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1.
Article in Chinese | WPRIM | ID: wpr-885995

ABSTRACT

Objective: To observe the intervention effect of auricular point sticking on dry eye in myopia patients after small-incision lenticule extraction (SMILE) surgery.Methods: This was a prospective randomized controlled study conducted among the myopia patients who received SMILE surgery at Eye and ENT Hospital of Fudan University. The post-SMILE operation patients who screened by the inclusion and exclusion criteria were randomized into a control group and a treatment group. Patients in the control group were given 0.1% fluorometholone and 0.5% carboxymethylcellulose sodium eye drops, while the treatment group was given additional unilateral auricular point sticking for 1 month. The patients were estimated using ocular surface disease index (OSDI), Schirmer tear test-1 (STT-1), tear film break-up time (TF-BUT), corneal fluorescein staining (CFS) score, corneal sensitivity (CS) and visual quality (VQ) at 1 d, 1 week and 1 month after surgery; the changes in anxiety and depression were also observed in the patients. Results: Compared with the first day after operation, CS in the nasal region was improved in the treatment group, and the VQ score increased in the control group patients at 1 week after operation (both P<0.05); at 1 month after operation, the TF-BUT increased, CFS score decreased, CS in the central and nasal regions increased (all P<0.05), and VQ score increased (P<0.01) in the treatment group, and the CS in the central, upper, lower and nasal regions were improved (all P<0.05), and VQ score increased (P<0.01) in the control group. The between-group comparison showed that the differences in the change of TF-BUT were statistically significant at 1 week and 1 month after surgery, respectively (both P<0.05). Conclusion: Auricular point sticking therapy can increase the TF-BUT and accelerate the repair of ocular surface function in post-SMILE patients.

2.
Chinese Journal of Nephrology ; (12): 414-423, 2021.
Article in Chinese | WPRIM | ID: wpr-885504

ABSTRACT

Objective:To observe heart rate circadian rhythm in patients with chronic kidney disease (CKD) stage 5 and to analyze the effects of parathyroidectomy (PTX) on heart rate circadian rhythm in severe secondary hyperparathyroidism (SHPT) patients.Methods:A cross-sectional observation was performed in 213 patients with CKD stage 5 and 96 controls, and the patients were divided into those with severe SHPT (PTX group, n=70) and without severe SHPT (non-PTX group, n=143). Forty-six PTX patients were followed up prospectively. The baseline data were compared among these groups. Holter electrocardiogram was performed for each participant. Non-dipping heart rate was defined as night/day heart rate ratio greater than 0.9. Multiple linear regression analysis was used to analyze the related factors of heart rate circadian rhythm in patients with CKD stage 5. Results:The 24-hour, daytime and nighttime mean heart rate in patients with CKD stage 5 were all higher than those in controls, especially in PTX group (all P<0.05). The night/day heart rate ratios of controls and CKD stage 5 patients were (0.81±0.08) and (0.91±0.08) respectively ( P<0.01). Correlation analysis showed 24-hour and daytime or nighttime mean heart rate in patients with CKD stage 5 were positively correlated with serum levels of phosphorus and ln(alkaline phosphatase), while nighttime mean heart rate and night/day heart rate ratio were positively related with serum intact parathyroid hormone level. After adjusting with postoperative follow-up period (median time: 10.9 months), 24-hour and nighttime mean heart rate, and night/day heart rate ratio in PTX patients all decreased significantly (all P<0.01). Conclusions:Heart rate is increased and circadian rhythm is abnormal in patients with CKD stage 5, which are related with mineral and bone disorder. PTX significantly decreases 24-hour and nighttime mean heart rate in severe SHPT patients, and improves the heart rate circadian rhythm.

