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Objective To study the quality standard of Gardenia jasminoides and its effective parts. Methods TLC was used to identify Gardenia jasminoides and its effective parts. The heavy metals, harmful elements, and moisture in Gardenia jasminoides and its effective parts were examined. The content of Gardenia jasminoides and its effective parts was determined by high performance liquid chromatography. Results TLC method could be used to identify Gardenia jasminoides and its effective parts. The moisture content of Gardenia jasminoides and its effective parts were 8.4% and 3.2%, respectively. ICP-MS was used to determine the contents of five elements in Gardenia jasminoides and its effective parts simultaneously. There was a good linear relationship between arsenic, cadmium, copper, mercury, and lead in the range of 0~20, 0~10, 0~500, 0~5 and 0~20 ng/ml, respectively; The method detection limit of each metal element was 3.3×10−5~1.3×10−3 mg/kg. The relative standard deviation (RSD) of precision was 0.32%~0.82%. RSD values of each element content showed that the method had good repeatability. And the recoveries of arsenic, cadmium, copper, mercury, and lead were 103%~112%, 98%~99%, 98%~99%, 105%~106% and 100%~103%, respectively (n=3). The stability of each element was good within 8 h. The contents of the five elements were within the limits of the current edition of Chinese Pharmacopoeia. The standard curve equation of gardenia was Y=15860X+22543, r=0.9999, indicating that there was a good linear relationship of gardenia in the range of 20.16~322.6 μg/ml. The RSD of precision was 1.86%. RSD of the two samples were 2.38% and 2.60%, respectively, indicated that the method had good repeatability. The average recovery of Gardenia was 99.1% (n=6). The stability of the two solutions was good within 8 h. The contents of gardenia and its effective parts were 5.71% and 34.2%, respectively. Conclusion The research on the quality of Gardenia jasminoides effective parts was carried out based on the research on the quality of Gardenia jasminoides, and the results met the requirements. Therefore, the method established in this experiment could control the quality of Gardenia jasminoides and its effective parts simultaneously.
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With the continuous development of artificial intelligence technology, ChatGPT, as an emerging natural language processing technology, although there is currently no mature application mode, its application prospects in the medical field are becoming increasingly broad. However, its application also faces some possible ethical risks and challenges, including personal privacy data leakage, discrimination and bias in machine algorithms, difficulty in defining responsibility, inexplicability of algorithms, and lack of supervision and so on. It is necessary to strengthen the training of relevant personnel, guide public opinion to pay attention to risks, focus on algorithm validation standards, emphasize multi-party cooperation and co-governance, strengthen medical ethics research, as well as deepen regulatory supervision and standardization construction to solve the above problems.
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Objective:To investigate the clinical efficacy of a medial support plate and a row of screws in the treatment of Schatzker type Ⅳ tibial plateau fracture involving the postero-lateral condyle.Methods:A retrospective analysis was performed of the data of 26 patients who had been admitted to Department of Orthopedic Trauma, Honghui Hospital Affiliated to Xi'an Jiaotong University for Schatzker type Ⅳ tibial plateau fracture involving the postero-lateral condyle from December 2015 to December 2020. There were 17 males and 9 females, aged from 19 to 51 years (average, 36.1 years). All their fracture lines involved the postero-lateral condyle and all fractures were fixated with a medial support plate and a row of screws via one medial and one lateral incisions. Recorded were the operation time, hospital stay, blood loss, incision length, fracture healing, complications, quality of knee joint reduction and knee joint function at the last follow-up.Results:The length of hospital stay ranged from 8 to 16 days, averaging 10.4 days. The 26 patients were followed up for 8 to 18 months, with an average of 14.3 months. All the fractures got united after 11 to 17 weeks (average, 13.7 weeks). During the follow-up, no reduction loss, internal fixation failure or surgical complications were observed. Rasmussen radiographic scores at the last follow-up ranged from 11 to 18 points, averaging 16.1 points. The range of motion of the knee joint ranged from 0° to 140°, averaging 120.8°. The Rasmussen scores of the knee function ranged from 14 to 28 points, averaging 24.4 points.Conclusion:In the treatment of Schatzker type Ⅳ tibial plateau fracture involving the postero-lateral condyle, the use of a medial support plate and a row of screws can achieve satisfactory clinical results.
