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ObjectiveTo investigate the association of sleep disorders with the development and progression of nonalcoholic fatty liver disease (NAFLD). MethodsA total of 1 868 participants from the health examination cohort and fatty liver cohort of Beijing Friendship Hospital from June 2022 to June 2023 were enrolled as subjects. Related data were collected from all subjects, including age, sex, education level, chronic medical history, and biochemical parameters, and all subjects completed Pittsburgh Sleep Quality Index (PSQI) scale independently. According to the diagnostic criteria, the subjects were divided into non-NAFLD group with 1 122 subjects and NAFLD group with 746 subjects, and according to the stage of progression, the patients in the NAFLD group were further divided into simple fatty liver group (SFL group with 624 subjects) and nonalcoholic steatohepatitis (NASH) group with 122 subjects. A one-way analysis of variance or the Kruskal-Wallis H test was used for comparison of continuous data between three groups. The chi-square test was used for comparison of categorical data between the three groups. The binary Logistic regression analysis was used to investigate the association between sleep factors and NAFLD, and the multinomial Logistic regression analysis was used to investigate the association between sleep factors and the different stages of NAFLD; two multivariate models were constructed for adjustment of potential confounding factors, i.e., an age-sex adjustment model and a multivariate adjustment model, and the multivariate adjustment model adjusted the factors of age, sex, education level, smoking, diabetes, hypertension, body mass index (BMI), triglyceride (TG), and high-density lipoprotein cholesterol (HDL-C). ResultsThere were significant differences in age, sex, BMI, education level, smoking, diabetes, hypertension, alanine aminotransferase, TG, and HDL-C between the non-NAFLD, SFL, and NASH groups (all P<0.05). There were also significant differences between the three groups in the total score of PSQI scale and the proportion of subjects with a score of 0 — 3 points for the 7 sleep components (all P<0.05). The multivariate adjustment model showed no significant association between sleep disorders and SFL, while long sleep latency (odds ratio [OR]=4.04, 95% confidence interval [CI]: 2.33 — 7.03, P<0.001), short sleep duration (OR=3.53, 95%CI: 1.83 — 6.82, P<0.001), and severe sleep disorders (OR=2.96, 95%CI: 1.48 — 5.93, P=0.002) were closely associated with the risk of NASH. ConclusionOverall sleep condition and its components of sleep disorders are not significantly associated with the simple fatty liver; however, long sleep latency, short sleep duration, and severe sleep disorders can increase the risk of NASH, which should be taken seriously in clinical practice.
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Objective@#To analyze the association between non-school sedentary time and myopia among primary and secondary school students with different levels of physical activity, so as to provide data for precise measures to prevent and control myopia.@*Methods@#From September to December 2019, stratified cluster sampling was used to select 7 872 primary and secondary students in grades 4 to 12, middle and high school students from Hefei, Suzhou, Chizhou and Wuhu Cities in Anhui Province. Face-to-face questionnaires and vision examinations were conducted to collect demographic information, physical activity time, sedentary study time and visual health status. Potential categories were analyzed for different types of physical activity time, and Logistic regression was used to assess the relationship between non-school sedentary time and myopia at different levels of physical activity.@*Results@#A total of 2 976 primary and secondary school students were found with high physical activity levels and 4 896 primary and secondary school students with low physical activity levels. The proportion of low physical activity was higher in girls than in boys (68.7% vs . 55.6%), and the differences were statistically significant ( χ 2=143.97, P <0.01). The overall screening myopia rate was 48.2%, with statistically significant differences among female students (53.0%) compared with male students (43.3%), urban students ( 51.8 %) compared with rural students (44.5%), and longer non-school sedentary time students (60.6%) compared with average (45.1%) and shorter (42.1%) non-school sedentary time students, and the differences were statistically significant ( χ 2=73.15, 41.96 , 161.74, P <0.01). Adjusting for confounders such as residence, grade, gender, age, father s education, mother s education, and body mass index (BMI), multivariate Logistic regression analysis revealed that prolonged after-school sedentary study was positivety correlated with myopia among primary and secondary school students of low physical activity levels ( OR=1.52, 95%CI=1.27-1.83, P <0.01), and there was no statistical association between after-school sedentary time and myopia in primary and secondary school students with high physical activity levels ( P >0.05).@*Conclusion@#Attention should be paid to non-school sedentary time for primary and secondary school students with low physical activity levels. And students who spend a lot of time sitting outside of school should be encouraged to maintain high physical activity levels to reduce the risk of myopia.
