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1.
Article in Chinese | WPRIM | ID: wpr-877572

ABSTRACT

Given that the biomechanical theory cannot well explain the therapeutic effect of


Subject(s)
Acupuncture , Acupuncture Points , Acupuncture Therapy , Humans , Muscle, Skeletal , Musculoskeletal Pain
2.
Article in Chinese | WPRIM | ID: wpr-887500

ABSTRACT

OBJECTIVE@#To observe the clinical therapeutic effect on mild and moderate postpartum depression treated with acupuncture of @*METHODS@#A total of 116 patients with mild and moderate postpartum depression were divided into an acupuncture group (103 cases) and a non-acupuncture group (13 cases) according to treatment regimen provided. In the acupuncture group, acupuncture of @*RESULTS@#The total effective rate of the acupuncture A group was 100.0% (31/31), better than 76.9% (10/13) in the non-acupuncture group and 58.1% in the acupuncture B group (18/31) (@*CONCLUSION@#Acupuncture of


Subject(s)
Acupuncture Points , Acupuncture Therapy , Depression/therapy , Depression, Postpartum/therapy , Female , Humans , Needles , Treatment Outcome
3.
Cancer Research and Clinic ; (6): 119-123, 2021.
Article in Chinese | WPRIM | ID: wpr-886019

ABSTRACT

Objective:To explore the value of pre- and postoperative red cell distribution width-to-lymphocyte count ratio (RLR) in predicting the disease-free survival (DFS) for non-metastatic colorectal cancer patients.Methods:The data of 108 patients pathologically diagnosed with non-metastatic colorectal adenocarcinoma after surgery from December 2012 to January 2020 in Hainan Hospital of PLA General Hospital were retrospectively analyzed. RLR was calculated and its differences in patients with varied clinicopathological characteristics were analyzed. The receiver operating characteristics (ROC) curve was applied to analyze the value of pre- and postoperative RLR in predicting DFS of patients, and the cut-off value was determined by Youden index. DFS of patients with different stratification stratified by a cut-off value of RLR was analyzed by using Kaplan-Meier method followed by log-rank test. Cox proportional hazards model was used to make univariate and multivariate analysis.Results:Youden index of pre- and postoperative RLR in predicting DFS was 8.86%, 9.15%; based on the above index, the patients were divided into the preoperative RLR<8.86% group (73 cases) and preoperative RLR≥8.86% group (35 cases), postoperative RLR<9.15% group (48 cases) and postoperative RLR≥9.15% group (60 cases). According to ROC curve, the area under the curve (AUC) of preoperative RLR in predicating DFS was 0.66 (95% CI 0.55-0.77, P = 0.01), and AUC of postoperative RLR in predicating DFS was 0.62 (95% CI 0.51-0.74, P = 0.04). Pre- and postoperative RLR cut-off values were used to predict 3-year DFS rate of patients with the sensitivity of 51.60% and 71.00%, respectively, and the specificity of 76.60% and 50.60%, respectively. Kaplan-Meier analysis showed that patients in preoperative RLR<8.86% group had a better DFS compared with those in preoperative RLR≥8.86% group ( χ2 = 7.35, P < 0.01); there was no statistical difference in DFS between postoperative RLR<9.15% group and postoperative RLR≥9.15% group ( χ2 = 3.69, P = 0.06). Preoperative RLR was an independent affecting factor for DFS of patients ( HR = 1.13, 95% CI 1.04-1.22, P <0.01). Conclusions:Pre- and postoperative RLR could be useful in predicating 3-year DFS for patients with non-metastatic colorectal cancer. Preoperative RLR is an independent affecting factor for DFS, and the patients with low RLR have a better prognosis.

4.
Chinese Medical Journal ; (24): 1-8, 2020.
Article in English | WPRIM | ID: wpr-781614

ABSTRACT

BACKGROUND@#The Chinese appropriate use criteria (AUC) for coronary revascularization was released in 2016 to improve the use of coronary revascularization. This study aimed to evaluate the association between the appropriateness of coronary revascularization based on the Chinese AUC and 1-year outcomes in stable coronary artery disease (CAD) patients.@*METHODS@#We conducted a prospective, multi-center cohort study of stable CAD patients with coronary lesion stenosis ≥50%. After the classification of appropriateness based on Chinese AUC, patients were categorized into the coronary revascularization group or the medical therapy group based on treatment received. The primary outcome was a composite of death, myocardial infarction, stroke, repeated revascularization, and ischemic symptoms with hospital admission.@*RESULTS@#From August 2016 to August 2017, 6085 patients were consecutively enrolled. Coronary revascularization was associated with a lower adjusted hazard of 1-year major adverse cardiovascular and cerebrovascular events (MACCEs; hazard ratio [HR]: 0.62; 95% confidence interval [CI]: 0.45-0.86; P = 0.004) than medical therapy in patients with appropriate indications (n = 1617). No significant benefit in 1-year MACCEs was found after revascularization compared to after medical therapy in patients with uncertain indications (n = 2658, HR: 0.81; 95% CI: 0.52-1.25; P = 0.338) and inappropriate indications (n = 1810, HR: 0.80; 95% CI: 0.51-1.23; P = 0.308).@*CONCLUSIONS@#In patients with appropriate indications according to Chinese AUC, coronary revascularization was associated with significantly lower risk of MACCEs at 1 year. No benefit was found in coronary revascularization in patients with inappropriate indications. Our findings provide evidence for using Chinese AUC to guide clinical decision-making.@*CLINICAL TRIAL REGISTRATION@#NCT02880605. https://www.clinicaltrials.gov.

