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Objective: To analyze the feasibility and safety of bridge therapy with active fixed electrodes connected to external permanent pacemakers (AFLEP) for patients with infective endocarditis after lead removal and before permanent pacemaker implantation. Methods: A total of 44 pacemaker-dependent patients, who underwent lead removal due to infective endocarditis in our center from January 2015 to January 2020, were included. According to AFLEP or temporary pacemaker option during the transition period, patients were divided into AFLEP group or temporary pacemaker group. Information including age, sex, comorbidities, indications and types of cardial implantable electionic device (CIED) implantation, lead age, duration of temporary pacemaker or AFLEP use, and perioperative complications were collected through Haitai Medical Record System. The incidence of pacemaker perception, abnormal pacing function, lead perforation, lead dislocation, lead vegetation, cardiac tamponade, pulmonary embolism, death and newly infection of implanted pacemaker were compared between the two groups. Pneumothorax, hematoma and the incidence of deep vein thrombosis were also analyzed. Results: Among the 44 patients, 24 were in the AFLEP group and 20 in the temporary pacemaker group. Age was younger in the AFLEP group than in the temporary pacemaker group (57.5(45.5, 66.0) years vs. 67.0(57.3, 71.8) years, P=0.023). Male, prevalence of hypertension, diabetes mellitus, chronic renal dysfunction and old myocardial infarction were similar between the two groups (all P>0.05). Lead duration was 11.0(8.0,13.0) years in the AFLEP group and 8.5(7.0,13.0) years in the temporary pacemaker group(P=0.292). Lead vegetation diameter was (8.2±2.4)mm in the AFLEP group and (9.1±3.0)mm in the temporary pacemaker group. Lead removal was successful in all patients. The follow-up time in the AFLEP group was 23.0(20.5, 25.5) months, and the temporary pacemaker group was 17.0(14.5, 18.5) months. In the temporary pacemaker group, there were 2 cases (10.0%) of lead dislocation, 2 cases (10.0%) of sensory dysfunction, 2 cases (10.0%) of pacing dysfunction, and 2 cases (10.0%) of death. In the AFLEP group, there were 2 cases of abnormal pacing function, which improved after adjusting the output voltage of the pacemaker, there was no lead dislocation, abnormal perception and death. Femoral vein access was used in 8 patients (40.0%) in the temporary pacemaker group, and 4 patients developed lower extremity deep venous thrombosis. There was no deep venous thrombosis in the AFLEP group. The transition treatment time was significantly longer in the AFLEP group than in the temporary pacemaker group (19.5(16.0, 25.8) days vs. 14.0(12.0, 16.8) days, P=0.001). During the follow-up period, there were no reinfections with newly implanted pacemakers in the AFLEP group, and reinfection occurred in 2 patients (10.0%) in the temporary pacemaker group. Conclusions: Bridge therapy with AFLEP for patients with infective endocarditis after lead removal and before permanent pacemaker implantation is feasible and safe. Compared with temporary pacemaker, AFLEP is safer in the implantation process and more stable with lower lead dislocation rate, less sensory and pacing dysfunction.
Subject(s)
Humans , Male , Bridge Therapy , Feasibility Studies , Pacemaker, Artificial , Endocarditis, Bacterial/etiology , Electrodes , Device RemovalABSTRACT
OBJECTIVE: To explore the protectiveness of Guhong injection (GHI) on H9c2 cardiomyocytes injured by hypoxia/reoxygenation (H/R) based on PI3K/AKT signaling pathway. METHODS: H9c2 cardiomyocytes were cultured and the optimal GHI doses were screened by CCK-8. The cells were randomly subjected into 8 groups: control group, model group, low, medium and high GHI dose groups (30, 60 and 90 μL•mL-1 respectively), positive drug group (verapamil injection 7.5 μL•mL-1), GHI+LY294002 (PI3K inhibitor) group and LY294002 group. Cells were established H/R model with hypoxia for 4 h and reoxygenation for 16 h excepted the control group. The CK-MB, LDH, MDA content and SOD activities in each group were detected by Elisa, and the expression levels of p-PI3K, PI3K, p-AKT, AKT and GSK-3β in each group were detected by Western blot. RESULTS: Compared each drug-treated group with the model group, LDH and CK-MB contents were decreased (P<0.05), MDA content was decreased (P<0.01), and SOD activity was increased (P<0.01). Meanwhile, the expression levels of p-PI3K/PI3K, p-AKT/AKT, and GSK-3β protein were elevated (P<0.01). Compared with the model group, LDH, CK-MB, MDA and SOD activity in LY294002 group were no significant difference, while the expression levels of p-PI3K/PI3K, p-AKT/AKT and GSK-3β protein decreased (P<0.01). CONCLUSION: GHI could represent anti-oxidative and anti-apoptotic effect which reduced the damage of injured H9c2 myocardial cells caused by H/R. These effects might be related to the PI3K/AKT signaling pathway.
