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@#Objective To systematically evaluate the risk factors for postoperative pulmonary infection in patients with esophageal cancer. Methods CNKI, Wangfang Data, VIP, CBM, PubMed, EMbase, The Cochrane Library were searched from inception to January 2021 to collect case-control studies, cohort studies and cross-sectional studies about risk factors for postoperative pulmonary infection in patients with esophageal cancer. Two researchers independently conducted literature screening, data extraction and quality assessment. RevMan 5.3 software and Stata 15.0 software were used for meta-analysis. Results A total of 20 articles were included, covering 5 409 patients of esophageal cancer. The quality score of included studies was 6-8 points. Meta-analysis results showed that age (MD=1.99, 95%CI 0.10 to 3.88, P=0.04), age≥60 years (OR=2.68, 95%CI 1.46 to 4.91, P=0.001), smoking history (OR=2.41, 95%CI 1.77 to 3.28, P<0.001), diabetes (OR=2.30, 95%CI 1.90 to 2.77, P<0.001), chronic obstructive pulmonary disease (OR=3.69, 95%CI 2.09 to 6.52, P<0.001), pulmonary disease (OR=2.22, 95%CI 1.16 to 4.26, P=0.02), thoracotomy (OR=1.77, 95%CI 1.32 to 2.37, P<0.001), operation time (MD=14.08, 95%CI 9.64 to 18.52, P<0.001), operation time>4 h (OR=3.09, 95%CI 1.46 to 6.55, P=0.003), single lung ventilation (OR=3.46, 95%CI 1.61 to 7.44, P=0.001), recurrent laryngeal nerve injury (OR=5.66, 95%CI 1.63 to 19.71, P=0.006), and no use of patient-controlled epidural analgesia (PCEA) (OR=2.81, 95%CI 1.71 to 4.61, P<0.001) were risk factors for postoperative pulmonary infection in patients with esophageal cancer. Conclusion The existing evidence shows that age, age≥60 years, smoking history, diabetes, chronic obstructive pulmonary disease, pulmonary disease, thoracotomy, operation time, operation time>4 h, single lung ventilation, recurrent laryngeal nerve injury, and no use of PCEA are risk factors for postoperative pulmonary infection in patients with esophageal cancer. Due to the limitation of the quantity and quality of included literature, the conclusion of this study still needs to be confirmed by more high-quality studies.
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Objective:To explore the predictive value of 18F-FDG PET/CT metabolic parameters combined with inflammatory markers for the medium-term efficacy of chemotherapy in patients with primary gastrointestinal diffuse large B cell lymphoma (PGI-DLBCL). Methods:From April 2011 to May 2020, 67 patients (37 males, 30 females, age: 28-85 years) with PGI-DLBCL examined by 18F-FDG PET/CT before chemotherapy in Changhai Hospital, Navy Medical University were retrospectively analyzed. All patients were treated with cyclophosphamide+ doxorubicin+ vincristine+ prednisone (CHOP) or rituximab+ CHOP (R-CHOP) regimens, and the medium-term efficacy was evaluated after 2-4 cycles of chemotherapy. The effect outcome was divided into complete remission (CR) group and non-CR (NCR) group based on the Lugano lymphoma response evaluation criteria. Mann-Whitney U test was used to compare the differences of SUV max, peak of SUV (SUV peak), metabolic tumor volume (MTV), total lesion glycolysis (TLG), platelet/lymphocyte ratio (PLR) and neutrophil/lymphocyte ratio (NLR) between two groups. The independent risk factors of NCR were analyzed by multivariate logistic regression and the binary logistic regression model was established according to the results. The model was tested with external validation data ( n=15). Results:Of 67 PGI-DLBCL patients, 28(41.8%) were CR and 39(58.2%) were NCR. SUV peak, MTV, TLG, PLR and NLR in NCR group (17.3(12.3, 28.1), 73.8(42.9, 141.7) cm 3, 887.5(300.9, 2 075.3) g, 203.9(155.7, 297.1), 3.9(3.0, 4.9)) were significantly higher than those in CR group (9.5(6.2, 15.2), 11.3(4.7, 23.2) cm 3, 85.2(35.5, 214.6) g, 149.3(102.8, 173.1), 2.2(1.8, 4.6); z values: from -6.41 to -2.33, all P<0.05). The logistic regression model was as follows: P=1/(1+ e - x), x=0.100×MTV+ 0.024×PLR-8.064. The prediction accuracy for NCR risk was 86.57%(58/67), with the accuracy of 13/15 tested by external validation data. Conclusion:MTV combined with PLR has a good predictive value for medium-term efficacy of CHOP/R-CHOP chemotherapy in patients with PGI-DLBCL.
