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1.
Article in Chinese | WPRIM | ID: wpr-921926

ABSTRACT

OBJECTIVE@#To summarize the complications of core drilling intramedullary nail in the treatment of femoral shaft closed fracture and explore the treatment strategy.@*METHODS@#From August 2014 to June 2018, a total of 215 patients with closed femoral shaft fractures were treated with closed reduction core drill intramedullary nail, including 129 males and 86 females, aged from 18 to 62 years, with an average of (44.2±10.6) years old. The time from injury to operation was 3 to 21 days. There were 102 cases of AO type A fracture, 82 cases of AO type B fracture and 31 cases of AO type C fracture. The time of operation, the amount of blood loss during operation, the duration of hospitalization, the time of fracture healing and the HSS score of knee joint function at the last follow-up were recorded. The observation of complications included:iatrogenic fracture, core drill broken, core drill twist, postoperative infection, and fracture nonunion.@*RESULTS@#The average operation time was (63.2± 15.6) min and intraoperative blood loss was (150.0±34.5) ml. All the incisions reached grade A healing. Patients were follow up for a mean of (18.5±3.2) months, the average hospital stay was (4.3±1.2) days, and the average fracture healing time was (5.6±2.3) months. At the final follow-up, the average HSS score of knee joint was 90.3±4.7. Related complications occurred in 37 cases (17.2%). The core drill related complications occurred in 13 cases (6.0%), including core drill broken in 5 cases (2.3%), core removal in 1 case and slotting in 4 cases;core drill twist in 8 cases (3.7%). After the core was cut, the core was removed. Similar complicationsof conventional intramedullary nail:iatrogenic fracture was performed in 12 cases (5.6%), including 10 cases of fracture end split and 2 cases of distal perimedullary fracture of intramedullary nail. The patients with cleavage at the fracture end were not treated after judging their stability, and the patients with fracture around the distal end of the intramedullary nail were fixed with auxiliary steel plate during operation;1 case(0.4%) with delayed infection after operation, debridement and external fixation was replaced and healed after bone transfer; fracture nonunion occurred in 11 cases (5.1%), of which 7 cases (3.3%) were hypertrophic nonunion and healed with additional plate. Atrophic nonunion occurred in 4 cases (1.9%), which healed after additional steel plate and bone graft.@*CONCLUSION@#Core drilling intramedullary nail is an effective method for the treatment of closed femoral shaft fracture, and the complications include core drill related complications and conventional intramedullary nail similar complications. Accurate preoperative evaluation, careful operation during operation and early postoperative symptomatic treatment can effectively reduce the occurrence of related complications.


Subject(s)
Adult , Bone Nails , Female , Femoral Fractures/surgery , Fracture Fixation, Intramedullary/adverse effects , Fracture Healing , Fractures, Closed , Humans , Male , Middle Aged , Treatment Outcome
2.
Chinese Journal of Urology ; (12): 303-308, 2020.
Article in Chinese | WPRIM | ID: wpr-869640

ABSTRACT

Objective:To evaluate the relationship between dyslipidemia and uric acid urolithiasis, and explore the risk factors of uric acid urolithiasis.Methods:93 patients with uric acid urolithiasis identified by stone composition analysis were retrospective analyzed from January 2014 to October 2019 were classified as uric acid urolithiasis group.Among them there were 77 men accounting for 82.8%, 16 women accounting for 17.2%, the median age is 64 years old.According to sex, age and other conditions, 321 patients with calcium oxalate urolithiasis in the same period were selected as calcium oxalate stone group. Among them there were 264 men accounting for 82.2%, 57 women accounting for 17.8%, the average age is 64 years old.While 306 non-stone people examined in hospital as control group in the same period who matched with age and gender. Among them there were 252 men accounting for 82.4%, 54 women accounting for 17.6%, the average age is 61 years old. There was no significant difference in age and sex ratio among the three groups. The body mass index (BMI) of uric acid urolithiasis group, calcium oxalate urolithiasis group and control group were significantly different( P<0.01). Serum uric acid, urine pH and blood lipids: triglyceride (TG), cholesterol (TC), high density lipoprotein (HDL-C) and low density lipoprotein (LDL-C) were recorded in the three groups, and the correlation between the above indexes and stone composition was analyzed.The uric acid urolithiasis group was divided into hyperuricemia(HUA) group (n=41) and Non HUA group (n=52) according to serum uric acid, and 66 cases with HUA were selected in the control group. The dyslipidemia and urine pH levels of the above three groups were compared. The multivariate Logistic regression analysis was used to identify the independent risk factors associated with uric acid urolithiasis formation. Results:There were significant differences in TG level, incidence of hypertrigly-ceridemia, low HDL-cholesterolemia, high LDL-cholesterolemia, serum uric acid and urine pH between uric acid urolithiasis group and calcium oxalate urolithiasis group( P<0.05). Significant differences were seen in TG level, HDL-C level, incidence of hypertriglyceridemia and low HDL-cholesterolemia, serum uric acid and urine pH between uric acid urolithiasis group and control group.There was significant difference in urine pH between uric acid urolithiasis with and Non HUA group. Significant difference in the incidence of hypertriglyceridemia and low HDL-cholesterolemia were seen between uric acid urolithiasis with HUA group and HUA group.Multivariate Logistic regression analysis showed that obesity(odds ratio=1.68, P<0.001), hypertriglyceridemia(odds ratio=7.37, P=0.002), low HDL-cholesterolemia(odds ratio=10.46, P=0.001) and low urinary pH(odds ratio=0.10, P<0.001) were independent risk factors for uric acid urolithiasis. Conclusions:Dyslipidemia was more likely associated with uric acid urolithiasis. Obesity, hypertriglyceridemia, low HDL-cholesterolemia and low urinary pH are closely related to the occurrence of uric acid urolithiasis.

