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1.
Chinese Journal of Orthopaedics ; (12): 506-514, 2021.
Article in Chinese | WPRIM | ID: wpr-884739

ABSTRACT

Objective:To summarize the age, gender difference, cause, location, time, treatment and prognosis of femoral intertrochanteric fracture complicated with pseudoaneurysm, and analyze the influence of different treatment methods on the occurrence of femoral intertrochanteric fracture complicated with pseudoaneurysm.Methods:Using the method of systematic literature review, a total of 76 literatures were retrieved from multiple databases at home and abroad, and 45 literatures were screened out through the second screening of title, abstract and full text. The patients with intertrochanteric fracture complicated with pseudoaneurysm were selected as the research objects, and the duplicate cases were deleted; the age, gender, onset age, etiology, location, treatment and prognosis of the disease were retrospectively analyzed.Results:A total of 54 cases of femoral intertrochanteric fracture related pseudoaneurysms were selected from 45 literatures, including 25 males and 27 females, and 2 cases had no gender; aged from 43 to 94 years old, and 4 cases were younger than 60 years old, 6 between 61 and 70, 17 between 71 and 80, and 25 between 81 and 90. Forty-five cases occurred in deep femoral artery, 3 cases in superficial femoral artery, 1 case in superior gluteal artery, 1 case of medial circumflex artery, 1 case of lateral circumflex femoral artery, 1 case of femoral artery, and 2 cases of unknown location. The occurrence time of pseudoaneurysm: 17 cases within 1 week after fracture, 8 cases from 1 week to 3 weeks, 19 cases from 3 weeks to 3 months, 2 cases more than 3 months, and 8 cases unknown. The causes of pseudoaneurysm: among the 54 patients, 41 cases had definite causes, including 21 cases of vascular injury caused by fracture block; 20 cases of iatrogenic injury, of which the incidence of direct injury of blood vessels by screw or drill was the highest, accounting for 55% (11/20). Twenty-two cases were treated with vascular embolization, 10 cases with surgical sutures, 8 cases with surgical ligation, 4 cases with resection of pseudoaneurysm, 5 cases with covered stent, and 4 cases with thrombin injection. There were 42 cases who had follow-up data, and no recurrence and other complications were found during the follow-up period.Conclusion:The peak age of femoral intertrochanteric fracture complicated with pseudoaneurysm was 71-90 years old. The incidence of femoral intertrochanteric fracture complicated with pseudoaneurysm was more often within 1 week after fracture and 3 weeks to 3 months after fracture, due to fracture fragments and iatrogenic vascular injury caused by the location of the profundus femoris artery. Treatment options include vascular embolization, surgical ligation, suture or resection of pseudoaneurysm, covered stent and thrombin injection, and the prognosis is generally good.

2.
Article in Chinese | WPRIM | ID: wpr-883962

ABSTRACT

Objective:To investigate the relationship between life events, cognitive emotional regulation strategies, neuroticism and depression in pregnant women and the internal mechanism of action.Methods:Short-term longitudinal follow-up design were used in this study.A total of 327 pregnant women in the third trimester of pregnancy were investigated with pregnant women's life events scale, cognitive emotion regulation strategy questionnaire, neuroticism subscale of Chinese big five personality questionaire-short form at T1 time point, and patient health questionnaire 9 were measured after 6 weeks(T2).SPSS 20.0 macro program PROCESS was used to examine the mediating effect of cognitive emotion and the moderating effect of neuroticism.Results:(1) The incidence of depression in the third trimester pregnant women was 12.23%.(2)There was significant positive correlation between the total score of life events in pregnant women(T1) and the total score of non-adaptive cognitive emotional regulation strategies(T1) ( r=0.25, P<0.01).Total neurotic personality(T1) and total depressive mood(T2) were significantly positively correlated ( r=0.46, P<0.01).The total scores of life events(T1) of pregnant women were significantly positively correlated with the total scores of depression(T2) ( r=0.36, P<0.01).(3) The non-adaptive cognitive emotion regulation strategy (T1) played a partial mediating role between life events (T1) and depression (T2).The direct effect (effect size=0.29) and the mediating effect (effect size=0.07) accounted for 80.55% and 19.44% of the total effect (effect size=0.36).(4) Neuroticism regulates the second part of the mediating effect of the mediating model.Specifically, the higher the level of individual neuroticism, the stronger the positive predictive effect of non-adaptive cognitive emotion regulation strategies on maternal depression. Conclusion:Pregnant life events play a role in maternal depression through the mediating role of non-adaptive cognitive emotional regulation strategies and the moderating role of neuroticism.