5.
Chinese Medical Journal ; (24): 2674-2681, 2020.
Article in English | WPRIM | ID: wpr-877875

ABSTRACT

BACKGROUND@#The mechanism and characteristics of early and late drug-eluting stent in-stent restenosis (DES-ISR) have not been fully clarified. Whether there are different outcomes among those patients being irrespective of their repeated treatments remain a knowledge gap.@*METHODS@#A total of 250 patients who underwent initial stent implantation in our hospital, and then were readmitted to receive treatment for the reason of recurrent significant DES-ISR in 2016 were involved. The patients were categorized as early ISR (<12 months; E-ISR; n = 32) and late ISR (≥12 months; L-ISR; n = 218). Associations between patient characteristics and clinical performance, as well as clinical outcomes after a repeated percutaneous coronary intervention (PCI) were evaluated. Primary composite endpoint of major adverse cardiac events (MACEs) included cardiac death, non-fatal myocardial infarction (MI), or target lesion revascularization (TLR).@*RESULTS@#Most baseline characteristics are similar in both groups, except for the period of ISR, initial pre-procedure thrombolysis in myocardial infarction, and some serum biochemical indicators. The incidence of MACE (37.5% vs. 5.5%; P < 0.001) and TLR (37.5% vs. 5.0%; P < 0.001) is higher in the E-ISR group. After multivariate analysis, E-ISR (odds ratio [OR], 13.267; [95% CI 4.984-35.311]; P < 0.001) and left ventricular systolic dysfunction (odds ratio [OR], 6.317; [95% CI 1.145-34.843]; P = 0.034) are the independent predictors for MACE among DES-ISR patients in the mid-term follow-up of 12 months.@*CONCLUSIONS@#Early ISR and left ventricular systolic dysfunction are associated with MACE during the mid-term follow-up period for DES-ISR patients. The results may benefit the risk stratification and secondary prevention for DES-ISR patients in clinical practice.


Subject(s)
Coronary Angiography , Coronary Restenosis , Drug-Eluting Stents/adverse effects , Humans , Percutaneous Coronary Intervention/adverse effects , Prognosis , Treatment Outcome
6.
Cancer Research and Clinic ; (6): 149-153, 2020.
Article in Chinese | WPRIM | ID: wpr-872479

ABSTRACT

Objective:To explore the value of tumor diameter to preoperative carcinoembryonic antigen (CEA) ratio (TCR) in predicting prognosis of patients with non-metastatic colorectal cancer.Methods:The clinical data of 144 patients with colorectal cancer in Hainan Hospital of PLA General Hospital between July 2012 and December 2017 were retrospectively analyzed. Patients were divided into the low TCR group and the high TCR group according to the optimal value of TCR in predicting the disease-free survival (DFS) determined by the receiver operating characteristic curve (ROC). The clinicopathological features of both groups were analyzed, and the influencing factors of DFS were also analyzed by using Cox proportional hazard model.Results:ROC analysis showed that TCR had a certain value in predicting DFS, and area under the curve (AUC) was 0.614 (95% CI 0.507-0.722); when the value of TCR was set at 0.690, the sensitivity and specificity of predicting the 3-year DFS rate was 46.3% and 70.9%, respectively. According to 0.690 of TCR, there were 50 cases in the low TCR (< 0.690) group and 94 cases in the high TCR (≥0.690) group. There were no statistically significant differences in the high and low TCR between the two groups for patients stratified by gender, age, tumor location, differentiation degree, invasive depth, lymph node metastasis, TNM stage (all P > 0.05). Univariate analysis showed that TCR, preoperative CEA level and TNM stage played a role in predicting DFS of patients (all P < 0.05), while Cox multivariate analysis indicated that TCR < 0.690 ( HR = 2.369, 95% CI 1.279-4.388, P = 0.006) and Ⅲ stage in TNM stage ( HR = 2.214, 95% CI 1.346-3.640, P = 0.002) were the independent risk factors of influencing DFS (all P < 0.01). The 3-year DFS rate of patients in the low TCR group was lower than that of those in the high TCR group (62.0% vs. 83.0%, P = 0.007). Conclusion:TCR could have a certain value in judging the prognosis of non-metastatic colorectal cancer patients, and low TCR patients have a poorer prognosis.

