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1.
Braz. j. otorhinolaryngol. (Impr.) ; 88(1): 53-62, Jan.-Feb. 2022. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1364583

ABSTRACT

Abstract Introduction A refractory cervical anastomotic fistula which postoperatively remains unhealed for more than 2 months under conservative care severely impacts the quality of life of the patient and potentially leads to anastomotic stricture after the fistula heals. It is widely accepted that, to avoid this complication, refractory cervical anastomotic fistulas should undergo more aggressive treatments. However, when and which surgical intervention should be considered is unclear. Objective This study was designed to evaluate the role of the pectoralis major myocutaneous flap in the management of refractory cervical anastomotic fistulas based on our experience of 6 cases and a literature review. Methods Six patients diagnosed with refractory cervical anastomotic fistula after esophagectomy treated using pectoralis major myocutaneous flap transfer were included in the study. The clinical data, surgical details, and treatment outcome were retrospectively analyzed. Results All patients survived the operations. One patient who had a circumferential anastomotic defect resulting from surgical exploration developed a mild fistula in the neo-anastomotic site in the 5th postoperative day, which healed after 7 days of conservative care. This patient developed an anastomotic stricture which was partially alleviated by an endoscopic anastomotic dilatation. All the other 5 patients had uneventful recoveries after operations and restored oral intake on the 10th-15th days after operation, and they tolerated normal diets without subsequent sequelae on follow-up. One patient developed both local and lung recurrence and died in 15 months after operation, while the other 5 patients survived with good tumor control during the follow-up of 25-53 months. Conclusion The satisfactory treatment outcome in our study demonstrates that pectoralis major myocutaneous flap reconstruction is a reliable management modality for refractory cervical anastomotic fistulas after esophagectomy, particularly for those patients who experienced persistent fistulas after conservative wound care and repeated wound closures.


Resumo Introdução Uma fístula anastomótica cervical refratária, que permanece sem cicatrização por mais de 2 meses sob cuidados conservadores, afeta gravemente a qualidade de vida do paciente e potencialmente causa estenose anastomótica após a cicatrização da fístula. É amplamente aceito que as fístulas anastomóticas cervicais refratárias devem ser submetidas a tratamentos mais agressivos. No entanto, quando e qual intervenção cirúrgica deve ser considerada ainda é incerto. Objetivo Avaliar o papel do retalho miocutâneo do peitoral maior no manejo de fístula anastomótica cervical refratárias com base em nossa experiência de 6 casos e uma revisão da literatura. Métodos Foram incluídos no estudo seis pacientes diagnosticados com fístula anastomótica cervical refratária após esofagectomia tratados com transferência de retalho miocutâneo do peitoral maior. Os dados clínicos, detalhes cirúrgicos e resultado do tratamento foram analisados retrospectivamente. Resultados Todos os pacientes sobreviveram às cirurgias. Um paciente com defeito anastomótico circunferencial, resultante da exploração cirúrgica, desenvolveu uma fístula leve no sítio neoanastomótico no 5° dia de pós-operatório, que foi resolvida após 7 dias de tratamento conservador. Esse paciente desenvolveu uma estenose anastomótica parcialmente aliviada por uma dilatação endoscópica anastomótica. Todos os outros 5 pacientes tiveram recuperações sem intercorrências após as cirurgias, restabeleceram a ingestão oral 10 ou 15 dias após a operação e toleraram dietas normais sem sequelas subsequentes no seguimento. Um paciente desenvolveu recorrência local e pulmonar e morreu 15 meses após a cirurgia, enquanto os outros 5 pacientes sobreviveram com bom controle tumoral durante o seguimento de 25 a 53 meses. Conclusão O resultado satisfatório do tratamento em nosso estudo demonstra que a reconstrução com o retalho miocutâneo do peitoral maior é uma modalidade de manejo confiável para as fístula anastomótica cervical refratárias após a esofagectomia, particularmente nos pacientes que apresentaram falha após o tratamento conservador das feridas cirúrgicas e com fechamento repetido delas.

2.
Rev. Assoc. Med. Bras. (1992) ; 68(2): 217-221, Feb. 2022. tab
Article in English | LILACS | ID: biblio-1365360

ABSTRACT

SUMMARY OBJECTIVE: This study aimed at the oral health problems of elderly patients with diabetes. A training course of integrated traditional Chinese and Western medicine was constructed, helping patients improve their oral health quality of life. METHODS: A randomized controlled prospective experimental study was conducted. A total of 190 elderly patients were divided randomly into an observation group and a control group with 95 cases in each. The control group received regular health education, while the observation group was based on the control group to implement the integrated experiential learning of traditional Chinese and Western medicine in small groups. The oral health knowledge, attitude, behavior, and blood glucose control status along with the oral health quality of life of the two groups were compared before the intervention and at 3-month postintervention. RESULTS: Three months after the intervention, the fasting blood glucose control and the 2-h postprandial blood glucose/glycosylated hemoglobin levels in the observation group were significantly better than in the control group, and the difference was statistically significant (p<0.05). The oral health quality of life in the observation group was significantly better than in the control group, and the difference was statistically significant (p<0.05). CONCLUSION: The small-group experiential learning model of integrated Chinese and Western medicine can promote the transformation of knowledge-beliefs-behaviors in elderly patients with diabetes, which is conducive to controlling blood sugar levels and improving the quality of oral health.


