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This study aimed to explore key quality control factors that affected the prognosis of intensive care unit (ICU) patients in Chinese mainland over six years (2015-2020). The data for this study were from 31 provincial and municipal hospitals (3425 hospital ICUs) and included 2 110 685 ICU patients, for a total of 27 607 376 ICU hospitalization days. We found that 15 initially established quality control indicators were good predictors of patient prognosis, including percentage of ICU patients out of all inpatients (%), percentage of ICU bed occupancy of total inpatient bed occupancy (%), percentage of all ICU inpatients with an APACHE II score ⩾15 (%), three-hour (surviving sepsis campaign) SSC bundle compliance (%), six-hour SSC bundle compliance (%), rate of microbe detection before antibiotics (%), percentage of drug deep venous thrombosis (DVT) prophylaxis (%), percentage of unplanned endotracheal extubations (%), percentage of patients reintubated within 48 hours (%), unplanned transfers to the ICU (%), 48-h ICU readmission rate (%), ventilator associated pneumonia (VAP) (per 1000 ventilator days), catheter related blood stream infection (CRBSI) (per 1000 catheter days), catheter-associated urinary tract infections (CAUTI) (per 1000 catheter days), in-hospital mortality (%). When exploratory factor analysis was applied, the 15 indicators were divided into 6 core elements that varied in weight regarding quality evaluation: nosocomial infection management (21.35%), compliance with the Surviving Sepsis Campaign guidelines (17.97%), ICU resources (17.46%), airway management (15.53%), prevention of deep-vein thrombosis (14.07%), and severity of patient condition (13.61%). Based on the different weights of the core elements associated with the 15 indicators, we developed an integrated quality scoring system defined as F score=21.35%xnosocomial infection management + 17.97%xcompliance with SSC guidelines + 17.46%×ICU resources + 15.53%×airway management + 14.07%×DVT prevention + 13.61%×severity of patient condition. This evidence-based quality scoring system will help in assessing the key elements of quality management and establish a foundation for further optimization of the quality control indicator system.
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Traumatic brain injury (TBI) is much more complex considering the unique pathophysiological changes under high-altitude hypoxic environment. Moreover, because of limited source of medical transportation and facilities at high altitude, TBI patients often lack urgent and standard treatment and have to be transported to the district medical center at high altitude or even the neurotrauma center at plain region as soon as possible. The transportation has high risk and takes serious effect on lives and prognosis of the TBI patients. Up to date, the evacuation and support process for TBI patients in the western plateau region of China has been improved through years of practice, but there are still deficiencies compared to the Critical Care Air Transport Team (CCATT). The authors sought to discuss certain issues related to medical evacuation and support after TBI at high altitude from aspects of early damage control operation and timely safety medical transportation, aiming to improve the survival rate, neurological outcomes and life quality for these patients.
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Objective:To investigate the application value of right-hand rule in determining left-right axis and fetal situs in prenatal MRI.Methods:The prenatal MRI data of 254 fetuses were included retrospectively in West China Second University Hospital, Sichuan University from December 2017 to February 2021, which were followed by clear postpartum diagnosis. Fetal left-right axis and situs (orientation of gastric vacuole, liver and heart) were determined by the same radiologist blindly using general experience and right-hand rule respectively, meanwhile, results and time of each case were recorded. The right-hand rule was described in detail below: use your right hand to make a fist, and with thumb outstretched; the fetal head was represented by your right fist, the forearm represented the fetal body, the dorsal side of your fist represented the fetal occiput and spine column, the palm side represented the fetal belly, and your four fingers represented the fetal face, then the left side of fetus was exactly the direction your thumb pointing to. The postpartum imaging was used as the gold standard for situs anomalies. The time to determine the fetal left-right axis was compared using paired t test for statistical analysis. Results:Four fetuses were found situs anomalies in postpartum imaging. There were 1 missed case and 1 misdiagnosed case when using general experience to determine fetal situs, neither missed case nor misdiagnosis were present when using right-hand rule. The average time of using general experience or right-hand rule to determine the fetal left-right axis and situs were (35±6)s and (24±9)s respectively, and the difference was statistically significant ( t=20.65, P<0.001). Conclusions:The right-hand rule is an accurate and efficient method for determining left-right axis and situs in prenatal MRI, which can effectively reduce missed diagnosis and misdiagnosis of situs anomalies, especially in situs inversus totalis.