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Diabetic peripheral neuropathy is one of the common chronic complications of diabetes,and the traditional Chinese medicine (TCM) has unique advantages for its treatment.This paper reviews the progress of the mechanism of TCM for peripheral neuropathy of diabetes in the past five years,The studies shows that TCM may work from five aspects including oxidative stress,inflammatory response,microvascular dysfunction,neurotrophic disorder and lipid metabolic abnormality.
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Objective To investigate the efficacy of anatomic plate internal fixation in treatment of complex proximal humeral fractures combined with humeral shaft fractures.Methods This retrospective case series study included 58 patients with complex proximal humeral fractures combined with humeral shaft fractures admitted from July 1998 to July 2015.There were 31 males and 27 females,with a mean age of 63 years (range,18-86 years).According to the Neer classification of proximal humeral fractures,three-part fractures were noted in 42 patients and four-part fractures in 16 patients.Four patients were combined with compressed or splitting fractures of the head of humerus and 38 patients with dislocation of the shoulder.According to the site classification of femoral shaft fractures,proximal 1/3 shaft fractures were noted in 36 patients,middle and distal 1/3 shaft fractures in 19,and multisegmental shaft fractures in three.All patients underwent anatomic reduction and anatomic plate internal fixation.Bone healing,Neer score of function outcome and complications were evaluated after operation.Results Mean duration of follow-up was 8.6 years (range,1-18 years).Bone union was observed in all patients after 10 to 24 weeks (mean,14.5 weeks).According to the Neer score,the outcomes were excellent in 23 patients,good in 25,fair in eight and poor in two,with the excellent rate of 83 ％.Complications such as infection,nerve injury and vascular injury were not observed after operation.Six patients suffered from limitations of shoulder anterior flexion and rise,one patient had humeral head necrosis and treated by shock wave treatment,and one patient had poor incision healing with hemorrhagic effusion and cured after dressing.Conclusion Anatomic plate internal fixation can contribute to fast functional recovery and few complications in treatment of complex proximal humeral fractures combined with humeral shaft fractures.
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Objective To investigate clinical effect of surgical treatment of complex scapular fracture with improved minimally invasive Judet approach and annularity internal fixation.Methods In this retrospective study,17 patients with complex scapular fracture accepted open reduction and internal fixation with improved minimally invasive Judet approach complying with the three points-two lines annularity internal fixation principle.After postoperative rehabilitation training,the curative effect was evaluated by the neer shoulder joint function score evaluation.Results All the 17 patients were followed up for 14 months on average (12-25 months).According to neer score evaluation,the percent of patients with excellent and good results was 88.2％ (excellent:12 cases;good:3 cases;middle:2cases;unsatisfactory:no case).Conclusions Improved minimally invasive Judet approach hase simple operation,adequate exposure and less injury.Annularity internal fixation complying with the three points-two lines principle is a safe and effective method for the treatment of complex scapular fracture.