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Objective:To detect the characteristics of vascular remodeling after carotid balloon injury model in rats using ultrasound biomicroscopy(UBM), and to discuss the application value of UBM technique by comparing ultrasonic characteristics with histopathological results.Methods:Carotid balloon injury was performed in 10-week-old SD rats(11 female and 11 male) by 2F Fogarty balloon catheter. The left common carotid artery(CCA) was injured and the right side in the same animal was used as an uninjured control. Arterial structures and hemodynamics were evaluated pre-procedure and post-procedure at 7, 14 days.The intima-media thickness(IMT) inner diameter, outer diameter, lumen area, vessel area, peak systolic velocity, end diastolic velocity of CCA were measured by UBM, and the vascular resistance index, shear stress and blood flow were calculated to evaluate the vascular hemodynamics. The histological data were obtained by H&E staining in cross-sections at 14 days after balloon injury. The characteristics of arterial structure and hemodynamic changes at various time points were compared, the structural changes of CCA between injured and control side after injury were compared. The Spearman correlation and linear regression were used to test the correlation between ultrasonic and histological measurements 14 days after balloon injury.Results:①Compared with pre-procedure, the IMT at 14 days after balloon injury was increased, the inner diameter was decreased, the shear stress in ultrasound was increased(all P<0.05). H&E staining histological test showed that IMT and neointima area in male rats were larger than those of female rats (all P<0.001). ②After carotid balloon injury, the lumen area decreased, but the CCA underwent compensatory positive remodeling and the vessel area increased. ③Significant correlations were demonstrated between UBM and histology in IMT, inner diameter, outer diameter and vessel area of CCA( rs=0.819, 0.965, 0.896, 0.955; all P<0.001). The vessel area value measured by UBM was larger than that of histology( P=0.006). Conclusions:The CCA of rats can be showed clearly by UBM in males and females. The arterial structure cab be measured by UBM accurately with good correlation with histology, as did arterial hemodynamic parameters, which may be benefit for the study in carotid balloon injury model of rats.
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Objective To explore the clinical efficacy of sacubitril/valsartan(SV)in the treatment of maintenance hemodialysis(MHD)with heart failure with preserved ejection fraction(HFpEF).Methods A total of 90 patients with MHD combined with HFpEF admitted to the Second People′s Hospital Affiliated of Hefei to Bengbu Medical College from January to December 2021,they were divided into control group and treatment group according to the random number method,with 45 cases in each group.Patients in the control group tookangiotensin-converting enzyme inhibitor/angiotensin Ⅱ receptor blocker(ACEI/ARB)conventional drugs orally;patients in the treatment group took ARNI orally,the initial dose was 50mg,twice a day,followed by an increase to 100mg twice a day,after 2 weeks.After 3 months of treatment,the relevant indicators of cardiac function,including left ventricular ejection fraction(LVEF),left ventricu-lar end-diastolic dimension(LVEDD),left ventricular end-systolic dimension(LVESD),pulmonary artery pressure(PAP),N-ter-minal pro-B-type natriuretic peptide(NT-pro BNP),6-minutes walk test(6MWT),blood pressure level,serum potassium and the incidence of adverse events before and after treatment were collected and compared.Results After 3months of treatment,there were no significant differences in the clinical data,cardiac function index,cardiac function grade,6MWT,blood pressure level and serum potassi-um between the control group and the treatment group before treatment(P<0.05);after 3months of treatment,the levels of LVEF,LVEDD,LVESD,PAP,NT-pro BNP,6MWT,and blood pressure were all improved significantly compared with the baseline in both groups(P<0.05),and there was no significant difference of serum potassium before and after treatment in the two groups(P>0.05);after treatment,LVEF and 6MWT in the treatment group were higher than those in the control group,the LVEDD,LVESD,PAP,NT-pro BNP and blood pressure were lower than in the control group(P<0.05).There were significant differences in LVEF,LVEDD,LVESD,NT-pro BNP,6MWT,systolic blood pressure and diastolic blood pressure between the two groups before and after treatment(P<0.05).Conclusion The clinical efficacy of SV in MHD patients with HFpEF is certain,and can significantly improve cardiac function,increase the NYHK grade,improve blood pressure levels and exercise tolerance,reduce rehospitalization rates.
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Objective:To evaluate the value of lymph node regional sorting in radical colorectal cancer surgery.Methods:Between Jan 2021 and Mar 2022, A total of 307 colorectal cancer patients undergoing radical surgery at the Tianjin Medical University General Hospital were retrospectively included and assigned to either the lymph node regional sorting group (123) or no-sorting group (184) according to the lymph node examination methods.Results:There was a significant difference between the two groups in the number of total lymph nodes and negative lymph nodes (26.74±13.08 vs. 16.80±4.87, t=9.381, P<0.001; 25.65±13.25 vs. 16.04±4.87, t=8.979, P<0.001). The number of positive lymph nodes of lymph node regional sorting group increased compared with no-sorting group (1.09±2.28 vs. 0.76±1.34, t=1.589, P=0.113). A total of 52 cases in the lymph node regional sorting group showed metastasis, of which 10 showed lymph node skip metastases. There was no significant difference in tumor location and TNM stage between skip and non-skip lymph node metastasis patients. Conclusions:The lymph node regional sorting increase the number of examined lymph nodes. The method can determine the positive lymph node distribution and ensure the accuracy of staging.
