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Objective To study the relationship between serum lipids level and bone mineral density( BMD)in postmenopausal OSAHS patients.Methods One hundred and twelve postmenopausal OSAHS patients were divided into osteoporosis group(n=35)with a T value＜-2.5,osteopenia group(n=39)with a T value=-2.5-1.0,and normal BMD group(n=38)woth a T value＞ -1.0,36postmenopausal OSAHS-free patients served as a control group and their BMD was detected. The relationship between blood lipids level and BMD was analyzed.Results The serum TC,TG and LDL-C levels were significantly higher in normal BMD group,osteopenia group and osteoporosis group than in control group(P＜0.05).The serum TG and LDL-C levels were significantly higher while the serum phosphorus level was significantly lower in osteopenia group and osteoporosis group than in normal BMD group (P ＜0.05).Pearson correlation analysis showed that the serum ALP and LDL-C levels were negatively related with the BMD of lumbar vertebrae 1-4(r=-0.145,P=0.041;r=-0.331,P=0.000)while the serum phosphorus and TG levels were positively related with the BMD of double femoral neck(r=0.290,P=0.000;r=0.085,P=0.031;r=0.310,P=0.000;r=0.160,P=0.029).Conclusion The serum TG and LDLC levels are related with the BMD in postmenopausal OSAHS patients.Serum blood lipids level is an indicator for the early diagnosis and treatment of osteoporosis.
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Objective@#To investigate the blood lead level of outpatient children and associated factors in Zhuzhou, and to offer targeted advice for the prevention and control of lead exposure.@*Methods@#The lead level in blood of 1 600 children aged ≤14 years old and the content of serum calcium, iron, zinc, magnesium, copper were tested, and the children and their parents were given a questionnaire regarding influencing factors of blood lead exposure.@*Results@#The average blood lead level of the children was (95.2±46.5)μg/L, The proportion of children with blood lead level ≥100 μg/L was 25.7%. The blood lead level between boys and girls had a statistical differences(Z=1.85, 2.85, P<0.05). The blood lead level was negatively correlated with serum calcium, iron, zinc, magnesium and copper(F=16.80，P<0.01). The risk factors for lead exposure included frequently drinking canned or bottled soft drinks, failing to wash one’s hands before meals, taking popcorn frequently, using coal for heat and for cooking, and constantly sucking fingers or biting fingernails (OR=2.12, 1.57, 1.46, 1.78, 3.24, P<0.01).@*Conclusion@#The blood lead levels of children in Zhuzhou is higher than national average level. We should strengthen environmental protection and behavioral interventions, and regularly monitor lead exposure among children.
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Objective The aim was to screen the expression profiles of microRNAs (miRNAs) in gastrointestinal stromal tumors (GIST) and explore the function of microRNA-301 a (miR-301 a). Methods Collected the tumor and adjacent normal tissues of 45 patients, who were diagnosed primary GIST. The expression profiles of tumor miRNAs in 5 of the 45 patients were obtained by microarray technology, and the abnormal expression levels of miRNAs in the remaining 40 patients were detected by Real Time-PCR as a validation experiment. Correlation analysis was analyzed between the significantly up-regulated expression of miR-301 a and the clinicopathological features of the patients. The MTT experiment was used to explore the effect of miR-301 a on the growth of GIST cell lines. Results Five kinds of miRNAs with high expression and five kinds of miRNAs with low expression were screened out from GIST, of which the expression of miR-301 a was up-regulated most obviously. The expression of miR-301 a was closely related to tumor risk grade, tumor size, mitosis and necrosis (P < 0.05). The overexpression of miR-301 a in GIST cell lines could significantly enhance the proliferation of cells. Conclusions MiR-301 a was up-regulated in GIST, which was closely related to malignant clinicopathological features and could affect the growth and proliferation of tumor cells in vitro. MiR-301 a might be a potential target for future treatment of GIST.
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Objective To compare the application effect between problem-based learning (PBL) and traditional teaching in cardiovascular intervention . Methods 39 training physicians were divided randomly into the PBL group (n=20) and control group (n=19). The control group was trained with the tradi-tional teaching method while PBL group used PBL seven step method, namely they were trained through the process of clarifying unfamiliar terms—defining the problem—brainstorming—restructuring problem—defining learning goals—collecting information, personal learning, information sharing, and group discus-sion. After the end of the training, the two groups were tested by using the unified test questions and skills test, and the questionnaire survey of teaching satisfaction. SPSS 18.0 was used to do line t test or chi square test to the data of both groups. Results PBL group training physicians' cardiovascular intervention oper-ation [(30.07±1.67) vs. (28.54±1.98), P=0.036], their comprehensive analysis of clinical cases, [(34.47± 1.77) vs. (32.08 ±1.80), P=0.002], and the total score [(86.47 ±2.75) vs. (82.23 ±3.63), P=0.002], were better than the control group, and the difference was statistically significant. The survey results showed that the PBL group's evaluation on how the teaching methods stimulate the training physicians' interest in learning, enhance their ability of independent thinking and cultivate their teamwork ability, improve their language expression and clinical thinking and other aspects was higher than the control group (P Conclusion Compared with the traditional teaching, the application effect of PBL in the training of car-diovascular intervention can better exert training physicians' subjective initiative and improve the teaching effect.