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Breast cancer is one of the common diseases among women. It is a malignant tumor with a variety of complex mechanisms. Its pathogenesis has not been clearly studied. Physical, chemical and surgical treatments often cause vomiting, nausea, dizziness and headache for women. As compared with traditional treatment, Chinese medicine is characterized by multiple targets, small side effect and good effect in treating breast cancer. In this paper, 85 kinds of Chinese herbal medicines that can treat breast cancer were included. Among them, 69 kinds of Chinese herbal medicines have been included in the 2015 edition of the Chinese Pharmacopoeia, and 16 kinds of Chinese herbal medicines have not been included. The main medicinal ingredients in these Chinese herbal medicines for treatment of breast cancer were alkaloids, glycosides, phenols, terpenes, carbohydrates, volatile oils, coumarins and so on. In addition, these herbal medicines were classified according to their effects in breast cancer. Then, combined with the recent studies at home and abroad, this paper summarized the effect of traditional Chinese medicine(TCM) on breast cancer, including the reversal of multi-drug resistance, the inhibition of metastasis and proliferation, the induction of tumor cell apoptosis, and the arrest of the cell cycle for breast cancer. This paper also explained three pathways for treating breast cancer by TCM, including intervening the tumor cell related apoptosis gene to inhibit breast cancer, inhibiting the expression of P-glycoprotein in the cell membrane to reverse the multi-drug resistance of breast cancer cells, and regulating the related epithelial mesenchymal transition signal pathway to prevent breast cancer cells metastasis and proliferation. In the end, it was concluded that Chinese medicine can reduce the drug resistance and metastasis of breast cancer cells, block the cell cycle of breast cancer cells, and also intervene the expression of apoptotic factors to promote the death of breast cancer cells. The inhibition of breast cancer by Chinese medicine was the result of the common effect of various ingredients. Therefore, Chinese medicine treatment for breast cancer has the unparalleled advantages as compared with chemical and surgical treatment. Chinese medicine is one of our important means to overcome breast cancer.
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Objective@#To investigate the etiology and clinical characteristics of vocal fold paralysis in children. To provide useful information for diagnosis, management and prognosis in the clinical work.@*Methods@#Two hundred and seven children with vocal fold paralysis in Children′s Hospital of Fudan University were retrospectively studied, and followed-up.@*Results@#All the patients had hoarseness.151 cases had vocal paralysis in the left side and the main etiology was pulmonary arterial hypertension.43 cases had bilateral vocal paralysis and all of them had respiratory problems.The main etiology were congenital tracheoesophageal malformations.13 cases had vocal paralysis in the right side.In terms of etiology, 8 cases were related to intracranial lesions, 2 cases were idiopathic.@*Conclusions@#The main etiologies of left vocal fold paralysis were cardiovascular diseases, and bilateral vocal paralysis were congenital tracheoesophageal malformations.The main etiologies of right vocal fold paralysis were neoplastic and central lesion.The prognosis of bilateral vocal fold paralysis and right vocal fold paralysis was poor.
