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1.
Organ Transplantation ; (6): 111-2022.
Article in Chinese | WPRIM | ID: wpr-907041

ABSTRACT

Hepatocellular carcinoma (HCC) is one of the most common malignant tumors worldwide. At present, hepatectomy is one of the most frequent therapeutic options, whereas the high postoperative recurrence rate severely affects the long-term survival of HCC patients. Therefore, it is urgent to choose appropriate therapeutic regime to treat the recurrence of HCC to improve the long-term survival of HCC patients. Surgical treatment is an efficacious treatment for recurrent HCC, including re-hepatectomy, salvage liver transplantation and radiofrequency ablation. Currently, individualized treatment is recommended for postoperative recurrence of HCC. The selection of treatment should be conducted based on the tumor conditions after the first hepatectomy, the characteristics of recurrent tumors, baseline data of patients and recurrence time, etc., aiming to formulate appropriate treatment regimes for patients. In this article, these surgical regimes were reviewed and compared to explore appropriate surgical schemes for postoperative recurrence of HCC, aiming to provide reference for prolonging the survival of HCC patients.

2.
China Occupational Medicine ; (6): 523-528, 2021.
Article in Chinese | WPRIM | ID: wpr-923081

ABSTRACT

OBJECTIVE: To explore the effect of intervention adherence on the use of respiratory protective equipment(RPE) among migrant workers who occupationally exposed to organic solvents. METHODS: A total of 901 migrant workers from 60 small and medium-sized enterprises exposed to organic solvents in a district of Guangzhou City were selected as study subjects using three-arm cluster randomized controlled trial. The enterprises were divided into control group, intervention group, and combined intervention group. Migrant workers in the control group did not receive any intervention, while migrant workers in the intervention group received traditional health education and mobile health(mHealth) intervention, and migrant workers in the combined intervention group received interventions of the intervention group plus peer education. The use of RPE by the migrant workers was evaluated in these three groups in the last week, and at the sixth month. RESULTS: The adherence rates of the three mHealth intervention measures(following the WeChat official account of the project, joining the WeChat/QQ group of the project, and reading the provided messages from project team) in the combined intervention group were higher than that in the intervention group(74.8% vs 53.6%, 70.7% vs 41.8%, 78.5% vs 65.0%, all P<0.01). In the two intervention groups, the adherence rates of traditional health education(attending occupational health training, and browsing public welfare posters) were higher than that of mHealth intervention and/or peer education(all P<0.01). Logistic regression analysis showed that regardless of mHealth intervention, traditional health education or peer education, the high compliance subgroups of the two intervention groups were more likely to wear RPE all the time(all P<0.05) compared with the control group. The intervention effectiveness of the combined intervention group was better than that of the intervention group. CONCLUSION: Improving compliance with occupational health education interventions can promote the use of RPE among migrant workers. The implementation of peer education is beneficial to improve intervention compliance and intervention effect of migrant workers.

3.
Chinese Journal of Orthopaedics ; (12): 1116-1124, 2021.
Article in Chinese | WPRIM | ID: wpr-910698

ABSTRACT

Objective:To analyze the surgical techniques, surgical indications and early clinical effects of 3D printed hemipelvic prostheses in the reconstruction of pelvic malignant tumors resected by the sacroiliac joint.Methods:From January 2016 to March 2020, a retrospective analysis of 9 patients with malignant tumors involving pelvis I+II or I+II+III region were treated with sacroiliac joint osteotomy and 3D printed pelvic prosthesis reconstruction. There were 7 males and 2 females; their age was 51.1±10.5 years (range 27-66 years). Among them, 5 cases were chondrosarcoma, 1 case was pleomorphic undifferentiated sarcoma, 2 cases were metastatic renal cell carcinoma, and 1 case was metastatic primitive neuroectodermal tumor. Resection of pelvic area I+II or I+II+III were according to the extent of tumor involvement. During the resection of pelvic I region, osteotomy was done through sacroiliac joint surface, and 3D printed hemipelvic prosthesis that fits the sacral auricular surface was used for reconstruction. Postoperative imaging examination was used to evaluate the acetabular rotation center deviation of the pelvic prosthesis; the International Bone Tumor Society (Musculoskeletal Tumor Society, MSTS) function score was used for functional evaluation; the patient's oncology outcome and postoperative complications were evaluated.Results:All 9 patients successfully completed the operation. The operation time was 3.5-6 hours, with an average of 4.5 hours. The intraoperative blood loss was 800-3 000 ml, with an average of 1 400 ml. 3 patients underwent resection and reconstruction of pelvis I+II area, 4 patients underwent pelvic resection and reconstruction of I+II+III area, 2 patients underwent pelvic I+II+III area combined with proximal femur resection and reconstruction; all patients were followed up. The follow-up time was 6-50 months, with an average of 16 months. At the last follow-up of 9 patients, the MSTS score was 12-26, with an average of 20.2; the postoperative rotation center horizontal displacement distance was 10.67±7.12 mm, and the vertical displacement was 8.56±4.22 mm. One case of metastatic cancer was found to have multiple metastases throughout the body during chemotherapy 3 months after surgery, and died in 7 months after surgery; 1 case of pelvic metastatic renal cell carcinoma developed multiple metastases within one and a half years after surgery, controlled by targeted drugs, and survived with the tumor; the rest seven cases had no recurrence at the surgical site and no distant metastasis was found.Conclusion:The semipelvic prosthesis with 3D printed auricular surface has potential advantages in reconstructing the bone defect of the pelvis I+II or I+II+III area after the sacroiliac joint osteotomy. The short-term efficacy is relatively satisfactory, and the long-term efficacy remains to be further observed.

