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1.
Article in English | WPRIM | ID: wpr-888487

ABSTRACT

OBJECTIVES@#To study the survival rate and the incidence of complications of very preterm infants and the factors influencing the survival rate and the incidence of complications.@*METHODS@#The medical data of the very preterm infants with a gestational age of <32 weeks and who were admitted to the Department of Neonatology in 11 hospitals of Jiangsu Province in China from January 2018 to December 2019 were retrospectively reviewed. Their survival rate and the incidence of serious complications were analyzed. A multivariate logistic regression analysis was used to evaluate the risk factors for death and serious complications in very preterm infants.@*RESULTS@#A total of 2 339 very preterm infants were enrolled, among whom 2 010 (85.93%) survived and 1 507 (64.43%) survived without serious complications. The groups with a gestational age of 22-25@*CONCLUSIONS@#The survival rate is closely associated with gestational age in very preterm infants. A low 1-minute Apgar score (≤3) may increase the risk of death in very preterm infants, while high gestational age, high birth weight, and prenatal use of glucocorticoids are associated with the reduced risk of death. A low 5-minute Apgar score (≤3) and maternal chorioamnionitis may increase the risk of serious complications in these infants, while high gestational age and high birth weight may reduce the risk of serious complications.


Subject(s)
Female , Gestational Age , Humans , Infant, Newborn , Infant, Premature , Infant, Premature, Diseases , Infant, Very Low Birth Weight , Pregnancy , Retrospective Studies , Survival Rate
2.
Asian Journal of Andrology ; (6): 421-428, 2021.
Article in English | WPRIM | ID: wpr-888434

ABSTRACT

Sperm morphology was once believed as one of the most predictive indicators of pregnancy outcome in assisted reproductive technology (ART). However, the impact of teratozoospermia on in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) outcomes and its offspring remains inconclusive. In order to evaluate the influence of teratozoospermia on pregnancy outcome and newborn status after IVF and ICSI, a retrospective study was conducted. This was a matched case-control study that included 2202 IVF cycles and 2574 ICSI cycles and was conducted at the Reproductive and Genetic Hospital of CITIC-Xiangya in Changsha, China, from June 2013 to June 2018. Patients were divided into two groups based on sperm morphology: teratozoospermia and normal sperm group. The pregnancy outcome and newborn outcome were analyzed. The results indicated that couples with teratozoospermia had a significantly lower optimal embryo rate compared to those with normal sperm morphology in IVF (P = 0.007), while there were no statistically significant differences between the two groups in terms of the fertilization rate, cleavage rate, implantation rate, and pregnancy rate (all P > 0.05). Additionally, teratozoospermia was associated with lower infant birth weight in multiple births after IVF. With regard to ICSI, there was no significant difference in both pregnancy outcome and newborn outcome between the teratozoospermia and normal groups (both P > 0.05). Furthermore, no increase in the risk of birth defects occurred in the teratozoospermia group after IVF/ICSI. Consequently, we believe that teratozoospermia has limited predictive value for pregnancy outcomes in IVF/ICSI, and has little impact on the resulting offspring if multiple pregnancy is avoided.

3.
Article in Chinese | WPRIM | ID: wpr-910090

ABSTRACT

Objective:To investigate the feasibility, effectiveness and safety of ultrasound-guided transperineal prostate biopsy (TPB) with coaxial needle technique, and to improve the pain perception of TPB patients by reducing the number of direct perineal needling.Methods:A total of 200 patients who underwent ultrasound-guided TPB at the first clinical college of Three Gorges University & Yichang Central People′s Hospital from January 2019 to December 2020 were randomly divided into coaxial needle group (coaxial needle positioning puncture, n=100) and traditional group (traditional puncture frame guided repeated transperineal puncture, n=100). Visual analog scale (VAS) was used to evaluate the pain of patients during puncture. The number of samples, time-consuming of puncture, cancer detection rate, VAS pain score and complications between the two groups were compared. Results:The success rate of puncture in the coaxial needle group and the traditional group was 100%, and there was no significant difference in the cancer detection rate between the two groups (48% vs 40%, P>0.05). The average number of samples in the coaxial needle group was larger than that in the traditional group, the average puncture time in the coaxial needle group was less than that in the traditional group, and the average intraoperative VAS score of the coaxial needle group was lower than that of the traditional group, the differences were statistically significant[(14.8±1.8) vs (12.1±1.1), (12.9±1.3)min vs (16.5±1.9)min, (2.6±1.2) vs (4.4±1.4); all P<0.001]. The complication rate of the coaxial needle group was lower than that of the traditional group, the difference was statistically significant (18% vs 39%, P<0.001), the incidences of perineal hematoma and perineal pain in the coaxial needle group were lower than that in the traditional group (1% vs 8%, 8% vs 19%; all P<0.05). Conclusions:Coaxial needle technology for ultrasound-guided TPB can ensure the number of samples and accurate sampling in different areas, significantly reduce the number of direct perineal puncture, improve the pain in the process of puncture, reduce the incidence of postoperative perineal pain, with shorter operation time and fewer complications, which is worthy of clinical promotion.

