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Objective:Objectives To investigate the predictive value of color Doppler flow imaging (CDFI) for the proteinuria following pyeloplasty for congenital ureteropelvic junction obstruction (UPJO) in children.Methods:We identified a series of 206 children with a mean age of (20.0±28.8) months (1-132 months), consisted of 171 males and 35 females, diagnosed with congenital UPJO accepted pyeloplasty from January 2014 to September 2018, the preoperative mean urinary Albumin/Creatinine Ratio (ACR) was (17.3±160.1) mg/mmol and the mean β2-microglobulin/Creatinine Ratio (β2-MG/Cr) was (135.6±383.8) μg/mmol, ultrasound showed a mean renal pelvis dilatation of (3.1±1.5) cm and a mean cortical thickness of (0.3±0.1) cm, and classified as grade Ⅰ-Ⅴ according to the blood flow distribution in renal by CDFI, these children were divided into three groups of increased, decreased and unchanged blood flow according to the postoperative CDFI within 1 week, the postoperative urinary protein and renal function indexes within 1 week and 2 years were retrospectively analysed among groups.Results:Within 1 week postoperatively, an increased, decreased and unchanged blood flow occurred in 113 (54.9%), 31(15.0%), 62(30.1%) children, respectively. Urinary ACR in above mentioned groups was (112.3±400.7), (16.1±29.3), (32.7±48.4) mg/mmol, β2-MG/Cr was (887.4±6061.0), (50.2±62.7), (51.9±57.8)μg/mmol, there were significant differences among groups ( P<0.01). Contralateral hydronephrosis occurred in 21(18.6%), 4(12.9%), 8(12.9%) children, urinary N-Acetyl-β-D-glucosaminidase (NAG) was (7.5±5.2), (7.0±5.4)、(5.7±4.5) U/L, these indexes showed no significant differences among groups. There was a positive correlation between the increased blood flow level and the decreased renal pelvis dilatation (Spearman’s correlation coefficient 0.2, P<0.01), ACR (Spearman’s correlation coefficient 0.4, P<0.01) and β2-MG/Cr (Spearman’s correlation coefficient 0.3, P<0.01). After a follow up of 2 years, 67 children were diagnosed with proteinuria in this series, 51 cases of them with an increased blood flow, which had significantly higher percentage than children with a decreased (4 cases, 12.9%) or unchanged blood flow (12 cases, 19.3%). Logistic multivariate analysis indicated that early postoperative (within 1 week) increased blood flow ( OR=1.9, 95% CI 1.5-2.6), contralateral hydronephrosis ( OR=2.2, 95% CI 1.1-4.8) and urinary NAG ( OR=1.1, 95% CI 1.0-1.1) were predictive of proteinuria, the increased blood flow was independent predictor of proteinuria (Ⅰ level increased: OR=1.9, 95% CI 1.5-2.6). Conclusions:The CDFI reveals good predictive value for the postoperative proteinuria, an early marked increased blood flow postoperatively indicated risk of proteinuria in the long term.
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Objective@#To investigate the trends in cerebrovascular disease mortality among residents in Hangzhou City from 2006 to 2020, so as to provide insights into the development of cerebrovascular disease control strategy. @*Methods@#The cerebrovascular disease mortality data were collected from residents in Hangzhou City through household registered death cards recorded in county- and city-level hospitals, township-level health centers and community health service centers in Hangzhou City and standardized by the national population census data in China in 2010. The changes in the crude and standardized mortality of cerebrovascular diseases were estimated using annual percent change (APC) in Hangzhou City from 2006 to 2020.