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Objective:To explore the application effect of progressive case teaching method based on core competency in standardized nursing training.Methods:A total of 63 nursing students rotated in department of neurosurgery from June 2020 to June 2022 were selected as the research objects and randomized into experimental group ( n=31) and control group ( n=32). The experimental group adopted the progressive case teaching method based on core competency, and the control group adopted the conventional teaching mode. The data was analyzed using SPSS 26.0 to conduct t-test or non-parametric test based on the data normality for comparing the theory results, objective structure clinical examination (OSCE) scores, core competency, self-directed learning ability scores, teaching satisfaction and nursing satisfaction of patients in two wards between the two groups. Results:The theoretical results ( t=4.74, P<0.001) and OSCE scores ( t=3.81, P<0.001) of the experimental group were better than those of the control group. The scores of core competency and autonomous learning ability ( t=4.32, P<0.001) of the experimental group were better than those of the control group. The teaching satisfaction score ( t=2.21, P=0.044) and patient satisfaction score ( t=2.92, P=0.011) of the observation group were better than those of the control group. Conclusion:The progressive case teaching method based on core competency can improve the post competency of nurses, and also improve the teaching satisfaction rate and patient satisfaction rate, which is worthy of being carried out in the subsequent teaching activities.
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The differentiation of pluripotent stem cells has been used to study disease mechanisms and development. We previously described a method for differentiating human pluripotent stem cells (hPSCs) into salivary gland epithelial progenitors (SGEPs). Here, cystic fibrosis transmembrane conductance regulator (CFTR) knockout hPSCs were differentiated into SGEPs derived from CFTR knockout hESCs (CF-SGEPs) using the same protocol to investigate whether the hPSC-derived SGEPs can model the characteristics of CF. CF—a disease that affects salivary gland (SG) function—is caused by mutations of the CFTR gene. Firstly, we successfully generated CFTR knockout hPSCs with reduced CFTR protein expression using the CRISPR-Cas9 system. After 16 days of differentiation, the protein expression of CFTR decreased in SGEPs derived from CFTR knockout hESCs (CF-SGEPs). RNA-Seq revealed that multiple genes modulating SG development and function were down-regulated, and positive regulators of inflammation were up-regulated in CF-SGEPs, correlating with the salivary phenotype of CF patients. These results demonstrated that CFTR suppression disrupted the differentiation of hPSC-derived SGEPs, which modeled the SG development of CF patients. In summary, this study not only proved that the hPSC-derived SGEPs could serve as manipulable and readily accessible cell models for the study of SG developmental diseases but also opened up new avenues for the study of the CF mechanism.
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The latest epidemiological data suggests that the situation of adult diabetes in China is severe, and metabolic diseases have become significant chronic illnesses that have a serious impact on public health and social development. After more than six years of practice, the National Metabolic Management Center(MMC) has developed distinctive approaches to manage metabolic patients and has achieved a series of positive outcomes, continuously advancing the standardized diagnosis and treatment model. In order to further improve the efficiency, based on the first edition, the second edition guideline was composed by incorporating experience of the past six years in conjunction with the latest international and domestic guidelines.
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Liver is the central hub regulating energy metabolism during feeding-fasting transition. Evidence suggests that fasting and refeeding induce dynamic changes in liver size, but the underlying mechanisms remain unclear. Yes-associated protein (YAP) is a key regulator of organ size. This study aims to explore the role of YAP in fasting- and refeeding-induced changes in liver size. Here, fasting significantly reduced liver size, which was recovered to the normal level after refeeding. Moreover, hepatocyte size was decreased and hepatocyte proliferation was inhibited after fasting. Conversely, refeeding promoted hepatocyte enlargement and proliferation compared to fasted state. Mechanistically, fasting or refeeding regulated the expression of YAP and its downstream targets, as well as the proliferation-related protein cyclin D1 (CCND1). Furthermore, fasting significantly reduced the liver size in AAV-control mice, which was mitigated in AAV Yap (5SA) mice. Yap overexpression also prevented the effect of fasting on hepatocyte size and proliferation. Besides, the recovery of liver size after refeeding was delayed in AAV Yap shRNA mice. Yap knockdown attenuated refeeding-induced hepatocyte enlargement and proliferation. In summary, this study demonstrated that YAP plays an important role in dynamic changes of liver size during fasting-refeeding transition, which provides new evidence for YAP in regulating liver size under energy stress.