Subject(s)
Humans , Aged , Oral Health , Diabetes Mellitus/therapy , Quality of Life , China , Prospective Studies , Problem-Based Learning , Medicine, Chinese Traditional
3.
Article in English | WPRIM | ID: wpr-922533

ABSTRACT

BACKGROUND@#Coronavirus disease 2019 (COVID-19) has become a worldwide life-threatening pandemic. Lianhua Qingwen is believed to possess the ability to treat or significantly improve the symptoms of COVID-19. These claims make it important to systematically evaluate the effects of using Lianhua Qingwen with Western medicine to treat COVID-19.@*OBJECTIVE@#To evaluate the safety and efficacy of combination therapy, employing Lianhua Qingwen with Western medicine, to treat COVID-19, using a meta-analysis approach.@*SEARCH STRATEGY@#China National Knowledge Infrastructure, Wanfang Database, VIP Database, PubMed, Embase, and Cochrane Library databases were searched for studies evaluating the effect of Lianhua Qingwen-Western medicine combination therapy in the treatment of COVID-19.@*INCLUSION CRITERIA@#(1) Research object: hospitalized patients meeting the diagnostic criteria of COVID-19 were included. (2) Intervention measures: patients in the treatment group received Lianhua Qingwen treatment combined with Western medicine, while the control group received either Western medicine or Chinese medicine treatment. (3) Research type: randomized controlled trials and retrospective study were included.@*DATA EXTRACTION AND ANALYSIS@#Two researchers extracted the first author, the proportion of males and females, age, body temperature, course of treatment, rate of disappearance of main symptoms, duration of fever, adverse reactions, and total effectiveness from the literature. Odds ratio (OR) and 95% confidence interval (CI) were used as the effect value for count data, and mean difference (MD) and 95% CI were used as the effect value for measurement data.@*RESULTS@#Six articles met the inclusion criteria, including a total of 856 COVID-19 patients. The meta-analysis showed that Lianhua Qingwen combination therapy achieved higher rates of fever reduction (OR = 3.43, 95% CI [1.78, 6.59], P = 0.0002), cough reduction (OR = 3.39, 95% CI [1.85, 6.23], P < 0.0001), recovery from shortness of breath (OR = 10.62, 95% CI [3.71, 30.40], P < 0.0001) and recovery from fatigue (OR = 2.82, 95% CI [1.44, 5.53], P = 0.003), higher total effectiveness rate (OR = 2.51, 95% CI [1.73, 3.64], P < 0.00001), and shorter time to recovery from fever (MD = -1.00, 95% CI [-1.04, 0.96], P < 0.00001), and did not increase the adverse reaction rate (OR = 0.65, 95% CI [0.42, 1.01], P = 0.06), compared to the single medication control.@*CONCLUSION@#The Lianhua Qingwen and Western medicine combination therapy is highly effective for COVID-19 patients and has good clinical safety. As only a small number of studies and patients were included in this review, more high-quality, multicenter, large-sample-size, randomized, double-blind, controlled trials are still needed for verification.


Subject(s)
COVID-19 , Drugs, Chinese Herbal , Female , Humans , Male , Multicenter Studies as Topic , Pandemics , Randomized Controlled Trials as Topic , Retrospective Studies , SARS-CoV-2
4.
Rev. bras. med. esporte ; 27(spe2): 46-49, Apr.-June 2021. tab, graf
Article in English | LILACS | ID: biblio-1280094

ABSTRACT

ABSTRACT As far as competitive sports are concerned, scientifically organizing the training process and strictly following the training rules are the only way to success. Tennis is the foundation of all sports. It develops physical and motor skills in a comprehensive and effective manner. Biomechanical diagnosis is mainly carried out on the basis of force-time curve recording of different movement modes, and the generated data is processed by computer through a special measuring device. The main purpose of this study is to use data fusion technology to analyze and evaluate the injury factors involved in various sports. Based on this, a dynamic chain model for early warning of sports injury risk factors is established, which can provide a reference for athletes to avoid and reduce the risk of injuries and ensure normal training and competition. In tennis training, scientific training monitoring is applied to diagnose and monitor athletes' physical function and psychological state. Conduct humanized and scientific management of the training process.


RESUMO No que se refere aos esportes competitivos, a organização científica do processo de treinamento e o cumprimento estrito das regras de treinamento são a única forma de êxito. O tênis é a base de todos os esportes. O tênis desenvolve competências físicas e motoras de uma forma abrangente e eficaz. O diagnóstico biomecânico é realizado principalmente com base na gravação da curva força-tempo de diferentes modos de movimento, e os dados gerados são processados pelo computador através de um dispositivo de medição especial. O objetivo principal deste estudo é usar a tecnologia de fusão de dados para analisar e avaliar vários fatores de lesão esportiva. Com base nisso, estabelece-se um modelo dinâmico de cadeia para o alerta precoce de fatores de risco de lesão esportiva, podendo fornecer uma referência para que os atletas evitem e reduzam o risco de lesão e garantam a normalidade dos treinos e das competições. No treinamento de tênis, aplica-se o monitoramento de treinamento científico para diagnosticar e monitorar a função física dos atletas e seu estado psicológico. Conduzir a gestão humanizada e científica do processo de treinamento.


