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@#Objective To verify the reliability of Anticlot Assistant, a patient self-management system for warfarin therapy assisted by artificial intelligence. Methods It was a single-center, prospective cohort study. The eligible 34 participants were recruited consecutively between November 29, 2017 to September 27, 2018 and managed by warfarin therapy via Anticlot Assistant. The recommendations of Anticlot Assistant were examined and verified by the doctors to ensure the security. Medical records were exported from the the background management system. An univariate analysis compared the outcomes between accepted and overridden records and a logistic regression model was built to determine independent predictors of the outcomes. The research team analyzed 153 medical records, which were from 18 participants and were input by 19 doctors. There were 97 records with doctor accepting the suggestion and 56 records with doctor rejecting the suggestion . Results When the doctors accepted the recommendations, the percentage of the next-test international normalized ratio (INR) in the therapeutic range was higher (64.95% vs. 44.64%, RR=2.298, 95%CI 1.173 to 4.499, P=0.014). The logistic regression analysis revealed that accepting the recommendations was an independent predictor for the next-test INR being in the therapeutic range after controlling potentially confounding factors (OR=2.446, 95%CI 1.103 to 5.423, P=0.028). Conclusion The algorithm of Anticlot Assistant is reasonable and reliable.
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Objective:To evaluate an anticoagulation management method based on mobile health technology and artificial intelligence.Methods:The study was a single-center, prospective, randomized, controlled, non-inferiority clinical trial. From November 2017 to September 2018, 67 patients who received warfarin therapy after mechanical valve replacement were consecutively enrolled and randomized into two groups: 34 were randomized to intervention group and 33 to control group. The intervention group was managed via Anticlot Assistant and the control group was handled as routine care. Evaluations were performed at least 3 months after enrollment and ended on 30 September 2019. Non-inferiority was evaluated using one-sided tests with a non-inferiority margin set 11.0% for time in therapeutic range (TTR) and 10.0% for the percentage of international normalized ratio (INR) in the therapeutic range.Results:The mean TTR was (58.2±23.4)% in the intervention group and (54.8±23.6)% in the control (the difference: 3.4%; low limit of one-side 95% confidence interval for the difference: -6.4%; and P value for non-inferiority was 0.009). The percentage of INR in the therapeutic range was (55.4±21.9)% in the intervention group and (52.8±22.5)% in the control (the difference: 2.6%, low limit of one-side 95% confidence interval for the difference: -6.6%; and P value for non-inferiority was 0.012). Conclusion:The outcomes of patients managed via the anticoagulation management method base on mobile health technology and artificial intelligence are not inferior to those handled as routine care.
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Objective To observe the early effect of Fructus mume extract on KIM-1 and OPN levels in rats with kidney stone formation induced by nanobacteria and to investigate the therapeutic significance of F.mume extract on early kidney stone formation.Methods Nanobacteria were separated and cultured from human upper urinary calculi.The study group appropriately included 54 healthy male SD rats.The renal calculus model was constructed by tail vein injection of nanobacteria.A kidney stone model was created with an F.mume extract intervention,and rats were killed at different stages of the intervention.Real-time polymerase chain reaction was used to detect the KIM-1 mRNA expression in rat renal tissue,and the KIM-1 concentration in urine was detected by using enzyme-linked immunosorbent assay.We detected kidney tissue stone crystals and OPN expression by using hematoxylin-eosin staining and immunohistochemistry.Results Renal tubules of the experimental model were significantly expanded,that is,the formation of renal tubular stones.The early KIM-1 and OPN expression levels were increased.The above-mentioned changes positively correlated with the injection time of the nanobacteria,and F.mume extract antagonized the changes.Conclusion F.mume extract may be useful for the repair of renal injury to reduce kidney stone formation,which may be related to the gene regulation of KIM-1 and OPN.
