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Objective:To evaluate the effects of smart stethoscope on the monitoring childhood asthma exacerbation, so as to assist family management in childhood asthma.Methods:A prospective randomized controlled study was carried out.A total of 80 children with asthma who were treated at Department of Pediatric Respiratory, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine and Shanghai Tonxin Pediatric Clinic from November 2020 to May 2021 were enrolled and randomly divided into a test group of 40 cases (used the smart stethoscope) and a control group of 40 cases(not used the smart stethoscope). Medical history data were collected.The control group received monthly routine follow-up, while the test group was followed up both routinely and by smart stethoscope.In the test group, hearing wheezing sound was regarded as asthma exacerbation, and in the control group, the asthma exacerbation was reported by the parents themselves.The frequency of asthma exacerbation, asthma control level and quality of life were compared between the two groups.The recognition, diagnosis, treatment and outcomes of acute asthma exacerbation in two groups of children were described and analyzed.Measurement data were analyzed by t test or Mann- Whitney U test.Numeration data were analyzed by χ2 test. Results:Respiratory sounds collected by smart stethoscope in the test group were assessed by 3 specialist physicians.There were 12 wheezing rales (42.86%), 1 moist rale (3.57%) and 1 rhonchi rale (3.57%). Besides, 12 files (42.86%) were difficult to distinguish, and 2 files (7.14%) induced inconsistent identification.The number of asthma exacerbation was 12 in the test group and 5 in the control group.In the test group, 12 were recognized by the smart stethoscope, and only 6 were recognized by the parents.Comparing the diagnosis and treatment measures between two groups, it was found that there were more children in the test group (38.1%) receiving home treatment through telemedicine than those in the control group (20.0%). Besides, there were less children (61.9%) in the test group receiving unplanned hospital treatment (including unplanned outpatient, emergency and hospitalization) than those in the control group (80.0%). There was no statistically significant difference between the two groups of children during acute asthma exacerbation ( χ2=4.67, P=0.097). Parents were satisfied with the common functions, convenience and stability of smart stethoscope. Conclusions:Smart stethoscope can acquire the respiratory sounds of children with asthma in real time, achieving timely detection, diagnosis and treatment of asthma exacerbation in children.What′s more, smart stethoscope reduces the incidence of unplanned hospital diagnosis and treatment, and assists parents with better family management of children asthma.
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Chronic atrophic gastritis (CAG), a common disease of digestive system, is an extremely important cause of gastric cancer (GC). The occurrence and development of CAG involves the abnormality of multiple signaling pathways. Traditional Chinese medicines (TCMs) has the advantages of mild action, multi-target and small adverse reaction, etc., which broadens the way for the treatment of the disease, and TCMs can play a therapeutic role by regulating multiple signaling pathways. In this review, based on the related experiments of TCMs and Chinese herbal compounds in recent years, the related literatures were searched and 10 kinds of signaling pathways involved were summarized, in order to provide a reference for further research on reversing or delaying the progress of CAG and preventing gastric cancer.
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The genus Rosa (Rosaceae family) includes about 200 species spread in the world, and this genus shows unique advantages in medicine and food. To date, several scholars concentrated on compounds belonging to flavonoids, triterpenes, tannins, polysaccharide, phenolic acids, fatty acids, organic acids, carotenoids, and vitamins. Pharmacological effects such as antineoplastic and anti-cancer properties, anti-inflammatory, antioxidant, liver protection, regulate blood sugar, antimicrobial activity, antiviral activity, as well as nervous system protection and cardiovascular protection were wildly reported. This article reviews the chemical constituents, pharmacological effects, applications and safety evaluations of Rosa plants, which provides a reference for the comprehensive utilization of medicine and food resources and gives a scientific basis for the development of medicinal plants of the genus Rosa.