3.
Chinese Journal of Orthopaedics ; (12): 471-479, 2021.
Article in Chinese | WPRIM | ID: wpr-884735

ABSTRACT

Objective:To investigate the risk factors of rotator cuff tears combined with long head of bicep tendon (LHBT) lesion and its effects on preoperative function.Methods:From January 2016 to January 2020, there were 680 patients with rotator cuff tears, including 260 males and 420 females, were included. The average age was 56.1±8.7 (range 27-74 years). There were 250 cases on the left side and 430 cases on the right side. There were 436 cases on the main side, while 274 cases had definite trauma before operation. The following were the Post rotator cuff tears classification, 133 cases in partial injury, 473 cases in small and medium size of rotator cuff tears, 74 cases in large and massive size of rotator cuff tears. The Habermayer-Walch classification of LHBT lesions was as following, 302 cases in type 0 (normal), 216 cases in type 1 (tendonitis), 29 cases in type 2 (dislocation and subluxation), 104 cases in type 3 (partial tear), 20 cases in type 4 (complete tear) and 9 cases in type 5 (SLAP injury above type II). The patient with rotator cuff tears were divided into partial tears group, medium and small tears group, large and massive tears group according to the classification of Post. The visual analogue scale (VAS), simple shoulder test (SST), Constant-Murley function score and the score of the University of California Los Angeles (UCLA) were recorded. The differences in age, sex, main side, trauma and LHBT lesion in patients with three types of rotator cuff tears were analyzed. The preoperative pain and function scores of patients with or without LHBT lesions in various rotator cuff tears were compared among the groups by t-test. The age, sex, main side, with trauma or not, and the classification of rotator cuff tears were analyzed by Logistic regression to investigate the risk factors of patients with rotator cuff tears with LHBT lesions. Results:There were 378 cases (55.6%) with LHBT lesions in 680 patients with rotator cuff tears, including 216 cases of tendinitis (57.1%), 104 cases of partial tear (27.5%), 29 cases of dislocation and subluxation (7.7%), 20 cases of complete tear (5.3%) and 9 cases of SLAP injury (2.4%). The incidence of partial injury, small and medium injury, large and massive rotator cuff injury combined with LHBT lesions were 35.3% (47/133), 57.5% (272/473) and 79.7% (59/74) respectively. The preoperative VAS score, UCLA score, Constant-Murley score and SST score were 5.20±1.52, 14.81±4.12, 41.45±4.93 and 4.56±1.96 respectively in rotator cuff tears group and 5.29±1.65, 14.34±4.01, 41.60±5.88, 4.47±1.97 in LHBT group ( P>0.05). In the partial rotator cuff tears group, the VAS score was 5.16±1.41 in patients with simple rotator cuff tears and 5.68±1.46 in patients with LHBT lesion ( t=2.004, P=0.047). Regression analysis showed that age ≥60 years and rotator cuff tears degree were the risk factors for rotator cuff tears with LHBT ( P<0.001). Conclusion:It is common for patients to have rotator cuff tears with LHBT lesions. The more severe the rotator cuff tears are, the higher the incidence of LHBT lesions will be. Patients with rotator cuff tears aged 60 and above are more likely to have LHBT lesions. However, the complications of LHBT could not affect the preoperative pain and functional scores of patients with rotator cuff tears.

4.
Article in Chinese | WPRIM | ID: wpr-884218

ABSTRACT

Objective:To evaluate the efficacy of posterior subtotal vertebrectomy in the treatment of thoracolumbar vertebral refractures after vertebroplasty.Methods:A retrospective analysis was conducted in the 28 patients with refracture after percutaneous vertebroplasty(PVP) or percutaneous kyphoplasty(PKP) who had been treated at Department of Spinal Surgery, Henan Provincial People's Hospital from June 2017 to October 2019. They were 7 males and 21 females, with an average age of 62.4 years(from 61 to 76 years). A total of 28 vertebrae were involved, including 5 T11s, 9 T12s, 11 L1s and 3 L2s. Their previous operations were PKP in 17 cases and PVP in 11. After the spinous process, vertebral plate, articular process and transverse process were resected by posterior approach, the vertebral body, bone cement and upper and lower intervertebral discs were partially resected by trans-vertebral lateral approach. At the same time, nerve decompression was performed. Finally, the inter-vertebral support was fixated followed by the posterior screw-rod orthopedic fixation. The operation time and intraoperative bleeding volume were recorded. The cobb angles of kyphosis were compared on the X-ray films of the whole spine between preoperation and the last follow-up to evaluate correction. Functional improvement of the spine was evaluated by comparison of the visual analogue scale (VAS) and JOA(Japanese Orthopedics Association) scores between preoperation and the last follow-up.Results:The operation time averaged 182.1 min and intraoperative bleeding volume 996.2 mL. All the 28 patients were followed up for 8 to 29 months (mean, 19.8 months). No obvious neurological lesions or other serious complications were observed. The cobb angle was improved from preoperative 41.3°±10.3° to 6.4°±2.5° at the last follow-up, the VAS score from preoperative 7.3±1.8 to 2.5±1.0 at the last follow-up, and the JOA score from preoperative 8.4±2.3 to 21.3±2.5 at the last follow-up, showing a significant difference in all the comparisons ( P<0.05). Conclusion:The posterior subtotal vertebrectomy is effective for thoracolumbar vertebral refractures after vertebroplasty because it can remove bone cement, decompress the spinal canal, fuse the inter-vertebral graft and reconstruct the spinal stability in one stage.