7.
Chinese Medical Journal ; (24): 1276-1284, 2020.
Article in English | WPRIM | ID: wpr-827609

ABSTRACT

BACKGROUND@#Imprecise interpretation of coronary angiograms was reported and resulted in inappropriate revascularization. Synergy Between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery (SYNTAX) score is a comprehensive system to evaluate the complexity of the overall lesions. We hypothesized that a real-time SYNTAX score feedback from image analysts may rectify the mis-estimation and improve revascularization appropriateness in patients with stable coronary artery disease (CAD).@*METHODS@#In this single-center, historical control study, patients with stable CAD with coronary lesion stenosis ≥50% were consecutively recruited. During the control period, SYNTAX scores were calculated by treating cardiologists. During the intervention period, SYNTAX scores were calculated by image analysts immediately after coronary angiography and were provided to cardiologists in real-time to aid decision-making. The primary outcome was revascularization deemed inappropriate by Chinese appropriate use criteria for coronary revascularization.@*RESULTS@#A total of 3245 patients were enrolled and assigned to the control group (08/2016-03/2017, n = 1525) or the intervention group (03/2017-09/2017, n = 1720). For SYNTAX score tertiles, 17.9% patients were overestimated and 4.3% were underestimated by cardiologists in the control group. After adjustment, inappropriate revascularization significantly decreased in the intervention group compared with the control group (adjusted odds ratio [OR]: 0.83; 95% confidence interval [CI]: 0.73-0.95; P = 0.007). Both inappropriate percutaneous coronary intervention (adjusted OR: 0.82; 95% CI: 0.74-0.92; P < 0.001) and percutaneous coronary intervention utilization (adjusted OR: 0.88; 95% CI: 0.79-0.98; P = 0.016) decreased significantly in the intervention group. There was no significant difference in 1-year adverse cardiac events between the control group and the intervention group.@*CONCLUSIONS@#Real-time SYNTAX score feedback significantly reduced inappropriate coronary revascularization in stable patients with CAD.@*CLINICAL TRIAL REGISTRATION@#Nos. NCT03068858 and NCT02880605; https://www.clinicaltrials.gov.

8.
Article in Chinese | WPRIM | ID: wpr-775864

ABSTRACT

OBJECTIVE@#To observe the clinical efficacy of " acupuncture" and oral estradiol and dydrogesterone tablets (femoston) on premature ovarian insufficiency of kidney deficiency.@*METHODS@#A total of 50 patients with premature ovarian insufficiency of kidney deficiency were randomized into an observation group and a control group, 25 cases in each one.In the observation group, " acupuncture" was applied at Baihui (GV 20), Zhongwan (CV 12), Guanyuan (CV 4), Qihai (CV 6), Zhongji (CV 3), Yaoyangguan (GV 3), Yaoshu (GV 2), Mingmen (GV 4), etc. once every 2 days, 1 month as a course. In the control group, femoston was prescribed for oral administration, one tablet per time, once a day, 1 month as a course. Both of the two groups were given consecutive treatment for 3 courses. Before and after treatment, the clinical symptoms, menstrual improvement as well as the changes of estradiol (E), luteotrophic hormone (LH) and follicle-stimulating hormone (FSH) in serum were observed in the two groups.@*RESULTS@#After treatment, the clinical symptoms and menstrual conditions were improved (<0.01), the levels of FSH and LH were significantly reduced (<0.01), and the levels of E were significantly increased in the two groups (<0.01). There were no significant difference in menstrual improvement rate and menstrual improvement time between the observation group and the control group (<0.05), the recurrence rate of menopause and clinical symptom score improvement in the observation group were superior to the control group (<0.05). In the observation group, the level of E in serum was lower and the levels of FSH and LH in serum were significantly lower than those in the control group (<0.05, <0.01). In the observation group, the rate of adverse reaction was 4.0% (1/25), which was lower than 36.0% (9/25) in the control group (<0.05).@*CONCLUSION@#" acupuncture" has better therapeutic effect for premature ovarian insufficiency of kidney deficiency. It is superior to femoston in improving clinical symptoms and recurrence rate of menopause as well as reducing the levels of FSH and LH.


