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ABSTRACT Purpose: This study aimed to compare the safety and effectiveness of intraocular pressure reduction between micropulse transscleral cyclophotocoagulation and "slow cook" transscleral cyclophotocoagulation in patients with refractory primary open-angle glaucoma. Methods: We included patients with primary open angle glaucoma with at least 12 months of follow-up. We collected and analyzed data on the preoperative characteristics and postoperative outcomes. The primary outcomes were a reduction of ≥20% of the baseline value (criterion A) and/or intraocular pressure between 6 and 21 mmHg (criterion B). Results: We included 128 eyes with primary open-angle glaucoma. The preoperative mean intraocular pressure was 25.53 ± 6.40 and 35.02 ± 12.57 mmHg in the micropulse- and "slow cook" transscleral cyclophotocoagulation groups, respectively (p<0.001). The mean intraocular pressure was reduced significantly to 14.33 ± 3.40 and 15.37 ± 5.85 mmHg in the micropulse- and "slow cook" transscleral cyclophotocoagulation groups at the last follow-up, respectively (p=0.110). The mean intraocular pressure reduction at 12 months was 11.20 ± 11.46 and 19.65 ± 13.22 mmHg in the micropulse- and "slow cook" transscleral cyclophotocoagulation groups, respectively (p<0.001). The median preoperative logMAR visual acuity was 0.52 ± 0.69 and 1.75 ± 1.04 in the micropulse- and "slow cook" transscleral cyclophotocoagulation groups, respectively (p<0.001). The mean visual acuity variation was −0.10 ± 0.35 and −0.074 ± 0.16 in the micropulse- and "slow cook" transscleral cyclophotocoagulation, respectively (p=0.510). Preoperatively, the mean eye drops were 3.44 ± 1.38 and 2.89 ± 0.68 drugs in the micropulse- and "slow cook" transscleral cyclophotocoagulation groups, respectively (p=0.017), but those were 2.06 ± 1.42 and 1.02 ± 1.46 at the end of the study in the "slow cook" and micropulse transscleral cyclophotocoagulation groups, respectively (p<0.001). The success of criterion A was not significant between both groups. Compared with 11 eyes (17.74%) in the "slow cook" transscleral cyclophotocoagulation group, 19 eyes (28.78%) in the micropulse transscleral cyclophotocoagulation group showed complete success (p=0.171). For criterion B, 28 (42.42%) and 2 eyes (3.22%) showed complete success after micropulse- and "slow cook" transscleral cyclophotocoagulation, respectively (p<0.001). Conclusion: Both techniques reduced intraocular pressure effectively.
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Objective To investigate the difference of depressive symptoms between adolescents and adults,and to provide possible basis for early detection of adolescent depression.Methods From July 2021 to June 2022,a total of 4 096 patients with"depression"in the psychiatric clinic of the First Affiliated Hospital of Chongqing Medical University were selected as the research objects.They were divided into the adolescent group(n=2 439)and adult group(n=1 657)according to their ages,and the results of self-rating depression scale(SDS)and symptom checklist 90(SCL-90)were collected and analyzed.Results There were significant differences in nationality,residence,native place,family history and degree of depression between the two groups(P<0.05).The adolescent group has more severe depressive symptoms,which were mainly manifes-ted in negative ideas,obsessive-compulsive symptoms,hostile and interpersonal relationship,and psychotic symptoms(P<0.05).The adult group showed more obvious in sleep(P<0.05).Conclusion Early inter-vention should be carried out for adolescents'depressive symptoms such as negative thoughts.
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BACKGROUND:Establishing a stable and reliable animal model of acute pancreatitis is of great significance for understanding its pathogenesis,pathophysiological characteristics,and clinical medication.Domestic and foreign studies have shown that cerulein,L-arginine,and sodium taurocholate can induce acute pancreatitis,but their pathophysiological characteristics and model characteristics are still unclear. OBJECTIVE:To establish an acute pancreatitis rat model using cerulein,L-arginine,and sodium taurocholate and to observe the changing patterns of model features at different time points. METHODS:Ninety-six healthy male Sprague-Dawley rats were randomly divided into normal group,cerulein group,L-arginine group,and sodium taurocholate group,with 24 rats in each group.Within each group,there were three subgroups(n=8 per group):12-,24-,and 48-hour subgroups.Cerulein was administered via intraperitoneal injection six times with a 1-hour interval.L-arginine was administered through two intraperitoneal injections with a 1-hour interval.Sodium taurocholate was injected for inducing acute pancreatitis models through retrograde injection into the bile-pancreatic duct.By examining the rat survival rate,gross morphology of the pancreas,calculating the pancreatic organ index,and measuring levels of amylase,lipase,alanine transaminase,aspartate transaminase,blood urea nitrogen,and creatinine,as well as observing pancreatic tissue pathological features through hematoxylin-eosin staining and conducting a pancreatic injury scoring,we evaluated the changing patterns of model features at different time points. RESULTS AND CONCLUSION:Compared with the normal group,the overall survival rate of rats was 100%in the cerulein group,88%in the L-arginine group,and 96%in the sodium taurocholate group.The pancreatic organ index was increased in all groups.Gross observation indicated that,In the cerulein group,pancreatic edema,blurred lobes,and looseness were visible.In the L-arginine group,the pancreatic glands were enlarged and thickened with patchy bleeding.In the sodium taurocholate group,pancreatic tissue showed varying degrees of congestion and edema accompanied by scattered flakes of hemorrhage and necrosis.The levels of serum alanine transaminase,aspartate transaminase,blood urea nitrogen,creatinine,amylase,and lipase in rats exhibited consistent changes.In the cerulein group,these parameters possibly peaked at 12 hours(P<0.05)and then showed a declining trend.In the L-arginine group,they reached the highest levels at 24 hours(P<0.05)and significantly decreased at 48 hours.In the sodium taurocholate group,serum amylase and lipase remained at higher levels at 12 hours with a slow decline trend(P<0.05).Compared with the normal group,microscopic examination revealed mild acinar edema and widened interlobular spaces in the cerulein group,with a higher presence of inflammatory cells.In the L-arginine group,there was widening of interlobular spaces,extensive infiltration of inflammatory cells,and patchy necrotic areas.In the sodium taurocholate group,significant pancreatic edema,structural disarray,extensive necrotic foci,and inflammatory cell infiltration were observed.Compared with the normal group,the pathological scores of induced acute pancreatitis in all three models were significantly different at each time point(P<0.05).Moreover,the pathological scores in each group increased over time,indicating a gradual worsening of pancreatic tissue damage.When comparing different models at the same time,there were differences in pathological scores,with the sodium taurocholate group having the highest scores,followed by the L-arginine group,and the cerulein group having the lowest scores.Analyzing the three models at the same time point,the most severe condition was in the sodium taurocholate group,which was characterized by pancreatic hemorrhage and necrosis,followed by the L-arginine group,which was characterized by necrosis,and the least severe condition was in the cerulein group,mainly characterized by edema.The serum biochemical index levels of the cerulein and L-arginine groups decreased at 48 hours,indicating that these two models may have a tendency to self-heal and belong to a self-limiting disease course.The serum biochemical index levels of the sodium taurocholate group decreased slowly after 12 hours.Therefore,pancreatic injury in the sodium taurocholate group might not be relieved after 48 hours or longer.
