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Objective:To investigate the clinical outcomes of using the levofloxacin combined with intrauterine infusion of metronidazole for the treatment of the infertility patients with chronic endometritis (CE).Methods:Using a case-control study method. 82 infertility patients with CE admitted to Xuzhou Central Hospital from March 2018 to March 2021 were selected and randomly divided into an observation group and a control group using a random number table method, with 41 cases in each group. The control group was treated with oral levofloxacin hydrochloride, while the observation group was treated with metronidazole sodium chloride injection intrauterine infusion on the basis of the control group. Both groups were treated for 14 days. Compare the serum C-reactive protein (CRP) and tumor necrosis factor between two groups before and after treatment α(tumor necrosis factor-α, TNF-α) The levels of monocyte chemotactic protein 1 (MCP-1), natural pregnancy rate within six months, total effective rate, and incidence of adverse reactions during treatment were measured. The measurement data with normal distribution is expressed as: independent sample t-test is used for comparison between the two groups, and paired t-test is used for comparison before and after treatment within the group; The measurement data of non normal distribution is represented by M( Q1, Q3), and the comparison between groups is made by Wilcoxon Rank sum test. The counting data is represented by examples (%), and the comparison between groups is conducted using the χ 2 test. Results:Before treatment, two groups of serum CRP and TNF-α There was no statistically significant difference compared to the levels of MCP-1 (all P>0.05); After 14 days of treatment, both groups had serum CRP and TNF-α、MCP-1 were all lower than before treatment, and the observation group was lower than the control group [(4.12±1.9) ng/L vs (6.36±1.63) ng/L, (47.28±9.10) ng/L vs (62.79±9.34) ng/L, (212.04±24.82) ng/L vs (326.15±27.38) ng/L], with statistically significant differences ( t-values of 5.61, 7.62, and 19.77, all P<0.001). After 14 days of treatment, the total effective rate of the observation group was higher than that of the control group [95.12% (39/41) vs 78.05% (32/41)], with a statistically significant difference (χ 2=5.14, P=0.023). After 6 months of treatment, the natural pregnancy rate in the observation group was higher than that in the control group [53.66% (22/41) vs 31.71% (13/41)], with a statistically significant difference (χ 2=5.96, P=0.044). There was no statistically significant difference in the incidence of adverse reactions between the two groups during the treatment period (χ 2=0.55, P=0.457). Conclusions:The combination of levofloxacin and intrauterine infusion of metronidazole has a good clinical effect in treating infertility patients with CE. It can significantly improve the inflammatory state of the body, reduce serum inflammatory factor levels, increase the natural pregnancy rate within 6 months, and do not increase the incidence of adverse reactions.
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Objective To study the influence analysis of patients with anxiety and depression in elderly patients with hypertension antihypertensive effect of psychological intervention combined with Flupentixol and Melitracen Tablets.Methods 60 elderly patients with hypertension accompanied by anxiety and depression in our hospital from January 2014 to December 2016 were selected as the subjects.They were randomly divided into the control group and the experimental group, with 30 patients in each group.The control group was treated with conventional antihypertensive treatment, the experimental group were given psychological intervention combined with treatment of Flupentixol and Melitracen Tablets.The clinical indexes of the experimental group and the control group were compared and analyzed.Results After the corresponding treatment, the effective rate of antihypertensive treatment in the experimental group was 28 cases, and the effective rate of depressurization was 93.3%.The effective rate of antihypertensive treatment in the control group was 21, and the effective rate of antihypertensive treatment was 70%.After treatment, the HAMD score and HAMA score of the experimental group were significantly lower than those before the treatment, and the score of the experimental group was significantly lower than that of the control group, with statistical difference(P<0.05).Conclusion The treatment of elderly hypertensive patients with anxiety and depression in patients with better antihypertensive effect of psychological intervention combined with Flupentixol and Melitracen Tablets, can improve the depression and anxiety of patients in a large extent, high safety, is further applied in clinical significance.
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Objective To analyze the cerebral autoregulation capability in patients with chronic insomnia disorder (CID).Methods Sixty CID patients (54 with generalized anxiety disorder) and 40 healthy controls were enrolled in this study.Polysomnography was done in all the participants.Noninvasive continuous cerebral blood flow velocity of bilateral middle artery and arterial blood pressure were recorded simultaneously using transcranial Doppler and a servo-controlled plethysmograph.Transfer function analysis was used to derive the autoregulatory parameters, including phase difference and coherence function.Results The phase difference values of CID patients with generalized anxiety disorder were significantly lower than that of the healthy controls ((46.89±15.39)°vs (56.00±12.05)°, t=3.439, P=0.001).In the correlation analysis, we further found that there was no correlation among phase difference values and the score of Hospital Anxiety and Depression scale.Conclusions The dynamic cerebral autoregulation was compromised in CID patients with generalized anxiety disorder regardless of the degrees of anxiety and depression.Dynamic cerebral autoregulation may be a potential therapeutic target in improving neurological symptoms in patients with CID.
