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1.
Article in Chinese | WPRIM | ID: wpr-928663

ABSTRACT

OBJECTIVE@#To analyze the efficacy of children with B-cell acute lymphoblastic leukemia (B-ALL) without prognostic fusion genes treated by CCLG-ALL 2008, and investigate the related factors affecting the recurrence of the patients.@*METHODS@#B-ALL patients without prognostic fusion genes treated by the protocol of CCLG-ALL 2008 in our hospital from March 2008 to December 2012 were retrospectively analyzed. Follow-up time was ended in August 31, 2019. The median follow-up time was 92 months (range 0-136 months). Kaplan-Meier was used to detect the RFS, and COX multivariate regression analysis was employed to identify the independent factors affecting the recurrence of the patients.@*RESULTS@#There were 140 males and 99 females enrolled in this study. The ratio of male to female was 1.41∶1. The median age was 4.4 years old and the median number of WBC at initial stage was 4.98×109/L. There were 77 cases relapsed during the observation while 162 without relapsed, 16 cases lost to follow-up and 72 cases died. The recurrence and mortality rate was 32.22% and 30.1%, respectively, in which 45 cases died of recurrence (62.5% of the total deaths). Univariate analysis showed that the age≥6 years old, WBC >100×109/L, the bone marrow blasts on day 15≥25%, the bone marrow minimal residual disease (MRD) at week 12 >10-4, and the higher risk were the main factors affecting the recurrence of the patients (P<0.05). Multivariate COX regression analysis showed that age≥6 years old, WBC >100×109/L, bone marrow MRD >10-4 at the 12th week were the independent risk factors affecting recurrence of the patients.@*CONCLUSION@#Age, initial WBC, and bone marrow MRD at the 12th week were correlated with recurrence in children with B-ALL without prognostic fusion genes, which can be used as prognostic indices of recurrence risk in clinical.


Subject(s)
Antineoplastic Combined Chemotherapy Protocols , Child , Child, Preschool , Disease-Free Survival , Female , Humans , Male , Neoplasm, Residual , Precursor Cell Lymphoblastic Leukemia-Lymphoma/genetics , Prognosis , Recurrence , Retrospective Studies
2.
Article in Chinese | WPRIM | ID: wpr-908015

ABSTRACT

Clinical data, nutrition support and 6-year follow-up results of a patient with Tricho-hepato-enteric syndrome (THES) diagnosed in the Children′s Hospital of Nanjing Medical University in December 2013 were analyzed.The patient suffered severe malnutrition, growth retardation, hypophosphatemia, hypoglobulinemia, high nutritional risk status and significant intestinal dysfunction.The genetic testing revealed SKIV2 L gene variation in this case of THES.During the acute exacerbation of diarrhea, enteral nutrition and periodical short-term parenteral nutrition were given as nutrition support.Deep-hydrolyzed formula by oral and low-fat, low-residue, high-quality-protein diet was given during the remission phase.At last, the diarrhea and nutritional status of the patient improved gradually.The growth and development, including neuromotor development of the case also caught up to children with the same age, and he was capable of schooling.It is suggested that rational individualized nutrition support can significantly improve intestinal function and nutritional status of children with THES, which overcome the dangerous period, improve the quality of life and prolong the survival time.

3.
Chinese Journal of Urology ; (12): 397-400, 2021.
Article in Chinese | WPRIM | ID: wpr-885033

ABSTRACT

DNA damage repair gene mutations are prevalent in advanced prostate cancer. Among these, mutations in homologous recombination repair genes could impair the ability of cell to restore the DNA double-strand break, which can be exploited by Poly-ADP-ribose polymerase (PARP) inhibitors through synthetic lethality and result in cell death. The phase Ⅲ study " PROfound" showed that the PAPR inhibitor Olaparib could significantly improve the survival of patients with homologous recombination repair gene mutations compared with novel hormone agents, starting the era of targeted, precise and individualized treatment based on genetic profile detection for prostate cancer treatment.