4.
Article in Chinese | WPRIM | ID: wpr-910007

ABSTRACT

Objective:To compare the prosthesis locations and postoperative hip functions between supercapsular percutaneously-assisted total hip (SuperPATH) approach and traditional posterolateral approach (PLA) in total hip arthroplasty.Methods:A retrospective analysis was conducted of the 107 patients who had undergone unilateral total hip arthroplasty at Department of Orthopedic Surgery, The First Affiliated Hospital to Soochow University from August 2016 to February 2019. They were divided into 2 groups according to their surgical approaches. In the SuperPATH group of 54 cases, there were 20 males and 34 females with an age of (64.3±9.1) years; in the PLA group of 53 cases, there were 20 males and 33 females with an age of (62.2±10.6) years. The 2 groups were compared in terms of abduction angle, ratio of abduction angle to safety zone, anteversion angle, ratio of anteversion angle to safety zone, retroversion angle, incidence of retroversion, and differences in eccentricity and lower limb length on the first day after operation, and Harris hip scores at 1 week, 3 months and the last follow-up postoperatively. Their complications were also recorded as well.Results:There were no statistically significant differences in the preoperative general data between the 2 groups, showing comparability ( P>0.05). The postoperative imaging data were complete for the 107 patients who had been followed up satisfactorily for 14 to 36 months (average, 25 months). The SuperPATH group had significantly larger retroversion angle (13.6°±9.6°) and incidence of retroversion (18.5%, 10/54), significantly smaller difference in eccentricity [0.26 (0.13,0.49) cm], and significantly higher Harris hip score [(74.8±7.8) points] at one week after surgery than those in the PLA group [3.0°±1.0°; 5.7%, 3/53; 0.38 (0.13,0.70) cm; (72.0±6.7) points] ( P<0.05). There were no statistically significant differences between the 2 groups in abduction angle, ratio of abduction angle to safety zone, anteversion angle, ratio of anteversion angle to safety zone, difference in lower limb length, or Harris hip scores at 3 months or the last follow-up postoperatively (all P>0.05). Follow-ups in both groups observed no more than one case of dislocation which responded to manual reduction. Conclusion:The minimally invasive SuperPATH approach may obtain better femoral eccentricity and higher early hip function scores than the traditional posterolateral approach, but may lead to a higher incidence of retroversion after prosthesis placement.

5.
Journal of Chinese Physician ; (12): 1523-1527, 2021.
Article in Chinese | WPRIM | ID: wpr-909738

ABSTRACT

Objective:To investigate the level and significance of CD4 + CD25 + Foxp3 + Treg in peripheral blood of patients with type 2 diabetes mellitus (T2DM) peripheral neuropathy. Methods:160 patients with T2DM (T2DM group) treated in Yancheng First People's Hospital from January 2018 to March 2019 were selected, including 54 patients with peripheral neuropathy and 106 patients without peripheral neuropathy. At the same time, 160 healthy people were selected as the control group to detect the levels of CD4 + CD25 + Foxp3 + Treg and 25-(OH)D 3 in peripheral blood. Pearson correlation analysis was used to analyze the correlation between CD4 + CD25 + Foxp3 + Treg in peripheral blood and other indexes. The receiver operating characteristic (ROC) value curve was used to analyze the predictive value of CD4 + CD25 + Foxp3 + Treg in peripheral blood of type 2 diabetic peripheral neuropathy. Results:The ratio of CD4 + CD25 + Foxp3 + Treg in T2DM group was (7.82±1.03)%, which was significantly lower than that in control group [(15.53±3.82)%, P<0.05]; The duration of T2DM patients with peripheral neuropathy was (7.71±1.18)years, which was significantly longer than that without peripheral neuropathy ( P<0.05), while the proportions of 25-(OH)D 3 and CD4 + CD25 + Foxp3 + Treg were (49.88±12.27)mmol/L and (5.88±1.20)% respectively, which were significantly lower than that without peripheral neuropathy ( P<0.05); Patients with peripheral neuropathy in group T2DM had significantly higher Michigan Diabetic Neuropathy Scores (MDNS) than that in patients without peripheral neuropathy [(14.82±2.01) vs (4.41±0.43), P<0.05]. The CD4 + CD25 + Foxp3 + Treg was positively correlated with 25-(OH)D 3 ( r=0.367, P<0.05), and negatively correlated with MDNS ( r=-0.398, P<0.05); the CD4 + CD25 + Foxp3 + Treg predicted that the area under the ROC curve of T2DM patients with peripheral neuropathy was 0.822, the cut-off value was 6.50%, and the sensitivity and specificity were 80.00% and 72.00% respectively. Conclusions:The level of CD4 + CD25 + Foxp3 + Treg in peripheral blood of T2DM patients decreased, which may play a role in the occurrence and development of peripheral neuropathy.

