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1.
Article in Chinese | WPRIM | ID: wpr-932443

ABSTRACT

Objective:To establish a scoring scale for trial of labor after cesarean section (TOLAC), to explore the evaluation ability of this scoring scale for vaginal delivery after cesarean section (VBAC), and to improve the success rate of TOLAC.Methods:The delivery information of 661 TOLAC pregnant women admitted to Zhengzhou Central Hospital Affiliated to Zhengzhou University from 2014 to 2017 was retrospectively analyzed, and the TOLAC scoring scale was established by referring to relevant literatures. A prospective cohort study of pregnant women with TOLAC from January 2018 to December 2019 in Zhengzhou Central Hospital was conducted, including 440 pregnant women who were excluded from contraindications in trial labor. According to TOLAC scoring scale, pregnant women were divided into 3 groups, 0-6 group (94 cases), 7-9 group (234 cases) and 10-15 group (112 cases). The success rate of trial labor, failure reasons and incidence of maternal and neonatal complications were compared among the three groups.Results:(1) The overall success rate of TOLAC in 440 pregnant women was 75.0% (330/440). The success rates of 0-6, 7-9 and 10-15 groups were 53.2% (50/94), 76.9% (180/234) and 89.3% (100/112), respectively. The success rate of 10-15 group were significantly higher than those of 0-6 and 7-9 groups (all P<0.05). (2) Among the causes of trial labor failure, there were statistically significant differences between the three groups in terms of threatened uterine rupture and maternal abandonment (all P<0.05). Pairings showed that the incidences of threatened uterine rupture and maternal abandonment in 0-6 group was lower than those in 7-9 and 10-15 groups, and the differences were statistically significant (all P<0.05). (3) Maternal and neonatal complications mainly included postpartum hemorrhage and neonatal asphyxia, but there were no significant difference in the incidence of TOLAC success or failure among the three groups (all P>0.05). There was no uterine rupture in all groups. (4) The main factors affecting TOLAC score of pregnant women in the three groups included natural labor, estimated weight of the fetus at this time, Bishop score of the cervix at admission and gestational age, and the scores of the above indexes in 10-15 group were significantly higher than those in 0-6 group and 7-9 group (all P<0.05). Conclusions:TOLAC scoring scale has more accurate evaluation ability for VBAC, which could improve the success rate of TOLAC and maternal and child safety. The score of 0-6 is not recommended for vaginal trial labor, the score of 7-9 is recommended for vaginal trial labor, and the score of 10-15 is strongly recommended for vaginal trial labor.

2.
Journal of Chinese Physician ; (12): 637-640,F3, 2022.
Article in Chinese | WPRIM | ID: wpr-932110

ABSTRACT

Sodium glucose cotransporter 2 inhibitor (SGLT2i) emerged as a new hypoglycemic agent, which can inhibit glucose reabsorption and thus play a hypoglycemic role. Recent studies have shown that SGLT2i not only lowers blood glucose, but also has a protective effect on the cardiovascular system, which may benefit patients with heart failure.The specific mechanism of action is still not fully elucidated. This paper aims to summarize the latest research results of SGLT2i in the treatment of heart failure, and analyze the possible mechanisms for clinical guidance.

3.
Acta Pharmaceutica Sinica B ; (6): 1288-1304, 2022.
Article in English | WPRIM | ID: wpr-929353

ABSTRACT

Osteosarcoma is a kind of bone tumor with highly proliferative and invasive properties, a high incidence of pulmonary metastasis and a poor prognosis. Chemotherapy is the mainstay of treatment for osteosarcoma. Currently, there are no molecular targeted drugs approved for osteosarcoma treatment, particularly effective drugs for osteosarcoma with pulmonary metastases. It has been reported that fibroblast activation protein alpha (FAPα) is upregulated in osteosarcoma and critically associated with osteosarcoma progression and metastasis, demonstrating that FAPα-targeted agents might be a promising therapeutic strategy for osteosarcoma. In the present study, we reported that the FAPα-activated vinblastine prodrug Z-GP-DAVLBH exhibited potent antitumor activities against FAPα-positive osteosarcoma cells in vitro and in vivo. Z-GP-DAVLBH inhibited the growth and induced the apoptosis of osteosarcoma cells. Importantly, it also decreased the migration and invasion capacities and reversed epithelial-mesenchymal transition (EMT) of osteosarcoma cells in vitro and suppressed pulmonary metastasis of osteosarcoma xenografts in vivo. Mechanistically, Z-GP-DAVLBH suppressed the AXL/AKT/GSK-3β/β-catenin pathway, leading to inhibition of the growth and metastatic spread of osteosarcoma cells. These findings demonstrate that Z-GP-DAVLBH is a promising agent for the treatment of FAPα-positive osteosarcoma, particularly osteosarcoma with pulmonary metastases.

