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Objective:To investigate the clinical effect of free anterolateral thigh perforator flap(ALTPF) in reconstruction of temporal scalp defect after blood circulation reconstruction surgery for moyamoya disease.Methods:From May 2020 to July 2022, 7 patients with scalp defect after revascularisation of moyamoya disease were treated in Department of Hand and Foot Microsurgery, Henan Provincial People’s Hospital (People’s Hospital of Zhengzhou University). The patients were 4 males and 3 females, aged 33-59 years old, at 43 years old in average. There were 5 defects in left tempus and 2 in right tempus. The sizes of scalp defect were 4.5 cm × 5.5 cm-7.5 cm × 9.5 cm. Debridement and VSD management were primarily performed. After wounds were stabilised, ultrasound location of perforator vessels of ALTPFs was performed. Having confirmed that the perforator vessels were suitable for the surgical requirements, flap transfers were then performed. The descending branch of the lateral femoral circumflex artery was end-to-side anastomosed with the superficial temporal artery, and the descending branch of the lateral femoral circumflex vein was end-to-end anastomosed with the superficial temporal vein. Postoperative follow-up was conducted through outpatient clinic visits, telephone and WeChat reviews. Appearance, texture of ALTPFs and the flap donor sites were observed in follow-ups. Comparisons of the changes of nervous system before and after surgery were made. Cognitive function of the patients was assessed with the Mini Mental State Examination (MMSE), together with the Activities of Daily Living (ADL) .Results:All 7 flaps survived. One flap had vascular compromise 6 hours after surgery, and was rectified after surgical intervention. All the patients were included in the postoperative follow-up for 7-33 (average 19) months. All flaps had good appearance with soft texture. There was no obvious difference in colour comparing with the skin around the recipient region. The donor sites healed well without hypertrophic scar. Examinations of nervous system of the patients were found the same as that before surgery. Using Manual Muscle Testing (MMT), the average limb muscle strength of the patients was 4 before surgery and 4 after surgery, without change; Using the Ashworth assessment scale, the average preoperative and postoperative limb muscle tension in this group of patients was 1, without change; The Berg balance scale was used to evaluate the patient's balance function, with an average score of 42 before surgery and 42 after surgery, without any changes; There was no change in limb sensation before and after surgery; Using the MMSE, the average preoperative score and postoperative score of this group of patients were 25 points, without any change. Using the modified Barthel index scoring standard, the average preoperative score for this group of patients was 75 points, and the average postoperative score was 79 points, and the ADL of the patient had improved to various levels.Conclusion:Reconstruction of scalp defect with free ALTPF after revascularisation of moyamoya disease has obvious advantages, such as it closes the wound quickly, prevents infection and achieves a good appearance. This surgical procedure can produce a good clinical effect.
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The clinical data of 6 acute promyelocytic leukemia (APL) patients with thrombosis as the first manifestation were retrospectively analyzed. Among 6 patients, 5 were males and 1 female.The median age at diagnosis was 55 years old. All patients had risk factors for cardiovascular disease (CVD), and 5 patients met the diagnostic criteria for disseminated intravascular coagulation (DIC). There were 3 patients at low risk (bcr1 subtype), 1 at intermediate risk (bcr2 subtype) and 2 at high risk (1 bcr3 subtype and 1 unknown). FLT3-ITD mutations were tested in 3 cases, all of whom showed negative results. Arterial thrombosis was found in all 6 cases, 4 cases had cerebral infarction, 1 had lower limb arterial embolism, and 1 had multiple arterial and venous thrombosis. Four patients with cerebral infarction received all-trans retinoic acid (ATRA) combined with arsenic trioxide (ATO)±chemotherapy and symptomatic treatment (1 patient at high risk did not receive ATRA), 2 patients achieved complete remission (CR), and the other 2 patients died of cerebral hemorrhage and cerebral infarction, respectively. One patient with lower extremity arterial thrombosis died suddenly within 12 h after admission likely due to acute myocardial infarction. One patient with mixed thrombosis received low molecular weight heparin and rivaroxaban successively after inferior vena cava filter implantation, and achieved CR after ATRA+ATO treatment. Thrombosis is a less common and under-recognized presentation in APL.Thrombosis patients with blood cells and/or coagulation abnormalities should consider the possibility of APL. APL patients complicated with thrombosis have a high probability of DIC and remain mostly intractable to existing treatments, who are at high risk of death and poor prognosis.