Subject(s)
Acupuncture Points , Acupuncture Therapy , Female , Follicle Stimulating Hormone , Humans , Kidney Diseases , Therapeutics , Primary Ovarian Insufficiency , Therapeutics
9.
Article in Chinese | WPRIM | ID: wpr-773994

ABSTRACT

Objective To evaluate the value of serum aminoterminal pro-brain natriuretic peptide (NT-proBNP) and interleukin(IL)-6 levels in diagnosis and severity assessment of the preterm infants with respiratory distress syndrome(RDS).Methods Totally 150 preterm infants with RDS who were hospitalized in our center from August 2016 to March 2018 were enrolled in this study as the RDS group. These infants were further divided into grades 1,2,3,and 4 according to chest radiography. In addition,158 preterm infants without RDS hospitalized in our center during the same period were included as the controls (control group). Serum NT-proBNP and IL-6 levels were measured by ELISA on days 1,3,and 7 after birth,and their pulmonary arterial pressure (PAP) was monitored as well.Results Serum NT-proBNP and IL-6 levels in RDS group were significantly higher than those in control group on day 1 (t=-91.04,P=0.000;t=-11.03,P=0.000),day 3 (t=-89.10,P=0.000;t=-9.909,P=0.000),and day 7 (t=-87.91,P=0.000;t=-8.548,P=0.000). There were significant differences in NT-proBNP levels among grades 1,2,3,and 4 on day 1 (F=50.89,P=0.000),day 3 (F=49.16,P=0.000),and day 7 (F=45.45,P=0.000),showing an increasing trend. Serum IL-6 levels showed no significant difference among grades 1,2,3,and 4 on day 1 (F=0.89,P=0.448),day 3 (F=0.76,P=0.518),and day 7 (F=0.85,P=0.469). The PAP of the RDS group on days 1,3,and 7 was (49.3±3.7),(40.1±5.4),and (39.0±2.6)mmHg (1 mmHg=0.133 kPa),which were significantly higher than those of the control group (35.0±2.7)mmHg (t=-90.01,P=0.000),(30.0±3.1)mmHg (t=-81.90,P=0.000),(26.0±3.0)mmHg (t=-88.89,P=0.000). Thus,there was a positive correlation between NT-proBNP and IL-6 levels (r=0.876,P=0.000) and a positive correlation between NT-proBNP and PAP (r=0.916,P=0.000) in preterm infants with RDS.Conclusion Monitoring serum NT-proBN contributes to early diagnosis and disease severity assessment in preterm infants with RDS.


Subject(s)
Biomarkers , Early Diagnosis , Humans , Infant , Infant, Newborn , Infant, Premature , Interleukin-6 , Natriuretic Peptide, Brain , Peptide Fragments , Respiratory Distress Syndrome
10.
Article in Chinese | WPRIM | ID: wpr-773881

ABSTRACT

OBJECTIVE@#To detect the core muscle group in the patients with myofascial pain syndromes(MPS) by using the surface electromyography; to detect the distribution of muscle fiber type by the analysis of the median frequency and the slope of the median frequency.@*METHODS@#From October 2017 to March 2018, there were 100 patients with the MPS, including 45 males and 55 females; the average age was 48.5 years old, ranging from 29 to 76 years old. There were 40 cases of left back pain and 60 cases of right back pain. The course of illness was more than 6 months. Another 40 healthy patients without pain in the waist were included in the control group, 20 males and 20 females; the average age was 47.3 years old, ranging from 29 to 76 years old. All the patients had different degrees of back pain and muscle stiffness, which were diagnosed as lumbar fasciitis by clinical and imaging examination. Surface electromyography was used to measure the characteristics of the lumbar core muscles (multifissions, iliocostal muscles, and longest muscle) of the three groups in the Biering-Sorensen testing, such as median frequency(MF) and absolute slope of median frequency (MFs).@*RESULTS@#The MF values of the multifidus muscle in the three groups were as follows:the left side of the non-pain group was 133.88±26.61, and the right side was 131.39±29.81; left side of lift side pain group 117.29±10.93, right side 133.70±17.81; in the right pain group, the left side was 131.36±17.37, and the right side was 118.28±13.57. The MF values of the iliocostal muscle in the three groups were:106.94±28.01 on the left side of the non-pain group, 114.68±18.96 on the right side; left side of lift side pain group 93.95±11.17, right side 107.60±27.86; in the right pain group, the left side was 105.93±15.52, and the right side was 97.27±19.27. The MF values of the longest muscle in the three groups were:109.24±26.20 on the left side of the non-pain group, 112.58±17.70 on the right side. Left side of left side pain group 95.58±10.83, right side 108.79±26.39; in the right pain group, the left side was 106.50±17.98, and the right side was 98.20±11.16. The MFs values of the multifidus muscle in the three groups were:0.221±0.109 on the left side of the non-pain group, and 0.259±0.169 on the right side; left side of left side pain group 0.318±0.184, right side 0.210±0.159; in the right pain group, the left side was 0.258±0.169, and the right side was 0.386±0.166. The MFs values of the iliocostal muscles in the three groups were:0.241±0.158 for the left side of the non-pain group, and 0.238±0.128 for the right side. Left side of left side pain group 0.330±0.208, right side 0.252±0.171; in the right side pain group, left side 0.249±0.150, right side 0.343± 0.144. The MFs values of the longest muscle of the three groups were:0.244±0.252 on the left side of the non-pain group, and 0.210±0.128 on the right side; left side of left side pain group 0.348±0.255, right side 0.241±0.224; in the right pain group, the left side was 0.239±0.155, and the right side was 0.334±0.233. There were no statistically significant differences in MF and MFs values of the left and right lumbar multifidus muscle, iliocostal muscle and longest muscle in the non-pain group(>0.05). MF values of the pain side multifidus muscle, iliocostal muscle and longest muscle in the lumbago group were lower than those in the non-pain group(<0.05). MFs values of the painful side multifidus muscle, iliocostal muscle and longest muscle in the low back pain group were higher than those in the non-pain group(<0.05).@*CONCLUSIONS@#The muscle fatigue degree of the back muscle in the pain side of patients with MPs is decreased, and the muscle fiber type is dominated by II muscle fiber.


