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Orthopedic surgeons treating fractures need to consider comorbidities, including chronic kidney disease (CKD), which affects millions worldwide. CKD patients are at elevated risk of fractures due to osteoporosis, especially in advanced stages. In addition, fractures in CKD patients pose challenges due to impaired bone healing and increased post-fracture complications including surgical site infection and nonunion. In this article, we will discuss factors that must be considered when treating fractures in CKD patients. Perioperative management includes careful adjustment of hemodialysis schedules, selection of anesthetic methods, and addressing bleeding tendencies. Tourniquet usage for fractures in limbs with arteriovenous fistulae should be cautious. Pain medication should be administered carefully, with opioids like hydromorphone preferred over nonsteroidal anti-inflammatory drugs. Medical management after fractures should address underlying factors and include physical rehabilitation to reduce the risk of subsequent fractures. A comprehensive approach to fracture management in CKD patients can improve outcomes.
Subject(s)
Fractures, Bone , Orthopedic Surgeons , Osteoporosis , Renal Insufficiency, Chronic , Humans , Fractures, Bone/etiology , Osteoporosis/complications , Renal Insufficiency, Chronic/complications , Renal Insufficiency, Chronic/therapy , Renal Dialysis/adverse effects , Bone DensityABSTRACT
BACKGROUND: Therapies for relapsed/refractory acute myeloid leukemia remain limited and outcomes poor, especially amongst patients who are ineligible for cytotoxic chemotherapy or targeted therapies. PATIENTS AND METHODS: This phase 1b trial evaluated venetoclax, a B-cell lymphoma-2 (BCL-2) inhibitor, plus cobimetinib, a MEK1/2 inhibitor, in patients with relapsed/refractory acute myeloid leukemia, ineligible for cytotoxic chemotherapy. Two-dimensional dose-escalation was performed for venetoclax dosed daily, and for cobimetinib dosed on days 1-21 of each 28-day cycle. RESULTS: Thirty patients (median [range] age: 71.5 years [60-84]) received venetoclax-cobimetinib. The most common adverse events (AEs; in ≥40.0% of patients) were diarrhea (80.0%), nausea (60.0%), vomiting (40.0%), febrile neutropenia (40.0%), and fatigue (40.0%). Overall, 66.7% and 23.3% of patients experienced AEs leading to dose modification/interruption or treatment withdrawal, respectively. The composite complete remission (CRc) rate (complete remission [CR]â¯+â¯CR with incomplete blood count recoveryâ¯+â¯CR with incomplete platelet recovery) was 15.6%; antileukemic response rate (CRcâ¯+â¯morphologic leukemia-free state/partial remission) was 18.8%. For the recommended phase 2 dose (venetoclax: 600 mg; cobimetinib: 40 mg), CRc and antileukemic response rates were both 12.5%. Failure to achieve an antileukemic response was associated with elevated baseline phosphorylated ERK and MCL-1 levels, but not BCL-xL. Baseline mutations in ≥1 signaling gene or TP53 were noted in nonresponders and emerged on treatment. Pharmacodynamic biomarkers revealed inconsistent, transient inhibition of the mitogen-activated protein kinase (MAPK) pathway. CONCLUSION: Venetoclax-cobimetinib showed limited preliminary efficacy similar to single-agent venetoclax, but with added toxicity. Our findings will inform future trials of BCL-2/MAPK pathway inhibitor combinations.