RESUMEN En lo que se refiere a los deportes competitivos, la organización científica del proceso de entrenamiento y el cumplimiento estricto de las reglas de entrenamiento son la única forma de éxito. El tenis es la base de todos los deportes. El tenis desarrolla competencias físicas y motoras de una forma abarcadora y eficaz. El diagnóstico biomecánico es realizado principalmente basándose en la grabación de la curva fuerza-tiempo de diferentes modos de movimiento, y los datos generados son procesados por la computadora por medio de un dispositivo de medición especial. El objetivo principal de este estudio es usar la tecnología de fusión de datos para analizar y evaluar varios factores de lesión deportiva. Sobre esa base, se establece un modelo dinámico de cadena para la alerta precoz de factores de riesgo de lesión deportiva, pudiendo proveer una referencia para que los atletas eviten y reduzcan el riesgo de lesión y garanticen la normalidad de los entrenamientos y de las competencias. En el entrenamiento de tenis, se aplica el monitoreo de entrenamiento científico para diagnosticar y monitorear la función física de los atletas y su estado psicológico. Conducir la gestión humanizada y científica del proceso de entrenamiento.


Subject(s)
Humans , Athletic Injuries/diagnosis , Computer Systems , Tennis/injuries , Monitoring, Physiologic/methods , Athletic Injuries/prevention & control
5.
Rev. bras. med. esporte ; 27(spe): 14-16, Mar. 2021. tab, graf
Article in English | LILACS | ID: biblio-1156148

ABSTRACT

ABSTRACT College students are often under great pressure, and their physical and mental health is the focus of attention in college education. In order to cultivate high-quality talents and relieve the pressure of college students, many colleges and universities have set up a variety of sports courses, including tennis courses. Analyzing the influence of tennis on the physical and mental health of college students, this study studies the situation of college students participating in tennis by consulting literature, designing questionnaires and using an experimental measurement method, while it constructs the physical health evaluation index and mental health evaluation index of college students. On this basis, this study evaluates the influence of tennis on students' physical and mental health. The results show that tennis has a positive impact on the physical and mental health of college students. Tennis can not only enhance college students' cardiopulmonary function and muscle strength, but also cultivate students' independent personality, eliminate depression tendency, make students independent, flexible and active, which is conducive to the development of students' mental health. It is hoped that this study can provide some reference for the research of college students' physical and mental health exercise based on tennis.


RESUMO Los estudiantes universitarios a menudo se encuentran bajo una gran presión y su salud física y mental es el centro de atención en la educación universitaria. Para cultivar talentos de alta calidad y aliviar la presión de los estudiantes universitarios, muchos colegios y universidades han establecido una variedad de cursos deportivos, incluidos cursos de tenis. Al analizar la influencia del tenis en la salud física y mental de los estudiantes universitarios, este estudio considera la situación de los estudiantes universitarios que participan en el tenis. Para ello usa la consulta de literatura, el diseño de cuestionarios y un método de medición experimental para construir el índice de evaluación de la salud física y la salud mental. Sobre esta base, este estudio evalúa la influencia del tenis en la salud física y mental de los estudiantes. Los resultados muestran que el tenis tiene un impacto positivo en la salud física y mental de los estudiantes universitarios. El tenis no solo puede mejorar la función cardiopulmonar y la fuerza muscular de los estudiantes universitarios, sino también cultivar la personalidad independiente de los estudiantes, eliminar la tendencia a la depresión, hacer que los estudiantes sean independientes, flexibles y activos, lo que favorece el desarrollo de la salud mental de los estudiantes. Se espera que este estudio pueda proporcionar alguna referencia para la investigación del ejercicio de salud física y mental de estudiantes universitarios basado en el tenis.


RESUMEN Estudantes universitários estão frequentemente sob grande pressão, e sua saúde física e mental é o foco da atenção na educação universitária. A fim de cultivar talentos de alta qualidade e aliviar a pressão dos estudantes universitários, muitas faculdades e universidades criaram diversos cursos de esporte, incluindo cursos de tênis. Analisando a influência do tênis na saúde física e mental dos estudantes universitários, este estudo investiga a situação dos estudantes universitários que praticam tênis através de consultas de literatura, elaboração de questionário e do método de medição experimental, enquanto constrói o índice de avaliação da saúde física e da saúde mental de avaliação dos estudantes universitários. Nesta base, o estudo avalia a influência do tênis na saúde física e mental dos estudantes. Os resultados mostram que o tênis tem um impacto positivo na saúde física e mental dos estudantes universitários. O tênis pode não só aumentar a função cardiopulmonar e a força muscular dos estudantes universitários, mas também cultivar a personalidade independente dos estudantes, eliminar a tendência de depressão, torna-los alunos independentes, flexíveis e ativos, o que favorece o desenvolvimento da saúde mental dos estudantes. Espera-se que este estudo possa fornecer alguma referência para a pesquisa do exercício de saúde física e mental dos estudantes universitários com base no tênis.


