Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 6.495
Filtrar
1.
Mater Sci Eng C Mater Biol Appl ; 110: 110728, 2020 May.
Artículo en Inglés | MEDLINE | ID: mdl-32204038

RESUMEN

In order to achieve an effective balance between plasticity and strength, a group of Ti-26Nb-xZr-yMn (x = 4, 7, 10 wt% and y = 3, 5 wt%) alloys were designed to evaluate the effects of Mn and Zr on the microstructures, mechanical properties and strengthening effects of the TiNb system. All the investigated alloys illustrate a monolithic ß phase in their microstructure and they all possess substantial true plasticity (~160%) and true maximum strength (~ 950 MPa) without fracture during the compression tests within the load capacity of 100 kN. The contribution of solid-solution, grain-boundary and dislocation strengthening mechanisms have been evaluated using the strengthening model for ß Ti alloys for all the investigated alloys. Among the investigated alloys, Ti-26Nb-4Zr-5Mn demonstrates the highest true yield strength (654 MPa), dislocation density (2.45 × 1015 m-2) and hardness (242 HV) along with improved strain hardening ability in terms of strain hardening indices (0.42 and 0.09). Furthermore, based on the superior mechanical properties among the investigated alloys, the electrochemical performance of Ti-26Nb-4Zr-3Mn and Ti-26Nb-4Zr-5Mn have also been analyzed in this work. The electrochemical measurements show that both alloys have almost similar corrosion potential and corrosion current density in simulated body fluid, i.e., -0.45 V and 0.838 nA/cm2 for Ti-26Nb-4Zr-3Mn, -0.48 V and 0.839 nA/cm2 for Ti-26Nb-4Zr-5Mn, respectively.

3.
J Nutr Health Aging ; 24(3): 269-276, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32115607

RESUMEN

OBJECTIVES: Multimorbidity is common in older hospitalized adults. To date, however, few studies have addressed multimorbidity in the older population of Chinese inpatients. We aimed to investigate the multimorbidity rate and associated risk factors in older adult inpatients in China. DESIGN, SETTING, PARTICIPANTS: This study was conducted in the medical wards of a tertiary-care hospital from. The patients were recruited aged between 60 to 101 (74.14±8.46) years. MEASUREMENTS: Data were obtained from the China Comprehensive Geriatric Assessment Study, conducted in 2011-2012 in China. A total of 4,633 inpatients older than 60 years was recruited from 12 hospitals in 7 cities throughout China. The prevalence of comorbidity, distribution of common chronic diseases, and the associated risk factors were studied. RESULTS: A total of 4,348 people aged 60 to 101 (74.14±8.46) years completed questionnaires. The average frequency of multimorbidity was 69.3% (95% CI, 67.9% to 70.6%). The prevalence of multimorbidity increased with age and was higher in men (71.6%; 95% CI, 69.9% to 73.3%) than in women (65.3%, 95% CI 63.0% to 67.6%), and higher in the northern region (71.7%, 95% CI 69.9% to 73.5%) than in the southern region (66.0%; 95% CI, 63.8% to 68.1%). The most frequent chronic diseases were hypertension, coronary heart disease, diabetes, cataract, and stroke. Area (OR=0.556; 95% CI, 0.465 to 0.666), region (OR=0.834; 95% CI, 0.723 to 0.962), body mass index (BMI) (OR=1.124; 95% CI, 1.017 to 1.242), and impairment of activities of daily living (OR=0.911; 95% CI, 0.855 to 0.970) were independent factors associated with multimorbidity. CONCLUSIONS: Multimorbidity is common in older Chinese inpatients with a national prevalence of 69.3% that increases in line with age. Age, region, area, BMI, and daily activities were independent factors significantly associated with multimorbidity in older inpatients. Clinicians should therefore focus more attention on multimorbidity.