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Objective:To analyze the medication rule of treating orthopedics in Tibetan Medicine by data mining, in order to summarize the characteristics and theory of ethnic minorities medicine for treating orthopedics and traumatology.Methods:By collecting the treatment methods of orthopedics and traumatologic diseases in books of Chinese Materia Medica·Tibetan Medicine Volume and Chinese Medical Encyclopedia·Tibetan Medicine to analyze the frequency, cluster and association rules of Tibetan Medicines by using Office Excel 2019, IBM SPSS Statistics 26.0 and IBM SPSS modeler 14.1 respectively. Results:Among the 202 Tibetan Medicine prescriptions of Orthopedic Department, 338 belongs to Chinese medicines. The top 3 Chinese medicines that are frequently appeared are Chebulae Fructus, Inula racemosa Hook.f, and Carthami Flos. The properties of those medicines are mainly cold, warm and cool, and the tastes are mainly pungent, bitter and sweet; the meridians mainly belong to liver, lung, stomach and spleen; The priscriptions mainly cover four kinds of diseases: trauma, arthralgia syndrome, lumbosacral tendon injury, chest and back tendon injury. The four kinds of cluster combinations were obtained. The core Chinese medicines were Chebulae Fructus, Terminaliae Belliricae Fructus, Phyllanthi Fructus, Cassiae Semen, Olibanum, Abelmoschus moschatus, and the common medicine pair were Chebulae Fructus- Terminaliae Belliricae Fructus, Abelmoschus moschatus- Cassiae Semen, Olibanum- Abelmoschus moschatus and so on. Conclusions:Tibetan Medicines treat orthopedics and traumatological diseases with antipyretic medicines as the main yellow water, followed by blood activating, Qi regulating and wind dampness removing medicines. With Sanguo Decoction and Sanhuang water of Tibetan medicine as the core, they are often combined with other antipyretic and blood cooling medicines and bone connecting medicines. Tibetan Medicine pays attention to the application of dry yellow water theory, which reflects the role of the core theory of Qingxie method and yellow water theory of Tibetan Medicine in the diagnosis and treatment of orthopedic and traumatologic diseases.
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Objective:To investigate the application of self-designed wound measuring grid in the measurement of wound and the design of perforator flap.Methods:From February 2018 to February 2020, 31 cases of soft tissue defects of limbs were repaired by free transfer of perforator flap. During the operation, the self-designed membrane with measurement grid was used to measure the wound surface. The flaps were designed and harvested according to the accurate measurement of the wound. The flaps were reviewed at hospital clinic during follow-up.Results:All patients entered 3-15 months of follow-up with an average of 8 months. All 31 flaps survived, of which 2 flaps encountered vascular crisis and were rescued after surgical exploration. There was no infection of flaps and all flaps had stage I healing. The flaps were satisfactory in appearance with the sensation recovery to S 2 in 21 cases and S 3 in 10 cases. Only linear scars were left on the donor sites. Conclusion:The membrane with a measurement grid can accurately measure a wound, and help the design of the flap according to the measured size and profile of the wound. It can reduce the operation time and the risk as well as to improve the operation efficiency. The clinical application is satisfactory. Large scale and multi-centre studies are required to further prove the benefit of the measurement grid.