5.
Journal of Chinese Physician ; (12): 249-253, 2021.
Article in Chinese | WPRIM | ID: wpr-884042

ABSTRACT

Objective:Bioinformatics was used to analyze the gene expression profile of renal chromophobe cell carcinoma (RCCC) to find out the key genes of RCCC.Methods:Chromophobe renal cell carcinoma gene chip data GSE15641 and GSE11151 were downloaded from the GEO database. Using R software packages such as " Affy" and " limma" in R software to screen differentially expressed genes, combining with David and STRING online bioinformatics tools to analyze the regulatory network of differentially expressed genes and construct protein-protein interaction (PPI) network, the Hub gene was screened through the Cytohubba plug-in of Cytoscape software.Results:A total of 261 differentially expressed genes were screened, including 194 down-regulated genes and 67 up-regulated genes. Gene enrichment (GO) analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis were performed to explore their biological functions. In GO enrichment analysis, biological processes were mainly enriched in cell secretion, gluconeogenesis and cell proliferation regulation; in cell composition, they were mainly enriched in exosomes, plasma membranes and their components; in molecular function, they were mainly enriched in heparin binding; in KEGG pathway analysis, they were mainly enriched in metabolic pathway, antibody biosynthesis pathway and renin angiotensin system pathway. PPI network was constructed by using online bioinformatics tools. The top 10 Hub genes were screened by using cytohubba plug-in in Cytoscape software, which were pipecolic acid and sarcosine oxidase (PIPOX), hydroxyacid oxidase 2 (HAO2), kynurenine 3-monooxygenase (KMO), solute carrier family 2 member 2 (SLC2A2), formimidoyltransferase cyclodeaminase (FTCD), angiogenin (ANG), APOBEC1 complementation factor (A1CF), aldehyde dehydrogenase 8 family member A1 (ALDH8A1), vitamin D binding protein (GC), histidine rich glycoprotein (HRG).Conclusions:Bioinformatics analysis of differentially expressed genes in renal chromophobe cell carcinoma can effectively explore the interaction information of these differentially expressed genes, and provide new ideas for the treatment of renal chromophobe cell carcinoma.

6.
Article in Chinese | WPRIM | ID: wpr-883528

ABSTRACT

Objective:To analyze the clinical features of post-pancreaticoduodenectomy hemorrhage, and explore effective and practical nursing strategies.Methods:Clinical data of 62 patients with post-pancreaticoduodenectomy hemorrhage from Jan 2014 to Dec 2019 in the First Affiliated Hospital of Naval Medical University were retrospectively analyzed. The bleeding time, location, vital signs, accompanying symptoms and surgical treatment measures and clinical outcomes were analyzed.Results:Among the 62 cases, early (within 24 h) hemorrhage occurred in 19/62 patients (30.6%), and late hemorrhage occurred in 43/62 patients (69.4%). 36/62 patients (58.1%) had arterial bleeding; And 43/62 patients (69.4%) had abdominal hemorrhage. Grade C hemorrhage occurred in 32/62 patients (51.6%). Sentinel hemorrhage occurred in 8/62 patients (12.9%). The manifestation of hemorrhage in 42 patients was bloody fluid from abdominal drainage tube (67.7%). Hemorrhage occurred in 23 patients with pancreatic fistula(37.1%), 12 patients with abdominal infection and other complications (19.4%). Shock symptoms occurred in 41 cases (66.1%) with postoperative hemorrhage. Pancreaticoduodenectomy hemorrhage were early detected in 0.3 h and last detected in 869 h, with a median time of 192.00 (14.63, 297.00) h. 30/62 cases (48.4%) of hemorrhage patients occurred 1 hour before and after nursing shift. When hemorrhage was found, emergency treatments such as blood transfusion to maintain blood volume ( n=47, 75.8%), hemostasis ( n=35, 56.5%) and vasoactive drugs to increase blood pressure ( n=32, 51.6%) were usually given immediately. 31/62 patients (50.0%) underwent emergency secondary surgery within 4 h of hemorrhage, and 45/62 patients (72.6%) were cured by emergency surgical treatment. A written treatment pre-plan for surgical nurses was established. Conclusions:Surgical nurses should be familiar with the clinical manifestations of post-pancreaticoduodenectomy hemorrhage, and improve the alarming ability of identifying the complications of post-operative hemorrhage. The establishment of an emergency pre-plan for surgical nurses could help to treat such patients timely and effectively.