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Objective:To study the patterns of tocilizumab (TCZ) use, its efficacy and safety in patients with rheumatoid arthritis (RA) in routine clinical practice.Methods:A total of 407 patients with RA were enrolled from 23 centers and treated with TCZ within 8 weeks prior to the enrollment visit, and were followed for 6-month. The patterns of TCZ treatment at 6 months, the effectiveness and safety outcomes were recorded. Statistical analysis was performed using SAS version 9.4.Results:A total of 396 patients were included for analysis, in which 330 (83.3%) patients received TCZ combined with conventional synthetic disease-modifying antirheumatic drugs (csDMARDs), and 16.7%(66/396) received TCZ monotherapy. At baseline, TCZ was initiated in 56.6%(224/396) and 9.6%(38/396) of patients after failure of DMARDs and other biological agents (bDMARDs) respectively. During the 6-month follow-up period, the mean frequency of TCZ administration was (3.7±1.6), the mean TCZ dosage was (7.4±1.2) mg/kg, and the mean interval between doses was (40±13) days. 120(25.8%) patients were on TCZ treatment at the end of the study. Improvements in disease activity, systemic symptoms and patient report outcomes were observed at the end of the study. 22.7%(90/396) patients experienced at least one treatment related adverse event, and 8 patients experienced at least one serious adverse event.Conclusion:This study demonstrates that TCZ treatment is effective in patients with RA when being treated for 6 months with an acceptable safety profile. The duration of TCZ treatment needs to be extended.
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Basophils have been neglected for a long time as an immune cell.Recently, it gained respect because of its important role in helper T lymphocytes(Th)2 immune response.Basophils are involved in the pathogenesis of bronchial asthma through a variety of possible mechanisms.Basophils can act as initiators initiate and establish Th2 immune response by interacting with dendritic cells; basophils can act as immune regulators, regulate immune cell functions such as type 2 innate lymphoid cells by secreting cytokines such as interleukin 4 to consolidate allergic inflammation; basophils can also act as immune effectors participate in allergic airway inflammation through IgE-depended and non IgE-depended activation.In addition, clinical research is focused on the usage of basophil activation status as possible biomarker in predicting the outcome of allergic disease therapy, which is of great clinic value in individualized management of asthma.
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BACKGROUND:Currently, the study of total hip arthroplasty in elderly is more. Perioperative treatment and postoperative rehabilitation are increasingly perfect, but the study of middle-aged total hip arthroplasty is less, especialy long curative effect in postoperative and long-term folow-up stil has many problems to be solved. In China, there are few studies addressing how to select the prosthesis during total hip arthroplasty in middle-aged patients, which kind or material of prosthesis is better, so the evidence for clinical application is less. OBJECTIVE:To compare and analyze the repair effects of bone cement total hip arthroplasty and uncemented total hip arthroplasty in middle-aged patients. METHODS:A total of 60 middle-aged patients who received total hip arthroplasty in the Department of Orthopedics, Xinjiang Uygur Autonomous Region Chinese Medicine Hospital from January 2005 to January 2008 were folowed up for 5 years. Their mean age was (37±6) years. There were 32 cases undergoing uncemented total hip arthroplasty and 28 cases receiving bone cement total hip arthroplasty. At 6 months, 2 and 5 years after replacement, Harris score for recovery of limb function and imaging findings were compared and analyzed. RESULTS AND CONCLUSION: Harris score for recovery of limb function was significantly better in the uncemented total hip arthroplasty group than in the bone cement total hip arthroplasty group at 6 months, 2 and 5 years after replacement (P < 0.01). No complications were found at 6 months in the uncemented total hip arthroplasty group, but one case affected osteolysis at 2 years and two cases experienced prosthesis loosing at 5 years after arthroplasty. In the bone cement total hip arthroplasty group, two cases had osteolysis and one case had prosthesis loosing at 6 months after arthroplasty, three cases had prosthesis loosing at 2 years, and two cases affected linear permeability dissolvement at 5 years after arthroplasty. These findings suggest that uncemented prosthesis achieved a high rate of functional restoration and a low rate of complications in middle-aged patients. Uncemented total hip arthroplasty had satisfactory clinical and radiographic outcomes at a minimum of 5-year folow-up.
