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1.
International Eye Science ; (12): 662-665, 2022.
Article in Chinese | WPRIM | ID: wpr-922872

ABSTRACT

@#AIM: To investigate the efficiency and safety of 3D visualization assisted phacoemulsification combined with intraocular lens(IOL)implantation. METHODS: Prospective non-randomized controlled clinical study. A total of 100 patients(103 eyes)who underwent phacoemulsification combined with IOL implantation were enrolled in the study. Among them, according to the way of surgery chosen by the participants, 24 cases(25 eyes)were enrolled from January to March 2020(3D-1 group), 24 cases(25 eyes)were enrolled from April to June 2020(3D-2 group), and 52 cases(53 eyes)were enrolled from January to June 2020(binocular microscope group)as the control group. Total operative time, capsulorhexis time, phacoemulsification operation time, cortical aspiration time, IOL implantation time, viscoelastic agent aspiration time, ultrasound time(UST), cumulative dissipated energy(CDE), fluid flow loss, intraoperative and postoperative complications were recorded in the three groups. Uncorrected visual acuity(UCVA), best corrected visual acuity(BCVA), intraocular pressure(IOP)and corneal endothelial cell count(CECC)were recorded preoperatively and 1mo postoperatively. RESULTS: The total operative time, the time of capsulorhysis, the operation time of phacoemulsification, and the time of removing viscoelastic agent between 3D-1 group and control group were statistically significant(all <i>P</i><0.01). There were no significant differences in the total operation time and each operation step time between the 3D-2 group and the control group(all <i>P</i>>0.05). The differences of UST, liquid flow loss, and CDE between 3D-1 group and the control group were statistically significant(all <i>P</i><0.05). There were no significant differences between the 3D-2 group and the control group in intraoperative parameters(all <i>P</i>>0.05). There were no statistical significances in UCVA, BCVA, IOP, and CECC among the three groups 1mo after surgery(all <i>P</i>>0.05). CONCLUSION: Phacoemulsification combined with IOL implantation using 3D visualization technology is safe and feasible. After a certain learning curve period, there is no significant difference in the surgical efficiency compared with traditional binocular surgery.

2.
Journal of Preventive Medicine ; (12): 217-221, 2022.
Article in Chinese | WPRIM | ID: wpr-920755

ABSTRACT

Objective@#To establish a prediction model of herpangina epidemic trend based on Baidu index and hand, foot and mouth disease, so as to provide insights into analyses of communicable disease epidemics with limited or missing surveillance data.@*Methods@#The incidence of hand, foot and mouth disease in Zhejiang Province during the period from the first week of 2015 through the 39th week of 2021 was retrieved from the China Information System for Disease Control and Prevention, and the Baidu index of hand, foot and mouth disease and herpangina was collected via the Baidu search engine during the same period. The correlation between the Baidu index and time series of hand, foot and mouth disease was examined using wavelet analysis. In addition, a random forest training model was created based on the Baidu index and incidence of hand, foot and mouth disease, and the fitting effectiveness was evaluated using the mean percentage error, while the Baidu index of herpangina was included in the model to predict the epidemic trend of herpangina during the study period.@*Results@#The Baidu index of herpangina and hand, foot and mouth disease, and the Baidu index and incidence of hand, foot and mouth disease all appeared two peaks at the 26th and 52th week. The phase difference was less than 0.1 week between the Baidu index and time series of hand, foot and mouth disease, and the mean percentage error of the training model was 13.07%, with high concordance between the predicted number and actual report number of cases with hand, foot and mouth disease. The numbers of herpangina cases were predicted to be 28 822, 27 341, 28 422, 51 782, 52 457 and 5 691 from 2015 to 2020, and there were totally 48 702 herpangina cases reported until the 39th week of 2021. Like hand, foot and mouth disease, the incidence of herpangina peaked between May and July.@*Conclusion@#The random forest training model based on the Baidu index and incidence of hand, foot and mouth disease is feasible to predict the epidemic trend of herpangina.