4.
Article in Chinese | WPRIM | ID: wpr-910002

ABSTRACT

Objective:To analyze the influence of comprehensive rehabilitation on postoperative functions in the elderly patients with femoral intertrochanteric fracture.Methods:From June 2015 to June 2019, 144 elderly patients were treated at Department of Orthopedics, China-Japan Friendship Hospital for femoral intertrochanteric fractures by internal fixation with proximal femoral nail anti-rotation (PFNA). Of them, 65 received comprehensive rehabilitation, including intervention measures for details, prevention and management of comorbidities and complications and active exercise of the injured limb, while 79 conventional rehabilitation. In the comprehensive rehabilitation group, there were 22 males and 43 females with an age of (76.6±6.7) years, and 18 cases of type 31-A1, 35 cases of type 31-A2 and 12 cases of type 31-A3 by the AO type. In the control group, there were 23 males and 56 females with an age of (75.2±7.0) years, and 25 cases of type 31-A1, 39 cases of type 31-A2 and 15 cases of type 31-A3 by the AO type. The 2 groups were compared in terms of visual analog scale (VAS), Harris hip score, Barthel index, postoperative ambulation time and complications at 6 months after operation.Results:The 2 groups were comparable because there was no significant difference between them in the preoperative or intraoperative general data ( P>0.05). The comprehensive rehabilitation group had a significantly lower VAS score (1.5±1.0), a significantly higher Harris hip score(83.9±5.4), a significantly higher Barthel index (81.6±5.4), significantly shorter postoperative ambulation time [(2.6±1.0) d], and a significantly lower incidence of complications [4.6% (3/65)] than the control group did [1.9±1.2, 80.2±7.9, 78.2±7.9, (3.2±1.4) d, 16.5%(13/79), respectively] (all P< 0.05). Conclusion:For elderly patients with femoral intertrochanteric fracture, comprehensive rehabilitation can significantly reduce complications, promote functional recovery of the hip, and speed up recovery of capabilities of daily living compared with conventional rehabilitation.

5.
Article in English | WPRIM | ID: wpr-888612

ABSTRACT

BACKGROUND@#Health literacy is a public health goal which can be used as an independent factor of health outcomes. This study aimed to assess the association between health literacy and health status, as well as the two mediating factors of behavior and self-efficacy among residents aged 15-69 years in Qingdao.@*METHODS@#A cross-sectional survey was implemented among residents aged 15-69 years (N = 3793) in Qingdao, China. A combination of stratified cluster random and proportional probability sampling methods was used to select subjects for this study. Data were collected using "The Chinese Citizen Health Literacy Questionnaire (2019)". We proposed a hypothetical model for the relationship between sociodemographic characteristics, health literacy, self-efficacy, health behavior, and health status, and used path analysis to validate the hypothesis.@*RESULTS@#The path analysis showed that higher education (β = 0.293) and income (β = 0.135) are positively and directly associated with greater health literacy, which was positively associated with health status (β = 0.057). Health literacy is a direct influencing factor of health behavior (β = 0.070) and self-efficacy (β = 0.099). Health behavior (β = 0.041) and self-efficacy (β = 0.173) exerted a positive direct effect on health status. The model explained 14.1% of variance for health literacy, 3.8% for self-efficacy, 5.7% for health behavior, and 15.0% for health status.@*CONCLUSIONS@#Health literacy was identified to be a critical factor in health status. The results emphasized that the dissemination of health knowledge, development of healthy behavior, and cultivation of self-efficacy should be jointly promoted to reinforce the level of health status among residents in future work.