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Objective@#To investigate the safety and efficacy of needle-tract assisted standard percutaneous nephrolithotomy (PCNL) for the treatment of complicated upper urinary tract calculi.@*Methods@#The clinical data of 1 562 patients with complicated upper urinary calculi who received standard PCNL from December 2013 to December 2017 at Department of Urology, the First Affiliated Hospital of Xiamen University were retrospectively analyzed. There were large residual stones in 256 patients through B-ultrasound exploration after standard PCNL, could′t be detected with nephoscope in standard PCNL tracts. 16 F mini PCNL tract were established in 120 cases for treatment of residual stones, while needle-tract were established in order to guide nephroscope to find residual stones in 126 cases. Needle-tract were transferred to 16 F mini PCNL tract for treatment of residual stones in 10 patients if these residual stones could′t be detected through needle-tract. Operation time, change of hemoglobin level after operation, incidence of postoperative complications, time of hospitalization and rate of stone clearance were measured in two groups. The statistical methods used included t test, Wilcoxon rank sum test, and χ2 test.@*Results@#There were 1 to 3 mini tracts (M(QR): 1(1)) established in the mini tracts group and 1 to 7 needle-tracts (M(QR): 3(2)) established in the needle-tract group (Z=-10.57, P=0.000). Compared with mini tract group, the operation time ((62.0±18.0) minutes vs. (84.0±15.5) minutes, t=10.242, P=0.000), hospitalization time ((4.40±0.86) days vs. (5.20±0.81) days, t=7.570, P=0.049), hemoglobin dropped ((1.31±0.47) g/L vs. (2.74±0.63) g/L, t=20.12, P=0.000), and incidence of postoperative complications (7.9% (10/126) vs. 19.2% (23/120), χ2=6.674, P=0.01) of needle-tract group were lower, while postoperative stone clearance rate was higher (89.7% vs. 76.7%, χ2=7.497, P=0.006). No perioperative severe complications such as pleural injury, pneumatothorax, perforation of renal, trauma of abdominal organ occurred in two groups.@*Conclusion@#Needle-tract assisted standard PCNL for the treatment of complicated upper urinary calculi can significantly improve stone clearance rate, reduce operation time, decrease risk of kidney and surrounding organs damage.
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Comparative analysis of the variations in HA 1 gene of the influenza A (H3N2) virus and the vaccine recommended were conducted in Shangluo city of China,during the surveillance year of 2014-2015.In this study,we collected the samples of H3N2 subtype strain from the Shanglou City of China during the surveillance period of 2014-2015.The strain was cultured in MDCK cells,HA gene fragment was amplified by RT-PCR and the nucleotide sequence was determined.Sequence alignment was performed using the clustax2.1 software.The phylogenetic tree was constructed by Mega6.0 software and was analyzed by Neighboring-joining method.Results showed that the homology of isolated strain during 2014-2015 was 97.2 ％-99.9％ and homology with the recommended vaccine strain A/Texas/50/2012 was 97.3％-98.5％.The amino acid sequence of the HA 1 gene of the isolated strain was compared with that of the vaccine strain.The major antigenic determinants of the isolates in 2014,having mutations were section B,Y159F,S198P,while the major antigenic determinants of isolates in 2015,having amino acid mutations were A zone G142R,B region S159F,S198P.These results indicated that the key antigenic determinant of influenza H3N2 subtype strain in Shangluo City has changed in 2014-2015 and A/Texas/50/2012 vaccine component is no more effective.Hence,there is an urgent need to update the influenza H3N2 subtype vaccine components and in future we should be deeply concerned about the evolution ofinfluenza H3N2 gene trends.
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To identify the precious bile powder and its adulterants by DNA barcoding, and establish its standard experimental process to ensure the safe and effective utilization. Total twelve sequences from samples of bear bile powder which come from Ursus thibetanus for DNA extraction, PCR(polymerase chain reaction) and sequence, then using CodonCode Aligner V 7.0.1 shear primer region to obtain COI sequence. The COI sequences of U. arctos and their adulterants were obtained from GenBank. MEGA7.0 software was applied for analyzing mutation, calculating intraspecific and interspecific K2P(Kimura 2-Parameter) genetic distance and constructing the Neighbor-joining tree(NJ). The results showed that the maximum K2P genetic distance of bear bile powder of U. thibetanus and U. arctos are far less than minimum K2P genetic distance within its adulterants species, and the results of NJ tree demonstrated that each species could be distinguished from the counterfeits obviously. DNA barcoding is a safe, convenient and reliable technique for species identification, and it is important to establish the standard sequence of COI sequences for animal medicines.