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OBJECTIVE:To observe clinical efficacy and safety of torasemide in the treatment of chronic heart failure(CHF). METHODS:94 patients with CHF were selected and randomly divided into control group and observation group,with 47 cases in each group. Control group were treated with routine treatment,such as bed rest,oxygen inhalation,control of total body fluid in-take,routine anti-heart failure therapy and use of diuretic in 24 h. Based on the above treatment,observation group were treated with Torasemide injection with initial dose of 5-10 mg,qd,gradually increasing to 20 mg/d,maximal does of 40 mg/d. Both group re-ceived 7 days of continuous treatment. Clinical efficacies were observed in 2 groups as well as serum potassium and sodium,Scr,24 h urine volume and the rate ofⅠ-Ⅱgrade cardiac function before and after treatment. The occurrence of ADR was compared between 2 groups. RESULTS:The total effective rate of observation group was 61.70%,which was significantly higher than that of control group (46.81%),with statistical significance (P0.05). There was no statistical significance in 24 h urine volume and the rate ofⅠ-Ⅱgrade cardiac function between 2 groups before and after treatment(P>0.05);after treatment,24 h urine volume and the rate ofⅠ-Ⅱgrade cardiac function of 2 groups were increased significantly,the observation group was higher than the control group, with statistical significance (P0.05). CONCLUSIONS:Torasemide is effective for CHF,and can promote diuresis and the recovery of cardiac function with good safety.
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OBJECTIVE@#To introduce a new method of complete remaining parotid fascia in parotidectomy, preventing Frey's syndrome.@*METHOD@#Thirty-five patients with benign tumor in the parotid gland were treated by remaining parotid fascia. All 35 patients were followed up after 6 months to 24 months.@*RESULT@#The parotid fasciae of 26 out of 35 were remained completely and none of these 26 patients developed Frey's syndrome. The parotid fasciae of 9 out of 35 were excised partly and Frey's syndrome occurred in 2 of these 9 patients. There was significant difference of Frey's syndrome between the parotid fasciae being remained completely and the parotid fasciae being remained partly.@*CONCLUSION@#The parotid fascia could be reserved completely in parotidectomy. The complete parotid fascia could prevent Frey's syndrome in the patients after undergoing parotidectomy.
Subject(s)
Adolescent , Adult , Aged , Aged, 80 and over , Child , Female , Humans , Male , Middle Aged , Young Adult , Fasciotomy , Parotid Gland , General Surgery , Parotid Neoplasms , General Surgery , Postoperative Complications , Sweating, GustatoryABSTRACT
Objective To establish the weights of risk factors indicators for lower limbs deep vein thrombosis through the scientific research methods.Methods 21 experts were consulted for two rounds of questionnaires survey with Delphi method,according to the experts'opinion,analytic hierarchy process (AHP) was used to calculate the weights of indicators in grade one and the experts'evaluation was used to calculate the weights of indicators in grade two.Results The weight coefficients of grade one including vascular endothelial injury,blood high condensation state and slow blood stream were 0.3325,0.5278 and 0.1396 respectively.The items with maximal weights of the 21 indicators in grade two was vascular trauma,in particular vein injury(0.0770).The Kendall's W of the indicators in grade two was 0.422.Conclusions Through qualitative and quantitative research methods,the risk factors indicators which provide the reference for the prevention of lower limbs deep vein thrombosis are scientific and reliable.
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Objective To evaluate comprehensively the effect of vibratory sputum ejectionmachine on patients by comparing the volume of vibratory sputum ejection machine and the traditional back percussion sputum expectoration.Methods Searching thoroughly Chinese Journal Full-text Database(CJFD),VIP CJFD,Wanfang Periodical Database,collecting the clinical randomized controlled trials of domestic vibratory sputum ejection machine and traditional back percussion sputum expectoration and employing RevMan5.0 processing software for statistical analysis.Results Vibration expectoration instrument is better than the traditional back percussion sputum expectoration.Conclusions Vibratory sputum ejection machine can increase the amount of expectoration drainage in patients and reduce pulmonary infection.
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Objective To study the effect of labeling esophageal carcinoma with sliver clips on two sides by esophagoscopy in mapping the target for conformal radiotherapy (CRT). Methods Eighty patients with esophageal carcinoma (28 patients in early stage, 52 patients in late stage), who were eligible for CRT, were collected and the tumor volume was detected by three methods: CT (A),CT combined with X-ray (B) and CT combined with sliver clip labeling by esophagoscopy (C). The differences of the tumor length and position in head-foot site (Y-axsis) among three methods were compared. Results The comparison of average length of tumor in early stage patients showed significant difference among three methods in all types of tumor (F= 4.07 ～ 7.43, P＜0.05 ) except papillary type (F= 1. 71, P＞0. 05). There was difference (ranged from 0. 5 cm to 2. 0 cm) in detection of position in head-foot site between A and B methods and C method. Significant difference was found in determining the displacement on head-foot site among three methods (F = 34. 36 ～193.50,P ＜0.01). The comparison of average length of tumor in middle or terminal stage patients showed significant difference among three methods in all types of tumor (F=4. 07～30.10 ,P＜0.05) except mushroom type (F = 2.44, P＞ 0. 05). Significant difference was found in determining the displacement on head-foot site among three methods (F= 12.00 ～ 21.16, P ＜ 0. 01 ). Conclusion These findings indicate that C method is more sensitive and correct in mapping the target for CRT in comparison with other two methods.