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Objective:To explore the efficacy of long intramedullary nails versus short intramedullary nails in the treatment of AO/OTA 31-A3 intertrochanteric fractures.Methods:A retrospective analysis was conducted on 60 patients with AO/OTA 31-A3 intertrochanteric femur fractures treated between March 2019 and August 2022. The patients were randomly divided into two groups (the long nail group and the short nail group). Thirty-four patients were treated with long intramedullary nails, including 16 males and 18 females, aged 68.41±17.84 years old (range 31-96 years). Twenty-six patients were treated with short intramedullary nails, including 13 males and 13 females, aged 72.23±13.97 years old (range 31-90 years). The causes of injury, fracture classification (AO/OTA classification), intraoperative blood loss, operation time, fracture healing time, imaging indexes (fracture reduction quality, postoperative neck trunk angle, and medial support), Harris score of the hip joint at the last follow-up, one-year mortality rates and complications were compared between the two groups.Results:The follow-up time was 24.26±6.67 months in the long nail group and 24.31±5.60 months in the short nail group, and the general information of the two groups were comparable. Between the long nail and short nail group, the intraoperative blood loss was 281.47±235.28 ml vs. 121.92±84.14 ml and the operation time was 110.44±24.63 min vs. 81.15±28.54 min with significant differences ( P<0.05). While the length of hospital stay was 12.35±4.81 d vs. 10.89±4.30 d, the good rate of fracture reduction was 55.9% vs. 61.53%, the fracture healing time was 120.44±16.43 d vs. 128.07±18.33 d, the presence rate of medial support was 67.6% vs. 79.4%, and the excellent rate of Harris score was 65.4% vs. 65.4% with no significant difference between the two groups ( P>0.05). One-year mortality rates was 5.3% vs. 7.1% and complications was 11.7% vs. 15.4% with no significant difference between the two groups ( P>0.05). Conclusion:Both long intramedullary nails and short intramedullary nails are effective in the treatment of AO/OTA 31-A3 intertrochanteric femur fractures. However, surgical time and intraoperative blood loss was less in the short nail group.
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Life education is an important course for cultivating students’ comprehensive quality， shaping their personality， and inheriting civilization. This paper compared the historical evolution， teaching contents， and practical approaches of life education between Chinese and American university students， and summarized the following problems faced by life education for Chinese university students： national legislative support and financial support can still be improved； there were few independent life education courses offered in colleges and universities and lack of practical activities； education on setbacks， adversity， and life values， and the students’ ability to independently solve difficulties needed to be improved； the lack of death education and other main challenges. Afterwards， this paper summarized the development of life education in the United States， life education courses were widely and comprehensively offered and had a long history； the content emphasized education on character， setbacks， and safety， more importantly， guided students to face life and death， and practical courses such as end-of-life care drills were provided to establish a positive outlook on life and death for students； the government had introduced laws and regulations to support， and families attached importance to cultivating children’s self-care ability， Finally， it proposed that the life education of Chinese university students should be based on their own cultural and social background： universities should seek breakthroughs in the construction of life education courses， society should form a joint effort to create the atmosphere of life education， and university students should reflect on life education issues independently.
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Resumo Este artigo aborda as normas gerais do esporte no Brasil e Portugal a partir de uma perspectiva comparativa. Parte-se do pressuposto que o esporte deve ser foco de atenção estatal e das políticas públicas como estratégia de desenvolvimento da cidadania. O objetivo principal é analisar comparativamente a legislação esportiva de Brasil e Portugal, sobretudo os atos que estabeleceram as normas gerais para este setor em âmbito nacional. Para isso, realizou-se uma pesquisa descritivo-analítica de abordagem qualitativa e abrangência exploratória, organizada a partir de trabalho de campo e análise e tratamento do material empírico e documental. A análise de conteúdo dos documentos confirmou que no Brasil o financiamento é o tema de destaque na atuação normativa do Estado, ao passo que em Portugal o exercício regulatório é a principal preocupação. Nos dois países foi possível observar o impacto dos megaeventos na esfera legislativa, com a produção de atos excepcionais.
Resumen Este artículo aborda las reglas generales del deporte en Brasil y Portugal, desde una perspectiva comparada. Se parte del supuesto de que el deporte debe ser el foco de atención estatal y de las políticas públicas como estrategia de desarrollo de la ciudadanía. El objetivo principal es analizar comparativamente la legislación deportiva en Brasil y Portugal, especialmente las leyes que establecieron las reglas generales para este sector a nivel nacional. Para ello, se realizó una investigación descriptivo-analítica con enfoque cualitativo y alcance exploratorio, organizada a partir del trabajo de campo y el análisis y tratamiento de material empírico y documental. El análisis de contenido de los documentos confirmó que en Brasil el financiamiento es el tema principal en la acción normativa del Estado, mientras que en Portugal el ejercicio regulatorio es la principal preocupación. En ambos países se pudo observar el impacto de megaeventos en el ámbito legislativo, con la producción de actos excepcionales.
