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Objective:To compare oxytocin combined with ergometrine with oxytocin alone in terms of primary prophylaxis for postpartum hemorrhage (PPH) at the time of cesarean section (CS).Methods:This was a multicenter double-blind randomized controlled interventional study comparing ergometrine combined with oxytocin and oxytocin alone administered at CS. From December 2018 to November 2019, a total of 298 parturients were enrolled in 16 hospitals nationwide. They were randomly divided into experimental group (ergometrine intra-myometrial injection following oxytocin intravenously; 148 cases) and control group (oxytocin intra-myometrial injection following oxytocin intravenously; 150 cases) according to 1∶1 random allocation. The following indexes were compared between the two groups: (1) main index: blood loss 2 hours (h) after delivery; (2) secondary indicators: postpartum blood loss at 6 h and 24 h, placental retention time, incidence of PPH, the proportion of additional use of uterine contraction drugs, hemostatic drugs or other hemostatic measures at 2 h and 24 h after delivery, the proportion requiring blood transfusion, and the proportion of prolonged hospital stay due to poor uterine involution; (3) safety indicators: nausea, vomiting, dizziness and other adverse reactions, and blood pressure at each time point of administration.Results:(1) The blood loss at 2 h after delivery in the experimental group [(402±18) ml] was less than that in the control group [(505±18) ml], and the difference was statistically significant ( P<0.05). (2) The blood loss at 6 h and 24 h after delivery in the experimental group were less than those in the control group, and the differences were statistically significant (all P<0.05). There were no significant differences between the two groups in the incidence of PPH, the proportion of additional use of uterine contraction drugs, hemostatic drugs or other hemostatic measures at 2 h and 24 h after delivery, the proportion requiring blood transfusion, and the proportion of prolonged hospital stay due to poor uterine involution (all P>0.05). (3) Adverse reactions occurred in 2 cases (1.4%, 2/148) in the experimental group and 1 case (0.7%, 1/150) in the control group. There was no significant difference between the two groups ( P>0.05). The systolic blood pressure within 2.0 h and diastolic blood pressure within 1.5 h of drug administration in the experimental group were higher than those in the control group, and the differences were statistically significant ( P<0.05), but the blood pressure of the two groups were in the normal range. Conclusion:The use of ergometrine injection in CS could reduce the amount of PPH, which is safe and feasible.
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Augmented renal clearance （ARC）refers to the significant enhancement of patients ’renal function ，which is manifested by the significant increase of glomerular filtration rate ，which increases the clearance of drugs ，and the effective blood drug concentration cannot be achieved under the conventional dose. The efficacy of antibiotics is closely related to the concentration. The influence of renal dysfunction on drug metabolism is an important factor that clinicians should consider when determining the dosage. This article reviews the definition ，risk factors ，occurrence mechanism ，evaluation methods of ARC ，as well as its impact on the pharmacokinetics/pharmacodynamics of antibiotics and administration methods. It is found that ARC widely exists in critically ill patients ，and the risk factors include age （≤50 years old ），brain trauma ，sepsis，multiple trauma ， etc. When using antibiotics in ARC patients ，the therapeutic effect of drugs can be improved by increasing the dosage ，prolonging the duration of administration and increasing the frequency of administration. However ，in order to prevent adverse reactions caused by high concentration accumulation of drugs ，it is recommended to try to combine treatment drug monitoring.
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Objective:To evaluate the effect of epidural labor analgesia administration methods on occurrence of postpartum urinary retention in nulliparous parturients through a comparison between programmed intermittent epidural bolus (PIEB) and continuous epidural infusion.Methods:Two hundred nulliparous parturients who were at full term with a singleton fetus in vertex presentation, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ, aged 22-35 yr, with body mass index of 22.4-42.6 kg/m 2, were divided into 2 groups ( n=100 each) using a random number table method: continuous epidural infusion group (group CEI) and group PIEB.Patient-controlled epidural analgesia (PCEA) was performed in active phase of labor (cervical dilatation≥1 cm) during the first stage of labor.The PCEA solution contained the mixture (10 ml) of 0.1% ropivacaine with 0.5 μg/ml sufentanil.The PCEA pump was set up to deliver a 5-ml bolus dose with a 30-min lockout interval.The analgesia solution contained the mixture (100 ml) of 0.08% ropivacaine and sufentanil 0.5 μg/ml.In group CEI, the drugs were given at 8 ml/h immediately after the initial dose.PIEB regimens were programmed as 8 ml over 80 s once an h after the initial bolus, and the administration was stopped after delivery of fetus.The labor time, consumption of analgesia solution and the incidence of postpartum urinary retention were recorded. Results:Compared with group CEI, the duration of the second stage of labor was significantly shortened, and consumption of analgesia solution and the incidence of postpartum urinary retention were decreased in group PIEB ( P<0.05). Conclusion:Compared with the continuous epidural infusion, the application of PIEB in labor analgesia can reduce the incidence of postpartum urinary retention in nulliparous parturients.
