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1.
Chinese Journal of Nephrology ; (12): 465-473, 2021.
Article in Chinese | WPRIM | ID: wpr-911875

ABSTRACT

Objective:To investigate the effects of hyperuricemia on the prognosis of IgA nephropathy (IgAN) using propensity score matching (PSM) method.Methods:IgAN patients proven by biopsy were included. PSM was used to match patients. Kaplan-Meier method was used for survival analysis, and Cox regression analysis was used to analyze the effects of hyperuricemia on IgAN prognosis. Primary outcome events were defined as death, or end-stage renal disease (dialysis, transplantation), or a decrease in estimated glomerular filtration rate (eGFR) greater than 40%. Renal outcome was defined as end-stage renal disease (dialysis, transplantation), or a decrease in eGFR greater than 40%.Results:A total of 1 454 IgAN patients were included in this study, including 850 females and 604 males. Uric acid level was (368.26±92.87) μmol/L in the males, and (277.23±92.71) μmol/L in the females. The median follow-up time was 85.00(56.10, 106.33) months. During the follow-up period, a total of 134 patients reached the primary outcome events, including 5 deaths, 24 dialysis patients, 5 kidney transplant patients, and 100 patients with eGFR decreased by more than 40%. After 1∶1 matching, 131 males and 159 females in the hyperuricemia group were successfully matched with 131 males and 159 females in the normal uric acid group, and there was no significant statistical difference in each parameter in baseline between the hyperuricemia group and normal uric acid group after matching. Kaplan-Meier survival analysis showed that either before or after matching, the incidence of primary outcome events in male or female patients with hyperuricemia was higher than those with normal uric acid, but there was no statistically significant difference in incidence of primary outcome events between female hyperuricemia group and female normal uric acid group after matching (Log-rank test, χ2=3.586, P=0.058). Cox proportional hazard regression model showed that, in the pre-match fully adjusted model, the hazard ratio ( HR) of entering primary outcome events was 2.29-fold (95% CI 1.27-4.11, P=0.006) for men with hyperuricemia and 1.85-fold (95% CI 1.01-3.37, P=0.045) for women with hyperuricemia compared with those with normal uric acid. In the post-match fully adjusted model, the HR of entering primary outcome events was 2.41-fold (95% CI 1.18-4.93, P=0.016) for men with hyperuricemia and 1.83-fold (95% CI 0.91-3.67, P=0.091) for women with hyperuricemia compared with those with normal uric acid. In the pre-match fully adjusted model, the HR of entering renal outcome events was 2.68-fold (95% CI 1.47-4.88, P=0.001) for men with hyperuricemia and 1.81-fold (95% CI 0.99-3.33, P=0.056) for women with hyperuricemia compared with those with normal uric acid. In the post-match fully adjusted model, the HR of entering renal outcome events was 2.89-fold (95% CI 1.36-6.15, P=0.006) for men with hyperuricemia and 1.81-fold (95% CI 0.88-3.72, P=0.106) for women with hyperuricemia compared with those with normal uric acid. Conclusion:Hyperuricemia may be associated with IgAN progression, and it has a more significant effect on male IgAN patients.

2.
Article in Chinese | WPRIM | ID: wpr-906399

ABSTRACT

Objective:To investigate the efficacy of Baxian Xiaoyaotang (BXT) in treating ankylosis of wind-cold-dampness obstruction syndrome after acute Achilles tendon rupture surgery and its effects on transforming growth factor-<italic>β</italic><sub>1</sub> (TGF-<italic>β</italic><sub>1</sub>), insulin-like growth factor-1 (IGF-1), and epidermal growth factor (EGF). Method:According to the visiting sequence, 66 patients with fresh closed Achilles tendon rupture were included and randomly divided into a treatment group (<italic>n</italic>=33) and a control group (<italic>n</italic>=33). Patients in both groups underwent surgical repair, followed by immobilization in long-leg brace, which was then replaced by the boot brace in the fourth week, with the plantar-flexion angle adjusted correspondingly. Six weeks later, the brace was removed for accelerated functional rehabilitation training. On this basis, patients in the treatment group were further instructed to fumigate and wash the affected Achilles tendon with BXT, twice a day, for 45 d. The Leppilahti Achilles tendon performance scores and American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot scores between the two groups were compared at the time of brace removal and the third, sixth, and twelfth months after surgery. The strength of triceps surae on the affected side was evaluated at the last follow-up visit. The serum TGF-<italic>β</italic><sub>1</sub>, IGF-1, and EGF levels were detected before and after treatment. The wind-cold-dampness obstruction syndrome scores, symptom scores, the changes in foot dorsiflexion angle, and the overall clinical efficacy were compared. Result:The changes in scores of patients receiving different treatment measures did not synchronize. After the removal of brace, the Leppilahti Achilles tendon performance score and AOFAS ankle-hindfoot score determined at three time points in the treatment group were higher than those in the control group (<italic>P</italic><0.05). At the last follow-up visit, the good-to-excellent rate of muscle strength in the treatment group was 93.94% (31/33), higher than 72.73% (24/33) in the control group (χ<sup>2</sup>=0.031,<italic>P</italic><0.05), implying that the strength of triceps surae in the treatment group was better recovered. After treatment, the serum TGF-<italic>β</italic><sub>1</sub>, IGF-1, and EGF levels in both groups were increased in contrast to those before treatment (<italic>P</italic><0.05), and these levels in the treatment group were all higher than those in the control group (<italic>P</italic><0.05). The foot dorsiflexion angle and the wind-cold-dampness obstruction syndrome score in the treatment group were superior to those in the control group (<italic>P</italic><0.05). The overall response rate of the treatment group was 90.91% (30/33), higher than 75.76% (25/33) of the control group (<italic>χ</italic><sup>2</sup>=6.981, <italic>P</italic><0.05). No adverse reactions occurred during the treatment. Conclusion:The external fumigation and washing with BXT alleviates both the clinical symptoms and traditional Chinese medicine (TCM) syndrome, improves the joint function score, triceps surae strength, and other indicators, elevates the serum TGF-<italic>β</italic><sub>1</sub>, IGF-1, and EGF levels, and enhances the strength and toughness of Achilles tendon of patients with ankylosis due to wind-cold-dampness obstruction after the acute Achilles tendon rupture surgery. Its clinical efficacy is better than that of functional rehabilitation training.