Subject(s)
Antineoplastic Combined Chemotherapy Protocols , Azetidines , Bridged Bicyclo Compounds, Heterocyclic , Leukemia, Myeloid, Acute , Piperidines , Sulfonamides , Humans , Bridged Bicyclo Compounds, Heterocyclic/therapeutic use , Bridged Bicyclo Compounds, Heterocyclic/pharmacology , Bridged Bicyclo Compounds, Heterocyclic/administration & dosage , Sulfonamides/pharmacology , Sulfonamides/therapeutic use , Sulfonamides/administration & dosage , Aged , Male , Female , Middle Aged , Azetidines/therapeutic use , Azetidines/pharmacology , Azetidines/administration & dosage , Piperidines/therapeutic use , Piperidines/pharmacology , Aged, 80 and over , Leukemia, Myeloid, Acute/drug therapy , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Antineoplastic Combined Chemotherapy Protocols/pharmacology , Antineoplastic Combined Chemotherapy Protocols/adverse effects , Treatment Outcome , Drug Resistance, Neoplasm/drug effectsABSTRACT
Due to increasingly documented health effects associated with airborne particulate matter (PM), challenges in forecasting and concern about their impact on climate change, extensive research has been conducted to improve understanding of their variability and accurately forecasting them. This study shows that atmospheric PM10 concentrations in Brunei-Muara district are influenced by meteorological conditions and they contribute to the warming of the Earth's atmosphere. PM10 predictive forecasting models based on time and meteorological parameters are successfully developed, validated and tested for prediction by multiple linear regression (MLR), random forest (RF), extreme gradient boosting (XGBoost) and artificial neural network (ANN). Incorporation of the previous day's PM10 concentration (PM10,t-1) into the models significantly improves the models' predictive power by 57-92%. The MLR model with PM10,t-1 variable shows the greatest capability in capturing the seasonal variability of daily PM10 (RMSE = 1.549 µg/m3; R2 = 0.984). The next day's PM10 can be forecasted more accurately by the RF model with PM10,t-1 variable (RMSE = 5.094 µg/m3; R2 = 0.822) while the next 2 and 3 days' PM10 can be forecasted more accurately by ANN models with PM10,t-1 variable (RMSE = 5.107 µg/m3; R2 = 0.603 and RMSE = 6.657 µg/m3; R2 = 0.504, respectively).
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Pigeons show flocking and homing behaviors,which require characteristics including long-distance weight-bearing and continuous flight,with excellent navigation and spatial cognitive abilities.Pigeons have been widely used in animal robot research in recent years.Pigeon robots achieve motor behavior control by applying neural information intervention to specific neural targets in the pigeon's brain.This review summarizes research progress in pigeon robots based on the sensory system,motivation and emotional system or cortex and midbrain motor area respectively,according to the distribution of hierarchical multi-level neural regulatory targets in the pigeon's brain,with the aim of providing reference and guidance for further applied research into the use of pigeon robots in space perception,reconnaissance,and anti-terrorism search and rescue.
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This systematic review and meta-analysis aimed to comprehensively evaluate the effectiveness of electroacupuncture (EA) for patients with anxiety. Randomized controlled trials (RCTs) on the treatment of anxiety by EA up to November 2022 were searched and collected from nine databases. Hamilton Anxiety Rating Scale (HAMA), self-rating anxiety scale (SAS), and adverse reactions were used as outcome indicators. The quality of relevant articles was evaluated using the Cochrane Collaboration's risk of bias tool. The quality of evidence for each outcome was classified as "low risk," "unclear risk," or "high risk." RevMan 5.0 was used for data analysis. A total of 633 articles were identified from nine electronic databases; 37 RCTs were included, which measured anxiety changes by using EA alone compared to the control group. For the main outcome, EA significantly reduced the HAMA score [Mean difference (MD):-1.13 (95% CI:-2.55-0.29), I2:80%], and the quality of evidence was moderate. EA significantly reduced the SAS score (MD:-3.47 (95% CI,-6.57--0.36), I2:88%), and the quality of evidence was moderate. Our meta-analysis shows that EA reduces HAMA and SAS. This study suggests that EA can relieve anxiety. For various uses, additional research is needed on its effect when combined with other treatments. Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=345658, identifier (CRD42022345658).
