ABSTRACT
Objective:To explore the effect of postoperative delirium risk management in elderly patients with hip fragility fracture based on failure mode and effect analysis (FMEA) theory, and to provide a basis for reducing the incidence of postoperative delirium.Methods:A total of 50 patients admitted to the First Affiliated Hospital of Sun Yat-sen University due to hip fragility fractures from January to December 2019 were selected as the control group, and 50 patients admitted to the First Affiliated Hospital of Sun Yat-sen University for hip fragility fractures from January to December 2020 were selected as the observation group. The control group received routine care, and the observation group implemented risk control intervention measures based on FMEA theory on the basis of the control group. The risk priority number (RPN) value, incidence of delirium, duration of delirium, pain score, satisfaction, and average length of hospital stay were compared between the two groups of patients in each link of failure risk.Results:The RPN values of each link failure risk of the observation group were 100.80 ± 13.39, 103.96 ± 9.96, 103.76 ± 8.04, delirium duration was (36.33 ± 9.07) min, pain scores were 1.86 ± 0.76, 4.16 ± 1.17, average length of stay was (8.98 ± 4.64) days, and incidence of delirium was 6.0% (3/50), the RPN values of each link failure risk of the control group were 274.10 ± 8.48, 291.00 ± 10.10, 287.78 ± 11.64, delirium duration (78.70 ± 20.10) min, pain scores 2.26 ± 1.02, 4.74 ± 1.19, average length of stay was (11.50 ± 7.66) days, and incidence of delirium was 22.0% (11/50). The differences between two groups showed significant differences ( t values were 1.99-93.24, χ2=4.07, P<0.05). The patient satisfaction score of the observation group was 99.36 ± 1.01, which was higher than that of the control group 89.63 ± 2.62, and the difference was statistically significant ( t=24.50, P<0.05). Conclusions:The perioperative implementation of postoperative delirium risk management model based on FMEA theory in elderly patients with hip fractures can reduce the incidence of postoperative delirium, relieve pain, shorten hospital stay, and improve satisfaction degree. It is worthy of clinical promotion.
ABSTRACT
Objective To explore the phenotype-genotype correlation of Alport syndrome in children. Methods Retrospectively analyze the clinical and pathological features of 55 patients with Alport syndrome with COL4A mutations detected by second-generation sequencing, who were treated at Beijing Children's Hospital from January 2016 to December 2020. Results A total of 55 children with Alport syndrome were included. All cases had hematuria, including 31 cases (56.4%) with gross hematuria and 24 cases (43.6%) with microscopic hematuria. A total of 39 (70.9%) patients also had proteinuria. Extrarenal manifestations were pres- ent in 12 patients (21.8%). 36(65.4%) patients had a family history of Alport syndrome. 32 patients underwent pathological examination and 23 of them had the specific pathological changes of Alport syndrome. In 55 cases, 36 (65.4%) were diagnosed as X-linked Alport syndrome, 5(9.1%) were diagnosed as autosomal recessive Alport syndrome, 10(18.2%) were diagnosed as autosomal dominate Alport syndrome, and 4(7.3%) were diagnosed as digenic Alport syndrome. Missense mutations in COL4A genes accounted for 62.5%, 67.5% of missense mutations resulted in glycine substitution. There were statistical significances in proteinuria degree and hearing loss between male and female patients with XLAS (P < 0.05) as well as statistical significance in the degree of proteinuria between autosomal recessive Alport syndrome and autosomal dominate Alport syndrome (P=0.044), and there was critical statistical significance in the age of onset. There was statistical significance in hearing loss between children with renal impairment and children with normal renal function (P=0.001). Conclusions Most of the pathogenic variants in COL4A genes that cause Alport syndrome result in glycine substitutions. The degree of proteinuria and hearing loss of males with XLAS were greater than those of females. The degree of proteinuria in autosomal recessive Alport syndrome was greater than that of children with autosomal dominate Alport syndrome, and the age of onset was earlier than that of autosomal dominate Alport syndrome. Renal manifestation was more severe in children with hearing loss. The early clinical manifestations of Alport syndrome are diverse and pathological manifestations may be atypical. The application of next-generation sequencing can reduce misdiagnosises of Alport syndrome.