4.
Article in English | WPRIM | ID: wpr-921380

ABSTRACT

OBJECTIVES@#This prospective study was performed to evaluate whether the distal-triangular flap was a practical alternative surgical approach for extracting mandibular third molars.@*METHODS@#Sixty participants with impacted mandibular third molars were randomly divided into three groups: group A, distal-triangular flap; group B, Szmyd flap; and group C, envelope flap. The impacted third molars were extracted by the corresponding flapping method. During a three-month follow-up observation after the extraction, the postoperative pain, swelling, mouth opening, and periodontal status were recorded and analyzed by ANOVA and chi-square tests.@*RESULTS@#The 60 participants had successful extraction and 3-month follow-up observation. No participant suffered from postoperative infections, lower lip disorder, or tongue sensory disorders. No statistical differences were found in the postoperative symptoms and signs of the three flap designs, such as postoperative pain, swelling, mouth opening, and periodontal status (@*CONCLUSIONS@#The distal-triangular flap was as safe and reliable as the Szmyd and envelope flaps but more advantageous because of its convenient operative field exposure and low requirement for the patient's mouth opening. Thus, the distal-triangular flap is one of the alternative flap options for extracting impacted mandibular third molars.


Subject(s)
Humans , Mandible/surgery , Molar, Third/surgery , Prospective Studies , Tooth Extraction , Tooth, Impacted/surgery
5.
Article in English | WPRIM | ID: wpr-878439

ABSTRACT

The morbidity rate of medication-related osteonecrosis of the jaws (MRONJ) increased rapidly in recent years. Thusfar, the mechanism of MRONJ has no consensus. The possible mechanisms may include bone remodeling inhibition theory, angiogenesis inhibition theory, oral microorganism infection theory, immunosuppression theory, cytotoxicity-targeted oral epithelial cells, microcrack formation of maxillary or mandibular bone, and single nucleotide polymorphism. However, the efficacy of prevention and treatment based on a single mechanism is not ideal. Routine oral examination before MRONJ-related drug treatment, treatment of related dental diseases, and regular oral follow-up during drug treatment are of great significance for the prevention of MRONJ. During the treatment of MRONJ, the stage of MRONJ must be determined accurately, treatment must be standardized in accordance with the guidelines, and personalized adjustments must be made considering the specific conditions of patients. This review aimed to combine the latest research and guidelines for MRONJ and the experiences on the treatment of MRONJ in the Maxillofacial Surgery Department of West China Hospital of Stomatology, Sichuan University, and discuss the strategies to improve the clinical process.


Subject(s)
Bisphosphonate-Associated Osteonecrosis of the Jaw/prevention & control , Bone Density Conservation Agents , Bone Remodeling , China , Humans , Jaw
6.
Article in Chinese | WPRIM | ID: wpr-878426

ABSTRACT

OBJECTIVES@#The present study aimed to explore the innervation of the anterior hard palatine and its relationship with individual development stage. Specifically, the effects of anesthesia on patients of different ages were observed, and neurodevelopment in the maxillofacial region was invesitgated. References that are helpful in selecting local anesthesia were provided.@*METHODS@#A total of 182 patients with mixed dentition were randomly divided into the nasopalatine nerve block and greater palatine nerve block groups. Then, 219 patients with permanent dentition were divided into an adolescent group (13-18 years old) and adult group (over 19 years old), all of whom underwent bilateral greater palatine nerve block. Palatal mucosal pain sensation was tested pre- and post-anesthesia with Von Frey hairs.@*RESULTS@#Among the children with mixed dentition, bilateral greater palatine nerve block tended to result in better anesthetic effects than nasopalatine nerve block (@*CONCLUSIONS@#The sensation of the anterior hard palatine seems mainly dominated by the greater palatine nerve until mixed dentition and gradually shifted to the nasopalatine nerve in conjunction with maxillary development and tooth replacement. Hence, the innervation of the anterior hard palatine induce a secondary development during the development of the maxilla.


Subject(s)
Adolescent , Adult , Child , Dentition, Mixed , Humans , Maxilla , Maxillary Nerve , Nerve Block , Palate , Palate, Hard , Young Adult
7.
Article in Chinese | WPRIM | ID: wpr-880130