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Objective To investigate the therapeutic effect of urolithin A (UA) on pediatric pneumonia and the underlying mechanisms. Methods The pediatric infantile pneumonia model was constructed by intratracheal induction of lipopolysaccharide (LPS) in 1-week-old C57BL/6 mice (male, 45 g). UA was also injected intraperitoneally. Lung tissues in each group were examined by histological analysis. Autophagy, inflammation, and oxidative stress were assessed by enzyme-linked--immunosorbent serologic assay and immunoblot analysis. Moreover, pyrophosis and endoplasmic reticulum stress were also evaluated by immunoblot analysis. Results UA alleviated lung inflammation in mice, and inhibited cell pyrophosis. In addition, UA A relieved both oxidative and endoplasmic reticulum stress. Furthermore, we found that UA alleviated pneumonia damage by inducing protective autophagy. Conclusion UA induced protective autophagy to alleviate inflammation, oxidative stress, and endoplasmic reticulum stress in pediatric pneumonia (AU)
Subject(s)
Animals , Male , Mice , Endoplasmic Reticulum Stress , Pneumonia/drug therapy , Disease Models, Animal , Inflammation/drug therapy , Mice, Inbred C57BL , Oxidative Stress , Apoptosis , AutophagyABSTRACT
OBJECTIVE@#To explore the therapeutic effect and safety of acupoint thread embedding therapy in treatment of simple obesity of stomach heat and damp obstruction.@*METHODS@#A total of 144 patients with simple obesity of stomach heat and damp obstruction were randomized into an acupoint thread embedding group (72 cases, 3 cases dropped off and 1 case removed) and a sham-embedding group (72 cases, 6 cases dropped off and 3 cases removed). On the base of the lifestyle adjustment, the acupoint thread embedding therapy with PGLA thread was applied to Tianshu (ST 25), Zhongwan (CV 12), Ganshu (BL 18), Shuidao (ST 28), etc. in the acupoint thread embedding group, while in the sham-embedding group, the acupoint selection and operation were all same as the acupoint thread embedding group, but without PGLA thread embedded. In either group, the treatment was given once every 2 weeks, consecutively for 12 weeks and the follow-up was conducted for 3 months after treatment. Separately, before and after treatment as well as in follow-up, the obesity indices (body mass index [BMI], waist circumference [WC], waist-to-hip ratio [WHR] and fat percentage [F%]) were observed in the two groups. Before and after treatment, the indices of blood glucose and insulin (fasting blood glucose [FBG], fasting insulin [FINS] and insulin resistance index [HOMA-IR]), adipocyte factor indices (adiponectin, leptin [LP] and serine protease inhibitor [Vaspin]) and inflammatory factor indices (tumor nercosis factor [TNF-α], interleukin-1β [IL-1β] and interleukin-6 [IL-6]) were observed separately in the two groups. The therapeutic effect and safety were compared between the two groups.@*RESULTS@#After treatment and in follow-up, except WC and WHR in the sham-embedding group, BMI, WC, WHR and F% were all reduced as compared with those before treatment in the two groups (P<0.01, P<0.05), and the values in the acupoint thread embedding group were lower than the sham-embedding group (P<0.01). After treatment, except FBG, LP and Vaspin in the sham-embedding group, FBG, FINS, HOMA-IR, LP and Vaspin were all reduced as compared with those before treatment in the two groups (P<0.01, P<0.05), and adiponectin was increased as compared with that before treatment (P<0.01, P<0.05); the improvements in the acupoint thread embedding group were more significant than the sham-embedding group (P<0.01). After treatment, the levels of serum TNF-α, IL-1β and IL-6 in the acupoint thread embedding group were reduced as compared with the values before treatment and those in the sham-embedding group separately (P<0.01). The total effective rate was 89.7% (61/68) in the acupoint thread embedding group, higher than 19.0% (12/63) in the sham-embedding group (P<0.01). There was no severe adverse reaction reported in the two groups.@*CONCLUSION@#Acupoint thread embedding therapy with PGLA thread can alleviate obesity, regulate glucose metabolism and adipocyte factors activity, improve insulin resistance and inhibit the expression of pro-inflammatory factors in the patients with simple obesity with stomach heat and damp obstruction, and this therapy presents a satisfactory safety in treatment.
Subject(s)
Humans , Acupuncture Points , Acupuncture Therapy , Body Mass Index , Hot Temperature , Obesity/therapy , StomachABSTRACT
BACKGROUND@#Intensive phototherapy (IPT) and exchange transfusion (ET) are the main treatments for extreme hyperbilirubinemia. However, there is no reliable evidence on determining the thresholds for these treatments. This multicenter study compared the effectiveness and complications of IPT and ET in the treatment of extreme hyperbilirubinemia.@*METHODS@#This retrospective cohort study was conducted in seven centers from January 2015 to January 2018. Patients with extreme hyperbilirubinemia that met the criteria of ET were included. Patients were divided into three subgroups (low-, medium-, and high- risk) according to gestational week and risk factors. Propensity score matching (PSM) was performed to balance the data before treatment. Study outcomes included the development of bilirubin encephalopathy, duration of hospitalization, expenses, and complications. Mortality, auditory complications, seizures, enamel dysplasia, ocular motility disorders, athetosis, motor, and language development were evaluated during follow-up at age of 3 years.@*RESULTS@#A total of 1164 patients were included in this study. After PSM, 296 patients in the IPT only group and 296 patients in the IPT plus ET group were further divided into the low-, medium-, and high-risk subgroups with 188, 364, and 40 matched patients, respectively. No significant differences were found between the IPT only and IPT plus ET groups in terms of morbidity, complications, and sequelae. Hospitalization duration and expenses were lower in the low- and medium-risk subgroups in the IPT only group.@*CONCLUSIONS@#In this study, our results suggest that IPT is a safe and effective treatment for extreme hyperbilirubinemia. The indication of ET for patients with hyperbilirubinemia could be stricter. However, it is necessary to have a contingency plan for emergency ET as soon as IPT is commenced especially for infants with risk factors. If IPT can be guaranteed and proved to be therapeutic, ET should be avoided as much as possible.