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In November 2019, we received and treated a patient with MTSCC of the left kidney. The tumor was located at the upper pole of the left kidney, with a size of 23.3 cm×18.0 cm×21.8 cm. She underwent transperitoneal radical nephrectomy. There was no local recurrence or distant metastasis during the follow-up of 3 years and 2 months. MTSCC of the kidney is a rare subtype of renal carcinoma, with slower disease progression, a clear and smooth rim, and fewer invasion or metastasis. Its final diagnosis should depend on pathology examination. Surgical treatment is the only effective intervention for this disease at present.
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Objective To analyze the disease burden of multidrug-resistant tuberculosis (MDR-TB) in China and regions with different income levels in the world from 1990 to 2019. Methods Using the Global Burden of Disease Study 2019 (GBD2019) results, the changes of the disease burden of MDR-TB in China and regions with different income levels in the world were described and analyzed using the Joinpoint Regression Program 4.8.0.1 software. Results From 1990 to 2019, the age standardized incidence, mortality and DALY rates in China and other areas with different income levels in the world basically showed a trend of first rising and then decreasing at the turning point of the late 20th century and early 21st century, except for low-income areas where the age standardized incidence rate showed an overall upward trend. In 2019, the incidence rate, mortality and DALY rate of MDR-TB in China were 9 times, 6.67 times and 6.89 times higher than those in high-income areas, respectively. The incidence rate in China was 6 times lower than that in low and middle-income areas, while the mortality and DALY rate in China were 26 times and 32.53 times lower than those in low-income areas, respectively. The age standardized incidence, mortality rate and DALY rate of MDR-TB in men were higher than those in women. Risk factors for the burden of MDR-TB disease included alcohol consumption, smoking, and high fasting blood glucose. Conclusion From 1990 to 2019, there are significant regional and gender differences in the disease burden of multidrug-resistant tuberculosis in China and regions with different income levels in the world. Multidrug-resistant tuberculosis is still a major challenge for tuberculosis control in the world. It is necessary to develop more effective control strategies and health care systems to deal with multidrug-resistant tuberculosis.
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In existing vascular interventional surgical robots, it is difficult to accurately detect the delivery force of the catheter/guidewire at the slave side. Aiming to solve this problem, a real-time force detection system was designed for vascular interventional surgical (VIS) robots based on catheter push force. Firstly, the transfer process of catheter operating forces in the slave end of the interventional robot was analyzed and modeled, and the design principle of the catheter operating force detection system was obtained. Secondly, based on the principle of stress and strain, a torque sensor was designed and integrated into the internal transmission shaft of the slave end of the interventional robot, and a data acquisition and processing system was established. Thirdly, an ATI high-precision torque sensor was used to build the experimental platform, and the designed sensor was tested and calibrated. Finally, sensor test experiments under ideal static/dynamic conditions and simulated catheter delivery tests based on actual human computed tomography (CT) data and vascular model were carried out. The results showed that the average relative detection error of the designed sensor system was 1.26% under ideal static conditions and 1.38% under ideal dynamic stability conditions. The system can detect on-line catheter operation force at high precision, which is of great significance towards improving patient safety in interventional robotic surgery.
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Humans , Catheters , Equipment Design , Mechanical Phenomena , Robotic Surgical Procedures/methods , RoboticsABSTRACT
Aging is by far the most prominent risk factor for Alzheimer's disease (AD), and both aging and AD are associated with apparent metabolic alterations. As developing effective therapeutic interventions to treat AD is clearly in urgent need, the impact of modulating whole-body and intracellular metabolism in preclinical models and in human patients, on disease pathogenesis, have been explored. There is also an increasing awareness of differential risk and potential targeting strategies related to biological sex, microbiome, and circadian regulation. As a major part of intracellular metabolism, mitochondrial bioenergetics, mitochondrial quality-control mechanisms, and mitochondria-linked inflammatory responses have been considered for AD therapeutic interventions. This review summarizes and highlights these efforts.