Subject(s)
Adult , Aged , Electromyography , Female , Humans , Low Back Pain , Male , Middle Aged , Muscle Fatigue , Muscle Fibers, Skeletal , Muscle, Skeletal , Myofascial Pain Syndromes
11.
Article in Chinese | WPRIM | ID: wpr-755065

ABSTRACT

Objective To compare the sensitivity of Deha4 and ArcCHECK 3D detectors to detect the multi-leaf collimator (MLC) positioning errors in the dose verification of volumetric modulated arc therapy (VMAT) plans for nasopharyngeal carcinoma (NPC).Methods Ten NPC patients receiving VMAT plans were selected.The positioning error of 0.5-4.0 mm was introduced into the leaves of each MLC segment in the original file to expand,contract or shift the whole segments.The possible positioning errors of MLC in the treatment of VMAT were simulated.The Delta4 and ArcCHECK were utilized to verify the measurements.The absolute gamma passing rate was compared between the calculated dose and the measured dose of the VMAT plan by using the paired t-test.Results When the evaluation criterion was taken as 3 mm/3%,the absolute passing rate verified by the original plans of two detectors was greater than 95%.The positioning errors of MLC expansion,contraction and shifting detected by Delta4 and ArcCHECK were 1.5 mm,1.0 mm,2.0 mm and 3.0 mm,1.0 mm,and 3.0 mm,respectively.When taking 2 mm/2% as the evaluation criterion,the absolute passing rate verified by the original plan was decreased significantly.Delta4 and ArcCHECK detected that the positioning errors of MLC expansion,contraction and shifting were 1.0 mm,1.0 mm,2.0 mm and 1.5 mm,0.5 mm,and 2.0 mm,respectively.Conclusions The dose verification of the VMAT plan for NPC by Delta4 and ArcCHECK can detect different types and sizes of MLC positioning errors,whereas the detection sensitivity slightly differs between Delta4 and ArcCHECK.Both of them are not sensitive to detect the MLC positioning errors less than 1.0 mm.It is fairly necessary to strengthen the quality assurance of MLC in the daily work.

12.
Article in Chinese | WPRIM | ID: wpr-754749

ABSTRACT

Objective To investigate the effect of our self-developed acetabular reduction clamp in the treatment of fractures of acetabular posterior column.Methods The data were retrospectively analyzed of the 32 patients who had been treated for acetabular posterior column fractures using our self-developed acetabular reduction clamp at Department of Minimally Invasive Surgery,Zhengzhou Orthopaedics Hospital from August 2016 to June 2018.They were 17 males and 15 females,aged from 18 to 62 years (average,41.3 years).According to the Letournel-Judet classification,there were 9 simple posterior column fractures,14 posterior column plus posterior wall fractures,4 T-shaped fractures and 5 double column fractures.The Kocher-Langenbeck (K-L) incision was used for simple posterior column and posterior column plus posterior wall fractures,and the K-L combined with anterior ilioinguinal approach for T-shaped and double column fractures.The displaced posterior column fracture was repositioned with our novel reduction clamp before pelvic reconstruction plate was used for fixation.The quality of fracture reduction,fracture union time,complications and hip function score at the last follow-up were recorded.Results This series of 32 patients were followed up for 7 to 20 months (average,12.9 months).According to the Matta scores for fracture reduction at the last follow-up,15 cases were excellent,16 good and one poor,yielding an excellent and good rate of 96.9%.The fracture union time ranged from 3 to 6 months (average,4.7 months).According to the modified Merle d'Aubign scores at the last follow-up,hip function was excellent in 18 cases,good in 11 and fair in 3,yielding an excellent and good rate of 90.6%.Postoperative symptomatic distraction injury to the sciatic nerve appeared in 2 patients,postoperative wound lipid liquefaction developed in one and heterotopic ossification of Brooker grade Ⅱ was observed in 2 patients during follow-up.Conclusion In the treatment of acetabular posterior column fracture with open reduction and internal fixation with pelvic reconstruction plate through the K-L approach,our novel acetabular reduction clamp can be used safely and effectively to assist fracture reduction,leading to satisfactory results.