3.
Asian Journal of Andrology ; (6): 288-293, 2021.
Article in English | WPRIM | ID: wpr-879753

ABSTRACT

Dozens of genes are associated with idiopathic hypogonadotropic hypogonadism (IHH) and an oligogenic etiology has been suggested. However, the associated genes may account for only approximately 50% cases. In addition, a genomic systematic pedigree analysis is still lacking. Here, we conducted whole exome sequencing (WES) on 18 unrelated men affected by IHH and their corresponding parents. Notably, one reported and 10 novel variants in eight known IHH causative genes (AXL, CCDC141, CHD7, DMXL2, FGFR1, PNPLA6, POLR3A, and PROKR2), nine variants in nine recently reported candidate genes (DCAF17, DCC, EGF, IGSF10, NOTCH1, PDE3A, RELN, SLIT2, and TRAPPC9), and four variants in four novel candidate genes for IHH (CCDC88C, CDON, GADL1, and SPRED3) were identified in 77.8% (14/18) of IHH cases. Among them, eight (8/18, 44.4%) cases carried more than one variant in IHH-related genes, supporting the oligogenic model. Interestingly, we found that those variants tended to be maternally inherited (maternal with n = 17 vs paternal with n = 7; P = 0.028). Our further retrospective investigation of published reports replicated the maternal bias (maternal with n = 46 vs paternal with n = 28; P = 0.024). Our study extended a variant spectrum for IHH and provided the first evidence that women are probably more tolerant to variants of IHH-related genes than men.

4.
China Pharmacy ; (12): 2184-2189, 2021.
Article in Chinese | WPRIM | ID: wpr-886797

ABSTRACT

OBJECTIVE:To prov ide reference for mobilizing the work enthusiasm of clinical pharmacists ,and further promoting the strategic objectives of performance appraisal in three-level public hospitals (“National examination ”for short ). METHODS:A department performance appraisal team was established ,and a key performance indicator system consisting of 4 first-level indicators and 9 second-level indicators was constructed by using literature retrieval and expert consultation. The performance distribution method of double assessment of performance score and performance score was established ,and a performance publicity and feedback performance mechanism was formed. Relevant data were collected to compare the core work indicators of clinical pharmacists ,use intensity of antibiotics ,compliance rate of essential drugs in our hospital from Apr. to Dec. 2019(before implementation )and Apr. to Dec. 2020(after implementation ). RESULTS :After the implementation of performance appraisal scheme ,the total number of medication recommendations of clinical pharmacists increased from 1 192 to 5 226,with an increase of 338.42%;the number of medication suggestions received increased from 846 to 4 855,with an increase of 473.88%; and the rate of drug suggestions received increased from 70.97% to 92.90%;the number of pharmaceutical consultation increased from 195 to 1 284,with an increase of 558.46%;the number of drug counseling increased from 1 203 to 2 719,increasing by 126.02%. Form Apr. to Dec. 2020,the number of patient safety medication evaluation forms reached 660. The antibiotics use density(AUD)in clinical departments of 13 clinical pharmacists were decreased to different extent after the implementation of performance appraisal scheme ,the decine rate was 92.31%(12/13),and the compliance rate was 69.23%(9/13);utilization rate of essential medicine among outpatients of 11 clinical pharmacists ’clinical departments had achieved positive growth ,and those among inpatients of 2 clinical pharmacists ’clinical departments had achieved positive growth. CONCLUSIONS :The performance appraisal system of clinical pharm acists formulated by our hospital links the “National examination ”index with the performance , appraisal of clinical pharmacists ,which can provide ideas for No.2018sxzx57,No.2020jyxm2328,No.2020jyxm2307) the performance appraisal of three-level public hospitals and help to promote the high-quality and sustainable development of hospital pharmaceutical care.