4.
Article in Chinese | WPRIM | ID: wpr-942350

ABSTRACT

Stroke is a common cerebrovascular disease, characterized by high incidence, mortality and disability rate. Neuronal cells, the basic unit of the central nervous system, can be injured to varying degrees when stroke occurs. Neuronal cell injury after stroke is also the key cause leading to neurological dysfunction, affecting the prognosis and quality of life of patients. Therefore, reducing the neuronal cell injury and delaying the process of cell death are effective to decrease the nerve function injury in stroke patients and improve their prognosis, thus lowering the death and disability rate of stroke. Ferroptosis is a new form of cell death that has been widely concerned in recent years. Several studies have confirmed that there is ferroptosis in neuronal cells after stroke. Since ferroptosis is an adjustable form, its intervention can help regulate the injury and death of neuronal cells. Studies have shown that inhibiting ferroptosis plays a role in protecting neuronal cells. Traditional Chinese medicine (TCM), with the multi-channel and multi-target treatment advantages, has been widely used in the whole stroke and has achieved good clinical efficacy. It might be a new direction taking TCM regulation of ferroptosis as the entry point for stroke treatment in the future. This review revealed the mechanism of ferroptosis, discussed the research status of TCM in intervening in neuronal cell ferroptosis, and provided reference for further improving the efficacy of TCM in stroke.

5.
Article in Chinese | WPRIM | ID: wpr-884289

ABSTRACT

Objective:To evaluate the characteristics of cervical hardness and softness in the second trimester, and to explore the predictive value of the combination of cervical elastographic parameters and cervical length(CL) in spontaneous preterm birth (sPTB).Methods:The clinical data of 147 women with full-term birth(full-term birth group) and 24 women with sPTB(sPTB group) who received prenatal examination in Chengdu Women′s and Children′s Central Hospital from January 2018 to December 2019 were reviewed. Multiple parameters were measured between 16-28 gestational weeks by the transvaginal ultrasound E-cervix technique. CL, elasticity contrast index(ECI), hardness ratio(HR), mean strain at internal os(IOS), mean strain at external os(EOS), the ratio of IOS to EOS(IOS/EOS) were obtained.Elastographic parameters and CL were compared between the two groups. Furthmore, binary regression was established, while the area under ROC curve(AUC) was used to evaluate the predictive efficiency of elastographic parameters and CL in sPTB, both alone and in combination with other parameters.Results:The elastographic parameters IOS and IOS/EOS in the sPTB group were higher than those in the full-term birth group, while HR and CL were lower than those in the full-term birth group (all P<0.05). There were no statistical differences of ECI and EOS between the two groups(both P>0.05). The AUCs of predicting sPTB with single IOS, IOS/EOS were 0.684 and 0.625, higher than the AUCs of HR, CL. The combination of IOS/EOS and CL, IOS and CL showed higher AUCs than elastographic parameters alone, with the AUC 0.788 of IOS/EOS combined with CL. The sensitivity was 70.8%, and the specificity was 87.3% corresponding to the optimum cutoff value(IOS/EOS was 1.22, CL was 3.46 cm). Conclusions:In the second trimester, sPTB has a lower hardness cervix than that of full-term women, especially the internal os of cervix. The combination of IOS/EOS and CL tends to improve the ability of predicting sPTB in pregnant women.

