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1.
Journal of Clinical Hepatology ; (12): 2822-2825, 2020.
Article in Chinese | WPRIM | ID: wpr-837657

ABSTRACT

Alcoholic liver disease (ALD) is a common cause of liver dysfunction and death due to liver-related diseases, which brings great harm to human health and social development. Many factors are involved in the development and progression of ALD, such as oxidative stress, change in gut microbiota, genetic variation, autophagy inhibition, and microRNAs. This article summarizes the mechanism of action of these factors in ALD, in order to provide a basis for the treatment of ALD and the discovery of new drug targets.

2.
Article in Chinese | WPRIM | ID: wpr-871412

ABSTRACT

Objective:To evaluate the diagnostic value of endoscopic ultrasonography (EUS) in colorectal submucosal lesions, and provide evidence for clinical diagnosis and treatment strategies.Methods:A retrospective analysis was performed on data of 229 patients with colorectal submucosal lesions discovered by electronic colonoscopy and EUS. The diagnosis was confirmed by pathology. The location, type, EUS features of lesions and the coincidence rate of EUS and histopathological diagnosis were analyzed.Results:Colorectal submucosal lesions were common in the rectum (44.98%, 103/229) and ascending colon (15.28%, 35/229). Lipoma was the most common pathological type of colorectal submucosal lesions (34.93%, 80/229), which was commonly located in transverse colon (22.50%, 18/80) and ascending colon (20.00%, 16/80). Neuroendocrine tumor was the second one, accounting for 33.63% (77/229), and was commonly located in rectum (96.10%, 74/77), followed by cyst (18.78%, 43/229). Under EUS, 229 cases of lesions originated from submucosa in 215 cases, muscularis mucosa in 11 cases, and muscularis propria in 3 cases. The overall coincidence rate of EUS and pathological diagnosis was 89.08% (204/229). The coincidence rate of EUS diagnosis was 100.00% (80/80) for lipoma, 5/5 for air-cyst, 3/3 for intestinal stromal tumor, 81.82% (72/88) for neuroendocrine tumor, 89.13% (41/46) for cyst, 1/4 for leiomyoma, 2/5 for lymphangioma, and granulosa cell tumor and neurofibroma were both 0.Conclusion:EUS has a more accurate diagnosis of the origin, echogenicity and pathological properties of colorectal submucosal lesions, but it has certain limitations for the diagnosis of rare tumors such as granulosa cell tumor and neurofibroma.

3.
Article in Chinese | WPRIM | ID: wpr-805508

ABSTRACT

Objective@#To investigate the effect of genioglossus (GG) activation at sleep onset on the outcome of velopharyngeal surgery in obstructive sleep apnea hypopnea syndrome (OSAHS) patients.@*Methods@#Thirty-five patients between April 2014 and February 2015 in Beijing Tongren Hospital with OSAHS underwent overnight polysomnography with synchronous genioglossus electromyography (GGEMG) using intraoral electrodes. The upper airway (UA) anatomy was evaluated by three-dimensional computer tomography (3D-CT) in OSAHS patients. Then, all of the patients received velopharyngeal surgery, including revised uvulopalatopharyngoplasty (UPPP) with uvula preservation or UPPP combined transpalatal advancement pharyngoplasty. All patients were followed-up using polysomnography 3-6 months after surgery. T-test or Wilcoxon test were used to compare the variables between groups, and Spearman correlation analysis was used to test the correlation between parameters.@*Results@#Thirty-five patients received velopharyngeal surgery. Twenty-two patients (62.86%) were responders, and 13 patients (37.14%) were non-responders. Responders had a higher mean GGEMG during sleep onset (15.31±3.74 vs. 9.92±2.93, t=4.504, P=0.001). The decreased AHI was significantly positively related to the sleep onset mean GGEMG (r=0.541, P=0.004) and the change in GGEMG (r=0.422, P=0.028). The decreased AHI was significantly negatively related to the minimal cross sectional airway area (mCSA,ρ=0.629,P=0.000) and the minimal lateral airway dimension (mLAT, ρ=0.484, P=0.009) at velopharynx.@*Conclusions@#The outcome of velopharyngeal surgery was affected by the mean GGEMG during sleep onset. We speculated that the patient with higher GGEMG at sleep onset and narrower velopharynx were more suitable candidates for velopharyngeal surgery.