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Objective:To compare the efficacy and safety of transurethral thulium laser enucleation of prostate for benign prostatic hyperplasia (BPH) with laser controller and sheath.Methods:The clinical data of 128 BPH patients who underwent transurethral thulium laser enucleation of prostate (THuLEP) in our hospital from January to June 2020 were retrospectively analyzed. Prostatic enucleation by laser controller was performed in 66 patients (LC-THuLEP group). The prostatic urethral mucosa was cut into Ω shape at 0.5 cm in front of the verumontanum to expose the prostate capsule, and then the fiber was retracted into the laser controller. Push the gland directly between the prostate gland and the prostate surgical capsule and expand along the capsule by the laser controller. In case of bleeding or prostate adhesive cord, the fiber was extended to coagulate or cut off, and the prostate was eventually en bloc removed. THuLEP by sheath was performed in 62 cases (THuLEP group). The ages of patients in LC-THuLEP group and THuLEP group were (71.00±8.72) years and (70.32±7.80) years, respectively. The prostate volumes were (74.80±40.88) ml and (73.14±36.31) ml, respectively. Prostate specific antigen (PSA) was (4.67±4.99) ng/ml and (4.89±4.59) ng/ml, International Prostate Symptom Score (IPSS) was (19.48±5.30) points and (18.50±5.05) points, respectively. The quality of life (QOL) scores were (4.17 ± 0.78) points and (4.18± 0.67) points, the maximum urine flow rate (Q max) was (9.82± 2.58) ml /s and (9.98± 2.91) ml/s, respectively. Postvoid residual (PVR) was (60.20±39.19) ml and (61.11±52.83) ml, respectively. The international index of erectile function (IIEF-5) score was (5.58±4.50) and (5.60±4.16), respectively.There was no significant difference in preoperative baseline data between 2 groups ( P>0.05). The operation time, the reduced level of hemoglobin, the weight of removed tissue, The time to postoperative bladder irrigation, the time to indwelling catheter and complications were compared between the two groups. IPSS, QOL score, Q max, PVR, and complications were compared between the two groups at 1, 3 and 6 months after surgery, while IIEF-5 score were compared only at 6 months after surgery. Results:The operative time of LC-THuLEP group and THuLEP group was (71.85±25.68) min and (80.65±29.64) min, respectively, and the decrease of postoperative hemoglobin was (6.42±9.89) g/L and (9.47±10.79) g/L, respectively, the weight of the removed tissue was (56.73±31.21) g and (48.11±24.50) g, respectively, and the time to postoperative bladder irrigation was (14.73±2.71) h and (16.06±2.71) h, respectively, the time to indwelling catheter was (4.41±1.92)d and (4.31±1.66)d, respectively, with no statistically significant differences between the two groups. IPSS scores of LC-THuLEP group were (6.52±2.46) points, (5.83±2.43) points and (5.30±2.49) points at 1, 3 and 6 months after surgery, respectively. QOL scores were (2.36±0.85) points, (2.27±1.02) points and (1.98±0.77) points, Q max were (22.89±2.41) ml/s, (23.61±2.62) ml/s and (23.83±3.53) ml/s, respectively. In THuLEP group, IPSS were (7.60±1.89) points, (6.86±1.81) points and (6.44±1.78) points at 1, 3 and 6 months after surgery, and QOL scores were (2.68±0.67) points, (2.74±1.01) points and (2.35±0.68) points, respectively. Q max were (21.31±2.52) ml/s, (22.13±2.51) ml/s and (22.11±2.49) ml/s, respectively. Those indexes (except Qmax at 6 months)were better in LC-ThuLEP group than THuLEP group, and the differences were statistically significant ( P<0.05). PVR of LC-THuLEP group were (15.95±12.31) ml, (14.83±12.19) ml and (13.67±15.03) ml, respectively, PVR of THuLEP group were (21.89±21.14) ml, (20.03±21.51) ml and (19.69±21.19) ml, respectively, and there were no significant differences. There was no bladder injury, severe bleeding, blood transfusion or secondary operation. The incidence of urinary incontinence 1 month after surgery was 6.1% (4/66) in the LC-THuLEP group and 19.4% (12/62) in the THuLEP group, the difference was statistically significant ( P<0.05). There was no significant difference at 3 months (3/66 vs. 4/62) and 6 months (1/66 vs. 2/62) after surgery ( P>0.05). There were no significant differences in the incidence of epididymitis, urethral stricture and bladder neck contracture between the two groups ( P>0.05). Conclusion:Compared by sheath, THuLEP by laser controller could be a safe and effective surgical method with better curative effect and lower complication rate.
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Objective:To investigate the clinical effect of Flow-through perforator flap of posterior interosseous artery in repair of dorsal digital soft tissue defect with disorder of blood supply in digital tip.Methods:From January 2018 to June 2020, 12 patients who had digital dorsum soft tissue defect with digital tip blood supply disorder were treated with Flow-through perforator flap of posterior interosseous artery. The size of flaps was 2.0 cm× 2.0 cm-5.5 cm×3.0 cm. The posterior interosseous artery in the flap was bridged with the proper palmar artery of digit, 1 subcutaneous vein in the flap was anastomosed with the dorsal subcutaneous vein, and 1 subcutaneous vein in the posterior interosseous artery with the palmar subcutaneous vein. The donor sites were sutured directly. The wound healing, blood supply of digit and flap survival were observed after operation. The quality of flap survival and digital joint function were observed in the follow-up reviews at outpatient clinic.Results:All the 12 Flow-through perforator flaps of posterior interosseous artery survived, the blood supply of digit was good, and the wounds healed in the first stage. The follow-up period was 6-24 months. The appearance and texture of the flaps were good without obvious bloating. Only linear scar was left in the forearm donor site. According to the Trial Standard of Upper Limb Function Evaluation of Chinese Society of Hand Surgery, the results were excellent in 11 cases and good in 1 case.Conclusion:The perforator flap of posterior interosseous artery has constant anatomy, and the diameter of blood vessel matches the blood vessels of digits. It is suitable for Flow-through technique. It has less subcutaneous tissue, no secondary thinning, and the donor site can be closed directly. It is a good method to repair the dorsal soft tissue defect with disorder of digital end blood circulation.
