Impact of asthma action plan-based remote joint management model on asthma control in children / 中华儿科杂志

Objective: To compare the effects of the China Children's Asthma Action Plan (CCAAP)-based remote joint management model with traditional management model on the control of childhood asthma. Methods: A retrospective cohort study was conducted to analyze the general data and asthma control assessment data of 219 children with asthma who attended the respiratory department of Guangzhou Women's and Children's Medical Center from April 2021 to October 2021 and were followed up for 1 year or more. According to the follow-up management model, the CCAAP-based remote joint management model was used in the observation group and the traditional management model was used in the control group, and the propensity score matching method was applied to match the data of children in the two management models for comparison. Paired-samples t-test, Wilcoxon signed-rank test, McNemar χ2-test or χ2-test or nonparametric tests were used to compare the general data and asthma control assessment data between the two matched groups of children. Results: Among 219 children with asthma, 145 were male and 74 were female, aged at consultation (7.2±2.4) years. There were 147 cases in the observation group and 72 cases in the control group, and 27 cases in each of the observation and control groups were successfully matched. The number of asthma exacerbation aura, acute exacerbations, and emergency room visits or hospitalizations for asthma exacerbations were lower in the observation group than in the control group after pairing (1 (0, 2) vs. 3 (1, 5) times, 0 (0,0) vs. 0 (0, 1) times, 0 (0,0) vs. 1 (0, 1) times, Z=-3.42, -2.58, -3.17, all P<0.05). The use of peak flowmeters was higher in children aged 5 years and older in the observation group than in the control group after pairing (100% (22/22) vs. 13% (3/23), χ2=54.00,P<0.001). The ratio of actual to predicted 1st second expiratory volume of force after follow-up in the observation group after pairing was higher than that before follow-up in the observation group and after follow-up in the control group ((95±11)% vs. (85±10)%, (95±11)% vs. (88±11)%, t=-3.40, 2.25, all P<0.05). The rate of complete asthma control after follow-up was higher in both the observation and control groups after pairing than before follow-up for 12 months in both groups (93% (25/27) vs. 41% (11/27), 52% (14/27) vs. 41% (11/27), H=56.19, 45.37, both P<0.001), and the rate of complete control of asthma in children in the observation group was higher than that in the control group at 3 and 12 months of follow-up management (56% (15/27) vs. 25% (5/20), 93% (25/27) vs. 52% (14/27), χ2=47.00, 54.00, both P<0.001). The number of offline follow-up visits, inhaled hormone medication adherence scores, and caregiver's asthma perception questionnaire scores were higher in the observation group than in the control group after pairing (6 (4, 8) vs. 4 (2,5), (4.8±0.3) vs. (4.0±0.6) score, (19.3±2.6) vs. (15.2±2.7) score, Z=6.58, t=6.57, 5.61, all P<0.05), and the children in the observation group had lower school absences, caregiver absences, asthma attack visit costs, and caregiver PTSD scores than the control group (0 (0,0) vs.3 (0, 15) d, 0 (0,0) vs. 3 (0, 10) d, 1 100 (0, 3 700) vs. 5 000 (1 000, 10 000) yuan, 1.3 (1.1, 1.9) vs. 2.0 (1.2, 2.7) score, Z=-2.89, -2.30, 2.74, 2.73, all P<0.05). Conclusion: The CCAAP-based joint management model of asthma control is superior to the traditional management model in the following aspects: it can effectively improve asthma control, self-monitoring, and lung function in children; it can improve treatment adherence and caregivers' asthma awareness; and it can reduce the duration of absenteeism from school, the cost of asthma exacerbation visits, and caregiver's negative psychology.

Nucleosides-based identification model for Fritillariae Cirrhosae Bulbus / 中国中药杂志

A high performance liquid chromatography( HPLC) method was established for the fast,and precise determination of ten nucleosides in Fritillariae Cirrhosae Bulbus and its counterfeits. Then multivariate statistical analyses,such as clustering analysis,principal component analysis( PCA),and Fisher' s linear discriminant analysis( LDA),were conducted to establish a discriminant function model for an integrated analysis. The results indicated that data acquisition time of a single sample was shortened within 16 min by the HPLC method. In the range of 5-1 000 mg·kg~(-1),the mass concentrations of all nucleosides exhibited good linear relationships with the corresponding peak areas( R2> 0. 999). The spiked recoveries were in the range of 93. 83%-108. 9% with RSDs of0. 12%-1. 3%( n = 5). The limit of quantitation( LOQ) was 0. 98-4. 13 mg·kg~(-1). As revealed by the clustering analysis,Fritillariae Cirrhosae Bulbus and the counterfeits could be discriminated into two clusters based on the content of nucleosides. Fisher's LDA could achieve this discrimination,while PCA dimension reduction failed. The accuracy of the discriminant function model established on the screened characteristic indicators reached 97. 5%. The present study proposed a new identification method of Fritillariae Cirrhosae Bulbus with one-dimensional indicators,which is simple,accurate,and reliable. It can provide a scientific basis for further optimizing the identification techniques for Fritillariae Cirrhosae Bulbus and inspiration for quality control strategy development of Chinese medicinal materials.