ABSTRACT

OBJECTIVE@#To analyze the efficacy of CCLG-ALL-2008 protocol and the related factors of treatment failure in children with acute lymphoblastic leukemia (ALL).@*METHODS@#The clinical data of 400 children newly-diagnosed ALL in Children's Hospital of Soochow University from March 1, 2008 to December 31, 2012 was retrospectively analyzed. All the children accepted CCLG-ALL-2008 protocol, and were followed-up until October 2019. The dates of relapse, death and causes of death were recorded. Treatment failure was defined as relapse, non-relapse death, and secondary tumor.@*RESULTS@#Following-up for 10 years, there were 152 cases relapse or non-relapse death, the treatment failure rate was 38%, including 122 relapse (80.3%), 30 non-relapse deaths (19.7%) which included 7 cases (4 cases died of infection and 3 cases died of bleeding) died of treatment (23.3% of non-relapse deaths), 8 cases died of minimal residual disease (MRD) continuous positive (26.7% of non-relapse deaths) and 15 cases died of financial burden (50% of non-relapse deaths). According to the relapse stage, 37 cases (30%) in very early stage, 38 cases (31%) in early stage, and 47 cases (39%) in late stage, while according to the relapse site, 107 cases relapsed in bone marrow, 3 cases in testis, 3 cases in central nervous system (CNS), 5 cases in bone marrow plus testis and 4 cases in bone marrow plus CNS. Bone marrow relapse was the main cause of death in 89 cases, followed by nervous system. Initially diagnosed WBC count (≥50×10@*CONCLUSION@#Relapse is the main cause of treatment failure in children with ALL. The initially diagnosed WBC count, immunophenotype and MRD at week 12 were the independent prognostic factors for relapse of the patients. Financial burden accounts for a large proportion of non-relapse death.


Subject(s)
Antineoplastic Combined Chemotherapy Protocols , Child , Disease-Free Survival , Humans , Male , Neoplasm, Residual , Precursor Cell Lymphoblastic Leukemia-Lymphoma/drug therapy , Prognosis , Recurrence , Retrospective Studies , Treatment Failure , Treatment Outcome
8.
Article in Chinese | WPRIM | ID: wpr-876304

ABSTRACT

Objective To investigate the knowledge of HIV/AIDS among the female sex workers in Songjiang District of Shanghai, changes in their related behaviors, and prevalence of human immunodeficiency virus(HIV), syphilis, and hepatitis C virus (HCV), providing evidence for related prevention and control work in this regard. Methods During 2011-2015 sentinel surveillance period, in the area of Songjiang District, according to the survey method of the National AIDS Sentinel Monitoring Implementation Program, questionnaires were conducted on the female sex workers and their venous blood was collected to detect HIV, syphilis and HCV antibodies. Results A total of 2 064 secret prostitutes were surveyed.The overall awareness rate of AIDS-related knowledge among them was 94.77%, and the annual awareness rates were 93.33%, 95.01%, 93.00%, 99.76%, and 92.57%, respectively(P < 0.05);The total proportion of the female sex workers who used condoms in the last commercial sex was 90.07%, and 84.05%, 80.55%, 93.72%, 99.06%, and 95.79% respectively in the calendar year(P < 0.05);The total proportion of the female sex workers who insisted on using condoms for commercial sex in the last 1 month was 76.74%, and 69.29%, 60.60%, 86.47%, 87.76%, and 78.96% respectively in the calendar year(P < 0.05);The average detection rate of HIV antibodies for 5 years was 0.00%, syphilis antibody detection rate was 3.00%, and HCV antibody detection rate was 0.34%. Conclusion The knowledge level of AIDS related knowledge is high among the female sex workers in Songjiang District.The persistent condom use rate during commercial sex is low in the last month; the syphilis detection rate is slightly higher than the national average.

9.
Article in Chinese | WPRIM | ID: wpr-876286

ABSTRACT

Objective To investigate the knowledge of HIV/AIDS among the female sex workers in Songjiang District of Shanghai, changes in their related behaviors, and prevalence of human immunodeficiency virus(HIV), syphilis, and hepatitis C virus (HCV), providing evidence for related prevention and control work in this regard. Methods During 2011-2015 sentinel surveillance period, in the area of Songjiang District, according to the survey method of the National AIDS Sentinel Monitoring Implementation Program, questionnaires were conducted on the female sex workers and their venous blood was collected to detect HIV, syphilis and HCV antibodies. Results A total of 2 064 secret prostitutes were surveyed.The overall awareness rate of AIDS-related knowledge among them was 94.77%, and the annual awareness rates were 93.33%, 95.01%, 93.00%, 99.76%, and 92.57%, respectively(P < 0.05);The total proportion of the female sex workers who used condoms in the last commercial sex was 90.07%, and 84.05%, 80.55%, 93.72%, 99.06%, and 95.79% respectively in the calendar year(P < 0.05);The total proportion of the female sex workers who insisted on using condoms for commercial sex in the last 1 month was 76.74%, and 69.29%, 60.60%, 86.47%, 87.76%, and 78.96% respectively in the calendar year(P < 0.05);The average detection rate of HIV antibodies for 5 years was 0.00%, syphilis antibody detection rate was 3.00%, and HCV antibody detection rate was 0.34%. Conclusion The knowledge level of AIDS related knowledge is high among the female sex workers in Songjiang District.The persistent condom use rate during commercial sex is low in the last month; the syphilis detection rate is slightly higher than the national average.