ABSTRACT
Objective To effectively use the clinical data generated in daily operation and to realize information networking based on the existing resources of radiotherapy department. To improve quality management efficiency in radiotherapy process. Methods The radiotherapy process and required documents were analyzed. The reporting tool Microsoft Report Builder, which is based on SQL database, was applied to design the patient documents by extracting and analyzing a large number of data generated by Aria, the existing network of our radiotherapy department. PDCA Tools was used to analyze the weak links in the process. Reports with quantitative indices have been designed according to corresponding countermeasures, so as to improve quality control level of the process. Results More than one thousand patients were treated in our department since 2020. All patient documents of radiotherapy can be archived and inquired online after registration only once. 13 daily statistical reports, 5 quarters and 3 annual reports were scheduled according to practical demands. The waiting time before radiotherapy was shortened from 16.2 days to 14.8 days after operating the reporting system 3 months later. The staff could master the treatment progress of patients easily and patients who interrupted the treatment were found in time. Conclusion The reporting tools can realize patient information extraction and networked management effectively in radiotherapy process. Staff efficiency of personnel work and communication was improved. The resource allocation was optimized according to the report data in real time, improving the efficiency and quality of radiotherapy. This method is generally applicable and practical to radiotherapy department.
ABSTRACT
Objective:To explore the effects of multidisciplinary team based nursing intervention on nutritional status, muscle strength, physical function and daily living ability of super-aged patients with sarcopenia.Methods:A total of 29 super-aged patients with sarcopenia from July to November in 2017 in Department of Geriatric, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School were selected as the observation group with multidisciplinary team intervention. And 29 super-aged patients with sarcopenia from February to June 2017 were selected as the control group with routine management. Nutritional indicators, muscle strength, physical activity function and daily living ability scores were compared between the two groups at 1 and 6 months after intervention.Results:After 1 month of intervention, hemoglobin and serum albumin was (118.79±11.47), (35.86±5.73) g/Lin the observation group and (112.27±11.69), (31.35±5.48) g/L in the control group, the difference between the two groups was statistically significant ( t value was 2.09, 2.98, P<0.05 or 0.01). After 6 months of intervention, hemoglobin, serum albumin, muscle strength, physical activity function and daily living ability was (124.66±13.52) g/L, (38.47±6.02) g/L, (23.75±3.61) g, (9.18±1.85) points, (86.19±14.36) points in the observation group, and (112.03±11.89) g/L, (31.01±5.91) g/L, (19.15±3.19) g, (6.14±1.69) points, (64.12±15.83) points in the control group, the difference between the two groups was statistically significant ( t value was 3.68-6.37, all P<0.01). Conclusions:Nursing intervention based on multidisciplinary team can improve the nutritional status, muscle strength,physical function and quality of life of super-aged patients with sarcopenia.
ABSTRACT
Objective:To evaluate the safety and effectiveness of tranexamic acid in the treatment of spontaneous intracerebral hemorrhage.Methods:Patients with spontaneous intracerebral hemorrhage admitted to the Departments of Emergency and Neurology, Nanjing Drum Tower Hospital from December 2015 to December 2018 were enrolled prospectively. The patients were randomly divided into two groups according to a random number table: tranexamic acid group and control group. All patients received conventional treatment. On this basis, 1 g of tranexamic acid injection was given to the tranexamic acid group, dissolved in 100 ml of normal saline, intravenous injection for 10 min; then 1 g of tranexamic acid was given, dissolved in 250 ml of normal saline, intravenous drip for 8 h. The control group was given an equal volume of normal saline. The main outcome measures were good outcome (defined as modified Rankin Scale score0-2) and mortality at 90 d after treatment. The secondary outcome was hematoma enlargement at 24 h after treatment and the National Institutes of Health Stroke Scale (NIHSS) score at 7 and 30 days after treatment. Platelet count and fibrinogen level were measured before treatment and 4 h after the infusion of tranexamic acid. Various adverse events were monitored.Results:A total of 150 patients were included, including 83 males (55.3%). There were 73 patients in the tranexamic acid group and 77 in the control group. There was no statistically significant difference in baseline data between the two groups. The rate of good outcome in the tranexamic acid group at 90 d was significantly higher than that in the control group (57.5% vs. 40.3%; χ2=4.476, P=0.034), while there were no significant differences in mortality rate (0% vs. 1.3%; Fisher's exact test P=1.000) and the proportion of patients with hematoma enlargement at 24 h (6.8% vs. 15.6%; χ2=2.845, P=0.092). The NIHSS score at 7 d (9.26±3.35 vs. 11.68±4.25; t=3.859, P<0.001) and at 30 d (5.45±2.52 vs. 7.38±3.28; t=4.030, P<0.001) in the tranexamic acid group were significantly lower than those of the control group. Fibrinogen in the tranexamic acid group increased significantly after treatment compared with baseline (4.20±0.56 g/L vs. 3.33±0.60 g/L; t=8.997, P<0.001), and was significantly higher than that in the control group after treatment (4.20±0.56 g/L vs. 3.30±0.55 g/L; t=9.906, P<0.001). No adverse events such as venous thromboembolism, ischemic events, and seizures were observed. Conclusion:Tranexamic acid can promote the recovery of neurological function, and improve the outcome of patients with acute spontaneous intracerebral hemorrhage, and the safety is good.