3.
Article in English | WPRIM | ID: wpr-829140

ABSTRACT

@# Current Issue Archive 15 December 2020, Volume 11 Issue 4 Previous Issue Improving antibiotic prescribing in the emergency department for uncomplicated community-acquired pneumonia Rebekah Shaw, Erica Popovsky, Alyssa Abo, Marni Jacobs, Nicole Herrera, James Chamberlain, Andrea Hahn World Journal of Emergency Medicine. 2020, 11(4): 199-205. doi:10.5847/wjem.j.1920-8642.2020.04.001 Asbtract HTML PDF (151KB) Outcome prediction value of National Early Warning Score in septic patients with community-acquired pneumonia in emergency department: A single-center retrospective cohort study Hai-jiang Zhou, Tian-fei Lan, Shu-bin Guo World Journal of Emergency Medicine. 2020, 11(4): 206-215. doi:10.5847/wjem.j.1920-8642.2020.04.002 Asbtract HTML PDF (255KB) Effects of fluid balance on prognosis of acute respiratory distress syndrome patients secondary to sepsis Yu-ming Wang, Yan-jun Zheng, Ying Chen, Yun-chuan Huang, Wei-wei Chen, Ran Ji, Li-li Xu, Zhi-tao Yang, Hui-qiu Sheng, Hong-ping Qu, En-qiang Mao, Er-zhen Chen World Journal of Emergency Medicine. 2020, 11(4): 216-222. doi:10.5847/wjem.j.1920-8642.2020.04.003 Asbtract HTML PDF (107KB) Effects of sepsis on hippocampal volume and memory function Miao Yuan, Ding-yi Yan, Fang-shi Xu, Yi-di Zhao, Yang Zhou, Long-fei Pan World Journal of Emergency Medicine. 2020, 11(4): 223-230. doi:10.5847/wjem.j.1920-8642.2020.04.004 Asbtract HTML PDF (138KB) Death and do-not-resuscitate order in the emergency department: A single-center three-year retrospective study in the Chinese mainland Chuan-qi Ding, Yu-ping Zhang, Yu-wei Wang, Min-fei Yang, Sa Wang, Nian-qi Cui, Jing-fen Jin World Journal of Emergency Medicine. 2020, 11(4): 231-237. doi:10.5847/wjem.j.1920-8642.2020.04.005 Asbtract HTML PDF (144KB) BACKGROUND: Consenting to do-not-resuscitate (DNR) orders is an important and complex medical decision-making process in the treatment of patients at the end-of-life in emergency departments (EDs). The DNR decision in EDs has not been extensively studied, especially in the Chinese mainland. METHODS: This retrospective chart study of all deceased patients in the ED of a university hospital was conducted from January 2017 to December 2019. The patients with out-of-hospital cardiac arrest were excluded. RESULTS: There were 214 patients’ deaths in the ED in the three years. Among them, 132 patients were included in this study, whereas 82 with out-of-hospital cardiac arrest were excluded. There were 99 (75.0%) patients’ deaths after a DNR order medical decision, 64 (64.6%) patients signed the orders within 24 hours of the ED admission, 68 (68.7%) patients died within 24 hours after signing it, and 97 (98.0%) patients had DNR signed by the family surrogates. Multivariate analysis showed that four independent factors influenced the family surrogates’ decisions to sign the DNR orders: lack of referral (odds ratio [OR] 0.157, 95% confidence interval [CI] 0.047-0.529, P=0.003), ED length of stay (ED LOS) ≥72 hours (OR 5.889, 95% CI 1.290-26.885, P=0.022), acute myocardial infarction (AMI) (OR 0.017, 95% CI 0.001-0.279, P=0.004), and tracheal intubation (OR 0.028, 95% CI 0.007-0.120, P<0.001). CONCLUSIONS: In the Chinese mainland, the proportion of patients consenting for DNR order is lower than that of developed countries. The decision to sign DNR orders is mainly affected by referral, ED LOS, AMI, and trachea intubation.