@*Results@#A total of 109 891 deaths were reported due to cerebrovascular diseases among residents in Hangzhou City from 2006 to 2020, accounting for 17.72% of all deaths in Hangzhou City during the 15-year period, and the crude and standardized mortality rates were 105.83/105 and 65.15/105, which both appeared a tendency towards a decline (crude mortality: APC=-0.80%, t=-3.832, P=0.002; standardized mortality: APC=-4.69%, t=-24.084, P<0.001). The crude mortality of hemorrhagic stroke showed a tendency towards a decline among residents in Hangzhou City from 2006 to 2020 (APC=-7.97%, t=-30.704, P<0.001), and the crude mortality of both ischemic stroke (APC=5.76%, t=6.106, P<0.001) and sequelae of cerebrovascular disease (APC=13.20%, t=18.103, P<0.001) appeared a tendency towards a rise. The crude mortality of cerebrovascular diseases was significantly higher in men than in women (110.15/105 vs. 101.51/105; χ2=183.078, P<0.001), which both appeared a tendency towards a decline among residents in Hangzhou City from 2006 to 2020 (men: APC=-0.90%, t=-4.669, P<0.001; women: APC=-0.70%, t=-2.658, P=0.020). The crude mortality of cerebrovascular diseases was 101.95/105 and appeared a tendency towards a decline among urban residents in Hangzhou City from 2006 to 2020 (APC=-1.19%, t=-3.655, P=0.003), and was 112.46/105 and showed no remarkable changes among rural residents in Hangzhou City from 2006 to 2020 (t=-0.719, P=0.485). In addition, the crude mortality of cerebrovascular diseases appeared a tendency towards a rise with age among residents in Hangzhou City from 2006 to 2020 (χ2trend=502 711.682, P<0.001), and the crude mortality of cerebrovascular diseases appeared a tendency towards a decline among residents at ages of 35 years and above in Hangzhou City from 2006 to 2020 (P<0.05). @*Conclusions@#The cerebrovascular disease mortality appeared a tendency towards a decline among residents in Hangzhou City from 2006 to 2020, and a high mortality rate of cerebrovascular diseases was seen among rural residents, men and the elderly.
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@#PLZ-NPs (PNS-lipid-zein nanoparticles) prepared by co-assembly of Panax notoginseng saponins, lecithin, β-sitosterol and zein were applied for in vitro cell experiment and oral gavage to study the protective effect of cerebral ischemia-reperfusion rats.PLZ-NPs were characterized by Malvin-particle size analyzer and transmission electron microscope (TEM), respectively. The toxicity of PLZ-NPs and free carrier were evaluated by MTT, and the uptake of nanoparticles in Caco-2 cells was analyzed by laser confocal and flow cytometry. The cerebral ischemia reperfusion rat model was established by MCAO method and then be given samples by gavage for 3 days. The brain tissues were taken to stain by 2, 3, 5-triphenyltetrazole chloride (TTC) and the biochemical indicators of MDA, inflammatory cytokines IL-1β and TNF-α, apoptosis-related proteins Bax and Bcl-2 from the harvested brain tissues were detected to evaluate the protective effect of PNS in PLZ-NPs on cerebral ischemia reperfusion. The particle size, PDI, and zeta potential of formed PLZ-NPs were (116.4 ± 0.81) nm, 0.048 and -(31.5 ± 0.31) mV, respectively. The results of MTT showed that the zein lipoprotein carrier was non-toxic to Caco-2 cells. The results of laser confocal and flow cytometry showed that FITC uptake of nanoparticles could be significantly improved in Caco-2 cells.The uptake from the nanoparticles at 4h was 1.76 times of that of the free FITC group.Compared with the model group, the TTC staining images of free drug PNS group and PLZ-NPs group showed certain reduction in the white infarct area.The contents of MDA, IL-1β, TNF-α and Bax were significantly decreased, while the content of Bcl-2 was significantly increased. Furthermore, all parameters of PLZ-NPs group showed better results than those of PNS group, and there was a significant difference (P < 0.05). All results indicated that the prepared PLZ-NPs had good stability and biological safety, and could significantly increase the uptake in intestinal epithelial cells, and effectively protect against the damage caused by cerebral ischemia reperfusion in rats.