Subject(s)
Adolescent , Adult , Aged , China , Cross-Sectional Studies , Female , Health Behavior , Health Knowledge, Attitudes, Practice , Health Literacy/statistics & numerical data , Health Status , Humans , Male , Middle Aged , Young Adult
6.
Article in English | WPRIM | ID: wpr-921875

ABSTRACT

Computed tomography (CT) examination is the major measure for detecting and diagnosis of foreign bodies in human body. Although CT has high sensitivity in diagnosis of foreign body, some interference factors may still lead to missed diagnosis or misdiagnosis. Here we report a rare case that a bamboo stick accidentally pierced into the left chest of a young man who was drunk and unware of this hurt. The patient experienced cough, chest pain, fever, hemoptysis, and was misdiagnosed as primary and secondary tuberculosis based on chest CT examinations at a local hospital, although no tubercular bacillus detected by sputum smear. He subsequently received anti-tuberculous treatments in the following three years, but no improvement of his symptoms was observed. Until one month before his death, the bamboo stick was detected by spiral CT examination as well as three-dimensional image reconstruction at another hospital. Postmortem examination revealed pneumonia, pulmonary infarction, and abscess as the causes of his death. We analyze the potential reasons of misdiagnosis in this case, aiming to provide reference for the diagnosis and treatment of pulmonary inflammation associated with foreign body in the future.


Subject(s)
Abscess , Diagnostic Errors , Humans , Male , Pneumonia , Pulmonary Infarction , Tuberculosis, Pulmonary
7.
Chinese Medical Journal ; (24): 206-211, 2020.
Article in English | WPRIM | ID: wpr-878028

ABSTRACT

BACKGROUND@#Minimal change nephropathy (MCD) is a common pathological type of nephrotic syndrome and is often associated with acute kidney injury (AKI). This study aimed to investigate the clinical characteristics and related factors of AKI in patients with MCD and nephrotic syndrome.@*METHODS@#Patients from Chinese People's Liberation Army General Hospital who were diagnosed with pathological renal MCD with clinical manifestations of nephrotic syndrome were included from January 1, 2013 to December 31, 2017. Patients diagnosed with membranous nephropathy (MN) by renal biopsy from January 1, 2013 to December 31, 2017 are included as a control population. We retrospectively analyzed the clinical and pathological characteristics of patients as well as the percentages and clinical characteristics of AKI in different age groups. We assessed the correlation of pathological characteristics with serum creatinine using multivariate linear regression analysis.@*RESULTS@#A total of 367 patients with MCD were included in the analysis, with a sex ratio of 1.46: 1 (male: female) and an age range of 6 to 77 years. Among all the patients, 109 developed AKI (29.7%), and of these patients, 85 were male (78.0%). In the 586 patients with MN, 27 (4.6%) patients developed AKI. The percentage of AKI in MCD patients was significantly higher than that in MN patients (χ2 = 41.063, P < 0.001). The percentage of AKI increased with age in the MCD patients. The percentage of AKI in patients aged 50 years or older was 52.9% (46/87), which was significantly higher than that [22.5% (63/280)] in patients under 50 years (χ2 = 6.347, P = 0.013). We observed statistically significant differences in age (43 [27, 59] years vs. 28 [20, 44] years, Z = 5.487, P < 0.001), male (78.0% vs. 51.4%, χ2 = 22.470, P < 0.001), serum albumin (19.9 ± 6.1 g/L vs. 21.5 ± 5.7 g/L, t = 2.376, P = 0.018), serum creatinine (129.5 [105.7, 171.1] μmol/L vs. 69.7 [57.7, 81.9] μmol/L, Z = 14.190, P < 0.001), serum urea (10.1 [6.2, 15.8] mmol/L vs. 4.7 [3.6, 6.4] mmol/L, Z = 10.545, P < 0.001), IgE (266.0 [86.7, 963.0] IU/ml vs. 142.0 [35.3, 516.5] IU/ml, Z = 2.742, P = 0.007), history of diabetes (6.4% vs. 1.2%, P = 0.009), and history of hypertension (23.9% vs. 5.1%, χ2 = 28.238, P < 0.001) between the AKI group and the non-AKI group. According to multivariate linear regression analysis, among the renal pathological features analyzed, renal tubular epithelial cell damage (β = 178.010, 95% CI: 147.888-208.132, P < 0.001) and renal interstitial edema (β = 28.833, 95% CI: 11.966-45.700, P = 0.001) correlated with serum creatinine values.@*CONCLUSIONS@#The percentage of AKI in MCD patients is significantly higher than that in MN patients. Patients over 50 years old are more likely to develop AKI. Renal tubular epithelial cell injury and renal interstitial edema may be the main pathological lesions that are associated with elevated serum creatinine in patients with MCD.


Subject(s)
Acute Kidney Injury/etiology , Adolescent , Adult , Aged , Child , Cross-Sectional Studies , Female , Humans , Kidney , Male , Middle Aged , Nephrosis, Lipoid/complications , Nephrotic Syndrome/complications , Retrospective Studies , Young Adult
8.
Chinese Journal of Trauma ; (12): 111-116, 2020.
Article in Chinese | WPRIM | ID: wpr-811516

ABSTRACT

Since December 2019, novel coronavirus pneumonia (NCP) has been reported in Wuhan, Hubei Province, and spreads rapidly to all through Hubei Province and even to the whole country. The virus is 2019 novel coronavirus (2019-nCoV), never been seen previously in human, but all the population is generally susceptible. The virus spreads through many ways and is highly infectious, which brings great difficulties to the prevention and control of NCP. Based on the needs of orthopedic trauma patients for emergency surgery and review of the latest NCP diagnosis and treatment strategy and the latest principles and principles of evidence-based medicine in traumatic orthopedics, the authors put forward this expert consensus to systematically standardize the clinical pathway and protective measures of emergency surgery for orthopedic trauma patients during prevention and control of NCP and provide reference for the emergency surgical treatment of orthopedic trauma patients in hospitals at all levels.