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Objective:To compare the thickness of the macular ganglion cell inner plexiform layer (mGCIPL) in patients with a history of laser photocoagulation (LP) versus intravitreal injection of ranibizumab (IVR) for retinopathy of prematurity (ROP).Methods:A retrospective clinical study. From June 2020 to January 2021, 70 eyes of 35 children with a history of surgery for ROP in Shenzhen Eye Hospital were included in the study. Among them, 18 males had 36 eyes, and 17 females had 34 eyes. The average age was 5.54±1.04 years. There were 18 patients (36 eyes) in LP group and 17 patients (34 eyes) in IVR group. There was no significant difference in age ( t=-1.956), sexual composition ratio ( χ2=0.030), birth gestational age ( t=-1.316) and birth weight ( t=-1.060) between the two groups ( P=0.059, 0.862, 0.197, 0.297). All the eyes underwent the examination of optical coherence tomography (OCT). An elliptical region of 14.13 mm 2 centered on macular fovea was scanned according to the macular cube 512×128 model of the Cirrus HD-OCT 5000. The software was used to automatically divide macular fovea into six sectors (superior, inferior, temporal-superior, temporal-inferior, nasal-superior and nasal-inferior) and the average and minimum thickness of mGCIPL. t test was used to compared mGCIPL thickness between two groups using independent samples. Pearson correlation analysis was used to evaluate the correlation between mGCIPL thickness and age, birth gestational age, birth weight. Results:Patients in IVR group had significantly decreased mGCIPL thickness than that in LP group in the six sectors (superior, inferior, temporal-superior, temporal-inferior, nasal-superior and nasal-inferior) and the average and minimum ( t=6.484, 6.719, 7.682, 7.697, 5.151, 5.008, 7.148, 6.581; P<0.05). The thickness of mGCIPL was not significantly correlated with age, birth gestational age, birth weight ( P>0.05). Conclusion:The thickness of mGCIPL in patients with IVR treatment history is thinner than that in LP treatment.
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OBJECTIVE@#To analyze the clinical phenotype and genetic variants in five Chinese pedigrees affected with Dysferlinopathy.@*METHODS@#Next generation sequencing (NGS) was carried out for the probands from the five pedigrees. Suspected variants were validated by Sanger sequencing. Pathogenicity of the variants was assessed based on the standards and guidelines by the American College of Medical Genetics and Genomics (ACMG).@*RESULTS@#Ten DYSF gene variants (including 5 frameshift variants, 3 splicing variants, 1 missense variant and 1 nonsense variant) were detected. Among these, c.1375dupA (p.Met459Asnfs*15), c.610C>T (p.Arg204X), c.1180+5G>A and c.1284+2T>C were known to be pathogenic, while c.4008_4010delCCTinsAC (p.Leu1337Argfs*8), c.1137_1169del (p.379_390del), c.754A>G(p.Thr252Ala), c.1175_1176insGCAGAGTG (p.Met394Serfs*7), c.3114_3115insCGGC (p.Arg1040Profs*74) and c.1053+3G>C were unreported previously. Of the six novel variants, c.1137_1169del, c.1175_1176insGCAGAGTG and c.3114_3115insCGGC were predicted as pathogenic (PVS1+PM2+PM3), c.4008_4010delCCTinsAC as likely pathogenic (PVS1+PM2), c.754A>G and c.1053+3G>C as variants of uncertain significance based on the ACMG standards and guidelines.@*CONCLUSION@#Variants of the DYSF gene probably underlay Dysferlinopathy in the patients among the five pedigrees. Above finding has enriched the spectrum of DYSF gene variants.