3.
Chinese Journal of Trauma ; (12): 1034-1041, 2021.
Article in Chinese | WPRIM | ID: wpr-909973

ABSTRACT

Objective:To investigate the effect of mechano-growth factor(MGF)on osteoclast activity and its mechanism.Methods:The RAW264.7 precursor osteoclast cell line was cultured with 25 ng/ml macrophage-colony stimulating factor(M-CSF)and 30 ng/ml receptor activator of NF-κB ligand(RANKL),and identified by tartrate resistant acid phosphatase(TRAP)staining after 7 days of culture. Western blot anslysis was used to determine the effect of 45 ng/ml MGF on the phosphoinositide-3-kinase/protein kinase B(PI3K/AKT)signaling pathway in separated osteoclasts,including levels of AKT,phosphorylation(p)-AKT,lactation mammalian target of rapamycin(mTOR),p-mTOR and TRAP at 0,4,8 and 12 hours. Real-time fluorescence quantitative PCR was used to expressions of TRAP in osteoclasts at 0,4,8 and 12 hours. The PI3K/Akt phosphorylation inhibitor LY294002(20 μmol/L)combined with MGF(45 ng/ml)was used to act on osteoclasts,and expression levels of Akt,p-Akt,mTOR,p-mTOR and TRAP were detected by Western blot at 0,4,8 and 12 hours.Results:After culturing RAW264.7 cells with M-CSF and RANKL for 7 days,a large number of osteoclasts with positive TRAP staining can be obtained. Western blot analysis showed expression levels of Akt and mTOR did not change significantly over time( P>0.05),expression levels of p-Akt and p-mTOR increased continuously from(2.18±0.34)pg/ml and(0.83±0.10)pg/ml at 0 hour to(3.86±0.36)pg/ml and(1.56±0.19)pg/ml at 12 hours( P<0.05),and expression level of TRAP decreased significantly over time,from(5.66±0.47)pg/ml at 0 hour to(3.76±0.38)pg/ml at 12 hours( P<0.05). Real-time fluorescence quantitative PCR analysis of expression of TRAP in osteoclasts showed that MGF inhibited the expression of TRAP in osteoclasts,which decreased from 1.02±0.06 at 0 hour to 0.53±0.11 at 12 hours( P<0.05). After acting LY294002 combined with MGF on osteoclasts,Western blot analysis showed expression levels of Akt and mTOR did not change significantly over time( P>0.05),expression levels of p-AKT and p-mTOR decreased significantly from(3.28±0.18)pg/ml and(3.29±0.22)pg/ml at 0 hour to(2.06±0.34)pg/ml and(2.04±0.20)pg/ml at 12 hours( P<0.05),and expression level of TRAP had no significant difference over time( P>0.05). Conclusions:MGF inhibits osteoclast activity by inhibiting the expression of TRAP in osteoclasts through PI3K/Akt signaling pathway. LY294002 inhibits the expression of PI3K/Akt signaling pathway in osteoclasts,further verifying the mechanism of MGF inhibiting osteoclast activity,and this finding puts forward new ideas for clinical prevention and treatment of osteoporosis.

4.
Article in Chinese | WPRIM | ID: wpr-867894

ABSTRACT

Pelvic fracture is a common serious injury in traumatic orthopedics. Internal fixation with percutaneous sacroiliac screws is an effective minimally invasive method widely applied in clinic which enables the patients to carry out early weight-bearing and functional exercise. Novel auxiliary placement techniques for sacroiliac screws have been introduced into the field of orthopaedics to improve placement accuracy and reduce operative risk, such as 3D navigation, 3D printing and orthopedic robots. These new techniques have advantages of precision and convenience, but their disadvantages and limitations cannot be ignored. This article reviews the research progress in the above 3 auxiliary techniques for placement of sacroiliac screws, and discuss their advantages, disadvantages and safety, hoping to provide a reference for clinicians who want to choose a new auxiliary placement technique in the treatment of pelvic fractures with sacroiliac screws.