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BACKGROUND@#Norepinephrine infusion decreases hypotension after spinal anesthesia during cesarean section. This study aimed to compare the efficacy of norepinephrine infusion and ephedrine bolus against post-spinal hypotension in parturients.@*METHODS@#In this double-blinded, randomized controlled clinical trial, parturients scheduled for elective cesarean section were randomly allocated to receive norepinephrine infusion (0.05 μg·kg-1·min-1) just before spinal anesthesia continuing for 30 min or ephedrine bolus (0.15 mg/kg) just before spinal anesthesia. A rescue bolus (5 μg norepinephrine for the norepinephrine group, and 5 mg ephedrine for the ephedrine group) was administered whenever hypotension occurred. Our primary outcome was the incidence of hypotension within 30 min of spinal anesthesia administration. Secondary outcomes included maternal and neonatal outcomes 30 min after spinal block, and neonatal cerebral oxygenation 10 min after birth.@*RESULTS@#In total, 190 patients were enrolled; of these patients, 177 were included in the final analysis. Fewer patients suffered hypotension in the norepinephrine group than in the ephedrine group (29.5% vs. 44.9%, odds ratio [OR]: 0.51, 95% confidence interval [CI]: 0.28-0.95, P = 0.034). Moreover, the tachycardia frequency was lower in the norepinephrine group than in the ephedrine group (OR: 0.22, 95% CI: 0.11-0.44, P < 0.001), and patients suffered less nausea and vomiting (OR: 0.28, 95% CI: 0.11-0.70, P = 0.004). There was no difference in Apgar scores and umbilical arterial blood gas analysis between the two groups. However, neonatal cerebral regional saturations were significantly higher after birth in the norepinephrine group than in the ephedrine group (mean difference: 2.0%, 95% CI: 0.55%-3.45%, P = 0.008).@*CONCLUSION@#In patients undergoing elective cesarean section with spinal anesthesia, norepinephrine infusion compared to ephedrine bolus resulted in less hypotension and tachycardia, and exhibited potential neonatal benefits.@*TRIAL REGISTRATION@#ClinicalTrials.gov, NCT02542748; https://clinicaltrials.gov/ct2/show/record/NCT02542748.
Subject(s)
Female , Humans , Infant, Newborn , Pregnancy , Anesthesia, Spinal/adverse effects , Cesarean Section/adverse effects , Double-Blind Method , Hypotension/prevention & control , Phenylephrine , Randomized Controlled Trials as Topic , Vasoconstrictor Agents/therapeutic useABSTRACT
The paper summarizes the ideas and characteristics of acupoint selection in treatment of mental disorder with acupuncture and moxibustion by professor
Subject(s)
Humans , Acupuncture Points , Acupuncture Therapy , Mental Disorders/therapy , Meridians , MoxibustionABSTRACT
Objective:To evaluate the effect of self-management model of community diabetes patients under the guidance of general practitioners.Methods:A total of 22 communities in Hangzhou were selected as intervention pilot from 2016 to 2017, and 10-15 diabetic patients were recruited to form a self-management team in each community. Relying on the construction of medical alliance and there sources of contracted service of family doctors, intervention teams were set up to conduct regular, personalized and continuous self-management interventions on patients. Intervention continued for 4-6 months. Before, after and 6 months after the intervention, the basic information of patients, knowledge of diabetes, faith in managing disease, self-management behavior, self-management ability of patients, and quality of life were collected through questionnaire survey, body mass index (BMI), 2-hour postprandial blood glucose and glycosylated hemoglobin were detected uniformly, and statistical analysis was conducted.Results:A total of 292 patients were involved in the self-management group, the average age was (66.38±7.90) years old, most of them were female (64.73%). Six months after the intervention, the awareness rate of basic knowledge, risk factors and prevention and treatment knowledge about diabetes in patients (68.64%, 78.75%, 63.41%) were significantly higher than those before the intervention (28.08%, 48.29%, 39.38%), the proportion of patients with reasonable diet, moderate exercise, active problem-solving, management plan making and action according to the plan increased (from 65.41%, 28.76%, 39.04%, 31.85%, 27.74% to 86.76%, 60.28%, 65.16%, 78.05%, 73.17%)(all P<0.05).In terms of time effect, the scores of physical functioning, role-physical, bodily pain, general health, vitality, social functioning, role-emotional and mental health in SF-36 after intervention and 6 months after intervention were all increased step by step (all P<0.05). Before the intervention, BMI, 2-hour postprandial blood glucose and glycosylated hemoglobin were (24.20±3.11) kg/m 2, (9.29±2.23) mmol/L, (6.81±1.01)% respectively. After the intervention, the three indexes all showed a downward trend, which were (22.89±2.98) kg/m 2, (8.81±1.61) mmol/L, (6.57±0.76)% respectively ( F=14.832, 6.828, 9.667; all P<0.05). Conclusion:Under the guidance of general practitioners, the self-management model of community diabetes patients can effectively improve the level of recognition, belief and behavior of patients, improve their self-management ability and quality of life, and improve BMI and blood glucose control level.