Subject(s)
Humans , Students/psychology , Tennis/physiology , Tennis/psychology , Vital Capacity/physiology , Heart Rate/physiology , Universities , Surveys and Questionnaires
6.
Article in Chinese | WPRIM | ID: wpr-884234

ABSTRACT

Objective:To evaluate the treatment strategy of primary shortening plus secondary lengthening for Gustilo ⅢC open fractures in the lower limb.Methods:From January 2010 to January 2018, 12 patients (8 males and 4 females) with complex Gustilo ⅢC open fracture in the lower limb received emergency treatment at Department of Orthopaedic Surgery, Wuhan Fourth Hospital. Their ages ranged from 22 to 67 years (average, 41.2 years). All patients were complicated with bone and soft tissue defects associated with nerve and vascular injury in the lower limb. The sizes of soft tissue defects ranged from 4 cm × 2 cm to 17 cm × 12 cm; the main arteries were shortened after debridement by an average of 4.2 cm (from 1.2 cm to 8.3 cm); the broken nerves were shortened after debridement by an average of 4.0 cm (from 1.0 cm to 8.1 cm); the tibial shaft defects averaged 6.3 cm in length (from 2.0 to 9.6 cm). All cases were treated at the first stage by emergency debridement and shortening at the fracture site to directly repair the damaged bone, blood vessels and nerves before the wound was covered. After the limb survived and the wound completely healed, an Ilizarov external fixator was installed to lengthen the limb by bone transport. Recorded were speed of bone lengthening, time with external fixation and complications. The lower limb functions were evaluated at the last follow-up by Paley criteria.Results:The 12 patients were followed up for 14 to 32 months (average, 19.1 months). All the limbs survived with no serious infection. The shortening ranged from 2.0 to 8.2 cm (average, 3.6 cm); the mean speed of bone transport was 0.87 mm/day; the time with external fixation ranged from 11 to 16 months (average, 13.2 months); the bony union was achieved after 10 to 14 months (average, 11.2 months). Postoperative horseshoe inversion was reported in 7 patients, and needle tract infection below Dahl grade 3 in 2 cases. According to Paley criteria, the function of lower limb was rated as excellent in 8 cases, as good in 3 cases, and as fair in one.Conclusion:The treatment strategy of primary shortening plus secondary lengthening using Ilizarov technique has lowered the risk for limb salvage and the surgical difficulty, leading to fine clinical outcomes.

7.
Article in Chinese | WPRIM | ID: wpr-884219

ABSTRACT

Objective:To compare the therapeutic effects between sequential therapy of external-internal fixation and internal fixation alone in the treatment of high-energy pilon fracture.Methods:A total of 61 patients with high-energy pilon fracture were enrolled by our team for this retrospective analysis who had been treated from January 2015 to July 2017. They received sequential therapy of external-internal fixation (the sequential group) or internal fixation alone (the internal group). In the sequential group of 26 cases, there were 19 males and 7 females (aged from 18 to 65 years), 4 cases of type C1, 8 cases of type C2 and 14 cases of type C3 by the OTA classification, and 7 cases of closed injury and 19 cases of open injury. In the internal group of 35 cases, there were 25 males and 10 females (aged from 19 to 64 years), 6 cases of type C1, 13 cases of type C2 and 16 cases of type C3 by the OTA classification, and 21 cases of closed injury and 14 cases of open injury. The 2 groups were compared in terms of postoperative infection, fracture reduction, fracture union time, nonunion, American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, short form 36 health survey questionnaire (SF-36) and reduced range of motion between healthy and affected ankles.Results:There was no significant difference between the 2 groups in gender, age, fracture type, injury cause or follow-up time ( P>0.05), but a significant difference in soft tissue injury favoring the sequential group ( P=0.010). There were no significant differences between the 2 groups in postoperative infection rate [15.4% (4/26) versus 17.1% (6/35)], fracture reduction, fracture union time [(7.4±3.4) months versus (6.5±3.2) months], nonunion rate [7.7% (2/26) versus 8.6% (3/35)], AOFAS ankle-hindfoot score (71.7±29.4 versus 74.4±19.5), or SF-36 (83.1±9.9 versus 83.8±7.9) ( P>0.05). The reduced range of motion between healthy and affected ankles at 6 months postoperation in the sequential group (34.6°±7.2°) was significantly greater than that in the internal group (23.7°±5.1°) ( P<0.05), but there was no significant difference between the 2 groups in the reduced range of motion between healthy and affected ankles at 2 years postoperation (26.0°±11.1° versus 21.8°±11.3°) ( P>0.05). Conclusion:Although both sequential therapy of external-internal fixation and internal fixation alone can lead to fine clinical efficacy in the treatment of high-energy pilon fracture, the former may be more suitable for the patients with severe soft tissue injury.

8.
Article in Chinese | WPRIM | ID: wpr-883304

ABSTRACT

With the development of corneal refractive surgery, especially the application of femtosecond laser, and the lack of corneal donor, corneal stromal lenticules produced in refractive surgery have gradually attracted the attention of ophthalmologists.Most fresh corneal stromal lenticules are difficult to put into use immediately, so how to better preserve and treat the lenticules is a problem that ophthalmologists need to solve.Corneal stromal lenticules can be used in the treatment of many kinds of ophthalmic diseases.In this article, the preservation and treatment of corneal stromal lenticules, as well as its application and prospects in treating hyperopia and presbyopia, keratoconus, corneal ulcer, corneal dystrophy, dermoid tumors and recurrent pterygium, corneal thinning after laser in situ keratomileusis, and covering glaucoma drainage valve to prevent exposure were reviewed to provide reference for further clinical research and application.