5.
Article in Chinese | WPRIM | ID: wpr-867864

ABSTRACT

Objective:To analyze the biomechanical characteristics of bilateral lumbo-iliac fixation by finite element analysis after digital optimization of a safe screw pathway.Methods:Firstly, a healthy adult male volunteer was recruited for this study who underwent CT scanning of the lumbus and pelvis, with a slice thickness of 0.625 mm.The original data were imported into Mimics 16.0 software for 3D lumbar and pelvic reconstruction.At the same time, a geometric screw pathway and a free screw pathway were generated in the pedicles of L4 and L5 and ilium.Secondly, all 3D models were imported into Ansys 12 software to assemble a finite element model.The displacements and von Misses stress distribution were measured in the conditions of forward bending, backward extending, lateral bending to the left and right, and left and right rotations in the models of 2 kinds of pathway after gravity axial load of 500 N was applied.Results:The models of 2 different pathways were similar in comprehensive displacement and stress in the conditions of forward bending, lateral bending and backward extending, and in the maximum stress of the screw in the conditions of forward bending and lateral bending.However, the comprehensive displacement and stress in the condition of rotation and the stress of the screw in the conditions of backward extending and rotating in the model of geometric screw pathway were obviously smaller than those in the model of free screw pathway.The maximum pelvic stress was on the screw surface between 190 and 260 MPa, concentrated on the bending area of the 2 screws connecting the sacrum and vertebral body.The lumbar-iliac fixation model showed high com-pressive stiffness.The maximum von Misses stress appeared in the L4-L5 pedicle screw on the longitudinal rod.Under rotational loading, the upper longitudinal rod connecting the L4-L5 pedicle screw and the iliac bone screw bore the maximum stress.Conclusions:Our finite element analysis shows that double verte-bral bodies and long screw fixation are effective ways of iliolumbar fixation.The geometric screw path optimized by digital analysis exhibits better fatigue resistance, rotation resistance and overall stability.Internal lum-bo-iliac fixation can effectively share the stress of vertebral bodies.

6.
Article in Chinese | WPRIM | ID: wpr-864602

ABSTRACT

Objective:To explore the correlation between parents′ posttraumatic growth, mental resilience and family functioning in children with autism spectrum disorder.Methods:Using the convenience sampling method, 169 parents of children with autism spectrum disorders were selected. General data questionnaire, Posttraumatic Growth Inventory (PTGI), Conner-Davidson Resilience Scale (CD - RISC) and Family Assessment Device (FAD) were investigated.Results:The total PTGI score of parents of children with autism spectrum disorder was 58.79±18.92. The scores of appreciation of life, new possibilities, personal strength, relating to others and spiritual change were 19.49±6.15, 10.46±4.59, 9.05±3.32, 7.79±3.65, 12.01±3.83. The PTGI score of 37.3% parents was lower than 52, which was at a low level. Parents in the high score (> 74) group and the low score (< 52) group had statistically significant differences ( P<0.05) in the total score of CD - RISC and scores in all dimensions, as well as the differences in the scores of the four dimensions of FAD, namely problem solving, communication, role and behavior control. The total score of PTGI of parents was positively correlated with the total score of CD - RISC and the scores of its all dimensions ( r values were 0.201-0.317, P<0.05), and negatively correlated with the scores of Problem Solving, Communication and Behavioral Control of FAD ( r values were -0.233 - -0.196, P<0.05). Conclusions:The parents of children with autism spectrum disorder have an average level of posttraumatic growth. People with better mental resilience and healthier family functions have higher post-traumatic growth level.

7.
Article in Chinese | WPRIM | ID: wpr-856579

ABSTRACT

Objective : To manufacture fish swim bladder membrane material by crosslinking techniques, and to explore its physical and chemical properties and cytotoxicity. Methods: After decellularization, the swim bladders were randomly divided into two groups. The swim bladders were treated with 1-ethyl-3-(3-dimethylaminopropyl) carbodiimide (EDC)/N-hydroxysuccinimide (NHS) crosslinking method, surface hole making, and freeze-drying in crosslinking group, and only surface hole making and freeze-drying in non-crosslinking group. The physical and chemical properties of the materials were observed, including microstructure by scanning electron microscopy (SEM), mechanical properties (tensile strength and breaking elongation) by universal tensile machine, hydrophilicity by contact angle measuring instrument, porosity by ethanol infiltration method, degradation performance in vitro and thermal stability test, and the components of materials by infrared spectrum analysis. Mouse fibroblasts (L929) were cultured with the extracts of two groups of materials in order to determine the cytotoxicity of materials by using cell counting kit 8 (CCK-8) method. Results: The porous structure and rough surface of materials were observed by SEM. Compared with the non-crosslinking group, the tensile stress of the crosslinking group was higher, the breaking elongation was lower, and the porosity increased, showing significant differences ( P0.05). The degradation was faster within the first 7 days and then tended to be smooth in the two groups. But the degradation rates of crosslinking group were significantly lower than those of non-crosslinking group ( P0.05). Conclusion: The fish swim bladder membrane obtained by crosslinking treatment with EDC/NHS method has good physical and chemical properties, no cytotoxicity, and is expected to be used as a dura mater repair material.