4.
Ann Oncol ; 31(4): 517-524, 2020 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-32151507

RESUMEN

BACKGROUND: Adenosquamous carcinoma (ASC) of the lung is a heterogeneous disease that is composed of both adenocarcinoma components (ACC) and squamous cell carcinoma components (SCCC). Their genomic profile, genetic origin, and clinical management remain controversial. PATIENTS AND METHODS: Resected ASC and metastatic tumor in regional lymph nodes (LNs) were collected. The ACC and SCCC were separated by microdissection of primary tumor. The 1021 cancer-related genes were evaluated by next-generation sequencing independently in ACC and SCCC and LNs. Shared and private alterations in the two components were investigated. In addition, genomic profiles of independent cohorts of adenocarcinomas and squamous cell carcinomas were examined for comparison. We have also carried out a retrospective study of ASCs with known EGFR mutation status from 11 hospitals in China for their clinical outcomes. RESULTS: The most frequent alterations in 28 surgically resected ASCs include EGFR (79%), TP53 (68%), MAP3K1 (14%) mutations, EGFR amplifications (32%), and MDM2 amplifications (18%). Twenty-seven patients (96%) had shared variations between ACC and SCCC, and pure SCCC metastases were not found in metastatic LNs among these patients. Only one patient with geographically separated ACC and SCCC had no shared mutations. Inter-component heterogeneity was a common genetic event of ACC and SCCC. The genomic profile of ASC was similar to that of 170 adenocarcinomas, but different from that of 62 squamous cell carcinomas. The incidence of EGFR mutations in the retrospective analysis of 517 ASCs was 51.8%. Among the 129 EGFR-positive patients who received EGFR-TKIs, the objective response rate was 56.6% and the median progression-free survival was 10.1 months (95% confidence interval: 9.0-11.2). CONCLUSIONS: The ACC and SCCC share a monoclonal origin, a majority with genetically inter-component heterogeneity. ASC may represent a subtype of adenocarcinoma with EGFR mutation being the most common genomic anomaly and sharing similar efficacy to EGFR TKI.

5.
AJNR Am J Neuroradiol ; 41(3): 373-379, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-32165361

RESUMEN

Intracranial aneurysms with subarachnoid hemorrhage lead to high morbidity and mortality. It is of critical importance to detect aneurysms, identify risk factors of rupture, and predict treatment response of aneurysms to guide clinical interventions. Artificial intelligence has received worldwide attention for its impressive performance in image-based tasks. Artificial intelligence serves as an adjunct to physicians in a series of clinical settings, which substantially improves diagnostic accuracy while reducing physicians' workload. Computer-assisted diagnosis systems of aneurysms based on MRA and CTA using deep learning have been evaluated, and excellent performances have been reported. Artificial intelligence has also been used in automated morphologic calculation, rupture risk stratification, and outcomes prediction with the implementation of machine learning methods, which have exhibited incremental value. This review summarizes current advances of artificial intelligence in the management of aneurysms, including detection and prediction. The challenges and future directions of clinical implementations of artificial intelligence are briefly discussed.

6.
Zhonghua Yi Xue Za Zhi ; 100(10): 757-762, 2020 Mar 17.
Artículo en Chino | MEDLINE | ID: mdl-32192288

RESUMEN

Objective: To investigate the correlations of serum total 25-hydroxyvitamin D (T-25 (OH) D) levels with serum cytokine levels including interleukin-6 (IL-6), interleukin-8 (IL-8) and tumor necrosis factor α (TNF-α) and Crohn's disease activity index (CDAI) in patients with Crohn's disease (CD). Methods: A total of 60 patients with CD admitted in Peking Union Medical College Hospital from April 2014 to March 2019 who completed the tests for serum T-25 (OH) D and cytokines (IL-6, IL-8 and/or TNF-α) were retrospectively enrolled. Clinical data were collected for analysis. Results: Among 60 CD patients, there were 46 male patients, and the age was (34±13) years. There were 16 patients (26.7%) in remission and 44 cases (73.3%) in active status. The T-25(OH)D level was (16.0±7.7)µg/L. The prevalence of vitamin D sufficiency, insufficiency and deficiency was 26.7%, 40.0% and 33.3%, respectively. Correlation analysis showed that serum T-25 (OH) D level was negatively correlated with CDAI (r=-0.363,P=0.004), IL-6 level (r=-0.360,P=0.007), hsCRP level(r=-0.272, P=0.043) and ESR level(r=-0.293, P=0.024), while positively correlated with serum Alb level(r=0.372, P=0.003)、Hb(r=0.330, P=0.010) and BMI(r=0.276, P=0.033).Twenty-three cases (52.3%) of active CD patients accompanied with infection had a lower level of serum T-25 (OH) D than those without infection [(12.55±7.17) vs (17.41±6.49)µg/L, P=0.023]. Conclusion: Serum T-25 (OH) D level was negatively correlated with CDAI, serum IL-6 level and inflammatory markers in patients with CD, and it was lower in active CD patients with infection than those without infection.