7.
Article in Chinese | WPRIM | ID: wpr-883404

ABSTRACT

Objective:To investigate the expression of serum caspase-cleaved cytokeratin 18(CCCK-18) in patients with cerebral ischemic stroke and its diagnostic value.Methods:One hundred and six patients with cerebral ischemic stroke who were diagnosed and treated in Affiliated Dongfeng Hospital from October 2018 to October 2019 were selected as the study group. Ninety patients who underwent digital subtraction angiography (DSA) during the same period and showed no other abnormalities inside or outside the skull were selected as control group. The baseline data of gender, age, drinking history, smoking history, hypertension history, diabetes history, coronary heart disease, and other subjects in the two groups had no significant differences ( P>0.05). Cubital venous blood of 5 ml from two groups of subjects were collected, and the level of serum CCCK-18 was detected by enzyme-linked immunosorbent assay. The levels of total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C) were detected by enzymatic method. The receiver operating characteristic curve (ROC curve) was used to analyze the diagnostic efficacy of serum CCCK-18 in patients with ischemic stroke, and the relationship between serum CCCK-18 and TC, TG, LDL-C, HDL-C were analyzed by Pearson test. Results:The levels of serum CCCK-18, TC, TG, and LDL-C in the study group were significantly higher than those in the control group: (158.10 ± 50.89) U/L vs. (85.57 ± 35.25) U/L, (4.26 ± 0.92) mmol/L vs. (3.92 ± 0.80) mmol/L, (2.34 ± 0.53) mmol/L vs. (1.83 ± 0.47) mmol/L, (3.12 ± 0.73) mmol/L vs. (2.61 ± 0.67) mmol/L, and HDL-C level was lower than that in the control group: (1.20 ± 0.24) mmol/L vs. (1.32 ± 0.28) mmol/L, and there were significant differences ( P<0.05). Logistic regression analysis showed that CCCK-18, TC, TG, LDL-C, and HDL-C were independent risk factors for patients with ischemic stroke ( P<0.05). The area under the curve(AUC) of serum CCCK-18 to distinguish ischemic stroke from the control group was 0.878, with a sensitivity of 84.91% and a specificity of 78.89%. The AUC of serum CCCK-18 to identify patients with mild ischemic stroke was 0.763, with a sensitivity of 70.37% and a specificity of 78.89%. Correlation analysis showed that serum CCCK-18 was positively correlated with TC, TG, and LDL-C in patients with ischemic stroke ( r = 0.711, 0.722, 0.705), and negatively correlated with HDL-C ( r = - 0.714), and there were significant differences ( P<0.01). Conclusions:Serum CCCK-18 levels are significantly increased in patients with cerebral ischemic stroke, which can be used as a biomarker for diagnosis and judgment of disease severity.

8.
Article in Chinese | WPRIM | ID: wpr-882924

ABSTRACT

Infantile spasm is the most common epileptic encephalopathy in infancy.Without early diagnosis and effective treatment, serious consequences and economic burden maybe caused.One of the main characteristics of infantile spasm is the hypsarrhythmia on electroencephalography (EEG). It is important to analyze EEG accurately and reliably by scoring EEG.In order to further improve the EEG scoring system and better play the role of EEG in the diagnosis, treatment and prognosis implications of infantile spasm, in this paper, the advantages and disadvantages of various EEG scoring systems were analyzed, so as to provide clues by summarizing current EEG scoring systems and their applications in clinical practices.

9.
Article in Chinese | WPRIM | ID: wpr-882013

ABSTRACT

Objective Based on the text analysis of COVID-19 media report, text mining was used to probe the trend of major public health emergencies and response of the government and social subjects in China. Methods Using the topic model method, we focused on the quantity of news report, topic content, development trend, and emotional tendency, to present the characteristics of media report on China's public health emergency, and the response mechanism of the Chinese government and the whole society. Results The media report and news commentary of COVID-19 showed a consistent trend with the epidemic progress. The governmental response was the main target of media report, while social power, medical progress and other categories also attracted some attention. The development trend of different topics was characterized by continual or periodic variation due to their different attributes. Conclusion The topic model method comprehensively demonstrates the development and response process of the COVID-19 epidemic. The model may provide a new perspective to improve the national public emergency management system.

10.
Article in Chinese | WPRIM | ID: wpr-880422

ABSTRACT

It is well known that chitosan-based composites are widely used in implantable medical devices. The development of chitosan-based composite materials with different types was summarized in this paper, such as inorganic, organic and composite phases. Then, combined with the research focus, the development of 3D printing technology and chitosan-based composites was summarized. It was also pointed out that the existing problems in our research, which need to be solved urgently. At last, the development direction and broad application prospect of chitosan-based composites were prospected. And we look forward to providing reference for relevant research.


Subject(s)
Biocompatible Materials , Chitosan , Printing, Three-Dimensional , Prostheses and Implants
11.
Article in Chinese | WPRIM | ID: wpr-879256

ABSTRACT

The emergence of regular short repetitive palindromic sequence clusters (CRISPR) and CRISPR- associated proteins 9 (Cas9) gene editing technology has greatly promoted the wide application of genetically modified pigs. Efficient single guide RNA (sgRNA) is the key to the success of gene editing using CRISPR/Cas9 technology. For large animals with a long reproductive cycle, such as pigs, it is necessary to screen out efficient sgRNA


Subject(s)
Animals , CRISPR-Cas Systems/genetics , Clustered Regularly Interspaced Short Palindromic Repeats/genetics , Gene Editing , RNA, Guide/genetics , Swine
12.
Article in Chinese | WPRIM | ID: wpr-879152