4.
Article in Chinese | WPRIM | ID: wpr-804685

ABSTRACT

Objective@#To investigated the effect of long-term low-concentration mixed benzene exposure on peripheral blood of male workers.@*Methods@#A case-control study was conducted to select 452 male workers exposed to mixed benzene (benzene, toluene, xylene) for five consecutive years from January 2012 to December 2016 in an automobile manufacturer as case group, and 438 male administrative and logistic managers who underwent physical examination during the same period as control group. The peripheral blood of the two groups was tested and compared, and the occupational hazards in the workplace were detected.@*Results@#There were low dose exposure to mixed benzene in the enterprise, but the test results met the occupational exposure limit requirements. During the five years from 2010 to 2016, between the two groups of workers, the mean values of WBC, NEUT, RBC and Hb were statistically different (P<0.05). There was no statistical difference (P>0.05) in the mean value of PLT. The abnormal rate of main peripheral blood indexes in the control group was higher than that in the exposed group. There were significant differences in NEUT, RBC and Hb (P< 0.05), but no significant differences in WBC and PLT (P>0.05).@*Conclusion@#It can not be concluded that long-term low-concentration mixed benzene exposure can cause the change of peripheral blood index.

5.
Article in Chinese | WPRIM | ID: wpr-802761

ABSTRACT

Objective@#To summarize the nursing experience of postoperative infection of hip joint replacement combined with gaucher′s disease.@*Methods@#According to the characteristics of the disease, nursing intervention and symptomatic treatment were given, including infection control, nursing of complications, nursing of joint puncture, medical treatment and nursing, and strengthening psychological nursing and safety nursing.@*Results@#Through targeted nursing, the patient′s infection was controlled, the condition was stable, the symptoms were relieved, and the patient was discharged.@*Conclusions@#In view of the patient′s condition, the development and implementation of comprehensive and integrated targeted nursing measures can effectively reduce the complications, alleviate the progress of the disease, improve the understanding of gaucher′s disease and the quality and effect of the disease nursing.

6.
Article in Chinese | WPRIM | ID: wpr-796413

ABSTRACT

Objective@#To understand the prevalence of gynecologic diseases among married female workers.@*Methods@#The data of married female workers who underwent occupational health examination in a physical examination center from January to December 2017 were collected. The relationship between the detection of common gynecological diseases, age and occupational types examined by gynecological routine, TCT, breast B-mode ultrasound, uterus and appendix B-mode ultrasound were analyzed.@*Results@#Among the 1142 female workers, the total detection rate of reproductive tract infections was 67.25% (768/1142), the total detection rate of breast-related diseases was 75.22% (859/1142) ; the total detection rate of gynecological tumors and benign lesions was 14.71% (168/1142). The detection rate of breast hyperplasia was the highest 67.08% (766/1142), followed by vaginitis 51.66% (590/1142). Among the abnormalities detected in breast-related diseases, gynecological tumors and benign lesions, the highest detection rate was found in public institutions (85.66% and 27.13%), and the lowest was found in factory workers (70.24% and 7.89%). With the increase of age, the detection rate of breastrelated diseases (breast hyperplasia, breast cyst), gynecological tumors, benign lesions (uterine myoma), and Nessler's cyst abnormalities in married female workers increased (χ2trend=7.647、21.653、107.411、53.802, P<0.05), while the detection rate of columnar epithelium of cervix decreased (χ2trend=7.404, P<0.05). There was no significant difference in the total detection rate of reproductive tract infectious diseases (vaginitis, cervical polyps, cervical hypertrophy) among married famale workers of different ages (P<0.05) .@*Conclusion@#The common gynecological diseases of married female workers are affected by many factors such as age and occupation. Health examination and health education should be carried out regularly to reduce the incidence of gynecological diseases among female workers according to different ages and occupations.

