of NBI method was analyzed. Results:There were 190 people in the LPR group, 157 of whom showed characteristic performance under the NBI mode, with a positive rate of 82.6%(157/190); there were 85 people in the non-LPR group, with a positive rate of 18.8%(16/85). There was a statistically significant difference in the positive rate between the two groups(χ²=102.47, P<0.05). The consistency rate between RSI, RFS and NBI was 82.2%(226/275). Kappa consistency analysis was used, and Kappa=0.605(P<0.05), indicating good consistency between the two diagnostic methods. Using RSI and RFS as diagnostic criteria for LPR, the sensitivity of NBI diagnostic method was 82.6%(157/190), specificity 81.2%(69/85), positive predictive value 90.8%(157/173) and negative predictive value 67.6%(69/102). Conclusion:Narrow-band imaging, as a new endoscopic imaging technique, can show small changes in mucosal surface micro vessels and play an important role in the diagnosis of laryngopharyngeal reflux.


Subject(s)
Humans , Laryngopharyngeal Reflux/diagnostic imaging , Narrow Band Imaging , Laryngoscopy/methods , Pharynx , Predictive Value of Tests
13.
Article in Chinese | WPRIM | ID: wpr-965307

ABSTRACT

@#To evaluate bioequivalence and safety of two kinds of metformin hydrochloride sustained-release tablets (test preparation vs reference preparation) under the condition of fed and single administration.A single center, randomized, open, single-dose, two-period, two-sequence, and double-crossover design was used.32 healthy subjects took 0.5 g of test preparation or reference preparation under fed and single-dose administration.4 mL of venous blood was collected from before administration (0 h) to 1, 3, 4, 4.5, 5, 5.5, 6, 7, 8, 9, 10, 12, 15, 24, 36 and 48 h after administration.The concentration of metformin in plasma samples was detected, and then the pharmacokinetic parameters were calculated by WinNonlin 7.0 software.When the 90% confidence intervals of cmax, AUC0-t and AUC0-∞ geometric mean ratio of test preparation and reference preparation were within 80.00%-125.00% equivalent intervals respectively, the bioequivalence of the two preparations was proved.One subject fell off due to adverse events.The main pharmacokinetic parameters of test preparation and reference preparation as follows: cmax were (0.68 ± 0.14) and (0.65 ± 0.11) mg/L, AUC0-t were (7.33 ± 1.65) and (7.00 ± 1.89) h·mg/L, AUC0-∞ were (7.39 ± 1.67) and (7.06 ± 1.91) h·mg/L, respectively.The 90% confidence intervals of the geometric mean ratio of the two main pharmacokinetic parameters were 101.45%-109.14%, 100.08%-112.32% and 100.24%-112.28%, respectively, which fell within the bioequivalence interval of 80.00%-125.00%.There were no serious adverse events and unexpected adverse events during the trial.The results show that test preparation and reference preparation are bioequivalent under fed and single-dose administration, safe and well tolerated in healthy subjects.

14.
Article in Chinese | WPRIM | ID: wpr-965835

ABSTRACT

The new variant B.1.1.529 of COVID-19 was reported to the WHO for the first time by South Africa on November 24, 2021. At present, Omicron has become the dominant strain in the world and is spreading rapidly. Although Omicron infected during pregnancy shows the lower risk of serious maternal and fetal complications than the previous variants and Delta variant, the rapid increase in the number of cases and the wide range of patients still worth attention of obstetricians. This article reviews the prevalence of Omicron variant infection, the clinical characteristics , the prevention and the treatment of pregnant women infected with Omicron, as well as the breastfeeding of newborns. It is believed that Omicron infection will not increase the rate of early spontaneous abortion and the infant congenital malformations, but it may increase the risk of gestational hypertensive disorders, premature delivery, cesarean section, and postpartum hemorrhage in the third trimester of pregnancy.We put forward corresponding management strategies and suggestions to provide references for the diagnosis and treatment of novel coronavirus infection in pregnant women in China.