9.
Article in Chinese | WPRIM | ID: wpr-867904

ABSTRACT

Objective:To explore the incidence and morphology of the posterolateral fracture fragment affecting the fibular notch in posterior pilon fracture.Methods:A retrospective analysis was conducted of the CT and clinical data of the 31 patients with posterior pilon fracture who had been treated at Department of Orthopaedic, China-Japan Friendship Hospital from May 2013 to May 2018. They were 17 men and 14 women, aged from 20 to 68 years (average, 42 years). The injury affected the left side in 13 cases and the right side in 18 ones. The incidence of the posterolateral fracture fragments affecting the fibular notch was counted. The morphologic indexes of the fragments were measured like axial angle of their fracture line, fragment area, fragment height, and sagittal angle of their fracture line.Results:A posterolateral fracture fragment affecting the fibular notch was found in all the 31 posterior pilon fractures, giving an incidence of 100% in the posterior pilon fracture. The fracture line of the fragments tended to be in the coronal plane. The axial angle of the fracture line was 20.25°±9.48°; the ratio of the fragment area to the distal tibial articular area was 15.78%±6.75%; the fragment height was 36.59 mm ± 10.70 mm; the sagittal angle of the fracture line was 18.37°±5.45°.Conclusions:A posterolateral fracture fragment affecting the fibular notch can be found in all the posterior pilon fractures. It does not affect a large articular area and its fracture line is usually located in the coronal plane. These data may help choose appropriate surgical approach and internal fixation.

10.
Chinese Journal of Trauma ; (12): 111-116, 2020.
Article in Chinese | WPRIM | ID: wpr-867685

ABSTRACT

Since December 2019, corona virus disease 2019 (COVID-19) has been reported in Wuhan, Hubei Province, and spreads rapidly to all through Hubei Province and even to the whole country. The virus is 2019 novel coronavirus (2019-nCoV), never been seen previously in human, but all the population is generally susceptible. The virus spreads through many ways and is highly infectious, which brings great difficulties to the prevention and control of COVID-19. Based on the needs of emergency surgery for orthopedic trauma patients and review of the latest diagnosis and treatment strategy of COVID-19 and the latest principles and principles of evidence-based medicine in traumatic orthopedics, the authors put forward this expert consensus to systematically standardize the clinical pathway and protective measures of emergency surgery for orthopedic trauma patients during prevention and control of COVID-19 and provide reference for the emergency surgical treatment of orthopedic trauma patients in hospitals at all levels.

11.
Clinical Medicine of China ; (12): 250-254, 2020.
Article in Chinese | WPRIM | ID: wpr-867528

ABSTRACT

Objective:To investigate the risk factors of acute kidney injury (AKI) in patients undergoing cardiopulmonary bypass (CPB) during cardiac surgery, and to determine the relationship between preoperative biochemical examination and intraoperative CPB time and the incidence of AKI.Methods:From October 2017 to October 2018, the clinical data of cardiopulmonary bypass patients admitted to the First Affiliated Hospital of Guangxi Medical University were analyzed retrospectively.Logistic regression was used to analyze the influence of patients′ basic diseases, preoperative biochemical examination and cardiopulmonary bypass time on postoperative AKI.At the same time, the changes of serum creatinine in patients with AKI 7 days after operation were analyzed to provide help for the early diagnosis of AKI after operation.Results:A total of 370 patients with cardiopulmonary bypass were included.Logistic regression analysis results: diabetes basic history( OR=5.226, 95% CI: 1.084-25.191, P=0.039), the increase of age ( OR=1.041, 95% CI: 1.018-1.065, P<0.001), BMI ( OR=1.127, 95% CI: 1.043-1.218, P=0.003), urea nitrogen ( OR=1.211, 95% CI: 1.077-1.360, P=0.001), and CPB time ( OR=1.013, 95% CI: 1.006-1.020, P<0.001) were the risk factors of postoperative AKI in patients with cardiopulmonary bypass.The detection rate of AKI was 4.19%(9/215), 51.63%(111/215), 87.91%(189/215), 97.67%(210/215), 99.07%(213/215), 100%(215/215) and 100%(215/215) on the first day, the third day, the fourth day, the fifth day, the seventh day, respectively. Conclusion:Diabetes history, age, BMI, Urea nitrogen and CPB times are risk factors of AKI patients after CPB.In order to reduce the rate of misdiagnosis, creatinine should be detected for at least 4 consecutive days in clinical observation of post-operative serum creatinine.