Subject(s)
Animals , Bile , Chemistry , DNA Barcoding, Taxonomic , Medicine, Chinese Traditional , Phylogeny , Quality Control , UrsidaeABSTRACT
In 1905, Henry Head first suggested that transmission of pain-related protopathic information can be negatively modulated by inputs from afferents sensing innocuous touch and temperature. In 1965, Melzak and Wall proposed a more concrete gate control theory of pain that highlights the interaction between unmyelinated C fibers and myelinated A fibers in pain transmission. Here we review the current understanding of the spinal microcircuits transmitting and gating mechanical pain or itch. We also discuss how disruption of the gate control could cause pain or itch evoked by innocuous mechanical stimuli, a hallmark symptom for many chronic pain or itch patients.
Subject(s)
Animals , Humans , Nerve Net , Pathology , Pain , Pathology , Pruritus , Pathology , Spinal Cord , Pathology , Synaptic Transmission , PhysiologyABSTRACT
Objective To evaluate the efficacy and safety of the new active-fitation right ventricular lead temporary-permanent pacemaker (TPPM) rersus the traditional temporary transvenous pacing system .Methods Between January 2011 and June 2013, 234 patients had their infected leads removed at our center. A total of 105 (44.9%) patients were pacemaker dependent. Thirty-five patients underwent TPPM implantation and 70 patients had implanted with traditional temporary transvenous pacing system. For traditional temporary pacing, the quadrupole catheter was implanted into the right ventricle through the femoral vein to connect the temporary pacemaker. In TPPM, an active-fixation electrode was implanted into the right ventricular septum through the subclavian and internal jugular veins to connect to the reused permanent pacemaker. parameters from the pacemakers,time for the procedure,the occurance of complications and rates of infection and mortality during the 2 years of follow up were compared between the 2 groups. Results There were more patients with infectious endocarditis in the TPPM group than in the traditional temporary pacing group(22.9% vs. 5.7%,P=0.019). Therefore,the electrode retention time in the TPPM group was longer[2(2,7)d vs.2(2,3)d,P=0.032]and the hospital stay was slightly prolonged[15(14,21)d vs.17(15,25)d,P=0.05]compared with the traditional temporary pacing group.The pacing threshold in the TPPM group was lower than that in the traditional temporary pacing group[(0.7±0.2)V vs.(1.0±0.3)V, P=0.035)].There was no difference in X-ray exposure time between the groups[(24.7±15.4)min vs.(27.5±17.7)min,P=0.242].There were no complications related to bridging in the TPPM group, but 11 patients in the traditional temporary pacing group had developed complications (P=0.009). Conclusions TPPM is effective and safer as compared to traditional temporary pacing for pacemaker-dependent patients with device infection. The operation time does not increase in patients with TPPM implantation.
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Objective To investigate the effect of fractional laser on the expression of stem cell factor (SCF) and c-kit receptor in body surface of guinea pig.Methods 20 guinea pigs were adopted.The back skin of each guinea pig was divided into four zones:A zone (the skin was not treated),B zone (the skin was treated by fractional laser at a low fluence:20 mJ/cm2),C zone (the skin was treated at a medium fluence:60 mJ/cm2),and D zone (the skin was treated at a high fluence:120 mJ/cm2).The immunohistochemical method was used to detect the expression of SCF and c-kit in body surface of guinea pig.The results were quantified using an HPIAS-1000 system.Results One week later,the SCF expression level in B,C and D groups was increased obviously,which showed statistical difference compared with A group (P＜0.05);the c-kit expression level in C and D groups was increased obviously,compared with A group (P＜0.05).4 weeks later,the SCF expression level in C and D groups was higher than A and B groups;furthermore the level in D group was higher than C group (P＜0.05);the c-kit expression level in D group was higher than A and B groups (P＜0.05).Conclusions The fractional laser could generate the curative effect by increasing the expression of SCF and c-kit in body surface.