15.
Article in Chinese | WPRIM | ID: wpr-957881

ABSTRACT

Objective:To analyze the clinical characteristics, antibiotic resistance and prognostic risk factors of patients with Klebsiella pneumoniae bloodstream infection (Kp BSI).Methods:The clinical data of 188 patients diagnosed with Kp BSI from January 1,2017 to December 1,2021 in Beijing Shijitan Hospital, Capital Medical University were retrospectively analyzed.There were 118 patients males (62.8%) with a median age 77.0(63.0, 85.0) years old. The median length of hospital stay was 20.0 days, and 78 patients (41.5%) were admitted to intensive care unit(ICU). There were 121 cases with carbapenem-sensitive Klebsiella pneumoniae (64.4%, CSKP group) and 67 cases with carbapenem-resistant Klebsiella pneumoniae (35.6%, CRKP group).Fifty six patients died within 28 days after admission (death group), and 132 patients survived (survival group).The clinical characteristics and bacterial drug resistance of Kp BSI patients were analyzed, and univariate analysis and multivariate logistic regression analysis were used to explore factors related to the CRKP infection and patient mortality.Results:The most common infection sites were respiratory system, abdominal cavity and biliary tract accounting for 39.4% (74/188), 18.1% (34/188) and 14.4% (27/188), respectively.The common comorbidities were coronary heart disease, hypertension, chronic kidney disease and diabetes, accounting for 63.8% (120/188), 59.6% (112/188), 46.3% (87/188) and 43.1% (81/188), respectively and 118 patients (62.8%) had 3 or more comorbidities. Most patients (146 cases, 77.7%) underwent ≥1 invasive procedures before bloodstream infection;and 90 patients (47.9%) had a history of antibiotic use. CRKP strains showed higher resistance rates to piperacillin, quinolones, cephalosporins and carbapenems. Univariate analysis showed that there were statistically significant differences in age (69.0 vs. 83.0 years), ICU admission 25.6%(31/121) vs. 70.1%(47/67)], invasive procedures [67.8%(82/121) vs. 95.5 %(64/67)], and antibiotic use [37.2% (45/121) vs. 67.2%(45/67)] between the CSKP group and the CRKP group ( Z=-5.73, χ 2=35.22, χ 2=19.15, χ 2=15.53, all P<0.001). Multivariate logistic regression analysis showed that age, ICU admission, invasive procedures and antibiotic use in recent 30 days were independent risk factors for CRKP infection( OR=1.06, P<0.001; OR=3.22, P=0.003; OR=5.93, P=0.009; OR=2.40, P=0.022). The total fatality rate was 29.8%(56/188). Univariate analysis showed that there were statistically significant differences in CRKP infection [19.7%(26/132) vs. 73.2% (41/56)], albumin level (32.6 vs. 27.8 g/L) and sequential organ failure assessment score (SOFA score, 2 vs. 8 score) between the survival group and the death group (χ 2=49.10, Z=-4.64, Z=-10.36,all P<0.001). Multivariate logistic regression analysis suggested that CRKP infection, low albumin and high SOFA score on the day of bloodstream infection were risk factors for death of Kp BSI patients( OR=5.13, P=0.021; OR=0.86, P=0.044; OR=3.04, P<0.001). Conclusion:Kp BSI patients have a high fatality rate and fairly severe drug resistance. CRKP infection, low albumin, high SOFA score on the day of bloodstream infection are associated with poor prognosis in Kp BSI patients.

16.
Chinese Journal of Epidemiology ; (12): 572-577, 2022.
Article in Chinese | WPRIM | ID: wpr-935429

ABSTRACT

Among kinds of methods for causal inference in observational studies, the propensity score (PS) method to control measured confounding is more widely used. PS method usually consists of two critical steps: first, estimating the propensity score, followed by calculating the causal parameters of interest by regression, weighting, matching, and stratification. Unlike the traditional dichotomous treatment, the generalized propensity scoring estimator used for continuous treatment has been proposed in recent years. Many methods have been developed to estimate the generalized propensity score or even estimate the balancing weight directly. This paper introduces the existing estimators from both the model-based and balance-based perspectives.


Subject(s)
Humans , Causality , Computer Simulation , Propensity Score , Research Design
17.
Article in Chinese | WPRIM | ID: wpr-935744

ABSTRACT

Objective: To understand the distribution and characteristics of suspected occupational chronic lead poisoning reported online by Jiangsu Province, and to track the final diagnosis of suspected cases. Methods: The suspected occupational chronic lead poisoning cases in Jiangsu Province reported online from 2014 to 2018 were collected as the survey objects. Based on the reporting of the Occupational Disease Report Card from January 1, 2014 to November 5, 2019, the distribution characteristics and reporting institutions of suspected cases and final confirmed cases were analyzed. Results: From 2014 to 2018, 312 cases of suspected occupational chronic lead poisoning were reported online in Jiangsu Province. There were significant differences in the number of online reported cases of occupational chronic lead poisoning, online reported cases of suspected occupational chronic lead poisoning and confirmed cases of suspected occupational chronic lead poisoning in different years (P<0.05) , especially in 2015. Among the suspected occupational lead poisoning cases reported online, 236 cases (75.6%) were male, mainly distributed in the manufacturing industry, and 246 cases (79.1%) were operators. All the suspected occupational chronic lead poisoning cases reported online were concentrated in private enterprises, 229 cases (73.4%) in small and medium-sized enterprises. The top three cities were Suqian with 111 cases (35.6%) , Yangzhou with 79 cases (25.3%) and Huai'an with 50 cases (16.0%) . From 2014 to 2018, 19 suspected cases of occupational chronic lead poisoning were finally confirmed in Jiangsu Province, with a diagnosis rate of 6.1%. Conclusion: The majority of suspected occupational chronic lead poisoning cases reported online in Jiangsu Province are men, manufacturing and small and medium-sized enterprises, and the final diagnosis rate of suspected occupational chronic lead poisoning cases reported online is low.