7.
Zhonghua Bing Li Xue Za Zhi ; 49(3): 234-238, 2020 Mar 08.
Artículo en Chino | MEDLINE | ID: mdl-32187894

RESUMEN

Objective: To analyze the expression of SMARCE1 in clear cell meningioma (CCM), and evaluate the role of SMARCE1 in the differential diagnosis in morphologically similar diseases. Methods: Thirteen samples/11 cases of CCMs were collected from the First Affiliated Hospital of Fujian Medical University, Shandong Provincial Hospital, Xuanwu Hospital of Capital Medical University and Thaihe Hospital of Hubei Province from January 2000 to December 2018, as well as 17 cases of meningiomas with clear-cell-like morphology, 782 cases of other types of meningiomas and other intracranial tumors with clear-like morphology. A tissue microarray was made using these cases, on which immunohistochemical/histochemical staining of SMARCE1, SSTR2, EMA, Ki-67, p53, PAS and D-PAS were performed. Result: The tumor cells of CCM had sheet-like architecture, without typical whorl formation.The CCM had round to polygonal cells, with clear, glycogen-rich cytoplasm and prominent blocky perivascular and interstitial collagen. The immunohistochemistry staining showed that none of the CCMs expressed SMARCE1(0/13).However, all of the other types of lesions, including meningioma(782/782), meningiomas with clear-like morphology(17/17), intracranial metastatic clear cell renal cell carcinoma(10/10), haemangioblastoma(10/10), central neurocytoma(10/10), oligodendroglioma(10/10), ependymoma(13/13), lioblastoma(42/42), and solitary fibrous tumor/hemangiopericytoma(35/35) showed positive nuclear staining of SMARCE1. Ki-67 index were 1%-5%, and p53 positive-rate were 0-40% in CCMs. PAS stain showed cytoplasmic granular positive and D-PAS were negative in all CCMs and meningiomas with clear-like morphology. Conclusion: SMARCE1 is a useful marker for the diagnosis of CCM and its mimickers.

8.
Int Endod J ; 2020 Mar 19.
Artículo en Inglés | MEDLINE | ID: mdl-32189340

RESUMEN

AIM: The objectives of this laboratory-based study were to investigate the effects of GH12 on E. faecalis biofilm and virulence. METHODOLOGY: Minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) of GH12 against E. faecalis were first determined. Time-kill assay was further conducted. The effects of GH12 on the expression of virulence and stress genes in E. faecalis were evaluated by RT-qPCR. Crystal violet stain was used to investigate the effects of GH12 on E. faecalis biofilm formation and 1-day-old biofilm. Finally, an ex vivo tooth model contaminated with E. faecalis was used to evaluate the antimicrobial activity of GH12 as an irrigant by CFU counting, SEM and CLSM. One-way ANOVA and Tukey's multiple comparisons test were used to compare the differences among groups (α = 0.05). RESULTS: The MICs and MBCs of GH12 against E. faecalis were 8.0 ± 0.0 mg/L and 16.0 ± 0.0 mg/L, respectively and GH12 at 32.0 mg/L reduced the bacterial numbers by more than 99.9% within 1 min. Various virulence genes (efaA, esp, gelE) and stress genes (dnaK, groEL, ctsR, clpPBCEX) in E. faecalis were significantly downregulated by GH12 at sub-MIC levels (P < 0.05). Additionally, both E. faecalis biofilm formation and the biomass of 1-day-old E. faecalis biofilms were significantly reduced by GH12 (P < 0.05). Elimination of E. faecalis in biofilms from root canal walls was achieved through irrigation with 64.0 mg/L GH12 for 30 min. CLSM analysis revealed that GH12 at 64.0 mg/L was most effective in eliminating bacteria within dentinal tubules (P < 0.05). CONCLUSION: In a laboratory setting, and when used as an irrigant, GH12 suppressed E. faecalis, downregulated specific virulence and stress-associated genes, eliminated intracanal E. faecalis protected by biofilms and killed bacteria in dentinal tubules. These results emphasise the need for preclinical and clinical studies to explore the potential of GH12 as an antimicrobial agent in root canal treatment.

