RESUMO
Objective:To search, evaluate and summarize the best evidence summary of perioperative accelerated rehabilitation nursing for patients undergoing hip and knee arthroplasty, so as to provide reference for clinical perioperative nursing.Methods:Evidence-based nursing methods were used to search for relevant databases such as BMJ Best Practice, UpToDate, PubMed, CINAHL, and CNKI, etc.. The search period was from December 2010 to December 2022. Four researchers independently evaluated the quality of the guidelines, and two researchers independently evaluated the quality of expert consensus and system evaluation. Finally, the included literature was summarized.Results:A total of 12 pieces of literature, 3 guidelines, 5 expert consensus and 4 systematic reviews were included. From 13 aspects of preoperative education, preoperative optimization, anesthesia management, perioperative blood management, perioperative pain management, perioperative fluid management, perioperative temperature protection, infection prevention, thrombus prevention, postoperative nausea and vomiting, postoperative drainage, functional exercise, and perioperative rehabilitation promotion, 35 pieces of the best evidence for hip and knee replacement patients to accelerate rehabilitation nursing in the perioperative period was summarized.Conclusions:This study summarizes the best evidence of accelerated rehabilitation nursing in the perioperative period of hip and knee arthroplasty, aiming to build and standardize the accelerated rehabilitation nursing scheme in the perioperative period of hip and knee arthroplasty, so as to provide reference for clinical perioperative nursing.
RESUMO
Objectives:To evaluate the tricuspid valve(TV)geometric remodeling in patients with idiopathic pulmonary arterial hypertension(IPAH)by three-dimensional transthoracic echocardiography. Methods:Two-dimensional and three-dimensional transthoracic echocardiography were performed in 30 IPAH patients and 15 healthy controls,and the geometry parameters of TV were obtained by four-dimensional auto tricuspid valve quantitative(4D Auto-TVQ)in the right ventricular-focused apical view.Pulmonary arterial hypertension was determined by right heart catheterization within 48 hours of echocardiography. Results:The 4-chamber diameter,tricuspid annular(TA)perimeter,TA area,maximal tenting height,coaptation point height and tenting volume were larger in IPAH patients than those in healthy controls(all P<0.05),2-chamber diameter was similar between two groups.In IPAH group,maximal tenting height and coaptation point height were moderately correlated with right ventricular end-diastolic volume(r=0.710,r=0.515,both P<0.05),while TA perimeter,4-chamber diameter and TA area were moderately correlated with right atrial end-systolic volume(r=0.712,r=0.558,r=0.545,all P<0.05). Conclusions:IPAH patients have larger maximal tenting height,coaptation point height and tenting volume,TA enlargement is mainly visible in 4-chamber diameter.TV tenting height is associated with right ventricular volume,but TA size is associated with right atrial volume in IPAH patients.
RESUMO
OBJECTIVE@#To investigate the expression level and the diagnostic value of serum free light chain in B-cell non-Hodgkin's lymphoma (B-NHL).@*METHODS@#We retrospectively analyzed the results of serum free light chain (sFLC) of 394 newly treated B-NHL patients in our hospital from January 2014 to December 2021 and compared the secretion levels of sFLC among different subtypes of B-NHL. The value of sFLC secretion levels in the diagnosis of WM was evaluated using ROC.@*RESULTS@#Increased proportion of sFLC, abnormal ratio of sFLC (κ / λ) and the secretion levels of sFLC (κ+λ) were different in different B-NHL subtypes, Waldenstrom's macroglobulinemia (WM) had the highest proportion of elevated sFLC(82.68%) and abnormal sFLC(κ/ λ)(87.0%), the proportion of FL(18.0%) and DLBCL patients(12.8%) with elevated sFLC was lower (P<0.05). The expression levels of sFLC can helpful in the diagnosis of WM (AUC=0.874,P<0.001, 95% CI: 0.779-0.970). At the same time, higher sFLC levels and sFLC cloning patterns predicted the possibility of bone marrow infiltration of lymphoma.@*CONCLUSION@#The serum free light chains is common in patients with B-NHL. The elevated level and type of free light chain are associated with the type of lymphoma, and the patients with bone marrow infiltration have higher sFLC(κ+ λ) expression level.