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Humans , Muscular Dystrophies, Limb-Girdle/genetics , Mutation , Pedigree , Phenotype , RNA SplicingABSTRACT
Objective:To observe the changes of macular morphology and best corrected visual acuity (BCVA) in children with retinopathy of prematurity (ROP) after single treatment of laser photocoagulation or intravitreal injection of ranibizumab (IVR) by optical coherence tomography angiography (OCTA).Methods:A cross sectional study was conducted.Fourteen cases (23 eyes) of ROP children with a treatment history aged 4-10 years were enrolled as the ROP group in Shenzhen Eye Hospital from April to August 2018, with 8 cases (16 eyes) of age-matched full-term children as control group.Among the ROP group, 9 cases (14 eyes) receiving photocoagulation were set as the photocoagulation group and 5 cases (9 eyes) receiving IVR as the injection group.The 3 mm×3 mm scanning mode of OCTA was adopted to measure the area of foveal avascular zone (FAZ), FAZ morphological index, superficial retinal vascular density (VD) and superficial retinal perfusion density (PD), and the B-scan mode was used to determine the central foveal thickness (CFT). BCVA of all children was recorded and analyzed.This study adhered to the Declaration of Helsinki and was approved by an Ethics Committee of Shenzhen Eye Hospital (No.b-03). Written informed consent was obtained from guardians prior to any examination.Results:Compared with the control group, there was smaller area of FAZ, more irregular FAZ morphology and thicker CFT in the ROP group.The central fovea of macula in the laser photocoagulation group was shallow and almost indiscernible, and FAZ morphology was irregular.The FAZ area, FAZ morphological index, VD and PD in the ROP group were (0.09±0.08) mm 2, 0.51±0.25, (19.18±2.50)mm/mm 2 and 0.35±0.04, respectively, which were significantly lower than (0.32±0.08)mm 2, 0.68±0.07, (20.94±0.93)mm/mm 2, 0.38±0.02, respectively in the control group ( t=-8.03, -3.14, -3.02, -2.52; all at P<0.05). The CFT in the ROP group was (215.00±21.32) μm, which was significantly thicker than (164.29±20.20) μm in the control group ( t=8.91, P<0.05). There was no statistical difference in BCVA between the two groups ( t=0.16, P=0.87). The CET in the laser photocoagulation group was significantly thicker than that in the injection group ( t=3.50, P=0.01). Conclusions:There are obvious morphology changes of macula in ROP children with single treatment history of laser photocoagulation or IVR, while the BCVA is not significantly affected by the treatment.
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Objective:To investigate the characteristics of polypoidal lesions and abnormal branching vascular network (BVN) in patients with polypoidal choroidal vasculopathy (PCV) by optical coherence tomography angiography (OCTA).Methods:A case series study was conducted.Untreated 45 eyes of 42 patients with initial diagnosis of PCV from May 2016 to April 2017 in Peking Union Medical College Hospital were enrolled.There were 26 males (27 eyes) and 16 females (18 eyes) with the average age of (68.59±8.52) years.All patients underwent fundus fluorescein angiography (FFA), indocyanine green angiography (ICGA) and OCTA.The OCTA image features and detection rate of polypoidal lesion and BVN were analyzed.The study protocol was approved by the Ethics Committee of Peking Union Medical College Hospital (No.S-K631). Written informed consent was obtained from each patient prior to any examination.Results:ICGA images showed obvious polyps with higper fluorescence in all PCV patients, and BVN structure was observed in the ICGA images of 38 eyes.Ring, circle, cluster or node like hyper-reflective structures were detected in polypoidal lesions in the en face OCTA images of 35 eyes, and the detection rate was 77.8% (35/45). The BVN structure was detected in the OCTA images of all the 38 eyes, with the 100% (38/38) detection rate.Conclusion:OCTA can detect polypoidal lesions and BVN of PCV non-invasively, which can locate the lesion in combination with en face image and B-scan image.
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Objective:To establish a comprehensive and effective scoring model based on ultrasonic characteristics for predicting the restenosis risk after superficial femoral artery stenting, in order to assess the possibility of in-stent restenosis and to provide guidance for the selection of therapeutic strategies.Methods:A retrospective review of a database of 328 patients (381 limbs) undergoing superficial femoral artery stents in Xuanwu Hospital, Capital Medical University from January 2016 to January 2018 was made as a modeling group.In the modeling cohort, the multivariate logistic regression analysis was performed to screen independent risk factors for in-stent restenosis. A predictive scoring model of restenosis risk was established with weighted score of independent risk factors according to the odd ratio values. Based on the best cut-off value of the receiver operating characteristic (ROC) curves, the scoring table was divided into low-risk and high-risk groups of restenosis.Results:Multivariate logistic regression analysis showed that 8 factors were included in the score system to establish the scoring model of in-stent restenosis risk prediction including calcified plaque, peak systolic velocity of popliteal artery<40 cm/s, runoff scores≥4, ankle-brachial index<0.5, female (1 point each); complicated stroke, complicated chronic renal disease, total lesion length 15.0-24.9 cm (2 points each); total lesion length≥25.0 cm (3 points), a total of 12 points in the model. The validation indicated that the scoring system had good predictive value(AUC=0.775, 95% CI=0.727-0.824, P<0.001) and goodness of fit (Hosmer-Lemeshow χ 2=4.921, P=0.766). The agreement with digital subtraction angiography(DSA) was good (Kappa value=0.609). The scoring system was further divided into the low-risk restenosis (0-5 points) and high-risk restenosis (6-12 points) according to the best cut-off value of 5.5, with a sensitivity of 68.1%, a specificity of 74.6%, and the accuracy of 72.7%. Conclusions:The superficial femoral artery in-stent restenosis risk predicting score model based on ultrasonic characteristics may accurately predict the restenosis preoperatively. It provides a theoretical basis for the precise surgical plans.