3.
Article in Chinese | WPRIM | ID: wpr-883232

ABSTRACT

Objective:To investigate the application value of hepatic vein outflow tract reconstruction with ringed polytetrafluoroethylene vascular in right lobe living donor liver trans-plantation.Methods:The retrospective and descriptive study was conducted. The clinicopatho-logical data of 4 donors and 4 recipients undergoing right lobe living donor liver transplantation in Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School and 17 donors and 17 recipients undergoing right lobe living donor liver transplantation in the First Affiliated Hospital with Nanjing Medical University from June 2015 to August 2018 were collected. Of 21 donors, there were 10 males and 11 females, aged from 35 to 57 years, with a median age of 46 years. The median body mass of 21 donors were 64 kg, with a range from 56 to 72 kg. Of 21 recipients, there were 16 males and 5 females, aged from 21 to 68 years, with a median age of 42 years. The median body mass of 21 recipients were 63 kg, with a range from 47 to 77 kg. Observation indicators: (1) surgical and postoperative situations; (2) follow-up. Follow-up was conducted by outpatient examination or telephone interview to detect graft function, tumor recurrence, vascular graft complications, patency of vascular graft and survival of recipients up to August 2020. All recipients will be followed up for all their lives. Measurement data with normal distribution were represented as Mean±SD and measurement data with skewed distribution were represented as M (range). Count data were represented as absolute numbers or percentages. The Kaplan-Meier method was used to calculate patency rates of hepatic vein outflow tract and survival rates to draw patency curve and survival curve. Results:(1) Surgical and postoperative situations: the operation time, the weight of donor graft, graft to recipient weight ratio and duration of hospital stay of 21 donors were (367±72)minutes, (557±68)g, 0.89%±0.16% and (10+2)days, respectively. No major complication requiring reoperation or intervention occurred in any of the 21 donors. One donor undergoing mild bile leakage preserved peritoneal drainage for one week. All 21 recipients underwent classic orthotopic liver transplantation successfully. The time of hepatic vein outflow tract reconstruction in donor graft, operation time and time of anhepatic phase of 21 recipients were (24±4)minutes, (326±66)minutes and (42±6)minutes, respectively. The number of reconstructed middle hepatic vein in hepatic segment 5 and 8 were 18 and 15, with the diameter of (6.1±1.3)mm and (7.2±1.2)mm, respectively. The number of reconstructed inferior right hepatic vein were 10, with the diameter of (6.3±1.3)mm. The postoperative treatment time at intensive care unit and duration of hospital stay of 21 recipients were (1.5±0.9)days and (22.6±6.7)days, respectively. Ten of 21 recipients underwent postoperative complications. Five recipients underwent graft dysfunction including the level of alanine aminotransferase and aspartate aminotransferase >1 000 IU/L and the level of bilirubin slightly increasing, combined with increased ascites. Enhanced computed tomography scan showed congestion in the right anterior of graft and thrombosis in the middle hepatic vein of hepatic segment 5 and segment 8. All 5 recipients undergoing graft dysfunction recovered with normal liver function and ascites decreasing after symptomatic treatment including liver protection therapy, anticoagulation and albumin infusion. Two recipients underwent inferior vena cava thrombosis and intractable pleural effusion one month after operation. Vena cava venography examination showed thrombosis in the graft vascular. Of the 2 recipients, one case with collateral circulation formation recovered undergoing balloon dilatation and stent placement combined with anticoagulation therapy of warfarin. The other one case recovered after anticoagulation therapy of warfarin. One recipient undergoing bile leakage and abdominal infection with klebsiella pneumoniae recovered after symptomatic treatment. Two recipients undergoing abdominal infection or pulmonary infection recovered after symptomatic treatment. There was no serious complication or death during perioperative period. (2) Follow-up: all 21 recipients were followed up for 10 to 57 months, with a median follow-up time of 38 months. During the follow-up, no recipient underwent graft dysfunction and 2 recipients had tumor recurrence at postoperative 6 months. Six of the 21 recipients died within 2 years after operation including 3 cases dying of tumor recurrence, 2 cases dying of acute hemorrhage and 1 case dying of liver failure. There was no death caused by vascular graft complica-tions. The postoperative 1, 3, 6-month, and 1-year and 2-year potency rates of hepatic vein outflow tract in 21 recipients were 88.4%, 88.4%, 82.4%, 68.0% and 42.1%, respectively. The 6-month, 1-year and 2-year overall survival rates in 21 recipients were 100%, 94.4%, 71.4%, respectively.Conclusion:Application of hepatic vein outflow tract reconstruction with ringed polytetrafluoroethylene vascular in right lobe living donor liver transplantation is safe and feasible.

4.
Article in Chinese | WPRIM | ID: wpr-882222

ABSTRACT

Objective:To evaluate the efficacy of Paishi decoction in ureteral calculi treatment. Methods:Ureteral calculi patients were voluntarily divided into two groups in Shanghai Baoshan Traditional Chinese Medicine-Integrated Hospital. Patients in the control group received anti-inflammatory symptomatic treatment for 2 weeks, and patients in the treatment group received anti-inflammatory symptomatic treatment combined with Paishi decoction for 2 weeks. Results:There was no significant difference between the two groups in gender, age, body weight and stone size. Compared with the control group, after taking Paishi decoction for 2 weeks, the urinary oxalic acid and calcium in the treatment group decreased significantly, and the urine citric acid increased (P<0.05). The difference in clinical effective rate was significant between the two groups (P<0.05). Conclusion:Paishi decoction is superior to single anti-inflammatory symptomatic treatment in the treatment of ureteral calculi, which reflects the advantages of integrated traditional Chinese and Western medicine. However, the number of patients included in this study was limited, further studies are in need to verify the result.