9.
Zhonghua Er Ke Za Zhi ; 58(3): 213-217, 2020 Mar 02.
Artículo en Chino | MEDLINE | ID: mdl-32135593

RESUMEN

Objective: To discuss the clinical characteristics and management approaches to hepatitis associated aplastic anemia (HAAA) presenting as hemophagocytic lymphohistiocytosis (HLH) at onset. Methods: The clinical data and laboratory results of hospitalized 5 HAAA patients presenting as HLH at onset in Beijing Children's Hospital from January 2017 to May 2019 were analyzed retrospectively. Results: Among 5 cases, there were 4 males and 1 female. The age of onset was 6.0 (2.7-12.7) years. All patients presented with high fever, hepatomegaly, hepatic dysfunction (aspartate aminotransferase 1 716 (1 409-2 570) U/L, alanine aminotransferase 1 699 (937-2 540) U/L) at onset. After admission, the laboratory results showed pancytopenia (white blood cell 1.2 (0.6-6.7) ×10(9)/L, haemoglobin 94 (65-111) g/L, blood platelet 29 (10-41) ×10(9)/L), decreased fibrinogen (1.3 (1.1-2.5) g/L), significantly elevated triglyceride (4.0 (2.8-5.1) mmol/L), ferritin (1 766 (399-5 253) µg/L) and soluble CD25 (27 457 (9 625-44 000) ng/L). Hemophagocytosis was found in the bone marrow smears of all 5 patients. The diagnosis of acute hepatitis and HLH was confirmed. During the treatment of HLH, the blood cells remain below normal level and the further biopsy of bone marrow (iliac bone) indicated low myeloproliferation. After exclusion of congenital bone marrow failure syndromes and other pancytopenic diseases, HAAA was confirmed. After the diagnosis of HAAA, 1 patient received antithymocyte globulin (ATG) and cyclosporin treatment in our hospital, 1 patient received allogeneic stem cell transplantation (HSCT) in other hospital, 2 patients received ATG in other hospitals. Only 1 patient died of severe infection. Conclusions: HAAA can present as HLH at onset. It is mainly manifested by high fever, acute severe hepatitis, pancytopenia, elevated ferritin and hemophagocytosis in the bone marrow. The diagnosis of HAAA should be considered whenever cytopenia could not completely corrected while apparent improvement of HLH and hepatitis related complications were improved after immunosuppressive therapy. ATG or HSCT treatment should be performed as soon as the diagnosis of severe or transfusion dependent aplastic anemia is confirmed.


Asunto(s)
Anemia Aplásica , Hepatitis , Anemia Aplásica/diagnóstico , Anemia Aplásica/etiología , Suero Antilinfocítico , Niño , Preescolar , Diagnóstico Diferencial , Femenino , Hepatitis/complicaciones , Humanos , Linfohistiocitosis Hemofagocítica/diagnóstico , Linfohistiocitosis Hemofagocítica/etiología , Masculino , Estudios Retrospectivos
10.
Zhonghua Jie He He Hu Xi Za Zhi ; 43(0): E035, 2020 Mar 10.
Artículo en Chino | MEDLINE | ID: mdl-32153167

RESUMEN

Novel coronavirus pneumonia was novel coronavirus infection that has dominated pulmonary infection since December 2019. The main manifestations were fever, dry cough, shortness of breath, normal or leukopenia in peripheral blood and changes in chest CT and in severe cases, multiple organ failure might occur. The National Health Commission, PRC has revised the consensus on diagnosis and treatment seven times in a short period of time, indicating the growing understanding of the disease. Patients with novel coronavirus pneumonia usually had history of travelling or living in the epidemic area including Wuhan within 14 days before onset, or have been exposed to patients who had fever or respiratory symptoms from the epidemic area, or had clustering diseases. However, novel coronavirus pneumonia was becoming more and more blurred after vanishing epidemic. The diagnosis and differential diagnosis of novel coronavirus pneumonia was facing challenges not only because of large number of tourists increasing dramatically after the relieving of epidemic, but also patients with other diseases return from different areas to search for medical care. In this article, the clinical and chest imaging features of the novel coronavirus pneumonia were reviewed and compared with other infections and non-infectious diffuse pulmonary diseases. We were trying to find the similarities and differences among them, and to identify clues to the diagnosis of novel coronavirus pneumonia, so as to ensure accurate diagnosis and treatment.