5.
Article in Chinese | WPRIM | ID: wpr-884666

ABSTRACT

Objective:To investigate the expression of microRNA (miR)-938, its effect on cell proliferation and its regulatory mechanism in hepatocellular carcinoma (HCC).Methods:HCC and paracancerous tissues were collected from 40 patients with HCC who underwent surgical resection in the Second Affiliated Hospital of Nantong University from January 2015 to June 2019, including 25 males and 15 females, with an average age of 61.4 years. HepG2 cells in the miR-938 overexpression group were transfected with miR-938 mimics, and the negative control group was transfected with the negative control sequence. Cell proliferation was detected by kit, the expression of miR-938 and the succinate dehydrogenase complex subunit D (SDHD) was detected by fluorescence quantitative polymerase chain reaction, and SDHD protein expression was detected by Western blot. The target genes of miR-938 were verified by dual luciferase reporting.Results:The relative expression of miR-938 in HCC tissues was (0.060±0.002), which was higher than that in adjacent tissues (0.030±0.002), and the difference was statistically significant ( P<0.05). The mRNA relative expression of SDHD in HCC tissues was (0.028±0.002), lower than that in adjacent tissues (0.062±0.002), and the protein expression of SDHD in HCC tissues was (0.963±0.008), lower than that in adjacent tissues (1.083±0.037), with statistical significance (both P<0.05). The proliferation activity of miR-938 overexpression group was significantly higher than that of negative control group, and the difference was statistically significant ( P<0.05). MiR-938 significantly inhibited the luciferase activity of SDHD wild-type 3’-untranslated regions. In the overexpression miR-938 cells, SDHD mRNA and protein levels were significantly lower than those in the negative control group ( P<0.05). Conclusion:MiR-938 was highly expressed in HCC tissues. MiR-938 promoted the proliferation of HCC cells by inhibiting the expression of SDHD.

6.
Article in Chinese | WPRIM | ID: wpr-883776

ABSTRACT

Objective:To investigate the effects of ultrasound-guided intervention with methotrexate combined with lauromacrogol on uterine wall thickness and menstrual recovery time in patients with uterine scar pregnancy.Methods:Sixty patients with uterine scar pregnancy who received treatment in Jinhua Wenrong Hospital, Jinhua Central Hospital, and Yiwu Maternity and Children Hospital from February 2019 to February 2020 were included in this study. They were randomly assigned to receive either uterine artery embolization treatment ( n = 30, control group) or ultrasound-guided interventions with methotrexate combined with lauromacrogol ( n = 30, study group). The success rate of treatment, uterine wall thickness at the scar, menstrual recovery time, hospitalization time, hospitalization expenses, incidence of adverse reactions, serum levels of beta-human chorionic gonadotropin (β-HCG) and high sensitivity C-reactive protein (hs-CRP) after 7 days of treatment and uterine wall thickness before and after treatment were compared between the study and control groups. Results:After treatment, the success rate of treatment in the study group was significantly higher than that in the control group [96.67% (29/30) vs. 70.00% (21/30), χ 2 = 7.680, P < 0.05]. Before treatment, there were no significant differences in β-HCG and hs-CRP levels between the control and study groups ( t = -0.197, 0.197, both P > 0.05). After treatment, serum level of β-HCG in the control and study groups was significantly decreased ( t = 22.803, 10.233, both P < 0.01), and serum level of hs-CRP in the control and study groups was significantly increased ( t = -16.357, 7.854, both P < 0.001) compared with before treatment. After treatment, there were no significant differences in serum β-HCG and hs-CRP levels between the control and study groups ( t = 20.413, -20.306, both P < 0.05). After treatment, the incidence of adverse reactions in the study group was significantly lower than that in the control group [6.67% (2/30) vs. 30.00% (9/30), χ 2 = 5.455, P < 0.05). After treatment, menstrual recovery time, hospitalization time and hospitalization expenses in the study group were shorter or less than those in the control group ( t = 5.080, 5.398, 7.599, all P < 0.05). There was no significant difference in the thickness of uterine wall at the scar site between the two groups ( t = -1.045, P > 0.05). Conclusion:Ultrasound-guided intervention with methotrexate combined with lauromacrogol for treatment of uterine scar pregnancy can effectively increase the success rate of treatment, promote the restoration of menstruation, shorten the length of hospital stay, and is highly safe.

7.
Article in Chinese | WPRIM | ID: wpr-799205

ABSTRACT

Children in the pediatric intensive care unit who continue to have ventilator-assisted breathing are often difficult to get off-line due to respiratory system disease, cardiovascular system disease, nervous system disease, nutritional status, genetic metabolism, abnormal diaphragm movement and other factors.Through the diagnosis and treatment of flexible bronchoscope, the etiology could be identified, the ventilation function is effectively improved, and the cure rate of weaning difficulty increases.This paper discussed the etiological diagnosis and treatment of flexible bronchoscopy in children with difficulty in weaning from pediatric intensive care unit.