ABSTRACT
Objective@#To explore the effects of multidisciplinary team based nursing intervention on nutritional status, muscle strength, physical function and daily living ability of super-aged patients with sarcopenia.@*Methods@#A total of 29 super-aged patients with sarcopenia from July to November in 2017 in Department of Geriatric, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School were selected as the observation group with multidisciplinary team intervention. And 29 super-aged patients with sarcopenia from February to June 2017 were selected as the control group with routine management. Nutritional indicators, muscle strength, physical activity function and daily living ability scores were compared between the two groups at 1 and 6 months after intervention.@*Results@#After 1 month of intervention, hemoglobin and serum albumin was (118.79±11.47), (35.86±5.73) g/Lin the observation group and (112.27±11.69), (31.35±5.48) g/L in the control group, the difference between the two groups was statistically significant (t value was 2.09, 2.98, P<0.05 or 0.01). After 6 months of intervention, hemoglobin, serum albumin, muscle strength, physical activity function and daily living ability was (124.66±13.52) g/L, (38.47±6.02) g/L, (23.75±3.61) g, (9.18±1.85) points, (86.19±14.36) points in the observation group, and (112.03±11.89) g/L, (31.01±5.91) g/L, (19.15±3.19) g, (6.14±1.69) points, (64.12±15.83) points in the control group, the difference between the two groups was statistically significant (t value was 3.68-6.37, all P<0.01).@*Conclusions@#Nursing intervention based on multidisciplinary team can improve the nutritional status, muscle strength,physical function and quality of life of super-aged patients with sarcopenia.
ABSTRACT
Neurodegenerative diseases are a group of diseases characterized by chronic progressive damage to tissues of central nervous system and peripheral nervous system, which include Alzheimer's disease, Parkinson's disease, amyotrophic lateral sclerosis, frontotemporal dementia, etc. The etiology is mainly related to factors such as aging, genetics and environment. More and more evidence indicate that mitochondrial dysfunction plays a vital role in the pathogenesis of neurodegenerative diseases. Variants of mitochondrial genes, including point variants, deletions, and copy number variations, have been recognized as important factors modulating genetic susceptibility to such diseases. This paper has reviewed recent studies for the influence of mitochondrial variants on the pathogenesis of neurodegenerative diseases, in order to provide clues for the pathogenesis, diagnosis and development of new drugs for such disorders.
ABSTRACT
The mammalian epididymis not only plays a fundamental role in the maturation of spermatozoa, but also provides protection against various stressors. The foremost among these is the threat posed by oxidative stress, which arises from an imbalance in reactive oxygen species and can elicit damage to cellular lipids, proteins, and nucleic acids. In mice, the risk of oxidative damage to spermatozoa is mitigated through the expression and secretion of glutathione peroxidase 5 (GPX5) as a major luminal scavenger in the proximal caput epididymidal segment. Accordingly, the loss of GPX5-mediated protection leads to impaired DNA integrity in the spermatozoa of aged Gpx5
ABSTRACT
For many years, studies on cholesteryl ester transfer protein inhibitors(CETP) have not been interrupted, intending to achieve further cardiovascular protection through increasing the level of HDL-C on the basis of statin-lowering LDL-C. However, the failure of large clinical studies of CETP inhibitors represented by torcetrapib has caused continuous controversy in this area of research. The 2017 European Society of Cardiology Annual Conference published the results of Phase 3 clinical trials on Anacetrapib, which regained significant attention to CETP inhibitors. Based on these, this article reviewed the development of the four major CETP inhibitors, and briefly discusses their clinical effects and differences.