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Objective To evaluate the safety and efficacy of tabularized urethral plate disassembly for epispadias repair in infant.Methods From January 2016 to September 2018,10 boys aged between 18 to 36 months old with mishaft epispadias were included.The main complaint was that the urethral opening was found on the dorsal side of the penis.Preoperative cystography revealed that 3 of them had unilateral vesicoureteral reflux (Grade Ⅰ),and white blood cells in routine urinary in all 10 patients were negative.Physical examination:the penis is short and flat,the width is 17-25 mm,average is 20.7 mm,the penis curvature is 15°-30°,average is 21.5°,and the urethral opening located on the dorsal side of the penis.The anesthesia method was selected for tracheal intubation,intravenous anesthesia combined with caudal anesthesia,and the surgical position was supine position.The surgical method:one stage of tabularized urethral plate disassembly urethroplasty:during the operation,the penile curve was corrected by free urethral plate and penile degloving.Two of them were unsatisfied with the correction of the curvature,and the ventral tunica folded was applicate.To avoid urethral plate ischemia,attention should pay to blood supply protection.The two corpus cavernosum are separated in the root,and the urethra is completely displaced to the ventral side of the cavernous body.The ventral side of the urethral under glans is shaped into a fissured that conforms to the anatomy.The prognosis and surgical choice of the midshaft epispadias were discussed combined with literature.Result The operation time was 130-200 min with an average of 157 mins.Intraoperative hemorrhage 5-30 ml,average is 16 ml,1 case of glans skin was black one day after surgery,with enhanced dressing change.After 1 month,the glans was local atrophy and scar formation.No skin incision infection case.After discharge from the hospital,the follow up through the internet and outpatients for 3-40 months,average is 21 months,2 cases with urethral fistula,more surgery to repair the fistula successfully after 6 months.The penile curvature was corrected in 8 cases,and the residual curvature of 2 cases was about 10-15°,which was temporarily observed.Patients with unilateral vesicoureteral reflux preoperatively,they still suffered from vesicoureteral reflux in the 6-12 months regular review after surgery without any intervention due to white blood cell was negative in urine routine.All cases had urinary patency and no cases with urethral stricture.Conclusion Tubularized urethral plate disassembly is a effective and simple procedure that can correct the midshaft epispadias in infant.
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OBJECTIVE@#To investigate the effects of Yiqi Huayu Hutan decoction on pulmonary fibrosis of rats which induced by bleomycin.@*METHODS@#The rat model of pulmonary fibrosis was induced by intratracheal injection of bleomycin hydrochloride (5 mg/kg). Sixty SD rats were randomly divided into the normal group (group N), the model group (group M), the positive control group (group Y), group of low concentration (group LC), group of medium concentration (group MC) and group of high concentration of Yiqi Huayu Hutan decoction (group HC). After 4 weeks, the experimental groups were treated with low concentration decoction, medium concentration decoction and high concentration decoction respectively, and the Y group was treated with hydrocortisone acetate, the Group N and group M were treated with saline by intragastric administration. Twelve weeks later, rats were killed and the pathomorphism of pulmonary tissues of each group was observed by HE staining and Masson staining. Further, the expressions of transforming growth factor-β1(TGF-β1), Snail1, E-cadherin and Fibronectin in pulmonary tissues of each group were detected by qTR-PCR and Western blot.@*RESULTS@#Compared with the model group, the collagen sediment in the interstitial was reduced in the experimental groups, especially in the group of medium concentration, which was observed by HE staining and Masson staining .Compared with the model group, the expressions of TGF-β1, Snail1 and Fibronectin protein in pulmonary tissues of the treatment groups were decreased in the experimental group, especially in the group of medium concentration, which were detected by qRT-PCR and Western blot.@*CONCLUSION@#Yiqi Huayu Hutan decoction can significantly improve the pulmonary fibrosis which is induced by bleomycin, and the mechanism is related to the inhibition of the expression of TGF-β/Snail pathway of transcription TGF-β1.