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Objective To analyze the infection status and epidemic characteristics of Vibrio parahaemolyticus diarrhea cases in Shanghai in recent years， and to explore its influencing factors and provide a basis for the prevention and control of Vibrio parahaemolyticus infection. Methods Food-borne disease surveillance data in Shanghai from 2017 to 2018 was collected， and the infection status and epidemic characteristics of Vibrio parahaemolyticus were analyzed. χ 2 test and multivariate unconditional logistic regression were used to analyze the factors of Vibrio parahaemolyticus infection. Results Among the food-borne surveillance cases in Shanghai from 2017 to 2018， the positive detection rate of Vibrio parahaemolyticus reached 5.1%， and the positive cases were concentrated in July， August， and September. Those working in the catering industry， migrant workers and workers， and the young and middle-aged people （19‒59 years old） have a high incidence. The results of multivariate analysis showed that dining in Qingpu， Songjiang or Minhang District， occupations of migrant workers and workers， age over 19 years old， the third quarter of a year， and the consumption of aquatic animals and related foods are risk factors for Vibrio parahaemolyticus infection. Conclusion The infection of Vibrio parahaemolyticus in Shanghai is still one of the food-borne diseases that warrant our attention. Strengthening food safety management and supervision， and promoting publicity and education for key populations are important for reducing the risk of infection by this pathogen. At the same time， long-term monitoring of infectious diarrhea cases in this city is necessary to dynamically understand the infection and epidemic characteristics of Vibrio parahaemolyticus ， and adjust the annual prevention and control measures in time.
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Objective To analyze the infection status and epidemic characteristics of Vibrio parahaemolyticus diarrhea cases in Shanghai in recent years， and to explore its influencing factors and provide a basis for the prevention and control of Vibrio parahaemolyticus infection. Methods Food-borne disease surveillance data in Shanghai from 2017 to 2018 was collected， and the infection status and epidemic characteristics of Vibrio parahaemolyticus were analyzed. χ 2 test and multivariate unconditional logistic regression were used to analyze the factors of Vibrio parahaemolyticus infection. Results Among the food-borne surveillance cases in Shanghai from 2017 to 2018， the positive detection rate of Vibrio parahaemolyticus reached 5.1%， and the positive cases were concentrated in July， August， and September. Those working in the catering industry， migrant workers and workers， and the young and middle-aged people （19‒59 years old） have a high incidence. The results of multivariate analysis showed that dining in Qingpu， Songjiang or Minhang District， occupations of migrant workers and workers， age over 19 years old， the third quarter of a year， and the consumption of aquatic animals and related foods are risk factors for Vibrio parahaemolyticus infection. Conclusion The infection of Vibrio parahaemolyticus in Shanghai is still one of the food-borne diseases that warrant our attention. Strengthening food safety management and supervision， and promoting publicity and education for key populations are important for reducing the risk of infection by this pathogen. At the same time， long-term monitoring of infectious diarrhea cases in this city is necessary to dynamically understand the infection and epidemic characteristics of Vibrio parahaemolyticus ， and adjust the annual prevention and control measures in time.
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To explore the application value of pushing endoscopic submucosal dissection (PESD) in treatment of large area of early cardiac cancer or precancerous lesions. Form January 2017 to January 2020, patients diagnosed as having early cardiac cancer or high-grade intraepithelial neoplasia with largest lesion diameter greater than 2.0 cm at the Baoding NO.1 Central Hospital were enrolled in the study. Patients who received PESD with water-injected knife were included in the PESD group (26 cases), and compared with those who received conventional ESD with common mucosal incision (the conventional ESD group, 17 cases) at the same period. The procedure time, the complete resection rate of lesions and the incidence of complications were analyzed.There were no difference in lesion size between the two groups ( P>0.05). The procedure time of PESD group was 53.7±18.2 min, which was 91.5±26.5 min in the conventional ESD group, and the difference was statistically significant ( P<0.001). In the PESD group, 7 cases (26.9%) had intraoperative hemorrhage. In the conventional ESD group, 8 cases (47.1%) had intraoperative bleeding, and 2 (11.8%) had intraoperative perforation. There were significant differences in the incidence of hemorrhage and perforation between the two groups (all P<0.001). Compared with conventional ESD, PESD can effectively improve the dissection speed, reduce the incidence of complications, and make endoscopic surgery safer and faster.