4.
Article in Chinese | WPRIM | ID: wpr-828297

ABSTRACT

OBJECTIVE@#To investigate the effect and feasibility of closed reduction and internal fixation with PFNA in the treatment of intertrochanteric fracture of femur in the supine position without traction bed.@*METHODS@#From June 2014 to March 2018, 45 patients with intertrochanteric fracture of femur who were treated and followed up were analyzed retrospectively. There were 21 males and 24 females, with an average age of 67.4 years (43 to 92 years);18 cases on the left side and 27 on the right side. According to Evans Jensen classification, there were 7 patients of type Ⅱ, 17 patients of type Ⅲ, 16 patients of type Ⅳ and 5 patients of type Ⅴ. The time from injury to operationwas 2 to 6 days. The operation time, blood loss and fracture healing, closing time, postoperative complications and Harris score of hip joint were recorded.@*RESULTS@#The operation time of 45 patients was 35 to 80 min, with an average of 52.6 min;the intraoperative bleeding volume was 40 to 110 ml, with an average of 68.7 ml;the hospitalization time was 6 to 11 days, with an average of 8.4 days;the follow up time was 12 to 18 months, with an average of 14.7 months;the internal fixation of 2 patients failed, and 43 patients achieved bony healing;the deep vein thrombosis of the lower extremity in the perioperative period was 1 case, and the inferior vena cava filter was inserted;the internal fixation of 2 patients was cut out, and the hip was renovated. The incidence of complications was 8.9%(4 / 45). At the final follow up, Harris score of hip joint was 56 to 95 (81.30±8.40), including excellent 15 cases, good 26 cases, fair 2 cases and poor 2 cases.@*CONCLUSION@#It is safe and feasible to treat intertrochanteric fracture of femur with closed reduction and anti rotation intramedullary nailing under the bed without traction in a supine position. It has the advantages of small trauma and low complications, and the clinical effect is satisfactory. It is worth popularizing and using in basic hospitals.


Subject(s)
Adult , Aged , Aged, 80 and over , Bone Nails , Female , Fracture Fixation, Intramedullary , Hip Fractures , General Surgery , Humans , Male , Middle Aged , Retrospective Studies , Supine Position , Treatment Outcome
5.
Article in Chinese | WPRIM | ID: wpr-826682

ABSTRACT

OBJECTIVE@#To explore the clinical therapeutic effect of light and heat of moxibustion for knee osteoarthritis (KOA).@*METHODS@#A total of 216 patients with KOA were randomized into a traditional moxibustion group (72 cases, 8 cases dropped off), a moxibustion light group (72 cases, 9 cases dropped off) and a moxibustion heat group (72 cases, 10 cases dropped off).The special light-heat separation moxibustion cup was applied, the patients in the traditional moxibustion group received the treatment of moxibustion, the patients in the moxibustion light group received the treatment of moxibustion light and the patients in the moxibustion heat group received the treatment of moxibustion heat. The acupoint selection of the three groups was Neixiyan (EX-LE 4), Dubi (ST 35) and Zusanli (ST 36), the treatment was given 20 min each time, 3 times a week, 4 weeks were required totally, and the follow-up surveys were made 4 and 8 weeks after treatment. The scores of Western Ontario and McMaster University osteoarthritis index (WOMAC) and visual analogue scale (VAS) were observed before treatment, after 2 and 4 weeks of treatment, 4 and 8 weeks after treatment. The therapeutic effects were evaluated according to the criterion of patient global assessment (PGA) after 4 weeks of treatment and 8 weeks after treatment.@*RESULTS@#Compared with before treatment, the pain scores, stiffness scores, physical function scores and total scores of WOMAC were reduced after 2, 4 weeks of treatment and 4 weeks after treatment in the three groups (<0.05). The pain scores, stiffness scores, physical function scores and total scores of WOMAC were reduced 8 weeks after treatment in the traditional moxibustion group and the moxibustion heat group (<0.05). The stiffness score, physical function score and total score of WOMAC were reduced 8 weeks after treatment in the moxibustion light group (<0.05). The pain score, physical function score and total score of WOMAC in the traditional moxibustion group after 4 weeks of treatment were lower than the moxibustion light group (<0.05). Compared with before treatment, the VAS scores were reduced after 2, 4 weeks of treatment and 4 , 8 weeks after treatment in the three groups (<0.05). The improvement rates in the traditional moxibustion group and the moxibustion heat group after 4 weeks of treatment and 8 weeks after treatment were superior to the moxibustion light group (<0.05).@*CONCLUSION@#The light and heat of moxibustion have therapeutic effect for KOA, and the therapeutic effect of moxibustion heat is superior to moxibustion light.