9.
Article in Chinese | WPRIM | ID: wpr-905179

ABSTRACT

Objective:To explore the effect of transcranial direct current stimulation on upper limb motor function for stroke patients. Methods:From December, 2017 to December, 2019, 50 first stroke patients in rehabilitation medicine department within six months were randomly divided into control group (n = 25) and experimental group (n = 25). All the patients accepted upper limbs routine rehabilitation and upper limb robot assisted training, while the experimental group accepted transcranial direct current stimulation in addition, for two weeks. They were evaluated with Reconn upper limb rehabilitation robot evaluation system, simple Fugl-Meyer Assessment-Upper Extremities (FMA-UE), Carroll Upper Extremity Function Test (UEFT) and modified Barthel Index (MBI). Results:There was no significant difference in all the scores between two groups before treatment (|t| < 2.954, P > 0.05). All the scores improved after treatment (|t| > 7.551, P < 0.001), and improved more in the experimental group than in the control group (|t| > 2.639, P < 0.05). Conclusions:Transcranial direct current stimulation can further improve the upper limb motor function and activities of daily living for stroke patients.

10.
Article in English | WPRIM | ID: wpr-890499

ABSTRACT

Background@#Subclinical hypothyroidism (SCH) is the most common thyroid dysfunction, and its relationship with blood pressure (BP) has been controversial. The aim of the study was to analyze the association between SCH and newly-diagnosed hypertension. @*Methods@#Based on data from the Thyroid disease, Iodine nutrition and Diabetes Epidemiology (TIDE) study, 49,433 euthyroid individuals and 7,719 SCH patients aged ≥18 years were enrolled. Patients with a history of hypertension or thyroid disease were excluded. SCH was determined by manufacturer reference range. Overall hypertension and stage 1 and 2 hypertension were diagnosed according to the guidelines issued by the American College of Cardiology/American Heart Association in 2017. @*Results@#The prevalence of overall hypertension (48.7%), including stage 1 (28.9%) and 2 (19.8%) hypertension, increased significantly in SCH patients compared with euthyroid subjects. With elevated serum thyroid stimulating hormone (TSH) level, the hypertension prevalence also increased significantly from the euthyroid to different SCH subgroups, which was more profound in females or subjects aged <65 years. The age- and sex-specific regression analysis further demonstrated the same trends in the general population and in the 1:1 propensity matched population. Similarly, several BP components (i.e., systolic, diastolic, and mean arterial BP) were positively associated with TSH elevation, and regression analysis also confirmed that all BP components were closely related with SCH in female subjects aged <65 years. @*Conclusion@#The prevalence of hypertension increases for patients with SCH. SCH tends to be associated with hypertension and BP components in females younger than 65 years.

11.
Article in Chinese | WPRIM | ID: wpr-912808

ABSTRACT

Objective:To establish a scientific and reasonable nurse scheduling model for ward nursing during COVID-19, to achieve collaborative and efficient scheduling of manpower and materials, and to provide an algorithm basis for the computerized scheduling as well as references for optimizing manpower scheduling in public health emergencies.Methods:The qualitative interview method was used to learn the challenges in nursing manpower scheduling at designated hospitals. In view of the nursing scheduling in the mild case wards during the pandemic and the premise of meeting the needs of different shift types and patient care, the goal was set as minimizing the consumption of nursing human resources and protective equipments. The objective functions, constraints and corresponding parameters were established. A multi-objective integer programming model was established by MATLAB software for solution by CPLEX solver.Results:Two objective functions, three hard constraints, two soft constraints and corresponding parameters were established. Calculations by the model so established found that a 28-day period requires at least 62 nurses, and at least 52 nurses in the contaminated wards, including 7 nurses in the department of intensive care, the infectious and the respiratory wards respectively. This number could meet in general the needs of epidemic care. In comparison, the manual scheduling of the mild care wards during the pandemic in February 2020 needed at least 69 nurses, and 61 in the contaminated wards, yet with a failure to meet all constraints.Conclusions:The model can solve the scheduling challenges in public health emergencies, namely numerous shift types, different nursing needs in different types of shifts, and complex staff structure.Furthermore, the model can save manpower and materials, serving a useful reference for manpower scheduling.