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Objective:To implement an intervention with community-dwelling middle-aged and elderly people through a new science promotion approach, and to evaluate changes in the level of bone health awareness.Methods:From April 2017 to June 2017, 200 community-dwelling middle-aged and elderly people aged 50 years and over were randomly included.They were divided into the intervention group receiving a new science promotion intervention(n=100, with 50 males and 50 females)and the control group(n=100, with 50 males and 50 females). Baseline and follow-up assessments of bone health awareness were performed before and after the one-year intervention.A questionnaire survey on preferences for different types of science promotion articles in WeChat accounts was conducted.Differences in scores for intervention effects before and after intervention were compared between the two groups.Potential influencing factors for the scale score were examined by a multi-factor analysis.Results:After one year of intervention, scores for intervention effects were higher in the intervention group than in the control group( P<0.001). In the intervention group, scores were higher after intervention than before intervention( P<0.001). In the control group, scores after follow-up were slightly higher than those at baseline(29.4±11.4 vs.27.9±10.1, P<0.001). The increase in scores before and after intervention was greater in the intervention group than in the control group( P<0.001). Baseline score, group designation, history of drinking and diabetes impacted the scores in middle-aged and elderly women, while other factors did not.Most middle-aged and older people preferred texts illustrated with pictures, and older people were more receptive to videos. Conclusions:The new science promotion method is beneficial to bone health management, can improve bone health awareness in middle-aged and elderly people.
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Objective:To investigate the correlation between white matter hyperintensities (WMHs) and stroke etiology classification in patients with acute isolated penetrating artery territory infarction.Methods:Patients with first-ever acute isolated penetrating artery territory infarction admitted to the Department of Neurology, the Affiliated Hospital of Xuzhou Medical University from January 2017 to May 2020 were enrolled retrospectively. According to the Chinese Ischemic Stroke Subclassification (CISS) system, they were divided into large artery atherosclerosis (LAA) and perforating artery disease (PAD). According to the distribution of infarcts, they were divided into lenticulostriate artery (LSA) territory infarction and paramedian pontine artery (PPA) territory infarction. The demographics, vascular risk factors, baseline clinical data, WMHs location, and Fazekas Scale scores were documented. Multivariate logistic regression analysis was used to identify the independent influencing factors of stroke etiology classification. Results:A total of 440 patients with acute isolated penetrating artery territory infarction were enrolled, including 120 (27.3%) in the LAA group, and 320 (72.7%) in the PAD group; 213 (48.4%) with LSA territory infarction, and 227 (51.6%) with PPA territory infarction. The proportion of patients with total Fazekas score 3-6 and periventricular WMHs (PWMHs) score 2-3 in the PAD group was significantly higher than those in the LAA group (all P<0.05). In patients with LSA territory infarction, the proportion of the patients with hypertension, WMHs total Fazekas score 3-6 and PWMHs score 2-3 in PAD subgroup was significantly higher than those in the LAA subgroup, while the proportion of the patients with hyperlipidemia was significantly lower than that in LAA subgroup (all P<0.05). In patients with PPA territory infarction, the levels of low-density lipoprotein cholesterol and homocysteine in the PAD subgroup were significantly lower than those in the LAA subgroup. Multivariate logistic regression analysis showed that PWMHs score 2-3 was an independent correlation factor of PAD (odds ratio [ OR] 2.220, 95% confidence interval [ CI] 1.085-4.541; P=0.029). In patients with LSA territory infarction, hyperlipidemia was independently correlated with LAA ( OR 0.432, 95% CI 0.192-0.972; P=0.042), and PWMHs score 2-3 was independently correlated with PAD ( OR 3.846, 95% CI 1.193-12.397; P=0.024). In patients with PPA territory infarction, higher low-density lipoprotein cholesterol ( OR 0.660, 95% CI 0.494-0.883; P=0.005), homocysteine ( OR 0.958, 95% CI 0.930-0.987; P=0.005) and C-reactive protein ( OR 0.987, 95% CI 0.977-0.997; P=0.008) were independently correlated with LAA. Conclusions:WMHs are common in patients with acute isolated perforating territory infarction caused by LAA and PAD, and more severe PWMHs suggest that PAD is more likely to be the cause of the acute isolated perforating territory infarction, especially in patients with LSA territory infarction.