Subject(s)
Acupuncture Points , Hot Temperature , Humans , Light , Moxibustion , Osteoarthritis, Knee , Therapeutics , Treatment Outcome
6.
Article in Chinese | WPRIM | ID: wpr-872705

ABSTRACT

Objective:To investigate the effect of Ru′ai Shuhou prescription (RSR) drug-containing serum on the proliferation and invasion ability of breast cancer cells MDA-MB-453 based on the biological axis of stromal cell-derived factor-1(SDF-1)/chemokine receptor 4 (CXCR4). Method:A model of MDA-MB-453 cells with SDF-1-induced high expression of CXCR4 was established, and the rat drug-serum containing RSR and blank rat serum were prepared respectively. The cells were divided into fetal bovine serum control group (Blank), blank rat serum group, SDF-1+blank rat serum group, SDF-1+RSR group, AMD3100+ SDF-1+blank rat serum group, and AMD3100+ SDF-1+RSR group. After intervention for 48 h, cell proliferation was detected by cell counting kit-8 (CCK-8) assay, cell invasion ability was detected by transwell assay, and mRNA and protein expressions of CXCR4, matrix metalloproteinase-2 (MMP-2) and MMP-9 were detected by Real-time fluorescence quantitative polymerase chain reaction (Real-time PCR) and Western blot, respectively. Result:As compared with the blank serum group, the proliferation of MDA-MB-453 cells was promoted and expression of CXCR4 mRNA was increased significantly when SDF-1 was 100 μg·L-1 (P<0.05). As compared with SDF-1+blank rat serum group, RSR inhibited the proliferation and invasion of MDA-MB-453 cells induced by SDF-1, and at the same time, down-regulated the mRNA and protein expressions of CXCR4, MMP-2 and MMP-9 (P<0.05). After pre-treatment with AMD3100 for 24 h, the inhibitory effect of RSR to cell proliferation was significantly increased (P<0.05), and meanwhile, the decreases in mRNA and protein expression of CXCR4, MMP-2 and MMP-9 were more obvious, with statistically significant differences (P<0.05). Conclusion:Through SDF-1/CXCR4 biological axis, RSR could down-regulate the expression of MMP-2 and MMP-9, reduce the degradation of extracellular matrix (ECM), and then inhibit the metastasis of MDA-MB-453 cells. In addition, it has a synergistic effect with CXCR4 inhibitor AMD3100.

7.
Article in Chinese | WPRIM | ID: wpr-806910

ABSTRACT

Objective@#To set up a chyle (n-hexane) testing method based on n-hexane extraction system.@*Methods@#The hydrothorax specimen which was positive in chyle testing was selected and the feasibility was evaluated by replace Diethyl ether with n-hexane. The optimal extraction volume ratio for the new chyle testing was confirmed and sultan Ⅲ dye process was improved. Then, the new chyle testing method and its standard operation process was established.A total of 120 specimens with triglyceride(TG)in different levels were collected and divided into three groups with 40 specimens for each group (group A. TG≤1.7 mmol/L; B. 5.6<TG<12.8 mmol/L; C. TG≥12.8 mmol/L). Then, 50 body fluid specimens were collected and used to confirm the above test results. A total of 134 real body fluid specimens were used to assessment the clinical using by review and calculating the clinical coincidence rate.@*Results@#N-hexane can replace Diethyl ether in the Chyle test. The extraction volume ratio of 1 ml sample plus 400 μl N-hexane is the best one and the sultan Ⅲ tube dying method is better than former direct smear. Compared with the old Chyle test using Diethyl ether, the new Chyle test using N-hexane is in good consistency with the Kappa value 0.95. The clinical coincidence rate of the above Chyle test reaches 94.8%(127/134) after the verification of 134 specimens.@*Conclusions@#A new N-hexane test is established successfully. It was convenient to operate with high security and little contamination and thus has a wide clinical application value.(Chin J Lab Med, 2018, 41: 527-530)