10.
Article in Chinese | WPRIM | ID: wpr-828635

ABSTRACT

OBJECTIVE@#To study the clinical features of aerophagia in children.@*MEYJODS@#A retrospective analysis was performed on the medical data of 46 children with aerophagia who were diagnosed and treated in Children's Hospital Affiliated to Nanjing Medical University from October 2011 to September 2019.@*RESULTS@#Among these 46 children, 15 (33%) had Tourette syndrome. Abdominal distension was the most common symptom and was observed in 45 children (98%). The 24-hour esophageal multichannel intraluminal impedance monitoring showed a mean number of 341 times of air swallowing and a mean number of 212 times of gas reflux, and 95% of gas refluxes occurred in the upright body position. Compared with those without Tourette syndrome, the children with Tourette syndrome had a significantly higher incidence rate of air swallowing symptoms (67% vs 6%, P<0.001), but there were no significant differences in other symptoms and the results of 24-hour esophageal impedance. Dietary adjustment, psycho-behavioral therapy, and drug intervention significantly improved the scores of clinical symptoms and quality of life, among which psycho-behavioral therapy was an important intervention measure.@*CONCLUSIONS@#Some children with aerophagia may have Tourette syndrome, and such children are more likely to have air swallowing symptoms. Psycho-behavioral therapy is one of the most important treatment methods, and children with aerophagia tend to have a good prognosis after treatment.


Subject(s)
Aerophagy , Child , Electric Impedance , Gastroesophageal Reflux , Humans , Quality of Life , Retrospective Studies
11.
Article in English | WPRIM | ID: wpr-826628

ABSTRACT

OBJECTIVE@#This study summarizes and compares clinical and laboratory characteristics of 34 patients admitted to the intensive care unit (ICU) for complications from coronavirus disease 2019 (COVID-19) at the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China from Jan. 22 to Mar. 5, 2020.@*METHODS@#A total of 34 patients were divided into two groups, including those who required noninvasive ventilation (NIV) and invasive mechanical ventilation (IMV) with additional extracorporeal membrane oxygenation (ECMO) in 11 patients. Clinical features of COVID-19 patients were described and the parameters of clinical characteristics between the two groups were compared.@*RESULTS@#The rates of the acute cardiac and kidney complications were higher in IMV cases than those in NIV cases. Most patients had lymphocytopenia on admission, with lymphocyte levels dropping progressively on the following days, and the more severe lymphopenia developed in the IMV group. In both groups, T lymphocyte counts were below typical lower limit norms compared to B lymphocytes. On admission, both groups had higher than expected amounts of plasma interleukin-6 (IL-6), which over time declined more in NIV patients. The prothrombin time was increased and the levels of platelet, hemoglobin, blood urea nitrogen (BUN), D-dimer, lactate dehydrogenase (LDH), and IL-6 were higher in IMV cases compared with NIV cases during hospitalization.@*CONCLUSIONS@#Data showed that the rates of complications, dynamics of lymphocytopenia, and changes in levels of platelet, hemoglobin, BUN, D-dimer, LDH and IL-6, and prothrombin time in these ICU patients were significantly different between IMV and NIV cases.


Subject(s)
Acute Kidney Injury , Virology , Aged , Aged, 80 and over , Betacoronavirus , Blood Urea Nitrogen , China , Coronavirus Infections , Therapeutics , Extracorporeal Membrane Oxygenation , Female , Fibrin Fibrinogen Degradation Products , Heart Diseases , Virology , Hemoglobins , Hospitalization , Humans , Intensive Care Units , Interleukin-6 , Blood , L-Lactate Dehydrogenase , Blood , Lymphopenia , Virology , Male , Middle Aged , Noninvasive Ventilation , Pandemics , Pneumonia, Viral , Therapeutics , Positive-Pressure Respiration , Prothrombin Time , Retrospective Studies
12.
Article in English | WPRIM | ID: wpr-826627