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Objective:To analyze the efficacy and safety of CLAG regimen (cladribine, cytarabine, granulocyte colony-stimulating factor) in treatment of relapsed/refractory acute myeloid leukemia (AML).Methods:The clinical data of 30 patients with relapsed/refractory AML who were admitted to Suzhou Hongci Blood Disease Hospital from January 2018 to February 2021 were retrospectively analyzed, and the efficacy and adverse reactions were observed.Results:Among 30 patients, 1 patient was not evaluated for efficacy due to treatment-related death. Among the 29 evaluable patients, 17 patients (58.6%) achieved complete remission (CR), 5 patients (17.3%) achieved partial remission (PR) and 7 patients (24.1%) had no remission (NR). One patient in low-medium-risk group achieved CR; the CR rate in medium-risk group was higher than that in high-risk group [68.8% (11/16) vs. 41.7% (5/12)], but the difference was not statistically significant ( P = 0.250). Seven patients with M 5 achieved CR. Five patients with positive MLL gene rearrangement achieved CR. Among 6 patients with extramedullary invasion of leukemia cells, 4 patients achieved CR, and among them 3 patients with central nervous system invasion achieved CR. Among 6 patients with cladribine 3.5 mg·m -2·d -1×5 d, 1 patient died of infection after chemotherapy, 1 patient had NR, and the rest achieved CR. Among 24 patients with cladribine 5 mg·m -2·d -1×5 d, the CR rate in patients with cytarabine 2 g·m -2·d -1×5 d was higher than that in patients with cytarabine 1 g·m -2·d -1×5 d [70.0% (7/10) vs. 42.9% (6/14)], but the difference was not statistically significant ( P = 0.240). All patients developed grade Ⅳ myelosuppression after chemotherapy. 12 patients underwent allogeneic hematopoietic stem cell transplantation (allo-HSCT) after CR, and 9 patients were still alive. Conclusions:CLAG regimen is effective and well tolerated in the treatment of relapsed/refractory AML. In order to improve the prognosis, allo-HSCT should be performed as soon as possible after CR.
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Objective:To investigate the surgical method and clinical effect in the repair of thumb tip defect with radial thenar fasciocutaneous flap.Methods:From March, 2016 to January, 2019, 15 patients with thumb tip defect were treated by radial thenar fasciocutaneous flap. There were 6 defects in left thumb and 9 in right thumb. All the thumbtip defects had the exposure of digital bone, and some had defects of digital bone itself. The size of defects ranged from 1.0 cm×2.0 cm to 1.5 cm×3.0 cm, and the size of the flaps ranged from 1.2 cm×2.5 cm to 1.8 cm×4.0 cm. All of the donor sites were directly closed. The patients entered follow-up by outpatient visit, telephone calls or WeChat reviews to evaluate the quality of the flaps and the clinical effects of the surgery.Results:All flaps survived with good quality. All the donor sites achieved primary healing. The follow-ups lasted for 6 to 18 months with an average of 10.5 months. At the final follow-up review, the appearance of flaps was satisfactory in natural colour, flexible and wear-resistant. There were various degrees of sensation recovery of the flaps, with TPD from 6 mm to 12 mm. The sensation around the donor site was close to normal. Function of the thumbs was evaluated according to the total active movement (TAM) evaluation system. Twelve thumbs were graded excellent and 3 in good.Conclusion:The radial thenar fasciocutaneous flap achieved satisfactory clinical effect in the repair of thumb tip defect. The texture of the flaps is close to the recipient site and the damage to the donor site is minimal.