The infection of Mycoplasma hominis after total knee replacement: Case report and literature review / 中华创伤杂志(英文版)

The Mycoplasma hominis infection is a rare postoperative complication after joint replacement. Based on our knowledge, there were only two cases reported by Korea all over the world currently. A case of postoperative Mycoplasma hominis infection after total knee replacement in our hospital was reported in this article. It was confirmed through mass spectrometer and Mycoplasma cultivation and treated by the first stage debridement, polyethylene insert replacement, and then drainage and irrigation combined with sensitive antibiotics after the operation. We observed that the C reactive protein (CRP) level correlates with the development of disease, while the erythrocyte sedimentation rate (ESR) remains at a high level, indicating the relevance between the Mycoplasma hominis infection caused by knee joint replacement and CRP. This study aims to report the case and review relevant literature.

Reduced Macular Vascular Density in Myopic Eyes / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Morphological changes of the vasculature system in patients with myopia have been observed by Doppler ultrasound and fundus fluorescein angiography (FFA); however, these studies have limitations. Doppler ultrasound provides low-resolution images which are mainly obtained from visualized large vessels, and FFA is an invasive examination. Optic coherence tomography (OCT) angiography is a noninvasive, high-resolution measurement for vascular density. The purpose of this study was to investigate the change of vascular density in myopic eyes using OCT angiography.</p><p><b>METHODS</b>This cross-sectional study includes a total of 91 eyes from 47 participants including control, moderate, and high myopia that were evaluated by OCT angiography. Patients with myopia were recruited from the Refractive Department, Shenzhen Aier Eye Hospital, from August 5, 2015 to April 1, 2016. Emmetropic eyes were from healthy volunteers. The vascular density at macula and optic disc regions, ganglion cell complex (GCC) thickness, and retinal nerve fiber layer (RNFL) thickness were measured. Their relationships with axial length (AL) and refractive error were analyzed. One-way analysis of variance (ANOVA), Pearson's correlation, and generalized estimating equation were used for statistical analysis.</p><p><b>RESULTS</b>Both superficial and deep macular vascular density were highest in control (25.64% ± 3.76% and 37.12% ± 3.66%, respectively), then in moderate myopia (21.15% ± 5.33% and 35.35% ± 5.50%, respectively), and lowest in high myopia group (19.64% ± 3.87% and 32.81% ± 6.29%, respectively) (F = 13.74 and 4.57, respectively; both P < 0.001). Both superficial (β = -0.850 and 0.460, respectively) and deep (β = -0.766 and 0.396, respectively) macular vascular density were associated with AL and spherical equivalent (all P < 0.001). Superficial macular vascular density was associated with GCC thickness (β = 0.244, P = 0.040), independent of spherical equivalent. The vascular density in optic disc region had no difference among the three groups, and it was not associated with AL, spherical equivalent, or RNFL thickness.</p><p><b>CONCLUSION</b>Our results suggested that with the increase of myopia, the vascular density decreased in macular region, but not in optic disc region.</p>

The comparative study of patients with severe polytrauma treated by damage control orthopedits in normal time and in earthquake / 中国骨伤

<p><b>OBJECTIVE</b>To compare the outcome of damage control in patients with severe polytrauma in normal time and in the earthquake of 2008 Sichuan China.</p><p><b>METHODS</b>In the retrospective study, 26 cases with severity polytrauma in peacetime and 24 cases with severe polytrauma who have mainly sustained in the earthquake of 2008 Sichuan China were involovd. The patients' demographics, the methods and effects of damage control were evaluated.</p><p><b>RESULTS</b>In the earthquake group, 24 cases succeeded in the rescuing life; among whom, 3 patients needed the further debridement and dermoplasty. In the normal time group, 26 cases succeeded in the rescuing life; among whom, 19 patients had returned to their former work and 3 patients needed the further treatment. There was no difference between two groups in therapeutic effects (P > 0.05).</p><p><b>CONCLUSION</b>Both in earthquake and in normal time, treating the severity polytrauma by damage control orthopedics can acquire satisfied effect.</p>

Damage control of multiple injuries headed by cervical spinal cord injury / 中华创伤杂志(英文版)