5.
Article in Chinese | WPRIM | ID: wpr-906158

ABSTRACT

Objective:Guided by nutrient-defense stages in the vessel-collateral theory, the modern medical cases of unstable angina pectoris(UAP) were systematically collated and analyzed to explore the rules of syndrome and treatment of UAP and the molecular mechanism of core Chinese herbal combination in the treatment of UAP based on network pharmacology. Method:All medical cases with UAP treated by Chinese medicinal compounds were retrieved from PubMed,China National Knowledge Infrastructure (CNKI),Wanfang Data, VIP, and SinoMed published between database inception and November 2020. The syndromes of medical cases were determined based on the nutrient-defense stages of the vessel-collateral theory. Rules of syndrome and treatment of UAP were investigated by data mining methods, such as frequency statistics, cluster analysis, and enhanced FP-Growth algorithm. The molecular mechanism of core Chinese herbal combination in the treatment of UAP was analyzed by network pharmacology. Result:The first four syndromes of UAP with high frequencies were deficiency and stagnation of collateral Qi, blood stasis obstructing collaterals, depression and stagnation of collateral Qi, and turbid phlegm obstructing collaterals. The Chinese herbal medicines with high frequencies included Salviae Miltiorrhizae Radix et Rhizoma, Glycyrrhizae Radix et Rhizoma, Chuanxiong Rhizoma, and Astragali Radix, which were effective in resolving stasis, dredging collaterals, replenishing Qi, consolidating defensive Qi, regulating Qi, relieving depression, and dispelling phlegm. The association analysis indicated that the core Chinese herbal combination in the treatment of UAP was Salviae Miltiorrhizae Radix Chuanxiong Rhizoma-Astragali Radix. Four Chinese herbal combinations were obtained by cluster analysis. As revealed by network pharmacology, the key components of Salviae Miltiorrhizae Radix et Rhizoma-Chuanxiong Rhizoma-Astragali Radix in the treatment of UAP included quercetin, luteolin, and tanshinone Ⅱ<sub>A</sub>, and the key targets included serine/threonine-protein kinase 1 (Akt1), mitogen-activated protein kinase 1 (MAPK1), Jun, interleukin (IL)-6, and MAPK8. Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis showed that phosphatidylinositol-3-kinase (PI3K)/protein kinase B (Akt) signaling pathway might serve as the main pathway for its therapeutic efficacy. Conclusion:The basic pathogenesis of UAP is deficiency/depression and stagnation of collateral qi and turbid phlegm obstructing collaterals. The treatment should follow the principles of replenishing Qi, resolving stasis, and dredging collaterals, assisted with regulating Qi and resolving phlegm. The therapeutic efficacy of Salviae Miltiorrhizae Radix-Chuanxiong Rhizoma-Astragali Radix was achieved via multi-component, multi-target, and multi-pathway. This study is expected to inspire future UAP-related studies at the molecular level based on vessel-collateral theory.

6.
Asian Nursing Research ; : 15-22, 2021.
Article in English | WPRIM | ID: wpr-897182

ABSTRACT

Purpose@#The purpose of this study was to explore the experiences of caregivers in long-term care facilities as they implement palliative care. Although palliative care has been available in Taiwan for more than 30 years, it is often provided in hospitals, few models in the long-term care facilities. @*Methods@#Semi-structured interviews using grounded theory methodology and purposive sampling. Two small long-term care facilities that had performed well in palliative care were selected from eastern Taiwan. A total of 12 caregivers participated in in-depth semi-structured face-to-face interviews. @*Results@#Four major stages in the implementation of palliative care were identified: (1) feeling insecure, (2) clarifying challenges, (3) adapting to and overcoming the challenges, and (4) comprehending the meaning of palliative care. The core category of these caregivers as “the guardians at the end of life” reflects the spirit of palliative care. @*Conclusion@#This study demonstrates that successful palliative care implementation would benefit from three conditions. First, the institution requires a manager who is enthusiastic about nursing care and who sincerely promotes a palliative care model. Second, the institution should own caregivers who possess personality traits reflective of enthusiasm for excellence, unusual ambition, and a true sense of mission. Third, early in the implementation phase of the hospice program, the institution must have the consistent support of a high-quality hospice team.

7.
Asian Nursing Research ; : 15-22, 2021.
Article in English | WPRIM | ID: wpr-889478

ABSTRACT

Purpose@#The purpose of this study was to explore the experiences of caregivers in long-term care facilities as they implement palliative care. Although palliative care has been available in Taiwan for more than 30 years, it is often provided in hospitals, few models in the long-term care facilities. @*Methods@#Semi-structured interviews using grounded theory methodology and purposive sampling. Two small long-term care facilities that had performed well in palliative care were selected from eastern Taiwan. A total of 12 caregivers participated in in-depth semi-structured face-to-face interviews. @*Results@#Four major stages in the implementation of palliative care were identified: (1) feeling insecure, (2) clarifying challenges, (3) adapting to and overcoming the challenges, and (4) comprehending the meaning of palliative care. The core category of these caregivers as “the guardians at the end of life” reflects the spirit of palliative care. @*Conclusion@#This study demonstrates that successful palliative care implementation would benefit from three conditions. First, the institution requires a manager who is enthusiastic about nursing care and who sincerely promotes a palliative care model. Second, the institution should own caregivers who possess personality traits reflective of enthusiasm for excellence, unusual ambition, and a true sense of mission. Third, early in the implementation phase of the hospice program, the institution must have the consistent support of a high-quality hospice team.