8.
Article in Chinese | WPRIM | ID: wpr-789440

ABSTRACT

Objective To ascertain the energy and main nutrients intake among residents in Changning District of Shanghai.Methods A stratified multistage random survey was conducted among 72 families to collect their ADI (acceptable daily intake) of nutrients through 3 d 24 h dietary recall and family condimentweigh surveys in comparison with recommended ADI.Results A total of 148 persons were included,of whom males were 75 and females 73.Every standard person daily vitamin B1,B2,A and calcium intake was relatively low.Calcium intake for 85.81% of persons was was lower than EAR.Vitamin A intake for 62.84% of persons was lower than EAR.Vitamin B1 intake for 77.7% of persons was lower than EAR.Vitamin B2 intake for 73.65% of persons was lower than EAR.In various age groups,except for women aged 18-49,contribution rate of fat in total energy exceeded recommended ADI.Conclusion Energy and main nutrients intake basically meet the needs of residents in Changning district of Shanghai.But some nutrients were still deficient severely.The source of energy nutrients was not well-balanced.More intake is recommended of milk and dairy product,soybean and bean product,vegetables and fruit.

9.
Herald of Medicine ; (12): 439-441, 2017.
Article in Chinese | WPRIM | ID: wpr-609588

ABSTRACT

Objective To investigate the role of clinical pharmacist in anti-infection therapy for patients with augmented renal clearance (ARC).Methods A case with multi-site severe infection after traffic accident was treated with anti-infection therapy.According to the characteristics of infection and pharmacokinetics,clinical pharmacist discussed the intervention by clinical pharmacist in terms of formulating anti-infection program and adjustment of individual dose.Results After consultation and evaluation by clinical pharmacist,the patient was diagnosed as ARC.According to pharmacokinetics characteristics reported by literature,vancomycin was adjusted to 1 g (once per 8 h).Based on detection result of pathogenic bacteria,meropenem was replaced by cefoperazone/sulbactam,and the dose was increased to 3 g (once per 6 h).And then,vancomycin concentration was detected again,and it reached > 10 μg· mL-1;pathogenic bacteria culture result was negative.This patient obtained good therapeutic effect.Conclusion Clinical pharmacist could assist physician on anti-infection treatment and dose adjustment of ARC patient,and improve ARC patient's therapeutic effect.

10.
China Pharmacy ; (12): 4527-4529, 2017.
Article in Chinese | WPRIM | ID: wpr-704453

ABSTRACT

OBJECTIVE:To investigate clinical efficacy of Sofren injection combined with Vinpocetine injection in the treatment of acute massive cerebral infarction,and its effects on hemorheological indexes and serum NOS.METHODS:A total of 60 patients with acute massive cerebral infarction in our hospital during Jan.2014-Jun.2016 were selected as research objects and divided into trial group and control group according to random number table,with 30 cases in each group.Control group was given Citicoline injection 0.5 g,ivgtt,qd.Trial group was additionally given Vinpocetine injection 20 mg added into 0.9% Sodium chloride injection 250 mL,ivgtt,qd;1 h later washing tube,they were given Sofren injection 10 mL added into 0.9% Sodium chloride injection 250 mL,ivgtt,for consecutive 14 d.Clinical efficacies and safety of 2 groups were observed,and hemorheological indexes and NOS levels were observed before and after treatment.RESULTS:The total response rate (83.33%)of trial group was significantly higher than that (50.00%) of control group,with statistical significance (P<0.05).Before treatment,there was no statistical significance in hemorheological indexes or serum NOS levels between 2 groups (P>0.05).After treatment,hemorheological indexes of 2 groups were decreased significantly,and the trial group was significantly lower than the control group.The level of serum NOS in 2 groups were increased significantly,and the trial group was significantly higher than the control group,with statistical significance (P<0.05).No obvious ADR was found in 2 groups.CONCLUSIONS:Sofren injection combined with Vinpocetine injection show significant therapeutic efficacy for acute massive cerebral infarction,can reduce blood viscosity and increase blood perfusion with good safety.