ABSTRACT

Since the global outbreak of severe acute respiratory syndrome (SARS) in 2003, China has gradually built a robust prevention and control system for sudden infectious diseases. All large hospitals have a fever clinic that isolates patients with all kinds of acute communicable diseases as the first line of medical defense. The emergency department, as the second line of medical defense in hospitals, is constantly shouldering the heavy responsibility of screening communicable diseases while also treating all kinds of other non-communicable acute and critical diseases (Zhang et al., 2012; Zhu et al., 2015; Wang et al., 2017; Feng et al., 2018; Lu, 2018; Xu and Lu, 2019). An outbreak of pneumonia of unknown etiology that began in Wuhan city (China) has spread rapidly in China since December 2019 (Huang et al., 2020; WHO, 2020; Zhu et al., 2020). In February 2020, the National Health Commission of China named the disease a novel coronavirus pneumonia (NCP); then, it was formally named the coronavirus disease 2019 (COVID-19) by the World Health Organization (WHO) on Feb. 11, 2020. The Coronavirus Study Group of the International Committee on Taxonomy of Viruses designated this causative virus as SARS coronavirus 2 (SARS-CoV-2). SARS-CoV-2 belongs to the β coronavirus genus, and its pathogenic mechanism has not been clarified, which requires further study. To better understand the clinical characteristics of COVID-19 and more effectively prevent and control this disease, we retrospectively analyzed four representative cases of COVID-19 that had recently been screened and diagnosed in our emergency department.


Subject(s)
Adult , Betacoronavirus , China , Epidemiology , Coronavirus Infections , Diagnosis , Emergency Service, Hospital , Female , Humans , Lung , Diagnostic Imaging , Male , Middle Aged , Pandemics , Patient Isolation , Pneumonia, Viral , Diagnosis , Tomography, X-Ray Computed
13.
Article in Chinese | WPRIM | ID: wpr-864305

ABSTRACT

Objective:To investigate the changes of eosinophil(EOS) in feces of children with allergic enteritis caused by milk protein, and to provide basis for diagnosis and treatment of allergic enteritis.Methods:From July 2018 to June 2019, 70 children with milk protein allergic enteritis (allergic group), 50 children with non allergic common diarrhea (non-allergic group) and 50 children with healthy physical examination (healthy control group) were selected from Children′s Hospital of Nanjing Medical University.White blood cell(WBC), hemoglobin(Hb), blood platelet(PLT), EOS and the percentage of EOS(EOS%) of the 3 groups were counted by automatic hematology analyzer.The EOS in the feces of the 3 groups and the allergic group after treatment were counted by Gomori staining, and the correlation between EOS in the feces and milk protein allergic enteritis was analyzed.Results:For allergic group, EOS count in peripheral blood was(0.71±0.74)×10 9/L, EOS% was (7.56±5.96)%, and PLT was (382.96±85.98)×10 9/L.For non-allergic group, EOS was (0.31±0.18)×10 9/L, EOS% was (3.53±2.26)%, PLT was(315.12±69.81)×10 9/L.For healthy control group, EOS was(0.31±0.15)×10 9/L, EOS% was (3.66±1.65)%, and the PLT was(307.56±85.20)×10 9/L.The number of EOS, EOS% and PLT in allergic group were higher than those in non-allergic group and healthy control group ( F=13.606, 19.055, 16.074, all P<0.05). The number of EOS in feces of allergic group[(10.75 ±17.17)/ 50 fields at ×1 000]was significantly higher than that of non-allergic group[(1.16±3.09)/50 fields at ×1 000], the difference was statistically significant ( F=17.25, P<0.05), and there was no EOS in feces of healthy control group.After 4 weeks of avoidance of milk, EOS in feces decreased significantly in allergic group [(2.26±5.32)/50 fields at ×1 000], the difference was statistically significant ( t=5.822, P<0.05), while EOS in blood decreased [(0.56±0.47)×10 9/L], the difference was not statistically significant ( t=1.981, P>0.05). Conclusions:EOS in fecal of children with milk protein allergic enteritis increased obviously and decreased after treatment, is helpful to guide the clinical diagnosis and may become a new indicator of efficacy monitoring.