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<p><b>OBJECTIVE</b>To explore the values of vestibular evoked myogenic potential (VEMP) in the diagnosis of vestibular nerve impairment in type 2 diabetes mellitus patients.</p><p><b>METHODS</b>Forty-two cases (84 ears) of diabetes mellitus patients and 42 cases (84 ears) normal subjects as the control group were enrolled from 2014 to 2015.Both the patients and normal subjects underwent conventional air-conducted ocular vestibular evoked myogenic potential (oVEMP) and cervical vestibular evoked myogenic potential (cVEMP) in bilateral ears.The results were compared between the patients and normal subjects. A commercially available software package, SPSS19.0, was used for statistical analysis.</p><p><b>RESULTS</b>In 84 ears of the normal subjects, oVEMP was present in 70 ears, the educible rate was 83.3% (70/84). cVEMP was present in 74 ears, and the educible rate was 88.1% (74/84). In 84 ears of the diabetes mellitus patients, oVEMP was present in 49 ears, with the educible rate of 58.3% (49/84). cVEMP was present in 52 ears, with the educible rate of 61.9% (52/84). The educible rate in the control group was significantly higher than the diabetic group (oVEMP: χ(2)=12.71, P<0.05; cVEMP: χ(2)=15.37, P<0.05). In the diabetic group, the mean values of both oVEMP and cVEMP P1, N1 latencies were significantly longer when compared to the control group (P<0.05). No significantly statistical difference was found in oVEMP and cVEMP parameters (threshold, latency interval and amplitude) between groups (P>0.05).</p><p><b>CONCLUSIONS</b>Vestibular nerve was impaired in diabetes mellitus patients in some degree. VEMP examinations could be useful in the diagnosis of vestibular nerve impairment in type 2 diabetes mellitus patients.</p>
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Humans , Case-Control Studies , Diabetes Mellitus, Type 2 , Vestibular Evoked Myogenic Potentials , Vestibular NerveABSTRACT
Objective To investigate the clinical effects of sound therapy and psychological counseling on chronic tinnitus .Methods Two hundred and thirty - two cases of chronic tinnitus patients were treated with sound therapy and psychological counseling in this study .The time course of treatment was 12 months .Tinnitus Evalua‐tion Questionnaire(TEQ) was filled out before sound therapy ,3 ,6 and 12 months after the therapy to evaluate the effects .Results After the therapy ,the patients had a significant improvement in tinnitus symptoms .Before the therapy ,178 patients had severe tinnitus ,while after the therapy ,this number decreased obviously .In the end of treatment there were only 36 cases ,with severe tinnitus(15 .52% ) .After the 6 months treatment ,the effective rate was 79 .31% ,after 12 months the effective rate was 86 .21% .Conclusion Sound therapy and psychological counse‐ling are effective treatments for chronic tinnitus ,and the effects are stable and durable .
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OBJECTIVE@#To investigate the clinical application effects of tinnitus diagnosis and treatment process.@*METHOD@#The 1541 clinic patients with tinnitus were included in the diagnosis and treatment process. The diagnosis was clarified based on comprehensive examinations and tests. According to the characteristics of tinnitus, the patients underwent etiological treatment, drug therapy, masking therapy, sound therapy and psychological therapy, respectively, and the curative effect was evaluated.@*RESULT@#There were 781 patients received etiological treatment, where the effective rate is 86.17%. For 369 cases of acute and subacute tinnitus, the effective rate for low frequency tinnitus is 80.77% (126/156), and that for high frequency is 72.30% (154/213). For 224 cases of chronic compensated tinnitus, the effective rate of masking therapy is 79.63% (86/108), and the effective rate of sound therapy is 79.31% (92/116). For the 124 cases of chronic decompensated tinnitus, the effective rate of sound therapy combined with psychological counseling is 83.06%.@*CONCLUSION@#The utilization of tinnitus diagnosis and treatment process can give the patients of tinnitus with different characteristics satisfactory curative effects, and is suggested to be proposed for clinical application.