ABSTRACT

This study aimed to elucidate the effective components of Shengxian Decoction and its mechanism of action in treating chronic heart failure. Firstly, UHPLC-Q-TOF-MS was established to identify the main chemical constituents in the rat serum after intragastric administration with Shengxian Decoction. Secondly, the absorbed components in serum were then used for the network pharmacology analysis to infer the mechanism and effective components. Targets for constituents in serum were predicted at TCMSP and Swiss-TargetPrediction database. An association network map was drawn by network visualization software Cytoscape 3.6.1. Finally, GO enrichment analysis and KEGG pathway enrichment analysis were carried out for the core target genes. By UHPLC-Q-TOF-MS, 18 prototype compounds were definitely identified, including five compounds from Astragali Radix, four compounds from Anemarrhenae Rhizoma, four compounds from Bupleuri Radix, four compounds from Cimicifugae Rhizoma, and one compound from Platycodonis Radix. Those components of Shengxian Decoction were closely associated with 13 key protein targets, including inflammatory factors, like IL6, IL1 B, TNF, PTGS2, IL10; redox enzymes CAT, HMOX1, and MPO; cardiovascular targets, like VEGFA, NOS3, and NOS2; and transmememial proteins CAV1 and INS. Network pharmacology analysis showed that the 18 compounds could be responsible for the treatment of chronic heart failure by regulating HIF-1 signaling pathways, PI3 K-Akt signaling pathways, cGMP-PKG signaling pathways, cAMP signaling pathways and TNF signaling pathways. This study provided a scientific basis for mechanism and effective ingredients of Shengxian Decoction.


Subject(s)
Animals , Chromatography, High Pressure Liquid , Drugs, Chinese Herbal , Heart Failure/genetics , Rats , Rhizome , Signal Transduction
13.
Article in Chinese | WPRIM | ID: wpr-879105

ABSTRACT

Weeds is one of the important parts of agricultural ecosystem of Chinese materia medica. Weeds is a double-edged sword with advantages and disadvantages for the cultivated medicinal plants. In this study, we firstly analyzed the positive and negative effects of weeds on the yield and quality of Chinese materia medica. We then explored the possible mechanisms for the weeds' positive effects from the aspects of interspecific relationship, soil microecological environment, light environment, natural control of pests and so on. We also summarized three basic principles of weed control, that is, "making medicinal plants and weeds coexist harmoniously, achieving the overall optimum growth of medicinal plants", "prevention first, integrated control" and "preserving beneficial weeds and increasing their beneficial effects, removing harmful weeds and control their adverse effects". Finally, we introduced several common weed ecological control technology in field of the cultivated medicinal plants in China, including technology of controlling weeds by no-tillage, stral mulch, rotation, alternative herbs, competitive crops, and allelopathy. This study is aimed to apply the ecology theory to guide weed management and control, so as to achieve the goal of advantages promotion and disadvantages elimination of weeds to cultivated medicinal plants, making weeds into treasure and to promote the sustainable and healthy development of Chinese medicinal materials production and the protection of weed diversity.


Subject(s)
Agriculture , China , Ecosystem , Materia Medica , Plants, Medicinal
14.
Article in Chinese | WPRIM | ID: wpr-876706

ABSTRACT

Objective To investigate the expression and clinicopathological significance of Bcl-2 and Bax genes in colorectal cancer (CRC) patients complicated with schistosomiasis. Methods The CRC patients receiving surgical treatment in the First Affiliated Hospital of Dali University from June 2016 to June 2020 were recruited as the study subjects, and 30 subjects were randomly sampled from the CRC patients complicated with schistosomiasis (CRC-S group) and 30 subjects were randomly sampled from the CRC patients without schistosomiasis (CRC group) using a random number table method. The cancer specimens were sampled from subjects in the CRC-S and CRC groups, and the peri-cancer specimens were sampled from subjects in the CRC group. The Bcl-2 and Bax expression was quantified in cancer and peri-cancer specimens using a real-time fluorescent quantitative PCR (qPCR) assay and immunohistochemistry at transcriptional and translational levels, and the cell apoptosis was detected in cancer specimens using HE staining. Results A total of 60 subjects were enrolled, including 30 cases in the CRC group and 30 cases in the CRC-S group. There were no significant differences between the two groups in terms of gender distribution (χ2 = 0.271, P > 0.05), mean age (t = -0.596, P > 0.05), tumor growth pattern (χ2 = 0.275, P > 0.05), tumor location (χ2 = 4.008, P > 0.05), tumor invasion depth (χ2 = 0.608, P > 0.05), degree of tumor differentiation (χ2 = 0.364, P > 0.05), or presence of vascular metastasis (χ2 = 1.111, P > 0.05), while significant differences were seen between the two groups in terms of histological type, presence of lymph node metastasis and TMN staging (χ2 = 5.963, 8.297 and 5.711, all P values < 0.05). qPCR assay and immunohistochemistry quantified significantly higher Bcl-2 and Bax expression in cancer specimens from the CRC and CRC-S groups than in the peri-cancer specimens from the CRC group at both translational and transcriptional levels (all P values < 0.05), and higher Bcl-2 and lower Bax expression were seen in the cancer specimens from the CSC-S group than that from the CRC group (all P values < 0.05). In addition, the cell apoptotic rate was significantly greater in the cancer specimens in the CRC group than in the CRC-S group (42.00% vs. 23.35%; χ2 = 41.500, P = 0.000). Conclusion Schistosomiasis may be involved in the development and progression of CRC through affecting Bcl-2 and Bax gene expression in the apoptosis signaling pathway.