14.
Article in Chinese | WPRIM | ID: wpr-733447

ABSTRACT

Objective To investigate the nutritional risk of hospitalized infants with severe pneumonia and its relationship with clinical outcome. Methods Totally 113 infants with severe pneumonia admitted to pediatric intensive care unit (PICU)were enrolled in the study. Nutritional risks were screened by STRONGkids, and the nutritional were assessment with WHO Anthro. Clinical outcomes were recorded and analyzed, including mechanical ventilation, length of PICU stay, total hospital expenses, prognosis, and biochemical test index. Results A total of 44 infants (38.9%) had high nutritional risk, 49 (43.4%) had medium nutritional risk, 20 (17.7%) had low nutritional risk when they admitted to PICU. A total of 59 (52.2%) infants were malnourished when they admitted to PICU. There was a significant correlation between the degree of malnutrition and nutritional risk (r =0.574, P<0.01).The incidence of high nutritional risk was significantly higher in 28d~1year-old group than in 1~3 year-old group (χ2=20.46, P<0.01). Nearly 42.5%(48/113) of the children had congenital disease and had higher incidence of high nutritional risk (χ2=11.375, P=0.003) and higher incidence of malnutrition (χ2=10.083, P=0.001) than those without congenital disease. The rate of mechanical ventilation (P=0.028), the duration of mechanical ventilation (P<0.01), total hospital expenses (P=0.002) and the incidence of poor prognosis(P=0.014) were significantly higher in high nutritional risk group than the low nutritional risk group. The retinol binding protein in the high nutrition risk group was significantly lower than the low nutrition risk group (χ2=6.333, P=0.021). Conclusions High nutritional risk and malnutrition are common in infants with severe pneumonia. Malnutrition and nutritional risk are increased in patients less than 1 year old or suffering from congenital disease. Patients with high nutritional risk are more likely to have worse clinical outcomes. STRONGkids is a valid tool for nutritional risk screening in hospitalized children, and early nutrition support is recommended.

15.
Article in Chinese | WPRIM | ID: wpr-772691

ABSTRACT

Resorption of alveolar bone that occurs following tooth extraction is irreversible, it may compromise the restoration of implants or conventional prostheses. Ridge preservation can minimize ridge resorption after tooth extraction. In this article, healing features of socket after tooth extraction, factors influencing ridge remodeling, and the use of bioma-terials were reviewed.


Subject(s)
Alveolar Bone Loss , Alveolar Process , Alveolar Ridge Augmentation , Humans , Tooth Extraction , Tooth Socket , Wound Healing
16.
Article in Chinese | WPRIM | ID: wpr-709051

ABSTRACT

Objective To observe the condition changes in patients with chronic hepatitis B (CHB) following medication withdraw of nucleoside/nucleotide analogues (NAs) treatment and to analyze the factors related to disease relapse.Methods Eighty-five CHB patients who discontinued medication of nucleoside/nucleotide analogues for antiviral therapy in Nanjing Second Municipal Hospital from January 2002 to December 2017 were enrolled in the study, among whom 22 cases met the withdrawal criteria (standard withdrawal group ) and 63 cases did not meet the withdraw criteria ( non-standard withdrawal group).The correlation of condition changes (abnormal liver function, positive rate of HBV DNA, hepatic failure with the drug withdrawal , the course of medication, serological transformation of HBeAg during drug withdrawal, HBsAg level, and liver cirrhosis during drug administration was analyzed.Results In standard withdraw group, the medication lasted for >3 years, only 1 case had HBV DNA positive conversion , abnormal ALT and TBil, and liver failure.In non-standard withdraw group, 50 cases (79.4%) had HBV DNA positive conversion, 36 (57.1%) had abnormal ALT, 25 ( 39.7%) had abnormal TBil and 14 (22.2%) had liver failure.There were 19 cases with HBsAg >1 000 IU/mL and 3 cases with HBsAg ≤1 000 IU/mL, and 1 case with HBsAg>1 000 IU/mL (5.3%) had HBV DNA positive conversion , ALT, TBil abnormality and liver failure.In non-standard withdraw group, there were 52 cases with HBsAg >1000 IU/mL, among whom 45 cases (86.5%) had positive HBV DNA conversion , 31 (59.6%) had ALT abnormalities, 25 (48.1%) had TBil abnormalities, and 13 (25.0%) had liver failure; there were 11 patients with HBsAg ≤1 000 IU/mL, among whom 6 cases (54.5%) had HBV DNA positive conversion , 5 (45.4%) had ALT abnormalities, and no TBil abnormalities or liver failure occurred.There were 5 cases of liver cirrhosis in the standard withdraw group , only 1 case had HBV DNA positive conversion , ALT, TBil abnormality and liver failure.None of the 17 patients with non-cirrhosis had HBV DNA positive conversion , ALT, TBil abnormality and liver failure.There were 29 patients with liver cirrhosis in non-standard withdraw group showed positive HBV DNA conversion , 28 (96.6%) had ALT abnormalities, 22 (75.8%) had TBil abnormalities, and 11 (37.9%) had liver failure; among 34 non-cirrhosis patients, 21 (61.8%) had positive HBV DNA conversion, 8 (23.5%) had ALT abnormalities, 3 (8.8%) had TBil abnormalities, and 2 (5.9%) had liver failure.According to the standard discontinuation , 12 patients (16.7%) had positive HBV DNA transformation after HBeAg serological conversion , and no ALT abnormality, TBil abnormality and liver failure occurred.In non-standard withdraw group, only 17 cases without HBeAg serological conversion , 10 cases (58.8%) had positive HBV DNA conversion , 5 cases (29.4%) had ALT abnormalities, 2 cases (11.8%) had TBil abnormalities and liver failure did not occur.Conclusion CHB patients with medication of NAs should be discontinued according to the withdrawal criteria .and the course of medication, the immune index and the liver cirrhosis should be taken into account.