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Objective:To investigate the clinical effects of lacunar closure-assisted internal fixation in the one-stage treatment of Morel-Lavallée injury complicated with pelvic fracture.Methods:The 32 patients were retrospectively analyzed who had been treated for Morel-Lavallée injury complicated with pelvic fracture at Department of Orthopedic Trauma, Honghui Hospital Affiliated to Xi'an Jiaotong University from May 2018 to November 2020. They were 21 males and 11 females, aged from 18 to 58 years (average, 40.5 years). The injury was located at a unilateral hip in 20 cases, at bilateral hips in 6 cases, at low back in 4 cases, and at posterior thigh in 2 cases. The pelvic fractures were treated by open reduction and internal fixation while the Morel-Lavallée injuries by lacunar closure at the same time. Their wound healing, pelvic function and complications were observed regularly.Results:The hospital stay of 32 patients ranged from 14 to 28 days, averaging 19.2 days. The patients were followed up for 6 to 18 months (mean, 9.3 months). The area of Morel-Lavallée injury healed after one lacunar closure in 23 patients who obtained fine skin survival and no soft tissue necrosis or other complications; the wounds in the Morel-Lavallée injury area healed well after secondary lacunae closure in 4 patients. Superficial sensation of the skin decreased around the Morel-Lavallée injury area after wound healing in 3 patients. Wound fat liquefaction was found in the Morel-Lavallée injury area but responded to symptomatic treatment in one patient. A small amount of wound secretion found in the Morel-Lavallée injury area was cured also by symptomatic treatment in another patient whose bacterial culture was negative. All the fractures healed after 3 to 6 months (average, 3.9 months). At the last follow-up, the Majeed scores for the pelvic function ranged from 65 to 100 points, averaging 84.5 points.Conclusion:For Morel-Lavallée injury complicated with pelvic fracture, lacunar closure-assisted internal fixation can result in a satisfactory one-stage treatment.
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Objective:To follow up and observe the intellectual development of school children aged 8 to 10 in Baicheng County, Xinjiang Uygur Autonomous Region, which was a severe iodine deficiency disorders region in history, before and after effective control of the disease, in order to evaluate the impact of iodine supplementation on protection of children's intellectual development and provide a theoretical basis for scientific supplements of iodine.Methods:From 1989 to 2018, Combined Raven's Test for Rural in China (CRT-RC) was used to observe the intellectual development status of 660 Uyghur school children aged 8 to 10 in Baicheng County in 1989, 2002, 2006, 2012 and 2018, respectively. Children's intelligence quotient (IQ) was calculated using CRT-RC's 1987 normal sample of rural children in the same age group; the data of average iodized salt coverage rate (C-IS) and childhood goiter rate (GR) from multiple local surveys and the median urinary iodine (MUIC) of children were collected, combined with the "Criteria for Elimination of Iodine Deficiency Disorders" (GB 16006-2008) and the United Nations International Children's Emergency Fund (UNICEF) recommended standards, the status of iodine deficiency during children's growth (IDG) was divided into complete exposure to iodine deficiency, no exposure, and semi-exposed. The Flynn effect (FE) gain was calculated using norm samples of children aged 8 to 10 in 1987, 1996 and 2006 of CRT-RC, and the differences in children's intellectual development after FE correction before and after IDG reached the standard were compared.Results:The IQ of children were (81.67 ± 14.13), (83.26 ± 14.05), (89.68 ± 13.58), (98.50 ± 14.33) and (103.23 ± 15.25) points in Baicheng County in 1989, 2002, 2006, 2012 and 2018, respectively, the difference between different years was statistically significant ( F = 58.357, P < 0.01). The three indicators of C-IS, GR, and MUIC didn't meet the standards during the IDG evaluation period in the 1989, 2002, and 2006 groups, which were the complete exposure to iodine deficiency; in the 2012 group, only the MUIC met the standard, which was semi-exposed; in the 2018 group, three indicators all met the standard, which was no exposure. The FE gains of 1987 with 1996, 1996 with 2006 were 0.96 points/year and 0.74 points/year, respectively; after FE correction, the actual gains of IQ of 2002 and 2006 compared with 1989, 2012 and 2018 compared with 2006 were - 9.57, - 6.11, 4.38, and 4.67 points, respectively. Conclusions:In iodine deficiency areas, intermittent iodine supplementation (1989 - 2009) for children exposed to iodine deficiency during growth still cannot effectively protect children's intellectual development; continuous and effective iodine supplementation (2010 - 2018) with iodized salt as the core and covering children's growth period has obvious positive effects on protection of children's normal intellectual development. In the future, we will continue to observe the influence of IDG full-cycle suitable iodine nutrition on children's intellectual development.