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Objective:To observe and analyze the function of intestinal barrier in patients with pouchitis, and to explore the role of nucleotide oligomerization domain 2 (NOD2) in ileal pouchitis, so as to provide new ideas for the pathogenesis of pouchitis.Methods:From January 2011 to December 2016, the clinical pathological data of patients with ileal pouch-anal anastomosis who underwent pouch mucosa biopsy at the Endoscopy Center of General Hospital of Tianjin Medical University were retrospectively analyzed. According to the disease activity index of pouchitis, patients were divided into pouchitis group (20 cases) and non-pouchitis group (30 cases). In addition, UC patients who did not undergo surgery were selected as the control group (10 cases). The intestinal structure of patients of the pouchitis group and non-pouchitis group was observed under transmission electron microscope. The positive expression rates of occludin, alpha human defensin and NOD2 in the control group, non-pouchitis group and pouchitis group were detected and calculated by immunohistochemistry. Levene test, independent sample t test and Spearman correlation analysis were used for statistical analysis. Results:Under the transmission electron microscope, the tight junction epithelial structure and microvilli of intestinal mucosal of patients in the pouchitis group were severely injured. The results of immunohistochemistry showed that the positive expression rates of occludin, alpha human defensin and NOD2 in the intestinal mucosa of patients in the pouchitis group were all lower than those of the control group and non-pouchitis groups ((19.3±0.4)% vs. (84.0±0.3)% and (77.9±0.5)%; (60.0±1.3)% vs. (85.0±0.1)% and (77.3±0.4)%; (46.1±1.6)% vs. (72.0±0.7)% and (60.7±0.5)%), and the differences were statistically significant ( t=-8.451, -7.514, -3.943, -2.970, -5.115 and -2.982, all P<0.05). The correlation analysis showed that the expression level of NOD2 was positively correlated with occludin and alpha human defensin ( r=0.671 and 0.628, both P<0.01). Conclusions:Intestinal barrier function is impaired in patients with ileal pouchitis, and NOD2-related intestinal barrier injury may play an important role in the pathogenesis of ileal pouchitis.
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Objective@#To observe the temperature changes of skin on patients with cold and dampness syndrome by using the non-contact infrared human body thermometer and infrared thermal imager to treat the patients with cold and dampness syndrome by Jin-Bohua national famous Chinese medicine practitioners using the "Mountain Burning Manipulation by Jin-Shi" method to clarify the clinical thermal effects of the "Heat-producing Needling" method.@*Methods@#This study included sixty patients with cold and dampness syndrome who met the enrollment conditionsfrom November 2015 to October 2017. In a room with fixed temperature, the patients were treated by "Heat-producing Needling" method. By using a non-contact infrared human body thermometer and infrared thermal imaging technology, this study observed the skin temperature changes in Quchi and Hegu, Zusanli and Chongyang before needling, immediately afterneedling, 15 minutes after needling, and 30 minutes after needling.@*Results@#After the "Mountain Burning Manipulation by Jin-Shi" treatment, the temperature of local skin surface at acupoints of upper and lower limbs increased with different degrees and the skin temperature reached the highest level when the needle was kept for 15 minutes. The upper limbs' result indicated that skin temperature increased with significant differences in acupuncture of Quchi point for immediately, 15 minutes and 30 minutes as compared with that before acupuncture. It was found that the skin temperature at Hegu point for 15 minutes have a significant increase than before and immediately after acupuncture. The skin temperature of Hegu point lasted 30 minutes, which was significantly higher than before and immediately after acupuncture. Compared with Hegu point, Quchi point has higher skin temperature immediately after acupuncture (t=3.793, P=0.034). The lower limbss' results indicated that skin temperature at Zusanli point increased with significant differences in Zusanli point for immediately needling, 15 minutes and 30 minutes as compared respectively with that beforeneedling. It was found that the skin temperature at Chongyang point for 15 minutes had a significant increase than before and immediately after acupuncture. The skin temperature at Chongyang point for 15 mins had a significant increase than before and immediately afterneedling. The skin temperature of Zusanli point was higher than that of Chongyang point (t=3.794, P=0.034) immediately afterneedling.@*Conclusions@#This study demonstrates that the "Mountain Burning Manipulation by Jin-Shi" method has a clear clinical thermal effect on both local and peripheral longitude of patients with cold dampness syndrome.