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Humans , Acoustic Stimulation , Counseling , Tinnitus , Diagnosis , Therapeutics , Treatment OutcomeABSTRACT
Objective To investigate the effects of the treatment of open injury and orthopedic postoperative wound infections with Vacuum Sealing Drainage.Methods Retrospective analysis of the clinical results of 32 patients with open injury or orthopedic postoperative wound infections in our hospital.Results Follow the indications and contraindications strictly and ensure right pressure,all the infection of wounds was controlled,and split skin graft survived.Without the package and pressurized fixation,the wounds healed better.Conclusion Vacuum Sealing Drainage can be considered one of the effective methods to treat the open injury or orthopedic postoperative wound infections and is worthy to be carried out as a routine.For patients with vascular rupture or defect,when there was still skin defects after vascular graft repair,as long as covered vascular anastomosis with the surrounding skin and soft tissue during the operation,there was still can use closed vacuum sealing drainage to cover the wound to prevent infection.
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[Objective] To research the plantar pressure distribution of the normal Chinese adult. [Method] The F-scan plantar pressure analysis system was used to collect plantar pressure distribution data of 100 volunteers who stand, walk, jog, go upstairs and downstairs.The plantar pressure distribution data of 5 kinds of physiological states, as well as influence of sex, height, body weight, body mass index and speed was analyzed. [Result] There's different characteristic between 5 kinds of states of the plantar pressure distribution in the Chinese normal adults. There's significant difference between static and dynamic. In four dynamic motions, the gait of walk was stalest, and it became unstable if speed up and go upstairs or downstairs. As for the influential factors of the plantar pressure distribution, there was non-significance of sex. But the speed had the significance. The height, the body weight, the BMI had weak correlation with the plantar pressure distribution. [Conclusion] The plantar pressure distribution of normal Chinese adults has the distinctive quality. The data obtained by this experiment, may provide the reference for the clinical plantar pressure analysis.
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Objective: To study the effect of enteral nutrition in the treatment of heart failure with hyponatremia.Methods: Forty patients sufferd from heart failure with hyponatremia were divided into two groups at random: control group(n=20) with regular therapy and treatment group(n=20) with enteral nutrtion on the base of regular therapy.Time intervals from hyponatremia to normal natremia of the two groups were compared.Results: Time interval from hyponatremia to normal in the treatment group was 5.30?1.82 days,and that in the control group was(8.85?2.44) days.Conclusion: The treatment with enteral nutrition can significantly shorten the clinical treatment time in heart failure with hyponatremia.
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Objective To explore the reliable method for primary cultivation and identification of satellite cells of mice skeletal muscles in vitro.Methods Cell suspension was obtained from posterior limb skeletal muscles of newborn mice by mixed enzymatic digestion,and the muscle satellite cells were separated by Percoll-density gradient centrifugation and purified with differential adherence method.Cells growth was observed under an inverted microscope and the growth curve was drawn.Satellite cells were identified with monoclonal antibody against desmin and ?-actin.Results The primary satellite cells were round in shape,and began on adherence one day after cultivation,and the cells distributed uniformly,most of the cells were roundish.After cultured for 48 hours,the cells began on proliferation,and then became bigger and started to division,bubble cell arrangements with 2-3 or more cells were observed.At the third or fourth day of cultivation,the cells were in exponential phase of growth,and the round cells predominated,many clusters of cell clones were found.The satellite cells formed monolayer sheet(50%-70%) 7-10 days after cultivation,the fusiform cells predominated,but there were still some round cells in this phase.The cell proliferation decreased after cultured for 10-12 days.Immunocytochemical staining showed that the obtained cells expressed myogenic marker desmin and skeletal muscle-specific protein ?-actin.Conclusions High purity muscle satellite cells could be obtained by mixed enzymatic digestion,Percoll-density gradient centrifugation and differential adherence method.Immunocytochemical staining of desmin and ?-actin is the effective method to identify muscle satellite cells.