11.
Article in Chinese | WPRIM | ID: wpr-701535

ABSTRACT

Objective To investigate anorectal infection with Neisseria gonorrhoeae (NG) and Chlamydia trachomatis (CT) among men who have sex with men (MSM) with anorectal condyloma acuminatum(CA),and provide evidence for the clinical diagnosis and treatment of anorectal CA.Methods Anorectal swabs were obtained from MSM who were diagnosed with anorectal CA(trial group) and without CA(control group),nucleic acid fragments of NG and CT were detected by fluorescent quantitative polymerase chain reaction.Data about social demographic characteristics and sexual behaviors of investigated people were collected,compared and analyzed.Results A total of 158 patients were enrolled in this study,63 were in trial group and 95 in control group.Among 63 patients in trial group,infection rate of NG and CT were 17.46% and 28.57% respectively,co infection rate of NG and CT was 12.70%;in control group,infection rate of NG and CT were 6.32 % and 9.47 % respectively,co-infection rate of NG and CT was 2.16%;infection rate of NG and CT,as well as co-infection rate of NG and CT in trial group were all significantly higher than control group(all P<0.05).Conclusion Infection rate of NG and CT is high in MSM with anorectal CA,suggesting that more attention should be paid to the screening of NG,CT and other sexually transmitted infection among those who were clinically diagnosed with anorectal CA.

12.
The Journal of Practical Medicine ; (24): 3216-3219, 2016.
Article in Chinese | WPRIM | ID: wpr-503246

ABSTRACT

Objective To evaluate the effectiveness of a newly designed modular flexible ureteroscope with holmium laser lithotripsy for the treatment of renal calculi based. Methods 40 patients were treated with modular flexible ureteroscopic lithotripsy (German Polydiagnost) with holmium laser. 40 patients were treated by traditional flexible ureteroscopic lithotripsy. Their therapeutic effects were compared. Results For modular flexible ureteroscopic lithotripsy group, 37 patients underwent successful operation, with lithotripsy with operation time of (86.0 ± 34.4) min and postoperative hospital stay of (5.3 ± 1.6) days. No severe complication including ureteral perforation, high fever or severe bleeding occurred. One month after the operation, KUB and B-ultrasonography showed complete stone free in 35 patients. Residual calculi (0. 4 cm in diameter) in the calyces were found in 2 patients. Medication and postural drainage therapy were applied. Two weeks later , KUB and B-ultrasonography showed that the residual stones have been removed completely. There was no significant differences in stone size , operation time, rate of calculus clearance, the incidence of postoperative complications, operating time and duration of postoperative hospitalization between the traditional flexible ureteroscopic lithotripsy group and modular ureteroscopic lithotripsy group. Conclusions The modular flexible ureteroscope is effective and safe in treating reanl calculi. It has similar surgical efficacy as traditional flexible ureteroscope , but is more costly effective in terms of maintenance costs.

13.
Chinese Medical Journal ; (24): 1682-1687, 2016.
Article in English | WPRIM | ID: wpr-251321

ABSTRACT

<p><b>BACKGROUND</b>It is unclear that how to decide the calcium infusion rate during continuous veno-venous hemofiltration (CVVH) with regional citrate anticoagulation (RCA). This study aimed to assess the determinants of calcium infusion rate during CVVH with RCA in critically ill patients with acute kidney injury (AKI).</p><p><b>METHODS</b>A total of 18 patients with AKI requiring CVVH were prospectively analyzed. Postdilution CVVH was performed with a fixed blood flow rate of 150 ml/min and a replacement fluid flow rate of 2000 ml/h for each new circuit. The infusion of 4% trisodium citrate was started at a rate of 29.9 mmol/h prefilter and adjusted according to postfilter ionized calcium. The infusion of 10% calcium gluconate was initiated at a rate of 5.5 mmol/h and adjusted according to systemic ionized calcium. The infusion rate of trisodium citrate and calcium gluconate as well as ultrafiltrate flow rate were recorded at 1, 2, 4, 6, 12, and 24 h after starting CVVH, respectively. The calcium loss rate by CVVH was also calculated.</p><p><b>RESULTS</b>Fifty-seven sessions of CVVH were performed in 18 AKI patients. The citrate infusion rate, calcium loss rate by CVVH, and calcium infusion rate were 31.30 (interquartile range: 2.70), 4.60 ± 0.48, and 5.50 ± 0.35 mmol/h, respectively. The calcium infusion rate was significantly higher than that of calcium loss rate by CVVH (P < 0.01). The correlation coefficient between the calcium and citrate infusion rates, and calcium infusion and calcium loss rates by CVVH was -0.031 (P > 0.05) and 0.932 (P < 0.01), respectively. In addition, calcium infusion rate (mmol/h) = 1.77 + 0.8 × (calcium loss rate by CVVH, mmol/h).</p><p><b>CONCLUSIONS</b>The calcium infusion rate correlates significantly with the calcium loss rate by CVVH but not with the citrate infusion rate in a fixed blood flow rate during CVVH with RCA.</p>