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Objective:To evaluate the effects of smart stethoscope on the monitoring childhood asthma exacerbation, so as to assist family management in childhood asthma.Methods:A prospective randomized controlled study was carried out.A total of 80 children with asthma who were treated at Department of Pediatric Respiratory, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine and Shanghai Tonxin Pediatric Clinic from November 2020 to May 2021 were enrolled and randomly divided into a test group of 40 cases (used the smart stethoscope) and a control group of 40 cases(not used the smart stethoscope). Medical history data were collected.The control group received monthly routine follow-up, while the test group was followed up both routinely and by smart stethoscope.In the test group, hearing wheezing sound was regarded as asthma exacerbation, and in the control group, the asthma exacerbation was reported by the parents themselves.The frequency of asthma exacerbation, asthma control level and quality of life were compared between the two groups.The recognition, diagnosis, treatment and outcomes of acute asthma exacerbation in two groups of children were described and analyzed.Measurement data were analyzed by t test or Mann- Whitney U test.Numeration data were analyzed by χ2 test. Results:Respiratory sounds collected by smart stethoscope in the test group were assessed by 3 specialist physicians.There were 12 wheezing rales (42.86%), 1 moist rale (3.57%) and 1 rhonchi rale (3.57%). Besides, 12 files (42.86%) were difficult to distinguish, and 2 files (7.14%) induced inconsistent identification.The number of asthma exacerbation was 12 in the test group and 5 in the control group.In the test group, 12 were recognized by the smart stethoscope, and only 6 were recognized by the parents.Comparing the diagnosis and treatment measures between two groups, it was found that there were more children in the test group (38.1%) receiving home treatment through telemedicine than those in the control group (20.0%). Besides, there were less children (61.9%) in the test group receiving unplanned hospital treatment (including unplanned outpatient, emergency and hospitalization) than those in the control group (80.0%). There was no statistically significant difference between the two groups of children during acute asthma exacerbation ( χ2=4.67, P=0.097). Parents were satisfied with the common functions, convenience and stability of smart stethoscope. Conclusions:Smart stethoscope can acquire the respiratory sounds of children with asthma in real time, achieving timely detection, diagnosis and treatment of asthma exacerbation in children.What′s more, smart stethoscope reduces the incidence of unplanned hospital diagnosis and treatment, and assists parents with better family management of children asthma.
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Objective:To observe the effect of Gongyanping Capsule on genital tract infected by ureaplasma urealyticum and fertility of mice, and to explore its mechanism.Methods:One hundred female ICR mice were divided into normal control group, model control group, azithromycin group, the low and high-dose group of Gongyanping Capsule according to random number table method. Except for the normal control group, the other groups were infected with ureaplasma urealyticum to establish the reproductive tract inflammation model. The azithromycin group was given 40 mg/kg of azithromycin, the low and high-dose groups were given 50 and 100 mg/kg of Gongyanping Capsule respectively, the normal control group and model control group were given equal volume of normal saline, once a day, for 4 consecutive weeks. The fertility status of each group was recorded. HE staining was used to observe the pathological changes of the vaginal tissues of the mice in each group, and the content of monocyte chemoattractant protein 1 (MCP-1), IL-4, IL-12, TNF-α myeloperoxidase (MPO) and GSH-Px of the mice in each group were determined; RT-PCR and Western blot were used to determine the vagina level of mRNA and protein expressions of TLR4 and NF-κB.Results:Compared with the model control group, the birth time and the number of dead mice in the azithromycin group and the low and high dose groups of Gongyanping Capsule decreased ( P<0.05), and the number of born mice increased ( P<0.05). The level of MCP-1, MPO, IL-4, IL-12, TNF-α decreased ( P<0.05), the level of GSH-Px increased ( P<0.05), the expression of TLR4 mRNA (1.25±0.33, 2.97±0.92, 2.32±0.72 vs. 3.69±1.32), NF-κB mRNA (1.48±0.42, 2.91±0.99, 2.13±0.70 vs. 3.83±1.41) decreased ( P<0.05), the expression of TLR4 (0.63±0.13, 1.32 ± 0.34, 1.04 ± 0.33 vs. 1.63 ± 0.41), NF-κB (0.63 ± 0.14, 1.36 ± 0.32, 1.03 ± 0.30 vs. 1.94 ± 0.58) decreased ( P<0.05), and had a certain dose-dependence. Conclusion:Gongyanping Capsule has obvious therapeutic effect on genital tract mice infected by ureaplasma urealyticum, and can significantly improve the fertility of mice; the mechanism may be related to that Gongyanping Capsule could inhibit the vaginal TLR4/NF-κB pathway in mice.
