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Objective@#To evaluate the efficacy and safety of different positions external physical vibration lithecbole (EPVL) therapy for ureteral calculi related renal colic.@*Methods@#This study was a prospective multicenter randomized controlled trial. The inclusion criteria was that patients volunteered to participate in the trial and signed informed consent, patients’age ranged from 18-65 years old, ureteral calculi related with renal colic, stone diameter was less than 7 mm, patients were not treated with analgesia, antispasmodic drugs. The exclusion criteria was that combination of severe urinary tract infection, severe hydronephrosis, urinary malformation, severe hypertension, history of cerebrovascular disease, vital organ dysfunction, obesity (BMI>35 kg/m2), history of ureteral calculi exceeded 2 months, abnormal blood coagulation. Patients were randomized into observation group and control group using random number table method. The observation group and the control group were placed on the physical vibration stone arranging machine with head low foot high position and head high foot low position respectively. The inclination angle was 24°. The secondary vibrator vibrated for 6 minutes, then the patient took the prone position and opened the main, the secondary vibrator. The treatment is completed after 6 minutes of vibration. The analgesic effect, stone removal, follow-up effects and adverse reactions in the two groups was compared. We defined the pain relief rate as(VAS score before treatment-VAS score after treatment)/VAS score before treatment×100%.@*Results@#A total of 100 patients were included in the study, 50 in the observation group and 50 in the control group. There were no statistical difference in the age of the two groups [(41.8±11.7)years and (46.6±13.9 years)], gender distribution [37(male)/13(female) and 42(male)/ 8(female)], location of stones (in the observation group, 19 cases in upper ureter, 7 cases in the middle ureter and 24 cases in the lower ureter; in the control group, 12 cases in the upper ureter, 3 cases in the middle ureter, and 35 in the lower ureter), left and right distribution of stones [21(right)/ 29 (left) and 22 (right)/ 28(left)], long diameter of stones [(5.2±0.9)mm and(5.1±1.1)mm], VAS scores before treatment (7.5±1.4 and 7.6±1.5), and readmission rate [22%(11/50)With 18%(9/50)], 1 week stone removal rate [70%(35/50) and 64%(32/50)]. The incidence of adverse reactions was 8%(4/50) in the observation group including 3 cases of nausea, 1 case of vomiting. The incidence of adverse reactions was 4% in the control group (2/50), which 2 cases showed nausea. The number of patients who chose EPVL, ESWL or surgery for the subsequent treatment in observation group was 35 cases, 9 cases, and 6 cases respectively. The number of patients who chose EPVL, ESWL or surgery for the subsequent treatment in the control group was 35 cases, 10 cases and 5 cases respectively. There was no significant difference between the two groups (P>0.05). The VAS score after treatment of the observation group was lower than that of the control group (2.4±1.3 and 3.7±1.5, P<0.01). The total effective rate of the observation group was higher than that of the control group [94%(47/50) and 76%(38/50), P<0.01]. 46 patients underwent urinary ultrasonography to check the degree of hydronephrosis. The reduction rate of hydronephrosis was higher in the observation group than in the control group [54.5%(18/33) and 30.8%(4/13)], but there was no significant difference between the two groups (P=0.146). In the upper ureteral calculi, the VAS score of the observation group was lower than that of the control group (2.4±0.3 and 3.9±0.4, P<0.01). There was no significant difference in the total effective rate between the two groups. In the lower ureteral calculi, the observation group had low VAS score after treatment. In the control group (2.4±0.2 and 3.5±0.2, P<0.01), there was no significant difference in the total effective rate between the two groups; the middle segment stones were less included (10 in total) and were not discussed.@*Conclusions@#The external physical vibration lithecbole adopts " head high and low position" has better effect than "head low foot high position" in treatment of ureteral calculi with renal colic, and security is acceptable.