8.
Chinese Journal of Orthopaedics ; (12): 1155-1164, 2020.
Article in Chinese | WPRIM | ID: wpr-869067

ABSTRACT

Objective:To develop a unilateral biportal endoscopic technique and investigate the clinical efficacy of unilateral biportal endoscopic technique in the treatment of lumbar disc herniation and lumbar spinal stenosis.Methods:Between July 2018 and June 2019, 60 patients with lumbar disc herniation or spinal stenosis were treated by unilateral biportal endoscopic technique. According to the inclusion and exclusion criteria, 51 patients were included in the study. There were 25 cases of prolapsed lumbar disc herniation, 26 cases of degenerative lumbar spinal stenosis, all of which were treated with posterior lumbar decompression by unilateral biportal endoscopic laminectomy, and contralateral stealth decompression by unilateral approach was performed on the patients with bilateral stenosis. Endoscopic interbody fusion and percutaneous pedicle screw fixation were performed in 5 patients with instability. Operation time, length of incision, hospital stay and complications were recorded. Visual analogue scale (VAS) for low back pain and leg pain, Oswestry dysfunction index (ODI) and the modified Macnab scale were used to evaluate the clinical efficacy.Results:All operations were completed successfully, and no cases were transferred to open surgery. The operative time was 70.29±19.55 min (44-151 min), while the length of incision was 1.79±0.34 cm (1.4-3.0 cm). Postoperative CT suggested complete decompression with intact contralateral structure. All patients got out of bed 1-3 d after surgery, and the postoperative hospital stay was 3.49±2.76 d (1-14 d). The postoperative follow-up time was 13.59±2.80 months (10-21 months). Forty-six patients returned to work or normal activities within 3 weeks and 5 patients with interbody fusion returned to normal activities within 4 weeks. According to the modified Macnab criteria, the final outcome was excellent in 43 cases, good in 6 cases, and fair in 2 cases. There were 3 cases of dural sac tear during operation and 2 cases of transient numbness of lower limbs after surgery and they all recovered after conservative treatment. The VAS score of low back pain of 26 patients with lumbar spinal stenosis was reduced from 6.69±1.44 before surgery to 3.27±1.43 at postoperative 1 month, 2.69±1.57 at postoperative 3 months, 2.31±1.16 at postoperative 6 months and 2.23±1.28 at the last follow-up, respectively, and the difference was statistically significant ( F=128.534, P<0.005). The VAS scoreof leg pain was reduced from 6.77±1.34 before surgery to 3.27±1.37 at postoperative 1 month, 2.88±1.48 at postoperative 3 months, 2.85±1.52 at postoperative 6 months and 2.54±1.53 at the last follow-up, and the difference was statistically significant ( F=146.951, P<0.005). The ODI score was reduced from 64.18%±8.23% before surgery to 37.53%±4.45% at postoperative 1 month, 27.51%±3.83% at postoperative 3 months, 19.91%±5.27% at postoperative 6 months and 6.84%±2.74% at the last follow-up, and the difference was statistically significant ( F=783.966, P<0.005). The VAS score of low back pain of 25 patients with lumbar disc herniation was reduced from 5.60±1.38 before surgery to 3.04±1.54 at postoperative 1 month, 2.84±1.75 at postoperative 3 months, 3.12±1.86 at postoperative 6 months and 3.44±1.69 at the last follow-up, respectively, and the difference was statistically significant ( F=22.357, P<0.005). The VAS scoreof leg pain was reduced from 5.48±1.45 before surgery to 2.88±1.64 at postoperative 1 month, 2.52±1.83 at postoperative 3 months, 2.76±1.83 at postoperative 6 months and 3.00±1.92 at the last follow-up, and the difference was statistically significant ( F=29.445, P<0.005). The ODI score was reduced from 53.59%±6.87% before surgery to 32.46%±3.78% at postoperative 1 month, 23.39%±2.78% at postoperative 3 months, 16.49%±3.49% at postoperative 6 months and 7.23%±3.15% at the last follow-up, and the difference was statistically significant ( F=790.985, P<0.005). Conclusion:Unilateral biportal endoscopic technique has the advantages of clear and wide field of vision, large operating space, relatively simple surgical instrument need and convenient and flexible operation procedure. It has excellent clinical effects in the treatment of lumbar disc herniation and lumbar spinal stenosis.