Assuntos
Humanos , Estudos Retrospectivos , Cadeias Leves de Imunoglobulina , Linfoma de Células B/diagnósticoRESUMO
The infection of Hepatitis B virus (HBV) can result in severe consequences, including chronic hepatitis, liver fibrosis, cirrhosis, and even liver cancer. Effective antiviral treatment has the potential to slow down the progression of the disease. HBV serum biomarkers play a crucial role in the dynamic management of chronic hepatitis B (CHB) patients. However, the conventional hepatitis B virus markers, such as hepatitis B serologic testing and HBV DNA, are insufficient to meet the clinical requirements. This review provided a comprehensive overview of the current research on the quantification of HBsAg and anti-HBc, HBV RNA and HBV core-associated antigen, which summarized the crucial role these markers play in the administration of antiviral medications, predicting the efficacy of treatment and anticipating the likelihood of virologic rebound following drug cessation, as well as assessing disease progression in CHB patients.
Assuntos
Humanos , Vírus da Hepatite B/genética , Relevância Clínica , Hepatite B Crônica/tratamento farmacológico , Antígenos do Núcleo do Vírus da Hepatite B/uso terapêutico , Biomarcadores , Cirrose Hepática/tratamento farmacológico , Antivirais/uso terapêutico , Antígenos de Superfície da Hepatite B/uso terapêutico , DNA Viral/uso terapêutico , Antígenos E da Hepatite B/uso terapêutico , Hepatite B/tratamento farmacológicoRESUMO
Objective: To compare clinical efficacy between laparoscopic radical proximal gastrectomy with double-tract reconstruction (LPG-DTR) and laparoscopic radical total gastrectomy with Roux-en-Y reconstruction (LTG-RY) in patients with early upper gastric cancer, and to provide a reference for the selection of surgical methods in early upper gastric cancer. Methods: A retrospective cohort study method was carried out. Clinical data of 80 patients with early upper gastric cancer who underwent LPG-DTR or LTG-RY by the same surgical team at the Department of General Surgery, the First Affiliated Hospital of Xi'an Jiaotong University from January 2018 to January 2021 were retrospectively analyzed. Patients were divided into the DTR group (32 cases) and R-Y group (48 cases) according to surgical procedures and digestive tract reconstruction methods. Surgical and pathological characteristics, postoperative complications (short-term complications within 30 days after surgery and long-term complications after postoperative 30 days), survival time and nutritinal status were compared between the two groups. For nutritional status, reduction rate was used to represent the changes in total protein, albumin, total cholesterol, body mass, hemoglobin and vitamin B12 levels at postoperative 1-year and 2-year. Non-normally distributed continuous data were presented as median (interquartile range), and the Mann-Whitney U test was used for comparison between groups. The χ(2) test or Fisher's exact test was used for comparison of data between groups. The Mann-Whitney U test was used to compare the ranked data between groups. The survival rate was calculated by Kaplan-Meier method categorical, and compared by using the log-rank test. Results: There were no statistically significant differences in baseline data betweeen the two groups, except that patients in the R-Y group were oldere and had larger tumor. Patients of both groups successfully completed the operation without conversion to laparotomy, combined organ resection, or perioperative death. There were no significant differences in the distance from proximal resection margin to superior margin of tumor, postoperative hospital stay, time to flatus and food-taking, hospitalization cost, short- and long-term complications between the two groups (all P>0.05). Compared with the R-Y group, the DTR group had shorter distal margins [(3.2±0.5) cm vs. (11.7±2.0) cm, t=-23.033, P<0.001], longer surgery time [232.5 (63.7) minutes vs. 185.0 (63.0) minutes, Z=-3.238, P=0.001], longer anastomosis time [62.5 (17.5) minutes vs. 40.0 (10.0) minutes, Z=-6.321, P<0.001], less intraoperative blood loss [(138.1±51.6) ml vs. (184.3±62.1) ml, t=-3.477, P=0.001], with significant differences (all P<0.05). The median follow-up of the whole group was 18 months, and the 2-year cancer-specific survival rate was 97.5%, with 100% in the DTR group and 95.8% in the R-Y group (P=0.373). Compared with R-Y group at postoperative 1 year, the reduction rate of weight, hemoglobin and vitamin B12 were lower in DTR group with significant differences (all P<0.05); at postoperative 2-year, the reduction rate of vitamin B12 was still lower with significant differences (P<0.001), but the reduction rates of total protein, albumin, total cholesterol, body weight and hemoglobin were similar between the two groups (all P>0.05). Conclusions: LPG-DTR is safe and feasible in the treatment of early upper gastric cancer. The short-term postoperative nutritional status and long-term vitamin B12 levels of patients undergoing LPG-DTR are superior to those undergoing LTG-RY.