8.
Journal of Experimental Hematology ; (6): 1231-1235, 2021.
Article in Chinese | WPRIM | ID: wpr-888543

ABSTRACT

OBJECTIVE@#To evaluate the diagnostic value of peripheral blood cell parameters for early recognition of myelodysplastic syndrome (MDS) patients.@*METHODS@#The clinical and laboratory data of 86 patients with MDS and 72 patients with non-malignant clonal anemia treated in first diagnosed in the Second Hospital of Hebei Medical University from January 1, 2015 to December 31, 2017 was retrospectively analyzed. The peripheral blood cell parameters of the patients in two groups were analyzed, generated the receiver operator characteristic curve (ROC curve) from the statistically significant parameters, the binary logistic model was build to calculate and compare the area under the ROC curve (AUC) combined with multiple indicators and individual indicators, sensitivity, specificity, positive and negative likelihood ratio, and diagnostic accuracy, the diagnostic efficacy of the patients was analyzed.@*RESULTS@#Compared with patients in the non-malignant clonal anemia group ,white blood cell count (WBC), neutrophil percentage (NE%), eosinophil percentage (E%), eosinophil absolute value (E#), platelet count (PLT), platelet specific volume (PCT%) in the MDS patients were significantly reduced; while percentage of lymphocytes (LY%), basophilic percentage (B%), and the width of platelet distribution (PDW) significantly increased. The several ROC curves with the above indicators were established, which showed that AUC@*CONCLUSION@#PDW, B% and LY% in peripheral blood cell parameters have certain diagnostic value for early recognition of MDS.


Subject(s)
Humans , Leukocyte Count , Lymphocytes , Myelodysplastic Syndromes/diagnosis , Platelet Count , Retrospective Studies
9.
Article in Chinese | WPRIM | ID: wpr-878988

ABSTRACT

The aim of this paper was to discuss the effect of swertiamarin, gentiopicrin and sweroside on rheumatoid arthritis fibroblast-like synoviocytes(RA-FLSs) and B-cell lymphoma-2(Bcl-2) and their mechanisms. ZINC database and RCSB PDB database were retrieved for 3 D chemical structures of swertiamarin, gentiopicrin and sweroside and 3 D target protein structures. AutoDock Mgltools 1.5.6, AutoDockVina 1.1.2 and pyMOL 2.2.0 were applied for molecular docking to analyze the relationship between Bcl-2(1 GJH) target protein and important ingredients. The cell apoptosis of RA-FLSs was tested by Annexin V-FITC. The Bcl-2 protein expression of RA-FLSs treated with different ingredients was tested by Western blot. The Bcl-2 mRNA expression of RA-FLSs treated with different ingredients was tested by RT-PCR. Swertiamarin, gentiopicrin and sweroside were docked well with Bcl-2(1 GJH). The binding energy of swertiamarin was-6.9 kcal·mol~(-1), the binding energy of gentiopicrin was-6.7 kcal·mol~(-1) and the binding energy of sweroside was-6.4 kcal·mol~(-1). Compared with the blank group, the Bcl-2 protein expression of each group were reduced, while that of the gentiopicrin group was the highest(P<0.01). Compared with the blank group, the Bcl-2 mRNA expression of each groups were reduced. Gentiopicrin can reduce the Bcl-2 protein expression and the Bcl-2 mRNA expression, so as to promote the RA-FLSs apoptosis.


Subject(s)
Apoptosis , Arthritis, Rheumatoid/genetics , Cell Proliferation , Cells, Cultured , Fibroblasts , Humans , Iridoid Glucosides , Molecular Docking Simulation , Proto-Oncogene Proteins c-bcl-2/genetics , Pyrones , Synoviocytes
10.
Article in Chinese | WPRIM | ID: wpr-875958

ABSTRACT

Shanghai is one of the cities with the highest economic level in China. Environmental health in Shanghai has always been a national pilot and at the forefront of the country. After 70 years of development, Shanghai has established a public health monitoring network for major environmental health issues. The main line of research work has turned to be on health risk assessment, exposure-health effect, and the relationship between environment and population health. This article reviews the achievements and problems of in various aspects of environmental health in the past 70 years, including drinking water, the atmosphere, public places, rural environments, emergency handling and featured researches. It provides reference for the development of environmental health in the future.