13.
Article in English | WPRIM | ID: wpr-327733

ABSTRACT

Objective To investigate the risk factors predicting the short-term outcomes of patients with peritoneal dialysis(PD)-associated peritonitis (PDAP). Methods In this retrospective cohort study,the clinical data at baseline and 0-3 months before peritonitis onset (peritonitis-free period) were collected from end-stage renal disease patients who started PD and suffered from PDAP between January 1,2004 and March 31,2017 in Peking Union Medical College Hospital. After 4 weeks of follow-up,these patients were divided into two groups according to the clinical outcomes,namely poor outcome group and good outcome group. Characteristics at baseline and before peritonitis were compared. Risk factors associated with short-term outcomes were also analyzed. Results Totally 162 PDAP patients were enrolled,among whom 55 (34.0%) experienced adverse outcomes and 107 (66.0%) had good outcome. At baseline,the proportion of clinical atherosclerotic vascular disease was significantly higher in poor outcome group than in good outcome group (49.1% vs. 31.8%;χ=4.639,P=0.031),whereas indicators were comparable (all P>0.05). During the peritonitis-free period,significantly higher level of high-sensitivity C-reactive protein (hsCRP) [9.3(2.2,16.3)mg/dl vs. 3.6(1.4,9.5)mg/dl,Z=-2.879,P=0.004],higher proportion of low transport type of peritoneum function (8.7% vs. 1.0%;Z=4.879,P=0.027),and lower creatinine clearance rate [56.7 (45.7,71.1) ml/(min·w·1.73 m)vs. 61.4 (54.5,76.4) ml/(min·w·1.73 m);Z=-2.084,P=0.037] were observed in poor outcome group. Univariate Logistic regression analysis showed the combination of clinical atherosclerotic vascular disease (OR=2.070,95%CI:1.062-4.034,P=0.033) and higher hsCRP before peritonitis (OR=1.032,95%CI:1.001-1.059,P=0.015) were the risk factors of short-term poor outcome in PDAP patients. Multivariate Logistic regression analysis showed that,after the gender,age at peritonitis,PD duration,diabetes,and serum albumin before peritonitis were adjusted,higher hsCRP before peritonitis (OR=1.026,95%CI:1.000-1.052,P=0.046) and comorbidity of clinical atherosclerotic vascular disease (OR=2.105,95% CI:1.014-4.367,P=0.046) were the independent risk factors for the poor outcomes in PDAP patients. Conclusion Higher pre-peritonitis hsCRP and comorbidity of clinical atherosclerotic vascular disease at baseline may predict poor short-term outcomes in PDAP patients.

14.
Article in Chinese | WPRIM | ID: wpr-665548

ABSTRACT

Objective To explore the roles of heme oxygenase-1 (HO-1 ) and protoporphyrin zinc IX (ZnPPIX ) , its inhibitor , in cisplatin chemotherapy for gastric cancer so as to provide potential targets for chemosensitivity in gastric cancer .Methods Gastric cancer cell line SGC7901 was used in vitro .MTT assay was carried out to determine the effects of ZnPPIX and CDDP on the proliferation in gastric cancer cells .The expression of HO-1 in gastric cancer cells was measured by Real-time PCR and Western blot ,respectively .The gastric cancer xenografts in nude mice were used to study the effects of ZnPPIX and CDDP in gastric cancer on tumor formation in vivo .Results The proliferation of cancer cells ,interfered by CDDP in combination with ZnPPIX ,could be significantly inhibited (P<0 .05) .Moreover ,CDDP could increase the expression of HO-1 in gastric cancer cells , which was reversed by ZnPPIX (P<0 .05) .The animal experiment showed that CDDP could inhibit gastric cancer growth in nude mice and reduce tumor volume and weight . Conclusion ZnPPIX could enhance the chemosensitivity of CDDP in gastric cancer ,which may be a potential sensitizer of cisplatin-based chemotherapy in gastric cancer .