Subject(s)
Child, Preschool , Humans , Infant , Infant, Newborn , Exchange Transfusion, Whole Blood/adverse effects , Hyperbilirubinemia, Neonatal/therapy , Kernicterus/therapy , Phototherapy/methods , Retrospective StudiesABSTRACT
Objective:To analyze the relationship between free androgen index and insulin function in obese young men aged from 20 to 35.Methods:A total of 82 young obese men in Obesity Clinic from February to October 2019 were enrolled in the study. The subjects were divided into 3 subgroups according to free androgen index level tertiles. The blood glucose and insulin levels were tested after oral glucose tolerance test. Homeostasis model assessment for insulin resistance (HOMA-IR), homeostasis model assessment for β cell function (HOMA-β), insulin secretion index, and insulin sensitivity index (Matsuda index) were used to evaluate β cell function in oder to analyze the relationship between free androgen index and insulin function.Results:In young obese men, participants with higher free androgen index levels exhibited less waist circumference, lower body mass index, 1 h postprandial insulin, 2 h postprandial insulin, HOMA-IR level but with a higher total testosterone, sex hormone binding globulin, and Matsuda index level (all P<0.05). There was a negative correlation between the free androgen index and the HOMA-IR ( r=-0.386, P=0.016), and the correlation tended to a linear trend after adjustment for age, sex, body mass index, and waist circumference ( Ptrend=0.034). Free testosterone was positively correlated with Matsuda index ( r=0.280, P=0.004), but the correlation disappeared after adjustment ( Ptrend=0.623). The results of further regression analysis showed that the level of free testosterone index decreased by 14.1% ( OR=0.869, 95% CI0.767-0.984, P=0.028) for each increase of HOMA-IR after adjustment. Conclusion:The level of free testosterone index is a predictor of insulin resistance in obese young men, but the association between this parameter and insulin sensitivity may be caused by obesity.
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Depression is a serious mental illness with a high incidence. At present, we do not fully understand the specific pathological mechanisms of depression, and the efficacy of drug treatments is very limited. Recent studies have shown that epigenetic changes that occur in specific brain regions may be a key mechanism by which environmental factors to interact with individuals to influence the risk of depression. Therefore, drugs that target epigenetic regulation may become a new direction for the development of antidepressants. Histone deacetylase inhibitors (HDACi) are a class of compounds that inhibit histone deacetylase activity, which has been reported to be associated with depression; this article addresses the use of HDACi in preclinical studies, and their potential therapeutic role and limitations of use in depression.