15.
Article in English | WPRIM | ID: wpr-827079

ABSTRACT

OBJECTIVES@#To develop a new Chinese medicine (CM)-based drug and to evaluate its safety and effect for suppressing acute respiratory distress syndrome (ARDS) in COVID-19 patients.@*METHODS@#A putative ARDS-suppressing drug Keguan-1 was first developed and then evaluated by a randomized, controlled two-arm trial. The two arms of the trial consist of a control therapy (alpha interferon inhalation, 50 µg twice daily; and lopinavir/ritonavir, 400 and 100 mg twice daily, respectively) and a testing therapy (control therapy plus Keguan-1 19.4 g twice daily) by random number table at 1:1 ratio with 24 cases each group. After 2-week treatment, adverse events, time to fever resolution, ARDS development, and lung injury on newly diagnosed COVID-19 patients were assessed.@*RESULTS@#An analysis of the data from the first 30 participants showed that the control arm and the testing arm did not exhibit any significant differences in terms of adverse events. Based on this result, the study was expanded to include a total of 48 participants (24 cases each arm). The results show that compared with the control arm, the testing arm exhibited a significant improvement in time to fever resolution (P=0.035), and a significant reduction in the development of ARDS (P=0.048).@*CONCLUSIONS@#Keguan-1-based integrative therapy was safe and superior to the standard therapy in suppressing the development of ARDS in COVID-19 patients. (Trial registration No. NCT04251871 at www.clinicaltrials.gov ).


Subject(s)
Administration, Inhalation , Adult , China , Coronavirus Infections , Diagnosis , Drug Therapy , Mortality , Dose-Response Relationship, Drug , Drug Administration Schedule , Drugs, Chinese Herbal , Female , Follow-Up Studies , Humans , Integrative Medicine , Interferon-alpha , Lopinavir , Male , Middle Aged , Pandemics , Pneumonia, Viral , Diagnosis , Drug Therapy , Mortality , Risk Assessment , Severe Acute Respiratory Syndrome , Diagnosis , Drug Therapy , Mortality , Severity of Illness Index , Survival Rate
16.
Article in Chinese | WPRIM | ID: wpr-871353

ABSTRACT

Objective:To analyze the genomic characteristics of H9N2 subtype avian influenza virus in external environmental specimens collected in Huainan city from February to April, 2016.Methods:Specimens positive for H9N2 nucleic acid (Ct value≤30) were screened by fluorescent PCR and cultivated in chicken embryos to extract RNA. Eight gene segments were amplified and analyzed with whole genome sequencing. The molecular characteristics of each gene segment of Huainan strains were analyzed. A phylogenetic tree was constructed based on the sequences.Results:The hemagglutinin (HA) and neuramidinase (NA) genes of two Huainan H9N2 avian influenza strains and the human-derived strain A/Anhui-Lujiang/39/2018/H9N2 shared the homology of 98.2%-98.3% and 97.2%-94.9% in nucleotide and 98.9%-98.8% and 99.2%-98.6% in amino acid. The other six endogenous genes were highly homologous to those of the A/Anhui/1/2013/H7N9 and A/Anhui/33163/2016/H5N6 strains. The phylogenetic tree showed that two H9N2 subtype avian influenza strains isolated in Huainan city in 2016 belonged to G57 genotype, and the endogenous genes of two Huainan H7N9 isolates and human-derived A/Anhui/1/2013/ H7N9 and A/Anhui/33163/2016/H5N6 strains were G57-like genotype. Amino acid mutations in the HA protein receptor binding domain including S132D, K138T, T189D, V/A190T and Q226L were detected. The " TEI" sequence was deleted from the NA stem region. Amino acid mutations associated with drug resistance including H274Y, R292K and N294S were not detected in the isolates, but they carried the mutations of I550L in PA gene, I368V in PB1 gene, I504V in PB2 gene, P42S in NS1 gene, N30D and T215A in M1 gene and S31N in M2 gene.Conclusions:The two H9N2 viruses isolated in the live poultry market in Huainan city were highly homologous to the A/Anhui-Lujiang/39/2018/H9N2 strain isolated from humans. The three strains were within the same evolutionary branch and belonged to G57 genotype. The endogenous genes of the two H9N2 viruses could recombine with H7N9 and H5N6 subtype avian influenza viruses that caused human infection. Amino acid mutations in the HA protein receptor binding domain, deleted sequences in the NA stem region and increased polymerase activity strengthened the ability of viruses to infect humans and were related to the drug resistance to M2 ion channel inhibitors (adamantane). The two Huainan H9N2 viruses remained sensitive to NA inhibitors (oseltamivir phosphate).