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<p><b>OBJECTIVE</b>To explore the therapeutic effects of distal humeral lateral closing wedge osteotomy followed by modified pinning combined with external tension band fixation in the treatment of cubitus varus deformity in children.</p><p><b>METHODS</b>Total 26 adult patients with cubitus varus deformity were treated by operation from March 2011 to June 2015, 15 patients were boys and the other 11 patients were girls, ranging in age from 4 to 13 years, with an average of 7.8 years. The cubitus varus angel ranged from 11 degrees to 24 degrees, with a mean(17.50±6.73) degrees, 3 patients complicated more than 10 degrees constriction of flexion. Lateral closing wedge osteotomy retaining the medial 3 to 4 mm intact cortex by lateral elbow approach was applied in these 26 patients. The wedge defect were closed and fixed by crossing pinning. The lateral column compression was achieved with external tension band(the crossing pins were bended laterally and the pin ends were hooked mutually). The pre-operative, post-oparetive and contralateral carrying angles were compared and Laupattarakasem criteria was used to evaluate the results at follow-up.</p><p><b>RESULTS</b>All the patients got bony union 2 months after operation and there was no infection or nerve palsy. The average follow-up period was 18.8 months (ranged, 13 to 29 months). The carrying angle was restored to(11.50±3.17) degrees(ranged, 8 to 14 degrees). According to the Laupattarakasem evaluation criteria, 14 patients got an excellent result, 13 good and 1 fair.</p><p><b>CONCLUSIONS</b>Normal carrying angle and elbow flexion could be restored by lateral closing wedge osteotomy, and stable fixation could be achieved with crossing pinning and external tension band, which is available for early mobilization.</p>
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DREAM (downstream regulatory element antagonist modulator), Calsenilin and KChIP3 (potassium channel interacting protein 3) belong to the neuronal calcium sensor (NCS) superfamily, which transduces the intracellular calcium signaling into a variety of activities. They are encoded by the same gene locus, but have distinct subcellular locations. DREAM was first found to interact with DRE (downstream regulatory element) site in the vicinity of the promoter of prodynorphin gene to suppress gene transcription. Calcium can disassemble this interaction by binding reversibly to DREAM protein on its four EF-hand motifs. Apart from having calcium dependent DRE site binding, DREAM can also interact with other transcription factors, such as cAMP responsive element binding protein (CREB), CREB-binding protein (CBP) and cAMP responsive element modulator (CREM), by this concerted actions, DREAM extends the gene pool under its control. DREAM is predominantly expressed in central nervous system with its highest level in cerebellum, and accumulating evidence demonstrated that DREAM might play important roles in pain sensitivity. Novel findings have shown that DREAM is also involved in learning and memory processes, Alzheimer's disease and stroke. This mini-review provides a brief introduction of its discovery history and protein structure properties, focusing on the mechanism of DREAM nuclear translocation and gene transcription regulation functions.
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Objective To investigate the clinical value of breast augmentation with autologous fat graft using water jet-assisted liposuction (WAL) technique.Methods From October 2010 to December 2012,20 patients underwent Water Jet-Assisted Lipoplasty and breast augmentation with autologous fat tissue (average,210 ml volume injected per breast).Pretreatment and posttreatment TN,bilateral SN and MP were measured,and the outcomes were statistically analysed using paired t test,combined with photos of pretreatment and posttreatment.Follow-up ranged from 3 months to 2 years.Results The results were satisfactory.All the patients got good shape of breasts.There was no infection in all the patients.TN and SN were signifigantly increased at 3 month after operation [(88.7±2.9) cm vs.(87.2±4.2) cm,P＜0.01],[left (20.1± 1.5) cm,right (20.1 ±1.5) cm,vs left (19.5±1.5) cm,right (19.5±1.6) cm,P＜0.01].MP was also increased compared with measurement of pre-operation [(4.6±0.4) cm vs.(4.2±0.9) cm,P＜0.05].Conclusions It is a good option to use water jet-assisted liposuction technique in the treatment of breast augmentation with autologous fat graft.