ABSTRACT
Collagen is the building component of temporomandibular joint (TMJ) discs and is often affected by inflammation in temporomandibular disorders. The macromechanical properties of collagen are deteriorated by chronic inflammation. However, the mechanism by which inflammation influences disc function remains unknown. The relationship between the ultrastructure and nanomechanical properties of collagen in inflamed discs should be clarified. Seven-week-old female Sprague-Dawley rats were randomly divided into two groups. Chronic TMJ inflammation was induced by intra-articular injection of complete Freund's adjuvant, and samples were harvested after 5 weeks. Picrosirius staining revealed multiple colours under polarized light, which represented alternative collagen bundles in inflamed discs. Using atomic force microscopy scanning, the magnitude of Young's modulus was reduced significantly accompanied with disordered collagen fibril arrangement with porous architecture of inflamed discs. Transmission electron microscopy scanning revealed a non-uniform distribution of collagen fibres, and oversized collagen fibrils were observed in inflamed discs. Fourier transform infrared microspectroscopy revealed a decrease in 1 338 cm/amide II area ratio of collagen in different regions. The peak positions of amide I and amide II bands were altered in inflamed discs, indicating collagen unfolding. Our results suggest that sustained inflammation deteriorates collagen structures, resulting in the deterioration of the ultrastructure and nanomechanical properties of rat TMJ discs.
Subject(s)
Animals , Female , Rats , Collagen , Fibrillar Collagens , Freund's Adjuvant , Inflammation , Metabolism , Pathology , Injections, Intra-Articular , Random Allocation , Rats, Sprague-Dawley , Temporomandibular Joint , Temporomandibular Joint Disc , Temporomandibular Joint DisordersABSTRACT
OBJECTIVE@#To study the relationship between Sonic hedgehog (Shh) associated single-nucleotide polymorphism (SNP) and non-syndromic cleft lip and/or palate (NSCL/P), and to explore the risk factors of cleft lip and/or palate. Many studies suggest that the pathogenesis of NSCL/P could be related to genes that control early development, in which the Shh signaling pathway plays an important role.@*METHODS@#Peripheral blood was collected from 197 individuals (100 patients with NSCL/P and 97 healthy controls). Haploview software was used for haplotype analysis and Tag SNP were selected, based on the population data of Han Chinese in Beijing of the international human genome haplotype mapping project. A total of 27 SNP were selected for the 4 candidate genes of SHH, PTCH1, SMO and GLI2 in the Shh signaling pathway. The genotypes of 27 SNP were detected and analyzed by Sequenom mass spectrometry. The data were analyzed by chi-squared test and an unconditional Logistic regression model.@*RESULTS@#The selected SNP basically covered the potential functional SNP of the target genes, and its minimum allele frequency (MAF) was >0.05: GLI2 73.5%, PTCH1 91.0%, SMO 100.0%, and SHH 75.0%. It was found that the genotype frequency of SNP (rs12674259) located in SMO gene and SNP (rs2066836) located in PTCH1 gene were significantly different between the NSCL/P group and the control group. Linkage disequilibrium was also found on 3 chromosomes (chromosomes 2, 7 and 9) where the 4 candidate genes were located. However, in the analysis of linkage imbalance haplotype, there was no significant difference between the disease group and the control group.@*CONCLUSION@#In China, NSCL/P is the most common congenital disease in orofacial region. However, as it is a multigenic disease and could be affected by multiple factors, such as the external environment, the etiology of NSCL/P has not been clearly defined. This study indicates that Shh signaling pathway is involved in the occurrence of NSCL/P, and some special SNP of key genes in this pathway are related to cleft lip and/or palate, which provides a new direction for the etiology research of NSCL/P and may provide help for the early screening and risk prediction of NSCL/P.