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Objective To investigate the clinical outcomes of using modified antegrade digital artery island flap for the treatment of the severely flexion contracture of the burned finger.Methods Between August,2013 to August,2015,21 patients (21 fingers) with severely flexion contracture of the burned finger were hospitalized for treatment.According to the Stren classification standard for the interphalangeal joint flexion contracture,all the patients were rated as type Ⅲ.The volar soft-tissue defect with exposed tendons,nerves,vessels or bone ranged from 1.0 cm × 2.0 cm to 2.5 cm × 4.0 cm after scar relaxation.The artery and the nerve defect were 1.5 to 4.5 cm and 2.0 to 4.2 cm,respectively.The wound were reconstructed with the modified antegrade digital artery island flap.The dorsal branches of the proper digital nerve of the flap were anastomosised with the proper digital nerve of the wound.The flap donor site was resurfaced with full-thickness skin grafting from inner aspect of the forearm.All the cases were called back for postoperative follow-up.Results All the reconstructed fingers and flaps survived completely without vascular problems.The donor skin graft survived and wound healed by first intention.All the patients were followed up with 11.5 months (range,6-22 months).The finger appearance was satisfactory.The texture and color of flaps in all cases were good.There was no pigmentation and contraction relapse.The contracted fingers received no cold intolerance.At the final examination,the average values of static 2-point discrimination were 5.2 mm (range,4.3-6.5 mm) of the flap.In the series,based on the Michigan Hand Outcome Questionnaire,18 patients were strongly satisfied with the injured finger appearance and 3 patients satisfied with the appearance.Conclusion The modified antegrade digital artery island flap,which is easy to raise with large flap size and can result with the good finger appearance and function,is an ideal technique for reconstruction of the severe flexion contracture of the burned finger.
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Objective To assay the clinical effect of proximal dorsal digital artery pedicled island flap in treatment and sensory reconstruction of adjacent finger soft-tissue defect.Methods The study enrolled 21 cases of soft-tissue defect in 21 fingers treated from January 2013 to January 2014.All the defects were covered with the proximal dorsal artery pedicled island flaps raised from the adjacent finger.Index finger was injured in 7 patients,middle finger in 9 patients,ring finger in 4 patients,and little finger in 4 patients.Defect and flap dimensions varied from 1.9 cm × 1.5 cm to 4.3 cm × 2.3 cm and from 2.0 cm × 1.7 cm to 4.5 cm × 2.5 cm respectively.Donor site was resurfaced with a fullthickness skin harvested from medial side of the upper arm.Postoperative flap appearance and two-point discrimination were evaluated.Total active motion (TAM) of the finger was evaluated after operation.Results All the flaps and skin grafts survived after operation.Duration of the follow-up was 6-18 months (mean,14.7 months).Through the final follow-up,appearance and function of the flap were satisfactory,donor site healed well,and two-point discrimination was 5-9 mm (mean,6.3 mm).TAM evaluation was excellent in 19 patients and good in 2 patients with the excellent-good rate of 100％.Conclusion The proximal dorsal artery pedicled island flap raised from the adjacent finger is an ideal choice in finger soft-tissue reconstruction,for the technique has advantages of high survival rate,satisfactory appearance and sensory function as well as few complications.
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<p><b>OBJECTIVE</b>To investigate the clinical outcomes of the use of the perforator propeller flaps based on the end dorsal branch of digital proper artery in the same finger in repair of finger pulp defects and sensory reconstruction in children.</p><p><b>METHODS</b>Twenty-three children (31 fingers) with index, middle, ring or little finger pulp defects were hospitalized from September 2012 to December 2013. The area of finger pulp defects ranged from 1.2 cm × 1.0 cm to 2.0 cm × 1.5 cm. The perforator propeller flaps based on the end dorsal branch of digital proper artery in the same finger were used to repair the defects, with the flap size ranging from 1.3 cm × 1.2 cm to 2.2 cm × 1.6 cm. The dorsal branch of the digital proper nerve of the flap was conducted end-to-end anastomosis with the broken end of the nerve of the wound to reconstruct sensation. The donor sites were covered with autologous full-thickness skin obtained from inner aspect of the thigh.</p><p><b>RESULTS</b>Primary healing of the wounds and donor sites were achieved in all 23 children. All the flaps and skin grafts of donor sites survived. All the patients were followed up for 6 to 20 months, with mean time of 14 months. At the last follow-up, the flaps and donor sites were in good appearance, the finger pulps were mellow and plump, with no obvious pigmentation or cicatricial contracture. The sensation of finger pulps reached S3(+), and the distance of two-point discrimination ranged from 4.5 to 6.0 mm, with mean distance of 5.1 mm. Twenty-one parents of the patients were strongly satisfied with the appearance of the repaired fingers, and the other 2 parents also expressed satisfaction.</p><p><b>CONCLUSIONS</b>Transplantation of the perforator propeller flap based on the end dorsal branch of digital proper artery in the same finger is a safe and reliable method for the repair of index, middle, ring, and little finger pulp defects and sensory reconstruction of children. The flaps are with good blood supply, appearance and sensory function after operation.</p>