8.
Chinese Critical Care Medicine ; (12): 1024-1027, 2019.
Article in Chinese | WPRIM | ID: wpr-754102

ABSTRACT

To compare the intra cuff pressure changes during improved and the traditional method of cuff pressure measurement, then evaluate the effects of ventilator-associated pneumonia (VAP) prevention. The results highlighted practical recommendations in the process of ETT cuff pressure measurement. Methods① Experimental studies were carried out on the tracheal model with two groups: traditional pressure measurement group and improved pressure measurement group. The traditional pressure measurement group was connected to a handheld pressure gauge with the indicate cuff to get the intra-cuff pressure. The improved method was to insert a 3-way stopcock between the handheld pressure gauge and the indicate cuff. The 3-way stopcock to stabilize handheld pressure gauge reading at 32 cmH2O (1 cmH2O = 0.098 kPa) before measure the intra-cuff pressure. The pressure loss caused by two pressure measurement methods and the leakage of liquid on the balloon after 10 minutes was compared.② Clinical researches: a historic cohort study, patients with mechanical ventilation (MV) admitted to intensive care unit (ICU) of Guangxi Medical University Cancer Hospital from June 2014 to May 2018 were enrolled. The control group (249 cases) was treated with traditional method during June 2014 to May 2016, and the observation group (314 cases) was treated with improved method during June 2016 to May 2018. Clusters of strategies and actions of VAP prevention were applied in both groups. Incidence of VAP, duration of MV, and the length of ICU stay were compared between the two groups. Results ① Experimental study: the pressure leakage of the traditional pressure measurement group was (10.18±0.47) cmH2O, and that of the improved pressure measurement group was (1.33±0.42) cmH2O, with statistically significant difference between the two groups (t = 32.535, P = 0.000). All fluid on the cuffs leak after 10 minutes of traditional ways of measurement, however, no visible fluid on the cuffs leaked with improved procedures. ② Clinical research: the incidence of VAP in the observation group was slightly lower than that in the control group, however there was no significant difference [5.10% (16/314) vs. 8.43% (21/249), P > 0.05]. The duration of MV and the length of ICU stay in the observation group were significantly shorter than those in the control group (days: 9.93±3.14 vs. 16.77±5.45, 11.63 ±2.28 vs. 19.12±5.10, both P < 0.01). Conclusion The improved procedures of intra-cuff pressure measurement is a practical method to avoid the pressure leakage and fluid leakage, and the clinical course of MV patients can be significantly improved by combining the clusters of nursing strategies and actions.

9.
Neuroscience Bulletin ; (6): 419-424, 2019.
Article in English | WPRIM | ID: wpr-776486

ABSTRACT

The complex spatial and temporal organization of neural activity in the brain is important for information-processing that guides behavior. Hence, revealing the real-time neural dynamics in freely-moving animals is fundamental to elucidating brain function. Miniature fluorescence microscopes have been developed to fulfil this requirement. With the help of GRadient INdex (GRIN) lenses that relay optical images from deep brain regions to the surface, investigators can visualize neural activity during behavioral tasks in freely-moving animals. However, the application of GRIN lenses to deep brain imaging is severely limited by their availability. Here, we describe a protocol for GRIN lens coating that ensures successful long-term intravital imaging with commercially-available GRIN lenses.


