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Objective:To explore the clinical value of synchronized 12-lead Holter in the diagnosis of coronary heart disease myocardial ischemia.Methods:A total of 101 patients with coronary heart disease who came to the Affiliated Hospital of Jining Medical College from May 2019 to May 2020 were selected. They all received conventional electrocardiogram(ECG) and synchronized 12-lead Holter examinations. The value of different examination methods in the diagnosis of myocardial ischemia was compared, and the characteristics of myocardial ischemia in patients with different degrees of coronary artery disease were analyzed.Results:The detection rates of synchronized 12-lead Holter for myocardial ischemia in single-vessel coronary artery disease and multi-vessel coronary artery disease were 28.71% (29/101) and 56.44%(57/101), respectively, which were slightly higher than 17.82%(18/101) and 45.54% (46/101) of conventional ECG, but with no statistically significant difference ( P>0.05), the total myocardial ischemia detection rate of synchronized 12-lead Holter was 85.15%(86/101), which was higher than 63.37%(64/101) of conventional ECG ( P<0.05). The mean frequency of myocardial ischemia in coronary heart disease diagnosed by synchronized 12-lead Holter was higher than that of conventional ECG, and the duration and amplitude of ST-segment depression were higher than those in conventional ECG ( P<0.05). The detection rates of lateral and inferior myocardial ischemia on synchronized 12-lead Holter were 16.28%(14/86) and 22.09%(19/86), respectively, which were higher than 0 of conventional ECG. The detection rate of myocardial ischemia in the anterior septum/anterior wall was 61.62%(53/86), which was lower than 100.00% (64/64)of the conventional ECG ( P<0.01). Synchronized 12-lead Holter in the diagnosis of coronary cardiac myocardial ischemia was highly consistent with that by coronary angiography, the Kappa value was 0.648, and the sensitivity, specificity, accuracy and negative predictive value were 93.33%, 81.82%, 92.08% and 60.00%, respectively, which were higher than 54.44%, 63.64%, 55.45%, 14.58% of conventional ECG ( P<0.05). The number of myocardial ischemic attacks in patients with multi-vessel disease of coronary heart disease was more than that of single vessel disease ( P<0.05), the mean frequency of myocardial ischemia was higher than that of single vessel disease, and the duration and amplitude of ST-terminal depression were higher than those of patients with single-vessel disease ( P<0.05). Conclusions:Synchronized 12-lead Holter is more effective than conventional ECG in the diagnosis of myocardial ischemic attack of coronary heart disease, and it is more consistent with coronary angiography. It can clarify the frequency and extent of myocardial ischemic attacks and help identify the location of myocardial ischemia. It can be used as an important basis for screening myocardial ischemia attacks of coronary heart disease.
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Background Front-line medical staff are an important group in fighting against Coronavirus Disease 2019 (COVID-19), and their mental health should not be ignored. Objective This study investigates the current situation and influencing factors of post-traumatic stress disorder (PTSD) among front-line anti-epidemic medical staff during COVID-19 epidemic. Methods Medical staff who had participated in fighting against the COVID-19 epidemic wereselected from three grade III Class A hospitals and four grade II Class A hospitals in a city of Hubei Province by convenient sampling method in May 2020. The survey was conducted online using the Post-traumatic Stress Checklist-Civilian Version (PCL-C) as the main survey tool to investigate current situation and characteristics of PTSD among these participants. A total of 1120 questionnaires were collected, of which 1071 were valid, and the effective rate was 95.6%. Results Of the 1071 participants, the average age was (32.59±5.21) years; the ratio of male to female was 1: 5.02; the ratio of doctor to nurse was 1:5.8; nearly 70% participants came from grade III Class A hospitals; married participants accounted for 75.4%; most of them held a bachelor degree or above (86.5%); members of the Communist Party of China (CPC) accounted for 22.9%; 50.9% had junior titles; the working years were mainly 5−10 years (42.8%); more than 80.0% participants volunteered to join the front-line fight; 95.1% participants received family support; 43.0% participated in rescue missions; 78.1% participants fought the epidemic in their own hospitals; more than 60% participants considered the workload was greater than before; 34.4% participants fought in the front-line for 2−4 weeks, and 23.5% participants did for more than 6 weeks. There were 111 cases of positive PTSD syndromes (PCL-C total score ≥38) with an