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Objective:To observe the temperature changes of skin on patients with cold and dampness syndrome by using the non-contact infrared human body thermometer and infrared thermal imager to treat the patients with cold and dampness syndrome by Jin-Bohua national famous Chinese medicine practitioners using the "Mountain Burning Manipulation by Jin-Shi" method to clarify the clinical thermal effects of the "Heat-producing Needling" method. Methods:This study included sixty patients with cold and dampness syndrome who met the enrollment conditionsfrom November 2015 to October 2017. In a room with fixed temperature, the patients were treated by "Heat-producing Needling" method. By using a non-contact infrared human body thermometer and infrared thermal imaging technology, this study observed the skin temperature changes in Quchi and Hegu, Zusanli and Chongyang before needling, immediately afterneedling, 15 minutes after needling, and 30 minutes after needling. Results:After the "Mountain Burning Manipulation by Jin-Shi" treatment, the temperature of local skin surface at acupoints of upper and lower limbs increased with different degrees and the skin temperature reached the highest level when the needle was kept for 15 minutes. The upper limbs' result indicated that skin temperature increased with significant differences in acupuncture of Quchi point for immediately, 15 minutes and 30 minutes as compared with that before acupuncture. It was found that the skin temperature at Hegu point for 15 minutes have a significant increase than before and immediately after acupuncture. The skin temperature of Hegu point lasted 30 minutes, which was significantly higher than before and immediately after acupuncture. Compared with Hegu point, Quchi point has higher skin temperature immediately after acupuncture ( t=3.793, P=0.034). The lower limbss' results indicated that skin temperature at Zusanli point increased with significant differences in Zusanli point for immediately needling, 15 minutes and 30 minutes as compared respectively with that beforeneedling. It was found that the skin temperature at Chongyang point for 15 minutes had a significant increase than before and immediately after acupuncture. The skin temperature at Chongyang point for 15 mins had a significant increase than before and immediately afterneedling. The skin temperature of Zusanli point was higher than that of Chongyang point ( t=3.794, P=0.034) immediately afterneedling. Conclusions:This study demonstrates that the "Mountain Burning Manipulation by Jin-Shi" method has a clear clinical thermal effect on both local and peripheral longitude of patients with cold dampness syndrome.
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Objective To evaluate the sensitivity and specificity of spectral domain optical coherence tomography (SD-OCT) for the differentiation of PCV from wet age-related macular degeneration (wAMD).Methods A cross-sectional study was conducted from Jun 2014 to Apr 2016 at Peking Union Medical College Hospital.The case series included 132 eyes of 126 patients with clinical diagnosis of PCV or wAMD.Eyes with three or more of the following SD-OCT findings were diagnosed with PCV:double layer sign,pigment epithelium detachment (PED),a sharp PED peak,a PED notch and a hyporeflective lumen representing polypoidal lesion.The sensitivity and specificity of the OCT-based diagnosis was estimated.Levels of agreement were determined by κ analyses.Results One hundred and twenty-six patients (132 eyes) with PCV or wAMD were enrolled in the study.In PCV patients,PED notch,a hyporeflective lumen representing polypoidal lesion,PED peak,double layer sign and PED were 38,35,48,40 and 46,accounting for 67.9%,62.5%,85.7%,71.4% and 82.1%,respectively.In wAMD patients,PED notch,a hyporeflective lumen representing polypoidal lesion,PED peak,double layer sign and PED were 12,3,11,8 and 26,accounting for 14.5%,10.5%,34.2%,15.8% and 3.9%,respectively,which were all lower than PCV,with statistically significant differences (all at P<0.001).SD-OCT detected PCV in 49 of 56 eyes and 10 PCV patients were misdiagnosed as wAMD.The sensitivity and specificity of SD-OCT for the differentiation of PCV from wAMD were 87.5% and 86.8%,respectively.The consistence between SD-OCT and imdocyanine green angiography (ICGA) was moderate (κ:=0.738,P<0.001).Conclusions SD-OCT exhibits high sensitivity and specificity in PCV diagnosis.The presence of DLS,PED,a sharp PED peak,a PED notch,and a hyporeflective lumen representing polypoidal lesion is suggested to be a new diagnostic strategy for PCV.