7.
Article in Chinese | WPRIM | ID: wpr-745477

ABSTRACT

Objective To analyze the relationship between onset of myocardial infarction(MI)to bivalent antibiotics therapy and outcome in elderly female MI patients.Methods One hundred and fourteen elderly MI patients admitted to our hospital from January 2016to January 2018were divided intoΔT≤188min group(n=57)andΔT>188min group(n=57)according to the onset of MI to bivalent antibiotics therapy.The major adverse cardiac events(MACE),arrhythmia,angina pectoris,heart failure and death were compared between the two groups.Results MACE occurred in 44out of the 144MI patients included in this study.Of the 44MI patients,17died,6 were diagnosed with arrhythmia,16were diagnosed with angina pectoris,5were diagnosed with heart failure.The incidence of arrhythmia,heart failure and the mortality were significantly higher while the incidence of angina pectoris was significantly lower inΔT≤188min group than inΔT> 188min group(7.0%vs 3.5%,7.0%vs 1.8%,15.8%vs 14.0%,7.0%vs 21.1%,P<0.05).Age,diabetes,ΔT,hyperlipidemia,hypertension and coronary artery disease were the independent influencing factors for the poor outcome in MI patients(P<0.05,P<0.01).Conclusion TheΔT should be shortened,the MI patients should be timely treated,the criminal blood vessels should be opened,and the ischemic myocardium should be saved in order to prevent the occurrence of severe cardiovascular events and reduce the mortality in elderly MI patients.

8.
Chinese Journal of Geriatrics ; (12): 631-634, 2019.
Article in Chinese | WPRIM | ID: wpr-755379

ABSTRACT

Objective To explore the correlation between depressive symptoms and frailty,in order to provide evidence for prevention and relief of depressive symptoms in elderly inpatients.Methods A cross-sectional survey and comprehensive geriatric assessment(CGA)were conducted with 248 eligible elderly inpatients from December 2015 to February 2017 in our hospital.Depressive symptoms were assessed by the 5-Item Geriatric Depression Scale(GDS-5),and frailty was identified by the frailty phenotype method.Results In all respondents,50 (20.2 %)patients showed depressive symptoms,93(37.5 %)patients had pre-frailty and 39 (15.7 %)patients had frailty.Correlation analysis showed that frailty degree,low grip strength,slow gait speed,low physical activity,fatigue,and weakness were all positively correlated with depressive symptoms in elderly inpatients (r =0.441,0.315,0.426,0.316,0.395 and 0.151,respectively,P < 0.05).Logistic regression analysis showed that patients who had more severe frailty faced a much higher risk of developing depressive symptoms (OR=2.608,P<0.05).Of the 5 indicators of frailty,slow gait speed and frailty also increased the risk of having depressive symptoms (OR =2.801 and 3.484,P < 0.05).Conclusions Frailty degree,gait speed and fatigue are associated with increased risk of depression in the elderly.Depressive symptoms can be reduced in elderly inpatients with prevention and intervention of pre-frailty and frailty.

9.
Article in Chinese | WPRIM | ID: wpr-752604

ABSTRACT

Objective To summarize the nursing experience of postoperative infection of hip joint replacement combined with gaucher′s disease. Methods According to the characteristics of the disease, nursing intervention and symptomatic treatment were given, including infection control, nursing of complications, nursing of joint puncture, medical treatment and nursing, and strengthening psychological nursing and safety nursing. Results Through targeted nursing, the patient′s infection was controlled, the condition was stable, the symptoms were relieved, and the patient was discharged. Conclusions In view of the patient′s condition, the development and implementation of comprehensive and integrated targeted nursing measures can effectively reduce the complications, alleviate the progress of the disease, improve the understanding of gaucher′s disease and the quality and effect of the disease nursing.