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Objective:To investigate the accuracy of colposcopic cervical biopsy in the diagnosis of cervical precancerous lesions and the factors of missed diagnosis of cervical cancer.Methods:A total of 327 cases of gynecological clinic in Liuzhou people's Hospital of Guangxi Zhuang Autonomous Region from January 2018 to May 2019 were selected. All patients underwent colposcopic biopsy and were histologically diagnosed as cervical intraepithelial neoplasia (CIN) Ⅰ, CIN Ⅱ, CIN Ⅲ, chronic cervicitis, cervical carcinoma in situ, and condyloma plana or condyloma-like change. The loop electrosurgical excision procedure (LEEP) was performed for treatment and pathological examination after operation was done. The results of pathological examination after colposcopic cervical biopsy and LEEP operation were compared. Univariate and multivariate logistic regression analysis was performed on the factors affecting missed diagnosis of cervical cancer by colposcopic cervical biopsy.Results:The diagnostic accuracy of colposcopic cervical biopsy for chronic cervicitis was 59.70% (40/67), for condyloma plana or condyloma-like lesions was 51.58% (49/95), for CINⅠ diagnosis was 85.14% (63/74), for CINⅠ, CINⅢ and carcinoma in situ was 73.63% (67/91). A total of 219 patients were consistent with the postoperative pathological results of LEEP, and the total diagnostic accuracy rate was 66.97% (219/327). The postoperative pathological results showed that there were 43 patients (13.15%) with acatalepsia and 48 patients (14.68%) with excessive diagnosis. The results of multivariate logistic regression analysis showed that the area of cervical lesions <50% of the cervix area, unsatisfactory colposcopy image quality, and the patient's age ≥50 years old were independent influencing factors for missed diagnosis of cervical cancer (all P < 0.05). Conclusions:Cervical biopsy under colposcopy has a certain inaccuracy in the diagnosis of cervical precancerous lesions, and it is prone to missed diagnosis of cervical cancer. Clinicians should improve the skills of colposcopy operation, and pay attention to the examination of elderly women and patients with unsatisfactory colposcopy images in order to further reduce the missed diagnosis rate of cervical cancer.
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Objective@#To convey health empowerment and self-concealment of community elderly patients with chronic disease and the correlation between them.@*Methods@#Convenient sampling was used, elderly patients with chronic disease health empowerment questionnaire, self-concealment questionnaire, general demographic information questionnaire were used to survey 490 community elderly patients with chronic disease.@*Results@#The elderly patients′ health empowerment average score was 3.02±0.86, self-concealment average score was 3.38±0.69, health empowerment and self-concealment had significant negative correlation (r=-0.389, P<0.01).@*Conclusions@#The community elderly patients with chronic disease was at a moderate lower level, self-concealment was at a moderate higher level, relative people should decrease the degree of self-concealment of community elderly patients with chronic disease, increase the degree of health empowerment of community elderly patients with chronic disease, so as to promote the physical and psychological health of community elderly patients with chronic disease.