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Objective:To investigate dermoscopic features of molluscum contagiosum.Methods:A total of 82 outpatients with molluscum contagiosum were collected from Dalian Dermatosis Hospital between August 2019 and January 2020, and the dermoscopic features of 227 skin lesions were analyzed retrospectively.Results:Of the 227 skin lesions, hilar depression and orifices were observed in 120 (52.86%) by naked eyes and 198 (87.22%) by dermoscopy, and blood vessels were observed in 20 (8.81%) by naked eyes and 214 (94.27%) by dermoscopy. Different vascular patterns were identified by dermoscopy, including crown-shaped vessels (132 lesions, 58.15%) , punctate vessels (34 lesions, 15.00%) , and a mixed pattern (48 lesions, 21.15%) . The proportion of punctate vessels was significantly higher in lesions with inflammation or exfoliation (86.00%) than in those without (22.03%, χ2=81.685, P < 0.001) , and significantly higher in lesions with eczematous changes (50.00%) than in those without (33.85%, χ2=17.784, P < 0.001) . The most frequently observed structures were round, white-yellow, amorphous structures (40.53%) , followed by four-leaf clover-like pattern (33.48%) , polylobular pattern (20.26%) and nonspecific pattern (5.73%) . Conclusion:Orifices, vascular structures and white-yellow amorphous structures can be observed in molluscum contagiosum by dermoscopy, and the most common vascular pattern is the crown-shaped vessel.
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Objective:To evaluate the efficacy of epidural labor analgesia in the latent phase for the re-pregnant parturients with scar uterus.Methods:One hundred re-pregnant parturients with scar uterus who were at full-term with a singleton fetus in vertex presentation, aged 26-38 yr, with height between 158-170 cm, weighing 61-95 kg, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ, were divided into 2 groups ( n=50 each) using a random number table method: epidural labor analgesia in active phase group (group A) and epidural labor analgesia in latent phase group (group B). Epidural labor analgesia was performed in active phase of labor (cervical dilatation≥3 cm) in group A and in latent phase of labor (cervical dilatation≥1 cm) in group B. Epidural labor analgesia solution contained the mixture (100 ml) of 0.1% ropivacaine and sufentanil 0.5 μg/ml, and the analgesia pump was set up to deliver a 5 ml bolus dose with a 30-min lockout interval and background infusion 8 ml/h and then turned off after delivery of fetus.Visual analogue scale scores were recorded on admission to the labor room, when the cervical dilation was 1, 2, 3, 4 and 10 cm and at the time point immediately after delivery.The labor time, volume of postpartum hemorrhage, emergency cesarean section, decision-to-delivery interval, Apgar score of the newborn at 1 min after birth and results of umbilical cord blood gas analysis were recorded. Results:Compared with group A, the visual analogue scale scores in latent phases of labor were significantly decreased at each time point of latent phases, the duration of the first stage of labor was prolonged, the rate of emergency cesarean section was decreased, and the decision-to-delivery interval was shortened ( P<0.05), and no significant change was found in the volume of postpartum hemorrhage in group B ( P>0.05). There was no significant difference in the Apgar score of the newborn and results of umbilical cord blood gas analysis between two groups ( P>0.05). Conclusion:Epidural labor analgesia performed in the latent phase provides better efficacy than that performed in the active phase when used for the re-pregnant parturients with scar uterus.
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Objective To analyze the effects of change water sources on population iodine nutrition and goiter status in historical high water-iodine area in Yufa Town of Daxing District,Beijing,and evaluate the control effects.Methods A retrospective analysis method was used to collect epidemiological survey data such as water iodine content,urinary iodine content and goiter rate before and after iodine reduction in Yufa Town of Daxing District,Beijing,2005-2016,and the data were compared and analyzed.Results Yufa Town had implemented water reform since 2005.As of 2015,8 change water source projects had been built,and all historical high-water iodine villages had completed drinking water transformation.Totally 64,12,26,26,and 37 water samples were collected and tested in 2005,2009,2010,2011,and 2014,the medians of water iodine were 185.2,20.9,14.1,16.8,and 21.6 μg/L,respectively,and the medians of water iodine decreased significantly through changing water source.Totally 148,153,150,and 40 urine samples of children aged 8 to 10 years old were collected and tested in 2005,2009,2011,and 2016,the medians of urinary iodine were 520.1,201.6,143.0,and 135.0 μg/L,respectively,and the medians of urinary iodine decreased to a suitable range (100-199 μg/L) through changing water source.Totally 154,292,40,and 40 school-age children were tested for thyroid volume in 2005,2009,2011,and 2016,and 10,6,0,and 1 thyroid enlargements were detected,respectively.The thyroid enlargement rates were 6.49％.2.05％,0,and 2.50％,and the rates of goiter were reduced to less than 5％ through changing water source.Conclusion The high water-iodine in water-borne high iodine area in Yufa Town,Daxing District,Beijing is basically eliminated after change water sources,water improvement to reduce iodine is a basic measure to control high iodine damage in high water-iodine areas.