overall positive rate of 10.4%, and the scores of reexperience [1.40 (1.00, 1.80)] and hypervigilance [1.40 (1.00, 2.00)] were higher than the score of avoidance [1.14 (1.00, 2.57)]. The results of univariate analysis revealed that PTSD occurred differently among participants grouped by age, political affiliation, working years, anti-epidemic activities location, accumulated working hours in fighting against COVID-19, having child parenting duty, voluntariness, family support, whether family members participated in front-line activities, and rescue mission assignment (P<0.05). The results of logistic regression analysis showed that the incidence rates of reporting PTSD syndromes in medical personnel aged 31−40 years (OR=0.346, 95%CI: 0.164−0.730) and aged 41 years and above (OR=0.513, 95%CI: 0.319-0.823) were lower than that in those aged 20−30 years; the incidence rates of reporting PTSD syndromes in medical staff who were CPC members (OR=0.499, 95%CI: 0.274−0.909), volunteered to participate (OR=0.584, 95%CI: 0.360−0.945), and received family support (OR=0.453, 95%CI: 0.222-0.921) were lower than those did not (P<0.05); the incidence rates of reporting PTSD syndromes among medical workers who had child parenting duty (OR=2.372, 95%CI: 1.392−4.042), whose family members participated in front-line activities (OR=1.709, 95%CI: 1.135−2.575), and who participated in rescue missions (OR=1.705, 95%CI: 1.133-2.565) were higher than those who did not (P<0.05). Conclusion The positive PTSD syndrome rate is 10.4% in the front-line anti-epidemic medical staff. Age, political affiliation, voluntariness, family support, having child parenting duty, with a family members participating in the fight, and rescue mission assignment are the influencing factors of PTSD.
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Objective To analyze the correlation of different antiphospholipid antibody isotypes in female infertility.Methods Selected 296 patients with female infertility and 31 normal female between May 2015 to August 2015 in Dalian Women’s and Children’s Medical Centre.All the antibodies were detected by chemilumininescence.The positiverate of antipholipid an-tibodies in female infertility patients and health controls were calculated.The concentrations of antiphospholipid antibodies in different groups were compared with Mann-Whitney U test.Results The positive rate of aCL IgG of female infertility and normal female were 0.34% and 0.00%.The positive rate of aCL IgM of female infertility and normal female were 1.35%and 0.00%.The positive rate ofβ2 GPⅠ IgG of female infertility and normal female were 0.00% and 0.00%.The positive rate ofβ2 GPⅠ IgM of female infertility and normal female were 0.34% and 0.00%.aCL IgG were differet beween female infertility and normal female (P=0.013),others had on significant difference.Conclusion Need to detect LA,combined with aCL and anti-β2 GPⅠ,exclusively diagnose APS,layed the foundation of sequential treatment.
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OBJECTIVE@#To investigate the procedure and efficacy of anatomical medial patellofemoral ligament (MPFL) reconstruction for the treatment of recurrent patellar dislocation assisted with arthroscopy. @*METHODS@#Between January, 2010 and December 2012, 13 patients with recurrent patellar dislocation, who underwent anatomical MPFL reconstruction and the grafts of operation, were all adopted with autograft semitendinosus. The patellar side used the modified double bone tunnels and the minimally invasive percutaneous grafts through double patellar bone tunnels, and then fixed in the femoral tunnel with absorbable interference screw. Follow-up included the records of the subjective feeling, patellar apprehension test, recurrent dislocation, CT evaluation of bone tunnel position and patellar tilt angle. Knee function was evaluated by the Lysholm score and Kujala score. @*RESULTS@#Twelve patients were followed up for 36 months (range 24-60 months). All patients were satisfied with the treatment. No recurrent dislocation occurred. All the patients showed negative apprehension test. Two patients felt uncomfortable after excessive activity in the knee. Another 2 cases lost 10° flexion than the healthy knee. CT showed that the bone tunnel position were all well. The patellar tilt angle was decreased from 20.52°±1.48° preoperative to 13.52°±1.32° postoperative, with significant difference (t=14.88, P<0. 05); the Kujala score was improved from 55.2±4.51 preoperative to 93.8±3.87 postoperative, with significant difference (t=-36.238, P<0.05); and the Lysholm score was improved from 56.68±5.52 to 93.08±4.68, with significant difference (t=-33.382, P<0.05). @*CONCLUSION@#MPFL reconstruction assisted with arthroscopy is an effective surgical procedure for the treatment of recurrent patellar dislocation, which can improve the knee function with little trauma and complications.