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Objective:To analyze the efficacy and safety of cranial approach priority, counterclockwise sequential comple mesocolic excision in laparoscopic right hemicolectomy.Methods:From Jan. 2020 to Dec. 2020, 30 patients with right colon cancer in Department of Gastrointestinal Surgery were retrospectively analyzed. Laparoscopic radical right hemicolectomy was performed via the approach of complete mesocolic excision. The general clinicopathological data of the patients, perioperative data such as operation time, intraoperative blood loss, number of cases of hemorrhage caused by Henle trunk and subordinate branch injury, whether or not converted to open surgery, postoperative pathological data (TNM staging, total number of dissected lymph nodes and the number of metastatic lymph nodes) , postoperative recovery (exhaust time, the time of fluid intake, drainage tube removal and hospital stay) , and complications (such as bleeding, anastomotic leakage, secondary surgery, lymphatic leakage, pulmonary infection, abdominal infection, incision infection, etc) were recorded. Follow-up was performed by telephone or outpatient in 1 year after surgery.Results:The total operation time was (197.80±31.20) minutes, ranging from 150 to 275 minutes, and the intraoperative blood loss was (58.33±30.30) ml, ranging from 10 to 100 ml. There were no cases of intraoperative Henle stem and branch injury bleeding or conversion to open surgery. Postoperative exhaust time was (2.97±0.67) d, ranging from 2 to 4d; postoperative fluid intake time was (3.67±0.76) d, ranging from 3 to 5d; postoperative drainage tube removal time was (6.60±4.00) d, ranging from 4 to 25 days; postoperative hospital stay was (7.87±3.94) days, ranging from 5 to 26 days. pTNM staging: 9 cases of stage I, 5 cases of stage IIA, 1 case of stage IIB, 6 cases of stage IIIA, 4 cases of stage IIIB, and 5 cases of stage IIIC. The total number of lymph nodes dissected was (29.50±8.18) , ranging from 19 to 51; the number of metastatic lymph nodes was (1.40±1.77) , ranging from 0 to 6. Postoperative complications included incision infection in 1 case, anastomotic leakage in 1 case, lymphatic leakage in 2 cases, and lung infection in 1 case. No tumor recurrence or metastasis was found during follow-up, and no patient died.Conclusion:Cranial approach priority, counterclockwise sequential complete mesocolic excision is safe and effective in laparoscopic right hemicolectomy.
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Neurogenic bladder caused by herpes zoster is not common.An 86 years old male patient with 6 months of dysuria and urinary retention caused by herpes zoster underwent sacral neuromodulation (SNM) operation. The symptoms of dysuria and fecal incontinence were improved significantly after operation.
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Objective:To study the effect of enhanced recovery after surgery (ERAS) on intestinal function and gut microbiota changes in patients who underwent laparoscopic gastrectomy.Methods:From Aug. 2018 to Dec. 2019, 80 patients who underwent laparoscopic radical D2 gastrectomy for gastric cancer in the first Department of Gastrointestinal Surgery of Yantai Yuhuangding Hospital were selected. According to whether it adopts ERAS treatment or not, patients were divided into 2 groups (n=40) : ERAS group and traditional perioperative treatment group. The time of postoperative bowel sounds, the time of first exhaust and defecation, the proportion of antibiotic-related diarrhea and surgical site infection (SSI) were recorded. Stools were collected before operation, first time after operation, 1, 2 weeks and 1 month after operation. 16S rRNA sequencing method was used to identify the diversity and species of gut microbiota. The diversity index of intestinal flora in the perioperative period and changes in the proportion of probiotics (bifidobacterium and lactobacillus) were compared.Results:The appearance time of bowel sounds, the first exhaust and defecation time [ (16.25±6.41) h, (23.95±6.02) h, (34.95±9.34) h] in ERAS group were significantly earlier than those in the traditional treatment group [ (22.3±6.49) h, (28.45±7.12) h, (48.1±15.64) h], and the difference was statistically significant ( P<0.05) . The incidence of antibiotic-related diarrhea was higher in the traditional treatment group (3/40) than in ERAS group (1/40) , but the difference was not statistically significant ( P>0.05) . The ratio of postoperative SSI was slightly higher in ERAS group, but the difference was not statistically significant ( P>0.05) . In the perioperative period, the intestinal flora diversity index (Chao1 and Shannon index) and the proportion of probiotics (lactobacillus acidophilus and bifidobacterium) were not significantly different between the two groups before surgery ( P>0.05) ; while at the first time, one week, 2 weeks after the operation, and 1 month after the operation, ERAS group was higher than the traditional group ( P<0.05) ; and at each postoperative time point, the traditional group decreased significantly than the ERAS group. The first time decrease was the largest, ( P<0.05) ; With the passage of time after operation, the diversity of intestinal flora and the proportion of probiotics gradually recovered. By 1 month after operation, the two groups did not return to the preoperative gut microbiota diversity state or proportion. Conclusion:The concept of enhanced recovery after surgery (ERAS) promotes the recovery of intestinal function in patients with gastric cancer, does not reduce the proportion of antibiotic-associated diarrhea (AAD) or surgical site infections (SSI) , and maintains the diversity of gut microbiota balance and stability.