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Objective:To explore the clinical effect of the second toenail flap with the dorsal bone of the phalange in repairing the defect of fingernail bed.Methods:From January, 2012 to June, 2019, 10 patients with large area of fingernail bed defect were treated by the second toenail flap with bone on the back of the phalanx. The survival of the flap was observed after the operation, and the fracture healing, the shape of the nail and the flexion and extension function of the finger joint were observed in the outpatient follow-up.Results:All flaps of the second toenail survived. The average follow-up period was 8 (4-12) months. The fractured ends of 10 patients' phalanges healed well without nonunion, good appearance of toenail and deformity of toenail. The recovery of hand function was evaluated according to the evaluation standard of upper limb function of Hand Surgery Society of Chinese Medical Association, 9 cases were excellent, and 1 case was good.Conclusion:The second toenail flap with dorsal bone of the phalanx preserved is easy to cut, simple to operate, and has good clinical effect. It is a good method to repair the defect of the fingernail bed.
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Objective:To investigate the pathological change mechanism of patients with chronic active Epstein-Barr virus infection (CAEBV).Methods:The clinical manifestations, laboratory examinations, diagnosis and treatment of one CAEBV patient in Suzhou Hongci Hematology Hospital of Jiangsu Province were retrospectively analyzed with review of related literature.Results:Combined with the results of laboratory, lymph node biopsy and bone marrow tests in different periods, the patient initially showed lymphoproliferative disease, and gradually transformed into lymphoma with the diagnosis results of EB virus-related lymphocyte clones in different periods. The patient received the corresponding treatment plan in different periods, but eventually died due to hemophagocytic syndrome and rapid progress of the disease.Conclusion:CAEBV may cause lymphocytes to gradually evolve from polyclonal to monoclonal state.
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Objective@#To observe the clinical efficacy and safety of transhepatic arterial chemoembolization (TACE) combined with radiofrequency ablation (RFA) in the treatment of colorectal cancer with liver metastasis.@*Methods@#The data of 92 patients with colorectal cancer with liver metastasis admitted to Nanyang First People′s Hospital of Henan Province from January 2014 to January 2016 were retrospectively analyzed. A total of 46 patients treated with TACE were selected as the TACE group, and another 46 patients treated with TACE and RFA were selected as the combined group. The clinical efficacies of the two groups were compared, and the changes of Karnofsky functional status (KPS) scores before and after treatment in the two groups were analyzed. The incidences of complications in the two groups were calculated. Patients in the two groups were followed up, and the progress-free survival (PFS) and overall survival (OS) were calculated.@*Results@#The disease control rate of the combined group was 82.61% (38/46), and that of the TACE group was 63.04% (29/46). The disease control rate of the combined group was higher than that of the TACE group (χ2=4.449, P=0.035). Before treatment, the KPS scores of the combined group and the TACE group were 71.84±4.37, 72.22±4.26, with no statistically significant difference (t=0.423, P=0.673). After treatment, the KPS scores of the two groups were higher than those before treatment, and the KPS score of the combined group was higher than that of the TACE group (79.81±6.15 vs. 75.86±6.02; t=3.108, P=0.003). The incidence of complications was 54.35% (25/46) in the combined group and 41.30% (19/46) in the TACE group. The difference between the two groups was not statistically significant (χ2=1.568, P=0.210). The median PFS and OS in the TACE group were 12.6 and 20.7 months, and those in the combined group were 18.9 and 28.2 months. The PFS and OS of the combined group were longer than those of the TACE group (χ2=72.025, P<0.001; χ2=26.580, P<0.001).@*Conclusion@#TACE combined with RFA is effective in the treatment of liver metastasis of colorectal cancer, which can effectively improve the KPS score of patients, prolong the PFS and OS, and do not increase the risk of complications.
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Riedel's thyroiditis (RT) is a rare form of thyroid disease,and the rate of misdiagnosis is high due to the low incidence of RT and the lack of understanding of the disease by clinicians.There is currently no standard and guidance for the diagnosis and treatment of RT.Improving the understanding of RT is of great significance for standardizing diagnosis and treatment and improving the life quality of patients.