Abstract This article addresses the general rules of sport in Brazil and Portugal, from a comparative perspective. It starts from the assumption that sport should be the focus of state attention and public policies as a citizenship development strategy. The main objective is to comparatively analyze the sports legislation in Brazil and Portugal, especially the acts that established the general rules for this sector at the national level. For this, a descriptive-analytical research with a qualitative approach and exploratory scope was carried out, organized from field work and analysis and treatment of empirical and documental material. The content analysis of the documents confirmed that in Brazil financing is the main issue in the State's normative action, while in Portugal the regulatory exercise is the main concern. In both countries, it was possible to observe the impact of mega-events in the legislative sphere, with the production of exceptional acts.
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ABSTRACT Objective: To compare effectiveness of Dynesys and hybrid system in treating patients with multi-segmental lumbar degenerative disease (LDD). Methods: Patients involved in this retrospective study were divided into Dynesys (n = 22) and Hybrid (n = 13) groups. Clinical outcomes were evaluated using Oswestry Disability Index (ODI), and Visual Analogue Scale (VAS). Radiologic evaluations included X-ray, MRI, and CT. Furthermore, different complications were analyzed. Results: At the last follow-up, ODI and VAS of each group were improved (p < 0.05), and the range of motion (ROM) of operating segments decreased. However, Dynesys group preserved a larger extent of ROM at the final follow-up (p < 0.05). ROM of the upper adjacent segment was increased in both groups (p < 0.05), while the disc heights were decreased at the final follow-up (p < 0.05). Besides, Dynesys group had a more obvious decrease in the disc height of dynamic segments (p < 0.05). No significant difference existed in complications between both groups (p > 0. 05). Conclusion: In our study, similar satisfactory results were obtained in both groups. Both surgical procedures can be employed as effective treatments for middle-aged and physically active patients with multi-segmental LDD. Level of Evidence III; Retrospective Comparative Study.
RESUMO Objetivo: Comparar a eficácia do Dynesys e do sistema híbrido no tratamento de pacientes com doença degenerativa lombar multissegmentar (DLD). Métodos: Os pacientes envolvidos neste estudo retrospectivo foram divididos em grupos Dynesys (n = 22) e Híbrido (n = 13). Os desfechos clínicos foram avaliados por meio do Oswestry Disability Index (ODI) e da Escala Visual Analógica (EVA). As avaliações radiológicas incluíram radiografia, ressonância nuclear magnética (RNM) e tomografia computadorizada. Ademais, diferentes complicações foram analisadas. Resultados: No acompanhamento final, o ODI e a EVA de todos os grupos melhoraram (p < 0,05), e houve diminuição da amplitude de movimento (ADM) dos segmentos operacionais. No entanto, o grupo Dynesys preservou uma maior extensão da ADM no acompanhamento final (p < 0,05). A ADM do segmento superior adjacente foi ampliada em ambos os grupos (p < 0,05), enquanto as alturas dos discos foram reduzidas no acompanhamento final (p < 0,05). No entanto, o grupo Dynesys apresentou uma redução mais evidente na altura do disco dos segmentos dinâmicos (p < 0,05). Não houve diferença significativa nas complicações entre esses dois grupos (p > 0,05). Conclusão: Neste estudo, resultados satisfatórios semelhantes foram obtidos em ambos os grupos. Ambos os procedimentos cirúrgicos podem ser empregados como tratamentos eficazes para pacientes de meia-idade e fisicamente ativos com LDD multissegmentar. Nível de Evidência III; Estudo Retrospectivo Comparativo.
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Abstract This paper analyzes ethno-racial residential segregation in two large metropolitan areas across the Global North and South: London (UK) and São Paulo (Brazil). Residential segregation is measured and mapped using global and local spatial segregation indices that portray different spatial dimensions across scales. To interpret results, the study adopted a relational approach that juxtaposes global figures and local variations of segregation, complementary dimensions of segregation (dissimilarity and exposure/isolation), multiple scales of segregation, and location patterns of different ethno-racial groups. Results indicate that London and São Paulo metropolitan regions have similar, although inverse, core-periphery patterns of ethno-racial segregation. The findings also revealed that segregation levels are higher for London than São Paulo across scales and dimensions, indicating that, against common assumptions, London is more ethno-racially segregated than São Paulo. These findings are discussed in the context of existing literature, exploring similarities and differences between ethno-racial segregation in the two metropolitan regions. The paper concludes with a discussion on the relevance of the comparative findings for segregation studies, and a reflection on future studies on urban segregation.
Resumo Este artigo analisa a segregação residencial do ponto de vista étnico-racial em duas grandes regiões metropolitanas localizadas no Sul e Norte Globais: Londres (Reino Unido) e São Paulo (Brasil). Utilizaram-se índices espaciais globais e locais para mapear e mensurar as diferentes dimensões espaciais e escalas da segregação étnico-racial nas duas metrópoles. O estudo adotou uma abordagem relacional para a interpretação dos resultados que justapõe resultados globais e variações locais da segregação, dimensões espaciais complementares (dissimilaridade e exposição/isolamento), múltiplas escalas geográficas e padrões de localização espacial dos diferentes grupos étnico-raciais. Os resultados indicam que as regiões metropolitanas de Londres e São Paulo apresentam padrões espaciais de segregação centro-periferia similares, mas inversos. Os resultados também relevaram que os níveis de segregação de Londres são mais altos do que os de São Paulo, indicando que contraintuitivamente Londres é mais segregada étnico-racialmente do que São Paulo. Esses resultados são discutidos no contexto da literatura, explorando as similaridades e diferenças entre as duas regiões metropolitanas. O artigo conclui com uma discussão sobre a relevância dos resultados e uma reflexão sobre a agenda futura para os estudos sobre a segregação urbana.
Resumen Este artículo analiza la segregación residencial desde un punto de vista étnico-racial en dos grandes regiones metropolitanas ubicadas en el Sur y el Norte Global: Londres (Reino Unido) y San Pablo (Brasil). Se usaron índices espaciales globales y locales para mapear y medir las diferentes dimensiones espaciales y escalas de la segregación étnico-racial en las dos metrópolis. El estudio adoptó un enfoque relacional para interpretar los resultados que yuxtapone resultados globales y variaciones locales de segregación, dimensiones espaciales complementarias (disimilaridad y exposición/aislamiento), múltiples escalas geográficas y patrones de ubicación espacial de diferentes grupos etnorraciales. Los resultados indican que las regiones metropolitanas de Londres y San Pablo presentan patrones espaciales similares, pero inversos, de segregación centro-periferia. Los resultados también revelaron que los niveles de segregación en Londres son más altos que en San Pablo, lo que indica que, contraintuitivamente, Londres está más segregada étnico-racialmente que San Pablo. Estos resultados se discuten en el contexto de la literatura, explorando las similitudes y diferencias entre las dos regiones metropolitanas. El artículo concluye con una discusión sobre la relevancia de los resultados y una reflexión sobre la agenda futura de estudios sobre segregación urbana.
