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Brain metastases are common intracranial diseases featured with high incidence rate, difficult clinical treatment and poor prognosis. Especially for refractory brain metastases (large volume, multiple recurrence and metastatic tumors), it is difficult for conventional therapies to achieve ideal prognosis. Compared with conventional therapies, stereotactic radiosurgery (SRS) has the advantages of high accuracy, large fractional dose and low damage to the surrounding tissues, and has gradually become the primary choice for the treatment of brain metastases. SRS has a good effect in the treatment of refractory brain metastases, and can effectively inhibit tumor proliferation and improve the quality of life of patients. SRS combined with surgery, chemotherapy, molecular targeted therapy and immunotherapy can improve the local tumor control rate of patients with intractable brain metastasis, but whether it can improve the prognosis of patients is still controversial. The adverse reactions of combined therapies should also be concerned. Therefore, this article reviews the therapeutic effects of SRS in the treatment of refractory brain metastases, the strategies and progresses of combined treatment.
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Objective@#To report the effects of operative treatment of Sneppen Ⅴ talus fracture through the approach for malleolus medialis Ⅴ osteotomy plus hollow compression screw fixation.@*Methods@#From January 2015 to January 2019, 16 patients with Sneppen Ⅴ talus fracture were treated at Department Ⅱ of Hand & Foot Microsurgery, The Second Affiliated Hospital to Inner Mongolia Medical University. They were 14 men and 2 women with a mean age of 38.4 years (range, from 20 to 55 years). All fractures were fixed with hollow compression screws through the approach for malleolus medialis Ⅴ osteotomy. The ankle and hindfoot functional scoring system developed by American Orthopaedic Foot and Ankle Society (AOFAS) was used to evaluate the clinical outcomes.@*Results@#All patients were followed up for a mean time of 12.6 months (range, from 6 to 30 months). The mean operation time was 68.4 minutes (range, from 52 to 96 minutes); the mean amount of hemorrhage during operation was 96.8 mL (range, from 48 to 122 mL); the mean period of bone union was 4.8 months (range, from 3 to 8 months). The postoperative mean AOFAS score was 75.3 points (range, from 43 to 91 points). Complications occurred in 4 cases, including one case of talus ischemic necrosis, one case of partial talus ischemic necrosis accompanied by tibial arthritis, one case of subtalar arthritis, and one case of combined tibial, talar and subtalar arthritis. All incisions obtained primary healing, with no complications like infection, screw breakage, delayed union or nonunion.@*Conclusion@#Operative treatment of Sneppen Ⅴ talus fracture through the approach for malleolus medialis Ⅴ osteotomy plus hollow compression screw fixation can provide sufficient operative exposure to facilitate reduction and fixation of the talus fracture so that the ischemic necrosis of the talus and traumatic arthritis can be effectively reduced.
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Objective To report the effects of operative treatment of Sneppen Ⅴ talus fracture through the approach for malleolus medialis Ⅴ osteotomy plus hollow compression screw fixation.Methods From January 2015 to January 2019,16 patients with Sneppen Ⅴ talus fracture were treated at Department Ⅱ of Hand & Foot Microsurgery,The Second Affiliated Hospital to Inner Mongolia Medical University.They were 14 men and 2 women with a mean age of 38.4 years (range,from 20 to 55 years).All fractures were fixed with hollow compression screws through the approach for malleolus medialis Ⅴ osteotomy.The ankle and hindfoot functional scoring system developed by American Orthopaedic Foot and Ankle Society (AOFAS) was used to evaluate the clinical outcomes.Results All patients were followed up for a mean time of 12.6 months (range,from 6 to 30 months).The mean operation time was 68.4 minutes (range,from 52 to 96 minutes);the mean amount of hemorrhage during operation was 96.8 mL (range,from 48 to 122 mL);the mean period of bone union was 4.8 months (range,from 3 to 8 months).The postoperative mean AOFAS score was 75.3 points (range,from 43 to 91 points).Complications occurred in 4 cases,including one case of talus ischemic necrosis,one case of partial talus ischemic necrosis accompanied by tibial arthritis,one case of subtalar arthritis,and one case of combined tibial,talar and subtalar arthritis.All incisions obtained primary healing,with no complications like infection,screw breakage,delayed union or nonunion.Conclusion Operative treatment of Sneppen Ⅴ talus fracture through the approach for malleolus medialis Ⅴ osteotomy plus hollow compression screw fixation can provide sufficient operative exposure to facilitate reduction and fixation of the talus fracture so that the ischemic necrosis of the talus and traumatic arthritis can be effectively reduced.