17.
Chinese Journal of Dermatology ; (12): 557-560, 2020.
Article in Chinese | WPRIM | ID: wpr-870317

ABSTRACT

Objective:To analyze efficacy of comprehensive surgical treatment for Kasabach-Merritt phenomenon (KMP) .Methods:Clinical data were collected from 18 patients with KMP who underwent surgical treatment in Department of Hemangioma, Henan Provincial People′s Hospital from November 2017 to March 2019, and analyzed retrospectively. Preoperative treatment included preoperative use of glucocorticoids and immunoglobulins to increase platelet counts in patients. For patients irresponsive to glucocorticoids, a single large-dose of platelets was infused 12-24 hours before surgery. The platelet dose for infusion should be 0.3 and 0.2 therapeutic dose (TD) /kg respectively for patients with platelet counts lower than 30 × 10 9/L and those with platelet counts higher than 30 × 10 9/L, and the total infusion dose should be no more than 1 TD (containing about 2.5 × 10 11 platelets in 200-250 ml of infusion solution) . During the operation, tumor tissues were removed as much as possible; if there were difficulties in suturing in patients with large tumors, in situ autologous skin grafting would be performed; for children with potential postoperative functional dysfunction, a clinical consultation with rehabilitation specialists was given, and individualized functional exercises were prescribed to promote functional restoration. Results:Eighteen patients were enrolled, including 9 males and 9 females, with an average age of 73 days (range, 7-354 days) . Skin lesions were located on the extremities in 3 cases, on the trunk in 11, and on the head, face and neck in 4. Surgeries were successful in 17 patients, but 1 died. Among the 17 patients with successful operation, platelet counts and coagulation function returned to normal within 1 week after the surgery in 16, and did not returned to normal until after regular oral administration of sirolimus in 1. Favorable movement ability was maintained in all the children.Conclusion:Comprehensive surgical treatment shows rapid efficacy with less adverse reactions in the therapy of KMP.

18.
Article in Chinese | WPRIM | ID: wpr-869790

ABSTRACT

Objective:To evaluate the efficacy of retroclavicular approach to brachial plexus block in overweight patients undergoing upper extremity surgery with general anesthesia.Methods:Sixty American Society of Anesthesiologists physical status Ⅰ or Ⅱ patients of both sexes, aged 18-64 yr, with body mass index≥25 kg/m 2, undergoing hand or wrist, forearm and elbow surgery, were divided into 2 groups ( n=30 each) using a random number table method: paracoracoid approach group (P group) and retroclavicular approach group (R group). The retroclavicular and paracoracoid approaches to brachial plexus block were performed with 0.2% ropivacaine 30 ml under ultrasound guidance in group P and group R, respectively.After completion of local anesthetic injection, sensory and motor blocks were evaluated every 10 min, lasting 30 min, and the comprehensive score ≥14 was considered as successful brachial plexus block.The surgery was performed under general anesthesia with laryngeal mask after successful block.Patient-centrolled intravenous analgesia(PCIA) was performed after surgery.PCIA solution contained 100 μg sufentanil, 800 mg tramadol and 5 mg tothenesetron in normal saline 200 ml.The PCA pump was set up with a 2 ml bolus dose, a 30 min lockout interval and background infusion at a rate of 2 ml/h.Analgesia was performed until 72 h after surgery.Parecoxib sodium 40 mg/12 h was intramuscularly injected within 48 h after surgery.Visual analogue scale score was maintained≤3 points.If visual analogue scale score was>3 points, 100 mg pethidine hydrochloride was intramuscularly injected as rescue analgesia.The success of brachial plexus nerve block was recorded.Imaging time, the number of puncture, puncture time, sensory block duration and motor block duration were recorded.The requirement for rescue analgesia and the first time for rescue analgesia were recorded within 72 h after surgery.The patient′s satisfaction with postoperative analgesia (0 for dissatisfaction, 1 for satisfaction, 2 for great satisfaction) was assessed and recorded at 72 h after surgery.The occurrence of adverse reactions such as nerve injury, vascular puncture injury, redness and swelling at the puncture site, and blood oozing and oozing from the puncture site were recorded. Results:The success rate of brachial plexus block was 97% in both groups.Compared with group P, the number of puncture was significantly reduced, motor block duration was prolonged ( P<0.05), and no significant change was found in imaging time, puncture time, sensory block duration, requirement for rescue analgesia, the first time for rescue analgesia, patient′s satisfaction with analgesia or incidence of blood oozing from the puncture site in group R ( P>0.05). No adverse reactions such as sensory nerve injury, vascular puncture injury, redness and swelling at the puncture site, or oozing from the puncture site were found in both groups ( P>0.05). Conclusion:Retroclavicular approach to brachial plexus block can be safely and effectively used for overweight patients undergoing upper extremity surgery with general anesthesia.