10.
China Occupational Medicine ; (6): 345-348, 2019.
Article in Chinese | WPRIM | ID: wpr-881803

ABSTRACT

OBJECTIVE: To explore the 2014 edition of the diagnostic criteria of occupational noise-induced deafness on the assessment of hearing loss in occupational health examination. METHODS: A total of 835 noise-exposed workers were selected as study subjects by cluster sampling method. The hearing threshold results were compared through two different editions of criteria: GBZ 49-2007 Diagnostic Criteria of Occupational Noise-induced Deafness( GBZ 49-2007) and GBZ 49-2014 Diagnosis of Occupational Boise-induced Deafness( GBZ 49-2014). RESULTS: The binaural high frequency threshold average calculated by GBZ 49-2007 was lower than that of GBZ 49-2014 [( 46. 8 ± 8. 1) vs( 49. 2 ± 8. 0) d B,P < 0. 01].The speech frequency threshold average of the good ear calculated by GBZ 49-2007 was lower than the monaural threshold of weighted value of the good ear of GBZ 49-2014 [( 18. 8 ± 3. 6) vs( 22. 0 ± 3. 3),P < 0. 01]. The speech frequency threshold average of the good ear and the monaural threshold of weighted value of the good ear calculated after age and sex correction using GBZ 49-2007 were lower than that calculated by using GBZ 49-2014 [( 18. 8 ± 3. 6) vs( 19. 4 ± 3. 6),( 21. 5 ±3. 4) vs( 22.0 ±3.3),P <0.05]. The detection rate of suspected occupational noise-induced deafness GBZ 49-2014 was higher than that of GBZ 49-2007( 6. 35% vs 2. 87%,P < 0. 01). CONCLUSION: In occupational health examination,the diagnostic criteria of GBZ 49-2014 can diagnose patients as suspected occupational noise-induced deafness easier than that of GBZ 49-2007.

11.
China Pharmacy ; (12): 523-527, 2019.
Article in Chinese | WPRIM | ID: wpr-817099

ABSTRACT

OBJECTIVE: To screen and characterize effective components of immunopotentiating activity in Senecionis cannabifolii Herba. METHODS: The polysaccharide components were obtained by water extraction and alcohol precipitation method to yield 50% alcohol precipitation sample (SCHE-1) and 80% alcohol precipitation sample (SCHE-2). The cells from mice mononuclear macrophage line RAW264.7 were divided into blank group (medium without serum), negative control group (medium with serum), lipopolysaccharide group (LPS, positive control drug, 1 μg/mL), SCHE-1 and SCHE-2 low-dose and high-dose groups (0.5, 1 mg/mL). The cell viability of RAW264.7 cells was detected by MTT assay. The levels of IL-1β, IL-6 and TNF-α in RAW264.7 were detected by ELISA. These were used to investigate the effects of SCHE-1 and SCHE-2 on the immunological enhancing activity of RAW264.7 cells. The molecular weight and distribution of SCHE-1 were determined by size exclusion chromatography; the monosaccharide composition of SCHE-1 was determined by HPLC pre-column derivatization. Methylation analysis of SCHE-1 was conducted by NaOH method. RESULTS: Compared with negative control group, the activity of RAW264.7 cells was enhanced significantly in SCHE-1 groups and LPS group, which also significantly increased the levels of IL-1β, IL-6 and TNF-α in cell culture fluids (P<0.01). SCHE-1 was an effective component with immunopotentiating activity. The neutral sugar content of SCHE-1 was 40.05%, the uronic acid was 35.62%, and the protein was 8.89%. SCHE-1 was a mixture, molecular weight of which was 62-6 119 Da; monosaccharide was mainly composed of galacturonic acid, arabinose (Ara) and galactose (Gal). The results of methylation analysis showed that the backbone was composed of 1→3, 1→4 and 1→6 linked Gal, and branches were on the O-6 position of the 1→3 linked Gal, and the non-reducing terminals were Ara. CONCLUSIONS: SCHE-1 may be the effective component of immuno potentiating activity, and main component of SCHE-1 is polysaccharide. SCHE-1 may regulate the immune function by activating macrophages to release IL-1β, IL-6 and TNF-α.