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To investigate the possibility of microsurgical anastomosis of artery, vein and lymphat-ic vessel under 3-dimension screen without eyepiece. Methods During March, 2019, 2 cases (48 and 62 years old) were operated for breast reconstruction, chest wall deformity modified, and axillary scar contracture release, under 3-dimension screen without eyepiece.Deep epigastric artery perforators (artery and vein) dissections were carried on, and microsurgical anastomosis of artery, vein and lymphatic vessel were finished. Coupler was used to do the end-to-end anastomosis of veins (2.5 mm), interrupted suture end-to-end anastomosis with 9-0 nylon for artery (2.0 mm). Reverse arm lymphatic dynamic fluorescence methylene blue tracer under Near Infrared Imaging was used to test the func-tion of lymphatic system. The ends of 2 dominant drainage lymphatic vessels was found in the released axillary area (0.2 mm and 0.3 mm, respectively), and were anastomosis to the vein (0.5 mm) of lateral chest lymphatic tissue.Im-mediate methylene blue tracer under near infrared imaging was used to confirm the patency of lymphatic vessels-veins anastomosis and follow-up post operation. Flap were monitored use HHD. Results Two patients recovered well, and the flaps survived completely with appreciated appearances. The lymphedema of the arms were getting better, the peripheral diameter was reduced by about 2.0 cm compared with that before operation. Conclusion The technique of microsurgical anastomosis of artery, vein and lymphatic vessel without eyepiece under 3-dimension screen is possi-ble and safe.
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Objective To convey health empowerment and self-concealment of community elderly patients with chronic disease and the correlation between them. Methods Convenient sampling was used, elderly patients with chronic disease health empowerment questionnaire, self- concealment questionnaire, general demographic information questionnaire were used to survey 490 community elderly patients with chronic disease. Results The elderly patients′ health empowerment average score was 3.02±0.86, self-concealment average score was 3.38±0.69, health empowerment and self-concealment had significant negative correlation (r=-0.389, P＜0.01). Conclusions The community elderly patients with chronic disease was at a moderate lower level, self-concealment was at a moderate higher level, relative people should decrease the degree of self-concealment of community elderly patients with chronic disease, increase the degree of health empowerment of community elderly patients with chronic disease, so as to promote the physical and psychological health of community elderly patients with chronic disease.
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Objective: To summarize the application progress of indocyanine green (ICG) angiography in diagnosis and treatment of lymphedema. Methods: The literature related to dynamic imaging tracing of lymphedema at home and abroad was reviewed extensively. And the research status and progress of ICG angiography in diagnosis and treatment of lymphedema were retrospectively analyzed. Results: ICG angiography can be used as the gold standard for the diagnosis of lymphedema at present and the classification of lymphedema severity, selection of surgical incisions and methods, and intraoperative operation. It can also be used to observe lymphatic drainage and regeneration within 1.5 cm of subcutaneous and determine the prognosis. Conclusion: Compared with traditional methods, ICG angiography has more obvious advantages and value in diagnosis and treatment of lymphedema. However, it also has problems such as slow development speed and difficulty in developing deep lymphatic vessels (nodes).
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Objective: To establish a UPLC-MS/MS method for the determination of the residual quantity of potential genetoxic impurity 1-(3-dimethylaminopropyl)-3-ethylcarbodiimide (EDC) in ledipasvir.Methods: The chromatographic conditions were as follows: an Agilent ZORBAX SB-C18 (75 mm×4.6 mm, 3.5 μm) column was used with methanol-0.1% formic acid (50∶50) as the mobile phase.The flow rate was 0.3 ml·min-1.The column temperature was 30 ℃ and the injection volume was 5 μl.The mass spectrometry conditions were as follows: electrospray ionization source (ESI), multistage reaction monitoring (MRM), positive ion scanning mode, ion spray voltage of 2 500 V, ion source temperature of 500 ℃, atomization gas of 379.0 kPa, auxiliary gas of 275.6 kPa, curtain gas of 137.8 kPa, collision gas of 41.3 kPa, ion collision energy of 15 V and scan time of 100 ms.The MRM ion pair for quantitative analysis was m/z→156.2/86.1.Results: The linear range of EDC was 0.03-2.25 μg·ml-1 (r=0.999 0).The limit of detection was 0.03 ng and the limit of quantitation was 0.08 ng.The average recovery was 98.3%(RSD=5.7%, n=9).Conclusion: The method is simple, rapid and accurate, and can be used for the quality control of EDC in ledipasvir.