11.
Artículo en Chino | MEDLINE | ID: mdl-32185923

RESUMEN

OBJECTIVE: To quantitatively evaluate the diagnostic value of variable-temperature and isothermal nucleic acid amplification techniques in the detection of schistosomiasis japonica using a meta-analysis. METHODS: The publications pertaining to the nucleic acid detection of schistosomiasis japonica were searched in electronic databases, including Chinese National Knowledge Infrastructure (CNKI), Wanfang Data, PubMed and ScienceDirect, and the compilations and proceedings of schistosomiasis were manually searched. In addition, the citations of publications associated with the nucleic acid detection of schistosomiasis japonica were traced using a document tracing method. The retrieved literatures were screened according to the inclusion and exclusion criteria, and data were extracted from the included literatures. The quality of the included literatures was assessed using the software RevMan version 5.3, and a meta-analysis was performed using the software MetaDiSc version 1.4. RESULTS: A total of 19 publications covering 24 groups of studies were enrolled, including 5 Chinese publications and 14 English publications. There were 17 groups of studies reporting the comparison between the variable-temperature nucleic acid amplification technique and the golden standard, and 7 groups of studies showing the comparison between the isothermal nucleic acid amplification technique and the golden standard. Assessment of the literature quality indicated a minor overall bias of the included literatures, and the Deek funnel plot showed a possible publication bias in the documents reports variable-temperature nucleic acid amplification techniques. There was a heterogeneity caused by non-threshold effect among the studies associated with the variable-temperature amplification technique, and the random effects model was therefore used to combine the effects. The pooled sensitivity and specificity of the variable-temperature amplification technique were 0.81 (0.79 to 0.83) and 0.73 (0.71 to 0.74) for the diagnosis of schistosomiasis japonica, and area under the SROC curve was 0.944 3. There was no heterogeneity among the studies associated with the isothermal amplification technique, and the fixed effects model was therefore used to combine the effects. The pooled sensitivity and specificity of the isothermal amplification technique were 0.96 (0.94 to 0.98) and 0.95 (0.94 to 0.97) for the diagnosis of schistosomiasis japonica, and area under the SROC curve was 0.989 9. CONCLUSIONS: Both variable-temperature and isothermal nucleic acid amplification techniques have a high efficiency for the diagnosis of schistosomiasis japonica, and the isothermal amplification technique shows a relatively higher accuracy than the variable-temperature amplification technique.


Asunto(s)
Técnicas de Amplificación de Ácido Nucleico , Esquistosomiasis Japónica , Humanos , Curva ROC , Esquistosomiasis Japónica/diagnóstico , Sensibilidad y Especificidad
12.
Zhonghua Xue Ye Xue Za Zhi ; 41(2): 132-137, 2020 Feb 14.
Artículo en Chino | MEDLINE | ID: mdl-32135630

RESUMEN

Objective: To evaluate the outcomes of myelodysplastic syndromes (MDS) patients who received HLA-matched sibling donor allogeneic peripheral blood stem cell transplantation (MSD-PBSCT) . Methods: The clinical data of 138 MDS patients received MSD-PBSCT from Sep. 2005 to Dec. 2017 were retrospectively analyzed, and the overall survival (OS) rate, disease-free survival (DFS) rate, relapse rate (RR) , non-relapse mortality (NRM) rate and the related risk factors were explored. Results: ①After a median follow-up of 1 050 (range 4 to 4 988) days, the 3-year OS and DFS rates were (66.6±4.1) % and (63.3±4.1) %, respectively. The 3-year cumulative incidence of RR and NRM rates were (13.9±0.1) % and (22.2±0.1) %, respectively. ②Univariate analysis showed that patients with grade Ⅲ-Ⅳ acute graft-versus-host disease (aGVHD) or hematopoietic cell transplantation comorbidity index (HCT-CI) ≥2 points or patients in very high-risk group of the Revised International Prognostic Scoring System (IPSS-R) had significantly decreased OS[ (42.9±13.2) %vs (72.9±4.2) %, χ(2)=8.620, P=0.003; (53.3±7.6) %vs (72.6±4.7) %, χ(2)=6.681, P=0.010; (53.8±6.8) %vs (76.6±6.2) %vs (73.3±7.7) %, χ(2)=6.337, P=0.042]. For MDS patients with excess blasts-2 (MDS-EB2) and acute myeloid leukemia patients derived from MDS (MDS-AML) , pre-transplant chemotherapy or hypomethylating agents (HMA) therapy could not improve the OS rate[ (60.4±7.8) %vs (59.2±9.6) %, χ(2)=0.042, P=0.838]. ③Multivariate analysis indicated that the HCT-CI was an independent risk factor for OS and DFS (P=0.012, HR=2.108, 95%CI 1.174-3.785; P=0.008, HR=2.128, 95%CI 1.219-3.712) . Conclusions: HCT-CI was better than the IPSS-R in predicting the outcomes after transplantation. The occurrence of grade Ⅲ-Ⅳ aGVHD is a poor prognostic factor for OS. For patients of MDS-EB2 and MDS-AML, immediate transplantation was recommended instead of receiving pre-transplant chemotherapy or HMA therapy.