6.
Article in Chinese | WPRIM | ID: wpr-909808

ABSTRACT

Objective:To investigate the clinical characteristics of patients with aspergillus spondylitis, and to provide reference for timely diagnosis and treatment.Methods:The clinical manifestations, imaging performance, laboratory examination results, diagnosis and treatment outcomes of six patients with confirmed aspergillus spondylitis in Department of Infectious Diseases, Henan Provincial People′s Hospital during April 30, 2015 and May 1, 2020 were retrospectively analyzed.Results:The main manifestations of six patients were fever and neck pain or low back pain. The time from the onset of clinical manifestations to diagnosis was more than two months to 14 months. Spine magnetic resonance imaging (MRI) showed long T1 and T2 signals on vertebral body, high pressure lipid signal, obvious enhanced scan enhancement, and paravertebral abscess formation might be presented. Among the six patients, C-reactive protein increased in four patients, erythrocyte sedimentation rate increased in five patients, β-D-glucan test (G test) increased in three patients, galactomannan antigen test (GM test) increased in four patients. Six patients with aspergillus spondylitis were all confirmed by biopsy of diseased tissue for fungal smear, tissue culture or metagenomics next generation sequencing. After treatment with voriconazole or itraconazole, five patients recovered and one patient was still under treatment.Conclusions:The clinical manifestations and imaging examination of patients with aspergillus spondylitis are nonspecific. Peripheral blood G test and GM test need to be combined for diagnosis. The diagnosis depends on tissue puncture pathology examination, and the metagenomics next generation sequencing is needed if necessary.

7.
Article in English | WPRIM | ID: wpr-922685

ABSTRACT

Porphyromonas gingivalis (P. gingivalis), a key pathogen in periodontitis, has been shown to accelerate the progression of atherosclerosis (AS). However, the definite mechanisms remain elusive. Emerging evidence supports an association between mitochondrial dysfunction and AS. In our study, the impact of P. gingivalis on mitochondrial dysfunction and the potential mechanism were investigated. The mitochondrial morphology of EA.hy926 cells infected with P. gingivalis was assessed by transmission electron microscopy, mitochondrial staining, and quantitative analysis of the mitochondrial network. Fluorescence staining and flow cytometry analysis were performed to determine mitochondrial reactive oxygen species (mtROS) and mitochondrial membrane potential (MMP) levels. Cellular ATP production was examined by a luminescence assay kit. The expression of key fusion and fission proteins was evaluated by western blot and immunofluorescence. Mdivi-1, a specific Drp1 inhibitor, was used to elucidate the role of Drp1 in mitochondrial dysfunction. Our findings showed that P. gingivalis infection induced mitochondrial fragmentation, increased the mtROS levels, and decreased the MMP and ATP concentration in vascular endothelial cells. We observed upregulation of Drp1 (Ser616) phosphorylation and translocation of Drp1 to mitochondria. Mdivi-1 blocked the mitochondrial fragmentation and dysfunction induced by P. gingivalis. Collectively, these results revealed that P. gingivalis infection promoted mitochondrial fragmentation and dysfunction, which was dependent on Drp1. Mitochondrial dysfunction may represent the mechanism by which P. gingivalis exacerbates atherosclerotic lesions.


Subject(s)
Endothelial Cells , Mitochondria , Mitochondrial Dynamics , Porphyromonas gingivalis
8.
Article in English | WPRIM | ID: wpr-922252

ABSTRACT

To construct a hypobaric hypoxia-induced cell injury model. Rat pheochromocytoma PC12 cells were randomly divided into control group, normobaric hypoxia group and hypobaric hypoxia group. The cells in control group were cultured at normal condition, while cells in other two groups were cultured in normobaric hypoxia and hypobaric hypoxia conditions, respectively. CCK-8 method was used to detect cell viability to determine the optimal modeling conditions like the oxygen concentration, atmospheric pressure and low-pressure hypoxia time. The contents of lactate dehydrogenase (LDH), superoxide dismutase (SOD) and malondialdehyde (MDA) were detected by microplate method. The apoptosis ratio and cell cycle were analyzed by flow cytometry. The hypobaric hypoxia-induced cell injury model can be established by culturing for 24 h at 1% oxygen concentration and 41 kPa atmospheric pressure. Compared with the control group and normobaric hypoxia group, the activity of LDH and the content of MDA in hypobaric hypoxia group were significantly increased, the activity of SOD was decreased, the percentage of apoptosis was increased (all <0.05), and the cell cycle was arrested in G0/G1 phase. A stable and reliable cell injury model induced by hypobaric hypoxia has been established with PC12 cells, which provides a suitable cell model for the experimental study on nerve injury induced by hypoxia at high altitude.