Subject(s)
Animals , Rats , Bleomycin , Cadherins , Metabolism , Drugs, Chinese Herbal , Pharmacology , Fibronectins , Metabolism , Idiopathic Pulmonary Fibrosis , Drug Therapy , Lung , Metabolism , Pathology , Random Allocation , Rats, Sprague-Dawley , Snail Family Transcription Factors , Metabolism , Transforming Growth Factor beta1 , MetabolismABSTRACT
Objective@#To evaluate the safety and efficacy of tabularized urethral plate disassembly for epispadias repair in infant.@*Methods@#From January 2016 to September 2018, 10 boys aged between 18 to 36 months old with mishaft epispadias were included. The main complaint was that the urethral opening was found on the dorsal side of the penis. Preoperative cystography revealed that 3 of them had unilateral vesicoureteral reflux (Grade Ⅰ), and white blood cells in routine urinary in all 10 patients were negative. Physical examination: the penis is short and flat, the width is 17-25 mm, average is 20.7 mm, the penis curvature is 15°-30°, average is 21.5°, and the urethral opening located on the dorsal side of the penis. The anesthesia method was selected for tracheal intubation, intravenous anesthesia combined with caudal anesthesia, and the surgical position was supine position. The surgical method: one stage of tabularized urethral plate disassembly urethroplasty: during the operation, the penile curve was corrected by free urethral plate and penile degloving. Two of them were unsatisfied with the correction of the curvature, and the ventral tunica folded was applicate. To avoid urethral plate ischemia, attention should pay to blood supply protection. The two corpus cavernosum are separated in the root, and the urethra is completely displaced to the ventral side of the cavernous body. The ventral side of the urethral under glans is shaped into a fissured that conforms to the anatomy. The prognosis and surgical choice of the midshaft epispadias were discussed combined with literature.@*Result@#The operation time was 130-200 min with an average of 157 mins. Intraoperative hemorrhage 5-30 ml, average is 16 ml, 1 case of glans skin was black one day after surgery, with enhanced dressing change. After 1 month, the glans was local atrophy and scar formation. No skin incision infection case. After discharge from the hospital, the follow up through the internet and outpatients for 3-40 months, average is 21 months, 2 cases with urethral fistula, more surgery to repair the fistula successfully after 6 months. The penile curvature was corrected in 8 cases, and the residual curvature of 2 cases was about 10-15°, which was temporarily observed. Patients with unilateral vesicoureteral reflux preoperatively, they still suffered from vesicoureteral reflux in the 6-12 months regular review after surgery without any intervention due to white blood cell was negative in urine routine. All cases had urinary patency and no cases with urethral stricture.@*Conclusion@#Tubularized urethral plate disassembly is a effective and simple procedure that can correct the midshaft epispadias in infant.
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Carcinoma of pancreatic body and tail is a high invasive disease with a low resectability rate.It was once believed that celiac axis infiltration usually contraindicated resection.Distal pancreatectomy with en bloc celiac axis resection (DP-CAR) is described as a new treatment method of this disease.In recent years,more and more literatures have reported this operation,but they were case reports or small sample retrospective study,the results of which differed according to the different treatments and perioperative managements in different centers.The advantages and disadvantages of DP-CAR are still controversial.Research progress of DP-CAR is reviewed in this article.
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Gastric resection can cause a multifactorial clinical manifestations of dyspepsia,such as flatulence,diarrhea,weight loss,and fat diarrhea.Exocrine pancreatic insufficiency (EPI) is one of the possible mechanisms of fat maldigestion following gastric surgery,the main causes may be related to rapid gastric emptying;asynchrony between gastric emptying and bilio-pancreatic secretion due to new tracts of various reconstructions;bacterial overgrowth after gastrectomy and so on.Oral pancreatic enzyme replacement therapy (PERT) is the mainstay of treatment for EPI,due to lack of available evidence so far,the efficacy and safety of pancreatic enzyme substitution in patients following gastric resection remains unclear and cannot be generally recommended.This review will sum up the revelant studies addressing EPI and PERT after gastric resection in recent years,and summarizes the mechanisms,clinical diagnostic methods and PERT treatment perscription of EPI after gastrectomy to improve the cognition of clinicans.