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Objective To evaluate the efficacy and safety of different positions external physical vibration lithecbole (EPVL) therapy for ureteral calculi related renal colic.Methods This study was a prospective multicenter randomized controlled trial.The inclusion criteria was that patients volunteered to participate in the trial and signed informed consent,patients' age ranged from 18-65 years old,ureteral calculi related with renal colic,stone diameter was less than 7 mm,patients were not treated with analgesia,antispasmodic drugs.The exclusion criteria was that combination of severe urinary tract infection,severe hydronephrosis,urinary malformation,severe hypertension,history of cerebrovascular disease,vital organ dysfunction,obesity (BMI ＞ 35 kg/m2),history of ureteral calculi exceeded 2 months,abnormal blood coagulation.Patients were randomized into observation group and control group using random number table method.The observation group and the control group were placed on the physical vibration stone arranging machine with head low foot high position and head high foot low position respectively.The inclination angle was 24°.The secondary vibrator vibrated for 6 minutes,then the patient took the prone position and opened the main,the secondary vibrator.The treatment is completed after 6 minutes of vibration.The analgesic effect,stone removal,follow-up effects and adverse reactions in the two groups was compared.We defined the pain relief rate as(VAS score before treatment-VAS score after treatment)/VAS score before treatment × 100％.Results A total of 100 patients were included in the study,50 in the observation group and 50 in the control group.There were no statistical difference in the age of the two groups [(41.8 ± 11.7) years and (46.6 ± 13.9 years)],gender distribution [37(male)/13 (female) and 42(male)/8(female)],location of stones (in the observation group,19 cases in upper ureter,7 cases in the middle ureter and 24 cases in the lower ureter;in the control group,12 cases in the upper ureter,3 cases in the middle ureter,and 35 in the lower ureter),left and right distribution of stones [21 (right) / 29 (left) and 22 (right) / 28 (left)],long diameter of stones [(5.2 ± 0.9) mm and (5.1 ± 1.1) mm],VAS scores before treatment (7.5 ± 1.4 and 7.6 ± 1.5),and readmission rate [22 ％ (11/50) With 18％ (9/50)],1 week stone removal rate [70％ (35/ 50) and 64％ (32/50)].The incidence of adverse reactions was 8％ (4/50) in the observation group including 3 cases of nausea,1 case of vomiting.The incidence of adverse reactions was 4％ in the control group (2/50),which 2 cases showed nausea.The number of patients who chose EPVL,ESWL or surgery for the subsequent treatment in observation group was 35 cases,9 cases,and 6 cases respectively.The number of patients who chose EPVL,ESWL or surgery for the subsequent treatment in the control group was 35 cases,10 cases and 5 cases respectively.There was no significant difference between the two groups (P ＞0.05).The VAS score after treatment of the observation group was lower than that of the control group (2.4 ± 1.3 and 3.7 ± 1.5,P ＜0.01).The total effective rate of the observation group was higher than that of the control group [94％ (47/50) and 76％ (38/50),P ＜ 0.01].46 patients underwent urinary ultrasonography to check the degree of hydronephrosis.The reduction rate of hydronephrosis was higher in the observation group than in the control group [54.5％ (18/33) and 30.8％ (4/13)],but there was no significant difference between the two groups (P =0.146).In the upper ureteral calculi,the VAS score of the observation group was lower than that of the control group (2.4 ± 0.3 and 3.9 ± 0.4,P ＜ 0.01).There was no significant difference in the total effective rate between the two groups.In the lower ureteral calculi,the observation group had low VAS score after treatment.In the control group (2.4 ±0.2 and 3.5 ±0.2,P＜0.01),there was no significant difference in the total effective rate between the two groups;the middle segment stones were less included (l0 in total) and were not discussed.Conclusions The external physical vibration lithecbole adopts " head high and low position" has better effect than "head low foot high position" in treatment of ureteral calculi with renal colic,and security is acceptable.