Тема - темы
Socioeconomic Factors , Social Segregation , Residential Segregation , Urban Renewal , Poverty Areas , Demography , Housing InstabilityРеферат
The maintenance of adequate fluoride (F) concentration in the public water supply is fundamental for ensuring that the community use of F can reach the maximum benefit for caries control and minimum risk for dental fluorosis. Thus, surveillance systems must use accurate and valid analytical methods to determine F concentration and, according to the literature, give preference to the ion-specific electrode (F- ISE) analysis. Aim: The objective of this study was to compare the accuracy of the ISE and SPADNS methods in the determination of the F concentration in the same water sample. Methods: Duplicate water samples were taken from 30 sampling sites in the municipality of Maringá, state of Paraná, monthly for 12 months, totaling 276 samples. An aliquot was analyzed by the FOP-UNICAMP Oral Biochemistry laboratory, using the F- ISE method, and the other one, by the SANEPAR laboratory in Maringá/PR, using the SPADNS method. Descriptive analysis and Pearson's correlation test were applied, with a significant level of p<0.05. Results: Results were expressed as ppm F (mg F/L), and a very strong positive correlation (r= 0.91; p<0.001) was detected between the two methods of analysis. Conclusion: Our findings suggest that the determination of f luoride concentration in water can be made with accuracy by the SPADNS method, a standardized analysis protocol
Тема - темы
Water Supply , Comparative Study , Fluoridation , Fluorine , Data AccuracyРеферат
Resumen: Introducción: la cirugía de revisión protésica de cadera constituye una indicación quirúrgica que se encuentra en crecimiento en los últimos años. La artroplastía total de cadera de revisión (ATCr) se trata de un reto quirúrgico destacado debido a la dificultad técnica de la propia cirugía. Entre las complicaciones de la cirugía de revisión des-tacan las luxaciones, el aflojamiento aséptico y la infección. Objetivo: comparar los resultados clínico-radiológicos, así como la incidencia de complicaciones, de dos muestras independientes de pacientes intervenidos de artroplastía total de cadera de revisión (ATCr) con defectos acetabulares leves-moderados utilizando implantes de doble movilidad respecto a implantes monopolares. Material y métodos: estudio retrospectivo comparativo de dos cohortes de 30 pacientes intervenidos de cirugía de revisión acetabular mediante cabezas monopolares de 36 mm o doble movilidad, respectivamente. Todos los pacientes presentaban defectos acetabulares tipo I o II de Paprosky. Se evaluaron los resultados con las escalas EVA, WOMAC y Harry hip score (HHS) pre y postoperatorios en ambas cohortes. Asimismo, se analizaron la incidencia de complicaciones postoperatorias y la tasa de supervivencia entre ambos grupos. Resultados: el seguimiento medio fue de 5.8 años (1-10.3 años). La diferencia entre los resultados pre y postoperatorios en cada cohorte fue significativa para la escala EVA, WOMAC y HHS. Las diferencias obtenidas en dichas escalas entre los distintos grupos de estudio no hallaron diferencias significativas. La incidencia de complicaciones postoperatorias entre ambas cohortes fue similar, sin encontrar diferencias significativas. Conclusiones: consideramos que la doble movilidad no aporta superioridad en cuanto a resultados clínico-funcionales e incidencia de complicaciones postoperatorias respecto a los montajes monopolares en cirugía de revisión acetabular con defectos leves-moderados.
Abstract: Introduction: hip revision arthroplasty surgery is a surgical procedure that has been growing in recent years. Revision total hip arthroplasty (THA) is a notable surgical challenge due to the technical difficulty of the surgery itself. Complications of revision surgery includes dislocation, aseptic loosening, and infection. Objective: to compare the clinical-radiological results, as well as the incidence of complications, of two independent samples of patients who underwent revision total hip arthroplasty (rTHA) with mild-moderate acetabular defects using dual mobility implants compared to monopolar implants. Material and methods: retrospective comparative study of two cohorts of 30 patients who underwent acetabular revision surgery using large 36 mm monopolar heads or dual mobility respectively. All patients had Paprosky type I or II acetabular defects. The results on the VAS scale, WOMAC, and Harry hip score (HHS) were evaluated pre and postoperatively in both cohorts. Likewise, the incidence of postoperative complications and the survival rate between both groups were analyzed. Results: mean follow-up was 5.8 years (1-10.3 years). The difference between the pre and postoperative results in each cohort was significant for the VAS, WOMAC and HHS scale. The differences obtained in these scales between the different study groups did not find significant differences. The incidence of postoperative complications between both cohorts was similar, without finding significant differences. Conclusions: we consider that dual mobility does not provide superiority in terms of clinical-functional results and incidence of postoperative complications with respect to monopolar assemblies in acetabular revision surgery with mild-moderate defects.