17.
Article in Chinese | WPRIM | ID: wpr-702657

ABSTRACT

Objective To investigate the current status of nutritional support in the children with severe traumatic brain injury (TBI),and the influence of nutritional support on the clinical outcomes.Methods A total of 60 children with severe TBI who were admitted to the surgical intensive care unit (SICU) of our hospital from April 2016 to July 2017 were enrolled in this study.The clinical data like gender,age,height,weight,diagnosis and Glasgow coma scale were collected.The children were divided into two groups by actual energy intake:target energy achieved group and unachieved group.Nutritional support indexes including the start time and the way of nutritional support,interruption of enteral nutritional support,predicted target energy value and actual energy intake,incidence of infectious complications,duration of mechanical ventilation,length of SICU stay,length of total hospital stay,total hospital expenses and prognosis were compared between the two groups.Results Among 60 children recruited,37 (61.6%) were caused by traffic accident,16 (26.7%) were caused by falling,7 (11.7%) by other causes.The average duration of SICU were (13.3± 8.0) days.22 (36.7%) children achieved the target energy,while 38 (63.3%) failed,and the percentage of actual energy supply was 126% and 65%,respectively (P=0.000).The average age of the target achieved group was younger than that of the target unachieved group [(3.5±2.8) years vs.(6.2±3.9) years,P=0.006],while the duration of the mechanical ventilation was shorter [(2.7±3.9) days vs.(6.8± 11.8) days,P=0.014],and the length of hospital stay was shorter [(16.8±7.7) days vs.(19.5±11.6) days,P=0.038].The total hospital expenses of the target achieved group were lower than the unachieved group [(5.4±4.1) × 104 yuan vs.(7.6±5.9) ×104 yuan,P=0.024] Conclusions The actual energy intakes of most severe TBI children are less than their target energy.Sufficient energy supply can shorten the length of SICU and hospital stay,and reduce the total hospital expenses.

18.
Article in Chinese | WPRIM | ID: wpr-665180

ABSTRACT

Objective To systematically evaluate the efficacy of small-needle-knife therapy combined with manipulation in treating frozen shoulder. Methods Articles about small-needle-knife therapy combined with manipulation treating frozen shoulder clinical randomized controlled trials in CNKI, CBM, VIP, Wanfang Data, Embase, Cochrane Library and Pubmed database were searched. Retrieval time was from the establisment of the database to February 2017. Two researchers screened literature, extract materials independently. The quality of the included studies was evaluated according to the Cochrane System Evaluation Manual 5.1.0. Meta-analysis was performed by using RevMan 5.3 software. Results 12 articles were included in a systematic review, a total of 1118 cases of patients. Meta-analysis showed that, compared with small-needle-knife therapy alone, small-needle-knife therapy combined with manipulation in the treatment of frozen shoulder could significantly improve the total effective rate [OR=5.07, 95%CI(3.07, 8.37), P<0.000 01] and cure rate [OR=2.89, 95%CI(2.21, 3.78), P<0.000 01], enhance motor function score [MD=63.98, 95%CI(38.61, 89.35), P<0.000 01], with statistical significance. Conclusion Small-needle-knife therapy combined with manipulation had definite efficacy in the treatment of frozen shoulder. However, the quality of included research is relatively low, so large-sample, multi-center and high-quality randomized controlled trials are required for verification.