Subject(s)
Animals , Cell Hypoxia , Hypoxia , Malondialdehyde , PC12 Cells , Rats , Superoxide Dismutase/metabolism
9.
Article in Chinese | WPRIM | ID: wpr-933352

ABSTRACT

Objective:To explore the association between abnormal thyroid stimulating hormone (TSH) and elevated blood pressure among females of child-bearing potential.Methods:A total of 294 674 females of child-bearing age who participated in pre-pregnancy health examination in Shenzhen from 2013 to 2019 were selected. Demographic characteristics, blood pressure, TSH, fasting blood glucose and other indexes were collected. Multivariate logistic regression model was used to analyze the association between abnormal TSH levels and elevated blood pressure (including prehypertension and hypertension).Results:This study showed that females of child-bearing potential with prehypertension and hypertension accounted for 21.77% and 2.41%, respectively. Compared with females of child-bearing potential with normal TSH, the risk of prehypertension and hypertension increased by 34.0% ( OR=1.340, 95% CI 1.248-1.438) and 59.6% ( OR=1.596, 95% CI 1.301-1.938) among those with decreased TSH, respectively, whereas the risk of prehypertension and hypertension increased by 13.6% ( OR=1.136, 95% CI 1.076-1.198) and 38.0% ( OR=1.380, 95% CI 1.198-1.581) among those with elevated TSH, respectively. Subgroup analysis showed that abnormal TSH levels in most subgroups, such as age, ethnicity, educational level, occupation, spouse smoking, alcohol drinking, body mass index, and fasting blood glucose, were associated with the risk of elevated blood pressure. Heterogeneity test showed that the association between decreased TSH and elevated blood pressure was higher in females with high school and below or alcohol drinking, and the association between elevated TSH and elevated blood pressure was higher in females with college/bachelor′s degree and above or non-smoking spouse. Conclusion:There is a significant association between abnormal TSH levels and the risk of prehypertension and hypertension in females of child-bearing potential, and the association should be explored with stratified educational level, alcohol drinking, and spouse smoking status.

10.
Article in Chinese | WPRIM | ID: wpr-865952

ABSTRACT

Objective:To study the application and effect of hybrid teaching based on the rain classroom in the teaching of periodontology for undergraduates.Methods:Sixty-four stomatological undergraduates in Phase 101 were selected as experimental group, and 62 in Phase 100 as control group. The hybrid teaching based on the rain classroom were conducted in experimental group, and mind mapping were used before and after class to help students understand and expand the content of class. The traditional teaching was adopted in the control group. SPSS 17.0 was applied to compare the differences between the written test scores and teaching satisfaction evaluation of the two groups. The learning behavior data of the students in experimental group before, during and after class were collected and analyzed.Results:The score of the written test in the experimental group were significantly better than that in the control group ( t=2.97, P<0.05). The result of questionnaire showed that the experimental group was significantly more satisfied with the improvement of lecture efficiency ( t=2.71, P<0.05) and self-learning ability ( t=4.35, P<0.05). The majority (82.55%) of students in the experimental group are in favor of the rain classroom; 89.06% of students finished the preview before class, and 67.19% of them completed the review after class. Conclusion:The hybrid teaching based on the rain classroom can be applied to the teaching of periodontology, which can effectively improve the learning quality and initiative of the students.