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ABSTRACT Purpose: This study aimed to compare the clinical outcomes following deep anterior lamellar keratoplasty and penetrating keratoplasty in contralateral eyes of the same patients. Methods: In this retrospective, comparative case series, clinical outcome data included best-corrected visual acuity, refractive spherical equivalent, refractive astigmatism, endothelial cell density, endothelial cell loss, central corneal thickness, and intraocular pressure, which were evaluated at 6, 12, 24, and 36 months after deep anterior lamellar keratoplasty and penetrating keratoplasty. Additionally, complications were assessed. Results: Fifty-two eyes (26 patients) were included, of which 19 patients had keratoconus, 6 had stromal dystrophy, and 1 had post-laser-assisted in situ keratomileusis ectasia. The mean follow-up was 44.1 ± 10.5 months in the deep anterior lamellar keratoplasty Group and 47.9 ± 11.9 months in the penetrating keratoplasty Group. No significant differences were observed in the mean best-corrected visual acuity, refractive spherical equivalent, refractive astigmatism, and central corneal thickness between the deep anterior lamellar keratoplasty and penetrating keratoplasty Groups during follow-up. The endothelial cell density was significantly higher in the deep anterior lamellar keratoplasty Group than in the penetrating keratoplasty Group at 24 and 36 months postoperatively (p=0.022 and 0.013, respectively). Endothelial cell loss was significantly lower in the deep anterior lamellar keratoplasty Group than in the penetrating keratoplasty Group at 24 and 36 months postoperatively (p=0.025 and 0.001, respectively). Intraocular pressure was significantly lower in the deep anterior lamellar keratoplasty Group than in the penetrating keratoplasty Grroup at 6 months postoperatively (p=0.015). Microperforation occurred in 4 eyes (15%) during deep anterior lamellar keratoplasty surgery; however, penetrating keratoplasty was not required. No endothelial rejection occurred in the penetrating keratoplasty Group during follow-up. Conclusions: Over the 3-year follow-up, endothelial cell loss and intraocular pressure in the deep anterior lamellar keratoplasty Group were significantly lower than those in the penetrating keratoplasty Group, while visual and refractive results were similar.
RESUMO Objetivo: Este estudo teve como objetivo comparar os resultados clínicos após ceratoplastia lamelar anterior profunda e ceratoplastia penetrante nos olhos contralaterais dos mesmos pacientes. Métodos: Nesta série de casos comparativa e retrospectiva, avaliaram-se os seguintes dados de resultados clínicos: melhor acuidade visual corrigida, equivalente esférico refrativo, astigmatismo refrativo, densidade de células endoteliais, perda de células endoteliais, espessura central da córnea e pressão intraocular. Esses dados foram avaliados aos 6, 12, 24 e 36 meses após ceratoplastia lamelar anterior profunda e ceratoplastia penetrante. Também foram avaliadas as complicações. Resultados: Foram incluídos 52 olhos (26 pacientes), sendo que 19 pacientes apresentavam ceratocone, 6 apresentavam distrofia estromal e 1 apresentava ectasia após ceratomileuse in situ assistida por laser. O tempo médio de acompanhamento foi de 44,1 ± 10,5 meses no grupo da ceratoplastia lamelar anterior profunda e 47,9 ± 11,9 meses no grupo da ceratoplastia penetrante. Nenhuma diferença significativa foi observada nas médias da melhor acuidade visual corrigida, equivalente esférico refrativo, astigmatismo refrativo e espessura central da córnea entre os grupos da ceratoplastia lamelar anterior profunda e da ceratoplastia penetrante durante o acompanhamento. A densidade de células endoteliais foi significativamente maior no grupo da ceratoplastia lamelar anterior profunda que no grupo da ceratoplastia penetrante aos 24 e 36 meses de pós-operatório (p=0,022 e 0,013, respectivamente). A perda de células endoteliais foi significativamente menor no grupo da ceratoplastia lamelar anterior profunda que no grupo da ceratoplastia penetrante aos 24 e 36 meses de pós-operatório (p=0,025 e 0,001, respectivamente). A pressão intraocular foi significativamente menor no grupo da ceratoplastia lamelar anterior profunda que no grupo da ceratoplastia penetrante aos 6 meses de pós-operatório (p=0,015). Ocorreu microperfuração em 4 olhos (15%) durante a cirurgia de ceratoplastia lamelar anterior profunda; entretanto, a ceratoplastia penetrante não foi necessária. Não ocorreu nenhuma rejeição endotelial no grupo da ceratoplastia penetrante durante o período de acompanhamento. Conclusões: Durante o acompanhamento de 3 anos, a perda de células endoteliais e a pressão intraocular foram significativamente menores no grupo da ceratoplastia lamelar anterior profunda que no grupo da ceratoplastia penetrante, mas os resultados visuais e refrativos foram semelhantes.
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Introducción: Las mujeres embarazadas con diabetes mellitus gestacional DMG tienen un mayor riesgo de tener resultados adversos materno-infantiles, debido a lo cual es importante estimar la prevalencia de DMG en Colombia de acuerdo con los criterios de la Asociación Internacional de Grupos de Estudio de Diabetes y Embarazo (IADPSG). Materiales y métodos: Se realizó una revisión sistemática mediante búsquedas en las bases de datos PubMed/Medline y Cochrane en inglés y español. La evaluación de la calidad se hizo mediante la metodología GRADE. Resultados: En la revisión sistemática se incluyó un total de 7 estudios con 37 795 participantes colombianas. La prevalencia de DMG en Colombia fue de 8,7 %. Conclusiones: Esta revisión sistemática se constituye en un primer estudio exploratorio en estimar la prevalencia de DMG en Colombia según criterios de la IADPSG. La estimación de la prevalencia global se sitúa cercana a la media mundial, sin embargo, estos resultados deben ser valorados con precaución por limitaciones en la opción de la guía para detección de diabetes gestacional y subregistro. WDF 15-955 Project, Barranquilla, Colombia.
Introduction: Pregnant women with GDM gestational diabetes mellitus have a higher risk of having adverse maternal-infant outcomes. Objective: To estimate the prevalence of GDM in Colombia according to the criteria of the International Association of Diabetes and Pregnancy Study Groups [IADPSG]. Materials and methods: A systematic review was carried out by searching the PubMed / Medline and Cochrane databases in English and Spanish. The quality assessment was done using the GRADE methodology. Results: A total of 7 articles with 37,795 Colombian participants were included in the systematic review. The prevalence of GDM in Colombia was 8.7 %. Conclusions: As far as we know, this systematic review is the first study to estimate the prevalence of GDM in women in Colombia according to criteria of the IADPSG. The results suggest a GDM prevalence in Colombia in the world average. Be careful with these results because there could be un-der-records.