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Objective To explore the surgical technique and clinical effects of free anterolateral thigh flaps with fascia lata for repair of dorsal tendon and soft tissue defect of ophisthenar.Methods From February,2014 to July,2016,dorsal tendon and soft tissue defect of ophisthenar in 13 cases was repaired by free anterolateral thigh flaps with fascia lata.The area of soft tissue defect was 5.0 cm×6.0 cm-9.0 cm×12.0 cm.Extensor tendon defect and bone exposure occurred in all cases.The area of flap was 6.0 cm×7.0 cm-10.0 cm×13.0 cm,while the area of anterolateral thigh flap was 3.0 cm×4.0 cm-6.0 cm×8.0 cm.The regular post-operatively followed-up was performed.Results All flaps survived.The donor sites healed well without skin graft.The followed-up time was 6-36 months with the average of 13 months.The appearance of the flap was good.The color and texture of flaps was similar to the dorsal skin of ophisthenar.Three female patients who were not satisfied with the flap appearance received the revision and the results were satisfactory.The activity of finger flexion and extension was satisfactory.All patients walked well without difficulty.According to the Upper Extremity Functional Evaluation Standard set up by Hand Surgery Branch of Chinese Medical Association,the function recovery result was excellent in 8 cases,good in 4 cases,and poor in 1 case.Conclusion It is a good method to use the free anterolateral thigh flaps with fascia lata to repair of dorsal tendon and soft tissue defect of ophisthenar.
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Objective To evaluate preoperative oral carbohydrate in patients receiving LC day surgery.Methods 117 patients undergoing LC day surgery in PLA General Hospital from Oct 2016 to Mar 2017 were evenly divided into three groups.Patients in group A took oral carbohydrate preoperatively,group B by iv glucose,group C by overnight fasting.The preoperative thristy and the indicators of inflammation,heart rate,blood glucose,serum insulin,insulin resistance index postoperatively were collected and compared.Results No patients suffered aspiration.There were no complications above Clavien Ⅰ level.Differences in insulin resistance index,fasting serum insulin were statistically significant between group A and group B (Z =-5.60,-4.78,P ＜ 0.05).That of insulin resistance index,fasting serum insulin and procalcitonin between group A and group C were statistically significant (Z =-2.65,-2.49,-4.02,P ＜0.05).Procalcitonin between group B and group C were statistically different (Z =-2.183,P ＜ 0.05).The preoperative thristy between group A and group B,group C were statistically different (x2 =6.47,P ＜ 0.05).Conclusions Preoperative oral carbohydrate intake is safe and feasible with the benefits of improving the quality of life in patients operated on LC day surgery.
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Objective To study internal fixation with Kirschner wire manipulation and suture traction reduction for the treatment of ulnoradial fractures.Methods From January 2013 to December 2016,50 patients with ulnoradial fracture were treated at Orthopaedic Department,Yuyao Chinese Traditional Medicine Hospital.They were divided into 2 equal groups (n =25).In the control group,there were 13 men and 12 women,aged from 21 to 76 years (average,43.8 years);18 right and 7 left sides were involved;there were 14 cases of type A3 and 11 cases of type B3 according to the AO classification.In the observation group,there were 15 men and 10 women,aged from 20 to 78 years (average,44.7 years);19 right and 6 left sides were involved;there were 12 cases of type A3 and 13 cases of type B3 according to the AO classification.The control group was treated by traditional open reduction and internal fixation while the observation group by internal fixation with Kirschner wire manipulation and suture traction reduction.Fracture reduction was evaluated by the Matta criteria and functional recovery by the Berton criteria after surgery.Results The 2 groups were comparable because there were no significant differences in the general data between the 2 groups (P ＞ 0.05).Both groups were followed up for 12 to 24 months with an average of 15.5 months.Follow-ups revealed no neurological dysfunction,postoperative wound infection,improper position of internal fixation,or such complications as internal fixation loosening or breakage.All the fracture eventually healed.The excellent to good rate by the Matta criteria was 92.0％ in the control group and 96.0％ in the observation group;the excellent to good rate one year after surgery by the Berton criteria was 88.0％ in the control group and 92.0％ in the observation group.The differences were not statistically significant (P ＞ 0.05).Conclusion In the treatment of ulnoradial fractures,internal fixation with Kirschner wire manipulation and suture traction reduction is recommendable because its procedures are easy,need simple materials and can be carried out in a common operative theater.