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Objective:To evaluate the efficacy of modified Xiaoji Baozhong granules combined with scraping in the treatment of abdominal obesity with gastric heat and dampness syndrome and its effect on adipocytokines. Method:One hundred and forty-four patients were randomly divided into the control group and the observation group, 72 cases in each group. The lifestyle adjustments were conducted in both groups. The observation group was given a comprehensive traditional Chinese medicine regimen of modified Xiaoji Baozhong granules combined with scraping. The control group was given modified Xiaoji Baozhong granules combined with scraping. The course of treatment was three months. The body mass index (BMI), body fat percentage (FP), waist circumference (WC), waist to hip ratio (WHR), obesity and abdominal fat thickness of the two groups were compared before and after treatment. The levels of fasting blood glucose (FBG), insulin resistance index (HOMA-IR), high density lipoprotein (HDL), low density lipoprotein (LDL), triglyceride (TG), total cholesterol (TC), adiponectin, leptin, resistin, endolipid and tumor necrosis factor-α (TNF-α) were compared between the two groups before and after treatment. The clinical efficacy and safety were evaluated. Result:After treatment, the BMI, FP, obesity, WC and WHR of the observation group were lower than those of the control group (<italic>P</italic><0.01). After treatment, the abdominal wall fat thickness and intra-abdominal fat thickness of patients in the observation group were lower than those in the control group (<italic>P</italic><0.01). The FBG, HOMA-IR, TG, TC and LDL of the observation group were lower than those of the control group (<italic>P</italic><0.01), while the HDL level was higher than the control group (<italic>P</italic><0.01). Adiponectin in the observation group was higher than the control group after treatment (<italic>P</italic><0.01). The leptin, resistin, visfatin and TNF-α were lower than those in the control group (<italic>P</italic><0.01). The total clinical efficacy rate of patients in the observation group was 88.24% (60/68), which was better than 73.53% (50/68) in the control group (<italic>χ</italic><sup>2</sup>=4.755, <italic>P</italic><0.05). Conclusion:In addition to lifestyle adjustments, modified Xiaoji Baozhong granules combined with scraping treatment can reduce the degree of obesity and fat thickness in patients with abdominal obesity, and regulate lipid, carbohydrate metabolism and adipocytokines, with a better clinical efficacy than simple scraping therapy and the safety in practice.
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Objective:To investigate the clinical characteristics and prognosis of cytomegalovirus (CMV) reactivation in patients with liver failure.Methods:A total of 75 patients diagnosed with liver failure and tested for serum CMV DNA between January 2016 and June 2019 in Huashan Hospital, Fudan University were retrospectively analyzed. According to the CMV DNA test results, the patients were divided into CMV DNA positive group and CMV DNA negative group. The classification of liver failure, the use of glucocorticoids, the proportions of T lymphocyte subsets of the two groups were compared and the prognosis was evaluated. Mann-Whitney U test and chi-square test were used to analyze the data. Results:Of the 75 patients with liver failure, 17 were CMV DNA positive and 58 were CMV DNA negative. Among the 17 CMV DNA positive patients, nine were acute (subacute) liver failure, and 13 were treated with glucocorticoids, which were all significantly higher than those in the CMV negative group (20.7%(12/58) and 20.7%(12/58), respectively). The differences were both statistically significant ( χ2=6.70 and 18.40, respectively, both P<0.05). The proportions of CD3 + T lymphocytes and CD8 + T lymphocytes in the CMV DNA positive group were both higher than those in the CMV DNA negative group, and the proportions of CD4 + T lymphocytes, the ratio of CD4 + /CD8 + T lymphocytes and the proportion of B lymphocytes were all lower than those in the CMV DNA negative group. The differences were all statistically significant ( U=274.50, 165.50, 273.00, 185.00 and 189.00, respectively, all P<0.05). Acute (subacute) liver failure (odds ratio ( OR)=4.3, 95% confidence interval ( CI) 1.3-12.6) and glucocorticoid use ( OR=12.5, 95% CI 3.4-38.3) were risk factors for CMV reactivation in patients with liver failure. The disease improvement rate in the CMV DNA negative group was 56.9% (33/58), and five out of 17 patients improved in the CMV DNA positive group, with a statistically significant difference ( χ2=1.99, P=0.04). Conclusions:The use of glucocorticoids increases the risk of CMV reactivation in patients with liver failure, and CMV reactivation in patients with liver failure presents immune disorders which seriously affect their prognosis. Therefore, it is important to pay attention to CMV DNA monitoring in patients with liver failure using glucocorticoids.
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Objective:To investigate the effect of Comprehensive Reminder System Based on Health Belief Model (CRS-HBM) on health knowledge, belief, behaviors, utilization of health services and clinical outcomes in stroke patients after discharge. Methods:From February, 2015 to March, 2016, 174 stroke patients with hypertension were divided into control group (n = 87) and intervention group (n = 87). The control group received routine stroke health education, and the intervention group received the CRS-HBM program in addition. They were investigated with Stroke Knowledge Questionnaire (SKQ), Short Form Health Belief Model Scale for Stroke Patients (SF-HBMS-SP), Health Behavior Scale for Stroke Patients (HBS-SP), and the utilization of health services and clinical outcomes (emergency, re-hospitalization, recrudescence and death) were recorded six months after discharge. Results:A total of 75 cases in the control group and 76 in the intervention group finished the research. The total scores of SKQ (U = 903.000), SF-HBMS-SP (t = -9.099) and HBS-SP (t = -7.786) were more in the intervention group than in the control group (P < 0.001). The outpatient re-visit rate was more in the intervention group (97.37%) than in the control group (76.00%) (P < 0.001). The incidence of emergency, re-hospitalization, recrudescence and death were not significantly different between the two groups (P > 0.05). Conclusion:The application of CRS-HBM can improve the health knowledge, belief, behaviors for stroke patients after discharge, but there are not enough effects on clinical outcomes.