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Objective: To study the effects of the palatal spur and chincup in the early treatment of anterior open bite in patients with Angle class Ⅰ malocclusion. Methods: Electronic search was conducted to find studies about the effects of the palatal spur and chincup in the early treatment of anterior open bite in patients with Angle class Ⅰ malocclusion. Data extraction and risk of bias assessment of included studies were conducted. RevMan5. 3 software was used fore Meta-analysis. Results: 6 clinical trials were qualified to the Meta-analysis. Compared to the control group, there was no significant change of skeletal measurments after treatment (P＞ 0. 05), and no significant change in dental measurments in chincup group (P＞ 0. 05) . While overbite, U1-PP (mm) and L1-MP (mm) were increased (P ＜ 0. 05), U1-NA (°) and L1-NB (°) decreased (P ＜ 0. 05) in the 3 groups of fixed palatal crib, bonded spur associated with the chincup and the removable palatal spur associated with the chincup. Conclusion: Chincup is not effective in the early treatment of the anterior open bite in patients with Angle class I malocclusion. But chincup combined with palatal spur or crib and have a positive effect on the closure of open bite through the palatal clination and extraction of the anterior teeth without influence of molar intrusion and skeletal change.
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Radiotherapy has been an effective non surgical treatment for brain metastases.While the benefit of survival was achieved,the potential cognitive impairment caused by radiotherapy gradually arouse people's attention.To improve patient's prognosis,ensuring tumor control and caring patients' quality of life and neurocognitive functions should be weighed equally.This article reviews the related research on the neurocognitive protection of brain metastasis radiotherapy.
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OBJECTIVE:To observe the clinical efficacy and safety of Calcitriol soft capsules combined with Telmisartan tab-lets in the treatment of early diabetic nephropathy(DN),and the effect on the levels of inflammatory factors. METHODS:Totally 110 patients with early DN were randomly divided into observation group and control group. The control group was orally given Telmisartan tablets with the initial dose of 40 mg,qd,and the maximum dose was 80 mg,qd;the observation group was orally giv-en Calcitriol soft capsules 0.25μg based on the treatment of control group,qd. The course was 1 month. The clinical data was com-pared,including the clinical efficacy and 24 h urinary protein,serum creatinine(Scr),urinary albumin excretion rate(UAER),se-rum C reactive protein (CRP),tumor necrosis factor-α(TNF-α) and interleukin-6 (IL-6) before and after treatment. The adverse reactions were observed. RESULTS:After treatment,the total effective rate in observation group was significantly higher than con-trol group,with significant difference (P<0.05);the 24 h urinary protein,Scr,UAER,and levels of CRP,TNF-α and IL-6 in observation group were significantly lower than control group and before treatment,with significant differences(P<0.01 or P<0.05). There were no obvious adverse reactions in 2 groups. CONCLUSIONS:Calcitriol soft capsules combined with Telmisartan tablets has better efficacy than only Telmisartan tablets in the treatment of DN,and can more effectively improve the levels of CR, TNF-αand IL-6,which is helpful to delay progression of patients.