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ABSTRACT Purpose: One of the most important disadvantages of using Mini Monoka stents in pediatric canalicular laceration repair is premature stent loss. In this study, we aimed to compare clinical outcomes between the use of Mini Monoka and Masterka monocanalicular stents in children and discuss the potential causes of premature stent loss. Methods: The medical records of 36 patients who underwent surgical repair of canalicular lacerations were retrospectively reviewed. Children aged <18 years who underwent canalicular laceration repair with either Mini Monoka or Masterka and had at least 6 months of follow-up after stent removal were included in the study. The patients' demographics, mechanism of injury, type of stent used, premature stent loss, and success rate were analyzed. Success was defined as stent removal without subsequent epiphora and premature stent loss. Results: Twenty-seven children fulfilled our study criteria, and their data were included in the analyses. Mini Monoka was used in 14 patients (51.9%), whereas Masterka was used in 13 patients (48.1%). The preoperative clinical features, including age, sex, and mechanism of injury, were similar between the two groups. The mean age was 8.3 ± 5.5 years in the Mini Monoka group and 7.8 ± 5.9 years in the Masterka group (p=0.61). Three patients in the Mini Monoka group (21.4%) underwent reoperation due to premature stent loss. No premature stent loss was observed in the Masterka group. As a result, the rate of success was 78.6% in the Mini Monoka group, whereas it was 100% in the Masterka group (p=0.22). Conclusions: Even though the two groups did not show any statistically significant difference in success rate, we did not observe any premature stent loss in the Masterka group. Further studies with larger and randomized series are warranted to elaborate on these findings.
RESUMO Objetivo: Uma das desvantagens mais importantes do uso de stents Mini Monoka no reparo de lacerações canaliculares pediátricas é a perda prematura do stent. Neste estudo, objetivamos comparar os resultados clínicos dos stents monocanaliculares Mini Monoka e Masterka em crianças e discutir as possíveis causas da perda prematura do stent. Métodos: Foram incluídos nesta revisão retrospectiva 36 pacientes <18 anos de idade que se submeteram ao reparo cirúrgico de uma laceração canalicular com um stent Mini Monoka ou Masterka e tiveram pelo menos 6 meses de acompanhamento após a remoção do stent. Foram analisados os dados demográficos, o mecanismo da lesão, o tipo de stent utilizado, a ocorrência de perda prematura de stent e o sucesso da intervenção. O sucesso foi definido como a ausência de epífora após a remoção do stent, sem a perda prematura deste. Resultados: Vinte e sete pacientes preencheram os critérios do presente estudo e foram incluídos nas análises. O stent Mini Monoka foi usado em 14 pacientes (51,9%), enquanto o Masterka foi usado em 13 pacientes (48,1%). As características clínicas pré-operatórias, incluindo idade, sexo e mecanismo de lesão, foram semelhantes entre os dois grupos. A média de idade foi de 8,3 ± 5,5 anos no grupo Mini Monoka e de 7,8 ± 5,9 anos no grupo Masterka (p=0,61). Três pacientes do grupo Mini-Monoka (21,4%) tiveram que ser operados novamente por perda prematura do stent. Nenhuma perda prematura do stent foi observada no grupo Masterka. Como resultado, a taxa de sucesso foi de 78,6% no grupo Mini Monoka e de 100% no grupo Masterka (p=0,22). Conclusões: Embora nenhuma diferença estatisticamente significativa tenha sido detectada entre os dois grupos em termos de taxas de sucesso, não observamos nenhuma perda prematura de stent no grupo Masterka. São necessários mais estudos, com séries maiores e randomizadas, para chegar a maiores conclusões sobre esses achados.
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Adolescent , Child , Child, Preschool , Humans , Stents , Lacerations , Retrospective StudiesРеферат
Introduction@#There is a sutra named “Detail explanatory of Ma la ya'i mystery and the giver everything wanted” (Ma la ya'i dka' 'grel 'dod pa 'jo ba) written by Mi'i nyi ma mthong ba don ldan, a Tibetan, which is considered as one of the undisputed ancient articles of Indian and Tibetan Medicines and to which Mongolian medical researchers in Mongolia and in Inner Mongolia, China haven't paid attention yet, so it is still not included in the scope of medical research work until now. </br>The sutra has an advantage that the place where the spring comes out is written in detail. Therefore, we now should thoroughly analyze the source place and features of the springs in order to convey a clear orderly understanding to future scholars by summarizing the research aligning it with traditional medical theory, and schematically mapping. @*Goal@#To make clearer the scholars' views of the four mountains included in the book “Rsta b’ai rgyud” and its theoretical and other concepts, as well as to analyze and conclude the interrelationships and features of springs in Ma la ya'i mountain. @*Materials and Methods@#In this research, I have studied the theory of Four mountains included in the book “Rsta b’ai rgyud” using the analyzing methods for original and source documents and summarized by the method of analysis and synthesis, as well as chosen the literature named “Detail explanation of Ma la ya'i mystery and the giver everything wanted” by sampling method and shown making sketch for the interrelations and features of springs by Hermeneutic method. @*Results@#As descried by a person named Gyutog yontan mgonpo (Gyutog yontan mgonpo) in terms of Foreign, Domestic and Secret Medicine Palaces, and according to the relevant sutras and mantras that said about them, the springs have the ability to heal diseases with the participation of earth directions, flora and fauna around the mountain and other factors. The sketch was clearly shown for the springs. @*Conclusion@#I believe that the debates about the Medicine Palace are highly dependent on the chronology in which the researchers lived and their own traditional ways. Currently, the five explanatory manuscripts written through XII - XX centuries about Medicine Palaces and Springs in Ma la ya'i Mountain have been found, among which, specially, the section written about the springs in the sutra named “Detail explanatory of Ma la ya'i mystery and the giver everything wanted” is a big thick book that was made at the level of "Great Explanation" in terms of its content. Therefore, I consider that this literature has become a new cognitive valuables added to the modern research resource because the knowledge of springs was presented greatly in depth and detail in this paper work.
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The Master of Public Health (MPH) is one of the internationally recognized ways of training professionals in the medical and health field. With the outbreak of COVID-19 pandemic, the need for talents who can serve the national public health emergency management system has accelerated. This article makes the comparison of public health education in China and the UK, starting from the reasons and advantages of medical education in two countries, selecting several universities with high rankings in public health in China and the UK as the research objects, collecting and summarizing their programme descriptions, from the enrollment mode, training objectives, cultivation mode and degree types, curriculum settings, etc., in the MPH programme descriptions in order to find the advantages of MPH education in the UK, which can be used for reference in the education and training of public health talents in China, and is of great significance for the improvement and optimization of MPH education in China.