Assuntos
Humanos , Albuminas , Anastomose em-Y de Roux/efeitos adversos , Colesterol , Gastrectomia/métodos , Hemoglobinas , Laparoscopia/métodos , Complicações Pós-Operatórias/etiologia , Estudos Retrospectivos , Neoplasias Gástricas/patologia , Resultado do Tratamento , Vitamina B 12RESUMO
Objective:To investigate the clinical effect of early bronchoalveolar lavage on patients with aspiration pneumonia.Methods:A retrospective study was conducted on 55 patients with aspiration pneumonia who met inclusion criteria but not exclusion criteria in the Intensive Care Department of our hospital from January 2020 to April 2021. The patients were divided into the control group (32 cases) and the bronchoscopic lavage group (23 cases) according to whether they received bronchoscopic lavage within 24 h after aspiration. Basic information (sex, age, body mass index, chest X-ray score, oxidation index, temperature, heart rate, respiratory rate, white blood cells, PCT, IL-6, CPR and APACHE Ⅱ score), etiology changes at the early stage (≤ 3 d) and later stage (4-7 d after admission), and changes in prognostic indexes (mechanical ventilation time, length of ICU stay, length of stay and mortality) were compared between the two groups. The clinical efficacy of early endoscopy lavage for aspiration pneumonia was evaluated.Results:The positive rate of early etiological culture was 85.2%, the bacterial positive rate was 72.9% and the fungal positive rate was 14.6%. Pseudomonas aeruginosa accounted for 20.8%, Klebsiella pneumoniae accounted for 14.6%, Staphylococcus aureus and Streptococcus accounted for 12.5%, and there was no significant difference in the distribution between the bronchoscopic lavage group and the control group (all P>0.05). The positive rate of late etiological culture was 88.6%, the bacterial positive rate was 85.7% and the fungal positive rate was 2.9%. The positive rate of late bacterial culture was significantly decreased in the bronchoscopic lavage group ( P < 0.05), and the other results were not significantly different from the control group (all P>0.05). After early bronchoscopic lavage, the duration of mechanical ventilation, length of ICU stay and length of stay were significantly shortened, and the fifth day CPIS score was significantly decreased (all P< 0.05). Conclusions:Early endotracheal lavage can reduce mechanical ventilation time, length of ICU stay and length of stay of aspiration pneumonia, and reduce the positive rate of bacterial culture in the lung at the later stage, which needs to be further verified by a large randomized controlled study.
RESUMO
Autophagy is a programmed cell degradation process that is involved in a variety of physiological and pathological processes including malignant tumors. Abnormal induction of autophagy plays a key role in the development of hepatocellular carcinoma (HCC). We established a prognosis prediction model for hepatocellular carcinoma based on autophagy related genes. Two hundred and four differentially expressed autophagy related genes and basic information and clinical characteristics of 377 registered hepatocellular carcinoma patients were retrieved from the cancer genome atlas database. Cox risk regression analysis was used to identify autophagy-related genes associated with survival, and a prognostic model was constructed based on this. A total of 64 differentially expressed autophagy related genes were identified in hepatocellular carcinoma patients. Five risk factors related to the prognosis of hepatocellular carcinoma patients were determined by univariate and multivariate Cox regression analysis, including TMEM74, BIRC5, SQSTM1, CAPN10 and HSPB8. Age, gender, tumor grade and stage, and risk score were included as variables in multivariate Cox regression analysis. The results showed that risk score was an independent prognostic risk factor for patients with hepatocellular carcinoma ( HR = 1.475, 95% CI = 1.280-1.699, P < 0.001). In addition, the area under the curve of the prognostic risk model was 0.739, indicating that the model had a high accuracy in predicting the prognosis of hepatocellular carcinoma. The results suggest that the new prognostic risk model for hepatocellular carcinoma, established by combining the molecular characteristics and clinical parameters of patients, can effectively predict the prognosis of patients.