11.
Protein & Cell ; (12): 128-144, 2021.
Article in English | WPRIM | ID: wpr-880899

ABSTRACT

Pancreatic ductal adenocarcinoma (PDAC) has poor prognosis due to limited therapeutic options. This study examines the roles of genome-wide association study identified PDAC-associated genes as therapeutic targets. We have identified HNF4G gene whose silencing most effectively repressed PDAC cell invasiveness. HNF4G overexpression is induced by the deficiency of transcriptional factor and tumor suppressor SMAD4. Increased HNF4G are correlated with SMAD4 deficiency in PDAC tumor samples and associated with metastasis and poor survival time in xenograft animal model and in patients with PDAC (log-rank P = 0.036; HR = 1.60, 95% CI = 1.03-2.47). We have found that Metformin suppresses HNF4G activity via AMPK-mediated phosphorylation-coupled ubiquitination degradation and inhibits in vitro invasion and in vivo metastasis of PDAC cells with SMAD4 deficiency. Furthermore, Metformin treatment significantly improve clinical outcomes and survival in patients with SMAD4-deficient PDAC (log-rank P = 0.022; HR = 0.31, 95% CI = 0.14-0.68) but not in patients with SMAD4-normal PDAC. Pathway analysis shows that HNF4G may act in PDAC through the cell-cell junction pathway. These results indicate that SMAD4 deficiency-induced overexpression of HNF4G plays a critical oncogenic role in PDAC progression and metastasis but may form a druggable target for Metformin treatment.

12.
Article in Chinese | WPRIM | ID: wpr-872728

ABSTRACT

Objective:To investigate the effect of icariin on neuroprotection in cerebral ischemia-reperfusion rats and microglia toll-like receptor 4 (TLR4)/nuclear transcription factor-κB (NF-κB) pathway. Method:In the blank group, blood vessels were only isolated but not ligated and blocked,and the rats were injected intraperitoneally with the same volume of normal saline. After successful modeling, they were randomly divided into model group, butyphthalide group (6 mg·kg-1), and high, medium and low (40,20,10 mg·kg-1)-dose icariin group,and abdominally administered with drugs at 5,12, 24 h after ischemia, respectively. The nerve function scores were detected, 2,3,5-triphenyltetrazole chloride (TTC) staining was used to measure the cerebral infarction rate,immunohistochemical assay was performed to detect the expressions of microglial markers ionized calcium binding adapter molecule 1(Iba1) and TLR4 in the rat brain cortex, Western blot immunoassay was used to detect the expression of NF-κB p65 in the cerebral cortex, and enzyme-linked immunosorbent assay (ELISA) was used to detect interleukin-1α (IL-1α) and tumor necrosis factor-α (TNF-α) content. Result:Compared with the sham-operation group, the nerve score, the cerebral infarction rate, the activations of Iba1 and TLR4 in microglial cells, the protein expression of NF-κB p65(P<0.01), and the contents of inflammatory factors IL-1α and TNF-α in the model group increased significantly(P<0.01). After treatment with icariin, compared with the model group, the neurological function score and the cerebral infarction rate of rats were improved, whereas the activations of Iba1 and TLR4 in microglia, the protein expression of NF-κB p65, and the contents of inflammatory factors IL-1α and TNF-α decreased obviously(P<0.05,P<0.01). Conclusion:Icariin may inhibit the activations of TLR4 and its downstream NF-κB signaling pathway and reduce the expression of relevant inflammatory factors IL-1α and TNF-α by regulating the activation of microglia, so as to play a protective role in the brain after stroke.

13.
Article in Chinese | WPRIM | ID: wpr-868824

ABSTRACT

Objective:To study the clinical role of ultrasound image-fusion and navigation system (UIFNS), which works through image fusion with volume navigation of ultrasound (VNUS) and computed tomography (CT) or magnetic resonance imaging (MRI), in percutaneous transhepatic cholangioscopic lithotripsy (PTCSL) for treatment of hepatolithiasis.Methods:The data of 54 patients with hepatolithiasis who underwent PTCSL between January 2017 and October 2019 in Hepatobiliary Center, the First Affiliated Hospital of Nanjing Medical University was retrospectively analyzed. Among 54 patients, 16 males and 38 females, aged 16-84 years with a median age of 59.5 years, were included. Preoperative ultrasound, CT, MRI and UIFNS were used to evaluate stone location and distribution in bile ducts. The rates of consistency of each single modality of evaluation with intraoperative examination by cholangioscopy plus ultrasound were compared. The stone clearance rates were compared among the different groups with different numbers of biliary sinus tracts used for stone extraction.Results:The rates of consistency of each single modality of evaluation, including ultrasound, CT, MRI and UIFNS, with intraoperative examination by choledochoscopy plus ultrasound were 75.9% (41/54), 55.6% (30/54), 72.2% (39/54) and 92.6% (50/54), respectively. The rates of consistency as assessed by UIFNS was significantly higher than that by CT or MRI (each P<0.05). The 54 patients were divided into the central-type group, the single-biliary-branch-type group and the multi-branch-type group according to biliary stone location and distribution, with 10 patients, 2 patients and 42 patients, respectively. Biliary sinus tract was established by the one-step method. One single tract was established in 43 patients, and two or more tracts in 11 patients. Each patient underwent 1-3 times of cholangioscopic lithotripsy (mean 1.76 times). The stone clearance rate in the central-type of patients and patients with single-biliary-branch stones was 100% (12/12). In 42 patients with stones in multiple branches of intrahepatic bile ducts, 31 patients underwent stone extraction through a single sinus tract while 11 patients through 2 or more sinus tracts. There was no significant difference in the stone clearance rate between patients with a single sinus tract and those with 2 or more sinus tracts ( P>0.05). The total stone clearance rate was 79.6% (43/54) and the total complication rate 18.5% (10/54). Conclusion:UIFNS was a useful tool with advantages in evaluating the location and distribution of biliary stones, and in selecting appropriate hepatic ducts for planning puncture routes to establish sinus tracts for stone removal.