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Objective To observe the efficacy ,safety and patient acceptance of the artificial airway with the oro‐pharyngo‐laryn‐gead airway cap(OPLAC) for hip replacement surgery in patients with intravenous‐inhalation combined anesthesia .Methods Sev‐enty eight cases of patients receiving the hip replacement surgery were included ,42 patients were to be adopted to establish artificial airway with the OPLAC for intravenous‐inhalation combined anesthesia ,another 36 patients treated with heath side‐lying position hypobaric spinal‐epidural anesthesia .There are two groups ,the oro‐pharyngo‐laryngead airway cap group(OPLAC ,n=42) and hy‐pobaric combined spinal‐epidural anesthesia group (CESA ,n=36) .Monitor the changes of respiratory and circulatory parameters of the two groups before the start of anesthesia ,anesthetic after 10 min ,30 min ,1 h ,and handling marrow ,observing occurrence of complications (delirium ,sore throat ,nausea ,vomiting ,deep vein thrombosis) ,following up the degree of satisfaction of patients and surgeons for anesthesia .Results The respiratory and circulatory parameters of the OPLAC group during anesthesia induction and maintenance were relatively stable ,on the other hand ,significant cyclic inhibition (blood pressure and heart rate decresing ) and re‐spiratory rate declining were observed in the CESA group after anesthesia ,cases with the use of atropine and dopamine significantly more than OPLAC group .The circulation and breath in the OPLAC group were relatively stable when handling marrow ,while cir‐culation fluctuating Significantly in the CESA group (blood pressure decreasing and heart rate increasing ) .The incidence of delirium in the CESA group was significantly higher than OPLAC group .The patient satisfaction of the OPLAC group was significantly bet‐ter than the CESA group .Conclusion The artificial airway with OPLAC for hip replacement surgery in patients with intravenous‐inhalation combined anesthesia is safe ,effective ,and satisfactory .
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As new-type powered sheaths are expensive and unavailable, the standard lead extraction techniques remain the mainstay in clinical applications in many countries. The purpose of this study was to re-evaluate the clinical application of the standard lead extraction techniques and equipment, and make some procedural modifications and innovations. In our center, between January 2006 and May 2012, 229 patients (median, 66 years) who underwent lead extraction due to infection and lead malfunction were registered and followed up prospectively with respect to clinical features, reasons for lead extraction, technical characteristics, and clinical prognosis. A total of 440 leads had to be extracted transvenously by using special tools from 229 patients (male, 72.1%). Vegetations ≥1 cm were detected in six patients. Locking Stylets were applied for 398 (90.5%) leads. Telescoping dilator polypropylene sheaths and counter traction technique were used for 202 (45.9%) leads due to lead adhesion, and the mean implant duration of the 202 leads was longer than the other 238 leads (48.9±22.6 vs. 26.6±17.8 months; P <0.01). In addition, modified isolation and snare techniques were used for 56 leads (12.7%). Minor and major procedure-related complications occurred in three (1.3%) and four (1.7%) cases respectively, including one death (0.4%). Severe lead residue occurred in one case. Complete procedural success rate was 96.1% (423/440), and clinical success rate was 98.9% (435/440). The median follow-up period was 18 (1-76) months. No infection- and procedure-related death occurred in our series. Our data demonstrated that high clinical success rate of transvenous lead extraction can be guaranteed by making full use of the standard lead extraction techniques and equipment with individualized modifications.