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Objective To evaluate the efficacy of epidural analgesia in latent phase of labor for preeclamptic women undergoing vaginal delivery.Methods A prospective study was conducted on 80 nulliparae of singleton pregnancy with preeclampsia and cephalic presentation in Tianjin Central Hospital of Gynecology Obstetrics from August 2016 to July 2017.All subjects were randomly divided into two groups including labor analgesia in active phase group (labor analgesia was commenced at cervical dilation over ≥ 4 cm,n=40,group 1) and the whole labor analgesia in latent phase group (labor analgesia was comenced at the onset of labor,n=40,group 2).Visual analogue score (VAS) was used to evaluate pain intensity at different time points.Maternal venous blood samples were collected at the time of parturient and fetal delivery to determine the serum concentrations of cortisol (Cor) and adrenocorticotropic hormone (ACTH) by enzyme-linked immunosorbent assay (ELISA).Clinical data was statistically analyzed using t-test or Chisquare test.Results (1) Compared with group 1,the duration of the first stage of labor [(521.3±103.5) vs (570.3 ±116.2) min,t=0.366,P＜0.05],the VAS scores immediately after analgesic administration and at cervical dilation of 2 and 3 cm [4.1±1.1 vs 7.3±1.2,3.5±0.9 vs 7.6±1.7,3.7±0.7 vs 8.1±1.4;t=4.387,9.652,5.321;all P＜0.05],the mean arterial pressure at cervical dilation of 2 and 3 cm [(98.3±9.1) vs (125.3±10.6) mmHg (1 mmHg=0.133 kPa),(98.6±10.4) vs (127.5±9.6) mmHg;t=8.014,5.496;both P＜0.05] and the cesarean delivery rate [15.0％ (6/40) vs 27.5％ (11/40),x2=4.012,P＜0.05] were all lower in group 2.(2) The serum levels of Cor [(565±76) vs (231 ±64) nmol/L,(457±79) vs (233±55) nmol/L;t=6.028,5.126;both P＜0.05] and ACTH [(81 ± 14) vs (38±11) pg/ml,(71 ± 16) vs (39±10) pg/ml,t=5.984,6.028;both P＜0.05]in group 1 and group 2 were both increased significantly after delivery as compared with those at the time of parturient,and they also showed significant differences between the two groups after delivery (t=5.009,3.862;both P＜0.05).Conclusions Epidural analgesia in latent phase of labor can be implemented in preeclamptic women attempting vaginal delivery through alleviating labor pain as sooner and earlier as possible,reducing their stress responses and maintain hemodynamic stability.