<p><b>OBJECTIVE</b>To explore the strategy of damage control in clinical treatment of multiple injuries headed by cervical spinal cord injury.</p><p><b>METHODS</b>A retrospective analysis was performed in 32 patients. Cervical fractures associated with tetraplegia occurred in 18 patients, traumatic intervertebral disk hernia associated with tetraplegia in 2 patients, and cervical fractures and dislocation associated with tetraplegia in 12 patients. Seventeen cases were combined with craniocerebral injury, 7 combined with pulmonary contusion, multi-fractures of rib or hemopneumothorax, 2 combined with pelvic fracture and other 8 combined with fracture of limbs. The neural function was assessed by the American Spinal Injury Association (ASIA) scale.</p><p><b>RESULTS</b>Thirty-one patients were followed up for an average of 14 months. Of them, 10 got complete recovery, 13 obtained improvement of more than one ASIA grade, 8 did not improve, and 1 died.</p><p><b>CONCLUSIONS</b>For the emergency treatment of multiple injuries headed by cervical spinal cord injury, the damage control strategy is the principle to follow. The final operations are preferably performed within 5 to 10 days after injury so as to raise the successful rate of remedy.</p>

Damage control orthopaedics in 53 cases of severe polytrauma who have mainly sustained orthopaedic trauma / 中华创伤杂志(英文版)

<p><b>OBJECTIVE</b>To discuss damage control orthopaedics in 53 cases of severe polytrauma who have mainly sustained orthopaedic trauma.</p><p><b>METHODS</b>The data of 53 cases of severe polytrauma who had mainly sustained orthopaedic trauma were retrospectively analyzed. And the methods and timing of damage control orthopaedics were discussed in this study.</p><p><b>RESULTS</b>We succeeded in rescuing the lives of all the 53 patients, and 38 patients returned to their former work.</p><p><b>CONCLUSIONS</b>Injury Severity Score (ISS(90)) should be 17 in severe polytrauma patients, but in severe polytrauma patients who have mainly sustained orthopaedic trauma, the ISS(90) of bone and joint injuries should be 16. We recommend that primary minimally-invasive external fracture stabilization should be made for extremities and pelvis in these patients to avoid additional surgical trauma and that definitive secondary fracture care should be performed after medical stabilization for these patients in intensive care unit (ICU).</p>

Application of injury severity score to multiple injuries headed by spinal cord injury / 中华创伤杂志(英文版)

<p><b>OBJECTIVE</b>To evaluate the application of injury severity score ( ISS) to multiple injuries headed by spinal cord injury.</p><p><b>METHODS</b>The data of 55 cases (40 males and 15 females, aged 17-69 years, mean equal to 41 years) of multiple injuries headed by spinal cord injury treated in our hospital from January 2000 to December 2004 were reviewed and analyzed with ISS (Version of AIS-2005) to explore their relationship.</p><p><b>RESULTS</b>The ISS values increased with the number of injured regions, so did the complications. The recovery rate was negatively related to ISS values. During the period of immunity observation, the patients with ISS larger than 25 could undergo planned operations safely.</p><p><b>CONCLUSIONS</b>Treatment for multiple injuries headed by spinal cord injury closely depends on the general and local conditions of the patients. ISS may provide useful data for the choice of treatment methods.</p>

Primary total hip arthroplasty for acetabular fracture / 中华创伤杂志(英文版)

<p><b>OBJECTIVE</b>To explore the operative indications and operative methods of primary total hip arthroplasty for acetabular fracture and to observe the clinical curative effect.</p><p><b>METHODS</b>We retrospectively summarized and analyzed the traumatic conditions, fracture types, complications, operative time, operative techniques, and short term curative effect of 11 patients (10 males and 1 female, with a mean age of 42.4 years) with acetabular fracture who underwent primary total hip arthroplasty.</p><p><b>RESULTS</b>The patients were followed up for 6-45 months (mean=28 months). Their average Harris score of postoperative hip joint was 78.</p><p><b>CONCLUSION</b>Under strict mastery of indications, patients with acetabular fracture may undergo primary total hip arthroplasty, but stable acetabular components should be made.</p>

Galectin-7 is associated with bronchial epithelial cell apoptosis in asthmatic children / 中华儿科杂志