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As new-type powered sheaths are expensive and unavailable, the standard lead extraction techniques remain the mainstay in clinical applications in many countries. The purpose of this study was to re-evaluate the clinical application of the standard lead extraction techniques and equipment, and make some procedural modifications and innovations. In our center, between January 2006 and May 2012, 229 patients (median, 66 years) who underwent lead extraction due to infection and lead malfunction were registered and followed up prospectively with respect to clinical features, reasons for lead extraction, technical characteristics, and clinical prognosis. A total of 440 leads had to be extracted transvenously by using special tools from 229 patients (male, 72.1%). Vegetations ≥1 cm were detected in six patients. Locking Stylets were applied for 398 (90.5%) leads. Telescoping dilator polypropylene sheaths and counter traction technique were used for 202 (45.9%) leads due to lead adhesion, and the mean implant duration of the 202 leads was longer than the other 238 leads (48.9±22.6 vs. 26.6±17.8 months; P <0.01). In addition, modified isolation and snare techniques were used for 56 leads (12.7%). Minor and major procedure-related complications occurred in three (1.3%) and four (1.7%) cases respectively, including one death (0.4%). Severe lead residue occurred in one case. Complete procedural success rate was 96.1% (423/440), and clinical success rate was 98.9% (435/440). The median follow-up period was 18 (1-76) months. No infection- and procedure-related death occurred in our series. Our data demonstrated that high clinical success rate of transvenous lead extraction can be guaranteed by making full use of the standard lead extraction techniques and equipment with individualized modifications.
Subject(s)
Adolescent , Adult , Aged , Aged, 80 and over , Child , Child, Preschool , Female , Humans , Male , Middle Aged , Young Adult , Anti-Bacterial Agents , Therapeutic Uses , Device Removal , Methods , Electrodes, Implanted , Follow-Up Studies , Pacemaker, Artificial , Prospective Studies , Prosthesis-Related Infections , Drug Therapy , General Surgery , Treatment OutcomeABSTRACT
<p><b>OBJECTIVE</b>To investigate the incidence and risk factors for recurrent falls in community-dwelling elderly in Beijing.</p><p><b>METHODS</b>A cross-sectional study was conducted in 472 elderly in the Longtan community of Dongcheng district,Beijing in 2009. Data on recurrent falls within the past 12 months were collected through face-to-face interview, with both single factor analysis and logistic regression analysis used to explore the related factors on recurrent falls in the elderly.</p><p><b>RESULTS</b>The incidence of recurrent falls among 472 older adults was 6.1% (29) within the past 12 months. Results from logistic regression analysis showed that factors as higher family monthly income(OR = 1.39, 95% CI:0.67-2.16), afraid of being fallen(OR = 2.23, 95% CI:1.47-3.85)and abnormal static balance(OR = 2.48, 95% CI:1.84-4.05)were risk factors, while bench height in the surrounding environment(OR = 0.49, 95% CI:0.21-1.12)and easiness of access to daily supplies (OR = 0.41, 95%CI:0.14-1.16)were protective factors for recurrent falls.</p><p><b>CONCLUSION</b>The incidence of recurrent falls among the elderly from the communities in Beijing was high. Since falls could be caused by various factors, intervention should be targeting on risk factors in a multi-dimensional way.</p>
Subject(s)
Aged , Female , Humans , Male , Accidental Falls , China , Epidemiology , Incidence , Logistic Models , Risk FactorsABSTRACT
<p><b>OBJECTIVE</b>To observe the therapeutic effect of propranolol with 1 064 nm Nd:YAG laser on proliferating hemangioma in body surface.</p><p><b>METHODS</b>97 patients with proliferating hemangiomas in body surface were randomly assigned to three groups: A group (32 patients were treated by propranolol with 1064 nm Nd:YAG laser), B group (35 patients were treated by 1064 nm Nd:YAG laser), C group (30 patients were treated by propranolol). Their visual analog scores, clinical outcomes and adverse events were compared respectively.</p><p><b>RESULTS</b>18 weeks later, A group had a mean visual analog score of 65.50 +/- 16.55, compared with 54.03 +/- 20.13 in B group, 28.08 +/- 30.34 in C group (P < 0.05); 24 weeks later, the mean visual analog scores of three groups were 76.88 +/- 19.05, 63.89 +/- 19.43 and 45.48 +/- 31.86 (P < 0.05). After 24 weeks' treatment, 9 cases (28.1%) in A group, 3 cases (8.6%) in B group, 1 cases (4.0%) in C group obtained complete healing (P < 0.05). To effect of adverse events in body surface, the mean score of B group was higher than the scores of A group and C group (P < 0.05).</p><p><b>CONCLUSIONS</b>Propranolol with 1064 nm Nd:YAG laser is effective and safe in the treatment of proliferating hemangioma.</p>