Assuntos
Humanos , Autofagia/genética , Biomarcadores Tumorais/genética , Carcinoma Hepatocelular/patologia , Neoplasias Hepáticas/patologia , Proteínas de Membrana/genética , PrognósticoRESUMO
By preparing 15 batches of lyophilized powder samples of substance benchmark in Houpo Wenzhong Decoction,the fingerprint,index component content and extract rate were determined,and the characteristic peaks,the range of similarity with the reference map,the content range and transfer rate range of magnolol,hesperidin,glycyrrhizic acid and pinocembrin,the extract rate range and the change range were clarified. The results showed that the similarity between the fingerprint of substance benchmark and the reference map R generated from the 15 batches of substance benchmark samples was higher than 0. 90. The assignment of the characteristic peaks in the full prescription's fingerprint of the herbs except Poria cocos was clarified. Nineteen characteristic peaks were assigned,and 12 characteristic peaks were assigned by the reference substance,of which 4 were from Magnolia ocinalis Cortex,5 from Exocarpium Citri Rubrum,2 from Radix aucklandiae,3 from Glycyrrhiza Radix et Rhizoma,4 from Semen Alpiniae Katsumadai,and one from Rhizoma Zingiberis and Zingiber officinale Roscoe. The index component content range and transfer rate range were 0. 80%-1. 14% and 20. 25%-39. 61% for hesperidin,0. 49%-0. 79% and 23. 09%-33. 87%for glycyrrhizic acid,0. 03%-0. 07% and 3. 55%-10. 09% for pinocembrin,0. 15%-0. 38% and 8. 08%-24. 35% for magnolol. The extract rate range and the change range were22. 60%-25. 57% and 12. 67%-23. 68% respectively. In this study,we introduced the concepts of index component content,fingerprint,extract rate,explored the transfer relation of quality value transmitting of substance benchmark in Houpo Wenzhong Decoction,and initially established the quality standard of Houpo Wenzhong Decoction,all of which would provide ideas for the development and research of similar prescriptions.
Assuntos
Benchmarking , Cromatografia Líquida de Alta Pressão , Medicamentos de Ervas Chinesas , Glycyrrhiza , Controle de QualidadeRESUMO
By preparing 15 batches of Zhenwu Decoction substance benchmarks,the characteristic map,index component content and paste-forming rate were determined to define the peak attribution,similarity range,paste-forming rate range,paeoniflorin and6-gingerol content range and transfer rate range. The similarity between the substance benchmark characteristic map and the control map R generated from the 15 batches of substance benchmarks was higher than 0. 970. There were 19 characteristic peaks in total. By further summarization of the characteristic peaks,it could be seen that tuckahoe had 3 characteristic peaks,white peony root had 10 characteristic peaks,atractylodes had 3 characteristic peaks,ginger had 1 characteristic peak,and Aconite root had 3 characteristic peaks; among them,white peony root and aconite root had 1 common peak. The contents and transfer rates of the 15 batches were0. 50%-0. 93 and 16. 11%-26. 20%; those for 6-gingerol were 0. 018 2%-0. 033 9% and 13. 16%-24. 10%,respectively. The pasteforming rate ranged from 10. 00% to 14. 85%. In this study,the transfer process of substance benchmark value of classic formula Zhenwu Decoction was analyzed based on the characteristic map,the paste-forming rate and the content of the index components; a scientific and stable substance benchmark quality evaluation method was preliminarily established to provide a basis for subsequent development of classic formula Zhenwu Decoction and quality control of relevant preparations.