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Objective: To compare the sedation induced by target-controlled infusion of propofol with that by propofol-remifentanil in third molar exaction surgery. Methods: 60 patients for third molar exaction were divided randomly into 2 groups(n = 30): group P(propofol group) and group PR(propofol-remifentanil group). In group P,a titrated infusion of propofol was started until the OAA/S score had reached level 3 in the patients,then the surgery began. In group PR,a infusion of remifentanil with a target plasma concentration of 1 ng /ml and a titrated infusion of propofol was started until the OAA/S score had reached level 3,then the surgery began. In all patients,the heart rate,blood pressure,respiratory rate,oxyhemoglobin saturation and narcotrend index were recorded during the operation. The reactions of the patients in the operation were recorded. The satisfaction of the patients and surgeons was asked. Results: The respiratory rate and the oxyhemoglobin saturation in group PR was lower than those in group P(P ＜ 0. 05). No obvious adverse reaction was observed in the 2 groups. The satisfaction of the patients in the 2 groups was 30 /30 and 30 /30(P＞ 0. 05). Conclusion: The sedation induced by target-controlled infusion of propofol or propofol-remifentanil in third molar extraction is safe. The sedation under target-controlled infusion of propofol-remifentanil is better than that by propofol when inhalating oxygen.
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Objective:To investigate the clinical efficacy of stereotactic radiation therapy combined with temozolomide on recurrent glioma.Methods:A total of 36 patients with recurrent glioma were retrospectively analyzed and divided into a control group (n=12),who received stereotactic radiation therapy,and an experimental group (n=24),who received stereotactic radiation therapy plus temozolomide.The clinical efficacy and adverse reactions for the 2 groups were compared.Results:Total effective rate and local control rate for clinical treatment were 66.67％ and 93.94％,respectively.Late adverse reaction was not observed.The effective rate and local control rate in the experimental group were 77.27％ and 95.45％,which were slight higher than those in the control group,with no statistical significance (P＞0.05).The 0.5-,1-,2-,3-year follow-up total survival rates were 90.91％,63.64％,42.42％,and 15.15％,respectively.The 0.5-,1-,2-,3-year follow-up survival rates in the experimental group were 95.45％,72.72％,54.54％ and 22.73％,respectively,while those in the control group were 81.82％,45.45％,18.18％,and 0％,respectively.Survival analysis showed the survival time for the experimental group was significantly longer than that of the control group (30.00 months vs 14.00 months,P=0.010).Conclusion:Stereotactic radiation therapy combined with temozolomide for recurrent glioma is effective,and it has positive effect on improving the clinical efficacy and survival rate for the patients.
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Objective To evaluate the traditional Chinese medicine(TCM) output efficiency of the coUnty-level TCM hospitals in Jiangsu Province before and after the reimbursement mechanism reform,and to analyze the factors which affect the efficiency of county-level TCM hospitals.Methods Using DEA to analyze the efficiency of county TCM hospitals,and using the Tobit regression to analyze the influence factors.Results The output efficiency of county-level TCM hospitals in Jiangsu Province is low,and the reimbursement mechanism reform in county-level hospitals of TCM efficiency further decreases;payment model,cost model and revenue model of regression analysis indicate that different factors has different influence on output efficiency of county hospitals of TCM.Conclusion The reimbursement strategy of county-level TCM hospitals should be optimized,the balance of revenue and expenditure structure be adjusted,and the intensity of TCM services reimbursement be increased.
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Objective:To explore the value of cone beam CT(CBCT) scanning following parotid sialography in the diagnosis of chronic parotitis.Methods:20 cases of suspected chronic parotitis patients underwent parotid gland sialography followed by CBCT scanning.The images were observed by transverse plane,coronal plane,sagittal plane of multiplanar reconstruction (MPR) and 3D reconstruction.Results:The acinus and ducts system of parotid were clearly displayed from any orientation by MPR and 3D-reconstructed images.The images of 6 cases of chronic recurrent parotitis in CBCT sialography were charactered by punctiform dilatation in whole parotid gland,4 of them showed a normal ductal system,while 2 exhibited expression of ductal inflammation.The images of 14 cases of chronic obstructive parotitis showed irregular ductal dilatations and stenosis.Punctiform dilatations were found in 2 cases,and small filling defects (negative salivary calculi) in 3 cases.Conclusion:CBCT sialography is an effective clinical examination for the diagnosis and treatment chronic parotitis.
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[Summary] To evaluate the relationships between plasma GPC4 levels and HbA1C . Plasma GPC4 levels were measured in subjects with different glucose tolerances. The relationship between plasma GPC4 levels and HbA1C were studied. Increasing levels of GPC4 showed a significant linear trend and were independently associated with HbA1C . GPC4 levels gradually declined after gradually increased , which is similar with Fins, 2hIns, and AUCinsulin . GPC4 may be involved in the regulation of blood glucose and GPC4 may be regulated by insulin.