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Objective To evaluate the efficacy of transcutaneous electrical acupoint stimulation ( TEAS) combined with epidural block for labor analgesia in parturients with preeclampsia. Methods One hundred and twenty parturients with preeclampsia who were at full term with a singleton fetus in vertex pres-entation, aged 24-37 yr, weighing 66-105 kg, with height between 157-171 cm, of American Society of Anesthesiologists physical statusⅢ, were divided into 3 groups ( n=40 each) using a random number table method: epidural labor analgesia in active phase of labor group ( group A) , epidural labor analgesia in la-tent phase of labor group ( group B) and TEAS combined with epidural labor analgesia in active phase of la-bor group ( group C) . Epidural labor analgesia was performed in active phase of labor ( cervical dilatation≥3 cm) in group A and in latent phase of labor ( cervical dilatation≥1 cm) in group B. In group C, TEAS was carried out in latent phase of labor, bilateral Hegu and Sanyinjiao acupoints were selected as the main acupoints and Zusanli as the auxiliary acupoints, patients received TEAS with a frequency 2∕100 HZ, dis-perse dense waves, intensity ( starting at a voltage of 15 mA) increasing to the maximum current that could be tolerated until delivery of fetus, and epidural labor analgesia was performed when parturients were in ac-tive phase of labor. Epidural labor analgesia solution contained the mixture ( 100 ml) of 0. 08％ ropivacaine and sufentanil 0. 4 μg∕ml, and the analgesia pump was set up to deliver a 5 ml bolus dose with a 30-min lockout interval and background infusion at 8 ml∕h and then turned off after delivery of fetus. Mean arterial pressure and visual analogue scale ( VAS) scores were recorded when the cervical dilation was 1, 2, 3, 4 and 10 cm and immediately after delivery. The labor time, volume of postpartum hemorrhage, requirement for oxytocin, cesarean section, adverse reactions and Apgar score of the newborn were recorded. Maternal venous blood samples were collected when the cervical dilation was 1 and 10 cm for determination of the con-centrations of dynorphin ( DYN) and cortisol in serum and adrenocorticotropic hormone, norepinephrine and epinephrine in plasma ( by enzyme-linked immunosorbent assay) and serum glucose concentration ( by glu-cose oxidase method) . Results Compared with group C, the VAS scores and mean arterial pressure were significantly increased when the cervical dilation was 2 and 3 cm, the concentrations of DYN, cortisol and blood sugar in serum and adrenocorticotropic hormone, norepinephrine and epinephrine in plasma were in-creased when the cervical dilation was 10 cm ( P<0. 05) , and no significant change was found in the dura-tion of each phase of labor or requirement for oxytocin in group A ( P>0. 05) , and the duration of the first stage of labor was significantly prolonged, the requirement for oxytocin was increased, the serum concentra-tion of DYN was decreased when the cervical dilation was 10 cm ( P<0. 05) , and no significant change was found in VAS scores at each time point in group B (P<0. 05). There was no significant difference in the volume of postpartum hemorrhage, rate of cesarean resection, adverse reactions or Apgar score of the new-born among the three groups (P>0. 05). Conclusion Compared with epidural labor analgesia performed in the latent and active phases of labor, TEAS combined with epidural block provides better efficacy for la-bor analgesia in parturients with preeclampsia.
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Objective To investigate the characteristics of brain network based on brain electrical activity induced by somatosensory electrical stimulation,and to provide a theoretical basis for further understanding the mechanism of brain neural plasticity induced by somatosensory electrical stimulation.Methods Ten healthy subjects were selected and a somatosensory electrical stimulation experiment was constructed based on the directed transfer function (DTF).In the experiment,the DTF causal connection matrixes of the 32-channel EEG data of Delta,Theta,Alpha and Beta bands were obtained under the somatosensory electrical target and non-target stimulation,and the differences of clustering coefficient and global efficiency between two stimulation states were contrasted based on graph theory.Results Under the target stimulation and non-target stimulation states,the regions with stronger DTA causal connections were mainly concentrated in FCz,Cz,CPz and Pz channels.The causal connection intensity under target stimulation state was greater than that of non-target stimulation.Also,in the Delta,Theta,and Alpha bands,the clustering coefficient under the target stimulation state was significantly higher than that in the non-target stimulation state (P＜0.05).In the Delta and Theta bands,the global efficiency of the target stimulation state was significantly higher than that of the non-target stimulation state (P＜0.05).Conclusions Somatosensory electrical stimulation can activate and induce EEG brain networks.In the target stimulation state,the role of the parietal lobe in the EEG causal network is enhanced,which helps to induce attention to specific brain region plasticity,and thus realizing the nerve rehabilitation in the brain regions of interest.While in the non-target stimulation state,the synergistic interactions between brain regions were enhanced,which helps to activate and induce a wide range of associations in the whole brain network,so as to promote the global neural activity in the brain.
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Objective The single-trial extraction method of evoked potential has been one of the problems in EEG information processing field.According to the characteristics of somatosensory evoked electroencephalogram (EEG) with low signal-to-noise ratio and large parameter variation between trials,a novel single-trial extraction method for evoked potentials was proposed.This method aims to further improve the accuracy and characteristics of the single-trial extraction algorithm,preserve more dynamic characteristics between trials,and improve the estimation accuracy.Methods Based on wavelet filtering and multiple linear analysis,a new single-trial extraction method for EEG P300 parameters was proposed by applying the adaptive dynamic feature library.Four groups of wavelet filtered evoked EEG data were randomly selected,and used to build the feature library using overlapping average method and principal component analysis.For the single-trial extracted EEG data,the component with the highest correlation coefficient related with the current data was selected as the independent variable from the feature library,and the relevant multiple linear regression analysis was conducted.The single-trial evoked potential signal was reconstructed by the regression analysis results,in which the key features such as latency and amplitude were automatically extracted.Results Compared with the benchmark values determined by experts,the proposed algorithn can obtain more accurate estimation values of latency and amplitude in P300 components.The average difference of latency and amplitude by the proposed algorithm is (11.16±8.60) ms and (1.40±1.34)μV,respectively.These two values obtained by the proposed algorithm are much closer to that obtained by the commonly used overlapping average method of (23.26±25.76) ms and (2.52±2.50) μV,respectively.These results show that the proposed algorithm has significant advantages comparing with the traditional multiple linear regression analysis algorithm.Conclusions The dynamic updating principal component sample library of EEG data was applied to wavelet filtering and multiple linear regression,thus the dynamic characteristics were effectively preserved,and the accuracy of parameter estimation was improved.