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Soluble growth stimulating express gene 2(sST2)is a member of Toll/IL-1 receptor superfamily.sST2 plays an important role in the occurrence and development of respiratory diseases in children.Under normal circumstances, the concentration of sST2 in serum is very low, but the level of sST2 in serum of children with respiratory diseases such as bronchial asthma and community-acquired pneumonia increased significantly.sST2 blocks the IL-33 signaling pathway in airway inflammation, so serum sST2 levels can predict the severity of childhood asthma.sST2 can also be used as a prognostic marker of community-acquired pneumonia.This paper reviews the mechanism, clinical characteristics and prognosis of sST2 in children with asthma and community-acquired pneumonia, so as to lay a foundation for guiding clinical identification and treatment of respiratory diseases in children.
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OBJECTIVE：To overview and analyze the current evidence of systematic reviews of drug treatment for children with tic disorder （TD），and to provide evidence-based reference for clinical practice. METHODS ：Retrieved from Medline ，Embase， CBM，CNKI，VIP and Wanfang database ，and so on ，systematic reviews about the efficacy and safety of drug treatment for TD were collected. AMSTAR- 2 tools were used to evaluate the quality of included studies ；the intervention measures ，diagnosis standard，outcome index ，the types of included studies ，main conclusion ，control measures ，effect sizes of different drug treatment were also extracted and analyzed descriptively. RESULTS ：A total of 27 systematic reviews were included ，of which 5 were medium-quality，8 low-quality and 14 very-low-quality. Meta-analysis showed that although typical psychiatric drugs could control tic symptoms ，ADR were prominent and the safety was not good ；risperidone and aripiprazole as atypical psychiatric drugs had good efficacy and safety ，and the research evidence was relatively sufficient. Clonidine as α2 adrenergic agonist could effectively control tic symptoms with fewer ADR ，especially for patients with affention deficit and hyperactivity disorder （ADHD），and research evidence was sufficient. Tiapride could effectively improve tic symptoms ，and the overall tolerance was better. Tomoxetine and methylphenidate could significantly improve the tic symptoms of tic patients with ADHD. CONCLUSIONS ：In the clinical treatment of TD in children ，ADR induced by typical antipsychotics are prominent and the safety is not good ；risperidone， aripiprazole，clonidine and tiapride have good efficacy and safety. Clonidine ，tomoxetine and methylphenidate could significantly improve tic symptoms of TD patients with ADHD. But the quality of systematic review methodology for tomoxetine and methylp- henidate is not good and further improvement is needed.
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BACKGROUND@#The 2019 novel coronavirus disease (COVID-19) has had a massive impact on public health, resulting in sudden dietary and behavioral habit changes. Frontline epidemic prevention workers play a pivotal role against COVID-19. They must face high-risk infection conditions, insufficient anti-epidemic material supplies, mental pressure, and so on. COVID-19 seriously affects their dietary and behavioral habits, and poor habits make them more susceptible to COVID-19. However, their baseline dietary and behavioral habits before COVID-19 and their willingness to change these habits after the outbreak of COVID-19 remain unclear for these workers in China. This study aimed to explore the baseline dietary and behavioral habits of frontline workers and their willingness to change these habits after the outbreak of the epidemic; in addition, susceptible subgroups were identified by stratified analyses as targets of protective measures to keep them from being infected with COVID-19.@*METHODS@#A cross-sectional study was conducted through an online questionnaire using a sample of 22,459 valid individuals living in China, including 9402 frontline epidemic prevention workers.@*RESULTS@#Before COVID-19, 23.9% of the frontline epidemic prevention workers reported a high-salt diet, 46.9% of them reported a high frequency of fried foods intake, and 50.9% of them smoked cigarettes. After the outbreak of COVID-19, 34.6% of them expressed a willingness to reduce salt intake, and 43.7% of them wanted to reduce the frequency of pickled vegetables intake. A total of 37.9% of them expressed a willingness to decrease or quit smoking, and 44.5% of them wanted to increase sleep duration. Significant differences in the baseline dietary and behavioral habits and the willingness to change their habits were observed between frontline epidemic prevention workers and other participants. Among the frontline epidemic prevention workers with poor dietary and behavioral habits before COVID-19, frontline epidemic prevention experience was a promoting factor for adopting worse dietary and behavioral habits, including those in the high-salt intake subgroup (OR, 2.824; 95% CI, 2.341-3.405) and the 11-20 cigarettes/day subgroup (OR, 2.067; 95% CI, 1.359-3.143).@*CONCLUSIONS@#The dietary and behavioral habits of frontline epidemic prevention workers were worse than that those of other participants before COVID-19. They had a greater willingness to adopt healthy dietary and behavioral habits after experiencing the outbreak of COVID-19. However, frontline epidemic prevention workers with poor dietary and behavioral habits before COVID-19 continued in engage in these poor habits. Dietary and behavioral intervention policies should be drafted to protect their health, especially frontline epidemic prevention workers with poor habits at baseline.