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italic>N-Acetylaspartate (NAA) is a highly abundant brain metabolite. Nowadays, as an important marker reflecting the function of nervous system, NAA is widely used in the results analysis of nuclear magnetic resonance spectroscopy (1H MRS). NAA is synthesized in mitochondria of neurons and metabolized in oligodendrocytes. Additionally, NAA may be converted to the dipeptide N-acetylaspartylglutamate (NAAG), and catabolized into NAA and glutamate in astrocytes. NAA is related to a variety of central nervous system diseases, including Canavan disease, multiple sclerosis, depression, schizophrenia and other mental diseases. Therefore, NAA may be a biomarker of these diseases, and its related enzymes may be used as therapeutic targets for drug screening. Here, we combined the current research on the molecular mechanisms of NAA to reveal the process of NAA generation, metabolism and transport in the brain, explain the possible physiological effects of NAA and discuss its relationship with central nervous system diseases, explore the prospect of NAA in disease prediction and diagnosis, as well as the targeted treatment that may become the breakthrough of refractory diseases.
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Coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was found initially in Wuhan, China in early December 2019. The pandemic has spread to 216 countries and regions, infecting more than 23310 000 people and causing over 800 000 deaths globally by Aug. 24, 2020, according to World Health Organization (https://www.who.int/emergencies/diseases/ novel-coronavirus-2019). Fever, cough, and dyspnea are the three common symptoms of the condition, whereas the conventional transmission route for SARS-CoV-2 is through droplets entering the respiratory tract. To date, infection control measures for COVID-19 have been focusing on the involvement of the respiratory system. However, ignoring potential faecal transmission and the gastrointestinal involvement of SARS-CoV-2 may result in mistakes in attempts to control the pandemic.
Subject(s)
Humans , Betacoronavirus/isolation & purification , COVID-19 , China/epidemiology , Coronavirus Infections/virology , Environmental Microbiology , Feces/virology , Gastrointestinal Diseases/virology , Models, Biological , Pandemics , Pneumonia, Viral/virology , RNA, Viral/genetics , SARS-CoV-2 , Virus SheddingABSTRACT
How to extract high discriminative features that help classification from complex resting-state fMRI (rs-fMRI) data is the key to improving the accuracy of brain disease recognition such as schizophrenia. In this work, we use a weighted sparse model for brain network construction, and utilize the Kendall correlation coefficient (KCC) to extract the discriminative connectivity features for schizophrenia classification, which is conducted with the linear support vector machine. Experimental results based on the rs-fMRI of 57 schizophrenia patients and 64 healthy controls show that our proposed method is more effective ( ., achieving a significantly higher classification accuracy, 81.82%) than other competing methods. Specifically, compared with the traditional network construction methods (Pearson's correlation and sparse representation) and the commonly used feature selection methods (two-sample -test and Least absolute shrinkage and selection operator (Lasso)), the algorithm proposed in this paper can more effectively extract the discriminative connectivity features between the schizophrenia patients and the healthy controls, and further improve the classification accuracy. At the same time, the discriminative connectivity features extracted in the work could be used as the potential clinical biomarkers to assist the identification of schizophrenia.
Subject(s)
Humans , Algorithms , Brain , Brain Mapping , Magnetic Resonance Imaging , Schizophrenia , Diagnostic ImagingABSTRACT
Objective@#Hypoglossal nerve-facial nerve 'side'-to-side neurorrhaphy is a new method for the treatment of potential incomplete facial paralysis after acoustic neuroma. However, there are differences in postoperative outcomes among patients. This study analysed preoperative factors that may influence the treatment outcomes of neurorrhaphy.@*Methods@#We performed a retrospective study of 53 patients who were treated by neurorrhaphy for facial paralysis after acoustic neuroma resection. After a one-year follow-up period, the patients were divided into two groups according to facial functional outcome: better recovery or ordinary recovery. We analysed the following factors: gender, age, tumour size, and characteristics, tumour adhesion to the facial nerve, the duration of facial paralysis (DFP) and F wave appearance prior to neurorrhaphy (F wave).@*Results@#Univariate analysis showed significant differences between the two groups in DFP ( = 0.0002), tumour adhesion to the facial nerve ( = 0.0079) and F waves ( = 0.0048). Logistic regression analysis of these factors also showed statistical significance with values of 0.042 for the DFP, 0.043 for F waves, and 0.031 for tumour adhesion to the facial nerve.@*Conclusions@#Tumour adhesion to the facial nerve, F waves appearance and DFP prior to neurorrhaphy are the predominant factors that influence treatment outcomes.