9.
Chinese Journal of Orthopaedics ; (12): 1030-1038, 2020.
Article in Chinese | WPRIM | ID: wpr-869048

ABSTRACT

The unilateral biportal endoscopic technique is defined as posterior unilateral of two small incision with established percutaneous observation channel and endoscopic observation channel in monitoring field. The operation tools were placed within the channel for each operation inside and outside vertebral canal. The characteristics of dual channel intervention make this technology different from coaxial endoscopic technology. This technique has a clear vision for flexible and convenient operation with the advantages of relatively simple surgical instrument requirements. In recent years, the use of unilateral dual channel endoscopic surgery in treating spinal diseases was gradually increasing, especially in the removal of nucleus including lumbar intervertebral disc protrusion and lumbar spinal stenosis disease decompression, and in endoscopic space-occupying lesions such as vertebral fusion and spinal canal between inside and outside. It was also applied in cervical and thoracic diseases with good clinical effects. Its advantages include less surgical trauma and faster recovery process. In addition, it has a large surgical field of vision under the microscope for easy identification of structures and surgery and with relatively gentle learning curve. Thus, it is conducive to beginners' mastery. However, complications such as nerve injury and postoperative lower limb numbness are still frequently reported. Some factors have to be considered, including insufficient understanding of the new technology, the local anatomy of the dual-channel endoscope, the operation of the spinal canal under the microscope. The successful application of the technique in treating various lumbar diseases needs understanding the operation process of the technique and local anatomy under the microscope.

10.
Chinese Journal of Orthopaedics ; (12): 719-725, 2020.
Article in Chinese | WPRIM | ID: wpr-869015

ABSTRACT

Objective:To describe the treatment of the first carpometacarpal arthritis in Eaton Ⅱ, Ⅲ combining the hemi excision of trapezium with tendon ball and evaluate its clinical efficacy.Methods:Data of patients with the first carpometacarpal arthritis who were treated by hemi excision of trapezium and tamponade of the tendon ball from March 2013 to October 2018 were retrospectively analyzed. Twelve patients were all females with an average age of 55±2.8 years (range, 48-61 years). There were 3 cases of left thumbs and 9 cases of right. The study was only researched with primary osteoarthritis patients, preoperative imaging Eaton stages, including 8 cases inⅡstage, 4 cases in Ⅲ stage. Postoperative X-ray examination was performed, and the subsidence rate of the first metacarpal bone was evaluated according to height of arthroplasty. Preoperative and postoperative pain was evaluated according to visual analogue scales (VAS) score and DASH score. Preoperative and postoperative finger movement was evaluated according to the changes in preoperative and postoperative grip and pinch force.Results:The average follow-up period was 12±4.8 months (range, 6-17 months). The mean score of VAS after operation was 1.2±1.0 which was lower than 6.3±1.5 before operation ( t=13.4, P=0.0001); DASH score after operation was 26.2±9.6 which was lower than 48.9±13.0 before operation ( t=5.7, P=0.0001); Grip force after operation was 25.5±6.8 kg which was higher than 15.0±2.9 kg before operation ( t=7.3, P=0.0001); Pinch force after operation was 3.2±0.8 kg which was higher than 2.1±0.4 kg before operation ( t=3.6, P=0.0045), and all of these four above data has statistic difference. At the latest postoperative follow-up, the height index of arthroplasty was 0.299±0.022, and there was no significant change ( F=1.337, P=0.276) when compared with 0.306±0.021 before surgery and 0.313±0.024 after surgery. After the operation, 2 patients presented with incision redness and swelling and exudation. It was considered that local hematoma in the intra-articular operation could not be completely absorbed. After several dressing changes, the redness and swelling subsided and the exudation was controlled. Conclusion:Preserving the proximal joint surface of trapezium and tamponading tendon ball, could reduce the subsidence rate of the first metacarpal bone and alleviate the pain of the first carpometacarpal joint, thus may effectively improve the joint function. It has a significant effect on the treatment of Eaton Ⅱ,Ⅲ stage of the first carpometacarpal arthritis.

11.
Chinese Critical Care Medicine ; (12): 636-640, 2020.
Article in Chinese | WPRIM | ID: wpr-866874

ABSTRACT

Delirium is an acute brain dysfunction syndrome that is common in adult critical care patients. The pathogenesis of delirium is highly related with neuroinflammation, neurotransmitter imbalance, abnormal stress response, and cerebral ischemia. In intensive care unit (ICU), the occurrence of delirium is accompanied with long-term cognitive impairment in patients. Effective assessment tools can detect ICU delirium as early as possible, and subsequent treatment can improve the clinical outcome. However, there are no specific protocols for the treatment of ICU delirium, and active prevention is of particular important. This narrative review aims to address the risk factors, pathogenesis, diagnosis, treatment and prevention of ICU delirium, with a view to increase the understanding of ICU delirium and standardize management.

12.
Article in Chinese | WPRIM | ID: wpr-864870

ABSTRACT

Children in the pediatric intensive care unit who continue to have ventilator-assisted breathing are often difficult to get off-line due to respiratory system disease, cardiovascular system disease, nervous system disease, nutritional status, genetic metabolism, abnormal diaphragm movement and other factors.Through the diagnosis and treatment of flexible bronchoscope, the etiology could be identified, the ventilation function is effectively improved, and the cure rate of weaning difficulty increases.This paper discussed the etiological diagnosis and treatment of flexible bronchoscopy in children with difficulty in weaning from pediatric intensive care unit.