12.
Chinese Pharmaceutical Journal ; (24): 1325-1330, 2020.
Article in Chinese | WPRIM | ID: wpr-857606

ABSTRACT

OBJECTIVE: To study the chemical constituents of bamboo juice. METHODS: The compounds were isolated and purified by column chromatography on silica gel, ODS, macroporous resin, MPLC and HPLC. Their structures were elucidated by NMR spectroscopic evidence and compared with those in literature. RESULTS: Fifteen compounds were isolated and identified as (+)-lyoniresinol-3α-O-β-D-glucopyranoside (1), 5, 5'-dimethoxylariciresinol-4'-O-β-D-glucopyranoside (2), syringaresinol 4'-O-β-D-glucopyroside (3), (-)-4-epi-lyoniresinol (4), (-)-lyoniresinol -2α-O-β-D-glucopyranoside (5), (+)-lyoniresinol (6), 8, 8'-bisdihydrosiringenin glucoside (7), 2, 4, 6-trimethoxyphenyl-1-O-β-D-glucopyranoside (8), threo-8S-7-meth-oxysyringylglycerol (9), salidroside (10), (7S, 8R)syringoylglycerol (11), syringaldehyde (12), 2, 6-dimethoxy-1, 4-benzoquinone (13), n-butyl-β-D-fructopyranoside (14), and n-butyl pyroglutamate (15).CONCLUSION: Compounds 1-11 and 14-15 are isolated from bamboo juice for the first time. Compounds 14 and 15 are β-D-fructopyranoside and pyroglutamic acid artifacts produced during the extraction.

13.
Article in Chinese | WPRIM | ID: wpr-817845

ABSTRACT

OBJECTIVE: To evaluate the efficacy and safety of tigecycline therapy in children with severe infection.METHODS: We conducted a restrospective chart review of 114 children with severe infection in a tertiary hospital from May 1,2012 to April 30,2017. Inclusion criteria: receiving tigecycline administration for at least 2 days(4 doses). Clinical data and laboratory results were recorded before and after the therapy. RESULTS: Totally 114 children were enrolled,including 47 patients diagnosed with Acinetobacter baumanmii infection,with 52 Acinetobacter baumanmii strains. The in-hospital mortality was 23.4%. Median duration of tigecycline treatment was 13 days(2.5-13.5 days). Median duration of antibiotics prior to tigecycline treatment was 9 days(2-27 days). The total clinical improvement rate was 47.3%,and the etiological eradication rate was 38.9%. After treatment 24 cases got clinically improved in 47 patients and 26 strains were eradicated. No serious adverse effect was reported. CONCLUSION: The efficacy and safety of tigecycline should not be overvalued. Additional data from randomized controlled trials are required to assess the administration of tigecycline.

14.
Article in Chinese | WPRIM | ID: wpr-797900

ABSTRACT

Objective@#To investigate the value of acoustic parameters in the voice therapy for patients with unilateral vocal cord paralysis (UVCP).@*Methods@#From May 2015 to April 2018, 51 patients with UVCP and 59 healthy controls in Department of Otorhinolaryngology Head and Neck Surgery, Tianjin First Central Hospital, were involved in this research retrospectively. The UVCP patients were diagnosed with stroboscopic laryngoscopy. The minimum glottal area (MGA) was calculated by KIPS software when the people were pronouncing/i:/. The fundamental frequency (F0), Jitter, Shimmer and NHR were detected by CSL4500 multiple acoustic voice analyzer.@*Results@#MGA of UVCP patients was much higher than that of healthy control (male: 433.68±64.52 vs. 294.41±51.82, t=9.23, P=0.000; female: 498.80±73.42 vs. 302.03±76.54, t=13.21, P=0.000), which meaned vocal cord insufficiency.After voice therapy, MGA reduced significantly (male: 288.48±55.09, female: 258.22±57.17, t=24.41 and 31.22, P=0.000 vs. pre-therapy). MGA of untreated patients decreased in varying degrees. Compared with the voice therapy group, the MGA decreased in a significantly lower extent (24.25±22.91 vs. 188.31±54.37, t=8.97, P=0.000). The F0, Jitter, Shimmer and NHR raised significantly in UVCP patients group (P=0.000 vs. healthy control group), and they were reduced by voice therapy (all P<0.05). Each of the four acoustic parameters was relative with MGA, r=0.551, 0.867, 0.853 and 0.875 in turn, P=0.001, 0.000, 0.000, and 0.000.@*Conclusion@#MGA and acoustic parameters can reflect the acoustic features of UVCP patients, which are useful tools in the UVCP assessment and voice therapy.