Asunto(s)
Enfermedad Injerto contra Huésped , Trasplante de Células Madre Hematopoyéticas , Leucemia Mieloide Aguda , Síndromes Mielodisplásicos , Humanos , Estudios Retrospectivos , Hermanos , Acondicionamiento Pretrasplante , Trasplante Homólogo
13.
Zhonghua Xue Ye Xue Za Zhi ; 41(2): 138-142, 2020 Feb 14.
Artículo en Chino | MEDLINE | ID: mdl-32135631

RESUMEN

Objective: To reveal the related factors of inhibitors and differences ofhemorrhage and joint disease before and after the production of inhibitors in children with hemophilia A (HA) . Methods: Retrospective analyses of the clinical data of 381 children with HA under the age of 16 registered in the Registration Management Center of Hemophilia in Henan Provincial from January 2015 to August 2018. Results: A total of the 381 children were enrolled with 116 (30.4%) mild, 196 (51.4%) moderate, and 69 (18.1%) severe cases; 54 patients (14.2%) had inhibitors, including 22 high and 32 low titer inhibitors. Positive family history was positively associated with inhibitors[P<0.001, OR=3.299 (95%CI 1.743-5.983) ], and high-intensity exposure was associated with inhibitors[P=0.002, OR=2.587 (95%CI 1.414-4.731) ]. High-intensity exposure was associated with high titer inhibitor production[P=0.001, OR=8.689 (95%CI 2.464-30.638) ], and high-intensity exposure increased the risk of high titer inhibitors in HA patients. After inhibitors occurred in 54 patients with HA, the rates of overall joint annual bleeding (z=-3.440, P=0.001) and traumatic annual bleeding (z=-2.232, P=0.026) increased, but the rates of the annual joint bleeding (z=-1.342, P=0.180) and spontaneous annual bleeding (z=-1.414, P=0.157) remained to be not statistically significant. The joint ultrasound score did not change significantly after the inhibitor information (z=-0.632, P=0.527) . Conclusions: Positive family history and high-intensity exposure could increase the risk of F Ⅷ inhibitors in HA patients, and high-intensity exposure increased the risk of high titer inhibitors. The rates of the overall joint annual bleeding and traumatic annual bleeding increased after the inhibitor information.


Asunto(s)
Factor VIII/uso terapéutico , Hemofilia A , Niño , Hemartrosis , Hemofilia A/tratamiento farmacológico , Hemorragia , Humanos , Estudios Retrospectivos
14.
Artículo en Inglés | MEDLINE | ID: mdl-32156446

RESUMEN

The aim of this retrospective study was to use computer-aided design and manufacturing (CAD/CAM) patient-specific plates and cutting guides for the waferless positioning and fixation of the maxilla after bimaxillary osteotomies in cases of hemifacial microsomia with condylar dysplasia or absence of the temporomandibular joint (TMJ), and to compare the results with the CAD/CAM fabricated surgical wafer by 3-dimensional analysis. Eighteen patients were selected from the hospital database, preoperative surgical planning and simulation were done on 3-dimensional computed tomographic models for all patients, and they were divided into Group I - in which CAD/CAM patient-specific cutting guides and plates were used; and Group II - in which CAD/CAM fabricated surgical wafers were used. Finally, the outcome was evaluated by comparing planned with postoperative outcomes. The largest discrepancies of the Le Fort I segment were 0.50 (0.18) mm in the anteroposterior direction and 0.82 (0.60)° in the yaw orientation with Group I. The largest discrepancies of the Le Fort I segment were 1.32 (1.40) mm in superioinferior direction and 8.48 (7.73)° in the yaw orientation with Group II. The CAD/CAM patient-specific cutting guides and plates proved to be reliable and have great value in improving the accuracy in repositioning the Le Fort I segment and in the efficacy of orthognathic treatment of hemifacial microsomia with condylar dysplasia or no TMJ. The CAD/CAM patient-specific cutting guides and plates are therefore a useful alternative to the wafer technique.