15.
Chinese Circulation Journal ; (12): 964-968, 2018.
Article in Chinese | WPRIM | ID: wpr-703910

ABSTRACT

Objectives: To describe the differences between patients with angiography confirmed stent thrombosis in antiplatelet therapy and long term outcomes. Methods: We analyzed data from 1 204 patients with angiography – documented stent thrombosis between January 2008 to December 2016 in Beijing Anzhen Hospital. According to the timing of stent thrombosis post stent implantation, patients were divided into acute stent thrombosis (<24 h, n=106), subacute stent thrombosis(24 h~30 d, n=206), late stent thrombosis (>30 d~1y, n=268), and very late stent thrombosis (>1 y, n=624) groups. Death, recurrent stent thrombosis, recurrent myocardial infarction, target vessel revascularization, stroke and antiplatelet treatment during In-hospital or long-term clinical follow-up were compared among groups. Results: Prevalence of stent thrombosis was the highest in the left anterior descending artery (51.9%) in acute stent thrombosis group. Subjects with subacute stent thrombosis had a higher prevalence rate of LVEF<50% (28.2%), and subjects with very late stent thrombosis had a higher prevalence rate of diabetes (34.1%). All patients in acute stent thrombosis group received aspirin + clopidogrel, 96.5% patients in subacute stent thrombosis group and 94.5% patients in late stent thrombosis group were treated with double or triple antiplatelet therapy, while 95.2% patients in the very late stent thrombosis group were treated with double or mono antiplatelet therapy. During the follow up, mortality was 23.6%, 26.7%, 26.3% and 18.9% in acute stent thrombosis, subacute stent thrombosis, late stent thrombosis, and very late stent thrombosis groups, respectively. Conclusions: Most patients with angiography–documented stent thrombosis are treated with recommended antiplatelet therapy. Development of stent thrombosis is associated with poor outcomes.

16.
Chinese Circulation Journal ; (12): 958-963, 2018.
Article in Chinese | WPRIM | ID: wpr-703909

ABSTRACT

Objectives: This study sought to compare both the safety and efficacy of transradial (TRI) versus transfemoral (TFI) approach in women undergoing percutaneous coronary intervention (PCI) in China. Methods: We retrospectively analyzed data from 5 067 women undergoing PCI in Fuwai Hospital, Beijing, China between 2006 and 2011. 4 105 patients underwent TRI and 962 patients underwent TFI. A One-to-one propensity score matching (PSM) was performed to control for potential biases. A total of 897 pairs were matched. Results: After controlling for confounders using PSM, baseline and procedural characteristics were well-balanced between TRI and TFI groups. Patients undergoing TRI had significantly fewer major post-PCI bleeding (1.0% vs 3.5%, P<0.001) and access site complications (8.5% vs 19.7%,P<0.001) after PSM. There was no statistical differences in the incidence rates of major adverse cardiac events (a composite of cardiac death, myocardial infarction, and target vessel revascularization) during hospitalization (P>0.05). Multiple logistic regression analysis showed that TRI was an independent predictor of reduced major bleeding (OR=0.64, 95%CI: 0.54-0.76, P<0.001) and access site complications (OR=0.67, 95%CI:0.61-0.74, P<0.001). Conclusions: Our result show that TRI is related to reduced major bleeding and access site complications as compared to TFI in Chinese female patients undergoing PCI.

17.
Chinese Circulation Journal ; (12): 217-221, 2018.
Article in Chinese | WPRIM | ID: wpr-703842

ABSTRACT

Objective: To compare the prognosis of intra-aortic balloon pump (IABP) supported primary percutaneous coronary intervention (PPCI) between very elderly (age ≥ 80 years) and elderly (age < 80 years) patients with ST-segment elevation myocardial infarction (STEMI). Methods: A total of 288 STEMI patients received IABP supported PPCI in our hospital from 2004-01 to 2015-12 were retrospectively studied. Clinical condition, coronary angiography and follow-up data were analyzed; the patients with pre-operative cardiac shock, mechanical complication and non ST-segment elevation acute coronary syndrome were excluded. Eligible patients were divided into 2 groups: Very elderly group, n=51 and Elderly group, n=237. Major adverse cardiac and cerebral events (MACCE) as death, cardiac shock, new or worsen heart failure, re-MI and stroke were studied at 1 month and 1, 2 years after PPCI. Independent predictors for MACCE occurrence were investigated by Cox proportional hazard model analysis.Results: Compared with Elderly group, Very elderly group had increased incidence of MACCE at 1 month after PPCI (41.2% vs 24.5%), P=0.029 and obviously elevated incidence of stroke (9.8% vs 0.8%), P<0.001. Mortalities were similar between 2 groups at 1 month and 1 year after PPCI (17.6% vs 15.2%) and (25.5% vs 16.9%), both P>0.05; mortality was higher in Very elderly group at 2 years after PPCI (35.3% vs 20.7%), Log-rank P=0.037. Cox proportional hazard model analysis indicated that post-operative TIMI flow < 3 was the strong independent predictor for MACCE occurrence (HR=3.41, 95% CI 2.09-5.56, P<0.001), which was also the strongest predictor for death at different time points as at 1 month after PPCI (HR=9.51, 95% CI 5.23-17.29), at 1 year after PPCI (HR=7.24, 95% CI 4.13-12.69) and at 2 years after PPCI (HR=5.85, 95% CI 3.45-9.94), all P<0.001. Patients ≥ 80 years had no obvious predictors for end point event occurrence. Conclusion: Very elderly STEMI patients had the higher mortality at 2 years after IABP supported PPCI and increased incidence of MACCE at 1 month after PPCI. Patients≥80 years had no obvious predictors for end point event occurrence.