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Since December 2019, the outbreak of coronavirus disease 2019 (COVID-19) has occurred in China. Higher risk of COVID-19 infection and worse prognosis were observed among patients with diabetes. There are rigorous challenges existing in terms of diabetes prevention and glycemic control in primary medical care during period of COVID-19. Here, expert recommendations were developed by Chinese diabetologists, healthcare providers, and public health administrators to improve the ability of primary health facilities and provide standardized basic public health and medical services throughout country. The main contents include basic requirements for management, workflow of health management, referral, treatment, and long-term follow-up.
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With the progress of society and the improvement of living standard, the incidence of obesity is increasing. Serum leptin level increased significantly in the obese patients with hyperinsulinemia. However, the response to leptin is weakened, and then " leptin resistance" is widely concerned. Previous studies have focused on serum leptin levels and leptin receptor expression. In recent years, the mechanism of leptin resistance has been elucidated from different perspectives. This article tries to review the recent progress in the mechanism for leptin resistance, and briefly discusses the relationship between leptin resistance and insulin resistance, as well as the latest treatment measures for leptin resistance. With the development of leptin resistance research, it is believed that the increasing leptin sensitivity will be an important measure in obesity treatment.
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Since December 2019, the outbreak of coronavirus disease 2019 (COVID-19) has occurred in China. Higher risk of COVID-19 infection and worse prognosis were observed among patients with diabetes. There are rigorous challenges existing in terms of diabetes prevention and glycemic control in primary medical care during period of COVID-19. Here, expert recommendations were presented by Chinese diabetologists, healthcare providers, and public health administrators to improve the ability of primary health facilities and provide standardized basic public health and medical services throughout the country. The main contents include basic requirements for management, workflow of health management, referral, treatment, as well as the long-term follow-up.
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Objective:To evaluate the clinical efficacy and safety of transurethral columnar balloon dilation of prostate (TUCBDP) in treatment of patients with benign prostatic hyperplasia(BPH).Methods:A retrospective analysis was performed on 25 cases of BPH treated by TUCBDP in the First Affiliated Hospital of Anhui Medical University from June 2016 to July 2018. The median age was 80(57-94) years, and the median volume of prostate was 75 (30-176) ml. The median preoperative maximum urine flow rate (Q max) was 6 (2-9) ml/s, the median quality of life score (QOL)was 4(3-5) points. The median preoperative international prostate symptom score (IPSS) and residual urine volume (RUV) was 25(18-34) and 85 (30-510) ml respectively.The median preoperative international index of erectile function questionnaire-5 (IIEF-5) score was 11(5-21)points and the median preoperative premature ejaculation diagnostic tool (PEDT) score was 10(6-17)points.The standard procedure of TUCBDP includes injecting 5ml of normal saline into the inner capsule, touching the inner capsule at the apex of prostate, fixing the catheter and then injecting water into the outer capsule to make the pressure reach 2.5 kPa. When the pressure of the outer capsule was maintained at 3 kPa for 5 minutes, the prostate was split. The peroperative IPSS, QOL, Q max and RUV was compared. The IIEF-5 and PEDT score before and after surgery were compared in patients with normal sexual activity to evaluate whether there were reverse ejaculation and semen reduction. Results:One case of BPH failed to rupture and the other two cases was split at 6 o’clock. The three cases were converted to plasma resection. The rest 22 cases were operated successfully with the median operation time of 17(11-23)min, the hemoglobin loss of 19(15-22)g/L. The continuous bladder flushing time was 1(1-2)d, the indwelling catheter time was 10(7-11)d and the hospital stay time was 11(7-12)d. Twenty of 25 cases were followed-up for 12 months. IPSS was 8 (4-14) points, Q max was 17(9-25)ml/s, and RUV was 10 (0-150) ml; there were significant differences between the peroperative and postoperative (all P<0.001). The median QOL was 1(1-2) point, decreased than peroperative( P<0.05). No adverse ejaculation and semen reduction were found in the post-operative patients with normal sexual life. The post-operative IIEF-5 and PEDT score was 16 (7-24) points and 8 (6-14) points respectively, which was not significantly different while compared with pre-operative IIEF-5 and PEDT score. Conclusions:TUCBDP was proved to be effective and safe for treating high-risk BPH patients with the advantages of short operation time, less bleeding, significant improvement of residual urine and dysuria.