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Objective:To explore the incidence and dynamic change of apathy after minor stroke and its influence on the quality of life.Methods:One hundred and six patients with minor stroke(NIHSS≤3) were selected as the research group, one hundred and six cases with healthy physical examination were selected as control group.The apathy evaluation scale, clinician version(AES-C) scale was used to evaluate the degree of apathy after minor stroke, then the patients were divided into minor post-stroke apathy group(mPSA group) and non post-stroke apathy group(NPSA group). At 1, 3, 6, 9 and 12 months after onset, the follow-up visits were carried out and AES-C, modified Barthel index(MBI), modified Rankin scale(mRS) and stroke-specific quality of life scale(SS-QOL) were evaluated.The incidence of minor post-stroke apathy and its dynamic changes over time were analyzed, and the differences of related scales scores between the mPSA group and the NPSA group were compared.Results:The incidence of apathy in research group(35.1%) was higher than that of the control group(7.5%) ( P<0.05). The scores of MRS in the mPSA group at 1 month(1.06±0.86), 3 months(1.18±0.97), 6 months (1.09±0.85), 9 months(1.11±0.71), 12 months(1.11±0.72) after stroke were not significantly different from those in the NPSA group at 1 month(1.00±0.89), 3 months(0.95±0.83), 6 months (0.97±0.87), 9 months (1.00±0.80), 12 months(1.03±0.79) (all P>0.05). The scores of MBI in the mPSA group at 1 month (92.42±5.75), 3 months(91.32±5.81), 6 months (91.71±5.14), 9 months(91.67±4.78), 12 months (91.14±5.01) after stroke were not significantly different from those in the NPSA group at 1 month (91.97±5.79), 3 months(92.42±5.64), 6 months(92.29±5.67), 9 months(92.07±5.46), 12 months(92.12±5.35) (all P>0.05). The scores of SS-QOL in the mPSA group at 1 month (135.09±26.88), 3 months (132.71±24.91), 6 months (134.31±26.63), 9 months(135.89±24.86), 12 months (138.77±27.83) after stroke were lower than those in the NPSA group at 1 month (183.79±24.80), 3 months(183.77±24.18), 6 months (181.80±26.62), 9 months(179.86±28.92), 12 months (179.98±29.13) (all P<0.05). There were no significant differences in the incidence of mPSA at each time point of follow-up( P>0.05). Conclusion:The incidence of apathy after minor stroke is significantly higher than that of the control group, and it remains relatively stable in the first year and seriously affect the quality of patients' life.
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Objective:To evaluate the impact of runoff score on the patency of femoropopliteal artery (FPA) stent in patients with type 2 diabetes mellitus with ultrasonography.Methods:A retrospective review of a database of 127 patients with type 2 diabetes mellitus (127 limbs) undergoing femoropopliteal stents in Xuanwu Hospital from January 2016 to July 2018 was made. Demographic characteristics and possible related risk factors were recorded. The extent of FPA disease and the runoff lesions below the knee (anterior tibial artery, posterior tibial artery, and peroneal artery) were preoperative evaluated and regular followed-up by color Doppler ultrasonography (CDU). Femoropopliteal artery lesions were graded according to the Trans-Atlantic Inter-Society Consensus (TASCII), and the runoff lesions below the knee were scored according to the Society for Vascular Surgery (SVS). The patency and the predictors for in-stent restenosis were assessed using a Kaplan-Meier and Cox proportional hazards model.Results:Follow up period ranged from 1 month to 24 months.The total patency rates at the 3, 6, 12, 24 months were 91.5%, 70.9%, 45.7% and 31.7%, respectively. Post-procedural runoff score according to SVS criteria: 1-3 scores in 45 limbs, 3.5-5 scores in 37 limbs, 5.5-7 scores in 34 limbs, 7.5-10 scores in 11 limbs. The median runoff score was 4.Patients were stratified according to runoff scores (score ≤4 and >4 groups), and the difference of the patency rates between the two groups was statistically significant by Kaplan-Meier analysis and Log-rank test (χ 2=10.825, P=0.001). The runoff score affected patency significantly on COX analysis ( RR=1.155, P=0.006, 95% CI: 1.042-1.281). Conclusions:Compromised runoff negatively affects the patency of FPA stent. High post-procedural runoff score is a main risk factor related to loss of patency. CDU is a reliable method for monitoring patients with femoropopliteal stenting.