Subject(s)
Humans , Beijing , Case-Control Studies , Cleft Lip , Cleft Palate , Genotype , Hedgehog Proteins , Nucleotides , Polymorphism, Single Nucleotide , Signal TransductionABSTRACT
Objective To study the effect of predictive nursing combined with 317 nursing-nurse's education assistant on the bowel preparation of elderly patients.Methods The elderly patients who was hospitalized or physically examined between March and December 2017 were divided into two groups with their wills:60 cases in the observation group and 58 cases in the control group.In the former group, the education with the predictive nursing and the 317 nursing-nurse's education assistant by primary nurses was conducted and in the latter,the traditional oral and paper method was used for the bowel preparation. Results The quality of bowel preparation in the observation group was significantly higher than that in the control group. The complication rate in the observation group was significantly lower than that in the control group (P<0.05). Conclusion The predictive nursing combined with the 317 nursing-nurse's education assistant can improve the bowel preparation quality and reduce the complication rate in the elderly patients.
ABSTRACT
Objective To investigate the metabolomics characteristic of neuromyelities optica spectrum disorder (NMOSD) in plasma and cerebrospinal fluid.Methods Ultra high performance liquid chromatography-mass spectrometry (UHPLC-MS) was used to identify plasma metabolites in 16 patients with NMOSD and 8 healthy controls.At the same time,the identification of metabolites in cerebrospinal fluid of 8 NMOSD patients and 5 healthy controls was completed.Differential metabolites screening and metabolomic pathway analysis were performed by diversified data analysis methods.Results Compared with healthy control group,the content of 8 substances such as Cis.8.11.14.Eicosatrienoic acid in the plasma of NMOSD patients was increased.The content of 8 substances such as L-glutamine acid were decreased.There was no significant difference in the metabolites between Aquaporin 4 (AQP-4) antibody positive and negative NMOSD plasma.The content of 6 substances such as 3-hydroxybutyric acid in cerebrospinal fluid of patients with NMOSD was reduced.Conclusions The distribution of metabolites in plasma between NMOSD patients and healthy controls was significantly different.There was no significant difference in metabolites between AQP-4 antibody positive and negative NMOSD plasma.There are some differences in metabolites between cerebrospinal fluid of NMOSD patients and healthy controls.A variety of amino acid abnormalities,sphingomyelin dysfunction,energy metabolism and mitochondrial dysfunction were involved in the pathogenesis of NMOSD.
ABSTRACT
Artemisia genus (family Asteraceae) has been widely used as medicines and cosmetic. The chemical compositions of essential oils extracted from five Artemisia species (A. anethoides, A. giraldii, A. roxburghiana, A. rubripes and A. sacrorum) were analyzed and the repellent activities of five essential oils were investigated by testing percent repellency (PR) in petri dish against Tribolium castaneum. By GC-MS analysis, the common components of the five essential oils were eucalyptol (11.09%-50.05%), camphor (6.28%-33.10%), terpinen- 4-ol (2.46%-12.41%), ß-caryophyllene (0.63%-10.68%) and germacrene D (2.28%-10.01%). 3,3,6-trimethyl-1,4-heptadien-6-ol (11.72%), 2-isopropyl-5-methyl-3-cyclohexen-1-one (24.80%) and ß-farnesene (12.23%) were the characteristic compounds in essential oils of A. sacrorum, A. anethoides and A. rubripes respectively. The essential oils of five plants showed repellent activity against T. castaneum. The PR of others four essential oils were comparable with DEET expect for A. sacrorum. The results indicated that the essential oils of A. anethoides, A. giraldii, A. roxburghiana and A. rubripes had the potential to be developed as repellent for control of T. castaneum.
El geÌnero Artemisia (familia Asteraceae) ha sido ampliamente utilizado como medicamentos y cosmeÌticos. Se analizaron las composiciones quiÌmicas de los aceites esenciales extraiÌdos de cinco especies de Artemisia (A. anethoides, A. giraldii, A. roxburghiana, A. rubripes y A. sacrorum) y se investigaron las actividades repelentes de cinco aceites esenciales mediante la prueba de repelencia porcentual (PR) en placa de petri contra Tribolium castaneum. Por anaÌlisis GC-MS, los componentes comunes de los cinco aceites esenciales fueron eucaliptol (11,09% -50,05%), alcanfor (6,28% -33,10%), terpinen-4-ol (2,46% -12,41%), ß-cariofileno 0,63% -10,68%) y germacreÌn D (2,28% -10,01%). 3,3,6-trimetil-1,4-heptadien-6-ol (11,72%), 2-isopropil-5-metil-3-ciclohexen-1-ona (24,80%) y ß-farneseno (12,23%). Los compuestos caracteriÌsticos en los aceites esenciales de A. sacrorum, A. anethoides y A. rubripes respectivamente. Los aceites esenciales de cinco plantas mostraron actividad repelente contra T. castaneum. El PR de otros cuatro aceites esenciales eran comparables con DEET esperado para A. sacrorum. Los resultados indicaron que los aceites esenciales de A. anethoides, A. giraldii, A. roxburghiana y A. rubripes tienen el potencial de ser desarrollados como repelentes para el control de T. castaneum.