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Objective:To evaluate the efficacy and safety of laparoscopic spleen-preserving splenic hilar lymphadenectomy through endovascular arch approach for superior gastric cancer.Methods:From Oct. 2018 to Feb. 2019, 20 cases of upper gastric cancer underwent laparoscopic total gastrectomy in Gastrointestinal Surgery Ward 1 of Yantai Yuhuangding Hospital. The splenic hilar lymph nodes were dissected by endogastric omentum vascular arch approach. The total operation time, intraoperative bleeding volume, operation time and bleeding volume of splenic hilar lymph nodes dissection, total number of lymph nodes and metastatic lymph nodes, number of splenic hilar lymph nodes and metastatic lymph nodes, postoperative exhaust time, first feeding fluid time and postoperative hospital stay time, and postoperative complications such as abdominal infection, anastomotic leakage, pulmonary infection, incision infection and bleeding were recorded. The complications of splenic hilar lymph node dissection were bleeding, conversion to laparotomy, splenic ischemia and splenic necrosis. One year after operation, follow-up was carried out by telephone and outpatient.Results:Laparoscopic total gastrectomy and splenic hilar lymph node dissection were successfully performed in all cases. The total operation time ranged from 200 to 268 min, with an average of (240.8±31.7) min, intraoperative bleeding volume of 50 to 200 ml, with an average of (90.4±43.8) ml; the time of splenic lymph node dissection was (18.5±4.0) min; the amount of splenic lymph node dissection bleeding ranged from 5 to 20 ml, with an average of (10.2 ± 5.8) ml; the number of total lymph nodes dissection was 25 to 58, with an average of 37.68±3.89 and the number of metastatic lymph nodes 4.31±2.54; The number of splenic lymph nodes was 2 to 10, with an average of 3.51± 1.79; The number of metastatic lymph nodes was 0 to 4 lymph nodes, with an average of 0.98±1.19. The average time of anal exhaust was (3.5±1.9) days, the time of fluid intake was (4.5±1.7) days, and the postoperative hospital stay was (7.5±1.5) days. Postoperative complications were as following: one case had abdominal infection, one had pulmonary infection, one had anastomotic leakage and there were no complications related to splenic hilar lymph node dissection such as conversion to laparotomy, splenic ischemia or splenic necrosis. There was no recurrence or metastasis of the tumor and no death occurred one year after the operation.Conclusion:Laparoscopic spleen-preserving splenic hilar lymphadenectomy via endovascular arch approach is safe and effective.
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Polycystic ovary syndrome( PCOS) is one of the most common endocrine disorders in women of reproductive age, resulting in several health complications such as menstrual dysfunction, infertility, hirsutism, acne, obesity, and metabolic syndrome. PCOS is recognized to be a complex polygene disease. Although the cause of PCOS has not been fully clarified, hyperandrogenism is one of the key pathogenesises of PCOS. In this article, we reviewed the effects of genes related to androgen biosynthesis,metabolism,reserve,action and regulation on the pathogenesis of PCOS based on the research progress in the candidate gene studies, genome wide association studies, as well as its epigenetics.