Subject(s)
Acute Kidney Injury , Drug Therapy , Therapeutics , Adult , Aged , Anticoagulants , Therapeutic Uses , Calcium , Therapeutic Uses , Citric Acid , Therapeutic Uses , Female , Hemofiltration , Methods , Humans , Male , Middle Aged , Prospective Studies
14.
Article in Chinese | WPRIM | ID: wpr-230407

ABSTRACT

<p><b>OBJECTIVE</b>To analyze the therapeutic effect of plate cable system and cortical strut bone graft in the prosthesis revision of the total hip arthroplasty for the treatment of Vancouver type B1 periprosthetic femoral fracture.</p><p><b>METHODS</b>A total of 8 patients were selected from January 2006 to January 2013, including 6 males and 2 females, aged from 56 to 74 years old (62.52 years old on average). All the cases were treated by the long plate cable system and appropriate cortical strut bone graft. Harris score was used to evaluate the hip functions before and after the operation. Prosthesis stability and the bony union were assessed by the digital radiography.</p><p><b>RESULTS</b>All the patients were followed up for 45 months on average ranging from 24 to 60 months after operation. All the fractures reached union, and there was no infection, stem loosening, nonunion and malunion. The Harris score was 28.45±5.78 before operation, which was improved to 83.46±10.21 after operation. X ray showed that the prosthesis was stable, and the host bone and bone graft achieved bony union in 7 patients;and the other 1 patient need further operation of revision around the loose stem.</p><p><b>CONCLUSIONS</b>The prosthesis revision of the total hip arthroplasty with the locking plate and cortical strut bone graft used for the Vancouver type B1 periprosthetic proximal femur fractures has the advantages of simple manipulation, less complications, good recovery of the hip function and can improve bone quality to provide favorable conditions for operation of revision.</p>

15.
Article in Chinese | WPRIM | ID: wpr-281365

ABSTRACT

<p><b>OBJECTIVE</b>To investigate clinical effect of locking plate assisted intramedullary nail in treating femoral hypertrophic nonunions after intramedullary fixation.</p><p><b>METHODS</b>From January 2006 to December 2015, clinical data of 40 patients with femoral nonunions after intramedullary nail internal fixation treated with interlock plate internal fixation were respectively analyzed. Among patients, there were 22 males and 18 females, aged from 21 to 60 years old with an average age of (35.0±2.2) years. The time of bone nonunion ranged from 9 to 24 months with an average of (14.1±1.5) months. Operative time, blood loss, hospital stay , complications, bone healing time and recovery of function were observed, Evanich scoring was applied to evaluate clinical effects.</p><p><b>RESULTS</b>All patients were followed up from 12 to 24 months with an average of (15.2±2.7) months. Operative time ranged from 105.1 to 130.2 min with an average of (112.5±10.2) min;blood loss ranged from 207.0 to 250.2 ml with an average of (220.6±14.7)ml; hospital stay ranged from 10 to 15 days with an average of (12.2±1.5) d. All patients were obtained bone healing from 4 to 12 months after additional plate internal fixation, with an average of (6.2±1.9) months. No implant failure and infection occurred after operation. According to Evanich scoring of knee joint, total score was 83.2±5.6, 22 cases obtained excellent results, 17 good and 1 fair.</p><p><b>CONCLUSIONS</b>Limited incision approach locking plate with original intramedullary nail fixation for femoral hypertrophic nonunions subsequent to intramedullary fixation could receive good results, increase stability of fracture, and could increase stability of fracture, provide environment for callus growth. It had advantages of high cure rate, less trauma and complications, and also could do functional exercise earlier to promote good recovery of knee joint.</p>