Subject(s)
Animals , Biocompatible Materials , Brain , Physiology , Hippocampus , Cell Biology , Lenses , Mice, Inbred C57BL , Mice, Transgenic , Microscopy, Fluorescence , Methods , Neuroimaging , Methods , Neurons , Physiology
10.
Article in Chinese | WPRIM | ID: wpr-775244

ABSTRACT

OBJECTIVE@#To evaluate the efficacy and adverse effects of levonorgestrel-releasing intrauterine system (Mirena) in the treatment of adenomyosis.@*METHODS@#The clinical data of 75 patients with adenomyosis who had Mirena insertion in Women's Hospital,Zhejiang University School of Medicine from September 2013 to December 2013 were retrospectively analyzed. The patients were followed up to 39 months. The efficacy and adverse effects were assessed.@*RESULTS@#Pictorial Blood Loss Assessment Chart (PBAC) scores were decreased significantly after Mirena insertion both in patients with menorrhea (118±13 vs. 29±33, 0.05).@*CONCLUSIONS@#Mirena is effective and safe in the long term management of adenomyosis, but about one third patients may require further treatment because of the expulsion or ineffectiveness of Mirena.


Subject(s)
Adenomyosis , Female , Humans , Intrauterine Devices, Medicated , Reference Standards , Levonorgestrel , Reference Standards , Retrospective Studies
11.
Article in Chinese | WPRIM | ID: wpr-775243

ABSTRACT

OBJECTIVE@#To determine the efficacy of second generation endometrial ablation (NovaSure) combined with levonorgestrel-releasing intrauterine system (Mirena) in the treatment of adenomyosis.@*METHODS@#Clinical data of patients with adenomyosis admitted in Women's Hospital, Zhejiang University School of Medicine from January 2015 to December 2018 were retrospectively analyzed. Among 66 patients, 44 received Mirena placement only (control group) and 22 received Mirena placement and NovaSure treatment (study group). The menstruation blood loss, dysmenorrhea score, uterine size, expulsion rate of Mirena and the patients' satisfaction rate were assessed in two groups.@*RESULTS@#There was a significant reduction in menstruation blood loss (0.05).@*CONCLUSIONS@#NovaSure can improve the efficacy of Mirena in treatment of adenomyosis.


Subject(s)
Adenomyosis , Therapeutics , Dysmenorrhea , Endometrial Ablation Techniques , Female , Humans , Levonorgestrel , Organ Size , Retrospective Studies , Uterus
12.
Article in Chinese | WPRIM | ID: wpr-823821

ABSTRACT

Objective To study the predictive value of general movements( GMs) quality assess-ment technique(writhing movements)on the motor development outcome of high-risk infants,so as to pro-vide a reference basis for clinical diagnosis and treatment. Methods A retrospective analysis was made on the high-risk infants who were hospitalized in the Neonatal Department of the Affiliated Hospital of Inner Mongolia Medical University from January 1,2017 to December 31,2018,and the GMs quality assessment was finished and followed up to 12-month-old among high-risk infants. The clinical diagnostic criteria for patients with cerebral palsy and Peabody Development Motor Scales-2 ( PDMS-2) were used to evaluate the motor development outcome of 12-month-old high-risk infants. Furthermore, the predictive value of GMs writhing movements on the motor development outcome of high-risk infants were evaluated. Results The predictive validity of writhing movements phase[cramped synchronized(CS) +poor repertoire(PR)]for mo-tor retardation and cerebral palsy in high-risk infants who met the inclusion criteria were as follows:the sensi-tivity,specificity, positive predictive value, negative predictive value were 94. 44%, 23. 03%, 11. 04%, 97. 62% and 100%,21. 88%,2. 60%,100%,respectively. The predictive sensitivity and negative predictive value of writhing movements PR for motor retardation and cerebral palsy were 92. 31%,100%;98. 18%, 100% respectively. The predictive sensitivity,specificity and negative predictive value of writhing movements CS for motor retardation and cerebral palsy were 100%,95. 81%,100% and 100%,95. 31% and 100%, respectively. Conclusion GMs quality assessment(writhing movements)has high reliability in predicting the motor development outcome of high-risk infants,especially cramped-synchronized has significant value in ear-ly screening of children with motor retardation and cerebral palsy.