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Adult , Female , Humans , Male , COVID-19/psychology , China/epidemiology , Cross-Sectional Studies , Diet/standards , Health Behavior , Health Knowledge, Attitudes, Practice , Health Personnel/psychology , Risk Reduction Behavior , SARS-CoV-2 , Surveys and QuestionnairesABSTRACT
Objective:To investigate the pathogen distribution and antimicrobial resistance among lower respiratory tract infections in patients with hematological malignancies.Methods:Sputum samples were collected from 967 patients with hematological malignancies and lower respiratory tract infections in Department of Hematology,the Second Hospital of Shanxi Medical University from January 2017 to July 2020. The pathogens and drug sensitivity reports were carried out by automatic bacterial identification instruments. WHONET 5.6 and SPSS 20.0 softwares were used for statistical analysis.Results:A total of 961 strains of pathogens were isolated, 516 (53.7%) pathogens were Gram-negative bacteria, mainly 118 strains of Klebsiella pneumonia (12.3%), 68 strains of Pseudomonas aeruginosa (7.1%), 67 strains of Acinetobacter baumannii (7.0%),52 strains of Stenotrophomonas maltophilia (5.4%), 43 strains of Escherichia coli (4.5%), and 42 strains of Enterbacter cloacae (4.4%). There were 171 (17.8%) strains of Gram-positive bacteria and 274 (28.5%) fungi. The drug resistance rates of Pseudomonas aeruginosa and Acinetobacter baumannii to carbapenem were 22.1%-31.3%. Stenotrophomonas maltophilia was sensitive to levofloxacin, compound sulfamethoxazole and minocycline. The antimicrobial resistance rates of these three enterobacteria to carbapenems, cefoperazone/sulbactam, piperacillin/tazobactam were low (<10%). The resistant Gram-positive bacteria to ticoplanin, vancomycin and linazolamide were not detected.Conclusion:The major pathogens related to lower respiratory tract infections in patients with hematological malignancies are gram-negative bacteria in our centre. Different pathogens appear different characteristics of antimicrobial resistance.
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Next-generation sequencing (NGS), also known as high-throughput sequencing, is more efficient compared with Sanger sequencing that has become the standard method of clinical DNA sequencing, and can obtain a large amount of information in a relatively short time at a lower cost.NGS has broad prospects in such aspects as diagnosing the pathogen of lower respiratory tract infection in children, identifying the pathogen of cross-infection in hospital, drug resistance research and vaccine development.It is still worth conducting further studies on the approach to improve the specificity and sensitivity of diagnosis and to optimize NGS.