16.
Zhonghua Yi Xue Za Zhi ; 100(7): 504-508, 2020 Feb 25.
Artículo en Chino | MEDLINE | ID: mdl-32164100

RESUMEN

Objective: To observe the difference of pulmonary function among patients with dysphagia after stroke, patients without dysphagia and normal people, and to explore the correlation between swallowing function and pulmonary function. Methods: From September 2018 to April 2019, 310 stroke patients were enrolled from the rehabilitation department and neurology department of sun yat-sen memorial hospital, sun yat-sen university, of which 60 were selected as standard stroke patients. Pulmonary function of the three groups was assessed by pulmonary function detector and further compared. The swallowing function of the dysphagia group after stroke was examined by using videofluroscopic swallowing study (VFSS). The swallowing function was quantitatively assessed by Rosenbek penetration-aspiration scale (PAS), dysphagia outcome and severity scale (DOSS) and videofluoroscopy dysphagia scale (VDS), and the correlation between swallowing function and respiratory function was analyzed. Results: There were significant differences in pulmonary function among three groups (P<0.05). Besides the FEF25,FVC, FIVC between patients with dysphagia after stroke and patients without dysphagia, the FEF75 between patients without dysphagia and normal people (all P>0.05), there were significant differences in the pairwise comparison of other indicators (all P<0.05). There were correlations between PAS and MIP (r=-0.618, P=0.001),PAS and MEP (r=-0.410, P=0.038), PAS and PEF (r=-0.443, P=0.024), DOSS and MIP (r=0.602, P=0.000),DOSS and MEP (r=0.496, P=0.005), DOSS and PEF (r=0.553, P=0.002), VDS and MEP (r=-0.483, P=0.012),VDS and PEF (r=-0.494, P=0.010), respectively. Conclusion: The pulmonary function of dysphagia patients after stroke decrease significantly, and the severity of dysphagia is correlated with the decrease of pulmonary function.

17.
Zhonghua Liu Xing Bing Xue Za Zhi ; 41(2): 167-172, 2020 Feb 10.
Artículo en Chino | MEDLINE | ID: mdl-32164124

RESUMEN

Post-traumatic tetanus is the main type of non-neonatal tetanus. To reduce the incidence and mortality rateof tetanus and guide the primary medical institutions to prevent and control tetanus after trauma, the National Immunization Planning Technical Working Group of the Chinese Center for Disease Control and Prevention has compiled this document in the reference with Position Paper by World Health Organization, and the latest research progress both at home and abroad. The guidelines focus on the basic procedures for the prevention and treatment of post-traumatic tetanus, the application of tetanus vaccines and immune preparation, and pre-exposure immunization in high-risk populations of trauma.

18.
Zhonghua Liu Xing Bing Xue Za Zhi ; 41(2): 173-177, 2020 Feb 10.
Artículo en Chino | MEDLINE | ID: mdl-32164125

RESUMEN

Objective: The aim of this study was to analyze the disease burden of cirrhosis and other chronic liver diseases caused by hepatitis B in China, from 1990 to 2016, and to provide evidence for the development of related strategies. Methods: Data were collected from the results of the Global Burden of Disease Study 2016 (GBD2016). We analyzed the current epidemiological patterns by calculating the prevalence, mortality, and disability adjusted life year (DALY) of cirrhosis and other chronic liver diseases, caused by hepatitis B during 1990 and 2016 in China. Results: Compared with data from 1990, the number of patients and deaths with cirrhosis and other chronic liver diseases caused by hepatitis B in 2016 increased by 79.6% and 2.4%, respectively. The prevalence increased by 49.2%, higher (50.3%) in males than that (42.3%) in females. Compared with other age groups, the increase (33.2%) of prevalence appeared the fastest, in the 15-49 age group. In males, the number of deaths and DALYs increased by 13.6% and 2.2%, respectively. In 2016, the five top provinces on age-standardized DALY rates, appeared as Qinghai (314.6 per 100 000), Guizhou (303.1 per 100 000), Yunnan (262.4 per 100 000), Guangxi Zhuang Autonomous Region (239.6 per 100 000) and Taiwan (227.2 per 100 000). Conclusions: From 1990 to 2016, the prevalence rates of hepatitis B related cirrhosis and other chronic liver diseases showed an upward trend, particularly in males and in people aged 15 to 49 years old, in China. However, the disease burden of different provinces was unevenly distributed. Based on our findings, we suggested that strategies that related to prevention and management of hepatitis B caused cirrhosis and other chronic liver diseases should be paid more attention to.