6.
Article in Chinese | WPRIM | ID: wpr-905949

ABSTRACT

Acute pancreatitis (AP) is one of the most common digestive system diseases in clinic. Its pathogenesis is complex and has not yet been fully clarified. It easily progresses to severe AP if the treatment is not provided in time, and the resulting condition is dangerous with high mortality. Intestinal mucosal barrier (IMB) injury is the key link leading to the aggravation of AP. The IMB injury in the late stage of AP promotes the translocation of harmful intestinal bacteria, the entry of bacteria and the produced endotoxins into blood circulation triggers endotoxemia and enterogenous infection,causing multiple organ failure and even death. Western medicine has limitations in the treatment of IMB injury induced by AP. By contrast, Chinese medicine has been proved effective and reliable in repairing the IMB injury induced by AP through oral administration and external application,and has been widely recognized by physicians and patients. AP falls into the categories of "precordial pain due to spleen disorder", "thoracic accumulation", and "pancreas-heat syndrome" in traditional Chinese medicine. The main causes of AP are excessive intake of sweet and greasy food, improper diet, and cholelithiasis, which lead to damp-heat accumulation in the middle energizer, stagnation of spleen and stomach, and obstruction of fu-organ intestine. Therefore, dredging the interior, purging, clearing heat, removing toxin, moving Qi, and activating blood should be emphasized in treatment. According to the related literature both in China and abroad in the past five years, this paper summarized the action mechanisms of Chinese medicine in the treatment of AP-induced IMB injury as follows: It protects the mechanical barrier by improving intestinal microcirculation disorders, relieving intestinal ischemia-reperfusion injury and oxidative stress response, reducing the release of inflammatory mediators and cytokines, and inhibiting the apoptosis of intestinal epithelial cells. It restores the chemical barrier by promoting gastrointestinal functional recovery and shortening enteral nutrition time. It improved the biological barrier by regulating intestinal microecological imbalance. It reinforces the immune barrier by adjusting the level of immune cells. This paper reviewed the characteristics of IMB injury in AP as well as its therapeutic principles and mechanisms with Chinese medicine, aiming to provide a theoretical and scientific basis for the in-depth study and rational application of Chinese medicine for the treatment of IMB injury in AP.

7.
Article in Chinese | WPRIM | ID: wpr-905292

ABSTRACT

Objective:To observe the relationship between bone metabolism biochemical markers and clinic features in patients with spinal cord injury. Methods:From July, 2018 to December, 2019, totally 135 patients with spinal cord injury were enrolled. They were assessed with American Spinal Injury Association Impairment Scale (AIS). β-collagen type I C-terminal telopeptide (β-CTX), total N-terminal propeptide of type I precollagen (TP1NP), 25-hydroxyvitamin D [25(OH)D] and parathyroid hormone (PTH), serum calcium and serum phosphorus were measured. The level of TP1NP, β-CTX, 25(OH)D and PTH among clinical characteristics (gender, age, disease course, AIS grade and so on) were analyzed. Results:The levels of β-CTX and 25(OH)D were lower in women than in men (|t| > 2.044, P < 0.01). There was difference in the level of 25(OH)D among different ages (F = 3.156, P < 0.05). The levels of β-CTX and TP1NP increased in the first four months after spinal cord injury, and decreased then; while the level of PTH decreased in the first four months, and increased then (P < 0.001). The level of β-CTX was lower in patients of AIS D than in patients of AIS A and C (t >2.679, P < 0.05). The level of TP1NP was higher in paraplegics than in quadriplegics (Z = -2.035, P < 0.05). The level of β-CTX was higher in patients with fractures or surgeries involving bone than in patients without fractures or surgeries involving bone (t = 2.169, P < 0.05). There was no difference in all the bone metabolism markers between patients with and without lower extremity motor function (t < 0.839, Z < 1.822, P > 0.05). The ratio of 25(OH)D deficience was 85.19%. Conclusion:Bone conversion was active in the first four months after spinal cord injury, and decreased gradually then, which may be related to fractures of spine or surgeries involving spine after injury. The effect of spinal cord injury on bone metabolism markers is not clear. Most of patients with spinal cord injury were lack of vitamin D.