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AIM:To observe the effect of Yiqi Huayu Huatan decoction(YHHD)on unilaterral ureteral ob-struction(UUO)-induced renal interstitial fibrosis in rats, and to investigate the possible mechanism.METHODS: Fe-male SD rats(n=48)were randomly divided into sham group, model group, telmisartan group, and low-, middle-and high-dose YHHD groups,with 8 rats in each group.The UUO model rats was established by ligating left ureter.The rats in sham group and model group were treated with equal volume of normal saline, others were treated with the corresponding drugs daily.After 12 weeks,the rats were sacrificed.The serum samples were collected for determining the concentrations of cystatin C(Cys-C)and uric acid(UA).The morphological changes of the renal tissue were observed by PAS staining. The collagen fiber was observed by Masson staining.The mRNA expression of Krüppel-like factor 15(KLF15),high-mo-bility group box protein 1(HMGB1),nuclear factor-κB(NF-κB),IκB,monocyte chemotactic protein-1(MCP-1),inter-leukin-1β(IL-1β), tumor necrosis factor-α(TNF-α),fibronectin(FN),collagen type I(Col I)and Col-Ⅳwas detec-ted by real-time PCR.The protein expression of KLF15, HMGB1 and NF-κB was detected by Western blot.The protein expression of MCP-1 was determined by the method of immunohistochemistry.RESULTS:Compared with sham group,the deposition rate of collagen fibers and the concentration of Cys-C in model group were significantly increased(P<0.05), the mRNA and protein expression of KLF15 was significantly down-regulated(P<0.05), while the mRNA expression of HMGB1,NF-κB,IκB,MCP-1,IL-1β,TNF-α,FN,Col I and Col Ⅳand the protein expression of HMGB1,NF-κB and MCP-1 were significantly up-regulated(P<0.05).Compared with model group,the deposition rates of collagen fibers in middle-and high-dose YHHD groups and telmisartan group were significantly decreased(P<0.05),with down-regulated protein expression of HMGB1 and NF-κB and mRNA expression of IL-1βand TNF-α(P<0.05).The protein expression of KLF15 was significantly up-regulated in high-dose YHHD group and telmisartan group(P<0.05),while the protein ex-pression of MCP-1 and the mRNA expression of FN were significantly down-regulated(P<0.05).The mRNA expression of KLF15 was significantly up-regulated in high-dose YHHD group(P<0.05), while the mRNA expression of MCP-1, Col I and Col IV was significantly down-regulated(P<0.05).The mRNA expression of NF-κB and IκB was significantly down-regulated and the concentration of Cys-C was significantly decreased in each dose of YHHD groups and telmisartan group(P<0.05).No significant difference of UA level among the groups was observed.CONCLUSION:YHHD allevi-ates renal interstitial fibrosis in a dose-dependent manner, and YHHD at high dose shows the most obvious effect.The mechanism may be associated with the up-regulation of KLF15 and the down-regulation of HMGB1, NF-κB and its down-stream inflammation-related factors in the renal tissue.
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Objective To merge the traditional magnetic imaging technology with emerging robotics and to create a new surgical model that replaces human eyes with robotic arms instead of manpower.Methods Structural compatibility analysis was executed with Monte Carlo method. According to the theory of magnetic field compatibility, the mechanical arm components were classified, the magnetic field compatibility of the manipulator was discussed, the key components of the manipulator were selected,and the finite element analysis was performed to verify its reliability.The positive and negative kinematics models of robotic arms were constructed by matrix transformation and robotics toolbox. The polynomial interpolation of five times was used to plan the trajectory of the end of the manipulator.Results The work space of the robot arm solved by Monte Carlo method was found to envelop completely the inner ring aperture of the NMR,and thus the spatial accessibility of the robot arm was verified.Finite element analysis proved that the structural strength of the manipulator was well-designed and the kinematics model of the manipulator was successfully constructed.The trajectory planning found that the joints rotated uniformly and the desired requirements were met.Conclusion The robot arm developed gains advantages in configuration and nuclear magnetic compatibility.
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Objective To investigate the effects of Yiqi Huoxue Xiaozheng Formula on cell apoptosis in rats with benign prostatic hyperplasia (BPH); To preliminarily explore its mechanism of action. Methods Totally sixty 8-week-old male SD rats were randomly devided into normal group, positive control group, Yiqi Huoxue XiaozhengFormula low-, medium-, and high-dose groups, with 10 rats in each group. Except for the rats in normal group, rats in other groups were treated with castrate and testosterone propionate injection to replicate BPH model. The normal group and the model group were given normal saline for gavage; Yiqi Huoxue Xiaozheng Formula low-, middle-, and high-dose groups were given Yiqi Huoxue Xiaozheng Formula 10, 20, 40 mg/100 g for gavage, respectively; rats in positive control group were given Longkai Granule suspension 11 mg/100 g for gavage, once a day, for 30 d. Twenty-four hours after the last administration, the rats were sacrificed by cervical dislocation. The prostate tissue was taken. The protein expressions of Bcl-2 and Bax in the prostate tissue were detected by immunohistochemistry. Results Compared with the normol group, the expression of Bax in the prostate tissue of the model group decreased significantly, while the expression of Bcl-2 increased significantly; Compared with the model group, the expression of Bax in the prostate tissue of rats in administration groups increased significantly, while the expression of Bcl-2 was significantly reduced, and Yiqi Huoxue Xiaozheng Formula high-dose group was superior to other groups. Conclusion Yiqi Huoxue Xiaozheng Formula can improve benign prostatic hyperplasia by promoting the apoptosis of rat prostate tissue, and its mechanism is related to the increase of the expression of Bax protein and the decrease of Bcl-2 protein expression in prostate tissue.