13.
Article in Chinese | WPRIM | ID: wpr-797419

ABSTRACT

Objective@#To evaluate the treatment of complex acetabular fractures involving the posterior column by anterograde lag screws via the ilioinguinal approach.@*Methods@#A retrospective study was conducted of the 8 patients with complex acetabular fracture involving the posterior column who had been treated at Department of Orthopaedics, The Second Affiliated Hospital to Inner Mongolia Medical University from January 2017 to June 2018. They were 5 males and 3 females, aged from 35 to 62 years (average, 43.5 years). According to the Letournel-Judet classification, 3 cases were T-shaped fractures, 4 anterior column plus posterior hemitransverse fractures and one both column fracture. The interval from injury to operation averaged 8 days (from 7 to 17 days). The anterior acetabulum was fixated by a reconstruction plate and the posterior column by antegrade lag screws, all through the ilioinguinal approach. The quality of fracture reduction, fracture union time, function of the affected hip and complications were recorded.@*Results@#By the Matta imaging criteria, the quality of fracture reduction was rated as excellent in 7 cases and as fine in one. Intraoperative major hemorrhage or injury to sciatic nerve occurred in none of the patients. This cohort obtained an average follow-up of 8 months (from 6 to 18 months). All fractures united well after an average of 10 weeks (from 8 to 12 weeks). The function of affected hip evaluated by the improved Merle d’Aubigne & Postel criteria at the last follow-up was excellent in 7 cases and fine in one. Follow-ups revealed no incidence of deep vein thrombosis or heterotopic ossification.@*Conclusions@#For patients with complex acetabular fracture involving the posterior column, internal fixation of the anterior acetabulum with a reconstruction plate through the ilioinguinal approach and fixation of the posterior column with antegrade lag screws also through the ilioinguinal approach can result in fine therapeutic effects, because complications like ectopic ossification and sciatic nerve injury related to the Kocher-Langenbeck approach can be prevented. This treatment is particularly suitable for the patients whose condition of the soft tissues at the posterior pelvis is poor.

14.
Article in Chinese | WPRIM | ID: wpr-791264

ABSTRACT

Objective To evaluate the treatment of complex acetabular fractures involving the posterior column by anterograde lag screws via the ilioinguinal approach.Methods A retrospective study was conducted of the 8 patients with complex acetabular fracture involving the posterior column who had been treated at Department of Orthopaedics,The Second Affiliated Hospital to Inner Mongolia Medical University from January 2017 to June 2018.They were 5 males and 3 females,aged from 35 to 62 years (average,43.5 years).According to the Letournel-Judet classification,3 cases were T-shaped fractures,4 anterior column plus posterior hemitransverse fractures and one both column fracture.The interval from injury to operation averaged 8 days (from 7 to 17 days).The anterior acetabulum was fixated by a reconstruction plate and the posterior column by antegrade lag screws,all through the ilioinguinal approach.The quality of fracture reduction,fracture union time,function of the affected hip and complications were recorded.Results By the Matta imaging criteria,the quality of fracture reduction was rated as excellent in 7 cases and as fine in one.Intraoperative major hemorrhage or injury to sciatic nerve occurred in none of the patients.This cohort obtained an average follow-up of 8 months (from 6 to 18 months).All fractures united well after an average of 10 weeks (from 8 to 12 weeks).The function of affected hip evaluated by the improved Merle d'Aubigne & Postel criteria at the last follow-up was excellent in 7 cases and fine in one.Follow-ups revealed no incidence of deep vein thrombosis or heterotopic ossification.Conclusions For patients with complex acetabular fracture involving the posterior column,internal fixation of the anterior acetabulum with a reconstruction plate through the ilioinguinal approach and fixation of the posterior column with antegrade lag screws also through the ilioinguinal approach can result in fine therapeutic effects,because complications like ectopic ossification and sciatic nerve injury related to the Kocher-Langenbeck approach can be prevented.This treatment is particularly suitable for the patients whose condition of the soft tissues at the posterior pelvis is poor.