Subject(s)
Humans , Angiogenesis Inhibitors , Therapeutic Uses , Combined Modality Therapy , Methods , Hemangioma , Therapeutics , Lasers, Solid-State , Therapeutic Uses , Propranolol , Therapeutic Uses , Skin Neoplasms , TherapeuticsABSTRACT
<p><b>BACKGROUND</b>Cardiac resynchronization therapy (CRT) device and coronary sinus (CS) lead extraction are required due to the occurrence of systemic infection, malfunction, or upgrade. Relevant research of CS lead extraction is rare, especially in developing countries because of the high cost and lack of specialized tools. We aimed to evaluate percutaneous extraction of CS leads by modified conventional techniques.</p><p><b>METHODS</b>Of 200 patients referred for lead extraction from January 2007 to June 2011, 24 (12.0%) involved CS leads (24 CS leads). We prospectively analyzed clinical characteristics, optimized extraction techniques and feasibility of extraction.</p><p><b>RESULTS</b>Complete procedural success was achieved in 23 patients (95.8%), and the clinical success in 24 patients (100.0%). The leading indication for CS lead extraction was infection (66.7%). Mean implant duration was (29.5 ± 20.2) months (range, 3 - 78 months). Sixteen CS leads (66.6%) were removed with locking stylets plus manual traction by superior transvenous approach. Mechanical dilatation and counter-traction was required to free fibrotic adhesions and extract 4 CS leads (16.7%), which had longer implant duration than other leads ((62.5 ± 12.3) vs. (22.9 ± 14.1) months, P < 0.05). Another 4 CS (16.7%) leads were removed by modified and innovative snare techniques from femoral vein approach. Median extraction time was 11 minutes (range, 3 - 61 minutes) per CS lead, which had significant correlation with implant duration (r = 0.8, P < 0.001). Sixteen patients (66.6%) were reimplanted with new devices at a median of 7.5 days after extraction. Median followed-up was 23.5 months (range, 8 - 61 months), three patients died due to sudden cardiac death (26 months), heart failure (45 and 57 months, respectively).</p><p><b>CONCLUSION</b>The modified procedure was proved to be practical for percutaneous extraction of CS leads, especially in developing countries lacking expensive powered sheaths.</p>
Subject(s)
Aged , Female , Humans , Male , Middle Aged , Cardiac Resynchronization Therapy Devices , Coronary Sinus , General Surgery , Device Removal , Methods , Electrodes, Implanted , Prospective StudiesABSTRACT
<p><b>OBJECTIVE</b>To probe into a better therapy for diabetic neurogenic bladder.</p><p><b>METHODS</b>The patients were randomly divided into a treatment group and a control group, 35 cases in each group. The control group were treated with intramuscular injection of Methycobal 250 microg, once every other day; the treatment group were treated with intramuscular injection of Methycobal 250 microg, once every other day, and acupuncture at Guanyuan (CV 4), Shenshu (BL 23), Ciliao (BL 32), Huiyang (BL 35), once every day. The residual urine were compared before and after treatment in the two groups; the effective rate for improvement of symptoms were compared between the two groups. The mental and healthy nursing were conducted for the patients.</p><p><b>RESULTS</b>After treatment, the improving rate for the urgency of urination, frequency of micturition, dribbling urination, urinary incontinence and dysuria in the treatment group was significantly better than that in the control group, but with no significant difference between the two groups in prolongation of urination time. After treatment, the residual urine in the bladder significantly improved in the two groups with more significantly improved in the treatment group than in the control group.</p><p><b>CONCLUSION</b>Methycobal plus acupuncture has a better result than the simple Methyeobal for treatment of diabetic neurogenic bladder, and strengthening nursing care in the treatment can significantly enhance life quality of the patient.</p>