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ObjectiveTo investigate the prevalence rate of mobile phone dependence， and to analyze the mediating role of emotional intelligence between parenting rearing behavior and mobile phone dependence among college students， so as to provide references for relieving the mobile phone dependence among college students. MethodsStratified cluster sampling method was applied to enroll 1 200 students from three colleges in He'nan province， and the selected individuals were assessed using Parental Bonding Instrument （PBI）， Mobile Phone Addiction Index （MPAI） and Emotional Intelligence Scale （EIS）. Then the relationship between parenting rearing behavior and mobile phone dependence was discussed， and the mediating effect of emotional intelligence was explored using AMOS path analysis. ResultsOf the students who completed the survey， 597 out of 1 090 （54.77%） suffered from mobile phone dependence. The scores of care and encouragement of behavioral freedom in PBI were negatively correlated with the total score and each dimension score of MPAI （r=-0.316~-0.197， P<0.01）， the denial of psychological autonomy score in PBI was positively correlated with the total score and each dimension score of MPAI （r=0.206~0.258， P<0.05 or 0.01）. EIS score was negatively correlated with total score and each dimension score of MPAI （r=-0.317~-0.219， P<0.01）. The indirect effect sizes of maternal care， encouragement of behavioral freedom and denial of psychological autonomy on mobile phone dependence through emotional intelligence were 47.98%， 47.00% and 42.93%， respectively. The indirect effect sizes of paternal care， encouragement of behavioral freedom and denial of psychological autonomy on mobile phone dependence through emotional intelligence were 47.99%， 48.71% and 44.70%， respectively. ConclusionEmotional intelligence partially mediates the relationship between parental rearing behavior and mobile phone dependence.
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The outbreak of novel coronavirus pneumonia (NCP) has become the most severe public health issue at the moment, threatening people′s lives. Pediatricians in Shanghai have recently launched a discussion on the focused questions of NCP, including the incidence situation, epidemiological features, essentials of early screening, treatment and nosocomial infection prevention of children′s novel coronavirus infection (2019-nCoV), and further put forward the experts proposal upon the patterns of disease occurrence, development, diagnosis and control, for the reference of frontline pediatricians.
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OBJECTIVES@#To explore the improvement of neurological symptoms in patients with Type 2 diabetic peripheral neuropathy via resistance exercise.@*METHODS@#A total of 100 patients with Type 2 diabetic peripheral neuropathy were selected as the research objects, and they were randomly divided into an observation group who performed resistance exercise (@*RESULTS@#Compared with the control group, there was statistically difference in the TCSS scores in the observation group at 3 months (@*CONCLUSIONS@#After the intervention of resistance exercise, the blood glucose and DPN can be improved in a certain extent, and which can be popularized in Type 2 diabetes patients.
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Humans , Blood Glucose , Body Mass Index , Diabetes Mellitus, Type 2/complications , Diabetic Neuropathies , Resistance TrainingABSTRACT
Objective:To investigate the surgical method and clinical effect of one-stage repair of soft tissue defects of dorsum of hand and multiple fingers by using the polyfoliate conjoined anterolateral thigh perforator flap (ALTP) .Methods:From November, 2015 to September, 2019, 9 cases of soft tissue defects of dorsum of hand and multiple fingers were treated, including 8 males and 1 female. The average age was 32 years old. Causes of injury: 4 cases of thermal injury, 3 cases of strangulation injury, and 2 cases of traffic accident injury. Location of injury: 7 cases of right hand, 2 cases of left hand. Three cases of dorsum of hand with 1st-4th fingers, 3 cases with 2nd-5th fingers, 2 cases with 2nd-4th fingers, and 1 case with 3rd-5th fingers; All with bone, joint and tendon exposure. There were 6 cases with fracture or joint dislocation. All of them had no obvious defect of bone and joint. VSD was used to cover them after debridement. According to the shape and size of the wound, all flaps were designed to repair the soft tissue defect as the polyfoliate conjoined ALTP. The flap size was 7 cm×13 cm-12 cm×17 cm. Regular outpatient, telephone and Wechat follow-up were carried out to evaluate the flap survival, appearance, color elasticity, donor scar, sensory recovery, finger function recovery and patient satisfaction.Results:Nine cases of flap survived well. The average followed-up time was 12 (6-18) months. The postoperative followed-up revealed satisfactory shapes of the flaps, protective touch and recovery of functions. The donor site had good healing and no effect on function. In the last followed-up, according to the trial criteria for function evaluation of upper limbs by Chinese Society of Hand Surgery, 5 cases were excellent, 3 cases were good, and 1 case was fair. The hand function recovered well and returned to work and daily life on average 6 weeks after operation.Conclusion:The polyfoliate conjoined ALTP can repair the soft tissue defect of hand dorsum with multiple fingers at one stage, and the flap is in good shape. There is no need to divide the fingers. It is one of the ideal methods to repair the soft tissue defect of hand dorsum.