Assuntos
Benchmarking , Cromatografia Líquida de Alta Pressão , Medicamentos de Ervas Chinesas , Controle de QualidadeRESUMO
As a novel technology, wearable physiological parameter monitoring technology represents the future of monitoring technology. However, there are still many problems in the application of this kind of technology. In this paper, a pilot study was conducted to evaluate the quality of electrocardiogram (ECG) signals of the wearable physiological monitoring system (SensEcho-5B). Firstly, an evaluation algorithm of ECG signal quality was developed based on template matching method, which was used for automatic and quantitative evaluation of ECG signals. The algorithm performance was tested on a randomly selected 100 h dataset of ECG signals from 100 subjects (15 healthy subjects and 85 patients with cardiovascular diseases). On this basis, 24-hour ECG data of 30 subjects (7 healthy subjects and 23 patients with cardiovascular diseases) were collected synchronously by SensEcho-5B and ECG Holter. The evaluation algorithm was used to evaluate the quality of ECG signals recorded synchronously by the two systems. Algorithm validation results: sensitivity was 100%, specificity was 99.51%, and accuracy was 99.99%. Results of controlled test of 30 subjects: the median (Q1, Q3) of ECG signal detected by SensEcho-5B with poor signal quality time was 8.93 (0.84, 32.53) minutes, and the median (Q1, Q3) of ECG signal detected by Holter with poor signal quality time was 14.75 (4.39, 35.98) minutes (Rank sum test,
Assuntos
Humanos , Algoritmos , Eletrocardiografia , Eletrocardiografia Ambulatorial , Projetos Piloto , Processamento de Sinais Assistido por Computador , Dispositivos Eletrônicos VestíveisRESUMO
Objective@#To investigate the application of a simplified technique for reconstruction of vesicourethral support (RVUS) in laparoscopic radical prostatectomy (LRP).@*METHODS@#From January 2017 to August 2019, 122 patients with localized prostate cancer underwent extraperitoneal LRP, 65 with RVUS (the RVUS group) and 57 without RVUS (the non-RVUS group). We compared the operation time, intraoperative blood loss, rate of pelvic lymph node dissection, neurovascular bundle sparing, incidence of urethrovesical anastomotic urinary leakage (UVAUL), postoperative urinary continence, postoperative hospital stay, intraperitoneal drainage tube removal time, and urethral catheter removal time between the two groups of patients.@*RESULTS@#No statistically significant differences were observed between the two groups in the operation time, intraoperative blood loss, rate of pelvic lymph node dissection, neurovascular bundle sparing, or urethral catheter removal time (P > 0.05). The incidence rate of UVAUL was lower in the non-RVUS than in the RVUS group (8.8% vs 0%, P 0.05) and 12 months after catheter removal (87.7% vs 92.3%, P > 0.05). The postoperative hospital stay was dramatically longer in the non-RVUS than in the RVUS group ([9.1 ± 4.3] vs [6.7 ± 1.8] d, P < 0.01) and so was the intraperitoneal drainage tube removal time ([6.9 ± 4.5] vs [4.8 ± 1.5] d, P < 0.01).@*CONCLUSIONS@#The simplified technique for reconstruction of vesicourethral support in laparoscopic radical prostatectomy improves early urinary continence, especially immediate continence, decreases the incidence rate of urethrovesical anastomotic urinary leakage, and shortens the intraperitoneal drainage tube removal time and postoperative hospital stay.?
Assuntos
Humanos , Masculino , Laparoscopia , ProstatectomiaRESUMO
Background and Objectives@#The nucleotide-binding oligomerization domain-like receptor (NLRP) 3 is known as a member of the NLR family, and it has been confirmed that the NLRP3 inflammasome is associated with various diseases such as asthma, inflammatory bowel disease, metabolic disorders and multiple sclerosis, as well as other auto-immune and auto-inflammatory diseases. However, the role of NLRP3 in chronic rhinosinusitis with nasal polyps (CRSwNP) has not yet been explored.Subjects and Method Forty-four specimens of nasal polyps and 25 specimens of uncinate processes were collected from patients with chronic rhinosinusitis with nasal polyps, and 25 specimens of uncinate tissues were collected from patients who underwent other rhino-surgeries. The western blot assay was employed to analyze the expression of NLRP3; interleukin (IL)-1β and IL-17A were detected using immunohistochemistry and real-time polymerase chain reaction. The production of lipopolysaccharide (LPS) induced IL-1β and IL-17A with or without the NLRP3 inflammasome inhibitor (MCC950) was measured using an enzyme linked immunosorbent assay in cultured dispersed nasal polyp cells. @*Results@#NLRP3 showed a high level of expression in nasal polyps than in the control group (p<0.01). The expression of IL-1β and IL-17A was significantly higher in nasal polyps in the CRSwNP group than in the control group (p<0.05). LPS-induced production of IL-1β was significantly suppressed by treatment with the NLRP3 inflammasome inhibitor (p<0.05). @*Conclusion@#The NLRP3 inflammasome plays an essential role in the pathogenesis of CRSwNP, and thus MCC950 can be considered a prospective therapeutic for NLRP3 inflammasome-mediated inflammation in nasal polyps. Our data provide new evidence that IL-17A is involved in inflammasome-associated inflammation in nasal polyps.