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Objective To discuss the treatment effect with Mitrofanoff procedure in lower urinary tract of pediatric patients.Methods 9 patients conducted Mitrofanoff procedure from January 2014 to January 2018 in our center were analyzed retrospectively.There were 2 boys and 7 girls,age from 4 to 14 years old (7.3 years old in average).1 child was diagnosed as bladder exstrophy,4 children were neurogenic bladder,2 children were bladder tumor and the other 2 were urethral trauma.All patients were conducted Mitrofanoff procedure under general anesthesia,used appendix as the conduit,3 patients used their original bladder as reservoir,bladder augmentation was employed in 4 patients and ileal neobladder was employed in 2 patients to construct reservoir.The distal of appendix was inserted into submucosal of reservoior and the proximal end was connected to the umbilical or lower abdominal wall.Results The operations were all successfully completed without sever complications,the time spent was 176-210 min,190 min in average,hemorrhage amount 20-35 ml.Patients were followed up 15 to 50 months,the bladder capacity is 80 to 120 ml.Hydronephrosis was improved compared with pre-operative condition.4 children diagnosed with neurogenic bladder still suffered vesical ureteral reflux.All patients can conduct clean intermittent catheterization without difficulty.There was no leakage of urine from the stoma,while 2 patients showed leakage of urine from urethra when exercising,so we closed the bladder neck 6 month later.Conclusion Mitrofanoff procedure can be implied in children with end-staged lower urinary tract dysfunction due to nerogenic bladder,bladder tumor,bladder exstrophy,which makes intermittent catheterization become more convenient.
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<p><b>OBJECTIVE</b>To analyze the clinical efficacy and possible influencing factors of autologous hematopoietic Stem cell transplantation (auto-HSCT) in the treatment of patients with multiple myeloma (MM).</p><p><b>METHODS</b>Clinical data of 40 MM patients received auto-HSCT in the Department of Hematology of Henan Cancer Hospital from September 2010 to November 2017 were retrospectively analyzed, the clinical curative efficiency was summarized and the related factors were analyzed.</p><p><b>RESULTS</b>The curative efficiency of the patients before transplantation was 9(22.5%) with complete remission(CR), 5(12.5%) with very good partial remission(VGPR), 26(65%) with partial remission(PR), respectively, one of them was PR after 3 recurrences. The curative efficiency after transplantation was 22(55%) with complete remission(CR), 12(30%) with very good partial remission(VGPR), 6(15%) with partial remission(PR), respectively. And 2 cases were CR after double transplantation. Median follow-up time was 28.4 (3.1 to 88) months,15 cases presented disease progression, 7 cases were dead, 3-year estimated progression-free survival(PFS) and overall survival(OS) rate were 45.1% and 82% respectively. Unvariate analysis showed that the OS was affected by ISS stage (P<0.05), CR and VGPR (P<0.05) after transplantation; PFS was affected by ISS stage (P<0.01), before transplantation induction therapy (27 cases with bortezomizomi or thalidomide) (P<0.05), disease risk stratification (6 cases in high risk group) (P<0.05) , CR and VGPR (P<0.05) before transplantation, CR and VGPR (P<0.01) after transplantation. Cox multivariate regression analysis showed that the independent prognostic factors for OS were ISS stage, CR and VGPR after transplantation; the independent prognostic factors for PFS were the CR, VGPR, ISS stage after transplantation and induction therapy before transplant.</p><p><b>CONCLUSION</b>Auto-HSCT can improve the clinical efficacy and survival rate of MM patients; ISS stage, CR and VGPR after transplantation are independent prognostic factors for OS and PFS, and induction therapy before transplantation is also an independent prognostic factor for PFS.</p>
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Abstract Background To better understand the trends of behavioral and psychological symptoms of dementia (BPSD) over the disease progression is important to provide psychoeducation for dementia caregivers. Objective This study examined the severity and occurrence of BPSD across the various degrees of the disease. Methods This study was a cross-sectional design. Patients (N = 276) who had dementia from July 2001 to October 2008 were surveyed and assessed for dementia stage, using the clinical dementia rating scale (CDR). BPSD was evaluated using the Neuropsychiatric Inventory (NPI). We examined the differences between the severities and occurrence of the individual's BPSD among various CDR stages with the Kruskal-Wallis test and Chi-square test. Results Delusion (p = 0.01), agitation/aggression (p = 0.033), apathy/indifference (p = 0.009), aberrant motor behavior (p < 0.001), nighttime behavior disturbances (p < 0.001), and eating abnormalities (p = 0.001) were significantly different among stages of dementia. The severity of BPSD became exacerbated over the course of the disease, and was highest in moderate (CDR = 2) or severe (CDR = 3) dementia. The occurrence of BPSD was highest when the CDR equaled 2 (97.5%). Discussion The association of global (or certain) BPSD, across different stages of dementia, is a non-linear relationship. These findings suggest the importance of taking into account clinical dementia stage for managing BPSD.