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Objective The single-trial extraction method of evoked potential has been one of the problems in EEG information processing field.According to the characteristics of somatosensory evoked electroencephalogram (EEG) with low signal-to-noise ratio and large parameter variation between trials,a novel single-trial extraction method for evoked potentials was proposed.This method aims to further improve the accuracy and characteristics of the single-trial extraction algorithm,preserve more dynamic characteristics between trials,and improve the estimation accuracy.Methods Based on wavelet filtering and multiple linear analysis,a new single-trial extraction method for EEG P300 parameters was proposed by applying the adaptive dynamic feature library.Four groups of wavelet filtered evoked EEG data were randomly selected,and used to build the feature library using overlapping average method and principal component analysis.For the single-trial extracted EEG data,the component with the highest correlation coefficient related with the current data was selected as the independent variable from the feature library,and the relevant multiple linear regression analysis was conducted.The single-trial evoked potential signal was reconstructed by the regression analysis results,in which the key features such as latency and amplitude were automatically extracted.Results Compared with the benchmark values determined by experts,the proposed algorithn can obtain more accurate estimation values of latency and amplitude in P300 components.The average difference of latency and amplitude by the proposed algorithm is (11.16±8.60) ms and (1.40±1.34)μV,respectively.These two values obtained by the proposed algorithm are much closer to that obtained by the commonly used overlapping average method of (23.26±25.76) ms and (2.52±2.50) μV,respectively.These results show that the proposed algorithm has significant advantages comparing with the traditional multiple linear regression analysis algorithm.Conclusions The dynamic updating principal component sample library of EEG data was applied to wavelet filtering and multiple linear regression,thus the dynamic characteristics were effectively preserved,and the accuracy of parameter estimation was improved.
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Objective To study Curative efficacy of Oryzanol combine with Dingkundan in treatment of perimenopausal period and its effects on endocrine improvement.Methods 90 patients of perimenopausal period who received therapy from March 2014 to March 2015 in our hospital were selected as research objects.According to draw method divided into the experimental group(n=45)and the control group(n=45).Two groups of patients were psychological support.The control group was treated with Oryzanol, each 10 mg, 3 times a day.while the experimental group was on the control group, treated with Dingkundan, 1 pills each time, 2 times a day, in the morning and evening.Then Serum estradiol(E2), Follicle stimulating hormone(FSH), Luteinizing hormone(LH)level, upset hot sweating, insomnia, irritability, hung up improve time, Kupperman score, clinical efficacy of two groups were compared.Results The E2 level in experimental group was significantly higher than the control group[(72.51±5.30)pg/mL vs.(66.80±4.75)pg/mL](P<0.05), FSH、LH level was significantly lower than the control group[(21.36±1.05)mIU/ml vs.(26.09±1.89)mIU/mL,(24.34±1.01)mIU/mL vs.(20.61±1.50)mIU/mL](P<0.05);upset hot sweating, insomnia, irritability, hung up improve time was significantly lower than the control group[(11.21±2.35)d vs.(20.05±5.07)d,(12.78±2.09)d vs.(18.32±4.13)d,(11.30±2.10)d vs.(20.16±5.02)d,(10.20±2.76)d vs.(16.58±4.03)d](P<0.05);Kupperman score was significantly lower than the control group[(4.32±1.09)score vs.(12.76±3.16)score](P<0.05);total effective rate was significantly higher than the control group[93.33%(42/45)vs.75.67%(34/45)](P<0.05).Conclusion Oryzanol combine with Dingkundan is well for perimenopausal period,which can significantly improve endocrine disorders, promote its balance, improve estrogen.