8.
Article in Chinese | WPRIM | ID: wpr-905291

ABSTRACT

Objective:To investigate the occurrence and related factors of autonomic dysreflexia (AD) during intermittent catheterization in patients with spinal cord injury (SCI). Methods:Case control study was used in this study. Intermittent catheterization was performed on 44 SCI patients hospitalized from April, 2019 to April, 2020, The data of age, gender, time after injury, segment of injury, degree of injury, resting blood pressure, immediate blood pressure after catheterization, catheterization numbers, catheterization volume and duration of catheterization were collected. Descriptive analysis and binary Logistic regression analysis were used to analyze the occurrence and related factors of AD. Results:Totally, AD happened in 26 (59.1%) patients. Urethral catheterization was done 1738 times, out of which AD accounted for 187 times (10.8%). The risk of AD increased with the time after injury and age (P < 0.05). The probability of AD was lower in T7 SCI and below than in T6 SCI and above (P = 0.002). Catheterization numbers, gender, degree of injury, catheterization volume and duration of catheterization were not influencing factors of AD (P > 0.05). Conclusion:It is necessary to have a full understanding for the occurrence of AD in patients with SCI during intermittent catheterization. For patients with SCI in T6 and above, long time after injury and elderly patients, routine monitoring of blood pressure during intermittent catheterization is recommended to detect and deal with AD in time.

9.
Article in Chinese | WPRIM | ID: wpr-905263

ABSTRACT

Objective:To explore the clinical manifestations and MRI features of pediatric spinal cord injury (SCI) after back bend. Methods:A retrospective study was performed. All the medical records and MRI images of children with SCI after back bend were identified in Beijing Bo'ai Hospital from January 1st, 2002 to August 31st, 2020. Results:A total of 120 SCI children after back bend were reviewed, out of whom 119 cases were girls, one case was boy. The age ranged from 38 to 162 months, with the median age of 76 months. More cases were discovered in July and September every year (32 cases, 26.7%), as well as in weekends (67 cases, 55.8%). The main clinical manifestations were sensory and motor dysfunction of both lower limbs (120 cases, 100%), bladder and bowl incontinence (120 cases, 100%). The common first symptoms included sudden attack of lumbar pain (39 cases, 32.5%), lower limbs paralysis (30cases, 25.0%) and leg pain (10 cases, 8.3%). The peak time of symptoms ranged from five minutes to two days, with the median time of 50 minutes. The MRI features of 104 children with SCI within one week after back bend were as follows: the abnormal signals of MRI in spinal cord involved lower cervical and all the following segments of spinal cord. The number of the segments of spinal cord with abnormal signals ranged from two to 15, with the median of seven segments. The most common segments with abnormal signals were T9 (96 cases, 92.3%), T10 (96 cases, 92.3%) and T11 (90 cases, 86.5%). Among the cases followed up, 48 cases with complete injury demonstrated a vast and serous spinal cord atrophy (SCA) below the injury segments as early as 37 days after the injury, the SCA would become worse at the chronic stage and maybe involve the spinal cord above the injury segments. In 31 cases with incomplete injury, the abnormal signals of MRI in spinal cord were limited in the lumbar enlargement, with a various degree of SCA at the late stage. All the cases were diagnosed as SCI without radiologic abnormality, out of whom 89 (74.2%) cases suffered from thoracic complete SCI, 31 (25.8%) cases suffered thoracic or lumbar incomplete SCI. The common complications included scoliosis, hip joint dysplasia, urinary tract infection, hydronephrosis, osteoporosis, pathological fracture of lower limbs and valgus knee. Conclusion:The main clinical symptoms of pediatric SCI after back bend were sudden lumbar pain, sensory and motor dysfunction of both lower limbs, and bladder and bowl incontinence. Most of the cases were thoracic complete SCI, the MRI features at the early stage were multiple segments of abnormal signals of spinal cord around T9 and T10, and later an extensive severe SCA below the injury segments to the conus medullaris, accompanied by the SCA above the injury segments.