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Objective To investigate the effect of hypobaric hypoxia postconditioning( HHP) on neurological func-tion prognosis in traumatic brain injury( TBI) rats. Methods 48 adult male Wistar rats were randomly divided into sham group(n=12),fpi group(n=18) and HHP group(n=18). The rat model of TBI was made by the method of fluid percussion injury( FPI) and rats in HHP group were submitted to HHP(360 Torr,2 h,3 trails spaced at 24 h) starting 3 h after FPI. The learning and memory abilitiy,motor coordination,anxiety and depression-like behaviors and surviving neurons of ipsilateral hippocampus were evaluated by Morris water maze( MWM) ,rotatord test,open-field test and hippocampus nissl stain respectly. Results Morris water maze:compared with sham and HHP group, learning and memory abilitiy of rats in fpi group were significantly decreased(F=4. 257 6,P0. 05);Rotatord test:compared with sham group,motor coordination of rats in HHP group were significantly decreased ( F=4. 335 , P0. 05 );Open-field test:compared with sham group, rats of fpi group showed significant anxiety and depression-like behavioral changes, whereas no difference was observed between sham and HHP group;Nissl stain:No difference of surviving neurons of ipsilateral hippocampus CA1 and CA3 re-gion was observed among three gourps at 3 d after FPI(P>0. 05). There were significantly fewer surviving neurons of ipsilateral hippocampus CA1 and CA3 region in fpi group than sham and HHP group at 24 d after FPI ( F =46. 758,5. 486,P<0. 05). Conclusion TBI induces learning and memory impairment,anxiety and depression-like behaviors and neurons death in hippocampus. HHP was first discovered having double effects on neurological func-tion prognosis in TBI rats. On the one hand,HHP can remove the impairment of learning and memory,anxiety and depression-like behaviors and neurons death in hippocampus;on the other hand,HHP impairs motor coordination at the same time.
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OBJECTIVE: Computer has become an important tool in medical works. However, application ability of clinical physicians is imbalanced with the fast development of information technology (IT) system. Therefore, it is necessary to explore a bridge between researchers and integrate decentralized IT resources. Based on this survey, we provide some views concerning IT applying in medical procedures. METHODS: The correlated computer information was collected from a patient with coronary heart disease from early diagnosis, interventional therapy to coronary bypass surgery, until rehabilitation. The medical staffs were investigated from the general status, computer skills, knowledge structure, as well as the acceptance degree of computer application to measure computer skills. RESULTS: The correlated computer information was characterized by large soft variability, a large time span, and various date categories with more dynamic data or three-dimensional data. The investigation of computer knowledge demonstrated that the lack of IT knowledge resulted in poor outcome in their appointed tasks. From the view of self-assessment of IT knowledge, nursing staff and technician exhibited deficiency IT knowledge than doctors, who learned from department training, self-study or internet. Resident physicians and attending physicians were familiar with office system, so they were satisfied with IT skills. In contrary, nurses and majority of high-ranking professor or chief physicians were found difficult to study IT skills. However, most nurses were fond of their office system. The results also demonstrated that people aged 31 -40 years were easy to receive IT system. CONCLUSION: It is very important to enhance the cooperation between computer researchers and medical users for the treatment of coronary atherosclerotic heart disease.
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OBJECTIVE:To provide a method for a scientific and rational formation of hospital drug purchase plan.METHODS:Based on the major factors influencing the drug purchase plans,a moving-average method(mathematical principle)was used to establish computational formula for hospital drug purchase plan model,which was then put into practice.RESULTS:The predicted amount calculated using the computation model could be used to track the actual consumption quantity rapidly;this model could auto-adjust the inventory and dynamically forecast the drug purchase amount.CONCLUSION:The computation model contributes to the scientific and reasonable formation of hospital drug purchase plan thus meeting the needs of majority clinical drugs.
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OBJECTIVE To learn the molecular epidemiologic character of 21 genotypes of human papillomavirus(HPV).METHODS Totally 500 samples from women genital tract secretion were monitored by flow-through hybridization and gene chip,then studying the molecular epidemiologic character of HPV included HPV6,11,16,18,31,33,35,39,42,43,44,45,51,52,53,56,58,59,66,68,and CP8304.RESULTS The total positive rate of 21 genotypes of HPV was 53% in women cervicitis patients,high-risk HPV genotypes were 60% in all positive samples.Among 21 genotypes of HPV,the positive rate of HPV11 was the first(12.4%),but HPV16 positive rate was the first among high-risk genotypes(11.2%).Among the positive rates in different stage of years,the 21-30 years old group was the highest,the 31-40 years old group was the second,total of two groups was 76.6%.CONCLUSIONS The molecular epidemiologic results can be used in development of HPV vaccine,and in prevention and cure of HPV infection.