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Objective:To investigate the clinical efficacy of five-element music therapy in the treatment of bipolar disorder.Methods:Eighty patients with bipolar disorder admitted to Shandong Mental Health Center from January 2018 to December 2019 were included in this study. They were randomly divided into a study group and a control group ( n = 40/group). The control group was treated with conventional drug treatment. The study group was treated with five-element music therapy based on conventional drug treatment. Before, during and after treatment, mania and depression were evaluated. Symptom self-evaluation scale and the Traditional Chinese Medicine Five State Emotion Questionnaire were completed to evaluate the curative effect. Patients were followed up by telephone call. Recurrence at 3, 6 and 12 months was recorded. Results:Before treatment, there were no significant differences in the scores of the Bech-Rafaelsen Mania Rating Scale (BRMs), Hamilton Depression Rating Scale (HAMD), Traditional Chinese Medicine Five State Emotion Questionnaire, Symptom Checklist-90 (SCL-90) between the two groups (all P > 0.05). During and after treatment, BRMs, HAMD, Traditional Chinese Medicine Five State Emotion Questionnaire, and SCL-90 scores were significantly decreased in each group compared with before treatment [Control group: BRMs score during and after treatment: (11.52 ± 1.57) points, (9.43 ± 1.05) points; HAMD score during and after treatment: (16.75 ± 3.05) points, (13.61 ± 2.51) points; Traditional Chinese Medicine Five State Emotion Questionnaire: emotional vocabulary (67.25 ± 5.7) points, (56.38 ± 4.97) points, physical symptoms (29.52 ± 3.94) points, (24.19 ± 3.05) points, SCL-90 score: (100.52 ± 10.26) points, (68.85 ± 7.33) points. Study group: BRMs score during and after treatment: (9.33 ± 1.09) points, (7.85 ± 0.82) points; HAMD score: (13.74 ± 2.54) points, (10.17 ± 1.97) points; Traditional Chinese Medicine Five State Emotion Questionnaire: emotional vocabulary: (58.19 ± 5.06) points, (46.85 ± 4.06) points, physical symptoms (25.14 ± 3.54) points, (20.11 ± 2.57) points; SCL-90 scores: (90.85 ± 8.97) points, (56.87 ± 5.81) points]. During and after treatment, scores of BRMs, HAMD, Traditional Chinese Medicine Five State Emotion Questionnaire and SCL-90 in the study group were significantly lower than those in the control group ( t = 3.77, 7.01, 4.48, 6.99, 8.78, 4.89, 6.05, 4.19, 7.57, all P < 0.05). Total response rate in the study group was significantly higher than that in the control group (90.0% vs. 72.5%, χ2 = 4.02, P < 0.05). At 3, 6 and 12 months after treatment, recurrence rate in the study group was 2.5%, 15.0% and 30.0%, respectively, which were significantly lower than 17.5%, 35.0%, and 52.5% in the control group ( χ2 = 5.00, 4.26, 4.17, all P < 0.05). Conclusion:Five-element music therapy for the treatment of bipolar disorder can markedly alleviate depression and mania, restore patient's emotional state, improve clinical efficacy, and decrease recurrence rate.
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Objective:To compare the efficacy between olecranon sled fixation and tension band wiring fixation in the treatment of Mayo ⅡA olecranon fractures.Methods:A retrospective study was conducted to analyze the data of 54 patients with Mayo ⅡA olecranon fracture who had been admitted to Department of Traumatology and Orthopedics, Beijing Jishuitan Hospital from October 2018 to February 2021. There were 20 males and 34 females with an age of (45.5±17.7 years), and 36 left and 18 right sides. They were divided into 2 groups according to different methods of internal fixation. Group A (25 cases) was subjected to olecranon sled fixation and group B (29 cases) to tension band wiring fixation. Preoperative data, operation time, reoperations and complications during follow-up were recorded and compared between the 2 groups. In both groups at the last follow-up, the range of the elbow motion, the Mayo elbow performance score (MEPS) and the Disabilities of the Arm, Shoulder and Hand (DASH) score were recorded to evaluate the elbow function.Results:The 2 groups were comparable because there were no significant differences in all their preoperative demographic data ( P>0.05). There were no significant differences between the 2 groups either in follow-up time [(32.8±8.9) months for group A and (35.8±9.0) months for group B] or in operation time [60.0 (60.0, 82.5) min for group A and 60.0 (60.0, 67.5) min for group B] ( P>0.05). At the last follow-up in group A and group B, respectively, the flexion and extension of the elbow was 141.0°±8.4° and 140.0 (140.0, 150.0)°, the pronation-supination 180.0 (175.0, 180.0)° and 180.0 (175.0, 180.0)°, the MEPS score 100.0 (85.0, 100.0) and 100.0 (92.5, 100.0), and the DASH score 4.2 (1.7, 6.3) and 5.8 (1.3, 8.3), all showing no statistically significant differences between the 2 groups ( P>0.05). Olecranon skin irritation occurred in 5 patients (20.0%,5/25) in group A and in 15 patients (51.7%,15/29) in group B, and 7 patients (28.0%,7/25) in group A and 21 patients (72.4%,21/29) in group B underwent removal of internal fixation, both showing statistically significant differences between the 2 groups ( P<0.05). Conclusion:In the treatment of Mayo ⅡA olecranon fractures, compared with tension band wiring fixation, olecranon sled fixation may lead to comparable efficacy in fixation and functional recovery, but significantly reduced rates of complications and internal fixation removal.