12.
Journal of Jilin University(Medicine Edition) ; (6): 275-280,后插1-后插2, 2018.
Article in Chinese | WPRIM | ID: wpr-691563

ABSTRACT

Objective:To observe the morphological features of liver injury induced by hydrodynamic injection, and to explore the procedure and mechanism of liver repair. Methods:Twenty-five female Balb/c mice were intravenously injected with large volume of saline solution(1.8-2.0 mL)in 3 s. The mice were divided into 30 min,8 h,1 d,3 d,and 7 d groups according to the post-injection time.Each group contained 5 mice.Six non-injected mice were used as control group.The blood samples from angular vein of the mice were collected to detect the levels of alanine transaminase(ALT).The morphological features of liver tissue of the mice in various groups were observed with HE staining.The proliferating cell nuclear antigen(PCNA)protein expressions in liver tissue of the mice in various groups were detected by immunohistochemical saining.The expression levels of tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),epidermal growth factor(EGF),hepatocyte growth factor (HGF),transforming growth factor-α(TGF-α),Cyclin D1,vascular endothelial growth factor(VEGF),Bax and Bcl-2 mRNA were determined by Real-time PCR.Results:Compared with control group,the ratio of liver weight/original body weight in 8 h group was significantly decreased(P<0.05),but there was no significant difference in 7 d group(P>0.05).Compared with control group,the serum ALT level in 1 d group was significantly elevated (P<0.01),but there was no significant difference in 7 d group(P>0.05).Compared with control group,the liver tissue of the mice in 30 min group showed hepatocyte swollen and small hemorrhagic area,and the number of hepatocytes per high power field was significantly declined(q=4.760,P<0.05)under microscope.Compared with 30 min group,the number of swollen cells was decreased in 8 h group,the hemorrhagic and necrotic area enlarged, both of the hepatocyte number and binuclear hepatocyte number per high power field were significantly increased (q=7.310,P<0.01;q=7.200,P<0.01).Compared with 8 h group,the hemorrhagic and necrotic areas in 1 d group were reduced,both of the hepatocyte number and binuclear hepatocyte number per high power field were significantly decreased(q=4.966,P<0.05;q=6.596,P<0.01);there were no significant differences compared with control group(P>0.05).The hemorrhagic and necrotic areas almost disappeared in 3 d group.The histological appearance of liver tissue of the mice in 7 d group was same as control group.Compared with control group,the PCNA indexes in hepatocytes in 8 h and 1 d groups were significantly increased(t=4.458,P<0.01;t=15.557,P<0.01);there was no significant difference in 7 d group(P>0.05).Compared with control group, the PCNA index in cholangiocytes in 30 min group was increased significantly(t=3.985,P<0.01);there was no significant difference in 7 d group(P>0.05).The mRNA expression levels of TNF-α,IL-6,EGF,and VEGF in liver tissue of the mice in 30 min group were significantly higher than those in 8 h group(q=4.952,P<0.05;q=14.750,P<0.01;q=14.750,P<0.01;q=13.551,P<0.01).The HGF mRNA expression level in liver tissue of the mice in 3 d group was significantly higher than those in 30 min group and 8 h group(q=5.031,P<0.05;q=4.631,P<0.05).The TGF-αmRNA expression levels in liver tissue of the mice in 8 h group and 1 d group were higher than that in 30 min group(q=4.592,P<0.05;q=8.137,P<0.01).The Cyclin D1 mRNA expression levels in liver tissue of the mice in 8 h group and 1 d group were higher than that in 7 d group(q=4.736, q=5.213,P<0.05).The Bax/Bcl-2 ratio of the mice in 1 d group was higher than that in 30 min group(q=5.731,P<0.01).Conclusion:Acute liver injury induced by hydrodynamic injection mainly shows the hepatocyte swelling and hemorrhagic necrosis.The injury could be repaired naturally in a week.The various cytokines and growth factors related with liver regeneration are involved in the repair procedure.