10.
Article in Chinese | WPRIM | ID: wpr-905259

ABSTRACT

Objective:To analyze the changes of bone mineral density (BMD), the characteristics of bone metabolic markers and related factors in patients with spinal cord injury (SCI). Methods:A total of 78 patients with SCI in our hospital from April, 2018 to May, 2020 were selected and divided into groups according to the injury courses. The people receiving physical examination in the same period were selected as control. BMD of proximal femur was measured by dual energy X-ray absorptiometry. Bone metabolic markers were detected. The correlation between BMD and clinical indicators was analyzed. Results:There was no difference in BMD between the patients within three months and the controls (P > 0.05). BMD at trochanter major, intertrochanteric and total hip in patients three to six months post injury was lower than that in the controls (|t| > 2.242, P < 0.05). The BMD at femoral neck, trochanter major, intertrochanteric and total hip in patients during six to twelve months post injury was lower than that in the controls (|t| > 2.026, P < 0.05). BMD at proximal femur in patients with twelve to 24 months post injury was lower than that in the controls (|t| > 2.189, P < 0.05). The decrease of BMD aggravated with the course of injury. There was no difference in BMD between paraplegia and quadriplegia, complete injury and incomplete injury (P > 0.05). Collagen type I C-terminal telopeptide (CTX) and N-terminal propeptide of type l precollagen (PINP) were higher than the reference range in the course of each injury, increased within three months post injury, reached the peak at three to six months post injury, and decreased to a steady state since seven months post injury. Vitamin D deficiency occurred in 87.5% of the patients. BMD at femoral neck and total hip was negatively correlated with the course of injury (|r| > 0.250, P < 0.05), and positively correlated with body mass index (r > 0.255, P < 0.05). Conclusion:The longer the duration of SCI, the more decrease of BMD. The early bone metabolism of patients with SCI is high conversion type. The rate of vitamin D deficiency in patients with SCI is quite high. It is necessary to detect and evaluate the bone metabolic markers combined with BMD at the early stage of SCI.

11.
Article in Chinese | WPRIM | ID: wpr-905231

ABSTRACT

Objective:To investigate the outcome of neurological function and the clinical characteristics of complications in children with spinal cord injury. Methods:From 2011 to 2019, children under 15 years old with spinal cord injury were selected in our hospital. Their level of injury and American Spinal Injury Association Impairment Scale (AIS) at one month, three months and one year were recorded. And the complications such as pressure ulcers/scald, urinary tract infection, hydronephrosis/vesicoureteral reflux, constipation, osteoporosis/fracture, deep vein thrombosis, neurodynia, heterotopic ossification, scoliosis and hip dysplasia were analyzed. Results:Of 159 individuals, 41 were boys and 118 were girls, the average age at injury was (6.08±2.57) years. The main cause of spinal cord injury was sports accidents (47.8%), and the main injury sites were thoracic spinal cord injury (89.3%). The cause of spinal cord injury was correlated with age at injury (r = -0.160, P = 0.044), gender (r = -0.458, P < 0.001) and injury sites (r = -0.249, P = 0.002). Complete spinal cord injury counted for 71.7%, and the AIS grade at one month was correlated with that at twelve months (r = 0.984, P < 0.001). The main complications were urinary tract infection (69.2%), constipation (67.9%), hydronephrosis/vesicoureteral reflux (37.7%), scoliosis (25.8%) and hip dysplasia (25.2%). The incidence of ulcers/scald was correlated with injury site (r = 0.179, P = 0.024). The AIS grade three months after injury was significantly correlated with urinary tract infection, constipation, scoliosis and hip dysplasia (|r| > 0.227, P < 0.01). The incidence of ulcers/scald was correlated with osteoporosis/fracture (r = 0.208, P < 0.01). The incidence of urinary tract infection was significantly correlated with hydronephrosis/vesicoureteral reflux, constipation, scoliosis and hip dysplasia (r > 0.261, P < 0.001), as well as osteoporosis/fracture (r = 0.195, P < 0.05). The incidence of hydronephrosis/vesicoureteral reflux was significantly correlated with constipation, osteoporosis/fracture, scoliosis and hip dysplasia (r > 0.146, P < 0.01). The incidence of constipation was significantly correlated with scoliosis and hip dysplasia (r > 0.313, P < 0.01), as well as osteoporosis/fracture (r = 0.160, P < 0.05). The incidence of osteoporosis/fracture was significantly correlated with scoliosis and hip dysplasia (r > 0.342, P < 0.01). The incidence of scoliosis was significantly correlated with hip dysplasia (r = 0.818, P < 0.001). Conclusion:The recovery of neurological function after spinal cord injury in children is closely correlated to AIS. The outcome of complete spinal cord injury is poor. The common complications after spinal cord injury in children demonstrate specific age characteristics, and the incidence of urinary tract infection, constipation, hydronephrosis/vesicoureteral reflux, scoliosis and hip dysplasia are common complications, which need more attention.