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Objective@#To evaluate the sensitivity and specificity of spectral domain optical coherence tomography (SD-OCT) for the differentiation of PCV from wet age-related macular degeneration (wAMD).@*Methods@#A cross-sectional study was conducted from Jun 2014 to Apr 2016 at Peking Union Medical College Hospital.The case series included 132 eyes of 126 patients with clinical diagnosis of PCV or wAMD.Eyes with three or more of the following SD-OCT findings were diagnosed with PCV: double layer sign, pigment epithelium detachment (PED), a sharp PED peak, a PED notch and a hyporeflective lumen representing polypoidal lesion.The sensitivity and specificity of the OCT-based diagnosis was estimated.Levels of agreement were determined by κ analyses.@*Results@#One hundred and twenty-six patients (132 eyes) with PCV or wAMD were enrolled in the study.In PCV patients, PED notch, a hyporeflective lumen representing polypoidal lesion, PED peak, double layer sign and PED were 38, 35, 48, 40 and 46, accounting for 67.9%, 62.5%, 85.7%, 71.4% and 82.1%, respectively.In wAMD patients, PED notch, a hyporeflective lumen representing polypoidal lesion, PED peak, double layer sign and PED were 12, 3, 11, 8 and 26, accounting for 14.5%, 10.5%, 34.2%, 15.8% and 3.9%, respectively, which were all lower than PCV, with statistically significant differences (all at P<0.001). SD-OCT detected PCV in 49 of 56 eyes and 10 PCV patients were misdiagnosed as wAMD.The sensitivity and specificity of SD-OCT for the differentiation of PCV from wAMD were 87.5% and 86.8%, respectively.The consistence between SD-OCT and imdocyanine green angiography (ICGA) was moderate (κ=0.738, P<0.001).@*Conclusions@#SD-OCT exhibits high sensitivity and specificity in PCV diagnosis.The presence of DLS, PED, a sharp PED peak, a PED notch, and a hyporeflective lumen representing polypoidal lesion is suggested to be a new diagnostic strategy for PCV.
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Objective To compare the effect of intensity modulated radiotherapy (IMRT) and conventional radiotherapy (CRT) combined with intracavitary brachytherapy on patients with cervical stump cancer. Methods A total of 47 patients with cervical stump cancer who were admitted to the First Hospital of China Medical University from October 2007 to September 2017 were retrospectively reviewed. Of the 47 patients, 19 patients received CRT combined with intracavitary brachytherapy (CRT group), and 28 patients received IMRT combined with intracavitary brachytherapy (IMRT group). In order to reduce the effects of selection bias and confounding factors, propensity score matching was performed to compare the groups. Results After the propensity score matching, there were 19 patients in each group. The 1-, 3-and 5-year overall survival (OS) rate for matched patients were 100.0%, 85.1% and 63.8% in IMRT group, and 84.2%, 57.9% and 42.1% in CRT group, respectively, and the difference in survival between the two groups was statistically significant (PLog-rank= 0.029, PCox= 0.043, HR= 3.723, 95%CI 1.044-13.280). The median progression-free survival (PFS) time of the IMRT group was better than that of the CRT group [median PFS time had not been reached (7-72 months) vs. 17 months (2-125 months), PLog-rank= 0.032, PCox= 0.042, HR=2.773, 95%CI 1.037-7.417]. The incidence of late rectal and bladder radiation injury was 15.8% (3/19) and 0 (0/19) in IMRT group, and 57.9% (11/19) and 26.3 %(5/19) in CRT group, respectively, and the difference was statistically significant (P= 0.017, P= 0.046). Conclusion Compared with CRT combined with intracavitary brachytherapy, IMRT combined with intracavitary brachytherapy has a better effect on patients with cervical stump cancer, and the incidence of complications is low, this method is worthy of clinical application.
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Objective To investigate the compliance of follow-up and the associated factors of diabetic retinopathy screening among diabetes patients in Muping District,Yantai City.Methods 438 diabetes patients who received free diabetic retinopathy (DR) screening in Traditional Chinese Medicine Hospital of Muping District of Yantai City from April 2012 to June 2013 were enrolled in the cross-sectional study.The re-examination rate at five years later,as well as the possible associated factors,including age,gender,height,weight,education level,occupation,past medical history,smoking and drinking habits,diabetes process,diabetes medication history,severity of DR,glycosylated hemoglobin (HbA1 c),renal functionand blood lipid were analyzed and evaluated.Results Among 438 patients,159 returned for check up five years later,with a follow-up rate of 36.3%.Further analysis revealed that follow-up rate was related to occupation types (P =0.003) and HbAlc level (P =0.006).Other factors did not show statistical significance (P > 0.05).Conclusions The compliance of DR screening visits is related to occupational type and blood glucose control.It is suggested that in the screening of DR in China,we should pay attention to the propaganda and education of diabetic patients to control blood glucose,and focus on some occupational diabetes people,such as housework workers and farmers.
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To introduce the experience of , the capital Chinese medicine master, in the differentiation of acupuncture and the treatment on trigeminal neuralgia with fire needle and filiform needle. Regarding the diagnosis of trigeminal neuralgia, Professor focuses on the coordination of meridian differentiation and differentiation. For the treatment, the fire needling technique and common filiform needling technique are used in combination. According to meridian differentiation, the acupoints are selected and stimulated with fire needle. In reference to , and blood differentiation, the treatment with filiform needles is applied. "The holistic treatment" and "seeking for the root cause of disorder" are the basic principle to be complied. When treating with filiform needle, Professor emphasizes the needling sequence, meaning stimulating the acupoints in the lower part of the body before those in the upper part of the body, aiming to eliminating the pathogens and strengthening the antipathogenic .