11.
Article in Chinese | WPRIM | ID: wpr-864551

ABSTRACT

Objective:To establish a quality control system of enteral nutrition nursing for critically ill patients, and to apply this system in clinical practice and evaluate its effect.Methods:Delphi method was used to construct the quality control system. By training nurses in this system, through the training of the system for nurses and clinical quality control, enteral nutrition complications of patients before and after the training and nurses' knowledge of enteral nutrition were compared.Results:after the system applied in the nursing clinic, the incidence of enteral nutrition gastrointestinal complications, infectious complications, metabolic complications and mechanical complications in patients with critical illness decreased from 11.3% (18/160), 1.9% (3/160), 5.6% (9/160), 6.9% (11/160) to 3.9% (6/152), 0.7% (1/152), 1.3% (2/152), 1.9% (3/152) respectively, with statistically significant differences ( χ 2 values were 6.35-91.33, P <0.01). ICU nurses' awareness of enteral nutrition theory was significantly improved, and the questionnaire score increased from (70.22±8.78) points to (95.25±4.18) points, with statistically significant difference ( t value was 18.792, P<0.01). Conclusion:The enteral nutrition nursing quality control system developed in this study can effectively guide nursing staff to implement enteral nutrition during nursing behavior, reduce the occurrence of enteral nutrition complications in patients with critical illness, to ensure the safety of patients, and is worthy of clinical promotion and application.

12.
Article in Chinese | WPRIM | ID: wpr-863160

ABSTRACT

Post-stroke depression is a common mental complication after the onset of stroke. Studies have shown that inflammation is closely associated with post-stroke depression. This article reviews the inflammatory mechanism of post-stroke depression.

13.
Article in Chinese | WPRIM | ID: wpr-825628

ABSTRACT

Objective To introduce the improvements of multi-mode outpatient pharmacy services based on the new medical reform policy. Methods The pharmacist’s roles, responsibilities, working procedures and the achievements were discussed. Results and conclusion On-site pharmacy counseling services and online WeChat pharmacy consulting services were established to include collaborative drug therapy management of pharmacists and physicians (Alzheimer's disease and anticoagulation clinic), the outpatient pharmacy services by pharmacists (chemo medication counseling). The multi-mode pharmacy services in our hospital have optimized patient's medication regime, safeguarded patient's medication therapy, improved patient's compliance and reduced medication cost. The individualized medication therapy reduced adverse reactions significantly. The multi-mode outpatient pharmacy services established by our hospital were successful and could serve as a model for other pharmacies in our country.

14.
Clinical Medicine of China ; (12): 477-478, 2019.
Article in Chinese | WPRIM | ID: wpr-754340

ABSTRACT

Objective Urticaria,itchy skin,chest tightness,abdominal pain and anaphylactic shock are the common clinical manifestations of allergic reactions.In addition,the relevant literature indicates that allergies can cause coronary vasospasm or rupture of atherosclerotic plaque, leading to acute coronary syndrome,which is named Kounis syndrome.Here we report a case of a child admitted to the emergency departments with myocardial injury and ST depression on electrocardiography while a severe allergic reaction.The patient was discharged from the hospital after receiving anti?allergic and nutritional myocardial medication.I hope that we can learn more about Kounis syndrome through this case.

15.
Article in Chinese | WPRIM | ID: wpr-751567

ABSTRACT

Lectin-like oxidized low-density lipoprotein receptor-1 (LOX-1) is a member of C-type lectin-like receptor family.It can recognize many ligands and is the main receptor of oxidized low-density lipoprotein for inducing vascular endothelial dysfunction.Early studies focused on the role of LOX-1 in atherosclerosis and diabetes mellitus.Recent studies have shown that LOX-1 is closely associated with ischemic stroke.This article reviews the biological characteristics of LOX-1 and its association with ischemic stroke.