Subject(s)
Animals , Tribolium/drug effects , Oils, Volatile/pharmacology , Plant Extracts/pharmacology , Artemisia/chemistry , Insect Repellents/pharmacology , Terpenes/analysis , Coleoptera/drug effects , Oils, Volatile/chemistry , Plant Extracts/chemistry , Asteraceae/chemistry , Gas Chromatography-Mass SpectrometryABSTRACT
Objective To investigate the value of adenosine triphosphate(ATP)bioluminescence assay for assessing object surface contamination degree in intensive care unit(ICU).Methods 30 groups of high frequency contact object(including ventilator panel,bedside table and computer keyboard)in ICU from January to December 2016 were enrolled for the study. Each object was sampled and evaluated before and after disinfection,and their surface was divided into two areas,whose sur-face contamination degree was evaluated by ATP bioluminescence assay and bacterial culture method that were classified as ATP group and control group.The fluorescence detection value and colony number were compared between two groups be-fore and after disinfection.The correlation between the fluorescence detection value and colony number was analyzed by Pearson correlation in the same sample,and the Kappa consistency test was used for the qualification rates of two detections. Results ①The fluorescence detection value and colony number of ventilator panel,bedside table and computer keyboard af-ter disinfection in two groups were significantly lower than that before disinfection(t=8.107~26.393,all P<0.05).②Pearson analysis result showed that both before and after disinfection,the fluorescence detection value had no significant cor-relation with colony number of ventilator panel,bedside table and computer keyboard(r=0.199~0.338,all P>0.05).③There were no significant differences in the qualification rate between two groups of ventilator panel,bedside table and com-puter keyboard before and after disinfection(χ2=0.000~1.404,all P>0.05).The qualification rate before the disinfection of ATP group and control group were 0 and 8.9%,and that after disinfection were 86.7% and 91.1%,whose Kappa consis-tency test result showed that the Kappa value was 0.776(95%CI:0.575~0.978)>0.75,so the consistency was quite sat-isfied.Conclusion ATP bioluminescence assay could be used as a rapid and handy preliminary screening to assist bacterial culture method to evaluate the object surface contamination in ICU,and the result was satisfactory and it would be worthy of clinical application.
ABSTRACT
Objective To investigate the prevalence of healthcare-associated infection(HAI)in a tumor hospital,and provide evidence for prevention and control of HAI.Methods According to requirement of cross sectional survey of nationwide HAI monitoring network,prevalence rates of HAI in hospitalized patients at a tumor hospital in 2013-2015 were surveyed,surveyed results were statistically analyzed.Results A total of 3 515 hospitalized patients were investigated from 2013 to 2015,24(0.68%)had HAI.The prevalence rates of HAI from 2013 to 2015 were 0.79%,0.54%,and 0.76%respectively,difference was not statistically significant(x2=0.65,P>0.05).The main infection site was lower respiratory tract,accounting for 45.83%.The main pathogens causing HAI were gram-negative bacilli,accounting for 47.37%,followed by fungi(26.32%).Conclusion The prevalence rate of HAI in tumor patients is low,targeted monitoring should be carried out according to the current situation,the prevention and control of lower respiratory tract infection should be focused on,fungal infection should be paid attention.