14.
Article in Chinese | WPRIM | ID: wpr-865124

ABSTRACT

Objective:To investigate the clinical efficacy of percutaneous transhepatic cholangioscopic lithotripsy with one-step biliary fistulation (PTCSL-OBF) for the treatment of hepatolithiasis.Methods:The retrospective and descriptive study was conducted. The clinicopathological data of 59 patients with hepatolithiasis who were admitted to the First Affiliated Hospital of Nanjing Medical University from March 2017 to December 2019 were collected. There were 16 males and 43 females, aged from 16 to 84 years, with a median age of 60 years. All patients underwent PTCSL-OBF. Observation indicators: (1) surgical and postoperative situations; (2) follow-up; (3) introduction of special cases. Follow-up using outpatient examination and telephone interview was performed to detect the hepotolithiasis-related symptoms, recurrence of hepatolithiasis , and survival of patients up to December 2019. Measurement data with skewed distribution were represented as M (range). Count data were represented as absolute numbers or percentages. Results:(1) Surgical and postoperative situations: 59 patients underwent PTCSL-OBF successfully. Of the 59 patients, 48 cases had 1 biliary sinus tract, 8 cases had 2 biliary sinus tracts, 2 cases had 3 biliary sinus tracts and 1 case had 4 biliary sinus tracts. A total of 106 times of cholangioscopic lithotripsy procedure were performed in the 59 patients, including 20 cases with once of cholangioscopic lithotripsy procedure, 31 cases with twice of cholangioscopic lithotripsy procedure and 8 cases with 3 times of cholangioscopic lithotripsy procedure. Among the 59 patients, 14 cases were diagnosed with residual stones after operation, 45 cases had stones removed completely with the stones removal rate of 76.3%(45/59). The duration of hospital stay of the 59 patients were 24 days(range, 3-88 days). Of the 59 patients, 11 cases had 14 times of postoperative complications. The total incidence of complications was 18.6%(11/59). Among the 14 times of complications, there were 4 times of pleural effusion combined with infection, 2 times of liver abscess, 2 times of ascites, 2 times of intraoperative hypotension septic shock, 2 times of bleeding, 1 time of colon perforation and 1 time of bile leakage. Patients with complications were cured with symptomatic support treatment including puncture drainage, anti-infection and hemostasis. (2) Follow-up: 59 patients were followed up for 1-34 months, with a median follow-up time of 18 months. Of the 59 patients, 9 had recurrence of hepatolithiasis, with a recurrence rate of 15.3%(9/59); 17 had hepatolithiasis related symptoms, with an incidence of 28.8%(17/59). Of the 45 patients who had stones removed completely, 6 had recurrence of hepatolithiasis, with a recurrence rate of 13.3%(6/45); 14 had hepatolithiasis related symptoms, with an incidence rate of 31.1%(14/45). Of the 14 patients who had residual stones postoperatively, 3 had recurrence of hepatolithiasis, with an incidence rate of 21.4%(3/14); 3 had hepatolithiasis related symptoms, with an incidence rate of 21.4%(3/14). During the follow-up, 7 of 59 patients died, 2 of whom died of biliary neoplasms and 5 died of decompensated cirrhosis. (3) Introduction of special cases: among the 5 patients with biliary cirrhosis, 3 cases had stones removed completely, but the original symptoms of the 2 cases were not improved postoperatively and cholangitis occurred repeatedly. The other 2 cases underwent only once of cholangioscopic lithotripsy procedure because of severe cirrhosis combine with massive ascites.Conclusion:PTCSL-OBF can be used in the treatment of hepatolithiasis with appropriate indications, careful operation and strengthened perioperative management to reduce complications.