13.
Asian Journal of Andrology ; (6): 296-301, 2020.
Article in Chinese | WPRIM | ID: wpr-842465

ABSTRACT

We aimed to study the association between sperm DNA fragmentation and recurrent pregnancy loss (RPL) in the Chinese population via a retrospective observational study of Chinese couples who had experienced RPL between May 2013 and August 2018. The study population included 461 men from couples with RPL and 411 men from a control group (couples with clinical pregnancy via in vitro fertilization owing to female causes). Routine semen analysis, sperm chromatin analysis, and microscopic (high-power) morphological analysis were performed using semen samples. Semen samples were assessed for volume, sperm count, and motility. The sperm DNA fragmentation index (DFI) was calculated, and the median DFI was obtained. Men were categorized as having normal (37.8%; DFI ≤ 15.0%), moderate (33.6%; 15.0% < DFI < 30.0%), or severe (28.6%; DFI ≥ 30.0%) DNA fragmentation levels. The percentage of men with severe DNA fragmentation was significantly higher in the RPL (42.3%) group than that in the control group (13.1%), whereas the percentage of men with normal levels of DNA fragmentation was significantly lower in the RPL group (22.8%) than that in the control group (54.7%). Subsequent analysis also demonstrated that the sperm DNA fragmentation rate had a moderate reverse correlation with the sperm progressive motility rate (r = -0.47, P < 0.001) and the total motile sperm count (r = -0.31, P < 0.001). We found a positive correlation between RPL and sperm DNA fragmentation. The results suggest that increased sperm DNA damage is associated with RPL.

14.
Article in Chinese | WPRIM | ID: wpr-846039

ABSTRACT

Objectives To prepare arbutin phospholipid complex (APC) to improve the skin permeability of arbutin and discuss the formation mechanism of APC. Methods Solvent evaporation method was used to prepare APC. The formation of APC was confirmed by differential scanning calorimetry (DSC), X-ray diffraction (XRD), infrared spectroscopy (IR), 1H nuclear magnetic resonance (1H-NMR), scanning electron microscopy (SEM) and transmission electron microscope (TEM). The solubility, skin permeability and the ability to inhibit tyrosinase of APC were evaluated. Results The analysis showed that the weak interaction between phospholipid and arbutin molecules formed APC. The solubility of arbutin in APC in n-octanol increased from 1.29 µg/mL to 9.54 µg/mL, and the formation of APC effectively increased the lipophilicity of arbutinn. In vitro release study demonstrated that APC exhibited sustained release behavior. Ex vitro penetration studies showed that arbutin was difficult to reach the subcutaneous tissue through the skin, but APC showed strong penetration ability, of which permeation flux was improved from 0.02 mg/cm2 to 0.42 mg/cm2. Enzyme inhibitory activity test showed that the inhibition of APC on tyrosinase activity was 1.85 times of arbutin. Conclusions The formation of the complex improved the bioavailability of arbutin, and the complex held higher application potential for medicinal and cosmetic.

15.
Article in Chinese | WPRIM | ID: wpr-828208

ABSTRACT

The distal radioulnar joint is not only the main load-bearing joint in the wrist, but also the pivot of the rotation of the forearm. It is one of the most important and unique joints in the body. Maintaining the stability of the distal radioulnar joint is very important for our daily life. The tissue to stabilize the distal radioulnar joint includes bone structures and soft tissue structures. Although the contribution of soft tissue structures to its stability is far exceeding that of bone structures, the influence of abnormal bone structure on the distal radioulnar joint cannot be ignored. By reviewing the relevant literatures, this article divides the bone structural abnormalities into congenital and acquired bone structural abnormalities. The effects of congenital and acquiredbone structural abnormalities on the distal radioulnar joint stability are analysized and collated in this article, and its clinical symptoms, clinical grading, clinical treatments are also summerized. The problems of distal radioulnar joint instability in clinical practicing and its future researching directions are briefly described in order to provide some suggestions for future clinical applications.


Subject(s)
Forearm , Humans , Joint Instability , Rotation , Ulna , Wrist , Wrist Joint
16.
Article in Chinese | WPRIM | ID: wpr-827741

ABSTRACT

OBJECTIVE@#To retrospectively analyze non-invasive prenatal screening (NIPS) data from two centers.@*METHODS@#The NIPS results of 10 840 samples were analyzed, including 21/18/13 trisomies (T21/T18/T13), sex chromosome and other autosomal aneuploidies, and copy number variants (CNVs). The maternal age, gestational week, body mass index and concentration of free fetal DNA (cffDNA) were also analyzed.@*RESULTS@#The average gestational age of the 10 840 pregnant women was (32.34±5.04) year old, and the average gestational week for NIPS was (17.60±3.55) week. The overall false positive rate for T21/T18/T13 was 0.11%, sensitivity was 100%, specificity was 99.89%, and positive predictive value was 81.5%. The positive predictive values for sex chromosome and other autosomal aneuploidies and CNVs were 56.67%, 11.76% and 83.33%, respectively. The incidence of T21/T18 in the elder women (35 years or elder) was 2.12 times(P 0.05) that of young women. cffDNA was in proportion to gestational week (r = 0.207) and in inverse proportion to body mass index (r = -0.177). It has increased slowly before 15 weeks of gestation and thereafter at a rate of 0.5% per week after the 16th week.@*CONCLUSION@#The performance of NIPS in this study is by large close to the reported in the literature, and the results can provide a reference for further study.