15.
Article in Chinese | WPRIM | ID: wpr-796879

ABSTRACT

Objective@#To analyze and discuss the parameters and clinical significance of nystagmus in patients with benign positional paroxysmal vertigo (BPPV) of posterior semicircular canal.@*Methods@#The subjects of the study were 564 BPPV patients diagnosed with posterior semicircular canal canalithis (PSC-can) from January 2016 to July 2017 in Tianjin No.1 Central Hospital, including 186 males and 378 females, with a median age of 57 years. The induced nystagmus in Dix-Hallpike test was recorded by video nystagmuo graph(VNG), and the direction, latency, duration time and intensity characteristics of nystagmus were compared with the position of hanging and sitting.SPSS17.0 software was used for statistical analysis.@*Results@#Vertical torsional nystagmus was both induced with the position of hanging and sitting during Dix-Hallpike test. The vertical direction of the induced nystagmus was upward and downward respectively. The latency, duration time and intensity of lesion side were L(2.65±1.92; 1.44±1.24), D(14.90±10.46; 15.28±8.06), and P(29.75±21.26; 14.08±9.48). The latency and intensity in hanging position were higher than those of sitting. The intensity rate was about 2∶1, with statistically significant difference (t=13.831, and 17.296, P all<0.01). The direction of the induced nystagmus was opposite to turning in HSC-Can BPPV. The intensity turning to normal side was larger than lesion side obviously. The intensity rate was about 2∶1, the difference was statistically significant (t=17.296, P<0.01). There was no statistical difference of nystagmus during time between the two positions(t=-0.735, P>0.05).@*Conclusions@#The nystagmus intensity rate in Dix-Hallpike test between hanging and sitting position of lesion side in PSC-Can is 2∶1, which conforms to the Ewald′s law. The direction, latency and intensity of nystagmus can be used as a reference index for the localization diagnosis of PSC-Canotolith.

16.
Chinese Journal of Nephrology ; (12): 588-595, 2019.
Article in Chinese | WPRIM | ID: wpr-756088

ABSTRACT

Objective To investigate the relationship between preoperative serum homocysteine (Hcy) level and acute kidney injury (AKI) after cardiac valve replacement surgery. Methods The data of the inpatients who accepted cardiac valve replacement surgery, age≥18 years, no renal replacement therapy before surgery, non - renal decompensation and preoperative serum creatinine (Scr)<178 μmol/L, survival within 48 h after surgery, and with preoperative serum Hcy data in the First Affiliated Hospital of Guangxi Medical University from January 1, 2015 to December 31, 2017 was retrospectively analyzed. AKI was diagnosed in patients whose Scr increased more than 26.5 μmol/L (0.3 mg/dl) within 48 hours or 1.5 times higher than baseline within 7 days after surgery. According to this, patients were divided into AKI group and non-AKI group, and the affecting factors for AKI were compared between the two groups. Multivariate logistic regression was used to analyze the independent influencing factors of AKI. The relationship between serum Hcy level and AKI incidence was analyzed by Spearman correlation analysis. Whether the AKI occurred and serum Hcy levels were used as variables to map the receiver operating characteristic curve (ROC), and was used to assess the value of preoperative serum Hcy level for predicting AKI after cardiac valve replacement surgery. Results A total of 810 subjects were included in the study, including 375 males and 435 females. They were (50±11) years old (19-78 years old). Among them, 329 patients with AKI occurred within 7 days after heart valve replacement, and the incidence rate was 40.6% (male 45.9%, female 36.1%). The serum Hcy level in the AKI group was higher than that in the non-AKI group [(15.74±4.55) μmol/L vs (13.87 ± 3.85) μmol/L, t=6.106, P<0.01]. Multivariate logistic regression analysis showed age (OR=1.030, 95% CI 1.014-1.045, P<0.001), extracorporeal circulation time (OR=1.011, 95% CI 1.007-1.016, P<0.001), Scr (OR=1.014, 95%CI 1.005-1.023, P=0.002), serum Hcy (OR=1.059, 95% CI 1.017-1.103, P=0.006), high level of Hcy (>13.64 μmol/L) (OR=1.465, 95%CI 1.059-2.027, P=0.021) and moderate to severe hyperhomocystinemia (16≤Hcy≤100 μmol/L) [with normal HHcy (Hcy<10 μmol/L) as reference, OR=2.180, 95% CI 1.245-3.816, P=0.006] were independent influencing factors of AKI after cardiac valve replacement surgery. Spearman correlation analysis showed that the incidence of postoperative AKI increased with the increase of preoperative serum Hcy level (rs=0.927, P<0.001). The results of ROC curve showed that the area under the curve of the preoperative serum Hcy level predicting AKI after heart valve replacement was 0.701, and the cutoff value was 13.64 μmol/L, with the sensitivity 61.3%, specificity 70.9%. Conclusions Preoperative serum Hcy level is an influencing factor for AKI after cardiac valve replacement surgery. The higher the level of preoperative serum Hcy, the higher the incidence of AKI after cardiac valve replacement surgery. Patients with preoperative serum Hcy levels>13.64 μmol/L have an increased risk of AKI after cardiac valve replacement surgery.