19.
Article in Chinese | WPRIM | ID: wpr-688037

ABSTRACT

<p><b>OBJECTIVE</b>The study aims to investigate the cognition degree and influencing factors of first aid knowledge among dentists in Sichuan province, and to provide suggestions for the training of oral clinician.</p><p><b>METHODS</b>A questionnaire was designed for this study. It included the basic situation of population, first aid knowledge level, emergency situation often encountered in stomatology clinic, first aid training situation, learning approach and attitude of first aid knowledge, etc. This questionnaire was used to investigate the dentists of medical institutions in various cities in Sichuan province. The survey results was statistical analyzed.</p><p><b>RESULTS</b>There were 245 valid questionnaires. 1) The level of first aid knowledge of dentists was generally lower in Sichuan province. Work department and other departments work experience were the influencing factors of knowledge level of first aid knowledge among dentists. 2) 87.3% of dentists believed that it was very necessary to master the knowledge of first aid, but in the event of an emergency situation, 73.5% of dentists only can find other doctors to guide themselves to help. 3) The most common way to learn first aid knowledge was through work experience and medical school's first aid course.</p><p><b>CONCLUSIONS</b>Dentists should strengthen the learning and training to improve the first aid skill.</p>

20.
Article in Chinese | WPRIM | ID: wpr-696623

ABSTRACT

Objective To investigate the nutritional status and the clinical outcome of the critically ill chil-dren,and to provide scientific evidence for further clinical nutrition management. Methods Nutritional risk screening was performed on 1183 critically ill children hospitalized at the Intensive Care Unit (ICU),Children′s Hospital of Nanjing Medical University from October 2016 to October 2017 by using the Screening Tool for Risk on Nutritional Sta-tus and Growth (STRONGkids),the ICU including of Pediatric Intensive Care Unit (PICU),Surgical Intensive Care Unit (SICU)and Coronary Care Unit (CCU). Median age of the children was (2. 6 ± 2. 4)years (29 d - 12. 9 years). Nutritional status was estimated,and scores of anthropometric parameters such as weight - for - age Z - score (WAZ)(< 5 years)or body mass index - for - age Z - score (BAZ)(≥5 years)were calculated. The data on inci-dence of infectious complications,duration of ICU stay and mechanical ventilation,the total hospital expenses and in -hospital mortality were recorded. Results Of the 1183 cases,134 children(11. 3%)had low nutritional risk,746 children(63. 1%)had moderate nutritional risk and 303 children(25. 6%)high nutritional risk. The prevalence of se-vere malnutrition,moderate malnutrition and mild malnutrition was 8. 1% (96 / 1183 cases),8. 2% (97 / 1183 ca-ses),and 12. 8% (151 / 1183 cases)respectively. The severe malnutrition group had a higher incidence of high nutri-tional risk than other groups [74. 0%(71 / 96 cases)vs. 67. 0%(65 / 97 cases),40. 4%(61/ 151 cases),12. 6%(106/839 cases)],and the differe-nce was statistically significant (P < 0. 001). The incidence of high nutritional risk in the CCU was higher than that than that in the PICU and SICU,and the difference was statistically significant [36. 5%(96 /263 cases),23. 8%(125 / 524 cases)and 20. 7%(82 / 396 cases)respectively,P < 0. 01]. And the incidence of high nutritional risk was higher in infants[37. 6%(198 / 527 cases)]than those in the other age groups[18. 4%(52 / 282 cases),12. 0%(21 / 175 cases),16. 0%(32 / 199 cases)],and the difference was statistically significant (χ2 = 68. 90, P < 0. 0001). Children with a high nutritional risk had increased incidence of infectious complications [8. 6%(26 / 303 cases)vs. 4. 7% (35 / 746 cases),3. 7% (5 / 134 cases)],incidence of mechanical ventilation [66. 0% (200 / 303 cases)vs. 41. 4%(309 / 746 cases),38. 8%(52 / 134 cases)]and total hospital expenses (¥ 52500 vs. ¥ 39700 and¥ 48700 RMB)compared with those with the moderate or the low nutritional risk,and the differences were statistically significant(all P < 0. 05). There were 16 deaths and 8 deaths (2. 7%)in the high nutrition risk group,which was sig-nificantly higher than those in the moderate nutrition risk group [8 cases (1. 1%)]and the low nutrition risk group [0 case(0)](χ2 = 7. 60,P = 0. 02). Conclusions Moderate or high nutritional risk is seen in the critically ill chil-dren,especially in infants and the children with congenital heart disease. Nutritional risk score is correlated with clinical outcomes. Nutritional risk screening and standard nutritional support are recommended so as to improve clinical treat-ment outcomes.

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