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Objective To compare ultra-performance liquid chromatography tandem mass spectrometry (UPLC-MS/MS) and chemiluminescence immunoassay(CLIA) measurement of human serum androgen levels in polycystic ovarian syndrome(PCOS). Methods 160 PCOS patients and 146 healthy subjects(control group) were recruited and their serum androgen levels——measurements of testosterone and dehydcoepiandrosterone sulfate (DHEA-S) were tested by UPLC-MS/MS and CLIA. The androgen results combined with body mass index(BMI) were analyzed by ROC curve. According to area under curve(AUC) calculated by SPSS, a better method will be selected to provide accurate test results for physicians. Results (1)AUC of DHEA-S tested by UPLC-MS/MS was significantly higher than the one tested by CLIA(P<0.01). There was no significant difference between the AUC of T tested by UPLC-MS/MS and the one tested by CLIA. (2)AUC of T combined with DHEA-S tested by HPLC was not only significantly higher than the AUC of two combined indicators tested by CLIA(P<0.01),but also significantly higher than the AUC of a single indicator——either T(P<0.01) or DHEA-S(P<0.01) tested by UPLC-MS/MS. (3)The AUC of T,DHEA-S combined with BMI tested by HPLC was not only significantly higher than the AUC of three combined indicators tested by CLIA(P<0.01),but also higher than the AUC of two combined indicators tested by UPLC-MS/MS(P<0.05). Conclusion T and DHEA-S tested by UPLC-MS/MS combined with BMI has a certain reference value in the diagnosis of PCOS.
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Objective To observe the complications and mortality of hyponatremia in patients with acute exacerbation of chronic obstructive pulmonary disease.Methods The patients with acute exacerbation of chronic obstructive pulmonary disease were selected and divided into non -hyponatremia group(252 cases)and hyponatremia group(65 cases).The differences in the general status,serum ions,blood gas,APACHE Ⅱ score,complications dur-ing the hospitalization,using of ventilator and mortality between the two groups were compared,and drew the receiver operating characteristic(ROC)curve,to acquire higher serum sodium cut -off values.Results In the hyponatremia group,the body weight was (68.3 ±14.4)kg,BMI was (25.5 ±4.9)kg/m2 ,those in the non -hyponatremia group were (74.9 ±15.9)kg and (28.2 ±5.3)kg/m2 respectively,there were statistically significant differences(t =2.009,8.494,all P <0.05).The incidence rate of pneumonia in the hyponatremia group was 23.1%,which was higher than 13.1% in the non -hyponatremia group(χ2 =4.007,P =0.045).The hospital days of the hyponatremia group was (13.1 ±8.9)d,which was longer than (7.8 ±4.9)d of the non -hyponatremia group(t =15.638,P =0.000).The invasive ventilation days of the hyponatremia group was (1.1 ±0.4)d,which was longer than (0.9 ± 0.1)d of the non -hyponatremia group(t =2.885,P =0.004).The non invasive ventilation days of the hyponatremia group was (3.1 ±0.8)d,which was longer than (0.8 ±0.3)d of the non -hyponatremia group (t =2.984,P =0.003).The hospital mortality rate of the hyponatremia group was 12.3%,which was higher than 3.1% of the non -hyponatremia group(χ2 =7.189,P =0.007).The 90 -day mortality rate of the hyponatremia group was 29.2%, which was higher than 15.1% of the non -hyponatremia group(χ2 =7.017,P =0.008).When the serum sodium cut-off value was 128.8mmol/L by drawing ROC curve,the mortality rate in patients with lower than this value was 26.3%,while the mortality rate in patients with higher than the value was 3.7%.Conclusion Hyponatremia is related with the severity and prognosis of acute exacerbation of chronic obstructive pulmonary disease.It is most important to prevent and correct hyponatremia at early disease stage.
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Objective To investigate the influence of severity of obstructive sleep apnea hypopnea syndrome (OSAHS)on acute ST -segment elevation myocardial infarction (STEMI).Methods 86 STEMI patients were divided into two groups,STEMI with OSAHS(OSAHS group,n=38)and STEMI without OSAHS(control group,n=48).Clinical data about biochemical index,cardiac function index and the duration of STEMI onset were compared between OSAHS group and control group.Logistic statistic analysis was used to investigate the risk factors that influ-ence the circadian rhythm of onset in STEMI.Results A total of 86 patients met the inclusion criteria,they were divided into two groups,STEMI with OSAHS(OSAHS group,n=38)and STEMI without OSAHS(control group,n=48).The incidence rate of STEMI onset during 0600 am~1 159 am was significantly higher in OSAHS group compared to control group(20.8% vs.44.7%,χ2 =5.626,P=0.018).This variation was weaken in mild OSAHS group compared to moderate-severe OSAHS group(20.8% vs.31.3%,χ2 =0.726,P=0.394;20.8% vs.54.5%,χ2 =7.956,P=0.005).Multivariate logistic analysis showed that the severity of OSAHS was a risk factor to the STEMI onset during 0600 am~1159 am(OR=2.458,95%CI 1.110~5.439,P=0.027).Conclusion The severity of OSAHS significantly increases the STEMI onset during 0600 am~1 159 am.