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The right ventricle owns a complex geometry chamber and a special anatomical structure , which makes it dif-ficult to precisely assess its function .Right ventricular function has been found to be important in the development of cardi -ovascular diseases .This review summarizes recent progress in the characteristics and elevation of right heart function .
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Objective:To observe the effects of different doses of advanced glycosylation end products ( AGEs ) on bFGF expression of cultured rabbit M üller cells in vitro.Methods:Immunocytochemistry and transmission electron microscopy methods were used identified cultured M üller cell.Immunocytochemistry method was used to semi-quantitate bFGF expression of retinal Müller cells at 640 μl/2 000 μl AGEs conditions.We observed effects of AGEs and PKC inhibitor Calphstion C on bFGF mRNA expression .Results:640 μl/2 000 μl AGEs stimulate bFGF expression of retinal Müller cell.Calphostin C inhibits bFGF mRNA increase stimulated by AGEs,and inhibition achieves strongest at concentration 50 nmol/L.Conclusion:AGEs can stimulate bFGF expression of Müller cell to exert the role of angiogenesis .bFGF mRNA expression may be regulated by activation of PKC pathway .
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Objective To investigate the effect and mechanism of pulmonary artery pressure on exercise capacity after acute high altitude exposure .Methods A total of 231 persons were recruited in this study , whose vital signs,SaO2 and physical working capacity ( PWC170 ) exercise capacity were collected .The difference between groups with normal and increased MPAP was observed .Results mean pulmonary artery pressure ( MPAP ) and right ventricle ( RV )-Tei index increased substantially after acute high altitude exposure ,while PWC170 was remarkably decreased .Furthermore,it was found that those whose MPAP increased(MPAP≥25 mmHg)had higher RV-Tei and lower PWC170(P<0.01) in acute high altitude exposure group .Correlation analysis suggested that there were different levels of correlation between MPAP, RV-Tei and PWC170(P<0.01).Conclusion After acute high altitude exposure , the increased pulmonary artery pressure is one of the main causes of lowered exercise capacity .The mechanism may be associated with the decrease of right heart functions .
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Objective To study the application of dynamic ultrasound countercurrent extraction technology in industrialization of Lianhua Qingwen Capsule by multi-index optimization. Methods Ultrasonic temperature and ultrasonic time were investigated by using single factor design. The three factors of dry extract yield, the active ingredient content, and fingerprints were selected as the optimization indexes to investigate the solvent consumption and extraction time between the dynamic ultrasound countercurrent extraction process and the original reflux extraction process under the fixed conditions of process parameters. Results Compared with traditional reflux extraction technology, dynamic ultrasound countercurrent extraction technology effectively reduced the alcohol consumption and saved extraction time on the basis of guarantee of the active ingredient content. Conclusion Dynamic ultrasound countercurrent extraction process, with simple and fast advantages, can be used to Lianhua Qingwen Capsule production, which can significantly reduce production costs and increase productivity.
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Objective:To analyze different age group elderly’s financial burden and risk due to non-communicable chronic diseases (NCDs). Methods:Based on CHARLS baseline investigation data, disease economic burden, disease economic risk for family and disease relative risk are used to analyze the economic risk and economic burden of the different age groups of urban and rural NCDs elderly. Results: The diseases financial burdens of urban NCDs elderly are greater than rural; for diseases family risk and relative risk, NCDs elderly are greater than non-NCDs elderly, urban NCDs elderly are greater than rural, high-age group NCDs elderly are greater than low-age group NCDs elderly. Conclusion: It is needed to improve the NCDs elderly’s medical security ability with basic health insurance, especially to improve medical security ability of the high-age group for rural elderly.