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Objective@#To evaluate the primary clinical outcomes of immediate provisionalization with a monolithic crown utilizing a novel chairside computer aided design and computer aided manufacture (CAD/CAM) workflow for single tooth immediate implant placement.@*Methods@#This pilot study was a prospective within-subjects design. Thirteen consecutive patients were included and diagnosed with untreatable single incisor or premolar with fine general and local anatomical conditions. The trial was conducted at Department of Implantology, Peking University School and Hospital of Stomatology, Beijing, between January 2016 and June 2016. The teeth were extracted atraumatically and implants were immediately placed in the fresh sockets. Two screw-retained interim crowns were fabricated for the same site utilizing different workflows, a monolithic lithium disilicate (LS2) crown produced by CEREC (Sirona, Germany) chairside CAD/CAM system (CER group) and a manually fabricated resin crown utilizing conventional workflow (CONV group) respectively. The patients were blinded to the group allocation of the two interim crowns. After the clinical try-in for both crowns in a randomized sequence, the patients' level of satisfaction was assessed with a virtual analogue scale (VAS) questionnaire. The restorations chosen by patients themselves were seated in the implants by one experienced prosthodontist. The accuracy, aesthetic effect and clinical time consumption of both groups were compared. Statistical analyses were performed with the Wilcoxon signed rank test.@*Results@#All patients were treated with atraumatic tooth extraction, immediate implant placement using flapless surgery and immediate provisionalization in a single visit. The interim crowns of both groups could be fitted with or without slight adjustments. For each patient, the interim crown of CER group was chosen to be seated with a relatively higher VAS result. The white esthetic score (WES) results demonstrated no statistically significant difference between CER group (7.5±1.1) and CONV group (7.9±0.9) (P>0.05). The mean total work time was significantly different resulting in (131.9±5.0) min for CER group and (205.2±6.3) min(P<0.05). The major difference lied in the laboratory work time, resulting in (113.5±6.3) min for CER group which was significantly shorter than (185.6±6.6) min for CONV group. As for impression taking time, the CER group (7.5±0.8) min was significantly shorter than CONV group (11.7± 1.1) min (P<0.05). However, analysis for clinical adjustment time showed a significantly longer time for CER group [(11.0±2.1) min vs (8.0±2.8) min, P<0.05]. After 3-6 months of observation, the overall survival rate was 100%. Screw loosening occurred in 4 patients and was tightened again. No other major complication soccurred.@*Conclusions@#The full digital workflow utilizing CEREC chairside CAD/CAM system to fabricate interim crowns after immediate implant placement in one single visit was feasible. It was more time-efficient and could effectively shorten the laboratory work time compared to the conventional workflow. Patients demonstrated high satisfaction and there was no statistical difference in WES results compared to the conventional workflow. Favorable clinical outcomes were gained in this short-term follow-up study.
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Objective: To evaluate different patterns for left ventricular configuration on ventricular systolic function in patients with primary hypertension by two-dimensional strain (2DS) echocardiography. Methods: Our research included in 2 groups: Control group,n=40 healthy volunteers, Primary hypertension group,n=70, based on left ventricular mass index, the patients were further divided into 2 subgroups as Left ventricular hypertrophy (LVH) subgroup, n=32 and Non-left ventricular hypertrophy (NLVH) subgroup,n=38. The peaks of systolic longitude strain (SSL) for left ventricular apical layers of subendocardium, midmyocardium and epicardium were compared among different groups. Results:①In Control group and LVH, NLVH subgroups, SSL in different myocardium layers were kept in gradient features as subendocardium > midmyocardium > epicardium.②Compared with Control group, NLVH and LVH subgroups showed decreased SSL of subendocardium, as in apical four chamber level: (-24.11 ± 3.52) % and (-22.78 ± 4.11) % vs (-27.49 ± 2.95) %, in apical two chamber level: (-22.79 ± 5.20) % and (-21.92 ± 4.88) % vs (-27.95 ± 3.13) %, and in apical long-axis level: (-20.07 ± 3.43)%and (-21.34 ± 3.64%)% vs (-27.24 ± 3.05) %, allP0.05.③Compared with NLVH subgroup, LVH subgroup presented decreased SSL of long-axis, in midmyocardium (-17.77 ± 4.35) % vs (-21.73 ± 3.97) % and in epicardium (-14.25 ± 3.78) % vs (-18.27 ± 2.96) %, allP<0.05. The pearson correlation coefifcient calculated by 2 physicians at 2 different times showed that SSL of subendocardium wasr=0.876, of midmyocardium was r=0.838 and of epicardium was r=0.823, allP<0.05. Conclusion: 2DS may quantitatively evaluate the layered myocardial strain of left ventricle, it provided a non-invasive examination for early diagnosing and estimating the heart involvement with severity in patients of primary hypertension.