12.
Article in Chinese | WPRIM | ID: wpr-905192

ABSTRACT

Objective:To investigate the clinical characteristics of old patients with spinal cord injury. Methods:From January 1, 2013 to December 31, 2019, totally 386 old (≥ 60 years) patients with spinal cord injury were enrolled. Their gender, age, etiology, American Spinal Injury Association Impairment Scale (AIS) and complications were analyzed. Results:In the old patients with spinal cord injury, traumatic spinal cord injury was more common in males (71.17%) and non-traumatic spinal cord injury was more common in females (56.19%). Fall on level surface was the most important cause of spinal cord injury both in old men (28.83%) and women (24.76%). Tumor (19.05%) was the most common non-traumatic cause of spinal cord injury in old female patients. Cervical segment (78.46%) was the most common site of injury in old traumatic spinal cord injury, while thoracic segment (52.14%) was the most common site of injury in non-traumatic spinal cord injury. Grade D (38.08%) was the most common AIS grade, followed by grades C (28.76%), A (21.50%), and B (11.66%). Spinal canal stenosis (23.31%) played an important role in the etiology of old spinal cord injury. Neuralgia, venous thrombosis of lower extremities and urinary tract infection were the most common complications in old patients with spinal cord injury. Conclusion:Fall on level surface is the leading cause of spinal cord injury in old patients, and the proportion of fall in the etiology of old spinal cord injury tends to increase with age. It is important to take effective measures to avoid falling in the old adults to prevent spinal cord injury.

13.
Article in Chinese | WPRIM | ID: wpr-904485

ABSTRACT

Objective:To analyze the prevalence trend and survival of liver cancer in Yangpu District, Shanghai, from 2002 to 2016. Methods:Data on liver cancer incidence and mortality from 2002 to 2016 were collected from the Shanghai cancer registry system for the registered population in Yangpu District and the number of the registered population published by the public security department. The standardized liver cancer incidence and mortality rates were calculated using the world standard population to analyze the trends of the liver cancer incidence and mortality, in general, by gender and by age. Life table method was used to calculate the survival rate, and log-rank test was used to analyze the difference of 5-year survival rates and the period of diagnosis between patients with liver cancer by gender. Results:The overall incidence and mortality of liver cancer showed a decreasing trend from 2002 to 2016. After removing the influence of community aging, the standardized annual percentage change (APC) of morbidity and mortality was -3.10% (P<0.01) and -3.44% (P<0.01), respectively. The morbidity and mortality of males were significantly higher than that of females (P<0.01) by Z test. The incidence of liver cancer started to rise obviously from 40 years old, and the death rate raised obviously from 50 years old. 4 007 liver cancer patients were followed up for 5 years. The 5 years observed survival rate was 12.45%, and the median survival time was 281.48 days. The 5-year survival rate of male liver cancer patients was higher than that of female patients, and there was a significant difference(P<0.01).46.58% of liver cancer patients were diagnosed in the advanced stage, and only 13.46% was diagnosed at the early-stage. There was no statistical difference in the proportion between men and women at different stages (P=0.11). Conclusion:The overall incidence and mortality rates of liver cancer from 2002 to 2016 show a slowly decreasing trend, with higher incidence and mortality rates in men than in women. Middle-aged and elderly people are still the main population of morbidity and death. The five-year survival rate is low, and the diagnostic periods are mostly in the middle and late stages of cancer.

14.
Article in English | WPRIM | ID: wpr-922772

ABSTRACT

Buxue Yimu Pill (BYP) is a classic gynecological medicine in China, which is composed of Angelica sinensis (Oliv.) Diels, Leonurus japonicus Houtt, Astragalus membranaceus (Fisch.) Bunge, Colla corii asini and Citrus reticulata Blanco. It has been widely used in clinical therapy with the function of enriching Blood, nourishing Qi, and removing blood stasis. The current study was designed to determine the bioactive molecules and therapeutic mechanism of BYP against hemorrhagic anemia. Herein, GC-MS and UPLC/Q-TOF-MS/MS were employed to identify the chemical compounds from BYP. The genecards database (https: //www.genecards.org/) was used to obtain the potential target proteins related to hemorrhagic anemia. Autodock/Vina was adopted to evaluate the binding ability of protein receptors and chemical ligands. Gene ontology and KEGG pathway enrichment analysis were conducted using the ClusterProfiler. As a result, a total of 62 candidate molecules were identified and 152 targets related to hemorrhagic anemia were obtained. Furthermore, 34 active molecules and 140 targets were obtained through the virtual screening experiment. The data of molecular-target (M-T), target-pathway (T-P), and molecular-target-pathway (M-T-P) network suggested that 32 active molecules enhanced hematopoiesis and activated the immune system by regulating 57 important targets. Pharmacological experiments showed that BYP significantly increased the counts of RBC, HGB, and HCT, and significantly down-regulated the expression of EPO, IL-6, CSF3, NOS2, VEGFA, PDGFRB, and TGFB1. The results also showed that leonurine, leonuriside B, leosibiricin, ononin, rutin, astragaloside I, riligustilide and levistolide A, were the active molecules closely related to enriching Blood. In conclusion, based on molecular docking, network pharmacology and validation experiment results, the enriching blood effect of BYP on hemorrhagic anemia may be associated with hematopoiesis, anti-inflammation, and immunity enhancement.