RESUMO
Aim To explore the effect of camellia nitidissima polysaccharides (CNP) on acute intracerebral hemorrhage (ICH) and its mechanism related to regulation of microglia polarization. Method Adult male C57 BIV6 mice were randomly divided into sham-oprated control group, ICH group and CNP group. CNP was intragastrically administered immediately after intracerebral hemorrhagefor a consecutive three days. Neural functional outcomes were evaluated by neurological deficiency score (NDS) , open field test, and adhesive removal test. Blood-brain barrier destruction and pathological injury were detected by Evans blue staining and brain water content. Inflammatory factors were detected by ELISA. Microglia phenotypic status was evaluated and determined by quantitative real-time polymerase chain reaction ( qPCR) analyses, and immunofluorescence labeling. Results CNP significantly reduced neurological deficit scores and ameliorated cerebral edema and blood-brain barrier injury three days after ICH. Also, CNP treatment improved signifi-cantly motor function three days after ICH. In addition, CNP decreased proinflammatory mediators and inhibited the activation of microglia. Furthermore, treatment of CNP decreased microglia Ml markers and increased M2 markers. Conclusion CNP attenuates acute intracerebral hemorrhage thrdugh skewing microglia toward a more anti-inflammatory property.
RESUMO
Since the emergence of novel coronavirus pneumonia in late 2019, it has quickly spread to many countries and regions around the world, causing a significant impact on human beings and society, posing a great threat to the global public health system. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was highly infectious, and some complications emerged rapidly in some patients, including acute respiratory distress syndrome, and multiple organ failure. The virus could trigger a series of immune responses, which might lead to excessive immune activation, thereby bringing about the immune system imbalance of the body. Up to now, there was no specific antiviral drug, and we conjectured that immunomodulatory therapy might play an essential part in the treatment of coronavirus disease 2019 (COVID-19) as adjuvant therapy. Therefore, we analyzed the possible mechanism of immune imbalance caused by the new coronavirus, and summarized the immunotherapeutic means of COVID-19 based on the mechanisms, to provide some reference for follow-up research and clinical prevention and treatment of COVID-19.
Assuntos
Humanos , Betacoronavirus , Infecções por Coronavirus , Pandemias , Pneumonia ViralRESUMO
Objective To investigate the early clinical efficacy of Masquelet membrane induction technique in the treatment of traumatic long bone defects.Methods A retrospective case series study was conducted to analyze the clinical data of 41 patients with traumatic long bone defects admitted to the General Hospital of the Northern Theater Command from January 2012 to April 2017.There were 36 males and five females,aged 15-70 years,with an average of 38.2 years.There were 20 patients with bone defect at the femur,19 at the tibia,one at the fibula,and one at the ulna.All patients received staged treatment using the Masquelet membrane induction technique.In stage Ⅰ surgery,thorough debridement was first performed,and the secretions were taken for bacterial culture.The average bone defect length after debridement was 6.9 cm (2.0-18.5 cm).The bone defect was filled with antibiotic bone cement to induce the biofilm formation.If the postoperative bacterial culture showed positive results,debridement surgery was performed again.Stage Ⅱ surgery was performed after 6-12 weeks.The white blood cell count,C-reactive protein (CRP),procalcitonin (PCT),erythrocyte sedimentation rate (ESR) were measured before the operation.During the operation,bone biopsy was performed,and the bone cement placeholder was completely removed.The autologous cancellous bone and artificial bone were implanted in the bone defect areas,and the induced membrane was sutured.The healing time of bone defects was recorded,and the Paley fracture healing scoring criteria were used to evaluate the limb function.The complications were observed.The inflammatory markers were reviewed at the last follow-up.Results All patients were followed up for 7-36 months with an average of 13.6 months.A total of 37 patients obtained bone healing.The fracture healing rate of stage Ⅰ was 90%,and the healing time was 6-13 months,with an average of 9 months.According to the Paley fracture healing scoring criteria,the results were excellent in 25 patients,good in 10,and fair in two patients,with the excellent and good rate of 85%.In terms of complications,one patient with superficial infection recovered after dressing change,three patients had deep infection,of which one patient was treated with amputation and two received other treatments,and three patients were treated with membrane induction again because of bone resorption.At the last follow-up,there were significant differences between preoperative and postoperative White blood cell count,CRP,PCT and ESR(P < 0.05).Conclusion For traumatic long bone defects,Masquelet membrane induction technique can promote fracture healing,restore limb function and reduce complications.