18.
Chinese Health Economics ; (12): 24-26, 2018.
Article in Chinese | WPRIM | ID: wpr-703454

ABSTRACT

Objective:To explore the mechanism and influences of population aging on medical insurance expenditure in China and put forward the improvement strategy of medical insurance.Methods:It constructed the structural equation model based on some related indicators in 31 provinces and cities of China from 2005 to 2015.Results:The indirect effect of population aging on medical insurance fund was higher than the direct effect.Medical expenses had the most influence degree of medical insurance fund.There were action and reaction between per capita GDP and medical insurance fund,while the reaction was much stronger.Conclusion:The government should construct a multi-level mode of disease prevention and control,further increase the government fiscal subsidies for medical insurance,improve the care coverage,and improve the financing mechanisms to develop the sustainable operation of medical insurance fund in China.

19.
Article in Chinese | WPRIM | ID: wpr-702315

ABSTRACT

Objective To explore the predictive factors of side branch occlusion in patients with ST-segment elevation myocardial infarction by coronary angiography. Methods A total of 1223 patients with acute ST segment elevation myocardial infarction undergoing primary percutaneous coronary intervention were consecutively enrolled in Fuwai hospital from January 2014 to December 2015. According to the coronary angiography there were 256 patients with bifurcation in the culprit lesions. Demographic data, past medical history and coronary angiography characteristics were collected in all patients. Results Among the 256 patients, there were 33 patients with branch occlusion and 223 patients without branch occlusion. Multivariate analysis demonstrated that severe stenosis of side branch ostium odds ratio 1.06, 95% confi dence interval 1.03-1.09,P < 0.001) and thrombus in side branch ostium (odds ratio 5.43, 95% confidence interval 1.23-23.93, P=0.025) were independent risk factors for predicting branch occlusion. Conclusions Side branch occlusion in culprit lesions of patients with ST-segment elevation myocardial infarction is related to the severity of branch ostium stenosis and thrombosis in branch ostium.

20.
Tianjin Medical Journal ; (12): 191-194, 2018.
Article in Chinese | WPRIM | ID: wpr-698004

ABSTRACT

Objective To evaluate the clinical effects of simple external skin expansion technique in treatment of skin necrosis defect after the surgery for Pilon fracture.Methods Data of 12 patients with skin necrosis defect after the surgery for Pilon fracture treated with simple external skin expansion technique in our hospital from May 2015 to January 2017 were retrospectively analyzed.There were 10 males and 2 females in the 12 patients with age 32-58 years old(average 45.30± 8.91 years old).There were 4 cases with open fractures and 8 cases with closed fractures.The defect area was about 9.1 cm long and 3.9 cm wide.There were 3 cases with skin necrosis of open fractures and 9 cases with postoperative skin necrosis of incision site. After completely debridement and removing infection from the skin necrosis areas, kirschner needle wired intermittented through the skin,the kirschner wire was around a sterile silicone rubber tube at both ends and the kirschner wire was connected to the both ends of the Kirschner on the opposite side.After giving moderate tensile force,which showed that the skin on both sides was still bleeding,no obvious pale color on skin,two ends of rubber tube were fixed with forceps. Using the ductility of skin and the tensile force of sterile silicone rubber tube to gradually extend the skin and to gradually narrow and close the suturing wound.All patients were followed up for 3-6 months to observe the effect of surgery.Results All of the 12 cases were healed in 2-4 weeks,average(2.50±0.59)weeks.The patients were sutured directly after simple external skin expansion,and 4 patients were sutured with the surface of the external plate or tendon,and parts of wound were delayed healed after the re-suture.The skin color,lustre,hair growth and elasticity were normal,no bloated,and tenderness was normal after simple external skin expansion.Conclusion The simple external skin expansion technique in treatment of skin necrosis defect after the surgery for Pilon fracture is a simple,effective and economic method,which is worthy of clinical promotion.

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