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Objective To investigate the features of empathy deficiency of the patients with schizophrenia, and to analyze the relationship between empathy ability, clinical symptoms, and social function.Methods The patients with first-episode schizophrenia (n=30)and the normal controls (n=30)were selected.Interpersonal Reactivity Index-C(IRI-C),Positive and Negative Syndrome Scale (PANSS),and the Scale of Social Function in Psychosis Inpatients (SSPI )were used to measure the score of empathy, mental symptoms and the social ability;the total score of empathy and the scores of four scales in two groups were compared;the relationships between the empathy ability score and clinical symptom score,social function score in patients group were analyzed.Results The IRI-C score of the patients in schizophrenia patients group was lower than that in normal control group (P0.05) in schizophrenia patients group. Conclusion The first-episode schizophrenia patients have empathy deficiency, which is affected by the negative syndromes. The more severe negative symptoms of the patients are,the worse empathy ability is.
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BACKGROUND:The selection of metal implant for old patients with femoral intertrochanteric fracture should focus on patient’s age, osteoporotic degree, perioperative status and type of fracture. Individual therapeutic program should be made. OBJECTIVE:To compare the therapeutic effects of four types of metal implant fixation for femoral intertrochanteric fracture in old patients. METHODS:180 old patients with femoral intertrochanteric fractures treated from September 2009 to September 2012 were analyzed. Four kinds of metal implants were used for repair of fracture. There were 45 patients in the dynamic hip screw group, proximal femoral nail anti-rotation group, Gamma nail group and anatomical dynamic hip lock nickelclad group, separately. Operation time, blood loss, hospital time, Harris score after operation, fracture healing time and complications in different groups were compared. RESULTS AND CONCLUSION:Operation time and hospital time were shorter, and blood loss was fewer in the anatomical dynamic hip lock nickelclad group and proximal femoral nail anti-rotation group compared with the dynamic hip screw group and Gamma nail group (P0.05). The incidence of complications was significantly lower in the anatomical dynamic hip lock nickelclad group and proximal femoral nail anti-rotation group compared with the Gamma nail group and dynamic hip screw group (P<0.05). Results suggested that anatomical dynamic hip lock nickelclad and proximal femoral nail anti-rotation are reliable in treatment of intertrochanteric fracture in old patients, show less postoperative complications, and are ideal choices for implant fixation of femoral intertrochanteric fracture in old patients.
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ObjectiveTo survey the incidence of depression in rheumatoid arthritis (RA) and explore the related factors.MethodsOne hundred and fifty-nine patients with RA were investigated.All of them were assessed by depression scale and Hamilton Depression Rating Scale.A mono-variate and multivariate Logistic regression analysis were carried out to determine the factors that best related to the occurrence of depression in RA.ResultsThe overall incidence rate was 39.6％.The regression analysis showed that factors related to the occurrence of depression in RA were HAQ-DI (OR=3.276,95％CI 1.315-7.814,P=0.003),the number of tender joints (OR=2.252,95％CI 1.117-3.362,P=0.029),low-income families (OR=1.629,95％CI 1.215-2.437,P=0.031 ) and serum CRP level (OR=1.528,95％CI 1.112-2.294,P=0.040).ConclusionDepression is common in patients with RA.Patients who havehigh HAQ-DI,CRP and from low-income families with more tender joints tend to develop depression.