13.
Article in Chinese | WPRIM | ID: wpr-751452

ABSTRACT

OBJECTIVE We hypothesized that unstable ventilatory control(high loop gain, LG) could predict the short-term efficacy of positive airway pressure therapy in patients with obstructive sleep apnea(OSA). METHODS 42 adult patients with OSA, M/F=39/3, were studied. The stability of the ventilatory control system(LG) was quantified by fitting a simplified mathematical model to the spontaneous ventilatory pattern obtained via polysomnography. LG, pulmonary function test results, and other PSG parameters were analyzed in patients who had post-treatment AHI≥10 events/hr(non-responders) using auto-positive airway pressure therapy. RESULTS The subjects aged(40±8) years, apnea-hypopnea index(AHI) were 68.2[42.9,81.0]events/hr). Nine patients(34.6%) were non-responders. Twenty pat ients(47.6%) had residual AHI<5 events/hr. Loop gain and pre-treatment mixed apnea index were higher in the non-responders versus responders(0.74 [0.62, 0.82] vs 0.49[0.37, 0.77], P =0.035) and(11.0[4.3, 22.9] vs 2.0[0.2, 5.3], P =0.004). In the 26 patients with LG>0.6, nine(34.9%) had posttreatment 5 events/hr≤AHI<10 events/hr. And all of the non-responders had LG(n=9, 34.9%). The difference was signif icant between the LG>0.6 a nd LG<0.6 group(P =0.007). CONCLUSION Loop gain and mixed apnea index was higher in patients with residual AHI>10 events/hr after short-term auto-PAP therapy. Ventilatory control stability evaluation might have predictive value for PAP treatment efficacy in OSA patients.

14.
China Occupational Medicine ; (6): 329-334, 2018.
Article in Chinese | WPRIM | ID: wpr-881702

ABSTRACT

OBJECTIVE: To investigate the prevalence of chronic diseases and main influencing factors in workers under high-temperature in a port of Guangzhou City.METHODS: A total of 5 603 workers under high-temperature operation condition were selected by judgment sampling method.The occupational health examination results were collected to analyze the prevalence of chronic diseases and the related influencing factors.RESULTS: The prevalence of chronic diseases was 67.6%.The prevalence rates of hyperlipidemia,hyperuricemia,hypertension and diabetes were 51.8%,29.3%,14.0% and 10.2%,respectively.Multivariate logistic regression analysis indicated that the risks of hyperlipidemia,hyperuricemia and hypertension in male workers were higher than that of female workers( P < 0.05).The prevalence risk of hyperlipidemia,hypertension and diabetes increased with the increase age( P < 0.01).With the increase of the length of high-temperature operation,the risk of hyperlipidemia,hyperuricemia and hypertension increased( P < 0.01).The risk of hypertension in regular smokers was higher than that of non-smokers( P < 0.05).The less exercise,the higher risk of hypertension and diabetes( P < 0.01).CONCLUSION: The prevalence of chronic diseases is high in workers exposed to high-temperature.The gender,age,length of high-temperature operation,smoking and exercise were the major influencing factors of chronic diseases in the workers.

15.
Article in Chinese | WPRIM | ID: wpr-810107

ABSTRACT

Objective@#To investigate the expression of marker proteins in vocal cord leukoplakia, and to find markers for the early stage of diagnosis and prognosis of precancerous lesions.@*Methods@#The study included 119 cases, 68 cases of vocal cord leukoplakia (22 cases with epithelial simple hyperplasia, 46 cases with epithelial dysplasia), and 51 cases of vocal cords benign lesions(31 cases of vocal cord polyps, 20 cases of Reinke′s edema). The expression of p53, Ki-67, p21, Survivin, p16, p27, PTEN, c-Myc and vascular endothelial growth factor (VEGF) in vocal cords leukoplakia were detected, vocal cord benign lesions (vocal cord polyps and Reinke′s edema) acted as controls, comparing the expression differences of different pathological tissue. Data was analyzed by SPSS 22.0 software.@*Results@#The expression of p53, p16, Ki-67, VEGF in vocal cord benign lesions and vocal cords leukoplakia with epithelial simple hyperplasia did not show significant differences. There was a grading increase in the positive expression of p53, Ki-67 in the vocal cord leukoplakia with epithelial dysplasia contrasting to those in vocal cord benign lesions and vocal cords leukoplakia with epithelial simple hyperplasia (p53: χ2=13.340, P=0.002, Ki-67: χ2=53.386, P=0.000). The expression of p27, PTEN, c-Myc in vocal cord benign lesions and vocal cords leukoplakia with epithelial dysplasia did not show significant differences. There was a grading increase in the positive expression of p21 Survivin in vocal cords leukoplakia with epithelial dysplasia contrasting to those in vocal cord benign lesions (P<0.05). Expression of Survivin in vocal cords leukoplakia with mild-moderate epithelial dysplasia showed a significant increase than those in vocal cord benign lesions (P<0.05). The positive expression grade of p21 showed a rising trend (P=0.073) between the different grades of dysplasia.@*Conclusion@#The positive expression grade of p53, Ki-67, p21 Survivin showed an increase in vocal cords leukoplakia with epithelial dysplasia contrasting to those in vocal cord benign lesions, which might be an implication for evaluating the diagnosis and prognosis of precancerous lesions. Expression of p21 was correlated to the degrees of dysplasia and expression of Survivin showed a significant difference in early stage of epithelial dysplasia contrasting to benign lesions.