15.
Article in Chinese | WPRIM | ID: wpr-743305

ABSTRACT

Objective To investigate the current situation of labor analgesia in Shanghai, provide data supportion and decision-making basis for further popularization of labor analgesia.Methods Using the self-made questionnaire, Shanghai Medical Doctor Association of Anesthesiologist issued a notice on the purpose of the study and the way how to fill it up.The questionnaire was distributed and recycled through the website wjx.com.Results The 58 hospitals included in this survey accounted for 90.44% of the total delivery in Shanghai in 2017, and the overall labor analgesia rate was37.22%.The number of deliveries in 13 maternal and child specialist hospitals accounted for 58.44%of 58 hospitals, and the labor analgesia rate was 56.75%.It accounted for 93.50%of the 58 hospitals analgesic deliveries.There are 44 (75.86%) hospitals carrying labor analgesia by intraspinal nerve block as the main method of labor analgesia.42 (95.45%) of these hospitals began to analgesia during the incubation period, 30 (68.18%) of these hospitals closed the analgesic pump during childbirth, and 40 (90.9%) hospitals had a maternal satisfaction of 85 or more, 36 (81.82%) of these hospitals charged labor analgesia in accordance with the anesthesia clause.However, among the 14 hospitals that did not practive labor analgesia, 13 (92.86%) were due to inadequate anesthesiologists and other relevant factors.Conclusion The overall labor analgesia rate in Shanghai was 37.22%.The service has been mainly provided in maternal and child specialist hospitals.The main factors restricting the labor analgesia are the shortage of anesthesiologists and the lack of specific charges.In order to promote the labor analgesia, policy support is an important aspect, and the labor analgesia process and innovative management mode should also be optimized.

16.
Article in Chinese | WPRIM | ID: wpr-745667

ABSTRACT

Objective To evaluate the efficacy of self-made nasal canal dilator for nasotracheal intubation.Methods Eighty patients requiring awake naso-tracheal intubation of both sexes,aged 21-63yr,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,were divided into cotton swab group (group Ⅰ) and self-made nasal canal dilator group (group Ⅱ),with 40 patients in each group according to a random number table method.The nasal cavity was expanded using cotton swabs in group Ⅰ and with a self-made nasal canal dilator in group Ⅱ.Awake blind nasotracheal intubation was performed in both groups.Heart rate (HR) and mean artery pressure (MAP) were recorded at 5 min after entering the operating room (To),immediately after the tracheal tube passed through the back nostrils (T1),immediately after successful tracheal intubation (T2),and at 5 min after successful intubation (T3).Intubation time,development of nasal mucosal injury and patient's comfort score while tracheal tube passed through nasal cavity were recorded.Results Compared with group Ⅰ,MAP and HR were significantly decreased at T1,2,intubation time was shortened,the incidence of nasal mucosal injury was decreased,and the degree of comfort was increased in group Ⅱ (P<0.05).Compared with the baseline at T0,MAP and HR were significantly increased at T2 in group Ⅱ and at T1,2 in group Ⅰ (P<0.05).Conclusion The self-made nasal canal dilator provides better efficacy than the traditional method,effectively reduces nasal damage and raises patient comfort when used for nasotracheal intubation.

17.
Article in Chinese | WPRIM | ID: wpr-800631

ABSTRACT

Objective@#To study the predictive value of general movements(GMs) quality assessment technique(writhing movements)on the motor development outcome of high-risk infants, so as to provide a reference basis for clinical diagnosis and treatment.@*Methods@#A retrospective analysis was made on the high-risk infants who were hospitalized in the Neonatal Department of the Affiliated Hospital of Inner Mongolia Medical University from January 1, 2017 to December 31, 2018, and the GMs quality assessment was finished and followed up to 12-month-old among high-risk infants.The clinical diagnostic criteria for patients with cerebral palsy and Peabody Development Motor Scales-2(PDMS-2)were used to evaluate the motor development outcome of 12-month-old high-risk infants.Furthermore, the predictive value of GMs writhing movements on the motor development outcome of high-risk infants were evaluated.@*Results@#The predictive validity of writhing movements phase[cramped synchronized(CS)+ poor repertoire(PR)]for motor retardation and cerebral palsy in high-risk infants who met the inclusion criteria were as follows: the sensitivity, specificity, positive predictive value, negative predictive value were 94.44%, 23.03%, 11.04%, 97.62% and 100%, 21.88%, 2.60%, 100%, respectively.The predictive sensitivity and negative predictive value of writhing movements PR for motor retardation and cerebral palsy were 92.31%, 100%; 98.18%, 100% respectively.The predictive sensitivity, specificity and negative predictive value of writhing movements CS for motor retardation and cerebral palsy were 100%, 95.81%, 100% and 100%, 95.31% and 100%, respectively.@*Conclusion@#GMs quality assessment(writhing movements)has high reliability in predicting the motor development outcome of high-risk infants, especially cramped-synchronized has significant value in early screening of children with motor retardation and cerebral palsy.