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Urinary tract infection (UTI) in traditional Chinese medicine (TCM) belongs to the category of stranguria. This article describes the unsatisfactory situations in clinical practice such as antibiotics abuse, increasing of drug-resistant bacteria, high recurrence rate, etc. According to evidence-based medicine, literatures as evidence are collected for summarizing and analyzing and the result shows the advantages of TCM of relieving symptoms, reducing the dosage of antibiotics, less side effects, lower recurrence rate, etc. In the field of fundamental research, literatures associated with UTI are also summarized and analysed from several perspectives, such as causes, pathogenesis, syndrome differentiation, pharmacological effects of Chinese herbal medicine, working mechanism of non-drug therapy, etc and the result presents that integrated treatment of TCM in UTI has significant advangtages and its own characteristic.
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Objective:To observe the clinical efficacy of needling thirteen ghost acupoints for children with autism spectrum disorder. Methods:A total of 90 cases with autism spectrum disorder (ASD) aged between 2 and 6 years were randomly allocated into 2 groups by random number table. The control group (n=45) received routine rehabilitative training, and the treatment group (n=45) received acupuncture at thirteen ghost acupoints plus routine rehabilitative training. The Beijing Gesell developmental (Gesell) scale and autism behavior checklist (ABC) were used to assess the intellectual, language and behavior development before and 3 months after the treatment. Results:After the treatment, the total effective rate in the treatment group was 82.2%, versus 55.6% in the control group, showing a statistical significance (P<0.05). As for the scores of social, emotional and language in Gesell scale, there were significant intra-group differences in the treatment group (allP<0.05), and all the five subscales in the Gesell scale in the treatment group were significantly better than those in the control group (allP<0.05). As for the scores of ABC, there were significant intra-group differences in the treatment group (P<0.05), and the scores in the treatment group were significantly better than those in the control group (allP<0.05). Conclusion: Rehabilitation training plus acupuncture at thirteen ghost acupoints can significantly improve the intellectual, language and abnormal behavior in autism spectrum disorder children.
ABSTRACT
Objective:To observe the clinical efficacy of needling thirteen ghost acupoints for children with autism spectrum disorder. Methods:A total of 90 cases with autism spectrum disorder (ASD) aged between 2 and 6 years were randomly allocated into 2 groups by random number table. The control group (n=45) received routine rehabilitative training, and the treatment group (n=45) received acupuncture at thirteen ghost acupoints plus routine rehabilitative training. The Beijing Gesell developmental (Gesell) scale and autism behavior checklist (ABC) were used to assess the intellectual, language and behavior development before and 3 months after the treatment. Results:After the treatment, the total effective rate in the treatment group was 82.2%, versus 55.6% in the control group, showing a statistical significance (P<0.05). As for the scores of social, emotional and language in Gesell scale, there were significant intra-group differences in the treatment group (allP<0.05), and all the five subscales in the Gesell scale in the treatment group were significantly better than those in the control group (allP<0.05). As for the scores of ABC, there were significant intra-group differences in the treatment group (P<0.05), and the scores in the treatment group were significantly better than those in the control group (allP<0.05). Conclusion: Rehabilitation training plus acupuncture at thirteen ghost acupoints can significantly improve the intellectual, language and abnormal behavior in autism spectrum disorder children.