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Objective To explore the application of intelligent real-time monitoring in infusion safety. Methods Totally 1 200 patients who received intravenous infusion from November 2017 to June 2018 in the Department of gastroenterology were selected as the study subjects. With system sampling method, 600 patients were selected as observation group who using Intelligent infusion system to monitor the infusion process. Another 600 patients were selected as control group without using the system. The current use rate of infusion fluid, the severity of local exudation during intravenous infusion, the blocking rate of intravenous pathway, the number of nurses dealing with dripping empty infusion of two groups and the rate of erroneous running caused by patients′wrong ringing or false alarm of intelligent infusion system were compared between the two groups. Results The current use rate of infusion fluid in the observation group was 91.33% (548/600) higher than 80.00% (480/600) in the control group (χ2=31.382, P<0.01). The severity of local exudation of intravenous infusion and the obstruction rate of venous access in the observation group were lower than those in the control group (u=415.500, χ2=20.345, P<0.05 or 0.01). The number of nurses in the observation group was lower than 202 in the control group (χ2=93.574, P<0.01). Conclusion The application of intelligent real-time monitoring in infusion can record the dynamic situation of infusion in real time. It can not only improve the quality management level of infusion, but also be accurate, efficient and safe, which is conductive to the treatment and nursing of patients.
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Objective:To investigate the neuroprotective effect of minocycline on the secondary injury after acute closed spinal cord injury in rats. Methods:A total of 24 Sprague-Dawley male rats were randomly divided into saline group (n = 8), magnesium chloride group (n = 8) and minocycline group (n = 8). The closed spinal cord injury model was prepared with balloon compression in the dorsal spinal cord of rat, which was evaluated with magnetic resonance imaging. All rats were successively administered their own drugs for seven days after injury, respectively. They were assessed with BBB score two to 31 days after operation. Their motor-evoked potential and sensory-evoked potential were detected 31 days after operation, and then Luxol Fast Blue was used to observe the area of secondary injury. Results:Animal magnetic resonance imaging showed hypointense in T2 images in T10 spinal cord. BBB score was more in the minocycline group than in the saline group since 17 days after operation (P < 0.05). The amplitude of motor-evoked potential was higher in the minocycline group than in the saline group (P < 0.05), while the area of secondary injury was less (P < 0.05). Conclusion:Minocycline may protect the nerves from secondary injury after acute spinal cord injury.
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Objective@#To explore the application of intelligent real-time monitoring in infusion safety.@*Methods@#Totally 1 200 patients who received intravenous infusion from November 2017 to June 2018 in the Department of gastroenterology were selected as the study subjects. With system sampling method, 600 patients were selected as observation group who using Intelligent infusion system to monitor the infusion process. Another 600 patients were selected as control group without using the system. The current use rate of infusion fluid, the severity of local exudation during intravenous infusion, the blocking rate of intravenous pathway, the number of nurses dealing with dripping empty infusion of two groups and the rate of erroneous running caused by patients′ wrong ringing or false alarm of intelligent infusion system were compared between the two groups.@*Results@#The current use rate of infusion fluid in the observation group was 91.33% (548/600) higher than 80.00% (480/600) in the control group (χ2=31.382, P<0.01). The severity of local exudation of intravenous infusion and the obstruction rate of venous access in the observation group were lower than those in the control group (u=415.500, χ2=20.345, P<0.05 or 0.01). The number of nurses in the observation group was lower than 202 in the control group (χ2=93.574, P<0.01).@*Conclusion@#The application of intelligent real-time monitoring in infusion can record the dynamic situation of infusion in real time. It can not only improve the quality management level of infusion, but also be accurate, efficient and safe, which is conductive to the treatment and nursing of patients.