Subject(s)
Female , Humans , Male , China/epidemiology , Cities , Lead , Lead Poisoning/epidemiology , Manufacturing Industry , Occupational Diseases/epidemiology
18.
Article in Chinese | WPRIM | ID: wpr-958204

ABSTRACT

Objective:To observe any curative effect of combining hydraulic dilatation with radial extracorporeal shock waves on scapulohumeral periarthritis.Methods:A total of 132 patients with scapulohumeral periarthritis were randomly divided into a hydraulic dilatation group, a shock wave group and a combination group. The three treatments were applied for 3 weeks, before and after which shoulder range of motion was evaluated. Shoulder function was quantified using the Japanese Orthopaedic Association′s (JOA′s) shoulder function scoring, pain was reported using a visual analogue scale (VAS), and ability in the activities of daily living (ADL) was also quantified. Serum prostaglandin E2 (PGE2), β-endorphin (β-EP), interleukin 6 (IL-6) and tumor necrosis factor α (TNF-α) were assayed.Results:The treatment response rate of the combination group (95%) was significantly higher than those of the hydraulic dilatation group (70%) and the shock wave group (82%). After the treatment, the average shoulder range of motion, JOA and ADL scores, and β-EP level in all 3 groups had improved significantly, while the average VAS score, and the PGE2, IL-6 and TNF-α levels had decreased significantly, but in each case the improvement in the combination group′s average was significantly greater than those of the other 2 groups. During the treatment there were no such adverse events as intra-articular infection, skin redness, numbness or palpitations.Conclusions:Combining hydraulic dilatation with radial extracorporeal shock waves significantly improves the treatment of scapulohumeral periarthritis. It can effectively promote the recovery of shoulder function and improve quality of life. Its greater effectiveness may be related to improving levels of PGE2, β-EP, IL-6 and TNF-α, and relieving pain and inflammation.

19.
Article in Chinese | WPRIM | ID: wpr-905265

ABSTRACT

Objective:To observe the effect of the tactile vibration feedback system on the balance and walking function of the unilateral transitional amputees with prostheses. Methods:From October, 2019 to November 2020, eleven unilateral transtibial amputees with prostheses were selected from our hospital. They performed daily activities for three hours wearing tactile vibration feedback system designed by our department. The patients were evaluated by Performance Oriented Mobility Assessment (POMA), gait analysis and outdoor 1000 meters complex road walking test before and after treatment. Results:The balance score of the POMA improved (Z = -2.264, P < 0.05), the gait score and total score of the POMA increased significantly (|t| > 6.249, P < 0.001) after treatment. Gait analysis showed that the step length of the affected side improved, the bilateral step time and double support phase shortened, and the walking speed increased (|t| > 2.250, |Z| > 2.756, P < 0.05) after installation. The outdoor 1000 meters complex road walking test showed that the total steps, energy consumption and time decreased (|t| > 2.412, |Z| > 2.045, P < 0.05). All the patients finished the trail, and no discomfort appeared. Conclusion:The tactile vibration feedback system could safely and effectively improve the balance and walking function of the unilateral transtibial amputees with prostheses.

20.
Article in Chinese | WPRIM | ID: wpr-905284

ABSTRACT

Objective:To explore the research focus, frontier and trend of global reseaches about low back pain using bibliometrics and visualization technology. Methods:The researchs in the Web of Science core database from 2016 to 2020 were retrieved with the subject terms of "low back pain" and categories of rehabilitation, and analyzed with Creating Citation Reports and Analyzing Retrieval Results of Web of Science, as well as the CiteSpace. Results:A total of 2026 papers were retrieved. The total frequency of citations in the last five years was 6793. The number of papers and citations increased year by year. Most of the papers came from the countries of America, Europe and Australia; the top five university institutions also with high centrality; and funded by US National Research Fund mostly. The top ten journals for number of papers and cited frequency were mainly rehabilitation journals, and the researches mainly focused on orthopedics, sports medicine and healthcare medicine. A total of 468 key words were obtained, including 33 key words with high centrality and 29 key words with Strongest Citation Bursts. Nine papers of highly cited were suggested by Web of Science. A total of 466 references were obtained through CiteSpace, including 35 references with high centrality and 53 references with Strongest Citation Bursts. The researches of key node literature were mainly randomized controlled trails and systematic review. Conclusion:The researches of low back pain mainly focus on the mechanism and management of pain, such as central sensitization, pressure pain threshold, pain pattern classification, pain directional preference and centralization, pain physiology/neuroscience education, and nonpharmacologic strategies for comprehensive pain care; as well as the psychological and social factors, such as behavioral cognitive therapy/psychologically informed physical therapy, self-efficacy, kinesiophobia, fear avoidance, and variables and interventions related to return-to-work. The trial studies of STarT Back tool, core instruments and standardization of core outcome reporting in clinical trials, and individualized and targeted treatment, would be the global trends in the research of low back pain.

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