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Objective · To explore the relationship between baseline lipid profiles and long-term cardiovascular outcomes after intervention with hypoglycemic drugs metformin and glipizide and to detect lipid components that can predict the long-term cardiovascular effect of metformin and glipizide.Methods· Liquid chromatography-quadrupole time of flight-mass spectrometry (LC-QTOF/MS) was used to measure 119 lipid components in baseline serum for 116 patients with type 2 diabetes (T2DM) and atherosclerotic heart disease (CHD) who were treated with glipizide (56 cases,the glipizide group)or metformin (60 cases,the metformin group).Cardiovascular complex end points (including cardiovascular death,all-cause death,nonfatal myocardial infarction,nonfatal stroke,and arterial revascularization) of all patients were followed up.The relationship between lipid components and cardiovascular complex end points was analyzed with Logistic regression analysis.The category-free net reclassification index (cfNRI) and the integrated discrimination improvement (IDI) were used to evaluate whether lipid components are helpful for predicting the recurrent cardiovascular events.Results· The differences in baseline drug distribution,clinical characteristics,and biochemical indexes between two groups were not statistically significant,except for diuretics use,serum PC (O-34:2) level,and SM (d18:0-24:0) level.Logistic regression analysis showed that baseline ChE (20:4) was a protective factor for recurrent cardiovascular events in the glipizide group (OR=0.87,P=0.039).ChE (20:4) significantly increased the cfNRI and IDI of cardiovascular complex end points by 69％ and 0.07,respectively (P=0.011,P=0.028).Baseline SM (dl 8:1-22:0) was a risk factor for recurrent cardiovascular events in the metformin group and all participants (OR=1.65,P=0.039;OR=1.64,P=0.014).SM (d18:1-22:0) significantly increased the cfNRI of cardiovascular complex end points in the metformin group and all participants by 74％ and 55％,respectively (P=0.012,P=0.005).Conclusion· Of 119 lipid components measured with LC-QTOF/MS,baseline ChE (20:4) is a protective factor and SM (d18:1-22:0) is a risk factor for cardiovascular complex end points in with T2DM and CHD patients after long-term treatment with metformin and glipizide.Both lipid components are helpful for improving the prediction of recurrent cardiovascular events.
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Objective To investigate the effect of combination of cervical manipulation with cervical conditioning exercise for the treatment of cervical spondylosis of neck type or nerve root type. Methods Seventy-two patients were randomly divided into a treatment group (37 patients) or a control group (35 patients) by using a random number table. Patients in the treatment group and in the control group were treated with combination of cervical manipulation or cervical manipulation only, respectively. At the end of treatment and 3 months, treatment effects were assessed by Neck Disability Index (NDI) and Visual Analog Scale (VAS). Results NDI scores in both of the treatment group and the control group after treatment were significantly lower han those before treatment (t=4.471 in the treatment group, t=3.599 in the control group, all P<0.05), and NDI score in the treatment group were significantly lower than that in the control group after treatment (t=-2.085,P<0.05). Follow-up at 3 months, NDI score in the treatment group was significantly lower than that in the control group (t=-4.549, P<0.05). Proportions of improved patients, as assessed by NDI items, including pain intensity, personal care, lifting, reading, headaches, concentration, work, sleeping, driving and recreation in the treatment group were significantly higher than those in the control groups (Z=-3.521,-3.331,-3.003,-3.001,-3.265,-3.198,-3.016,-3.000,-2.102,-2.971, respectively, all P<0.05). VAS scores in both of the treatment group and the control group after treatment were significantly lower than those before treatment (t=7.986 in the treatment group, t=6.507 in the control group, all P<0.05), and VAS score in the treatment group were significantly lower than that in the control group after treatment (t=-2.426,P<0.05). Follow-up at 3 months, the VAS score in the treatment group was significantly lower than that in the control group (t=-7.065, P<0.05). Proportions of improved patients in the treatment group was significantly higher than that in the control group (91.89% vs 74.29%; χ2=4.014, P=0.045). Conclusion Combination of cervical manipulation with cervical conditioning exercise may be superior to cervical manipulation only for the treatment of cervical spondylosis of neck type or nerve root type.