16.
Article in Chinese | WPRIM | ID: wpr-810025

ABSTRACT

Objective@#To investigate the sleep-related deglutition in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS) and its correlation with sleep stage and cortical arousals. @*Methods@#From December 2015 to September 2017, simultaneous polysomnography and pharyngeal pressure monitoring were performed in 23 adult patients with OSAHS, Mann-Whitney U test were employed to analyze the following parameters: (1) the relationship between arousal and deglutition; (2) the effect of sleep stage on deglutition; (3) The relationship between the frequency of deglutition and the severity of OSAHS. @*Results@#The subjects in this study aged (43±12) years, and the mean apnea-hypopnea index (AHI) was (49.2±27.7) times/hour. A total of 1 382 deglutition were recorded during sleep, with a median of 9.2[5.8, 13.8]times/person. There was a positive correlation between deglutition frequency and AHI(r=0.570, P=0.005) and negatively correlated with oxygen saturation (r=-0.639, P=0.001). The majority of the deglutition (73.7%) occurred after the respiratory event and in association with respiratory arousal. Deglutition occurred more in Non-rapid eye movement sleep stage 1 (N1) than N2, N3 and REM sleep (Z=-3.680, P<0.001; Z=-2.746, P=0.006; Z=- 3.490, P<0.001). @*Conclusions@#The occurrence of deglutition in patients with OSAHS is associated with cortical arousals. Deglutition frequency increased with the severity of apnea and affected by sleep staging.

17.
Article in Chinese | WPRIM | ID: wpr-733743

ABSTRACT

Objective To investigate the effect and feasibility of problem-based learning teaching model in case discussion and its influence on the cultivation of medical students' practical ability in primary hospitals under the guidance of the synergy of medical education. Methods Interns from this hospital of the year 2017 were chosen as subjects. Those who were organized by science and teaching department with PBL model in case discussion were observation group, while those who were organized in traditional case discussion by clinical departments were control group. Questionnaires were filled in and effects between two groups were compared. Results In both the cognitive and affective domain, PBL teaching group scored higher compared with traditional teaching group (P=0.000). Conclusion Under the current situation, carry-ing out PBL teaching model has certain feasibility and practical significance in primary hospitals and is more suitable for the development of medical cooperation between colleges and hospitals.

18.
Article in Chinese | WPRIM | ID: wpr-809412

ABSTRACT

Objective@#Juvenile on-set recurrent respiratory papillomatosis (JORRP) can be an aggressive and potentially life-threatening disease. To emphasize the importance of complication prevention in local excision surgery, the single-center experience of RRP treatment in a group of patients with relatively short recurrence-free-interval (>4 times/yrs) was reported.@*Methods@#Data of 49 patients underwent papilloma resection during 2002-2013 were retrospectively analyzed. Combined techniques of laser microsurgery and microdebriders were used to remove papillomas, prevent the formation of scar tissue and improve respiratory distress. Forty-nine cases were followed up for 99.0[74.5; 121.0]months, ranging from 39 to 185 months. The age of disease onset was 2[1; 3] years old. Most of the patients had difficulty in breathing(42 of 49 cases). Seven patients had hoarseness.53.0% patients had subglottic or trachea papillomatosis spreading. The rate of complications, synechia formation, tracheal stenosis, needing for tracheostomy, mortality was recorded. Patients were followed up for at least three years. The characteristics of the patients, improvement in symptoms, recurrence-free interval, and the rate of tracheal extubation were evaluated. Wilcoxon signed ranks test and chi-square test were used for data comparation.@*Results@#Long-term relieve in disease(≤2 surgeries were needed/year) were achieved in 29(59.1%) subjects, in which 8(16.3%) of the subjects did not need surgical treatment for at least 3 years. Long-term relieve had been achieved in 25 of subjects who did not accept tracheostomy. Seven subjects did not need surgical treatment for at least 3 years. The rate of successful tracheal extubation was 53.8% in 13 patients who had undergone tracheostomy. Three cases dead of intrapulmonary spread.@*Conclusions@#Combined techniques of laser microsurgery and microdebriders are effective in improvement in both respiratory distress and voice quality. The combined technique are helpful to avoid inevitable long-term stenotic complications, ultimately affecting the quality of life.