15.
Journal of Preventive Medicine ; (12): 217-223, 2020.
Article in Chinese | WPRIM | ID: wpr-815970

ABSTRACT

Objective @#To learn the epidemiological characteristics of coronavirus disease 2019 (COVID-19) cases reported from January 21 to February 20,2020 in Zhejiang Province,so as to provide basis for formulating and implementing effective control measures.@*Methods @#The COVID-19 cases reported by Zhejiang Province were extracted from the National Diseases Prevention and Control Information System. A descriptive analysis was adopted for the epidemiological characteristics of COVID-19 cases,including time,spatial and population distribution,severity of symptoms, and exposure history. @*Results @#Totally 1 284 cases were reported,of which 1 176 were confirmed cases (91.59%) and 108 were asymptomatic cases (8.41%). The first confirmed case was reported on January 21. The curve of the disease onset peaked from January 22 to 29, with 87 cases as the biggest number a day. The curve of the disease reported peaked from January 28 to 30, with 130 cases as the biggest number a day. Then the number of the cases showed a declining trend. By February 4, totally 79 counties (cities, districts) had confirmed cases, covering 87.78% of Zhejiang Province, and it has not increase since then. A male to female ratio of 1.02∶1 was reported among 1 284 cases,1 021 were 30-69 years old (79.52%) and 339 (26.40%) were business service providers. There were 11 health workers reported to be infected,but not by occupational exposure. Among the confirmed cases, 1 010 (85.88%) were clinically mild cases. One case died. Before January 23, the cases were mainly imported from Hubei Province, local cases were predominant by the end of January. @*Conclusions @#The COVID-19 epidemic has spread widely in Zhejiang Province and people are generally susceptible. Most cases were clinically mild, and were aged 30-69 years. No health workers infected were due to occupational exposure. The incidence of COVID-19 in Zhejiang Province has turned into a lower level,suggesting that the early prevention and control measures have achieved initial results. With people returning from holiday, precise prevention and control should be put into effect.

16.
Article in Chinese | WPRIM | ID: wpr-777480

ABSTRACT

Fifty cultivated Perilla seeds were collected all over the country and planted in Beijing experiment field for morphology and chemical-type researches. Twenty morphological characteristics were selected and observed, and the essential oil from leaves was extracted by steam distillation and analyzed by GC-MS to confirm chemical-types. There were significant diversities in plant height, leaf color and morphology, and fruit color and weight. Clustering analysis was carried out based on these morphological characteristics. Six types were divided with their chemical-type designated. Type Ⅰ: Six germplasms, attributed to P. frutescens var. crispa, with dwarf plants, thin creased purple leaf, named Crispa, their chemical types were diversified, including EK, PAPK, PA and PK. Type Ⅱ: Six germplasms, attributed to P. frutescens var. crispa, plants were taller than type I and with thin and creased green leaf, named Big Crispa, all PK type. Type Ⅲ: Seventeen germplasms, attributed to P. frutescens var. frutescens with leaf color upside green and underside purple, tall plant and wide distribution all over the China, named Ordinary Frutescens, all PK. Type Ⅳ: Four germplasms, attributed to P. frutescens var. acuta with tall plant and small seed, named Acuta, all PK. Type Ⅴ: Seven germplasms, attributed to P. frutescens var. frutescens with green leaves, tall plants and long clusters, named Long-spike Frutescens, all PK. Type Ⅵ: Ten germplasms, attributed to P. frutescens var. frutescens with big, thick and creased leaf, named Thick-leaf Frutescens, including PK, PP, PL and PA. The morphological classification of this paper would lay the foundation for the taxonomic naming and following evaluation of the Perilla germplasm resources.This study also showed that there was no correspondence but a certain correlation between volatile oil chemical-types and subspecies classification and morphological characteristics of Perilla.


Subject(s)
China , Oils, Volatile , Perilla frutescens , Chemistry , Plant Leaves , Chemistry
17.
Article in Chinese | WPRIM | ID: wpr-861241

ABSTRACT

Objective: To analyze CT and MRI manifestations of mucinous cystic neoplasms (MCN) and cyst-forming intraductal papillary neoplasms of the bile duct (IPNB). Methods: Clinicopathological and imaging data of 25 MCN patients (MCN group) and 16 cyst-forming IPNB patients (IPNB group, including 10 invasive IPNB patients and 6 noninvasive IPNB patients) confirmed pathologically were retrospectively analyzed. Results: There were significant differences of bile duct dilation, communication with lesions and bile ducts, mural nodules between MCN group and IPNB group (all P0.05). Only lesion diameter was significantly different between invasive and noninvasive IPNB (P=0.032). Conclusion: CT and MRI features of MCN and cyst-forming IPNB are similar. Dilated bile ducts, communication between dilated bile ducts and mural nodules in lesions have high value in differential diagnosis of these two diseases.

18.
Article in Chinese | WPRIM | ID: wpr-905678

ABSTRACT

Objective:To evaluate the effect of threshold inspiratory muscle training (TIMT) on respiratory muscle strength and clinical outcomes for machinery ventilates patients. Methods:The Cochrane Library, PubMed, Embase, Web of Science, CBM, Wanfang Database, CNKI and VIP were searched for the randomized controlled trials (RCT) about the effect of TIMT on respiratory muscle strength and clinical outcomes from establishment to July 1st, 2018. Two researchers strictly evaluated literature quality and extracted information, and then a Meta-analysis was carried out. Results:A total of 14 literatures were included with 650 patients, 323 cases in the experimental group and 327 cases in the control group. Compared with the control group, the massive inspiratory pressure (MIP) increased (MD = -6.65, 95%CI -8.27~-5.03, P < 0.001), the respiratory muscle strength increased (MD = -5.04, 95%CI -7.68~-2.04, P = 0.0002), the weaning time reduced (MD = -1.01, 95%CI -1.65~-0.37, P = 0.002), the mechanical ventilation time shortened (MD= -2.24, 95%CI -4.33~-0.15, P = 0.04), as well as the intensive care unit (ICU) length of stay (MD= -3.41, 95%CI -6.06~-0.76, P= 0.01). There was no significant difference in maximum expiratory pressure (MEP) (MD= 1.22, 95%CI -6.55~9.00, P = 0.76), the rate of reintubation/tracheotomy (RR = 0.99, 95%CI 0.56~1.73, P = 0.96) and mortality (RR= 1.05, 95%CI 0.53~2.06, P = 0.89) between two groups. Conclusion:TIMP could improve MIP and respiratory muscle strength of patients with mechanical ventilation, shorten the weaning time, the mechanical ventilation time and the ICU length of stay, and then reduce the incidence of weaning failure.