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Objective:To discuss the safety and curative effect of transurethral plasmakinetic enucleation of prostate(TUKEP) in the treatment of large-volume prostate hyperplasia.Methods:From October 2015 to April 2017, the clinical data of 126 patients with large-volume prostate hyperplasia(weight of prostate>80 g) who admitted to Yuncheng Central Hospital were retrospectively analyzed.Different enucleation methods were used according to weight of prostate: ball enucleation for 80~120 g prostate; divided enucleation for more than 120 g prostate.The clinical data were analyzed and summarized.Results:All 126 patients completed operation successfully.The mean enucleation time, cutting time upon harvesting, intraoperative blood loss and intraoperative mean weight of prostate removed of the 126 patients were (19.4±2.4)min, (61.9±16.7)min, (65.3±47.5)mL and (104.5±23.1)g, respectively.Five cases of them had capsule perforation during operation and indwelling catheter for one week after operation, and unobstructed micturition was recovered after removing the urinary catheter, with no repeated hemorrhage or urinary tract infection.Seven cases received intra-operative blood transfusion, with no transurethral resection syndrome(TURS) during and after operation.These patients were followed up for 1~6 months, 23 cases lost to follow up and 14 cases suffered from temporary urinary incontinence.They received health education and levator ani training and were able to completely control urination during follow-up.The IPSS score, QOL score, Qmax and PVR of the patients after operation were (7.6±1.4)points, (1.7±0.6)points, (20.2±3.1)mL/s and (15.0±9.3)mL, respectively, which showed statistically significant differences compared with before operation( t=15.712, 18.331, -21.382 and 16.380, all P<0.001). All of these indicators were obviously improved than before operation, but there was no statistically significant difference in normal ejaculation before and after operation( P=0.252). Conclusion:TUKEP can radically remove prostate tissue and is an effective and safe surgical method in the treatment of large-volume prostate hyperplasia.
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Objective:To use the methods of Health Care Failure Mode and Effects Analysis to reduce the paediatric wards noise pollution, Ensure the physical and mental health of medical staff and children, and maintain a good medical environment.Methods:The sampling method is adopted, noise investigation questionnaire was used in our study and we use the noise instrument to monitor the sound, and the focus source, the key time period and the key section of the room noise are obtained, then the HFMEA is carried out, we listed the work flow of the pediatric ward, and the flow is analyzed and discussed, calculate the Risk Priority Number (RPN). Then, some improvement measures were carried out aimed at the failure mode ,the noise survey questionnaire were used for evaluation.Results:After the implemented the HFMEA , The RPN value was significantly decreased ( P < 0.05). the degree of noise interference of children and their families decreased from 38 to 29, the difference was statistically significant ( χ2 value was 21.82, P<0.05) , and the satisfaction with control noise was improved from 18 to 30, the difference was statistically significant ( χ2 value was 36.28, P<0.05) .The intensity of noise key areas, The intensity of noise source and intensity in each period of the day were significantly improved and the difference was statistically significant ( P < 0.05), and the critical value was significantly decreased. Conclusion:Applying HFMEA can reduce ward noise pollution, improve patient satisfaction, ensure the physical and mental health of medical staff and children, and create a good medical environment.
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Air pollution has a comprehensive impact on human health, and PM2.5 exposure has become a research hotspot due to its special biohazard effect.Especially for children, environmental PM2.5 exposure has a profound impact on the occurrence and development of airway inflammation-related diseases.PM2.5 exposure can significantly increase the incidence of childhood asthma and the risk of asthma exacerbation, can increase respiratory tract symptoms such as cough, shortness of breath, chest tightness, and can increase the risk of lung cancer.PM2.5 exposure can lead to infiltration of airway inflammatory cells, up-regulation of helper T lymphocytes 17 and their corresponding cytokines and down-regulation of Treg cells and their cytokines, regulation of airway inflammation through aryl hydrocarbon receptor and Toll-like receptors (TLR)2/TLR4/medullary differentiation factor 88 signaling pathways, and induction of oxidative stress by increasing the production of reactive oxygen and depletion of antioxidant reserves.It may also affect offspring health through epigenetics.PM2.5 exposure can be addressed through enhanced outdoor and indoor health care and preventive drug therapy.It also poses a challenge to clean up the environment and how to effectively control air pollution and reduce PM2.5 from the source and policy level.