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OBJECTIVE To set up the infectious disease monitoring platform upon the hospital information system(HIS).In order to study the infectious disease′s early discovery,early reporting,early therapy and early control,to improve the hospital′s capability of prevention and cure of the infectious disease,generally improving the medical treatment quality.METHODS The computer technic was used to auto-collect,save,process the patient′s information.RESULTS To realize the information be shared;play a role in real time effective monitor;to provide the basic information of medical treatment,scientific research,education and management.CONCLUSIONS Realizing the scientific,standardized,systematized management of hospital infectious disease is becoming an important part in the whole HIS as the hospital medical treatment control system.
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OBJECTIVE Based on hospital information system operating platform,the Nosocomial Infection Early Warning Information System is designed to study nosocomial infection concerning its risk factors,occurrence pattern,and control measures so that the epidemic of nosocomial infection could be early found and controlled effectively,the capability of nosocomial infection supervision could be steadily increased.METHODS Adopting C/S framework,the backstage supporter adopted the large-scale database of SQL SERVER 2000 enterprises edition,the front application program used PowerBuilder7 programming.To structure a reporting,early warning,and supervising network,nosocomial infection reporting card software was integrated into resident physician′s working stations,and early warning control software was installed into working stations for department of nosocomial infection.RESULTS The application of the information system could early warn and supervise occurring nosocomial infection cases,help to find the epidemic of nosocomial infection in time and take effectively control measures as soon as possible.CONCLUSIONS Nosocomial Infection Early Warning Information System could early warn and control nosocomial infection on-the-spot,increase efficiency of nosocomial infection management and improve quality of care.
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OBJECTIVE Based on hospital information system operation platform,the antibacterial drugs utilization and control information system was designed to share prescriptions for antibacterial drugs and results for bacteria culture and drug sensitivity,to analyze pathogen composition and drug resistance trend,and supervise physicians to utilize antibacterial drugs properly. METHODS Adopting C/S framework,the backstage supporter adopted the large-scale database of SQL SERVER 2000 enterprises edition,the front application program used PowerBuilder7 programming.Antibacterial drugs utilization software was integrated into resident physician's working stations.Antibacterial drugs utilization control software was installed into working stations for department of nosocomial infection. RESULTS The application of the information system strengthened control of antibacterial drugs utilization and could guide physicians to utilize antibacterial drugs properly. CONCLUSIONS Antibacterial drugs utilization and control information system could reinforce management of antibacterial drugs utilization,and facilitate to utilize antibacterial drugs properly and safely.
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Objective To investigate the clinical characteristics, treatment, and factors of recurrence of abdominal wall endometrioms ( AWE). Methods 19 cases of AWE diagnosed at Shaoxing People' s Hospital from January 2005 to April 2009 were reviewed retrospectively. Results All patients had a history of cesarean section. Eleven patients (57.9%) had the typical complaint of an enlarging mass and pain during menstruation. All patients received surgical excision and postoperative adjuvant therapy of gonadotropin releasing hormone agonist (GnRHa) or Mifepristone treatment for 6 months. The diagnosis was confirmed by histological examination in all patients. At follow- up, ranging from 1 month to 3 years, there was 1 case of recurrence of endometrioms during a follow -up of 2 years. Conclusion AWE could be diagnosed easily by its typical clinical manifestations preoperatively. Sonography or MRI may be helpful in identifying the exact anatomical location of the lesion and in excluding other surgical conditions, however it lacks specificness. Surgical excision is the only effective treatment, and complete and wide local excision is the key point to prevent recurrence. Combination surgical excision with postoperative adjuvant therapy might reduce the recurrence, although its effectiveness need being testified in the future.
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OBJECTIVE To set up a multiple functional information system for prevention, health care and hospital infection management in order to substitute the primitive older methods.METHODS On the platform of hospital information system, to construct above mentioned system, adopting C/S framework, the backstage supporter adopted the large-scale database of SQL SERVER 2000 enterprises edition, the front application program used Power Builder7 programming. The application software where collected all data about happened public health event, infectious disease epidemic situation and hospital information management was integrated into the each work station of the information system of hospital management, in order to form the report related to any department of the hospital, and control network. RESULTS System could come down with the public health event to which every hospital department could find the infectious disease case, hospital infection case, etc. to check, put in order, report, count, analyze, have a look around, inquire about, feedback, and form the monitoring chart with excellent pictures and texts. CONCLUSIONS This software is a medical quality control system of a hospital, can to meet suddenly public health event, infectious disease epidemic situation and hospital infection control, and raise working efficiency in real time to control hospital infection.