19.
Zhonghua Liu Xing Bing Xue Za Zhi ; 41(2): 201-206, 2020 Feb 10.
Artículo en Chino | MEDLINE | ID: mdl-32164130

RESUMEN

Objective: To calculate both the epidemic and intensity thresholds for different levels in Beijing and to establish a tiered alert system in the 2018-2019 influenza season as well as to evaluate the performance of calculated thresholds. Method: Weekly count of influenza-like illness and percentage of influenza-like illness (ILI%) of the last five influenza seasons were modeled by 'moving epidemic method' (MEM) to calculate the influenza epidemic and intensity thresholds at different levels. A cross-validation procedure was used to evaluate the performance. Indicators of Matthew correlation coefficient, Youden's index, sensitivity and specificity were calculated. Results: For weekly count of influenza-like illness, data showed that the epidemic threshold for 2018-2019 influenza season was 12 984 and the medium, high and very high intensity thresholds were 22 503, 37 589, 47 157, respectively. Matthew correlation coefficient of the epidemic threshold was 62% and youden's index as 60% , sensitivity as 69%, specificity as 91%. Data on weekly ILI%, the epidemic threshold for 2018-2019 influenza season was 1.66%, with medium, high and very high intensity thresholds as 2.46%, 3.84% and 4.66%, respectively. The overall Matthew correlation coefficient of the epidemic threshold was 59%, with 54% for the Youden's index, sensitivity as 60% and specificity as 94%. Conclusions: MEM produced a good specific signal for detecting the influenza epidemics and the accuracy of the method was acceptable. The early warning performance regarding the application of weekly count on influenza-like illness was slightly better than ILI%. This method could be applied in the practical influenza epidemic alert "work in Beijing" .

20.
Zhonghua Liu Xing Bing Xue Za Zhi ; 41(2): 249-260, 2020 Feb 10.
Artículo en Chino | MEDLINE | ID: mdl-32164138

RESUMEN

Objective: To evaluate the relative safety of different ventilation methods regarding mortality and rates of complication, on neonatal respiratory distress syndrome (NRDS). Methods: Network Meta-analysis was used to collect data on randomized controlled trials of pulmonary ventilation strategies in preterm infants with a mean gestational age of less than 32 weeks. Diagnostic criteria on NRDS were published in the PubMed, Cochrane, Web of Science, EBSCO, and Springer Link databases from January 1986 to June 2018. Revman 5.3 software was used to evaluate the quality of studies, based on the Cochrane quality assessment tool. Data were analyzed by Bayesian and frequency methods, using both Win BUGS 1.4.3 and STATA 13.0 software. Safety of different ventilation strategies for NRDS mortality and complications would include intraventricular hemorrhage (IVH), patent ductus arteriosus (PDA) and retinopathy of prematurity (ROP) and were evaluated. Counted data was displayed by OR and 95%CI. Results: A total of 31 RCTs were included in this paper, including 5 827 preterm infants and 11 ventilation strategies. There were no statistically significant differences appearing in 11 ventilation strategies on mortality, PDA or ROP. IVH results were reported in 28 studies. Compared with nasal intermittent positive pressure ventilation (NIPPV), both high- frequency oscillation ventilation (HFOV) (OR=3.33, 95%CI: 1.08-16.67, P<0.05) and synchronized intermittent mechanical ventilation (SIMV) (OR=8.22, 95%CI: 1.25-29.44, P<0.05) schemes seemed to have increased the risk of IVH in preterm infants with NRDS. NIPPV appeared the optimal ventilation strategy in the rankings of cumulative probability. Results on clustering showed that NIPPV was probably the best ventilation strategy for children with NRDS after considering the orders of IVH, PDA and ROP on mortality, respectively. However, HFOV, IMV, and SIMV did not seem to be the ideal ventilated strategies. Conclusions: Most of the clinical decision makers might prefer using NIPPV in the treatment of children with NRDS through mechanical ventilation systems to reduce both the incidence and death caused by IVH, PDA and ROP. It was not recommended to use HFOV, SIMV and IMV in treating NRDS with gestational less than 32 weeks. We suggested that larger numbers of multi-center RCTs ba carried out to make the above conclusions more convincing.

SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA