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【Objective】 To explore the efficacy of flexible ureteroscopic lithotripsy (FURL) under local anesthesia (LA) in the treatment of upper urinary tract calculi, and to analyze the risk factors of pain. 【Methods】 Clinical data of 255 patients treated during Apr.2022 and Sep.2022 were reviewed, including visual analogue score (VAS) of pain during ureteroscopy, sheath placement, holmium laser lithotripsy, 1 hour and 8 hours after operation. VAS ≥5 was defined as significant pain. Clinical and follow-up data of the significant pain group and non-significant pain group were analyzed with logistic regression to analyze the risk factors of pain in FURL under LA. 【Results】 Altogether 198 patients (77.6%) successfully completed the operation, and the stone-free rate (SFR) was 89.9% (178/198). The VAS of ureteroscopy was the highest (4.49±1.08), and 73 patients (28.6%) experienced significant pain. Univariate analysis showed that significant pain was associated with gender, previous surgical history, age, body mass index (BMI), education level, and ASA classification (P<0.05). Multivariate analysis showed that male (OR=2.896, 95%CI:1.413-5.933, P=0.040) and BMI≥28 (OR=7.776, 95%CI:2.268-26.657, P=0.001) were independent risk factors of significant pain, while age ≥65 years (OR=0.237, 95%CI:0.083-0.672, P=0.007) and previous surgical history (OR=0.156, 95%CI:0.032-0.754, P=0.021) were the protective factors. 【Conclusion】 It is feasible and effective to treat upper urinary tract calculi with FURL under LA. The presence of significant pain is associated with factors such as gender, age, BMI and previous surgical history.
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With the development of modern economy and society, trauma has become an important global public health problem. Bone trauma is an important part. Whether it is high-energy complex trauma or low-energy osteoporotic fracture, it puts forward higher requirements for the improvement of mortality and long-term quality of life, and brings new challenges to the traumatic orthopedics.The application of new technologies and the development of treatment strategies have further improved the treatment level of traumatic orthopedics. This article will comment on the research progress of related techniques of traumatic orthopedics in recent years.
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Objective:To systematically evaluate the effect of pars plana vitrectomy (PPV) combined total peeling of internal limiting membrane (ILM) versus fovea-sparing peeling of ILM for myopic foveoschisis.Methods:A evidence-based medicine study. Chinese and English as search terms for myopic foveoschisis, vitrectomy, and peeling of internal limiting membrane were used to search literature in China National Knowledge Infrastructure, Wanfang database, VIP database, PubMed of National Library of Medicine, Medline, Embase, and Cochrane Library. The high myopic macular schisis was selected as the research object, the intervention method was PPV combined with complete ILM peeling and combined with foveal preservation ILM peeling surgery clinical control study between Jan 1, 2010, and Jun 31, 2021. Incomplete or irrelevant literature and review literature were excluded. The method of Newcastle-Ottawa Scale system was used to evaluate the included literature. The literature was meta-analyzed by RevMan5.3 software. The mean difference ( MD) and a confidence interval ( CI) of 95% were used to describe the effect sizes of continuous data, fixed effects model was performed. The data including the best corrected visual acuity (BCVA), central fovea thickness (CFT), and postoperative macular hole (MH) were analyzed. Results:In those databases, 232 articles based search stratery were totally retrieved, and 10 articles (417 eyes) were finally included for meta-analysis with 245 eyes for PPV combined total peeling of ILM and 172 eyes for PPV combined fovea-sparing peeling of ILM. Meta-analysis results showed there was no significant difference in BCVA and CFT between the two groups (BCVA: MD=0.05, 95% CI 0.00-0.11; P>0.05; CFT: MD=-4.79, 95% CI -18.69-9.11, P>0.05). It was compared with the incidence of MH, the difference was statistically significant (odds ratio=5.70, 95% CI 2.22-14.61, P<0.05). Conclusion:BCVA and CFT could be improved by PPV combined total and fovea-sparing peeling of ILM for myopic foveoschisis; compared with complete ILM peeling, the incidence of MH was lower after foveal-sparing ILM peeling.
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Objective:To compare the clinical outcomes between replacement with a composite press-fit radial head prosthesis versus open reduction and plate-screw internal fixation in the treatment of adult Mason Ⅲ radial head fractures.Methods:The clinical data of 64 adult patients with Mason Ⅲ radial head fracture were retrospectively analyzed who had been admitted to Department of Orthopedics, Beijing Friendship Hospital from January 2012 to December 2019. They were 18 males and 46 females, aged from 32 to 58 years (average, 45.7 years). They were divided into 2 groups: 32 cases received mini-plate-screw internal fixation (internal fixation group) and 32 cases replacement with a composite press-fit radial head prosthesis (replacement group). At the last follow-up, elbow valgus angle, range of elbow motion, Mayo score of elbow function and visual analogue scale (VAS) pain score were recorded and compared to evaluate the postoperative clinical outcomes.Results:There was no statistically significant difference in the preoperative general data between the 2 groups, showing they were comparable ( P>0.05). All patients were followed up for 8 to 48 months (average, 18.7 months). The operation time was, respectively, (81.4±8.2) min and (68.9±7.3) min for the internal fixation group and the replacement group, showing a statistically significant difference ( P< 0.05). For the internal fixation group and the replacement group at the last follow-up, the flexion and extension angles were 95° to 125° and 100° to 140°, the rotation angles 135.3°±11.2° and 143.5°±12.8°, and the Mayo scores 79.2±3.8 and 83.4±3.9, all significantly favoring the replacement group ( P<0.05). The VAS pain scores before operation and at the last follow-up were 7.6±0.7 and 0.9±0.7 for the internal fixation group, and 7.9±0.8 and 0.7±0.6 for the replacement group, showing significant differences between preoperation and the last follow-up in both groups ( P<0.05). All the incisions healed by the first intention, with no postoperative infection. Internal fixation loosening with ulnar neuritis was reported in one case in the internal fixation group; peri-prosthesis absorption with no prosthesis loosening was observed in one case in the replacements group. Conclusion:In the treatment of adult Mason Ⅲ radial head fractures, although both replacements with a composite press-fit radial head prosthesis and open reduction and plate-screw internal fixation can lead to satisfactory results, the former may be more effective.
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Recent studies have shown that acute blood glucose elevation in patients with ST-segment elevation myocardial infarction (STEMI) suggests a poor prognosis. To investigate the effect of fasting blood glucose (FBG) on the risk of heart failure (HF) and left ventricular systolic dysfunction (LVSD) in non-diabetic patients undergoing primary percutaneous coronary intervention (PCI) for acute STEMI, we retrospectively recruited consecutive non-diabetic patients who underwent primary PCI for STEMI in our hospital from February 2003 to March 2015. The patients were divided into two groups according to the FBG level. A total of 623 patients were recruited with an age of 61.3 ± 12.9 years, of whom 514 (82.5%) were male. The HF risk (odds ratio 3.401, 95% confidence interval (CI) 2.144-5.395, P < 0.001) was significantly increased in patients with elevated FBG than those with normal FBG. Elevated FBG was also independently related to LVSD (β 1.513, 95%CI 1.282-1.785, P < 0.001) in a multiple logistics regression analysis. In conclusion, elevated FBG was independently associated with 30-day HF and LVSD risk in non-diabetic patients undergoing primary PCI for STEMI.
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Aged , Female , Humans , Male , Middle Aged , Fasting , Glucose , Heart Failure , Percutaneous Coronary Intervention , Prognosis , Retrospective Studies , Risk Factors , ST Elevation Myocardial Infarction/surgeryABSTRACT
Objective To summarize CT and MRI features of hyaline vascular type localized Castleman disease(LCD)and analyze the causes of misdiagnosis,to improve the preoperative diagnosis rate.Methods The clinical and imaging data of 7 patients with hyaline vascular type LCD confirmed by operation and pathology were analyzed retrospectively.Results (1)6 cases were misdiagnosed before operation,1 case was misdiagnosed as pancreatic neuroendocrine tumor,1 case as thymoma,1 case as neurogenic tumor,1 case as pheochromocytoma, 1 case as clear cell renal cell carcinoma and 1 case as small mesenteric stromal tumor.(2)1 case was located in the right neck,1 case in the anterior superior mediastinum,1 case in the neck of the pancreas,1 case in the upper part of the left kidney,2 cases in the retroperitoneum and 1 case in the lower abdomen.(3)3 cases were scaned by dynamic enhanced MRI,3 cases were scaned by dynamic enhanced CT, and 1 case was checked by plain CT and enhanced MRI.CT and MRI showed that 7 cases had a round or elliptical soft tissue mass, and 4 cases with well defined margin,3 cases were not clear in edge,2 cases with spot or strip calcification on CT images,4 cases had slightly longer T1 and longer T2 signal,4 cases were restricted of diffusion and had higher signal on DWI.All the lesions were enhanced in arterial phase,and went on in the delayed phase.There were 5 cases with distorted vascular shadow in the middle and/or around of the mass, 3 cases with strips,spoke-like low-density areas or low-signal areas,and some lesions were filled in delayed phase.Conclusion CT and MRI features of hyaline vascular type LCD have certain characteristics such as rich blood supply,enhancement in persistent,tortuosity of peripheral vascular,with some short strip calcification and high signal on DWI,which may be helpful for preoperative diagnosis.
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Arsenic is a pollutant widely distributed in the natural environment.The liver is one of the main target organs of arsenic toxicity.Arsenic causes liver damage and liver disease by affecting the imbalance of hepatocyte apoptosis.However,its specific mechanism is not very clear.In this paper,the research on pathways and influencing factors of arsenic-induced hepatocyte apoptosis in recent years is reviewed,which might provide a reference for the mechanism study and clinical prevention of liver injury in the future.
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Accelerated forgetting has been identified as a feature of Alzheimer's disease (AD), but the therapeutic efficacy of the manipulation of biological mechanisms of forgetting has not been assessed in AD animal models. Ras-related C3 botulinum toxin substrate 1 (Rac1), a small GTPase, has been shown to regulate active forgetting in Drosophila and mice. Here, we showed that Rac1 activity is aberrantly elevated in the hippocampal tissues of AD patients and AD animal models. Moreover, amyloid-beta 42 could induce Rac1 activation in cultured cells. The elevation of Rac1 activity not only accelerated 6-hour spatial memory decay in 3-month-old APP/PS1 mice, but also significantly contributed to severe memory loss in aged APP/PS1 mice. A similar age-dependent Rac1 activity-based memory loss was also observed in an AD fly model. Moreover, inhibition of Rac1 activity could ameliorate cognitive defects and synaptic plasticity in AD animal models. Finally, two novel compounds, identified through behavioral screening of a randomly selected pool of brain permeable small molecules for their positive effect in rescuing memory loss in both fly and mouse models, were found to be capable of inhibiting Rac1 activity. Thus, multiple lines of evidence corroborate in supporting the idea that inhibition of Rac1 activity is effective for treating AD-related memory loss.
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Objective@#To analyze the diagnosis and treatment of acute myeloid leukemia (AML) complicated with myeloid sarcoma (MS).@*Methods@#The clinical features, diagnosis and therapy of 3 AML who were treated with routine regimen induction and consolidation therapy in Shanghai Beizhan Hospital and showed MS during the marrow remission stage were retrospectively analyzed.@*Results@#Three female patients included 2 cases of CBFβ-MYH11 positive and 1 case of AML1-ETO positive. One patient occurred in the first complete remission(CR1) and 2 patients occurred in CR2. The involved sites included brain, vagina, and breast respectively. Three patients all received short efficacy after chemotherapy, including 1 patient in bone marrow remission stage, 1 patient died of after bone marrow relapse and 1 patient without follow-up.@*Conclusions@#For AML patients in remission with extramedullary lesions, pathological examination is warranted to confirm the diagnosis of the disease. Systemic chemotherapy is still the main treatment for MS. Central nervous system(CNS) leukemia treatment should be performed to the patients with CNS involved. Allogeneic hematopoietic stem cell transplantation may be the best option for the treatment of these patients.
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Objective To quantitatively analyze the operation risks for femoral intertrochanteric frac-tures under the guidance of Acute Physiology and Chronic Health EvaluationⅡ( APACHEⅡ) . Methods A retrospective analysis was performed among the 226 patients with femoral intertrochanteric fracture who had re-ceived surgery between January 2013 and January 2016. They were 59 men and 167 women, aged from 69 to 106 years ( average, 75. 4 ± 6. 1 years ) . Their average APACHEⅡscore was 18. 3 ± 6. 3 ( from 5 to 34 ) . They were divided into 3 groups according to their APACHEⅡscores: 127 cases in the low risk group (≤ 15 ) , 68 cases in the medium risk group ( from 16 to 24 ) and 31 cases in the high risk group ( ≥25 ) . The mortality was compared between the 3 groups. The deaths and survivals were compared in each group in terms of age, oper-ation time, intraoperative blood loss, postoperative blood transfusion and combined internal diseases. Results Thirteen patients died during hospitalization, giving a mortality of 5. 7％ ( 13/226 ) . The causes for death were heart attack in 6 cases, respiratory failure in 4, toxic shock in 2 and renal failure in one. The mortality in the high risk group ( 22. 6％, 7/31 ) was significantly higher than in the low risk group ( 1. 6％, 2/125 ) and in the medium risk group ( 5. 9％, 4/68 ) ( P <0. 05 ) . In the low risk group, the intraoperative blood loss was sta-tistically different between deaths and survivals ( P <0. 05 ); in the medium risk group, the intraoperative blood loss and postoperative blood transfusion volume were statistically different between deaths and survivals ( P <0. 05 ); in the high risk group, the age and intraoperative blood loss were statistically different between deaths and survivals ( P <0. 05 ) . Conclusions APACHEⅡcan be used to quantitatively evaluate the patients with femoral intertrochanteric fracture who usually suffer from intraoperative complications and concomitant in-ternal diseases. The most significant risk factor may be intraoperative blood loss.
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Objective To investigate the influence of chronic periodontitis on implant survival rate and clinical indicators after implant restoration .Methods The chronic periodontitis dentition defect 50 patients ( group A ) and periodontal health dentition defect 50 patients (group B) with implant prosthesis were selected as the study objects . The implant retention and the amount of marginal bone loss , improved plaque index , modified bleeding index and probing depth at 3 months,6 months,12 months and 24 months after restoration were observed .Results The implant survival rate of group A (93.9％) and group B (95.7％) had no statistically significant difference (χ2 =0.339,P>0.05).The amount of marginal bone loss of group A at 3 months,6 months,12 months and 24 months were (0.41 ± 0.12)mm,(0.99 ±0.14)mm,(1.16 ±0.32)mm,(1.25 ±0.43)mm,respectively,which of group B were (0.38 ± 0.09)mm,(0.87 ±0.25)mm,(1.08 ±0.27)mm,(1.19 ±0.49)mm,respectively,the differences were not statisti-cally significant (t=0.712,0.613,0.426,0.412,all P>0.05).The modified plaque index of group A at 3 months, 6 months,12 months and 24 months were (1.14 ±0.12),(1.21 ±0.38),(1.38 ±0.21),(1.41 ±0.26),respectively,which of group B were (0.97 ±0.08),(1.18 ±0.34),(1.27 ±0.29),(1.35 ±0.22),the differences were not statistically significant (t=0.869,0.683,1.521,0.967,all P>0.05).The modified bleeding index of group A at 3 months, 6 months,12 months and 24 months were (0.34 ±0.09),(0.41 ±0.05),(0.64 ±0.13),(0.71 ±0.12),respectively,which of group B were (0.36 ±0.07),(0.44 ±0.12),(0.56 ±0.11),(0.62 ±0.14),the differences were not statistically significant (t=0.758,0.534,1.021,0.784,all P>0.05).The probing depth of group A at 3 months,6 months, 12 months and 24 months were (1.57 ±0.23) mm,(1.97 ±0.38) mm,(2.01 ±0.32) mm,(2.05 ±0.28) mm,respectively,which of group B were (1.48 ±0.16)mm,(1.81 ±0.33)mm,(1.83 ±0.37)mm,(1.84 ±0.31)mm, the differences were not statistically significant (t=0.783,0.934,0.376,0.745,P>0.05).Conclusion Chronic periodontitis with implant prosthesis treatment after periodontal therapy has no significant effect on implant retention rate and marginal bone loss ,improved plaque index ,modified bleeding index and probing depth .
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Objective To evaluate the diagnostic value of six-slice coronal reformations in patients with acute midepigastric pain. Methods A total of 974 patients with acute midepigastric pain were included in this study and divided into group A(coronal reformation)and group B(non-coronal reformation).For group A,reconstructed coronal and oblique-coronal images were acquired.A comprehensive diagnosis was made based on coronal reformations and axial planes.Anatomical nomenclature was adopted,including kidney-ureter plane,abdominal aorta plane,superior mesenteric artery plane,ascending colon-appendix plane,stomach-cholecyst plane and colon-small intestine plane.For group B,the diagnosis was made based on axial planes.Finally,a comprehensive analysis was made,missed cases in these two groups were counted and compared,and statistical analysis was performed using the SPSS software(version SPSS V17).Results For group A,the missed diagnosis was made in 12 cases(1.23%)and it was 53 cases(6.58%)for group B.There was a statistically significant difference between two groups(P<0.05).Conclusion Combined with axial planes or oblique coronal reformations,six-sclice coronal reformation can reduce the the rate of missed diagnosis of acute midepigastric pain.
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Objective To compare the clinical effects of the T-type volar locking compression plate and variable angle two-column locking compression plate in treatment of 118 cases with distal radial fractures.Methods Retrospectivly analyzed the clinical data of distal radius fracture cases from Dec.2011 to Nov.2015 in Department of Orthopedics,Beijing Friendship Hospital,Capital Medical University who were respectively underwent T-type locking compression plate and variable angle two-column locking compression plate.The T-type locking compression plate group of 60 cases;according to AO/OTA classification,including 3 cases of type A3,type B2 5 cases,type B3 7 cases,type C1 10 cases,typc C2 20 cases,type C3 in 15 cases.The variable angle two-column locking compression plate variable angle two-column locking compression plate group 58 cases;according to AO/OTA classification,including 1 cases of type A3,type B2 2 cases,type B3 4 cases,type C1 15 cases,type C2 18 cases,type C3 18 cases.Comparative analysis of two groups of postoperative radiographic parameters and functional recovery.Palm angle,ulnar deviation angle,radius height,wrist joint activity and G-W function score were measured by ((x) ± s),and the comparison was performed t test.Results All patients were followed up,mean follow-up time of T-type locking compression plate group was 26.5 months,the mean follow-up time of variable angle two-column locking compression plate group was 25.6 months.The results showed that there were no significant differences between the two groups in ulnar deviation angle,radius height,radial deviation angle and Gartland-Werley function score.There was significant difference between the two groups in the angle of palm angle,wrist dorsal extension,palmar flexion,ulnar deviation,Wrist rotation,and variable angle two-column locking compression plate had advantages.Conclusion Two kinds of treatment of distal radius fractures were satisfactory clinical efficacy,and variable angle two-column locking compression plate had more advantages,doctors can choose corresponding fixation methods according to the specific situation of patients.
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Objective To explore the clinical value of the monitoring of electronic cardiac index (CI) in the evaluation of neonatal congenital heart disease complicated with heart failure. Methods Sixty neonates with congenital heart disease treated in neonatal department from March 1, 2016 to December 30, 2016 were selected, and divided into severe group (n=11), moderate group (n=15), mild group (n=34), and no heart failure group (n=10) according to the modified Ross heart failure score. CI was measured by electronic force measurement. Left ventricular ejection fraction (LVEF) and pulmonary arterial pressure (PAP) were measured by echocardiography. Venous blood sampling was collected to detect the N-terminal type B brain natriuretic peptide (NT-proBNP). Results The neonates in the severe group were mainly under 2-week-old, while those in the mild group and the moderate group were more than 2-week-old. The differences of CI, LVEF, NT-proBNP, and PAP among the groups were statistically different. The CI and LVEF values were lowest in the severe group, followed by moderate group and mild group, and the highest in no heart failure group. The NT-proBNP and PAP values were the highest in the severe group, followed by moderate group and mild group, and the lowest in no heart failure group. Correlation analysis showed that CI was positively correlated with LVEF (r=0.845, P<0.001), and negatively correlated with NT-proBNP (r=-0.886, P<0.001); CI and PAP were weakly negatively correlated (r=-0.595, P<0.001). Conclusions CI reflects the degree of heart failure to some extent and has some clinical value.