18.
Article in Chinese | WPRIM | ID: wpr-707583

ABSTRACT

Objective To provide a method to modify accurately the Reverdin osteotomy template for hallux valgus using 3D reconstruction and printing.Methods From June 2015 to June 2016,11 patients (16 feet) with hallux valgus at our departments underwent weight-bearing X-ray examination and continuous spiral CT scanning of the feet.The outer turning angle of hallux averaged 33.50° ± 6.80°,the first intermetatarsal angle 12.20°± 2.90° and the distal metatarsal articular angle 15.20°± 2.60°.Their imaging Dicom data were imported into Materialise Mimics Innovation Suite v16.0 software for generation of 3D models of the pelvis which were then stored in stereolithography format and imported into Imageware 12 software.After optimal templates were reversely rebuilt to have the best angles and range for Reverdin osteotomy in the 3D models,they were manufactured by a rapid prototyping machine.The osteotomy templates were used in surgery to guide the osteotomy of hallux valgus.Correction of hallux valgus,bone union at the osteotomy sites and weight-bearing walk were observed postoperatively.Results Accurate angles of osteotomy were confirmed by postoperative radiography in all the 16 feet.Follow-ups for 6 to 12 months showed in the 16 feet a mean outer turning angle of hallux of 7.31 °±0.33° (from 5° to 11 °) and a mean correction of 21.92°± 4.8° (from 13° to 24°).Bone union was fine at the osteotomy sites and no pain was reported during weight-bearing walk.Conclusion 3D reconstruction and printing can produce a patient-specific template for accurate Reverdin osteotomy for hallux valgus,leading to increased contact area and fine union of the osteotomy ends.

19.
Article in Chinese | WPRIM | ID: wpr-707491

ABSTRACT

Objective To analyze and determine the optimal osseous pathway for anterograde screwing in the acetabulum posterior column.Methods Recruited for this study were 40 healthy adult volunteers,20 nales and 20 females,aged from 18 to 56 years (average,34.6 years).Firstly,their abdomen CT scanning images were transformed into Materialise Mimics Innovation Suite 16.0 software to obtain the 3D reconstruction images of the pelvis (.stl file).The Imageware 12.0 software (EDS,USA) was used to produce the optimal osseous pathway for anterograde screwing in the acetabulum posterior column.The diameter and length of the pathway were measured and statistically analyzed.Secondly,after 10 adult fresh pelvic specimens were scanned,the optimal osseous pathway for anterograde screwing in the acetabulum posterior column was determined in the same way as the above.A navigation template for anterograde screwing in the acetabular posterior column was manufactured.The screwing in the posterior column of the acetabulum was conducted using Kirschner wire with the aid of the navigation template.Imaging evaluation was performed after fixation.Results The projection of the safe zone in the acetabular posterior column was irregularly triangle;there were no significant differences regarding the projection size between different ages (P > 0.05).The maximum diameter and the maximum length of the left optimal pathway in males were respectively 22.37 ± 1.42 mm and 131.27 ± 3.63 mm,and those of the right optimal pathway in males respectively 23.16 ± 1.39 mm and 129.23 ± 3.27 mm.The maximum diameter and the maximum length of the left optimal pathway in females were respectively 17.58 ± 1.83 mm and 112.56 ±2.77 mm,and those of the right optimal pathway in females respectively 16.92 ± 1.66 mm and 114.41 ± 2.98 mm.There were no significant differences between the left and right sides for the same item in the same gender (P > 0.05).There were significant differences between males and females for the same item in the same side (P < 0.05).No penetration into the cortex or the hip joint happened.Conclusion The optimal osseous pathway for anterograde screwing in the acetabulum posterior column can be determined by digital techniques,leading to a simple and safe procedure for the treatment of fractures of the acetabular posterior column.

20.
Article in Chinese | WPRIM | ID: wpr-775299

ABSTRACT

In addition to regulating calcium and phosphorus metabolism to maintain strong bones, vitamin D also has immune regulating and anti-inflammatory effects. Moreover, it is related to chronic inflammatory diseases, autoimmune diseases and cancer. Many studies indicate the roles of vitamin D in the development and progression of endometriosis including the effects on modulation of immune responses, inflammation reactions, cell proliferation and apoptosis, angiogenesis, adhesion and invasion. Vitamin D supplementation can relieve pain and improve endometrial receptivity associated with endometriosis and play a preventive and therapeutic role. This paper summarizes the roles of vitamin D in endometriosis.


Subject(s)
Autoimmune Diseases , Endometriosis , Endometrium , Female , Humans , Inflammation , Vitamin D , Allergy and Immunology , Metabolism
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