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Objective To investigate the risk factors of pulmonary hypertension (PH) after rapid ascent to high altitude in healthy young Chinese men .Methods A total of 552 non high altitude natives ( healthy young Chinese men ) were recruited in the study between June to August in 2012.The subjects were delivered to high altitude (3700 m) in 2 h by plane from low altitude (450 m).Demographic data including smoking , alcohol consumption , high altitude exposure histo-ry, body mass index (BMI) and age were collected within 24 h after arrival at 3700 m.Furthermore, the oxygen saturation ( SaO2 ) , blood pressure , heart rate , pulmonary artery systolic pressure were measured using the echocardiography system . Analysis of risk factors of PH was performed by logistic regressions .Results The incidence of PH was 23.10%.SaO2 was significantly lower in the higher-pulmonary artery systolic pressure group (higher-PASP)[(86.10 ±3.34)%] than that in the normal-PASP group [(89.09 ±2.65)%, P<0.01].Smoking, alcohol consumption, high altitude exposure history, BMI, age, systolic blood pressure , diastolic blood pressure , heart rate were not significantly different between the two groups mentioned above .Logistic regressions revealed that lower SaO 2 (OR:0.711,95% CI:0.647-0.782, P<0.01) was an independent risks factor of PH .Conclusion Low SaO2 is an independent risk factor of PH upon rapid arrival at 3700 m in healthy young Chinese men .However, smoking, alcohol consumption , high altitude exposure history , BMI, age, blood pressure and heart rate are not risk of PH .These observations will provide valuable clues to theoretical studies on PH and prevention of PH .
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10.3969/j.issn.2095-4344.2013.25.013
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Taking Shinshu University of Japan for example,we attempted to introduce the postgraduate clinical education system for new oral surgeons by analyzing the management of clinical training programs,studies of oral maxillofacial and associated medicine,and practices of scientific research in the department of oral surgery.Their experiences may be useful for us to improve our medical continuing education for young oral surgery residences.
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Objective To study the regulatory effect of ethanol extract of glossy privet fruit and its monomer tyrosol on the adhesion and migration of human epidermal melanocytes.Methods Epidermal melanocytes were isolated from human foreskin,and subjected to a primary culture.Mter 3-5 passages,the melanocytes were treated with various concentrations of ethanol extract of glossy privet fruit (0.0375-0.6 mg/ml)and tyrosol (0.125-2 mmol/L) for 24-72 hours.The XTT colorimetric assay was carried out to evaluate the proliferation of melanocytes,fibronectin (FN)-coated culture plates were used to evaluate the adhesion activity of melanocytes,and Transwell assay was conducted to assess the migration activity of melanocytes.Confocal laser microscopy was utilized to observe the structure and distribution of actin cytoskeleton in melanocytes,and cellular fluorescence intensity was determined by a semi-quantitative analysis.Statistical analysis was carried out by using unpaired t test.Results The adhesion activity of melanocytes to FN was significantly enhanced by the ethanol extract of 0.0375-0.6 mg/ml from glossy privet fruit (P ＜ 0.05 or 0.01),and by tyrosol of 0.5-2 mmol/L (P ＜ 0.05 or 0.01).As XTT assay showed,neither the ethanol extract of 0.15 mg/ml nor tyrosol of 2 mmol/L had cytotoxicity or promotive effect on cell proliferation.Hence,0.15 mg/ml and 2 mmol/L were determined as the working concentrations of ethanol extract and tyrosol respectively.The number of cells migrating through micropore membranes per high-power field (× 200) was 43.7 and 51.0 in melanocytes treated with the ethanol extract of 0.15 mg/ml and tyrosol of 2 mmol/L,respectively,significantly higher than that in untreated melanocytes (20.3,both P ＜ 0.01).Compared with untreated melanocytes,those treated with the ethanol extract of 0.15 mg/ml and those with tyrosol of 2 mmol/L showed higher intracellular fluorescence intensity (P ＜ 0.01) and more stress fiber bundles which congregated inside the cell membrane and around the nuclei.Conclusions The ethanol extract of glossy privet fruit and its monomer tyrosol can promote the adhesion and migration of human melanocytes in vitro,likely by promoting the congregation of actin cytoskeleton in melanocytes.
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To understand the higher medical clinical teaching base teachers'demand for the training of basic teaching skills,we use our self-made questionaire to make a survey on teachers of specialty and the result shows that the trachers of different age and different technical post title have different demand.We thus put forward some suggestions to enhance the clinical teaching base teachers'teaching level