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Objective:To explore the similarities and differences of China Society of Gynecology Endoscopy (CSGE) and American Fertility Society (AFS) intrauterine adhesion (IUA) scoring criteria on IUA grading and their predictive value of reproductive prognosis.Methods:From January 2016 to January 2019, a total of 1 249 patients were diagnosed with IUA by hysteroscopy at Beijing Obstetrics and Gynecology Hospital. Totally, 378 patients with complete clinical data were enrolled, and the results diagnosed by CSGT and AFS scoring criteria were compared and analyzed.And follow-up for 2 years, the pregnancy rate and live birth rate were statistical analysis.Results:(1) The grade of IUA according to AFS and CSGE scoring criteria was less consistent ( κ=0.295, P<0.001). Compared with AFS, the proportion of severe IUA cases diagnosed by CSGE was significantly lower [45.8% (173/378) vs 15.1% (57/378); RR=0.22, 95% CI: 0.15-0.30, P<0.01); the proportions of both mild and moderate IUA cases were significantly higher ( RR=4.16, 95% CI: 2.38-7.14; RR=2.38, 95% CI: 1.75-3.23; both P<0.01). (2) The pregnancy rates of mild, moderate and severe IUA diagnosed according to CSGE were 11/13, 64.5% (147/228), 31.8% (7/22), live birth rates were 11/13, 54.8% (125/228) and 22.7% (5/22), respectively; there were statistically significant differences between the groups (all P<0.01). The pregnancy rates of mild, moderate and severe IUA diagnosed based on AFS were 3/3, 66.9% (97/145) and 56.5% (65/115), respectively, with no statistically significant difference between the groups ( P>0.05). (3) IUA grades based on both CSGE and AFS criteria were significantly negatively correlated with pregnancy rates and live birth rates (CSGE: r=-0.210, r=-0.226; AFS: r=-0.130, r=-0.147; all P<0.05). Univariate logistic regression analysis showed that CSGE had higher OR for both pregnancy rates and live birth rates compared to AFS (3.889 vs 1.657, 3.983 vs 1.554, respectrvely). Conclusions:Compared with AFS, the IUA grade based on CSGE is better related with reproductive prognosis, suggesting that the CSGE standard might be more objective and comprehensive and has better predictive value for reproductive prognosis, thus avoiding overdiagnosis and overtreatment.
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Objective:To investigate the clinical effect of minimally invasive-locking block modified Krackow (MI-LBMK) and open giftbox technique in the treatment of Achilles tendon rupture.Methods:Fifty-six patients with Achilles tendon rupture from January 2016 to December 2018 were collected, including 54 males and 2 females, aged 40.7±9.4 years (range 26 to 65 years). The MI group (30 patients) used two minimally invasive incisions without exposing the rupture site, and the LBMK technique was used to repair the Achilles tendon. The open group (26 patients) used a posteromedial longitudinal incision and the giftbox technique was used to repair the rupture tendon. The Achilles tendon was repaired with 6-strand sutures in both groups. Early rehabilitation programs were adopted for postoperative rehabilitation, and regular follow-up (6 weeks, 3, 6, 12 and 24 months after operation) was performed to record the Achilles tendon resting angle (ATRA), American Orthopaedic Foot and Ankle Society ankle-hindfoot score (AOFAS), Achilles tendon total rupture score (ATRS). The rupture gap and cross-sectional area (CSA) were measured by MRI at 6 weeks and 3 months after surgery.Results:A total of 30 patients in the MI group and 26 in the open group were enrolled. The differences between the two groups in age, body mass index, interval from injury to operation, and tendon rupture site were not statistically significant ( P>0.05). All patients were followed up to 24 months after surgery. There were no wound complications in MI group, and 2 cases of superficial infection and 1 case of wound skin necrosis occurred in open group. There was no re-rupture in both groups. The relative ATRA of MI group was -6.32°±0.99°, -3.90°±1.05°, -2.38°±0.84°, -0.25°±1.37° at 3, 6, 12 and 24 months after operation, respectively. The relative ATRA of open group was -7.88°±3.71°, -6.16°±1.10°, -4.53°±0.95°, -3.01°±0.95° at 3, 6, 12 and 24 months after operation, respectively. The differences between the two groups were statistically significant ( P<0.05). The ATRS of minimally invasive group at 6 months and 12 months were 72.70±7.41 and 92.97±3.35 respectively, and the ATRS of open group at 6 months and 12 months were 68.08±6.64 and 90.85±4.27 respectively, and the differences were statistically significant ( P<0.05). The AOFAS of minimally invasive group at 6 months and 12 months were 88.60±2.76 and 93.83±1.98 respectively, and the AOFAS of open group at 6 months and 12 months were 85.77±3.20 and 92.08±2.64 respectively, and the differences were statistically significant ( P<0.05). The difference in the gap between the tendon rupture ends measured by MRI sagittal plane T2WI between the two groups was not statistically significant ( P>0.05). The cross-sectional area of Achilles tendon in the MI group was higher than that of the open group at 12 weeks ( P<0.05). Conclusion:The MI-LBMK technique may protect the peritendon tissue and has fewer complications, and can enable the patient to return to daily life faster, with lower postoperative Achilles tendon elongation and better recovery of Achilles tendon function.
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Objective:To compare the clinical and imaging outcomes of fascia lata autograft bridging repair reinforecd with an artificial ligament as the internal brace with the autograft bridging repair for the treatment of irreparable massive rotator cuff tears (IMRCTs).Methods:The data of 26 patients with IMRCT who underwent fascia lata autograft bridging repair augmented with artificial ligament as the internal brace (internal brace group) and of 24 patients with IMRCT who underwent bridging autograft repair alone (control group) were retrospectively evaluated preoperatively and at 2-year follow-up. Clinical outcomes were assessed using shoulder activity, the American Shoulder and Elbow Surgeons (ASES) Score, University of California Los Angeles (UCLA) Score, and visual analogue scale (VAS) for pain. Imaging outcomes were evaluated using acromiohumeral distance (AHD), Goutallier grade, and status of fascia lata grafts according to radiographs or magnetic resonance imaging results.Results:All 50 cases were followed up for 34.2±7.2 months (range 24-45 months). Compared to the control group, the internal brace group showed better ASES score (93.5±5.3 vs. 89.5±5.7, P<0.05), UCLA score (31.7±3.8 vs. 28.5±5.6, P<0.05), improvement in UCLA score (19.6±4.2 vs. 15.9±5.7, P<0.05), active elevation (167.3°±8.4° vs. 159.4°±13.6°, P<0.05), abduction strength (8.9±1.2 vs. 8.2±1.2, P<0.05), improvement in abduction strength (4.1±1.2 vs. 3.3± 1.0, P<0.05), AHD (7.0±1.4 mm vs. 5.9±1.0 mm, P<0.05), improvement in AHD (3.3±1.5 mm vs. 2.0±0.6 mm, P<0.05), and healing rate of fascia lata autografts (92% vs. 54%, P<0.05) at 2-year follow-up. Conclusion:Fascia lata autograft bridging repair reinforced with an artificial ligament as the internal brace improves healing rate of bridging graft and postoperatively short-term clinical outcomes of patients with IMRCT.