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Objective To compare the clinical effects of the T-type volar locking compression plate and variable angle two-column locking compression plate in treatment of 118 cases with distal radial fractures.Methods Retrospectivly analyzed the clinical data of distal radius fracture cases from Dec.2011 to Nov.2015 in Department of Orthopedics,Beijing Friendship Hospital,Capital Medical University who were respectively underwent T-type locking compression plate and variable angle two-column locking compression plate.The T-type locking compression plate group of 60 cases;according to AO/OTA classification,including 3 cases of type A3,type B2 5 cases,type B3 7 cases,type C1 10 cases,typc C2 20 cases,type C3 in 15 cases.The variable angle two-column locking compression plate variable angle two-column locking compression plate group 58 cases;according to AO/OTA classification,including 1 cases of type A3,type B2 2 cases,type B3 4 cases,type C1 15 cases,type C2 18 cases,type C3 18 cases.Comparative analysis of two groups of postoperative radiographic parameters and functional recovery.Palm angle,ulnar deviation angle,radius height,wrist joint activity and G-W function score were measured by ((x) ± s),and the comparison was performed t test.Results All patients were followed up,mean follow-up time of T-type locking compression plate group was 26.5 months,the mean follow-up time of variable angle two-column locking compression plate group was 25.6 months.The results showed that there were no significant differences between the two groups in ulnar deviation angle,radius height,radial deviation angle and Gartland-Werley function score.There was significant difference between the two groups in the angle of palm angle,wrist dorsal extension,palmar flexion,ulnar deviation,Wrist rotation,and variable angle two-column locking compression plate had advantages.Conclusion Two kinds of treatment of distal radius fractures were satisfactory clinical efficacy,and variable angle two-column locking compression plate had more advantages,doctors can choose corresponding fixation methods according to the specific situation of patients.
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Objective To explore the clinical value of the monitoring of electronic cardiac index (CI) in the evaluation of neonatal congenital heart disease complicated with heart failure. Methods Sixty neonates with congenital heart disease treated in neonatal department from March 1, 2016 to December 30, 2016 were selected, and divided into severe group (n=11), moderate group (n=15), mild group (n=34), and no heart failure group (n=10) according to the modified Ross heart failure score. CI was measured by electronic force measurement. Left ventricular ejection fraction (LVEF) and pulmonary arterial pressure (PAP) were measured by echocardiography. Venous blood sampling was collected to detect the N-terminal type B brain natriuretic peptide (NT-proBNP). Results The neonates in the severe group were mainly under 2-week-old, while those in the mild group and the moderate group were more than 2-week-old. The differences of CI, LVEF, NT-proBNP, and PAP among the groups were statistically different. The CI and LVEF values were lowest in the severe group, followed by moderate group and mild group, and the highest in no heart failure group. The NT-proBNP and PAP values were the highest in the severe group, followed by moderate group and mild group, and the lowest in no heart failure group. Correlation analysis showed that CI was positively correlated with LVEF (r=0.845, P<0.001), and negatively correlated with NT-proBNP (r=-0.886, P<0.001); CI and PAP were weakly negatively correlated (r=-0.595, P<0.001). Conclusions CI reflects the degree of heart failure to some extent and has some clinical value.
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Objective To compare various risk factors of bipolar disorders with and without suicidal behavior. Methods A total of 5452 inpatients were divided into 2 groups; with (n=1739)and without (n=3713) suicidal behavior within 1 week. Socio-demographic and clinical data were compared between two groups. Multiple logistic regression models were used to assess risk factors of bipolar disorders with suicidal behavior. Results Compared to without suicidal behavior group, the suicidal behavior group had significantly higher rate of the following characteristics:older age [34.8±13.6 vs. 33.3±12.8, t=-3.46, P<0.01], female (58.3％vs. 52.7％,χ2=14.83, P<0.01), history of mental trauma (10.6％vs.7.8％,χ2=10.72, P<0.01), history of suicide (4.1％vs. 0.1％,χ2=140.11, P<0.01), family history of suicide (6.7％vs. 3.9％,χ2=20.22, P<0.01), family history of mental illness (33.8％vs. 29.6％,χ2=9.33, P<0.01) and history of suicide (4.1％ vs. 0.1％, χ2=140.11, P<0.01). Logistic regression analysis showed that female (OR: 1.192, 95％CI:1.043-1.363), older age (OR: 1.008, 95％CI: 1.003-1.013), history of mental trauma (OR: 1.355, 95％CI:1.083-1.696), history of suicide (OR:39.139, 95％CI:12.230-125.256) and family history of suicide (OR:1.648, 95％CI: 1.223-2.221) were significantly correlated with suicidal behavior in bipolar disorders. Conclusions The study indicates that female, older age, history of mental trauma, history of suicide and family history of suicide may be the key independent risk factors to suicidal behavior in bipolar disorders.