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Humans , Arthroscopy , Methods , Bone Screws , Femur , Knee Joint , Patella , Patellar Dislocation , General Surgery , Patellar Ligament , General Surgery , Postoperative Period , Range of Motion, Articular , Plastic Surgery Procedures , Recurrence , Transplantation, AutologousABSTRACT
Objective To explore the internal relations of HBV markers and its clinical significance.Methods HBV Pre S1-Ag、HBV-M(HBsAg、HBsAb、HBeAg、HBeAb、HBcAb)and HBV DNA of 106 patients were detected by ELISA and FQ-PCR respectively.Results The total positive rates of Pre-S1 antigen and HBV DNA in 106 cases were 81.1%and 84.9%respectively.In41 HBeAg-positive cases.Pre S1-Ag and HBV DNA detection rate was 95.1%.90.2%.And HBeAg-negative 2 groups Pre S1-Ag and HBV DNA detection rate was also higher.Conclusion HBV Per S1-Ag Was a very valuable serum marker in terms of direct HBV replication alone can not HBeAg-positive to determine whether the replication of the virus.
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Objective To establish a convenient ~(13)C-breath test system in live mice,and investigate the value of ~(13)C-methacetin breath test(~(13)C-MBT) in the diagnosis of acute liver damage of mice with domestically synthesized ~(13)C-methacetin. Methods Domestically synthesized ~(13)C.methacetin was prepared from aeamol by methylation. Abdominal injection of CCl_4 was adopted to duplicate acute liver damage of mice,then the mice were housed under normal laboratory condition for a whole month to gain recovery,which were indentified by hepatic pathological examinations and biochemical teats of liver function.After fasting, the mice were orally administered ~(13)C-methacetin,and the expired air was collected at various time points. Infrared spectrometer was employed, and delm over baseline(DOB) curves of ~(13)C-exhalation were drawn. Results Six to eight min after administration of ~(13)C-methacetin,the rate of ~(13)C-exhalation peaked in control group(51.9±2.04), and decreased thereafter. Sixteen min after administration of ~(13)C-methacetin,the rate of ~(13)JC-exhalation peaked in model group(26.37±5.74), and decreased thereafter.There were significant differences between these two groups(P<0.05).There was no significant difference in peak value and time to reach the peak on DOB curves of ~(13)C-methacetin breath test after the two groups of mice were housed under the same condition for a month(P>0.05).Conclution ~(13)C-MBT facilitates the collection and evaluation of ~(13)CO_2 in the expired air of live mice,and yields precise reflection of alterations of liver function in acute liver injury and functional recovery.
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Objective:To explore TCM syndrome variation regularity on acute stage of ischemia stroke.Methods:To collect clinical dynamic state information of ischemia stroke from 72h to 14days by using prospective clinical research method and investigate TCM syndrome variation regularity in acute stage of ischemia stroke.Results:Wind,fire and phlegm syndromes were the most frequent syndromes in acute stage of ischemia stroke.They appeared varied regularity.There were forty-four combination patterns about six basic syndromes.The wind syndrome and fire-phlegm syndrome were increasing in acute stage of ischemia stroke.The wind-phlegm syndrome was decreasing in the first three days,the wind-fire syndrome peaked on the third day,the phlegm was decreasing on the fifth day.The wind-fire-phlegm was the most frequent and undulate syndrome on the fifth day.The wind-phlegm-stagnation syndrome was increasing for the first three days.Conclusion:There were fastly morbility,changeable and complicated syndrome change in acute stage of ischemia stroke.It was very necessity and urgency for complementing diagnostic criteria of stroke differentiation.