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OBJECTIVE:To develop a method for simultaneous determination of 8 residual organic solvents in esomeprazole magnesium raw material,including ethanol,ethyl acetate,isopropylenzene,methanol,methylbenzene,2-phenyl-2-propanol,dichloromethane and acetonitrile.METHODS:Capillary GC was adopted.The determination was performed on HP-1 column by programmed temperature.The temperature of injector port was 220 ℃,with flame ionization detector at temperate of 250 ℃,using nitrogen as carrier gas,at the flow rate of 4.0 mL/min,with split ratio of 10∶1 and injection volume of 1 μL.RESULTS:The linear ranges of ethanol,ethyl acetate,isopropylenzene,methanol,methylbenzene,2-phenyl-2-propanol,dichloromethane and acetonitrile were 45.2-904 μg/mL(r=0.999 7),45.5-909 μg/mL(r=0.999 7),9.0-180 μg/mL(r=0.999 8),27.1-542 μg/mL(r=0.999 8),8.7-174 μg/mL(r=0.999 7),9.1-183 μg/mL(r=0.999 4),5.8-115 μg/mL(r=0.999 4),3.7-74 μg/mL(r=0.999 4),respectively.The quantitation limits were 4.5,3.0,1.4,2.7,0.6,3.0,3.9,2.8 ng,and the limits of detection were 2.2,1.0,0.4,1.4,0.3,1.0,2.0,1.4 ng,respectively.RSDs of precision tests were all lower than 2.0％.Only ethanol,methanol and methylbenzene were detected in reproducibility test,RSDs of their peak area were lower than 2.0％.The recoveries were 95.6％-104.9％ (RSD=3.3％,n=9),98.7％-102.0％ (RSD=1.1％,n=9),100.0％-103.1％ (RSD=1.1％,n=9),95.7％-104.4％ (RSD=3.0％,n=9),99.3％-104.4％ (RSD=1.7 ％,n=9),95.6％-102.2％ (RSD=2.6％,n=9),95.1％-103.3％ (RSD=2.6％,n=9),97.5％-103.3％ (RSD =1.7 ％,n =9),respectively.CONCLUSIONS:The method is sensitive and simple,and it is suitable for simultaneous determination of 8 residual organic solvents in esomerarazole magnesium raw material.
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<p><b>OBJECTIVE</b>To evaluate the effect of individualized scalp acupuncture base on location of brain function for motor dysfunction in stroke patients.</p><p><b>METHODS</b>A total of 180 patients were randomly assigned into an individualized scalp acupuncture (ISA) group, a conventional scalp acupuncture (CSA) group and a rehabilitation group, 60 cases in each one. In the ISA group, we stimulated Sishencong (EX-HN 1), motor area and balance area, matched with pre-motor area for higher muscle tension, application area and's three-needle for involuntary motion, application area for poor motor coordination, forehead five-needle for cognitive disorder, sensory area for sensory disturbance. In the CSA group, the affected Dingnieqianxiexian (MS 6), Dingniehouxiexian (MS 7) and Zhenxiapangxian (MS 14) were selected. Rehabilitation was used during needle retained in the two groups. Simple rehabilitation was used in the rehabilitation group. All the treatment was given from Monday to Friday for 4 weeks, once a day for 20 times. Eight-week follow-up was applied. The Fugl-Meyer assessment (FMA) for motor function, modified Barthel Index (MBI) were used to evaluate clinical effect.</p><p><b>RESULTS</b>After treatment and at follow-up, FMA and MBI scores increased compared with those before treatment in the three groups（all<0.01）, with significant differences among the three groups (all<0.000 1) and better results in the ISA group compared with those in the other two groups (<0.05,<0.01) at the two time points. The FMA and MBI scores in the CSA group were higher than those in the rehabilitation group after treatment and at follow-up (all<0.05).</p><p><b>CONCLUSION</b>The individualized scalp acupuncture can improve motor dysfunction and self-care ability of daily life for stroke patients.</p>
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Objective To analyze and summarize the short-term clinical efficacy and surgical points of transurethral columnar balloon dilation of prostate for middle-aged and high-risk prostatic hyperplasia patients.Methods A total of 30 patients with benign prostatic hyperplasia(BPH) admitted to our department from March 2016 to December 2016 was retrospectively analyzed,including 9 middle-aged patients(less than 60 years old) and 21 high-risk patients with various underlying diseases(more than 80 years old).Transurethral columnar balloon dilation of prostate was adopted and performed in accordance with standard operation process.Results All 30 patients were operated successfully by extending their prostate at the direction of 12 o'clock to the fat layer with short operation time and less amount of bleeding.The complication rate was 6.7％ (2/30),and the catheter was removed smoothly after the operation.After 1 month and 6 months follow-up,the international prostate symptom score(IPSS),quality of life score(QOL),maximum urinary flow rate(Qmax),residual urine(RUV) and other indicators were analyzed and were statistically significant(P＜0.05).Conclusion Transurethral columnar balloon dilation of prostate is an effective and supplemental method for the treatment of BPH in middle-aged and high-risk patients.