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Objective To study the anti-tumor effects of pEgr-1-endostatin-TNF-α generadiotherapy on mice bearing Lewis lung carcinoma, and to explore the mechanism involved. Methods 240 mice with Lewis lung carcinoma were randomly divided into four groups, including control group,irradiation group, liposome group, and liposome combined irradiation group. The plasmids packed by liposome were injected locally into the tumors of the mice, and the tumors of liposome combined irradiation group were irradiated with 10 Gy γ-rays 24 h later. The expression levels of TNF-α and endostatin in mouse serum were measured by ELISA. Then the tumor growth rates at different time were observed. Tumor angiogenesis density were estimated on frozen sections stained with CD31 by using the Chalkley counting method to vessel hot-spots. The tumor inhibition rates were also calculated. Results Radiation induced the expression of pEgr-1-endostatin-TNFα. The endostatin and TNF-α were expressed steadily for about 4 weeks. The highest levels of expression of the endostatin and TNF-α were (52. 64 ±4. 19)and( 12. 01 ±0. 87 ) ng/ml at 2 week. The expression levels of TNF-α and endostatin were higher in combined therapy group than those in other groups( F = 29. 726,P ＜ 0.05 ). Compared with the control group, the density of tumor angiogenesis were depressed [ (4.7 ± 0. 8 ) vs ( 10.0 ± 1. 2)/field, t = 14. 063, P ＜ 0.05 ] and tumor growth were significantly inhibited compared to the control group and irradiation group [ (5907. 2 ±78.6), (4653.4±32.8) and (763.5 ± 12.3) mm3, F= 16.415,P ＜0.05)]. Conclusions The expression of pEgr-1-endostatin-TNFα could be induced by irradiation in dose- and time-dependent manner. The effect of antitumor and angiogenesis inhibition may be more significant than irradition.
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@# ObjectiveTo observe the effects of sodium ozagrel on nail microcirculation and hemorrheology in patients with myocardial infarction (MI).Methods128 MI cases were randomly divided into the treatment group (group A, n=68) and control group (group B, n=60). On the base routine treatment, patients of group A were treated with sodium ozagrel (80～160 mg/d) and those of group B were treated with glucose-insulin-potassium solution (250～500 ml/d). The changes of nail microcirculation and hemorrheology were measured in pre-treatment and post-treatment.ResultsThe nail microcirculation and hemorrheology in group A were significantly better than group B (P<0.01).ConclusionSodium ozagrel can markedly improve nail microcirculation and hemorrheology in patients with MI.
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Objective: To investigate the mechanisms of curative effect of Tongxinluo capsule(通心络胶囊) on patients with coronary artery disease and angina pectoris.Methods: One hundred and twelve cases in accord with the diagnostic criteria of coronary heart disease of World Health Organization(WHO) were(randomly) divided into two groups: treatment group(n=60) and control group(n=52).The patients in both groups were treated with routine therapy including ?receptor retardant and ester of nitric acid etc.(Additionally),the treatment group was treated with Tongxinluo capsules,2 capsules each time and 2 times(per day) for 2 months consecutively.The clinical manifestations before and after treatment,the changes of(electrocardiogram)(ECG),microcirculation of nail bed and hemorrheology were observed in all the patients in both groups.Results: The total clinical effective rate and the rate of total improvement in ECG changes were 86.67% and 80.00% respectively after treatment in the treatment group,and compared with the control group(78.85% and 69.23%) the differences were significant(both P
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Prof. WANG Shou-chuan thought that children Tourette’s syndrome were due to wind and phlegm accumulation interior, imbalance between yin and yang. It is a manifestation excess include wind that is excess wind of liver wind and lung wind and deficiency wind due to yin deficiency, phlegm that is phlegm-fire and phlegm-turbidity; and root deficiency lying in the liver, spleen and kidney. He treated the patients with the main method of eliminating phlegm and extinguishing wind, according to the pathomechanism of wind and phlegm, accompanied with pacifying liver and purging fire, dispelling phlegm and calming mind, strengthening the spleen and nourishing the heart, nourishing the liver and tonifying the kidney. He produced the formula Fengning decoction, modif ication according to the symptoms of the patients. Its curative effect was remarkable and should be widely applied in clinic.