17.
Article in Chinese | WPRIM | ID: wpr-752982

ABSTRACT

Objective To investigate the predictive value of preoperative albumin-to-fibrinogen ratio (A/F) for postoperative survival of esophageal squamous cell carcinoma after radical esophagectomy.Methods The retrospective cohort study was conducted.The clinicopathological data of 559 patients with esophageal squainous cell carcinoma who underwent radical resection in the Sun Yat-sen University Cancer Center from January 2009 and January 2012 were collected.There were 443 males and 116 females,aged from 53 to 66 years,with an average age of 59 years.Of 559 patients,394 with A/F > 11.14 were in high A/F group,and 165 with A/F ≤ 11.14 were in low A/F group.Levels of plasma albumin and fibrinogen were measured at two weeks before surgery,and patients underwent radical esophagectomy.Observation indicators:(1) clinicopathological characteristics of patients;(2) survival of patients;(3) risk factors analysis of prognosis of patients.Follow-up was conducted by outpatient examination and telephone interview to detect postoperative survival of patients up to November 2018.The overall survival time was from surgery date to date of endpoint events including death or the last follow-up,and the overall disease-free survival time was from surgery date to date of endpoint events including tumor recurrence,tumor-falted death,or the last follow-up.Measurement data with skewed distribution were expressed by M (range).Count data were described as percentage,and comparison between groups was analyzed using chi-square test or Fisher exact probability.Comparison of ordinal data was analyzed by Mann-Whitney U nonparametric test.The survival rate and curve were calculated and drawn by Kaplan-Meier method and the Log-rank test was used for survival analysis.The univariate and multivariate analyses were done using COX proportional hazard model.Results (1) Clinicopathological characteristics of patients:of 559 patients,cases with age ≤ 60 years and > 60 years,cases in T1 stage,T2 stage,T3 stage(depth of tumor invasion)were 246,148,60,79,255 in the high A/F group,and 79,86,5,32,128 in the low A/F group,there were statistically significant differences in the age and depth of tumor invasion between the two groups (x2 =10.127,Z=-3.468,P<0.05).(2) Survival of patients:559 patients were followed up for 97 months (range,91-103 months).The 5-year overall survival rate and 5-year disease-free survival rate were 55.8% and 48.7% in the high A/F group,and 38.8% and 35.8% in the low A/F group,respectively,with statistically significant differences between the two groups (x2 =16.501,11.679,P<0.05).(3) Risk factors analysis of prognosis of patients:results of univariate analysis showed that sex,age,preoperative fibrinogen level,preoperative A/F level,surgical method,depth of tumor invasion,tumor pathological N staging,and postoperative adjuvant therapy were associated with 5-year overall survival rate of esophageal squamous cell carcinoma after radical esophagectomy [hazard ratio (HR) =1.362,1.358,1.421,0.617,0.772,1.490,1.732,1.436,95% confidence interval (CI):1.010-1.835,1.084-1.700,1.114-1.814,0.487-0.781,0.612-0.973,1.239-1.792,1.552-1.934,1.128-1.829,P< 0.05];age,preoperative fibrinogen level,preoperative A/F level,surgical method,depth of tumor invasion,tumor pathological N staging,postoperative adjuvant therapy were associated with 5-year disease-free survival rate of esophageal squamous cell carcinoma after radical esophagectomy (HR=1.248,1.371,0.675,0.740,1.427,1.665,1.606,95%CI:1.006-1.547,1.086-1.732,0.538-0.847,0.592-0.924,1.202-1.695,1.498-1.851,1.275-2.022,P< 0.05).Results of multivariate analysis showed that age,preoperative A/F level,surgical method,depth of tumor invasion,and tumor pathological N staging were independent factors for 5-year overall survival rate and 5-year disease-free survival rate of esophageal squamous cell carcinoma after radical esophagectomy (HR=1.491,0.699,0.741,1.353,1.761,95%CI:1.184-1.877,0.550-0.888,0.587-0.935,1.120-1.634,1.573-1.971,P<0.05;HR=1.372,0.760,0.703,1.281,1.692,95%CI:1.100-1.711,0.603-0.957,0.562-0.880,1.074-1.527,1.518-1.887,P<0.05).Conclusion Preoperative A/F level has a good predictive value for survival of esophageal squamous cell carcinoma after radical esophagectomy,and preoperative A/F level ≤ 11.14 is a independent risk factor for 5-year overall survival rate and 5-year disease-free survival rate of esophageal squamous cell carcinoma after radical esophagectomy.