RESUMO
Objective To analyze the treatment of acute ischemic stroke in the hyperacute stage in Changhai Hospital of Navy Medical University (Second Military Medical University), and to explore the effect of the establishment of Stroke Center on the treatment of in-hospital ischemic stroke (IHIS). Methods A total of 33 IHIS patients were retrospectively enrolled; they received acute treatment in Changhai Hospital of Navy Medical University (Second Military Medical University) from September 2013 to May 2017 (after the establishment of Stroke Center), and 765 patients with acute ischemic stroke attacked in community-based clinics and treated in Changhai Hospital served as controls. All patients received intravenous thrombolysis and arterial thrombectomy within the time window of onset. The onset to call time, the number of patients receiving acute treatment and the ratio of them to hospitalized patients in the same term, and the time from onset to onset (door to needle time, DNT) of IHIS and community ischemic stroke patients were recorded and analyzed. At the same time, the departments and main diseases related to IHIS in our hospital were analyzed. Results After the establishment of the emergency process, the number of thrombolysis and thrombectomy treatment in hyperacute IHIS patients was increased annually, and the onset to call time was shortened annually. The median DNT of patients with IHIS in our hospital from September 2013 to May 2017 was 39.0 (39.0, 45.0) min, and there was no significant difference compared with the control group (38.0 [30.0, 45.5] min; Z=1.872, P=0.061). IHIS patients were most common in the Depatment of Cardiology and Department of Thoracic Surgery, with 11 cases (33.3%) and 6 cases (18.2%), respectively. Atrial fibrillation was the main ralated disease of IHIS. Conclusion After the establishment of the treatment process in the hyperacute stage, the number of thrombolysis and thrombectomy treatment in IHIS patients is increased; IHIS most occurrs in the Depatment of Cardiology and Department of Thoracic Surgery.
RESUMO
To analyze the accuracy rate of a digital image recognition system in matching the palatal rugae Morphology after orthodontic treatment, before orthodontic treatment and to provide theoretical evidence for individual identification in the field of forensic dentistry. High-resolution digital images of the palatal rugae were taken under particular conditions from each patient before and after orthodontic treatment. Features of each digital image were extracted using a digital image recognition system and included in the palatal rugae database. Using an MATLAB software system, information matching of the palatal rugae was performed. From the matching results, the accuracy rate of individual identification of orthodontic patients was 100 %, with a Euclidean distance of 0. The accuracy rate in matching palatal rugae patterns before and after orthodontic treatment was 95.67 %. The results were statistically significant with P < 0.05. Palatal rugae pattern is highly individual-specific. After orthodontic treatment, palatal rugae are morphologically diverse, but these changes do not greatly influence the individual identification in the field of forensic dentistry, which provides a new method of and pathway to forensic identification.
El objetivo de este trabajo consistitó en analizar la tasa de exactitud de un sistema de reconocimiento de imágenes digitales en la adaptación de la morfología de la rugosidad palatina después del tratamiento ortodóncico, antes del tratamiento ortodóncico y proporcionar evidencia teórica para la identificación individual en el campo de la odontología forense. Las imágenes digitales de alta resolución de las rugas palatinas fueron tomadas bajo condiciones particulares de cada paciente antes y después del tratamiento ortodóncico. Las características de cada imagen digital se extrajeron utilizando un sistema de reconocimiento de imagen digital y se incluyeron en la base de datos de rugas palatinas. Utilizando el software MATLAB, se realizó la comparación de información de las rugas palatinas. A partir de los resultados coincidentes, la tasa de exactitud de la identificación individual de los pacientes ortodóncicos fue del 100 %, con una distancia euclídea de 0. La tasa de precisión en los patrones de rugas palatinas coincidentes antes y después del tratamiento ortodóncico fue del 95,67 %. Los resultados fueron estadísticamente significativos con P < 0,05. El patrón palatino de las rugas es altamente individual-específico. Después del tratamiento ortodóncico, las rugas palatinas son morfológicamente diversas, pero estos cambios no influyen mucho en la identificación individual en el campo de la odontología forense, lo que proporciona un nuevo método y vía para la identificación forense.