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Objective:To study the protective effects of collagen peptide-chromium (Ⅲ) complex (CPCC) on alloxan-induced hepatic injury in mice. Method:The mice were divided into three groups (normal, model, CPCC) and given (po.) water, water and CPCC (Cr3+40?g/kg?d) respectively once a day. After 4 weeks, the model and CPCC groups were injected with alloxan. Then the levels of liver index, serum aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP) were measured. Activities of superoxide dismutase (SOD) ,glutathione peroxidase (GSH-Px) and contents of malondialdehyde (MDA) in liver were tested. Also liver pathological changes were observed. Results:CPCC could reduce the levels of liver index, serum levels of AST,ALT and ALP as well as contents of MDA and activities of SOD and GSH-Px in liver. Hepatocytes lesion was alleviated markedly. Conclusion:CPCC has protective effects on alloxan-induced hepatic injury in mice.
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Objective To establish an effective method for inducing mouse bone marrow mononuclear cells(MNCs) to differentiate into hepatocytes.Methods MNCs were isolated by gradient density centrifugation,and the cells were cultured in Iscove's Modified Dulbecco's medium supplemented with 10 % new bovine serum(NBS),20 ng/ml hepatocyte growth factor(HGF),10 ng/ml fibroblast growth factor-4(FGF-4) and 10 ng/ml oncostatin m(OSM) for 21 days' induction.The medium was changed every 3 days.Results When MNCs were cultured with HGF,FGF-4 and OSM,cuboidal morphology was observed,and cells also expressed marker genes specific for liver cells in a time-dependent manner.?-fetoprotein(AFP) and cytokeratin 19(CK19) were expressed on the day 7,and CK18 and TAT were detected on the day 14-21,in common with the immunofluoresence results.Differentiated cells further demonstrated these cells also acquired functional characteristics of hepatocytes.Conclusion Mouse MNCs can differentiate into hepatocytes when induced by HGF,FGF-4 and OSM.
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Objective To compare rotational DSA with routine DSA in the assessment of intracranial aneurysms. Methods Conventional anteroposterior, lateral and oblique views of DSA and rotational DSA were respectively performed in 20 patients suspected of intracranial aneurysms in subarachnoid hemorrhage using DSA (Philips Integris V 3000DSA system). Images were compared for localization of the aneurysm, shape of the aneurysmal neck and vascular branch anatomy. Results Among 20 patients, only 18 intracranial aueurysms were found by convertional DSA and the other two were only by the rotational DSA. Furthermore, conventional DSA examination could not clarify the relationships of 6 (6/18) aneruysms with their parent arteries and with the vascular branch anatomy including the aneurysmal neck could not be clarified in 7 (7/18) patients. However, shape of the aneurysms and visibility of the aneurysmal neck could be clarified after using the rotational DSA, and meanwhile, vascular anatomy can be indentified with the rotational DSA. Conclusion Rotational DSA often allows better visibility of vascular anatomy and aneurysmal neck compared with conventional DSA, offering more important information for operation.
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OBJECTIVE:To prepare a rapid-disintegrated lozenge METHODS:The formula and technology were decided by taking the disintegrating time and dissolubility as standard RESULTS:The lozenge could completely disintegrate in 20s and the accumnlated dissolubility of the model drug was 99% after 5 minutes in phosphate buffer(pH=6 80) CONCLUSION:Using now available equipment,suitable excipients and workmanship can prepare a rapid-disintegrated lozenge
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Objective To obtain the molecular epidemiological data of Human Papilloma virus(HPV) 16 and HPV 18 and screen new HPV strains. Methods Common type HPV, HPV16 and HPV18 were amplified by PCR and then cloned and sequenced. Results The infection rates of HPV16、 HPV18 accounted for 10.51% of total HPV infection rate in the area. The infection rate of HPV16 was higher than that of HPV18 ( P