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Objective:To assess the clinical effects of carbon fiber reinforcement on the“All-on-Four”provisional prostheses.Methods:Provisional prostheses were divided into control group and carbon fiber reinforcing group according to whether carbon fiber reinforcement was used in the provisional prostheses base resin.In our study,a total of 60 patients (32 males and 28 females)with 71 provisional prostheses (28 maxilla and 43 mandible)were enrolled between April 2008 and December 201 2 for control group;a total of 23 patients (1 3 males and 1 0 females)with 28 provisional prostheses (9 maxillas and 1 9 mandi-bles)were enrolled between January 201 3 and March 201 4 for carbon fiber reinforcing group.The infor-mation of provisional prostheses in the patients was recorded according to preoperative examination.We used the date of definitive prosthesis restoration as the cut-off point,observing whether fracture occurred on the provisional prostheses in the two groups.Additionally we observed whether fiber exposure occurred on the tissue surface of the provisional prostheses and caused mucosal irritation.The interface between the denture base resin and the fibers was examined using scanning electron microscopy (SEM).Results:The age [(57.3 ±1 0.1 )years vs.(55.1 ±1 1 .4)years],gender (32 males and 28 females vs.1 3 males and 1 0 females),maxilla and mandible distributions (28 maxillas and 43 mandibles vs.9 maxillas and 1 9 mandibles),the number of extraction jaws (46 vs.23 ),the average using time [(7 .8 ±1 .3 ) months vs.(7 .5 ±1 .1 )months],and the opposing dentition distributions of provisional prostheses of the patients showed no significant differences between the control and reinforcing groups.There were 21 (29 .6%)fractures that occurred on the 71 provisional prostheses in the control group;there was no frac-ture that occurred on the 28 provisional prosthesesin the carbon fiber reinforcing group.The fracture rate of the carbon fiber reinforcing group was significantly lower than that of the control group (P=0.001 ). No carbon fiber exposure and mucosal irritation were observed from clinical examination.SEM revealed relatively continuous contact between the fiber and acrylic resin,and the resin particles adhered on the surface of the carbon fibers.Conclusion:The addition of carbon fibers between abutments placed on“All-on-Four”provisional fixed denture base resin may be clinically effective in preventing “All-on-Four”denture fracture and can provide several advantages for clinical use.
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OBJECTIVE@#To translate the English version of the assessment of chronic illness care (ACIC) to Chinese, to conduct a trial in Hunan province and to develop a Chinese version ACIC.@*METHODS@#According to the WHO rules, we translated the English version of the ACIC to Chinese and took the culture factor into account. Three hundred and ninety persons, who engaged in the work of chronic disease management in primary medical and health services in Hunan province, were enrolled for this study. One hundred and eighty three valid questionnaires were randomly selected. Six methods including discrete tendency method, good-poor analysis, correlation analysis, stepwise regression analysis, Cronbach's alpha coefficient and factor analysis were used for evaluation the questionnaire items.@*RESULTS@#The items in Chinese version ACIC showed as follows: 1) good sensitivity. The standard deviation of each item was more than 2 and the P value from the t test between the good and poor group was less than 0.001; 2) good representation. The correlation coefficients range of each item with the total score and each dimension score was 0.588-0.916; 3) high internal consistency. Cronbach's alpha coefficient for the total scale was 0.975, and for each dimension range was 0.854-0.936; 4) independent. Factor loadings were greater than 0.40 entries, and factor loadings ranged from 0.487-0.798; 5) importance. Stepwise regression analysis α(in)=0.01, α(out)=0.05) showed 34 items were kept in the equation.@*CONCLUSION@#Items of Chinese version ACIC retains ACIC 7 dimensions of 34 items in the original English version, which are sensitivity and typical with the internal consistency, independence and importance.
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Humans , China , Chronic Disease , Factor Analysis, Statistical , Language , Regression Analysis , Surveys and QuestionnairesABSTRACT
Objective To explore the clinical significance of adenosine deaminase ( ADA) in pleural ef-fusion for diagnosis of tuberculosis pleuritis in children. Methods The level of ADA in pleural effusion was ret-rospectively analyzed in 28 cases with purulent pleuritis,thirty-four cases with mycoplasma pneumoniae pleuri-tis,forty-five cases with tuberculosis pleuritis from July 2011 to January 2014 in Beijing Children′s Hospital Af-filiated to Capital Medical University. Results The level of ADA in three groups was expressed by median (range interquartile). ADA in the purulent pleuritis group [126. 35 (76. 80,178. 13)U/L]was higher than the group of mycoplasma pneumoniae pleuritis [ 55. 55 ( 42. 80, 79. 03 ) U/L ] and tuberculosis pleuritis [ 26. 50 (22. 05,50. 95)U/L]. The difference was statistically significant (P< 0. 01). The cut-off value of pleural effu-sion ADA for diagnosis of tuberculosis pleuritis is not available by application of ROC curve. Conclusion Higher ADA value is not only the characteristic of tuberculosis pleuritis,but also purulent pleuritis and mycoplas-ma pneumoniae pleuritis. ADA has no clinical value in diagnosis of tuberculosis pleuritis in children.