19.
Article in Chinese | WPRIM | ID: wpr-798345

ABSTRACT

Objective: To observe the effects of different combinations of Gentianae Macrophyllae Radix (Qinjiao) on the ankle joint matrix metalloproteinase-3 (MMP-3) and tissue inhibitor of matrix metalloproteinase-1 (TIMP-1) of rheumatoid arthritis (RA) model rats with wind-cold-dampness arthralgia.Method: Eighty healthy SD rats were randomly divided into 8 groups, namely blank control group, collage Ⅱ model group, wind-cold-dampness syndrome model group, positive control group, single-taste Gentianae Macrophyllae Radix group, Gentianae Macrophyllae Radix-Clematidis Radix et Rhizoma group (GC group), Gentianae Macrophyllae Radix-Taxilli Herba group (GT group), Gentianae Macrophyllae Radix-Stephanlae Tetrandrae Radix group (GS group), with 10 rats in each group. Rat model of wind-cold-dampness RA was induced through the injection with type Ⅱ collagen emulsion and wind-cold-dampness stimulation. After the establishment of the model, the blank control group, collage Ⅱ model group and wind-cold-dampness syndrome model group were given normal saline, and the corresponding liquid medicine was given to each administration group. In the experiment, the thickness of the left posterior metatarsal of rats was measured every 3 days, and the swelling degree of metatarsal was calculated. The arthritis index (AI) was evaluated on the 38th day of the experiment. The serum rheamatoid factor(RF) content of rats was detected by enzyme linked immunosorbent assay (ELISA). The expressions of MMP-3 and TIMP-1 in ankle joint were detected by Western blot. The expressions of MMP-3 and TIMP-1 mRNA in ankle joint were detected by real-time fluorescence quantitative PCR (Real-time PCR).Result: Compared with the blank group, the swelling degree, AI score, serum RF content, MMP-3 protein expression and MMP-3 mRNA expression in ankle joints of coll age Ⅱ model group and model wind-cold-dampness syndrome group were significantly increased (PPPPPPConclusion: For rheumatoid arthritis with wind-cold-dampness arthralgia, mild and warm traditional Chinese medicine (TCM) has a better effect than the combination of mild and cold TCM or mild TCM drugs. The experimental results are basically consistent with the principle of "treating cold diseases with hot medicine". The mechanism of the compatibility in treating rheumatoid arthritis due to wind-cold-dampness arthralgia may be related to the reduction of MMP-3, the increase of TIMP-1 expression and the reduction of articular cartilage damage.

20.
Article in Chinese | WPRIM | ID: wpr-744318

ABSTRACT

Objective To investigate the incidence of central line-associated bloodstream infection (CLABSI) in patients with hematopoietic stem cell transplantation (HSCT), explore risk factors for the occurrence of CLABSI.Methods Basic information of patients with acute myeloid leukemia (AML) and myelodysplastic syndrome (MDS) who underwent HSCT in a hematology department from November 1, 2016 to October 31, 2017 was collected, incidences of original CLABSI (OCLABSI) and modified CLABSI (MCLABSI) were calculated, related risk factors were analyzed by multivariate Cox regression.Results A total of 218 patients with AML and MDS who underwent HSCT were enrolled, 19 of whom had OCLABSI and 10 had MCLABSI.Twenty-one strains of pathogens were isolated from 19 patients with OCLABSI, including 9 gram-positive bacteria, 11 gram-negative bacteria, 1 fungus;9 strains were multidrug-resistant organisms.The main risk factors for OCLABSI included the female (HR=0.088;95%CI:0.017-0.440;P=0.003), age (HR=1.560;95%CI:1.066-2.530;P=0.034), bone marrow cell transplantation only (HR=4.408;95%CI:1.860-22.593;P=0.043), ATG/CSA/MMF/MTXG for preventing graft-versus-host disease (GVHD) (HR=0.101;95%CI:0.015-0.686;P=0.019), and MTX for preventing GVHD (HR=0.097;95%CI:0.011-0.816;P=0.032).Conclusion Definition of MCLABSI can provide more accurate monitoring on deep central venous catheter-related bloodstream infection.Incidence of CLABSI in HSCT patients can be reduced by early detection of high-risk population according to high-risk factors, strict adherence to the prevention and control measures of bloodstream infection, and implementation of immune recombination after enhanced transplantation.

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