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ObjectiveTo evaluate the clinical efficacy of acupuncture at Waiguan (TE5) and Zhigou (TE6) in treating post-stroke hand spasm.MethodSixty patients with post-stroke hand spasm graded≥Ⅰand≤Ⅲby the Modified Ashworth Scale (MAS) were randomized into a treatment group (30 cases) and a control group (30 cases). The treatment group was intervened by acupuncture at Waiguan and Zhigou plus rehabilitation training, while the control group was by dry rehabilitation training alone. The acupuncture and rehabilitation were performed once a day, 5 sessions a week, totally for 3 months. The change of hand spasm degree was observed by using MAS; the Fugl-Meyer Assessment (FMA) was adopted to observe the change of hand function; the Modified Barthel Index (MBI) was used to observe the change of the activities of daily living (ADL).ResultAfter treatment, there was a significant difference in comparing the MAS score between the two groups (P<0.05); there was a significant difference in comparing the FMA score between the two groups after treatment (P<0.05); after intervention, there was a significant difference in comparing the MBI score between the two groups (P<0.05).ConclusionAcupuncture at Waiguan and Zhigou can significantly improve the hand spasm sate after stroke; acupuncture plus rehabilitation can substantially improve the hand function and ADL of the patients, and can produce a more significant efficacy compared to dry rehabilitation training.
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LU’s acupuncture therapy is one of the representatives of Shanghai schools of traditional Chinese medicine, and has been indexed by Shanghai Intangible Cultural Heritage List and National Intangible Cultural Heritage List, making a profound influence. From the perspectives of its origin, main academic theories, and inheriting study basements of LU’s acupuncture school, this article elucidated and studied LU’s acupuncture therapy, for further promoting LU’s acupuncture school and reviving acupuncture schools of Shanghai region.
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Objective To investigate the level of the peripheral blood percentage of neutrophils(Neu% ) and C reactive protein (CRP) in the early diagnosis of burn infection .Methods A total of 84 burn infection patients were collected from August 2013 to May 2014 ,28 cases with minor burns ,28 cases with moderate burns and 28 cases with severe burns .According to test results of wound infection ,they were divided into infected group with 64 cases and control group with 20 patients .Two milliliter peripheral blood samples were collected and used to measure the WBC ,CRP ,and Neu% .Results In the 84 patients ,66 cases with elevated CRP(78 .6% ) ,43 cases with elevated WBC(51 .2% ) and 57 cases with Neu% (67 .9% ) .The WBC levels in the infected group and control group had no significant different(P>0 .05) ,but there were significant differences on the levels of Neu% and CRP(P0 .05) ,but there were significant differ-ences on the levels of Neu% and CRP(P<0 .05) .Conclusion Neu% ,CRP might reflect the presence or absence of infection in burn patients ,and also increased with the burn degree .The combined detection of CRP and Neu% is more sensitive than the com-bined detection of CRP and WBC .