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Objective To investigate the clinical efficacy of electroacupuncture incorporate with acupuncture point injection in treating cervical spondylotic radiculopathy.Methods 103 cases from Chen Jia Qiao Community Health Service Centre and other community centers during February 2011 to November 2012 were collected and randomly allocated into three group:a electroacupuncture group of 34 cases; an acupuncture point injection of another 34 cases and an observation group of 35 cases treated with electroacupuncture which incorporated with traction therapy.After the treatment,the therapeutic effects among three groups were compared.Results ① clinical efficacy comparing:total efficacy rate of observation group was 91.4％ (32/35),the electroacupuncture group was 73.5％ (24/34),the group treated with acupuncture point injection was 70.6％ (25/34).There were statistically significant differences between the observation group and the other two groups (Z=1.721,P＜0.05),while there's no statistically significant of comparison between the group treated with electroacupuncture and the group treated with acupuncture point injection (Z=2.473,P＞0.05).② NDI score comparing:NDI score of these three groups before and after treatment.Before treatment,the score of observation group was (12.32 ± 5.03) ; the electroacupuncture group was (12.96± 6.10) ; the acupuncture point injection group was (12.79±5.07),after treatment,the separate sore was (7.40±4.12),(6.08±3.60) and (6.08 ± 3.60) sequentially.There were statistically significant differences of NDI score of the three groups before and after treatment (P＜0.05).After treatment,the efficacy of observation group was better than the group treated with electroacupuncture and the group treated with acupuncture point injection(P＜0.05).③ signs or symptoms comparing:After treatment,there were statistically significant differences between the observation group and the other two groups on the aspect of relieving pain of neck and arm,numbness of arm and hand,and alleviating soreness when doing spurling test on cervical intervertebral foramen (Z-score is 2.603,2.862,2.307,P＜0.05).There's no statistically significant of comparison among three groups on the aspects of neck functional activities and segmental tenderness of cervical spondylosis (Z-score is 1.414,1.572,P＞0.05).Conclusion In treating cervical spondylotic radiculopathy,the total efficacy rate of electroacupuncture incorporate with acupuncture point injection was higher than only treat with electroacupuncture or acupuncture point injection.
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ObjectiveTo compare the sensitivity and specificity of a new index of insulin resistance (IR) derived from plasma triglyceride and glucose with homeostasis model assessment for insulin resistance index ( HOMA-IR) and insulin sensitivity index from frequent sampling intravenous glucose tolerance test (FSIGT-ISI).Methods A total of 1024 subjects (240 normal control,335 with obesity,312 impaired glucose regulation,and 137 type 2 diabetes mellitus) were included in the present study.Standard oral glucose tolerance test,insulin release test,lipid profiles,and other biochemical markers were measured. Among them 540 subjects were selected to undertake FSIGT.TyG index is derived from plasma triglyceride and fasting glucose.TyG2 index is derived from plasma triglyceride and postprandial 2 plasma glucose.ResultsPearson correlation coefficient between TyG and HOMA-IR or FSIGT-ISI was 0.427 ( P＜0.01 ) and -0.100 ( P=0.024 ),respectively,and that between TyG2 and HOMA-IR or FSIGT-ISI was 0.455 ( P＜0.01 ) and - 0.162 ( P＜0.01 ),respectively.The sensitivity and specificity of TyG index for diagnosis of IR was 68.5％ and 63.5％ compared with HOMA-IR,and 68.5％ and49.5％ compared with FSIGT-ISI.For TyG2 index,the slightly higher sensitivity ( 81.7％ with HOMA-IR,75.7％ with FSIGT-ISI),but lower specificity (51.5％ with HOMA-IR,48.2％ with FSIGT-ISI) were found.ConclusionsBothTyGandTyG2 indices could be used as a surrogate for assessing IR in Chinese subjects.However,considering its moderately high sensitivity but low specificity,these two indices are limited in the use of large-scale epidemiological screening.