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Objective To observe the clinical efficacy and safety of transhepatic arterial chemoemboli-zation (TACE)combined with radiofrequency ablation (RFA)in the treatment of colorectal cancer with liver metastasis. Methods The data of 92 patients with colorectal cancer with liver metastasis admitted to Nanyang First People's Hospital of Henan Province from January 2014 to January 2016 were retrospectively analyzed. A total of 46 patients treated with TACE were selected as the TACE group,and another 46 patients treated with TACE and RFA were selected as the combined group. The clinical efficacies of the two groups were compared, and the changes of Karnofsky functional status (KPS)scores before and after treatment in the two groups were analyzed. The incidences of complications in the two groups were calculated. Patients in the two groups were followed up,and the progress-free survival (PFS)and overall survival (OS)were calculated. Results The disease control rate of the combined group was 82. 61％ (38 / 46),and that of the TACE group was 63. 04％(29 / 46). The disease control rate of the combined group was higher than that of the TACE group (χ2 = 4. 449, P = 0. 035). Before treatment,the KPS scores of the combined group and the TACE group were 71. 84 ± 4. 37, 72. 22 ± 4. 26,with no statistically significant difference (t = 0. 423,P = 0. 673). After treatment,the KPS scores of the two groups were higher than those before treatment,and the KPS score of the combined group was higher than that of the TACE group (79. 81 ± 6. 15 vs. 75. 86 ± 6. 02;t = 3. 108,P = 0. 003). The incidence of complications was 54. 35％ (25 / 46)in the combined group and 41. 30％ (19 / 46)in the TACE group. The difference between the two groups was not statistically significant (χ2 = 1. 568,P = 0. 210). The median PFS and OS in the TACE group were 12. 6 and 20. 7 months,and those in the combined group were 18. 9 and 28. 2 months. The PFS and OS of the combined group were longer than those of the TACE group (χ2 = 72. 025, P < 0. 001;χ2 = 26. 580,P < 0. 001). Conclusion TACE combined with RFA is effective in the treatment of liver metastasis of colorectal cancer,which can effectively improve the KPS score of patients,prolong the PFS and OS,and do not increase the risk of complications.
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@#Objective To translate the Water Orientation Test of Alyn 2 (WOTA2) into Chinese, and to study its reliability and validity for patients with spinal cord injury. Methods After authorizing, the English version WOTA2 scale and its training package were translated into Chinese. From January to September, 2018, 137 patients with spinal cord injury were evaluated with the Chinese version WOTA2 by two evaluators independently, and evaluated again three days later by one of the evaluators. The Cronbach's α, Spearman-Brown coefficient, intra-group correlation coefficient (ICC) and Kappa coefficient were calculated to evaluate the reliability. Content Validity Index (CVI) of items (I-CVI) and scale (S-CVI) were used to evaluate the content validity, and factors analysis was used to evaluate the structure validity. Results The Cronbach's α was 0.947 in all items of the scale, 0.890 in mental adjustment items and 0.954 in aquatic skills items. Pearson correlation coefficient of the half scales separated by odd and even items was 0.948, and the Spearman-Brown coefficient was 0.973. The ICC of test-retest was 0.965 in total score, 0.965 in centesimal system total score, 0.847 in mental adjustment score and 0.970 in aquatic skills score. The ICC of inter-testers was 0.964 in total score, 0.965 in centesimal system total score, 0.847 in mental adjustment score and 0.970 in aquatic skills score. The Kappa coefficient was 0.528 to 0.927 in test-retest and 0.528 to 0.927 in inter-testers. The I-CVI was 0.8 to 1.0 and S-CVI was 0.63. Factors analysis extracted four factors, which met the theory, and contributed 67% of cumulative variance. Conclusion The Chinese version WOTA2 is good in reliability and validity for patients with spinal cord injury, and can be used in the clinical practice of aquatic therapeutic exercise in China.