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BACKGROUND:Traditional treatment of tibia and fibula fractures complicated with skin soft tissue defect is mainly external fixation, wound debridement and dressing plus skin graft or skin flap transplantation after the infection is control ed and granulation grow. This method is disadvantageous due to high cost, great pain, long hospitalization stay, infection and necrosis, even the possibility of amputation. OBJECTIVE:To explore the clinical efficacy of vacuum sealing drainage (VSD) and external fixator in the treatment of tibia and fibula open fractmes complicated with skin defects. METHODS:A total of 38 patients with severe open fractures of tibia and fibula complicated with skin defects were selected from Benxi Central Hospital between January 2009 and September 2013. The size of skin defects was more than 5 cm2. After external fixation, the patients underwent complete debridement and dressing, fol owed by VSD treatment for 5-7 days. After granulation tissue grew and the wound became fresh, the patients received intermedite thickness skin graft. And 15 cases treated without VSD were retrospectively selected, serving as control group. The infection control rate and wound healing time in the two groups were compared. RESULTS AND CONCLUSION:After 5-7 days of VSD treatment, VSD dressings were removed, wound infection was control ed, local wound granulation tissue was fresh. Both the wound and fractures were healed wel , no osteomyelitis or amputation occurred. Among the involved 38 patients, 23 cases were cured, 12 cases were effective, and three cases were ineffective. The total effective rate showed significant differences compared with the control group (92%vs. 53%;P<0.05). VSD can completely remove the wound secretions and necrotic tissue, improve local microcirculation, eliminate the infection, VSD plus external fixator and skin grating is a simple and effective method in treatment of tibia and fibula open fractures with soft tissue defects.
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Objective To explore potential related factors of left ventricular hypertrophy in maintenance hemodialy?sis (MHD) patients. Methods Sixty patients were enrolled in the study. Echocardiography was performed to exam LVH in?dexes. There are forty-three patients with LVH (LVH group), and seventeen patients without LVH (non-LVH group). Clini?cal data were collected to exam the levels of hemoglobin (HGB), creatinine (Cr), parathyrin (iPTH), albumin (ALB), triglycer?ide (TG), cholesterol(CHO), calcium(Ca), phosphorus(P), advanced oxygen protein products (AOPP) and C reactive protein (CRP). Results Compared with non-LVH group, age, BP, iPTH, AOPP were higher in LVH group patients while BMI and other biochemistry index does not show any statistical difference. Multiple linear stepwise regressions analysis shows that SBP, iPTH and AOPP are correlated factors to left ventricle mass index (LVMI). Conclusion LVH is prevalent in MHD pa?tients. BP, iPTH and AOPP are the risk factors for LVH.
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Objective: To evaluate the safety and anticoagulant efficacy of domestic bivalirudin injection during emergent percutaneous coronary intervention (PCI) in patients with ST-segment elevation myocardial infarction (STEMI). Methods: A total of 75 STEMI patients were randomly divided into 2 groups according to anticoagulant used in emergent PCI procedure. Bivalirudin group, the patients received intravenous domestic bivalirudin, n=40 and Heparin group, n=35. The activated clotting time (ACT) was tested at pre-PCI, 5 minutes after medication, immediately after PCI, 30 minutes, 1 hour and 2 hours after medication respectively. The activated partial thromboplastin time (APTT), prothrombin time (PT), thrombin time (TT) and ifbrinogen (FIB) level were measured at before medication and 6, 24, 72 hours after medication. Results: All patients in Bivalirudin group had ACT>225s at 5min after medication as PCI requirement, while 1 patient in Heparin group could not reach the requirement and the extra dose was added. Both groups maintained ACT>225s during PCI procedure. Bivalirudin group had the lower ACT levels than those in Heparin group at 30 min, 1-and 2-hour after the medication, P0.05. The no-cardiac event surviving rate at 30 days after PCI in Bivalirudin group and in Heparin group were similar P>0.05 and the mild bleeding at 24 hours after PCI in Bivalirudin group was lower (0 vs 11.43)%, P Conclusion: Compared with heparin, domestic bivalirudin may take faster effect, with shorter half-life period for anticoagulation during emergent PCI procedure in STEMI patients.