16.
Article in Chinese | WPRIM | ID: wpr-751561

ABSTRACT

Objective To investigate the effects of human urinary kallidinogenase (HUK) on cerebral perfusion,inflammatory marker level,neurological deficits,and short-term clinical outcomes in patients with acute ischemic stroke who exceeded the time window of thrombolytic therapy.Methods Patients with acute ischemic stroke exceeded the time window of thrombolytic therapy and treated in the Department of Neurology,the Second Affiliated Hospital of Nantong University from June 2016 to March 2018,and performed magnetic resonance perfusion imaging on the 1st and 14th d after admission were enrolled retrospectively.Patients were divided into HUK and control groups according to whether they received HUK treatment or not.All patients underwent magnetic resonance perfusion imaging and serum inflammatory markers measurement on the 1st and 14th d after admission.The National Institute of Health Stroke Scale (NIHSS) scores,cerebral perfusion levels,and serum inflammatory marker levels were compared between the 2 groups.On the 14thd after admission,the outcome was determined according to the modifiel Rankin Scale (mRS) scores.0-2 was defined as good outcome and >2 was defined as poor outcome.Multivariate logistic regression analysis was used to determine the independent influencing factors of outcome.Results A total of 62 patients with acute ischemic stroke exceeded the time window of thrombolytic therapy were enrolled,including 37 patients in the HUK group and 25 in the control group.There were no significant differences in the demographic and other baseline data between the HUK group and the control group,except for baseline NIHSS score (P =0.049).The reduction of NIHSS score after treatment in the HUK group was more significant than that in the control group (P <0.01).Serum high-sensitivity C-reactive protein level in the HUK group decreased significantly after treatment (P < 0.01),and plasma lipoprotein-associated phospholipase A2 also showed a downward trend.In terms of perfusion imaging parameters,the relative cerebral blood flow was significantly increased after treatment in the HUK group,and the relative mean transit time and relative peak time were significantly decreased.The above increase and decrease were statistically significant compared with the control group (all P<0.05).On the 14th d after admission,the mRS score showed that 51 patients had a good outcome and 11 had a poor outcome.Multivariate logistic regression analysis showed baseline NIHSS scores (odd ratio [OR] 2.545,95% confilence interval [CI]1.124-5.541;P=0.024),atrial fibrillation (OR 5.712,95% CI 1.737-24.685;P=0.039),and cardiogenic embolism (OR 4.485,95% CI 1.148-18.262;P =0.040) were the independent risk factors for poor outcomes,and whether using HUK was not significantly associated with the outcomes.Conclusion For patients with acute ischemic stroke that exceeds the time window for thrombolysis,HUK improves cerebral perfusion,reduces inflammation,and improves neurological deficits in patients,but does not improve short-term neurological outcomes.

17.
Article in Chinese | WPRIM | ID: wpr-813012

ABSTRACT

Cushing's syndrome is a clinically common type of clinical syndrome caused by excessive glucocorticoids. It can be divided into adrenocorticotropic-dependent and independent types according to its etiology. A female patient with Cushing's syndrome is reported to have a clinical manifestation of mild full moon face, masculinization of androgen increase, deeper skin color, elevated blood pressure, and pulmonary infection. The cause is unknown. Radiographic examination indicated that pituitary tumor and adrenal tumors did not exist. Chest enhancement CT examination revealed that the lesion was in the thymus. Thoracoscopy was performed to remove the tumor. Since wound infection occurred after operation, a variety of antibiotics were used for anti-infective treatment, and the wound gradually healed. After 21 months of follow-up, the above symptoms disappeared completely and the prognosis was good in the near future. Postoperative pathological diagnosis was thymic neuroendocrine carcinoma. This is a typical case that the thymoma ectopically secrets adrenocorticotropic hormone, which leads to Cushing's syndrome, referring to ectopic adrenocorticotropic hormone syndrome.


Subject(s)
ACTH Syndrome, Ectopic , Adrenocorticotropic Hormone , Cushing Syndrome , Female , Humans , Thymoma , Thymus Neoplasms
18.
Article in Chinese | WPRIM | ID: wpr-742992

ABSTRACT

MicroRNAs (miRNAs) are a class of short non-coding single-stranded RNAs.They can regulate gene expression at the post-transcriptional level by binding to the T-untranslated region of the target gene mRNA and participate in the regulation of almost all biological processes.Recent studies have shown that MiRNAs are widely involved in a variety of pathophysiological processes in ischemic brain injury,such as excitotoxicity,oxidative stress,inflammation,apoptosis,and cerebral edema,suggesting that they may serve as a biomarker for ischemic stroke,assisting early diagnosis and outcome assessment,and becoming a drug treatment target.