18.
Article in Chinese | WPRIM | ID: wpr-745124

ABSTRACT

Objective To compare the outcomes of Dresden technique versus open surgery for acute Achilles tendon ruptures.Methods From January 2013 to June 2017,67 patients were operatively treated for acute Achilles tendon rupture at Department of Orthopaedics,China Japan Friendship Hospital.Of them,Dresden technique was used in 32(minimally invasive group) and open surgery in 35(open surgery group).The 2 groups were compared in terms of baseline characteristics,operation time,operative incision length,hospital stay,postoperative complications like incision infection and tendon re-rupture and the Achilles Tendon Total Rupture Score(ATRS).Results The 2 groups were compatible due to insignificant differences in the baseline characteristics(P>0.05).They were followed up for 18 months.The minimally invasive group had significant shorter operation time(40.0min),incision length(3.0cm) and hospital stay(5 d) than the open surgery group(42.5 min,10.0 cm and 6 d)(P<0.05).No sural nerve lesion was observed in either group.The rate of wound complications was 0% for the minimally invasive group and 8.6% for the open surgery group;the rate of re-rupture was 3.1% for the former and 2.9% for the latter;the ATRS at the final follow-up was 98.0 for the former and 98.5 for the latter.There were no significant differences between the 2 groups in the above comparisons(P>0.05).Conclusions Percutaneous suture of the Achilles tendon with the Dresden instruments is a safe,fast and standardized surgical procedure for acute Achilles tendon ruptures,leading to shorter operation time,incision length and hospital stay,better functional recovery and a tendency of decreased wound complications than the open surgery.

19.
Article in Chinese | WPRIM | ID: wpr-743867

ABSTRACT

BACKGROUND: Tendon is a fibrous tissue that connects bone and muscle. The main function is to conduct stress from the muscles to the bone during exercise. Tendinopathy is a commonly seen disease, characterized by tendon inflammation, degeneration and injury. Autophagy is widely involved in the development of many degenerative diseases. The research method based on autophagy provides a new idea for tendon repair. OBJECTIVE: To review the process and regulation mechanism of autophagy, and to analyze the pathological mechanism of autophagy involved in the tendinopathy so as to provide a reference for the prevention and treatment of tendinopathy. METHODS: The articles concerning autophagy and tendinopathy were retrieved by computer in CNKI, WanFang and PubMed databases. The keywords were "autophagy, tendon, fibroblast, tendinopathy" in English and Chinese, respectively. Finally, 54 articles were obtained through systematic induction and analysis after excluding the irrelevant and repetitive articles. RESULTS AND CONCLUSION: Autophagy can alleviate the damage to human tendon stem cells induced by oxidative stress. With the increase of the degree of extracellular matrix degradation in the tendon tissue, autophagic cell death occurs in the tendon cells due to excessive autophagy. Prostaglandin E2 significantly induces fibroblast death and autophagy in a dose-dependent manner. The muscle atrophy after the rotator cuff injury is regulated by autophagy. Rapamycin prevents peritendinous fibrosis through activation of autophagy. In conclusion, autophagy plays an important role in tendinopathy. Autophagy will become a new hotspot in tendinopathy. Further understanding of autophagy and its role in tendinopathy will contribute to finding a targeted autophagy pathway and provide new theoretical and methodological support for the intervention and treatment of tendinopathy.

20.
Article in Chinese | WPRIM | ID: wpr-743815

ABSTRACT

BACKGROUND: Tendon is a fibrous tissue that connects bone and muscle. The main function is to conduct stress from the muscles to the bone during exercise. Tendinopathy is a commonly seen disease, characterized by tendon inflammation, degeneration and injury. Autophagy is widely involved in the development of many degenerative diseases. The research method based on autophagy provides a new idea for tendon repair. OBJECTIVE: To review the process and regulation mechanism of autophagy, and to analyze the pathological mechanism of autophagy involved in the tendinopathy so as to provide a reference for the prevention and treatment of tendinopathy. METHODS: The articles concerning autophagy and tendinopathy were retrieved by computer in CNKI, WanFang and PubMed databases. The keywords were "autophagy, tendon, fibroblast, tendinopathy" in English and Chinese, respectively. Finally, 54 articles were obtained through systematic induction and analysis after excluding the irrelevant and repetitive articles. RESULTS AND CONCLUSION: Autophagy can alleviate the damage to human tendon stem cells induced by oxidative stress. With the increase of the degree of extracellular matrix degradation in the tendon tissue, autophagic cell death occurs in the tendon cells due to excessive autophagy. Prostaglandin E2 significantly induces fibroblast death and autophagy in a dose-dependent manner. The muscle atrophy after the rotator cuff injury is regulated by autophagy. Rapamycin prevents peritendinous fibrosis through activation of autophagy. In conclusion, autophagy plays an important role in tendinopathy. Autophagy will become a new hotspot in tendinopathy. Further understanding of autophagy and its role in tendinopathy will contribute to finding a targeted autophagy pathway and provide new theoretical and methodological support for the intervention and treatment of tendinopathy.

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