ABSTRACT
Objective To investigate the predictive values of matrix metalloproteinase-9 (MMP-9) and serum ferritin (SF) for hemorrhagic transformation (HT) after acute ischemic stroke.Methods The patients with fist-ever acute ischemic stroke within 24 h of onset were selected.The demographic and clinical data were collected.The MMP-9 and SF levels were detected.The demographic and clinical data and laboratory results were compared between a HT group and a non-HT group.Multivariable logistic regression analysis was used to determine the independent risk factor for HT.The receiver operating characteristic (ROC) curve was used to identify the predictive values of MMP-9 and SF for HT.Results A total of 150 patients were enrolled,their mean age was 67.01 ± 9.11 years,including 65 males (43.33％).There were 32 patients (21.33％) in the HT group and 118 (78.67％) in the non-HT group.Univariate analysis showed that MMP-9 (161.19 ±36.86 μg/L vs.100.18 ±36.70 μg/L;t =8.333,P＜0.001) and SF (195.50 [188.25-201.00] μg/L vs.175.00[165.00-189.25] μg/L;Z =4.891,P ＜0.001) in the HT group were significantly higher than those in the non-HT group.Multivariable logistic regression analysis showed that diabetes (odds ratio [OR] 2.273,95％ confidence interval [CI] 1.019-5.070;P =0.047),atrial fibrillation (OR 4.846,95％ CI 1.934-12.146;P=0.001),MMP-9 (OR 3.176,95％ CI 1.842-5.479;P＜ 0.001),hypersensitivity C reactive protein (OR 2.243,95％ CI 1.015-4.954;P =0.045),and SF (OR 2.722,95％ CI 1.586-4.672;P ＜ 0.001) were the independent risk factors for HT.The ROC curve analysis showed that MMP-9 (area under curve 0.904,95％ CI 0.851-0.957) and SF (area under curve 0.776,95％ CI 0.684-0.869) had significant predictive values for HT.When the cut-off value of MMP-9 was 133 μg/L,the sensitivity and specificity were 84.4％ and 15.3％,respectively.When the cut-off value of SF was 187.5 μg/L,the sensitivity and specificity were 78.1％ and 27.1％,respectively.Conclusions The MMP-9 and SF levels were significantly increased in acute ischemic stroke patients with HT.Early detection of serum MMP-9 and SF levels help to predict the risk of HT.
ABSTRACT
Objective To explore the reasons and preventive measures of early dislocation after total hip arthroplasty in elder patients. Method A retrospective study was done to analyze dislocation time, reason and time of 168 elderly patients with early anti-dislocation after total hip arthroplasty in joint surgery. Results Only 7 patients (4.1%) had type I joint dislocation, including 2 male and 5 female patients aged 65~89 years. The dislocation happened in 4~5 weeks postoperatively, mainly resulting from hip joint over flexion when urinating in bed, sleep-turning, loaded-moving, walking and stoop and diachoresis. Conclusions For the elderly patients after total hip replacement, it is type I dislocation which happened 4 ~ 5 weeks after operation, more femal than male, reasons including over-exercrse. Effective prevention measures includes regular rehabilitation training, early precautions enhanced mental support and safety nursing.
ABSTRACT
Objective To investigate the expression of AR and its relationship with clinicopathological features in human epidermal growth factor receptor-2(Her-2) enrich breast cancer. Mehtods The expression of AR was detected by immunohistochemical staining in 102 patients with Her-2 enrich breast cancer. The relationship between AR expression and its clinicopathological characteristics was analyzed. Results The positive rate of AR expression was 75.5%. Patients in the positive group had a lower level of lymph nodes and Ki-67 value (P 0.05). Conclusion AR was highly expressed in Her-2 enrich breast cancer, which may be a potential target for treatment of Her-2 enrich breast cancer.
ABSTRACT
In the present report, we describe the successful use of miniscrews to achieve vertical control in combination with the conventional sliding MBT™ straight-wire technique for the treatment of a 26-year-old Chinese woman with a very high mandibular plane angle, deep overbite, retrognathic mandible with backward rotation, prognathic maxilla, and gummy smile. The patient exhibited skeletal Class II malocclusion. Orthodontic miniscrews were placed in the maxillary anterior and posterior segments to provide rigid anchorage and vertical control through intrusion of the incisors and molars. Intrusion and torque control of the maxillary incisors relieved the deep overbite and corrected the gummy smile, while intrusion of the maxillary molars aided in counterclockwise rotation of the mandibular plane, which consequently resulted in an improved facial profile. After 3.5 years of retention, we observed a stable, well-aligned dentition with ideal intercuspation and more harmonious facial contours. Thus, we were able to achieve a satisfactory occlusion, a significantly improved facial profile, and an attractive smile for this patient. The findings from this case suggest that nonsurgical correction using miniscrew anchorage is an effective approach for camouflage treatment of high-angle cases with skeletal Class II malocclusion.