19.
Article in Chinese | WPRIM | ID: wpr-670277

ABSTRACT

Objective To evaluate the antidepressant efficacy and adverse reactions of 3 different stimulus dosage of modified electroconvulsive therapy ( MECT) in patients with depressive episode. Methods 120 patients with depressive episode were randomized into low dosage group ( n=40) ,medium dosage group ( n=40) and high dosage group ( n=40) . Low dosage were 50%× age,medium dosage was 70%×age,high dosage was 80%×age . All patients received 6 treatments. Hamilton depression scale?17(HAMD?17) was used to evaluate the clinical symptoms at baseline,3 and 6 treatments. Effects and adverse reactions were compared among three groups.Results Compared with baseline the HAMD?17 scores of the 3 groups were significantly improved after 6 treatments( t=24.026, P=0.000;t=26.541, P=0.000;t=25.904, P=0.000) , but there were no statistically significant differences among the three dosage groups(F=0.409, P=0.665). Compared with low dosage group((27.2±5.4)%),the HAMD?17 scores reductive ratio of medium dosage group((34.3±6.8)%) and high dosage group((33.9±6.9)%)) were significantly improved after 3 treat?ments ( t=-5.513, P=0.000;t=-4.785, P=0.000). Compared with the low dosage group,the incidence rate of headache,nausea and vomiting,delirium were significantly higher in high dosage groups( headache:χ2=14.532, P=0.000;nausea and vomiting:χ2=13.333, P=0.000;delirium:χ2=14.907, P=0.000) . The re?covery time was significantly longer in medium dosage group ( ( 10. 5 ± 1. 6 ) min ) and high dosage group ((11.2±1.8)min) than that in low dosage group((8.8±1.2)min)( t=-5.144,=0.000;t=-6.889, P=0.000).Conclusion Different stimulus dosage of MECT for depressive episode has equivalent curative effect after 6 treatment . Medium dosage and high dosage treatments appear to have an early onset of efficacy,but may also be associated with more adverse reactions.

20.
Tianjin Medical Journal ; (12): 518-521, 2016.
Article in Chinese | WPRIM | ID: wpr-492440

ABSTRACT

Objective To evaluate the curative efficacy of endoscopic retrograde cholangiopancreatography (ERCP) on bile leaks after orthotopic liver transplantation (OLT). Methods Data of 12 cases, hospitalized in our hospital from March 2013 to February 2016, with bile leaks after OLT confirmed by magnetic resonance imaging of the pancreas (MRCP) or ERCP were retrospectively analyzed . The curative efficacy of ERCP was evaluated including clinical symptoms of bile leaks and complications, occurrence time and location, diagnosis and treatment process and efficacy. Results In this study, 12 cases were male patients, with the average age of 49.75 ± 8.55 (age from 35 to 62 years old). Among them 11 cases were successfully treated by endoscopic nasobiliary drainage (ENBD), and the success rate of endoscopical therapy was 91.7%, the curative rate of bile leaks was 91.7%(11/12). No ERCP related serious complications and death were found in patients. Nine cases combined with biliary strictures and/or biliary duct stone/bile plug were performed endoscopic sphinctrotomy (EST) during the first time of ERCP, and accepted further ERCP treatment after 2 weeks when the bile leaks were healed. All patients with ENBD were carried out well except one case. Conclusion ERCP is a safe and effective minimally invasive treatment method for different types of bile leaks after OLT.

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