12.
Article in Chinese | WPRIM | ID: wpr-912500

ABSTRACT

Objective:To investigate the diagnostic value of Flt3 ligand (Flt3L) and growth arrest specific protein 6 (Gas6) in post-chemotherapy infection of patients with non-Hodgkin′s lymphoma.Methods:A total of 94 NHL patients admitted to Wuhan No.1 Hospital for chemotherapy from July 2019 to October 2020 were collected, and divided into infection group ( n=40) and non-infection group ( n=54). Fifty healthy subjects at the same period were selected as the control group to analyze the expression levels of Flt3L, Gas6 and general inflammatory indicators among the three groups. The relationship between Flt3L, Gas6 and general inflammatory indicators were analyzed. The predictive value of Flt3L and Gas6 for post-chemotherapy infection in NHL patients was analyzed by ROC curve. Kaplan-Meier curve was used to analyze the infection status of NHL chemotherapy patients with serum Flt3L and Gas6 levels. Results:The levels of serum Flt3L [807.80(215.10-1 232.00) pg/ml] and Gas6 [20.04(13.14-27.52) ng/ml] in the infection group were higher than those in the non-infection group and the control group, and the differences were statistically significant (all P<0.05);The levels of serum Flt3L[887.3(321.60-1 367.00) pg/ml] and Gas6[25.24(17.61-42.86) ng/ml] in the severely infection group were higher than those in the mildly infection group, and the differences were statistically significant (all P<0.05). serum Flt3L was negatively correlated with WBC and positively correlated with IL-6;serum Gas6 was negatively correlated with WBC.ROC curve analysis showed that the AUC and 95% CI of Flt3L and Gas6 were 0.814 (0.718-0.909) and 0.644 (0.523-0.765), respectively. The combined application of serum Flt3L with hsCRP, PCT and IL-6 significantly improved the diagnostic efficiency, and the area under the curve was 0.956, 0.923 and 0.865, respectively. Kaplan-Meier curve analysis showed that when serum Flt3L≥649.80 pg/ml and serum Gas6≥21.50 ng/ml in NHL chemotherapy patients, the infection rate was significantly increased ( P all<0.05). Conclusion:Serum Flt3L and Gas6 levels in post chemotherapy-infection of NHL patients were significantly increased and correlated with the severity of infection. Early detection of serum Flt3L levels is helpful to predict the diagnosis of infection in NHL patients after chemotherapy.

13.
Article in Chinese | WPRIM | ID: wpr-910465

ABSTRACT

Objective:To evaluate the survival prognosis for T 1 stage nasopharyngeal carcinoma patients complicated with different stages of cervical lymph node metastasis, aiming to provide reference for optimizing the treatment plan. Methods:Clinical data of 413 patients in non-keratinizing carcinoma and undifferentiated locally early nasopharyngeal carcinoma (T 1N 0-3M 0-1) undergoing radiotherapy alone or radiochemotherapy in Department of Radiation Oncology of our hospital from January 2014 to December 2019 were retrospectively analyzed. The survival analyses were performed with Kaplan-Meier method and statistically compared using the log-rank test. Results:Of all patients, 291 were male, and 122 were female (aged from 9 to 78 years old) with a median age of 51 years old. All patients were diagnosed with T 1N 0-3M 0-1 nasopharyngeal carcinoma. In the TNM stage grouping system, 48(11.6%) patients were classified as stage Ⅰ (T 1N 0M 0), 158(38.2%) cases of stage Ⅱ(T 1N 1M 0), 162(39.2%) cases of stage Ⅲ(T 1N 2M 0), and 45(10.9%) cases of stage Ⅳ A to Ⅳ B(T 1N 3M 0/T 1N xM 1). Eight patients (1.9%) with stage Ⅳ B had metastasis at presentation. The lymph node positivity rate of all patients reached up to 88.1%. Seven patients received three-dimensional conformal radiotherapy, 371 cases of intensity-modulated radiotherapy and 35 cases of volumetric-modulated arc therapy. The 5-year overall survival rate was (95.9±1.2)% and with 100% for T 1N 0M 0 patients, (99.2±0.8)% for T 1N 1M 0 patients, (95.1±2.2)% for T 1N 2M 0 patients and (87.9±6.6)% for T 1N 3M 0 patients, respectively. Primary distant metastasis and N 3 stage were significantly correlated with poor prognosis (both P<0.05). The most common long-term side effect of radiotherapy was xerostomia with an incidence rate of 18.6%(17.9% for grade 1 toxicity), followed by hearing damage and tooth discomfort. Only 2 patients developed Grade Ⅲ toxic reactions, manifested as complete hearing loss. Conclusions:Although T 1 nasopharyngeal carcinoma patients have a high propensity of cervical node metastasis, favorable clinical prognosis can be obtained after radiotherapy alone. Moreover, the long-term side effects under precision radiation exert no severe effect upon the quality of life of patients.

14.
Article in Chinese | WPRIM | ID: wpr-910009

ABSTRACT

Objective:To explore the clinical efficacy of microsurgery combined with Ilizarov technique in the treatment of Gustilo ⅢC open tibiofibular fractures.Methods:From January 2014 to December 2016, 20 patients with Gustilo ⅢC open tibiofibular fracture were treated at Department of Hand Surgery 2, Repair and Reconstruction, Wuhan NO. 4 Hospital, Wuhan Puai Hospital. They were 13 men and 7 women, aged from 36 to 56 years (average, 42.6 years). The time from injury to operation ranged from 2 to 6 hours (average, 4.3 hours). The defects were at the proximal bone in 6 cases, at the middle bone in 9 cases and at the distal bone in 5 cases. The area of soft tissue defect ranged from 10 cm×6 cm to 12 cm×9 cm, and the lengths of bone defects averaged 10.3 cm. Microsurgery was conducted at the first stage to repair blood vessels and nerves and to reconstruct blood circulation, and an Ilizarov circular external fixator was installed at the second stage to repair bone and soft tissue defects by two-way bone transport. Bone transport time, wound healing time, bone transport distance, external fixation time, external fixation index, solidification time for the extended area and complications were recorded after operation. The curative efficacy was evaluated by Palay evaluation.Results:All patients were followed up for 12 to 30 months (average, 24 months). After the bone and soft tissue defects were well repaired, all the patients returned to daily life. The time from bone transport to apposition of fracture ends ranged from 50 to 160 days, averaging 75.8 days; the wound healing time ranged from 60 to 150 days, averaging 100.6 days; the bone transport distance ranged from 8 to 13 cm, averaging 10.3 cm; the external fixation time ranged from 12 to 20 months, averaging 14.0 months; the external fixation index was 1.6 months/cm; the solidification time for the extended area ranged from 5 to 16 months, averaging 10.9 months. No infection, malunion or re-fracture was observed; postoperative axis deviation was observed in 2 cases and ankle stiffness in 3 cases. According to the Palay evaluation, 5 cases were excellent, 12 cases good, and 3 cases fair.Conclusion:As microsurgery combined with Ilizarov technique can treat Gustilo ⅢC open tibiofibular fractures effectively by reconstructing limb blood circulation, it is worthy of clinical promotion.