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Objective To investigate the change in mortality of congenital malformation in children aged ＜5 years in Beijing from 2006 to 2015.Methods Using the death surveillance data in children aged ＜5 years in Beijing from 2006 to 2015,which was collected from the real-time surveillance network,we calculated the area and age distributions of the mortality of congenital malformation in children aged ＜5 years in Beijing.Meanwhile,the variations of age,time and space in the causes of deaths were discussed.Results The mortality rate of congenital malformation in the children s decreased from 1.909‰ in 2006 to 0.703‰ in 2015,the decrease rate was 63.17％.The decrease rate was highest in neonates (71.50％) (x2=57.993,P＜0.01).Expect urban area (x2=3.384,P＞0.05),the mortality rates of congenital malformation in the children showed a downward trend in outer suburban area and suburban area (x2=40.637 and 50.646,P＜0.01).The proportion of the children died of congenital malformation decreased from 32.97％ in 2006 to 23.24％ in 2015,which mainly occurred in infancy and neonatal period (x2=9.395 and 4.354,P＜0.05).The constituent ratios of the children died of neural tube defects,respiratory system abnormalities and other abnormalities decreased significantly (x2=13.478,7.358,7.912 and 10.074,P＜0.01).The constituent ratios of children died of chromosomal abnormality,multiple malformations and digestive tract abnormality didn't decreased significantly (P＞0.05).In the leading causes of deaths from congenital malformation,the mortality of congenital heart disease,neural tube defects and digestive tract atresia decreased obviously (x2=70.868,18.431 and 9.225,P＜0.01),except biliary atresia (x2=1.407,P＞ 0.05).There was an obvious area specific difference between the deaths of congenital heart disease and the deaths of neural tube defects,the mortality was higher in outer suburbs than in suburban and urban area (x2=45.783 and 6.649,P＜0.05).Conclusion Although the mortality rate of children with congenital malformation in Beijing has declined year by year,it is still the main cause of deaths in children under 5 years old,and the prevention and control of related diseases should be strengthened.
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Objective To investigate the change in mortality of congenital malformation in children aged ＜5 years in Beijing from 2006 to 2015.Methods Using the death surveillance data in children aged ＜5 years in Beijing from 2006 to 2015,which was collected from the real-time surveillance network,we calculated the area and age distributions of the mortality of congenital malformation in children aged ＜5 years in Beijing.Meanwhile,the variations of age,time and space in the causes of deaths were discussed.Results The mortality rate of congenital malformation in the children s decreased from 1.909‰ in 2006 to 0.703‰ in 2015,the decrease rate was 63.17％.The decrease rate was highest in neonates (71.50％) (x2=57.993,P＜0.01).Expect urban area (x2=3.384,P＞0.05),the mortality rates of congenital malformation in the children showed a downward trend in outer suburban area and suburban area (x2=40.637 and 50.646,P＜0.01).The proportion of the children died of congenital malformation decreased from 32.97％ in 2006 to 23.24％ in 2015,which mainly occurred in infancy and neonatal period (x2=9.395 and 4.354,P＜0.05).The constituent ratios of the children died of neural tube defects,respiratory system abnormalities and other abnormalities decreased significantly (x2=13.478,7.358,7.912 and 10.074,P＜0.01).The constituent ratios of children died of chromosomal abnormality,multiple malformations and digestive tract abnormality didn't decreased significantly (P＞0.05).In the leading causes of deaths from congenital malformation,the mortality of congenital heart disease,neural tube defects and digestive tract atresia decreased obviously (x2=70.868,18.431 and 9.225,P＜0.01),except biliary atresia (x2=1.407,P＞ 0.05).There was an obvious area specific difference between the deaths of congenital heart disease and the deaths of neural tube defects,the mortality was higher in outer suburbs than in suburban and urban area (x2=45.783 and 6.649,P＜0.05).Conclusion Although the mortality rate of children with congenital malformation in Beijing has declined year by year,it is still the main cause of deaths in children under 5 years old,and the prevention and control of related diseases should be strengthened.
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Objective To investigation the present situation of full‐time bachelor and upgraded clinical nurses ,in order to provide effective basis for the reasonable nursing hierarchical management and job arrangement .Methods Using cluster sampling method ,the working status of clinical nurses self‐designed questionnaire survey for 566 clinical nurses from 13 three level of first‐class hospitals of Nanning city were investigated by self‐designed questionnaire survey .Results The total score of full‐time bache‐lor and upgraded clinical nurses working status showed low satisfaction;the total score of working status of the upgraded nurse was higher than full‐time bachelor nurses .The upgraded clinical nurse in 4 dimensions of welfare treatment ,nursing working character‐istics and identity ,the work to be recognized ,interpersonal relationship scored higher than full‐time bachelor nurse(P0 .05) .Conclusion The overall performance of working statute of full‐time bachelor nurses is worse than upgraded nurses ,and some aspects including the occupation identification need to be further strengthened .The nursing managers need to increase the nursing hierarchical using of strength ,promote the rationalization process of job responsibility and arrangement of the high degree of clinical nurses ,in order to reduce the flow loss rate .