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Objective To assess the value of corrected TIMI frame count(CTFC) in patients with acute myocardial infarction(AMI) underwent primary percutaneous coronary intervention(PCI) and the change of CTFC before and after adenosine interference. Methods CTFC was defined as the number of cineframes from coronary filling with radiographic reagent to visualization of distal coronary landmark in the infarct-related artery. Normal antegrade flow was 0.05), and CTFC of the patients with slow antegrade flow, who underwent PCI, was not significantly different before and after administering adenosine. LVEF of the patients with normal antegrade flow was significantly higher than that of the patients with slow antegrade flow(P=0.001). MACE of the patients with slow blood flow were obviously higher than that of the patients with natural blood flow(P
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Objective To observe the change of C-reactive protein (CRP), Interleukin-6(IL-6) plasma levels before and after percutaneous coronary intervention(PCI) in angina pectoris patients to evaluate the relationships between the severity of coronary lesions, CRP and IL-6. Methods 36 patients diagnosed as angina pectoris by coronary angiography received PCI and 15 healthy subjects served as the control. Peripheral blood samples were taken before and after PCI, the serum levels of CRP and IL-6 were measured by ELISA. The relationships between serum CRP,IL-6 and the severity of coronary lesions were analyzed. Results The mean levels of serum CRP and IL-6 in the patients were higher than those in the control(P
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Objective To retrospectively analyze the complications and management of complications during percutaneous implementation of biliary stents in 17 patients. Methods Percutaneous biliary drainage and implementation of biliary stents for malignant biliary obstruction under fluoroscopic guidance was performed in 64 patients. 17 cases developed complications. Bradycardia and hypotension was seen in 5 cases, slipping of the stent into the duodenum in 1, bile duct perforation in 2, the fine guidewire broken in the hepatic parenchyma in 2, malposition of the stent in 3, hepato renal failure leading to hemorrhage in 2, exchanging guidewire broken in the duodenum in 1, and balloon broken leading to stent dislocation in 1, respectively. Results Bradycardia and hypotension in the 5 cases was treated medically and the procedure was interrupted. Slipping of the stent into the duodenum was passed off spontaneously. Broken of the fine guidewire in the liver did not present any complaints until the death of the patients. Perforation of bile duct was treated conservatively with a clinical successful outcome. Malposition of the stent was treated by reimplementation of shorter stents. The broken exchanging guidewire in the duodenum during implementation was removed with the gastroscope. The hepato renal failure leading to hemorrhage had poor prognosis. The broken balloon caused stent dislocation was treated by reimplementation of stent. Conclusion Percutaneous implementation of stent is effective and safe for elderly patients with proximal stenosis of the biliary tract. However, one must be very careful to avoid the complications.
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Objective To study different e mbolization methods in various aneurys ms with metallic coils. Methods In 6 spherical aneurysms, the e mbolization was p erformed with coils in their bodies, discontinuing the total or part of the bloo d supply to the corresponding viscera. While in 6 diverticulum aneurysms, the em bolization with coils was conducted in their bodies only, maintaining the blood supply of the corresponding viscera. For some pseudoaneurysms, both afferent and efferent arteries were embolized and collateral arterial supplies were prevente d. Results All 19 cases 20 aneurysms, of aneurysms were success fully embolized. Among 8 cases of pseudoaneurysms, bleeding had been stopped in 7 cases. Putting coils in the b odies of aneurysms or embolizing both afferent and efferent arteries improved su ccessful rate. Conclusion Embolizing aneurysms with metallic co ils is an efficient, reliable, and simple interventional method for stopping bleeding.
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Objective To investigate the relationship between tumor necrosis factor-alpha(TNF-?), endothelin(ET) and Interleukin-6(IL-6) plasma level of coronary heart disease(CHD) patients and the type of the coronary plaque morphology.Methods Peripheral blood samples were taken from 230 CAG confirmed CHD patients and the same number of CAG normal patients.Serum TNF-?,ET and IL-6 values were measured through enzyme-labeled immunosorbent assay(ELISA) technique in the 2 groups and their relationship between coronary plaque morphology were assesed.Results The mean levels of serum TNF-?,ET and IL-6 in the CHD group were higher than those of the normal group(P