19.
Chinese Journal of Burns ; (6): 405-409, 2019.
Article in Chinese | WPRIM | ID: wpr-805464

ABSTRACT

Objective@#To explore the effects of using free transplantation of expanded perforator flaps in the treatment of severe scar contracture deformities in children.@*Methods@#From January 2010 to December 2018, 18 pediatric patients with severe scar contracture were admitted to Xijing Hospital of Air Force Medical University, and 3 pediatric patients with severe scar contracture were admitted to Shenzhen Hospital, Southern Medical University. There were 14 males and 7 females among the 21 pediatric patients, who were 3-12 years old, with 15 cases of cervicothoracic adhesion, 5 cases of chin-chest adhesion, and 1 case of ankle joint contracture. According to the location of scar contracture and the size of wound after release, the donor site of perforator flap and expander volume were selected, and the expander was inserted to expand the flap. After expanding to proper volume, the contracted scar was resected and released. The perforator flap was designed and transplanted freely according to the wound. The flap area ranged from 14 cm×6 cm to 18 cm×15 cm. The location of the expanded flaps, the number, location, rated volume, and the location of injection port of the inserted expanders, the survival condition of flaps, the complications, the repair of donor sites, and the follow-ups were analyzed.@*Results@#Among this group of pediatric patients, 16 cases used expanded thoracodorsal artery perforator flap, 3 cases used expanded circumflex scapular artery perforator flap, and 2 cases used expanded anterolateral thigh perforator flap, with 14 cases of pure donor site expansion and 7 cases of donor site expansion together with expansion beside donor site. Thirty-four expanders were inserted in 21 pediatric patients, with 21 under flaps, 6 near scars, and 7 near donor sites. The rated volumes of 26 expanders were 200 mL, while those of the remaining 8 expanders were 400 mL. Eight injection ports were placed externally, while the rest were placed internally. All the 21 flaps survived completely. Vascular crisis occurred in 1 pediatric patient 5 days after operation, and exploratory operation and reanastomosis were performed. The donor sites of 19 pediatric patients were closed directly, while the small wounds in lateral thoracic donor sites of 2 pediatric patients were repaired with thin intermediate split-thickness skin graft collected beside the donor site. Follow-up for 6 to 36 months showed that the texture and color of area repaired by the flaps were close to the surrounding skin. The flaps in the neck region of 8 pediatric patients were slightly bulky, requiring debulking operation, while the other cases had good appearance. The movement function of the involved regions was basically restored to normal, and no recurrence of contracture occurred.@*Conclusions@#Free transplantation of expanded perforator flaps can achieve favorable appearance, texture, and function restore in treating severe scar contracture deformities in children, and the curative effect is stable and lasts long.

20.
Article in Chinese | WPRIM | ID: wpr-744407

ABSTRACT

Objective To observe the clinical effect of calcium dibutyryladenosine cyclophosphate injection combined with levocarnitine in the treatment of chronic heart failure (CHF).Methods From February 2016 to February 2017,80 patients with CHF were randomly divided into observation group and control group according to the digital table,with 40 cases in each group.The control group was treated with calcium dibutyryladenosine cyclophosphate injection.The observation group was treated with calcium dibutyryladenosine cyclophosphate and levocarnitine injection.The patients were treated for 2 weeks.The changes in cardiac function indicators before and after treatment,left ventricular ejection fraction (LVEF),cardiac output (CO),each stroke volume index (CI),N-terminal B-type natriuretic peptide (N-proBNP) and blood uric acid (UA) were observed.Resuts The cardiac function of two groups was improved after treatment.The LVEF,CO,CI in the two groups were increased after treatment.The LVEF,CO,CI in the observation group after treatment were (59.95 ± 4.17) %,(6.24 ± 0.22) L,(2.86 ± 0.10) L · min-1 · (m2)-1,respectively,which in the control group were (49.05 ± 5.72) %,(4.83 ± 0.44) L,(2.25 ± 0.16) L · min-1 · (m2)-1,respectively,the differences were statistically significant (t =2.26,18.18,5.78,P =0.03,0.00,0.01).After treatment,the N-proBNP and UA levels in the two groups were decreased (all P < 0.05).The N-proBNP and UA levels in the observation group were (207.78 ± 42.35) pg/mL,(268.50 ± 14.30) μmol/L,respectively,which in the control group were (498.88 ± 72.06) pg/mL,(422.75 ± 46.48) μ mol/L,respectively,the differences between the two groups were significant (t =-22.03,20.06,P =0.00,0.00).Conclusion Calcium dibutyryladenosine cyclophosphate combined with levocarnitine in the treatment of heart failure can improve cardiac function and the quality of life of patients.

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