17.
Article in Chinese | WPRIM | ID: wpr-802665

ABSTRACT

Objective@#To analyze the clinical value of magnetic resonance imaging (MRI) and hydrogen proton magnetic resonance spectroscopy (~1H-MRS) in the diagnosis of central neurocytoma (CNC).@*Methods@#From February 2010 to February 2018, the clinical data of 12 patients with CNC confirmed by surgery and pathology in Quzhou People's Hospital were retrospectively analyzed.All patients underwent MRI diagnosis before operation.Among them, 9 patients received ~1H-MRS check.@*Results@#In this group of 12 patients, 9 patients occurred in the 2/3 area of the lateral ventricle, 2 cases occurred in the posterior third of the lateral ventricle, 1 case occurred in the frontal lobe; 11 cases were solid tumors, and 1 case was cystic tumors.MRI showed plaque calcification in the tumor, distortion of vascular shadow, T1WI was equal low signal, T2WI was contoured mixed signal; 8 cases showed uneven light and moderate enhancement, 3 cases showed uneven enhancement, 1 case showed ring enhancement; 8 cases of ~1H-MRS showed a significant increase in choline peak (Cho), N-acetylaspartate (NAA) peak decreased, and Cho/NAA increased.Meanwhile, 1 case of glycine peak (Gly) increased.@*Conclusion@#CNC has specific MRI performance, and plays an important role in preoperative diagnosis and differential diagnosis.Combined with ~1H-MRS examination, it can grasp the tumor biochemical index and metabolism from the molecular level and improve the accuracy of preoperative diagnosis.

18.
Chinese Journal of Surgery ; (12): 834-839, 2019.
Article in Chinese | WPRIM | ID: wpr-800963

ABSTRACT

Objective@#To discuss the rationality of stage pT3 in the AJCC 8th TNM criteria of gallbladder carcinoma.@*Methods@#A retrospective study was performed to analyze the clinical and pathological data of 88 patients with pT3 gallbladder carcinoma admitted to Department of Second Biliary Surgery of Eastern Hepatobiliary Surgery Hospital, affiliated to Naval Medical University from May 2013 to September 2018.pT3 stage tumors were divided into two groups: (1) pT3a stage: tumors had penetrated serosa but not directly invaded liver and/or an adjacent organ or structure; (2) pT3b stage: tumor penetrating serosa and directly invaded liver and/or an adjacent organ or structure. There were 45 patients with pT3a stage, including 15 males and 30 females, aged 36 to 80 years, with a median age of 59 years; 43 patients with pT3b, including 24 males and 19 females, aged 41 to 78 years old, median aged 63 years old.Patients with pT3a and pT3b were further divided into two groups respectively: radical resection group and extended radical resection group according to surgical radicalization. Independent sample t-test was used for comparison between two groups with normal distribution measurement data. Wilcoxon rank sum test was used between groups of non-normally distributed measurement data.The comparison of the count data was performed by χ2 test or Fisher exact probability method. Survival analysis was performed using Kaplan-Meier method, and survival rate was compared using Log-rank test.@*Results@#(1)Serum total bilirubin(15.6(90.3)mmol/L), albumin(40.2(4.8)mmol/L), and CA19-9(132.90(455.78)U/ml) levels in pT3b patients were higher than that in pT3a patients(10.2(6.8)mmol/L, 41.8(4.9)mmol/L, 14.35(36.27)U/ml), respectively(Z=-3.816, -1.966, -3.739, all P<0.05),postoperative complication rate in pT3b patients(24.4%) was higher than that in pT3a patients(8.9%)(P<0.05),postoperative hospital stay(12(7)days) and overall hospital stay((26±17)days) of pT3b patients were longer than that of pT3a patients((10±5) days and (19±7)days) (P<0.05). (2) The 1-, 3-, 5-year survival rates of pT3b and pT3a patients were 53%,22%,22% and 69%, 46%,38%,and the median survival time was 13 months and 26 months, respectively. The difference in survival rates between the two groups was statistically significant(χ2=5.117, P=0.024). (3)The 1-, 3-year survival rates of extended radical resection group(n=19) and radical resection group(n=24) in the pT3b stage were 73%, 36% and 28%, 7%, respectively.The survival time was 20 months and 9 months,respectively,and the difference in survival rates between the two groups was statistically significant(χ2=4.976, P=0.026).@*Conclusions@#pT3 gallbladder carcinoma could be further subdivided into pT3a stage and pT3b stage based on the TNM criteria of AJCC 8th gallbladder carcinoma. Extended radical resection for pT3b gallbladder carcinoma should be further considered after comprehensive assessment of the patient′s basic condition and surgical tolerance.