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The major medications in asthma management includes bronchodilating B2-agonists,anti-inflammatory inhaled corticosteroids,leukotriene modifiers and theophyllines.However,there is a high degree of heterogeneity in each patient response to asthma drugs.Studies show that much as 70％ of the range of individual variability might be due to genetic characteristics of each patient.Pharmacogenomics offers the possibility to optimize medications for individual asthmatics to promote efficacy and avoid side effect by means of genetic information.Bronchodilator reversibility and asthma exacerbations in patients taking β-agonists contiously have relationship with the Gly16Arg genotype for the ADRβ2.Moreover,genetic variation in β2-adrenergic receptor (Arg16Gly) may predict response to anticholinergics for the treatment of asthma.In case of inhaled corticosteroids,using a traditional SNP-based approach identified a gene for corticotropin releasing hormone receptor 1 as a potential marker of response.Variants in CRHR1,TBX21,and FCER2 are related with the variability in response for lung function,airways responsiveness,and exacerbations in patients taking inhaled corticosteroids.Another major pathway is the one underlying response to cysteinyl leukotriene receptor antagonist.Variants in ALOX5,LTA4H,LTC4S,ABCC1,CYSLTR2 and SLCO2B1 are associated with the variable responses to LTs.Pharmacogenomic method based on the individual genetic information will be introduced into an asthma treatment guideline and provide patients best individual treatments.
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Objective To study the influence of anticipatory and post-event information processing on the memories and perception of the symptom in patients with social anxiety disorder (SAD). Methods A group of 32 SAD patients and a control group of 35 healthy indivisuals were included. Instruments including Self-Rating Depression Scale, Subjective Units Discomfort Scale( SUDS ), Rumination Questionnaire ,Open-ended Recall and Body Sensations Questionnaire were adopted in both groups. Results In the group SAD, no significant difference was identified between the experimental group( (49.68 ± 17.68), ( 19.00 ± 1.25), (0. 54 ±0. 17) ) and the experimental control group( ( 50.43 ± 20.72 ), ( 18.68 ± 1.25 ), ( 0.52 ± 0.17 ) ) when the ratings the memories of body sensations, rumination, and negative self-information score were compared (P＞ 0.05 ). There was a significant positive correlation between the level of rumination ,SUDS, the memories of negative self-information and the body sensations scores( r= 0.72; r= 0.94; r= 0.70, P＜ 0.01 ). The scores of rumination explained 64% of the variation in SUDS scores(β=0.82, P＜0. 01 ). Conclusion This study suggest that social anxiety is affected directly by rumination which can result in more memories of negative self-information and the body sensation. Symptoms are maintained by post-event information processing.
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<p><b>OBJECTIVE</b>To treat unstable fractures of the distal end of the radius with open reduction and internal fixation with T-type plate.</p><p><b>METHODS</b>45 patients were treated with T-type plate. Bone graft was used in fifteen patients with severe bone defect. Clinical findings of 45 patients with fractures of the distal end of the radius (one is bilateral fractures) showed fairly good results.</p><p><b>RESULTS</b>The patients were followed up for an average period of 25.36 months. 41 patients showed excellent or good results with a rate of 91.11%.</p><p><b>CONCLUSION</b>It is difficult to reduce unstable fracture of the distal end of the radius in the way of close reduction. Re-displacement is frequent for external fixation and is not reliable in maintaining reduction. These fractures should be treated with early open reduction and internal fixation, and reasonable exercise should be taken after the operation. Good results can be predicted. The most important factors affecting final outcome include radial shortening and reduction of articular surface.</p>
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Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Fracture Fixation, Internal , Radius Fractures , General SurgeryABSTRACT
Objective:To evalute the role of antidepressants in the treatment of functional dyspepsia.Methods:Separated 50 functional dyspepsia(FD)patients into 2 groups by random.Then treated the antidepressant group antidepressants,while the antidyspepsia group was treated with drugs to cure primary digestive system disease by individual principle.And both groups were treated with supportive psychotherapy.The therapy continued for 8 weeks.Mental and symptoms state evaluation was done before and after treatment by Self-Rating Anxiety Scale(SAS),Self-Rating Depression Scale(SDS)and by symptoms.Results:There was significant difference in the scores of SAS and SDS between the FD groups and normal groups(P0.05).Conclusions:FD patients commonly have depression or anxiety.Antidepressants have good efficiency in treatment of FD patients who has emotional impediment both for improving somatic and psychological symptoms.