19.
Chinese Journal of Radiology ; (12): 1003-1007, 2020.
Article in Chinese | WPRIM | ID: wpr-868362

ABSTRACT

Objective:To explore the radiation protection effect of a novel integrated radiation protection device for computed tomography and evaluate its influence on image quality.Methods:According to the radiation protection principle and CT model, a novel integrated CT radiation protection device was designed and developed. Under the normal operation condition of CT scanner, the radiation dose rate of 7 monitoring points around CT scanner before and after the use of radiation protection device was measured and the effective protection rate was calculated. Before and after using the protective device, the water equivalent phantom was scanned with CT respectively, CT value and signal-to-noise ratio were measured and calculated, and the image quality was evaluated subjectively with the 3-point system. The paired t-test was used to compare the difference of radiation dose rate, average CT value and signal-to-noise ratio of CT surrounding environment before and after using the protective device, and the Mann Whitney U-test was used to compare the difference of subjective scores of CT image quality of water model before and after using the protective device. Results:The radiation dose rates of the 7 monitoring points after the use of the novel CT radiation protection device was significantly lower than those before radiation protection device was used, the difference was statistically significant (P<0.05), and the effective protection rate was more than 50%; the average CT value, signal-to-noise ratio and subjective score in the range of water equivalent phantom before and after the use of the radiation protection device were not statistically significant ( P>0.05). Conclusions:The novel integrated CT radiation protection device can significantly reduce the radiation dose rate of the surrounding environment when the CT machine is running and has no effect on the image quality.

20.
Article in Chinese | WPRIM | ID: wpr-867597

ABSTRACT

Objective:To investigate and analyze the epidemiological and clinical characteristics of 46 patients with corona virus disease 2019 (COVID-19) in Beijing City.Methods:A retrospective study was conducted to analyze the data of 46 patients with COVID-19 in Beijing from 20th January 2020 to 8th February 2020 at the Fifth Medical Center of the PLA General Hospital in Beijing City. Twelve, 23 and 11 patients were assigned to the mild group, common group and severe group, respectively. The epidemiological history, clinical characteristics, laboratory tests and imaging inspections were analyzed. Statistical analysis used Fisher exact test. If P<0.05, post- hoc test was used for pairwise comparison, and the statistics were corrected by Bonferroni test. Results:Among the 46 patients included in this study, 27 were male and 19 were female. The age range was between 3-79 years old, and the age was (41.8±16.3) years old. The average incubation period was (4.85±3.00) days. A total of 26 cases (56.5%) were clustered patients, and 26 cases had a history of staying in Wuhan, 10 cases had contact with Wuhan personnel. Fever (39 cases, 84.8%), cough (27 cases, 58.7%), and fatigue (25 cases, 54.3%) were the main clinical symptoms for these patients. The decrease in white blood cell counts occurred in 12 patients, four had the decrease in T lymphocyte percentage, 17 had the decrease in CD4 + T lymphocyte counts, seven had the decrease in CD8 + T lymphocyte counts, 21 had the increase level of C reactive protein (45.7%), and interleukin-6 (IL-6) level increased in 32 cases (69.6%), erythrocyte sedimentation rate (ESR) increased in 23 cases (50.0%), serum ferritin level increased in 26 cases (56.5%), and blood lactic acid level increased in nine cases. There were statistically significant differences in the proportion of cases with decreased absolute value of CD8 + T lymphocytes and T lymphocytes counts among the mild, common and severe groups (all P<0.05). Comparing the proportion of cases in the three groups with elevated C reactive protein, IL-6, ESR, serum ferritin and blood lactic acid levels, the differences were statistically significant (all P<0.05). The proportion of cases with elevated C reactive protein levels in severe group was higher than those in mild and common groups. The proportion of cases with elevated IL-6, ESR, and serum ferritin levels in severe and common group were higher than those in mild group. The proportion of cases with elevated blood lactic acid levels in severe group was higher than those in mild group. The differences between the above groups were statistically significant (all adjusted P<0.017). Analysis of chest X-rays results showed that 34 patients (73.9%) had inflammation in the lungs. Conclusions:The epidemiological characteristics of patients with COVID-19 in Beijing City are mainly imported cases and clustered cases. The clinical manifestations are mainly fever, fatigue and cough. C reactive protein, IL-6, ESR, serum ferritin and blood lactic acid levels are higher in severe patients.

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