15.
Article in English | WPRIM | ID: wpr-898203

ABSTRACT

Background@#Subclinical hypothyroidism (SCH) is the most common thyroid dysfunction, and its relationship with blood pressure (BP) has been controversial. The aim of the study was to analyze the association between SCH and newly-diagnosed hypertension. @*Methods@#Based on data from the Thyroid disease, Iodine nutrition and Diabetes Epidemiology (TIDE) study, 49,433 euthyroid individuals and 7,719 SCH patients aged ≥18 years were enrolled. Patients with a history of hypertension or thyroid disease were excluded. SCH was determined by manufacturer reference range. Overall hypertension and stage 1 and 2 hypertension were diagnosed according to the guidelines issued by the American College of Cardiology/American Heart Association in 2017. @*Results@#The prevalence of overall hypertension (48.7%), including stage 1 (28.9%) and 2 (19.8%) hypertension, increased significantly in SCH patients compared with euthyroid subjects. With elevated serum thyroid stimulating hormone (TSH) level, the hypertension prevalence also increased significantly from the euthyroid to different SCH subgroups, which was more profound in females or subjects aged <65 years. The age- and sex-specific regression analysis further demonstrated the same trends in the general population and in the 1:1 propensity matched population. Similarly, several BP components (i.e., systolic, diastolic, and mean arterial BP) were positively associated with TSH elevation, and regression analysis also confirmed that all BP components were closely related with SCH in female subjects aged <65 years. @*Conclusion@#The prevalence of hypertension increases for patients with SCH. SCH tends to be associated with hypertension and BP components in females younger than 65 years.

16.
Article in Chinese | WPRIM | ID: wpr-921643

ABSTRACT

Chronic unpredicted mild stress(CUMS) combined with isolated feeding was used to induce depressed rat model. The anti-depressant effects of Zhizichi Decoction(ZZCD) and its solid fermented product(ZZC) were analyzed by behavioral test and comparison of pathological tissues of hippocampus and liver, metabolic characteristics of intestinal flora, and relative abundance of species. The results showed that ZZC could increase sucrose preference, shorten the immobility time in the forced swim test and tail suspension test(P<0.05), and repair damaged hippocampus and liver tissues, and the effect was superior to that of ZZCD. The results of Biolog ECO plates showed that the average well color development(AWCD) of intestinal flora in the model group significantly decreased and the metabolic levels of sugar and amino acids were reduced, while the AWCD of the treatment groups increased. The metabolic levels of the two carbon sources were improved in the ZZC group, while only sugar metabolic level was elevated in the ZZCD group. Metagenomic analysis of intestinal flora showed that the ratio of Firmicutes/Bacteroidetes was 3.87 in the control group, 21.77 in the model group, 5.91 in the ZZC group, and 18.48 in the ZZCD group. Lactobacillus increased by 3.28 times, and Prevotella and Bacteroidetes decreased by 75.59% and 76.39%, respectively in the model group as compared with that in the control group. Lactobacillus decreased by 31.13%, and Prevotella and Bacteroidetes increased by more than three times in the ZZC group as compared with that in the model group, while the corresponding changes in the ZZCD group were not significant. ZZC could improve depression-like beha-viors by regulating the structure of intestinal flora and metabolic functions and repairing damaged hippocampus and liver tissues in depressed rats, showing an anti-depressant effect superior to that of ZZCD. This study is expected to provide a basis for the development of new anti-depressant food products.


Subject(s)
Animals , Depression/drug therapy , Disease Models, Animal , Fermentation , Gastrointestinal Microbiome , Hippocampus , Rats , Stress, Psychological
17.
Article in Chinese | WPRIM | ID: wpr-888013