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During the recent decade, the advanced medical technology has brought the rapid development in the dentoalveolar surgery, and the medical concepts of humanity, painless, minimally invasive, safe and comfortable are gradually accepted by the patients and doctors. Many advanced techniques and equipments have been used in the dentoalveolar surgery. This paper would like to make a review on the clinical application and experience of the advanced medical technologies in the tooth extraction, such as the general anaesthetic technique, the nitrous oxide sedative technique, the computer-controlled local anesthesia delivery devices, the electrocardiogram montior, the location of embedded tooth by cone beam CT and minimally invasive surgical technique. Additionally, in this paper we also described the indication, contraindication, advantages and operating essentials of the orthodontic traction technique, ultrasonic bone surgery (piezosurgery) device and the surgery technology for alveolar bone shape and functional preservation in the extraction of tooth. Finally, we introduced the immediate implantation technique used in the dentoalveolar surgery.
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Humans , Cone-Beam Computed Tomography , Malocclusion , Minimally Invasive Surgical Procedures , Tooth , Tooth ExtractionABSTRACT
Objective To compare the effect between problem-based learning and lecture-based learning for clinical teaching in the department of cardiovascular medicine. Methods Totally 110 five-year-program cardiovascular interns from June 2011 and June 2012 were selected. They were randomly divided into the PBL group(n=55) and LBL group(n=55). PBL and LBL teach-ing methods were applied in the two groups respectively. Teaching effects were evaluated by exam and questionnaire investigation. SPSS 15.0 was used to do data processing; t test was used to compare the average score of two groups;chi-square test was used to process the results of the questionnaire. P<0.05 signifies sta-tistically significant differences. Results There were statistical differences in examinational average score between PBL group and LBL group ((87.89 ±5.39) vs. (82.63 ±5.26), P<0.05). PBL group had significantly higher satisfaction rate in motivating study interests , deepening understanding of theoretical knowledge, cultivating self-learning ability, training verbal expression and developing clin-ical thinking, etc(P<0.05). Conclusions PBL teaching method demonstrates advantages in teaching of cardiovascular medicine and enhances the teaching effect. But the PBL teaching method should be improved in basic knowledge teaching, cultivation of teachers' ability and case selection.
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Objective To study the diagnostic value of MR mammography(MRM) in judging the nature of breast disease.Methods 145 cases with breast disease were retrospectively studied to investigate the relationships between two parameters(early-phase enhancement rate and the type of the delayed enhancement) and different breast diseases.All patients underwent MRM examination before surgical operation.Results ①Strengthen multiple in early stage larger than 3 times was inclined to malignant lesion;Strengthen multiple smaller than 1 time was inclined to benign lesion.②Drop type of delayed enhancement was the important parameter in diagnosis of ductal carcinoma.If drop type of delayed enhancement was viewed as the diagnosis standard of the ductal carcinoma of breast only:81% cases with invasive type of the ductal carcinoma,65% cases with noninvasive type of the ductal carcinoma had been diagnosed correctly;14% cases with benign breast lesions had been diagnosed exaggeratedly.③If strengthen multiple in early stage larger than 2.5 times in rising type of delayed enhancement and drop type of delayed enhancement was viewed as the diagnosis standard of the ductal carcinoma of breast,87.9% cases with invasive ductal carcinoma,73.1% cases with noninvasive ductal carcinoma had been diagnosed correctly;21.4% cases within benign breast lesions had been diagnosed exaggeratedly.Conclusion Compared with differential of disease nature by the type of the delayed enhancement only,the correct rate of diagnosis of breast ductal carcinoma mentioned above is raised if two parameters are combined.But the correct diagnosis rate of benign lesions is decreased.
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Objective To determine whether the use of 18F-FDG PET/CT alters staging and management of nasopharyngeal carcinoma (NPC) when compared with MRI staging practice;and to explore the relation of standard uptake value (SUV) of 18F-FDG PET/CT and the pathological classification and T staging of NPC. Methods The study was performed retrospectively on a group of 41 patients with a new diagnosis of NPC. All the patients underwent whole body PET/CT scanning and head & neck MRI scanning within 3 weeks of each other. The AJCC protocol was introduced to stage NPC and the results of the PET/CT were compared with MRI based on pathologic diagnosis. Results ①Primary tumor:the accuracy of T staging of PET/CT was significantly higher than MRI (85.37% vs 60.98%,U=2.49,P
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Objective To generalize a valuable classification of mandibular condyle fractures and explore proper measures for such kind of fractures so as to provide reference for clinical treatment. Methods The data of 304 cases with 358 mandibular condyle fractures were analyzed retrospectively. After one year of the initial treatment, X-ray inspection was employed to get the information including mouth opening, pattern of mouth opening, occlusion, facial symmetry and healing condition of mandibular condyles. Results According to classification of position,displacement and age (PDA), 180 mandibular condyle fractures belonged to type Ⅰ, 96 to type Ⅱ and 82 to type Ⅲ, which coincided with the different fractures treated surgically or nonsurgically. All surgical and nonsurgical treatments got satisfactory outcome. Conclusion The classification of PDA is effective in guiding the treatment choice for mandibular condyle fractures. Both surgical and nonsurgical treatment can obtain effective results for corresponding case.