Assuntos
Humanos , Masculino , Feminino , Ortodontia , Interpretação de Imagem Assistida por Computador , Palato Duro/diagnóstico por imagem , Odontologia Legal , Software , Palato Duro/anatomia & histologiaRESUMO
<p><b>OBJECTIVE</b>To study the dynamic changes of levels of hepatocyte growth factor (HGF) in tears and their association with corneal haze in rabbits early after epipolis laser in situ keratomileusis (Epi-LASIK).</p><p><b>METHODS</b>Twenty-four New Zealand rabbits received Epi-LASIK with an ablation depth of 100 µm in one eye and of 150 µm in the other eye. Before and at 3, 7, 14, and 30 days after the surgery, the level of HGF in tears collected from the rabbits was measured using enzyme-linked immunosorbent assay (ELISA), and corneal haze was graded after surgery.</p><p><b>RESULTS</b>In all the rabbits, corneal epithelium healing occurred in 3 to 5 days after Epi-LASIK. Corneal haze appeared 3 days postoperatively in the rabbits accompanied by increased levels of HGF in tears. At 3, 7, 14, and 30 days after the surgery, the rabbits with an ablation depth of 150 µm showed more obvious corneal haze (P<0.05) and significantly higher levels of HGF in tears than those with an ablation depth of 100 µm (P<0.05).</p><p><b>CONCLUSION</b>In rabbits receiving Epi-LASIK, HGF levels in tears and the grade of corneal haze show a positive correlation early after the surgery and are both related with the depth of ablation.</p>
RESUMO
<p><b>OBJECTIVE</b>To explore the pathogenesis of a child with growth retardation, liver damage and congenital heart disease.</p><p><b>METHODS</b>G-banded chromosomal karyotyping, high-throughput next-generation sequencing (HT-NGS)and fluorescence in situ hybridization(FISH) were used to characterize the structural chromosomal aberration.</p><p><b>RESULTS</b>The child was found to have a karyotype of 46, XX, t(1;2) (q25;q21), t(7;20) (q21;p13). HT-NGS has detected a microdeletion at 2q21.3 and 7q21.11, respectively, which were verified by FISH.</p><p><b>CONCLUSION</b>Combined cytogenetic and molecular analysis can detect chromosome micrdeletions more precisely. The abnormalities of the child may be attributed to heterozygous deletion of ZEB2, ABCB4 and SEMA3A genes.</p>
Assuntos
Feminino , Humanos , Lactente , Aberrações Cromossômicas , Bandeamento Cromossômico , Métodos , Cardiopatias Congênitas , Genética , Deficiência Intelectual , Genética , Cariotipagem , Métodos , Hepatopatias , GenéticaRESUMO
Objective To compare the applicability of the Beijing Version of the Montreal Cognitive Assessment (MoCA) and the Mini Mental State Examination (MMSE) in screening for cognitive impairment in patients with acute ischemic stroke for 2-3 weeks.Methods MoCA and MMSE were conducted in 201 patients with acute ischemic stroke within 2 to 3 weeks after the onset of stroke.With MoCA<23 and MMSE <26 as the cut off value,we assessed the clinic effect of the MoCA and MMSE and explored the correlation between two instruments.Results The average scores of MoCA and MMSE scale were (20.5±4.3) and (25.4±3.5) points.The prevalence of cognitive impairment evaluated with MoCA and MMSE were 57.2%and 43.3%,respectively.MoCA showed significant correlation with MMSE score (Pearson's correlation coefficient=0.833,P<0.001),and an agreement with Kappa values of 0.532 (P<0.01) in screening for cognitive impairment.Conclusions The prevalence of cognitive impairment assessed with MoCA is higher than that of with MMSE when using MoCA<23 and MMSE<26 as the cut off values.Both instruments show a good agreement for screening cognitive impairment in acute ischemic stroke within 2 to 3 weeks following the disease onset.