<p><b>OBJECTIVE</b>It is supposed that bronchial epithelial cells responses to the environmental stimuli are different between asthmatic and non-asthmatic individuals, which contribute to the pathogenesis of asthma. These different responses produce different mediators. If differential gene expressions are found in bronchial epithelial cells of asthmatic and non-asthmatic individuals after the same stimuli in vitro, and these genes are overexpressed in asthmatic children in vivo, then it is concluded that these genes may be associated with asthma. Therefore the authors analyzed the differential gene expressions in the bronchial epithelium cells of asthmatic and non-asthmatic children after RSV infection in vitro. Among these genes, Galectine-7 (lectin, galactoside-binding, soluble, 7, Galectin-7) was 8 times up-regulated in asthmatic children. Galectine-7 was associated with skin keratinocyte apoptosis. The authors hypothesized that Galectin-7 may also be associated with bronchial epithelial cell apoptosis in asthmatic children. The aim of this study was to understand the role of Galectine-7 in bronchial epithelial cell apoptosis in asthma.</p><p><b>METHODS</b>The bronchial mucosae of one asthmatic child and one non-asthmatic child were obtained by biopsy and cultured in vitro. The bronchial epithelial cells were infected by RSV. The differential gene expressions were analyzed with micro array. Among those differentially expressed genes, Galectin-7 was 8 times up-regulated in asthmatic children. The bronchial mucosae from 10 asthmatic children and 17 non-asthma children were investigated for cell DNA break, Galectine-7 and mRNA expression, Caspase-3 expression by TUNEL, hybridization in situ and immunochemistry. Image analysis was used for quantitative assessment.</p><p><b>RESULTS</b>Galectine-7 gene was 8 times up-regulated in bronchial epithelial cells from asthmatic children after RSV infection in vitro. Galectin-7 and mRNA were overexpressed in bronchial epithelial cells in asthma in vivo. Bronchial epithelial cell apoptosis increased in asthma in vivo.</p><p><b>CONCLUSION</b>Galectin-7 may be associated with bronchial epithelial cell apoptosis in asthma.</p>

Surgical treatment of infected arterial injuries of the major limb / 中华创伤杂志(英文版)

<p><b>OBJECTIVE</b>To analyze retrospectively the surgical treatment of 21 cases of infected arterial injuries of the major limb hospitalized from 1989 to 2003 in our department.</p><p><b>METHODS</b>After a radical debridement and drainage, an autologous vessel bypass reconstruction, simple vessel ligation or amputation were carried out respectively according to each patient's condition. In order to make a better milieu for the grafts, local musculo-cutaneous flaps were translocated to cover the wounds in 9 cases.</p><p><b>RESULTS</b>1 case (4.8%) died during the treatment. 5 cases (5/21, 23.8%) underwent amputations. Blood supply reconstruction was successful in 15 cases (15/21, 71.4%). 93.3% (14/15) of the cases were successful in getting an unobstructed vessel at early stage. Thrombosis occurred in 1 case (1/15, 6.7%) and a sound result was obtained after a second operation.</p><p><b>CONCLUSIONS</b>Radical debridement combined with bypass vessel reconstruction with autologous vein and with musculo-cutaneous flap translocation is an effective treatment for infective limb vascular injuries.</p>

Revision of infected total hip replacement:a report of 30 cases / 中华创伤杂志

Objective To retrospectively study revisions for infected total hip replacements in 30 cases and discuss the bacteriological characters of the infected total hip replacements,difficulties and strategies in the revision.Methods Thirty revisions of infected total hip replacements were reviewed retrospectively.There were 12 males and 18 females,with mean age of 62.5 years(31-86 years)at revi- sion surgery.Infection was presented one month to four years(mean seven months)after THA operation. The diseases for initial operation included femoral neck fractures in 12 cases,femoral head necrosis in 11,hip osteoarthritis in five and rheumatoid arthritis in two.Twelve eases were treated by one-stage revi- sion and 18 by two-stage revision.Results Before the revision operation,the hip infection were diag- nosed by bacterial culture in 18 cases including five with Staphylococcus epidermidis,four with Staphylo- coccus aureus and nine with other bacteria.Bacteria growth appeared on the specimens from 23 hip joints during the revision surgery but not on the specimens from seven hip joints.Of 12 one-stage revisions,10 cases were followed for mean 16 months,which showed infection recurrence in two eases.Of 18 two-stage revisions,13 cases were followed for mean 20 months,which showed one case with infection recurrence. The mean Harris hip score was improved from preoperative 44 to 84 at follow-up.Conclusions 1) The main bacteria in the infected hip are antibiotic resistant Staphylococcus.2)Because the revision op- eration is difficult,careful preparation before revision is important for success.The fresh surgeon should not attempt.3)The revision strategies should vary according to specific status of the cases.The infection recurrence rate is lower when using a two-stage revision strategy.4)Application of antibiotic bone cement can help improve treatment effect and facilitate functional recovery of the joints.5)The scientific rehabil- itation after operation is very important to functional recovery.

Application of microsurgical technique in joint replacement / 中华显微外科杂志

Objective To report the experience of the application of microsurgery in joint replace- ment.Methods There were 22 cases,10 cases with segmental acetabular defects treated with the pedicle sartorius muscle iliac bone grafting,5 cases with vascular repair following major vascular injury of extremity during operation,6 cases with neural repair following neural injury during operation,1 case with serious injury reconstruction by elbow joint replacement and free flap.Results The operations succeeded in 22 cases without any postoperative infection.The mean follow-up was 40.1 months (3-72 months) in 22 cases,in which the joint function improved and the operative result was satisfactory with no joint pain.Conclusion Microsurgical technique can reconstruct bone and tissue defect effectively in joint replacement.