ABSTRACT

A novel HPLC method with the quantitative analysis of multi-components by single marker( QAMS) combined with the dual-wavelength method was developed for simultaneous determination of six flavonoids in Dendrobium officinale stems from different producing areas,cultivation and processing methods to clarify the main factors contributing to the different composition of flavonoids.The separation of six flavonoids was performed on a Shiseido Capcell PAK MGⅡ C18 column( 4. 6 mm×250 mm,5 μm) using a linear gradient elution system of acetonitrile-0. 1% formic acid aqueous solution. Schaftoside,isoschaftoside,vicenin-2,and glucosylvitexin were simultaneously analyzed using rutin as a reference standard at detection wavelength of 340 nm,and naringenin was determined at290 nm. The credibility and feasibility of QAMS method were validated and the results demonstrated that no significant differences were observed as compared with the external standard method. Finally,a total of 82 batches of D. officinale samples were analyzed and principal component analysis( PCA) and discriminant analysis were applied to distinguish and compare D. officinale samples from different producing areas,cultivation and processing methods. The results showed that the total flavonoid content of D. officinale stems cultivated in the simulated wild( attached tree cultivation or attached stone cultivation) was significantly higher than that in greenhouse bed cultivation. The content of flavonoids in simulated-wild D. officinale stems was higher in Jiangxi,Guizhou,Zhejiang,and Fujian provinces,while that in greenhouse bed cultivation was higher in Fujian and Zhejiang provinces. The content of naringenin was positively correlated with processing temperature,and that of the other five flavonoids was negatively correlated with processing temperature. PCA showed that wild-simulated D. officinale and greenhouse bed-cultivated D. officinale could be roughly divided into two clusters. The samples cultivated in the greenhouse bed were divided into four categories according to the geographical habitats. Wild-simulated D. officinale samples from Guizhou gathered together,and there was no obvious rule in samples from other producing areas. The established method simplified the determination method of flavonoids in D. officinale,and could provide the basis for effective quality control,cultivation and processing of D. officinale.


Subject(s)
Chromatography, High Pressure Liquid , Dendrobium , Drugs, Chinese Herbal , Flavonoids , Quality Control
18.
Article in Chinese | WPRIM | ID: wpr-885978

ABSTRACT

Objective: To observe the clinical efficacy of ginger-partitioned moxibustion plus pediatric massage (tuina) in treating infantile diarrhea due to spleen deficiency. Methods: Ninety infants were randomly divided into a massage plus moxibustion group, a massage group and a drug group by the random number table method, with 30 cases in each group. The intervention was conducted for two consecutive courses. The infants in the massage plus moxibustion group were treated with pediatric massage and ginger-partitioned moxibustion at Shenque (CV 8). The infants in the massage group were treated with pediatric massage alone, while those in the drug group were treated with smecta. The primary and secondary symptom scales were assessed before and after treatment and at the follow-ups, and the total effective rate was evaluated after treatment. Results: The total effective rate in the massage plus moxibustion group was significantly different from that in the massage group and drug group (both P<0.05). After treatment, the scores of primary and secondary symptoms decreased in all three groups, with statistically significant intra-group differences (all P<0.05); the scores of primary symptoms were significantly different between the massage plus moxibustion group and the drug group (P<0.05); the scores of secondary symptoms in the massage plus moxibustion group and the massage group were significantly different from that in the drug group (both P<0.05). The differences in the time to recover normal bowel movement frequency among the three groups were not statistically significant (P>0.05). Conclusion: Ginger-partitioned moxibustion plus pediatric massage compared with pediatric massage or smecta monotherapy shows superior clinical efficacy in treating infantile diarrhea due to spleen deficiency, and has the advantages of appetite improvement, physique strengthening and short course.

19.
Article in Chinese | WPRIM | ID: wpr-885080

ABSTRACT

Syndrome of resistance to thyroid hormone(RTH)is a rare hereditary thyroid disease with various clinical manifestations and laboratory findings. RTH could be misdiagnosed and mistreated, resulting in aggravation of the disease. We reviewed the medical records of a patient with RTH over the past six years. In addition, we provided a summary of latest progress for RTH to help the clinicians to improve the understanding of the disease.

20.
Article in Chinese | WPRIM | ID: wpr-879047

ABSTRACT

In this experiment, ultra high performance liquid chromatography-quadrupole time-of-flight mass spectrometry(UPLC-Q-TOF-MS) was used to analyze and identify chemical constituents of Ginseng-Douchi(GD) compound fermentation, and explore the conversion rules of ginsenosides and soybean isoflavones after compound fermentation. Waters Acquity UPLC BEH C_(18) column(2.1 mm×100 mm, 1.7 μm) was adopted, with 0.1% formic acid aqueous solution(A)-0.1% formic acid acetonitrile solution(B) as mobile phase for gradient elution; electrospray ion source(ESI) was used to collect data in positive and negative ion modes; according to the exact mass number, the secondary spectrum comparison of the database and the existing literature reports, Peakview 2.0/masterview 1.0 software was used to determine the common ion structure formula. Finally, a total of 133 chemical constituents were analyzed and identified from the GD. Ginseng saponins and isoflavone glycosides were significantly converted after fermentation. Among them, peak areas of prototype ginsenosides Rk_3, Rh_1, Rh_2, Rh_3, daidzin, glycitin and genistin decreased significantly; whereas peak areas of se-condary ginsenoside Rb_1, Rb_2, Rk_1, glycitein, genistein and daidzein increased significantly. In this experiment, liquid-mass spectrometry technique was used to investigate the conversion of active ingredients of GD compound fermented products after co-fermentation, so as to provide a scientific basis for elucidating pharmacodynamics material basis and quality control.


Subject(s)
Chromatography, High Pressure Liquid , Drugs, Chinese Herbal , Fermentation , Panax , Tandem Mass Spectrometry
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