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Objective:To evaluate the influence of the implant-supported porcelain bridges made from non-precious metals using spark erosion techniques, and to discuss the feasibility and details of making the implant restoration by spark erosion technique.Methods: The study included 12 patients ( 9 males and 3 females) with 92 units implant-supported non-precious porcelain bridge from Sep.2011 to Feb. 2013.All the patients received implant treatment in Department of Oral Implantology, Peking University School and Hospital of Stomatology.The total of 52 implants, were from Nobel Biocare implant system, Camlog implant system and Ankylos implant system.The implant analogs were connected in sequence with a copper wire to guarantee conductivity.The implant electrodes represented one electrode and the superstructure the other.During spark-erosion machining, the cast holding the implant electrodes and the prosthetic framework were moved toward one another, causing an electrical erosion of the protruding ele-ments.Results:After the spark-erosion machining, the minimum gap between the framework and abut-ment was 0.21 mm, which was two units bridge.The maximum was 2.59 mm, which was 11 units bridge with 6 implants.The average gap was 0.68 mm.After the spark-erosion machining, the bridge fitted well with the passive position stability.Conclusion: The method of making implant-supported non-precious porcelain bridge reduces costs on patients.Spark erosion has the potential to provide implant framework with an excellent fit.The patients are satisfied with the clinical results.
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Objective To evaluate the agreement between perfusion deficient score derived from dual-energy CT perfusion imaging and obstruction score derived from pulmonary CT angiography in patients with pulmonary embolism.Methods 40 patients who sus-pected PE excluded basic lung disease accepted the dual-energy CT scanning.The data was post-processed on Siemens workstation to obtain the CTA and PBV images.The quality of images was evaluated by radiology quality control center.Two doctors observed ima-ges and obtain the data of obstruction score and perfusion deficient score,then the data were analysed with analysis of variance.The correlation between obstruction score and perfusion deficient score from different doctors were analyzed with Person and Bland-Alt-man methods.Results Perfusion deficient score had a moderate correlation with obstruction score (doctor 1:r=0.560 5,P=0.000 2;doctor 2:r=0.585 1,P=0.000 1).Perfusion deficient score and obstruction score from different doctors had a strong correlation(Perfusion deficient score :r=0.968 9,P=0.000 0;obstruction score:r=0.973 3,P=0.000 0).Perfusion deficient score and obstruction score from same doctor showed significantly different (doctor 1:8.025,95% CI:6.247~ 9.803 ;doctor 2:7.475,95% CI:5.670~9.280),but perfusion deficient score or obstruction score from different doctors showed no obviously difference(perfusion deficient score:0.400,95%CI:-0.106~0.906;obstruction score:-0.150,95% CI:-0.594~0.294).The ICC between perfusion deficient score and obstruc-tion score from same doctor was low (doctor 1:ICC=0.061 7±0.157 5;doctor 2:ICC=0.153 1±0.154 4),but the ICC of perfusion deficient score or obstruction score from different doctors was high (perfusion deficient score:ICC=0.964 6±0.010 9;obstruction score:ICC=0.972 7±0.008 4).Conclusion The pulmonary CT angiography and perfusion blood volume images were both derived from dual-energy CT scanning,which showed the scope of pul-monary embolism at different angles.CTA and PBV were two different examination methods, and could not replaced each other.
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Objective Dipole source analysis was employed to investigate the transient changes in brain mechanisms at earlier latencies.Methods Fourteen healthy volunteers were recruited in this research and evoked event-related potentials (ERPs) of unimodal and bimodal visual auditory stimuli were recorded by 64-electrodes electroencephalograph (EEG) recording system.All these earlier phases of the stimuli were divided into several subphases by specific time window for source analysis.Results The results showed that ERPs sources were mainly generated from visual and audio cortex,and there were changes in the location and strength of the dipole sources in each sub-phase.Conclusions The result of this study implies a serial processing of sensory information in human cortices in early phase of visual and auditory stimuli.