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Objective:To observe whether the Simiao Yongan Decoction regulate the nuclear factor-?B(NF-?B) expression and related factors in atherosclerosis(AS)rabbit model,thus restrain the occurrence of atherosclerosis and plaque formation.Methods:56 male Japanese rabbits were randomly divided into normal group,model group,Simvastatin group and Simiao Yongan Decoction group,in addition to the normal group,other groups were established aortic atherosclerotic plaque model.From the1st day of experiment,the corresponding drug intervention began,10 weeks later,the rabbits were killed over the weekend after the anesthesia line access aortic NF-?B immunohistochemical staining,and the experimental dynamic 0,3,6,10 weeks in serum TNF-?,IL-1 and MCP-1 content.Results:The expression of NF-?B p65 subunit in model group was rich,and compared with it,the expression of NF-?B p65 subunit in treatment groups decreased,and the Simiao Yongan Decoction can obviously inhibit the expression of NF-?B p65 subunit.In model group,the expressions of IL-1,TNF-?and MCP-1 in serum increased significantly at different time points(P
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Objective To study the relationship between the mammographic features and clinicopathologic characteristics in breast cancer.Methods Digital mammograms of 176 patients with pathologically proved breast cancer were reviewed.X-ray findings were analysed compared with clinical and pathologic data(histological types and axillary nodes status).Results The breast cancer simplely with micro-calcifications was common seen is the young women under 50 years old(27/32,84.4%) and microcalcifications with the mass was common seen in the aged women over 50 years old(53.8%,28/52).Microcalcifications in mammography occurred frequently occurred in 51.9%(14/27)in intra-ductal carcinoma and early invasive carcinoma.The breast cancer with expression of microcalcification cimbined with burr-like mass had a high metastatic rate to axillary lymph nodes(69.4%,25/36).A high metastatic rate of axillary lymph nodes could also be found in the patients with solitary worm-like microcalcification,solitary burr-like tumor and simple non-wormlike microcalcification.Conclusion The X-ray features of breast carcinoma are certainly related to the clinicopathological manifestations.
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Objective To observe the syndrome manifestations of rabbit atherosclerosis models and explore the syndrome attribution rules of the models.Methods The 24 male Japanese rabbits were randomized into a control group(n=8)and a experimental group(n=16).The control group was given normal feed,and the experimental group was treated with high-fat diet and immune injury and surgical injury through the femoral artery balloon.They were fed totally for 10 weeks.Vascular morphological changes and blood lipid determine were used to evaluate the models.The ear,tongue,eye,and the overall state of rabbits were regularly observed to see the changes of TCM syndromes.Results The rabbits of the experimental group gradually reduced the amount of activity in early stage.When the climate changed,their nasal secretion was increased,and they had wheezing breathing,fever and other common cold symptoms like red auricle.In the medium stage,the fatty plaque or belt around the eyes,cold auricle,and listlessness could be seen,and the blood fat was significantly higher than that of the control group.To the tenth week,the dark tongue with blood spots and purple cold auricle appeared in the rabbits of the experimental group.It was difficult to draw blood from the ear,and the emboli could be seen in the vessels of auricles.Compared with the control group,the oxidized low density lipoprotein and malondialdehyde of the experimental group were significantly increased,and the activity of superoxide dismutase decreased.Conclusion The syndromes of rabbit atherosclerosis models are in the changing state,in early stage they can be manifested as Qi deficiency,in middle stage the manifestation can be Qi deficiency with phlegm retention,and in late stage there will be Qi deficiency with blood stasis.The rule is similar to that of the pathogenesis of atherosclerosis in clinic.
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Objective To explore the value of galactography in the diagnosis of breast diseases with nipple discharge. Methods X-ray features, clinical manifestations and pathological results in 70 patiens with nipple discharge proved by clinic and pathology were analyzed retrospectively. Results There were intraductal papilloma in 45 cases, ductal carcinoma in 5 cases, ductal dilatation in 17 cases, breast duct hyperplasia accompanied chronic mastitis in 3 cases .Conclusion Galactography plays important role in diagnosis and differentiation of the breast duct tumor and chronic mastitis diseases, and provides significant information for clinic.