19.
Chinese Journal of Anesthesiology ; (12): 1041-1046, 2019.
Article in Chinese | WPRIM | ID: wpr-798058

ABSTRACT

Objective@#To investigate the current status of the ten-year implementation of the World Health Organization (WHO) surgical safety checklist (SSC) in China.@*Methods@#A questionnaire was designed based on the three phases described by the checklist — the period before induction of anaesthesia, the period before skin incision, and the period before patient leaves operating room, taking into account some hotspots and disputes.The questionnaire was sent to the members of the Chinese-based online New Youth Anesthesia Forum through the WeChat platform.Answers were completed by mobile phones or desktop computers.Each WeChat ID number allowed only one answer for each individual participant.@*Results@#A total of 3 943 members red the questionnaire invitation, of which 2 121 members completed the questionnaire with an overall completion rate of 53.79%.For checks completed before induction of anesthesia, the percentage of members who routinely practiced checks before induction of anesthesia was 93.35%, the percentage of members who completed each and every element of the checklist was 60.16%, and the percentage of members who selected the element of the checklist the surgeon was not involved in the check was 14.05%.For checks practiced before skin incision, the percentage of members who routinely completed checks before skin incision was 78.22%, the percentage of members who completed each and every element of the checklist was 51.91%, and the percentage of members who selected the element of the checklist surgeons and anesthesiologists routinely stated their own professional key information was 18.24% and 18.81%, respectively.For checks practiced before the patient leaved the operating room, the percentage of members who routinely completed checks before removing the patient from the operating room was 64.26%, and the percentage of members who completed each and every element of the checklist was 44.18%.The percentage of members who was really serious about practicing the checklist was 56.20%.The percentage of members who believed that surgeons should participated in checks practiced before induction of anesthesia was 81.47%.If the member himself or a member of his family needed a surgery, the percentage of members who hoped to implement the checklist was 98.35%.The percentage of members who believed that practicing WHO SSC could reduce the complications of surgery and improve the anesthetic safety of patients was 94.34%.@*Conclusion@#The implementing rate of checks practiced before induction of anesthesia is high, while the implementing rates of checks completed before skin incision and before patient leaves operating room are sequentially reduced in China.Although there are some problems with the implementation of WHO SSC, most respondents believe that implementing SSC can improve the anesthetic safety of patients undergoing surgery.

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Chinese Journal of Surgery ; (12): 434-439, 2019.
Article in Chinese | WPRIM | ID: wpr-810658

ABSTRACT

Objective@#To compare the efficacy of modified pancreaticojejunostomy with traditional pancreaticojejunostomy following pancreaticoduodenectomy, and to investigate the risk factors of postoperative pancreatic fistula.@*Methods@#Clinical data of 68 patients who underwent pancreaticoduodenectomy between October 2017 and October 2018 at the Second Department of Biliary Tract Surgery, Eastern Hepatobiliary Surgery Hospital was retrospectively collected and analyzed.According to the method of pancreaticojejunostomy, the patients were divided into two groups: modified pancreaticojejunostomy group (34 patients) and traditional pancreaticojejunostomy group (34 patients). There were 18 males and 16 females, aged (60.4±9.6) years of modified pancreaticojejunostomy groups; there were 17 males and 18 females, aged (58.9±10.9) years of traditional pancreaticojejunostomy group. The major postoperative complications such as pancreatic fistula were compared between the two groups, and the risk factors of postoperative pancreatic fistula were analyzed by univariate and multivariate analyses.@*Results@#All of the 68 operations were successfully completed. The overall incidence of postoperative complications was 51.5% (35/68). The incidence of postoperative pancreatic fistula was 13.2% (9/68), of which all were cases of grade B.There were 16 patients (23.5%) occurred with abdominal infection, and 11 patients (16.2%) occurred with delayed gastric emptying, including 1 case of grade A, 1 case of grade B and 9 cases of grade C.And 9 patients (13.2%) occurred with postoperative bleeding was, including 2 cases of mild bleeding, 5 cases of moderate bleeding, and 2 cases of severe bleeding.Biliary leakage occurred in one patient (1.5%) and chylous leakage occurred in two patients (2.9%). The modified pancreaticojejunostomy could significantly reduce the incidence of postoperative bleeding compared with control group (χ2=4.610, P=0.032). And there were no significant differences for other postoperative complications between the two groups (all P>0.05). According to the results of univariate analysis: age, intraoperative bleeding and diameter of pancreatic tube were related factors affecting postoperative pancreatic fistula (P=0.025, 0.019, 0.017, respectively). The results of multivariate analysis showed that intraoperative bleeding>400 ml and diameter of pancreatic tube <3 mm were independent risk factors of pancreatic fistula following pancreaticoduodenectomy (P=0.025, 0.008, respectively).@*Conclusion@#The modified pancreaticojejunostomy is feasible with advantages of reducing postoperative bleeding following pancreaticoduodenectomy.

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