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Objective To investigate the trend of early neural development in premature infants. Methods At the age of 12 months and 24 months, Bayley Scales of Infant Development were used to assess the mental development index (MDI) and the psychomotor development index (PDI) in preterm (corrected age) and full-term infants. Results At 12 months, there was no significant difference in corrected age PDI scores among different gestational age groups (<32 , 32–33+6 and 34–36+6 weeks) (P=0.820). The actual age MDI and PDI scores of full-term infants and premature infants in 34~36+6 weeks group were significantly higher than those of premature infants in <32 and 32-33+6 weeks groups, and the PDI score of full-term infants was significantly higher than that of premature infants in 34-36+6 weeks group (P<0.05). There was no significant difference in actual age PDI scores among different birth weight groups (P=0.166). The actual age MDI and PDI of full-term infants and premature infants in birth weight≥2500 g group were significantly higher than those of premature infants in <1500 g, 1500~1999 g and 2000~2499 g groups (P<0.05). At 24 months, the actual age MDI scores of full-term infants were significantly higher than those of premature infants in different gestational age and birth weight groups (P<0.05). The actual age MDI curve of premature infants in birth weight <1500g group showed a downward trend, while the actual age PDI curve showed a significant upward trend. Conclusion The neurodevelopment of preterm infants at the corrected age of 12 and 24 months reaches the level of full-term infants.
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Objective · To evaluate the efficacy and prognostic factors of ifosfamide-cisplatin-etoposide (ICE) chemotherapy as salvage regimen for patients with relapsed/refractory diffuse large B-cell lymphoma (DLBCL).Methods · A retrospective analysis was performed on 84 relapsed/refractory DLBCL patients who were treated with ICE salvage regimen at Ruijin Hospital (Shanghai Jiao Tong University School of Medicine,China) from July 2004 to June 2016.Overall survival (OS) was analyzed by Kaplan-Meier method and multivariate Cox proportional hazards models.Results· Of the 84 patients who were treated with ICE regimen,37 (44.0％) patients had responses,including 26 (31.0％) achieving complete remission.The median number of cycles per patient was 3 (range 1-6 cycles).The 1-year and 2-year OS rates were 49.5％ and 30.0％,respectively.The median OS time was 12.2 months.On univariate analysis,patients with early progression/recurrence (P=0.041) and a high-intermediate/high risk according to the international prognostic index (IPI) (P=0.024) and NCCN-IPI (P=0.002) had poorer outcomes.While improved outcome was found in patients in complete remission after chemotherapy (P=0.000).The multivariate analysis revealed that the intermediate-high/high risk according to NCCN-IPI was an independent risk factor,and remission after chemotherapy was an independent prognostic factor for prolonging survival.Conclusion· The ICE regimen can be used as an effective salvage therapy for patients with relapsed/refractory DLBCL.
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AIM:To investigate the effect and mechanism of Aztreonam combined Azithromycin on Pseudomonas aeruginosa ATCC 27853,and clinical separation of 15 strains of Pseudomonas aeruginosain vitro.METHODS:Broth dilution method and checkerboard dilution method were used to determine Aztreonam alone or in combination with Azithromycin on Pseudomonas aeruginosa ATCC27853 and 15 clinical isolates of Pseudomonas aeruginosa.Then,the biofilm formation of the clinical separation of 15 strains of Pseudomonas aeruginosa was identified by Congo red plate method.The crystal violet experiment was used to compare the ability of biofilm formation of Pseudomonas aeruginosa.Growth curve and viable count of Pseudomonas aeruginosa biofilm were investigated by continuous dilution method.The silver staining method was used to observe the biofilm of Pseudomonas aeruginosa by Aztreonam alone and in combination with Azithromycin.RESULTS:Azithromycin combined with Azithromycin on Pseudomonas aeruginosa ATCC 27853 showed synergistic effect;of the 15 isolates of Pseudomonas aeruginosa,6 were synergistic,6 additive,and 3 irrelevant.Congo red plate experiments show that the clinical separation of 15 strains of Pseudomonas aeruginosa,12 strains can formed biofilm,3 did not formed biofilm,and the rate of biofilm formation was 80％.The results of crystal violet experiment showed that the biofilm formation ability of 16091217 was the strongest when compared with other strains.The continuous dilution method of viable bacteria count experiment showed that the number of viable bacteria in Azithromycin group,Aztreonam group was significantly different compared with Azithromycin + Aztreonam group.The silver staining method showed that the inhibition effect of Azithromycin on the formation,early and mature stages of biofilm formation.CONCLUSION:The study found that the effect of Aztreonam combined with Azithromycin was mainly synergistic and additive in vitro.Aztreonam combined with Azithromycin presents synergistic bactericidal effect on Pseudomonas aeruginosa biofilm formation.