Subject(s)
Anemia/drug therapy , Drugs, Chinese Herbal , Humans , Molecular Docking Simulation , Tandem Mass Spectrometry
15.
Chinese Medical Journal ; (24): 2025-2036, 2021.
Article in English | WPRIM | ID: wpr-921118

ABSTRACT

Chronic obstructive pulmonary disease (COPD) is a heterogeneous disease characteristic of small airway inflammation, obstruction, and emphysema. It is well known that spirometry alone cannot differentiate each separate component. Computed tomography (CT) is widely used to determine the extent of emphysema and small airway involvement in COPD. Compared with the pulmonary function test, small airway CT phenotypes can accurately reflect disease severity in patients with COPD, which is conducive to improving the prognosis of this disease. CT measurement of central airway morphology has been applied in clinical, epidemiologic, and genetic investigations as an inference of the presence and severity of small airway disease. This review will focus on presenting the current knowledge and methodologies in chest CT that aid in identifying discrete COPD phenotypes.


Subject(s)
Airway Obstruction , Humans , Phenotype , Pulmonary Disease, Chronic Obstructive/diagnostic imaging , Pulmonary Emphysema/diagnostic imaging , Tomography, X-Ray Computed
17.
Article in Chinese | WPRIM | ID: wpr-887142

ABSTRACT

Objective:To use autoregressive integrated moving average (ARIMA) model for predicting the mortality of cardiovascular diseases in residents in Yushui District, Jiangxi Province, and to provide basis for developing the prevention and control strategies as well as to promote the continuous optimization of chronic disease prevention and treatment demonstration area. Methods:Based on the cardiovascular death monitoring data of residents in Yushui District, Jiangxi Province from 2014 to 2018, Econometrics View 9.0 software was used to construct the ARIMA seasonal adjustment model to predict the monthly cardiovascular death in this area. Results:The monthly death rate of cardiovascular diseases in Yushui showed a long-term rising trend, with an apparent seasonal pattern (a peak of cardiovascular death from December to January each year). After the original sequence was subjected to first-order difference and first-order seasonal difference, the difference sequence showed good stationarity (P<0.05). All the theoretical models were listed and their model parameters were calculated respectively. After statistical test (P<0.05), 7 alternative models for seasonal adjustment of ARIMA were selected. Among them, ARIMA(1,1,1)(1,1,1)12 is the optimal model selected in this study (R2=0.749, Adjustment R2=0.724, AIC=8.454, SC=8.633, HQ=8.515).And its residual sequence was tested by white noise test (P>0.05), indicating that the prediction effect was good. Conclusion:ARIMA(1,1,1)(1,1,1) 12 model can accurately simulate the long-term trend and seasonal pattern of cardiovascular disease death in Yushui, and make a scientific prediction of the trend and monthly distribution of cardiovascular disease death in the next three years.

18.
Chinese Journal of Orthopaedics ; (12): 350-358, 2021.
Article in Chinese | WPRIM | ID: wpr-884720

ABSTRACT

Objective:To explore the early learning curve of OrthoPilot navigation assisted total knee arthroplasty (TKA).Methods:Data of 40 consecutive cases of OrthoPilot navigation assisted TKA completed by the same surgical team in our department were retrospectively analyzed. According to the operation order, 40 cases were divided into the original phase group (the first 20 cases) and the subsequent phase group (the second 20 cases). In original phase group, the average age was 69.85±6.86 years with mean body mass index 24.10±2.88 kg/m 2, preoperative HSS score 48.80±5.33, preoperative knee ROM 87.05°±11.02° and preoperative alignment deviation of 7.40°±5.59°. In subsequent phase group, the average age was 66.65±7.92 years with mean body mass index 22.85±3.15 kg/m 2, preoperative HSS score 49.00±5.47, preoperative knee ROM 85.80°±11.65° and preoperative alignment deviation of 8.22°±5.21°. Perioperative data such as operative duration, incision length, hemoglobin drop and postoperative hospital stay, radiographic outcomes including hip-knee-ankle angle (HKAA), mechanical lateral distal femoral angle (mLDFA), mechanical medial proximal tibial angle (mMPTA), sagittal femoral component angle (sFCA), sagittal tibial component angle (sTCA), joint line convergence angle (JLCA), and functional scores were compared between the two groups. Results:All 40 cases were followed up for 24-33 months (mean, 27.38± 2.73 months). No severe postoperative complications such as infection and loosening occurred during the follow-up. The mean operative duration was 112.35±25.49 min in original phase group versus 82.10±10.96 min in subsequent phase group ( P< 0.05). The durations of tibial cutting was 11.95±3.27 min in original phase group versus 7.35±2.23 min in subsequent phase group ( P< 0.05); the femoral planning + cutting time was 20.95±6.91 min in original phase group versus 16.60±4.78 min in subsequent phase group, and trial + prosthesis implantation time was 39.65±7.72 min in original phase group versus 25.10±5.72 min in subsequent phase group,which was significantly higher in original phase group. There was no significant difference in other perioperative data such as incision length, hemoglobin drop and postoperative hospital stay between the two groups. As for radiographic outcomes, there was no statistical difference between the two groups in the postoperative angular deviation of HKAA (0.70°±0.80° vs. 0.80°±1.06°), mLDFA (0.89°±0.91° vs. 1.00°±0.86°), mMPTA (0.77°±0.53° vs. 0.76°±1.03°), sFCA (0.73°±0.48° vs. 0.87°±1.06°), sTCA (0.95°±0.58° vs. 1.16°±1.14°) and JLCA (0.27°±0.25° vs. 0.39°±0.18°). In original phase group, the HSS scores preoperative and 3 days postoperative were 48.80±5.33 and 60.05±5.10 respectively, and those in subsequent phase were 49.00±5.47 and 60.75±4.47 respectively, and both groups showed satisfactory functional recovery. There was no significant difference in HSS scores at all follow-up time points between two phases, as well as ROM (113.20°±9.82° vs. 113.50°±12.44°) and FJS-12 scores (78.00°±10.98° vs. 76.65°±10.29°) at 2 years postoperatively. Conclusion:In this study, we described a time-related early learning curve for OrthoPilot navigation-assisted TKA, in which the operative duration tended to be shorter after the first 20 cases. However, benefiting from good operative accuracy and repeatability, satisfactory radiographic and functional outcomes can be obtained in early stage of the learning curve.

19.
Article in Chinese | WPRIM | ID: wpr-882919

ABSTRACT

Hyperlipidemia pancreatitis in children is mostly genetic metabolic disease.The incidence of acute pancreatitis in children is only (3-13)/100 000, and pancreatitis caused by hyperlipidemia accounts for 9% of acute pancreatitis.A child suffering from V-type hyperlipidemia pancreatitis was admitted to the Children′s Hospital Affiliated to Nanjing Medical University in July 2019.The missense mutation at position c. 2770G>A of CFTR gene (nucleotide 2770 in coding region changed from guanine to adenine) in children was detected by gene sequencing, thus resulting in amino acid change p. D924N.It is extremely rare to report that CFTR gene mutation causes hereditary pancreatitis, and there is no literature report on c. 2770G>A site.This case is reported as follows, hoping to provide reference and inspiration for pediatricians.

20.
Journal of Integrative Medicine ; (12): 111-119, 2021.
Article in English | WPRIM | ID: wpr-881016

ABSTRACT

BACKGROUND@#Shenyankangfu Tablet (SYKFT) is a Chinese patent medicine that has been used widely to decrease proteinuria and the progression of chronic kidney disease.@*OBJECTIVE@#This trial compared the efficacy and safety of SYKFT, for the control of proteinuria in primary glomerulonephritis patients, against the standard drug, losartan potassium.@*DESIGN, SETTING, PARTICIPANTS AND INTERVENTION@#This was a multicenter, double-blind, randomized, controlled clinical trial. Primary glomerulonephritis patients, aged 18-70 years, with blood pressure ≤ 140/90 mmHg, estimated glomerular filtration rate (eGFR) ≥ 45 mL/min per 1.73 m@*MAIN OUTCOME MEASURES@#The primary outcome was change in the 24-hour proteinuria level, after 48 weeks of treatment.@*RESULTS@#A total of 735 participants were enrolled. The percent decline of urine protein quantification in the SYKFT group after 48 weeks was 8.78% ± 2.56% (P = 0.006) more than that in the losartan 50 mg group, which was 0.51% ± 2.54% (P = 1.000) less than that in the losartan 100 mg group. Compared with the losartan potassium 50 mg group, the SYKFT plus losartan potassium 50 mg group had a 13.39% ± 2.49% (P < 0.001) greater reduction in urine protein level. Compared with the losartan potassium 100 mg group, the SYKFT plus losartan potassium 100 mg group had a 9.77% ± 2.52% (P = 0.001) greater reduction in urine protein. With a superiority threshold of 15%, neither was statistically significant. eGFR, serum creatinine and serum albumin from the baseline did not change statistically significant. The average change in TCM syndrome score between the patients who took SYKFT (-3.00 [-6.00, -2.00]) and who did not take SYKFT (-2.00 [-5.00, 0]) was statistically significant (P = 0.003). No obvious adverse reactions were observed in any group.@*CONCLUSION@#SYKFT decreased the proteinuria and improved the TCM syndrome scores of primary glomerulonephritis patients, with no change in the rate of decrease in the eGFR. SYKFT plus losartan potassium therapy decreased proteinuria more than losartan potassium therapy alone.@*TRIAL REGISTRATION NUMBER@#NCT02063100 on ClinicalTrials.gov.

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