16.
Military Medical Sciences ; (12): 304-307, 2016.
Article in Chinese | WPRIM | ID: wpr-486471

ABSTRACT

Objective To study the effect of Golgi protein 73(GP73) on inflammation, and to reveal the effect of GP73 on tumorigenesis and metastasis.Methods The transcriptional activity of NF-κB and the expression of IL-1β, IL-6 and TNF-αwith GP73 overexpression or knockdown were detected to illuminate the role of GP73 in inflammation.According to the TCGA database, the correlation between the transcriptional activity of GP73 and the expression of NF-κB, IL-1β, IL-6 and TNF-αwas analyzed to determine the role of GP73 in tumor inflammation.Results Correlative analysis showed that there was a positive correlation between the expression of GP73 with NF-κB, IL-1β, IL-6 and TNF-α.The transcriptional activity of NF-κB was upregulated by GP73 overexpression, but downregulated by GP73 knockdown.The expression of IL-1β, IL-6 and TNF-αwas upregulated by GP73 overexpression.Ammonium pyrrolidinedithiocarbamate ( PDTC ) was in-volved in inflammation reaction induced by GP73.Conclusion GP73 is possibly involved in inflammation and promotes tu-morigenesis and metastasis.

17.
Article in Chinese | WPRIM | ID: wpr-480765

ABSTRACT

Objective To investigate the clinical and pathological features of microscopic thymoma(MT).Methods The histopathological features of 12 cases of MT were observed by histopathologic and immunohistochemical methods.The pathological morphology,diagnosis,and differential diagnosis were discussed combined with literature.Results 6 cases of MT were accompanied by myasthenia gravis(MG) symptoms.Focal hyperplastic thymic epithelial islands were accompanied by large tracts of mature adipose tissue in 12 cases of MTs,and immunohistochemistry showed CK positive.Cyst formation was found in 5 cases,lymphoid hyperplasia in 7 cases,and vascular proliferation in 5 cases.Conclusions MG may be the clinical manifestation of MT.MT can occur in thymic cortex,medulla and cortex and medulla junction.Since the tumor is small and the lesions are multiple,it can not be found by X-ray or CT examination.Diagnosis depends on histopathological examination.Correct understanding of the clinical and pathological features of MT has guiding significance on the treatment and prognosis judgment of MT.Thymic resection was recommended for MG patients either with or without thymoma.

18.
Article in Chinese | WPRIM | ID: wpr-345238

ABSTRACT

<p><b>OBJECTIVE</b>To study clinical effects of one-hole microplate internal fixation for the treatment of collateral ligament injuries of the metacarpophalangeal joint of the thumb combined with fracture.</p><p><b>METHODS</b>Twenty-two patients (16 males, 6 females) with collateral ligament injuries of the metacarpophalangeal joint of the thumb combined fracture were treated with one-hole microplate internal fixation. The age of the patients ranged from 18 to 53 years old with a mean age of 28.5 years old. The duration from injury to surgery ranged from 2 hours to 2 months, and the mean time was 6 days. All the patients had collateral ligament injuries combined with fracture of the metacarpophalangeal joint of the thumb. Thirteen patients had injuries in the right hand and 9 patients had injuries in the left hand. There were 18 cases of closed wound and 4 cases of open wound. Eighteen patients had fresh injuries (< 2 weeks) and 4 had old injuries (> 2 weeks). Sixteen patients had injuries in the ulnar collateral ligament of the thumb combined with fracture, 6 patients had radial collateral ligament injuries of the thumb combined with fracture, 4 cases of which were complicated with injuries of abductor pollicis brevis and the end of the flexor pollicis brevis tender. The size of the avulsed fragment was about 3.0 mm x 4.0 mm to 6.0 mm x 7.0 mm.</p><p><b>RESULTS</b>The incisions of 22 patients healed by first intention. The follow-up periods ranged from 6 months to 5 years old,with an average of 2.5 years old. The thumb function was evaluated by Saetta and other evaluation criteria, and 20 patients got an excellent result and 2 good.</p><p><b>CONCLUSION</b>The application of one-hole microplate internal fixation in treating collateral ligament injuries with fracture of the metacarpophalangeal joint of the thumb is an effective method.</p>


Subject(s)
Adolescent , Adult , Bone Plates , Collateral Ligaments , Wounds and Injuries , General Surgery , Female , Fracture Fixation, Internal , Methods , Fractures, Bone , General Surgery , Humans , Male , Metacarpophalangeal Joint , Wounds and Injuries , General Surgery , Middle Aged , Thumb , Wounds and Injuries , General Surgery , Young Adult
19.
Article in English | WPRIM | ID: wpr-789609

ABSTRACT

@#BACKGROUND: Perforin gene (PRF1) mutations have been reported in patients with lymphoma, but the prevalence and characteristics of PRF1 mutation have not been identified in Chinese patients with lymphoma. METHODS: Seventy-seven patients with lymphoma, including 6 patients with Hodgkin lymphoma and 71 patients with non-Hodgkin lymphoma, were recruited. DNA samples from peripheral blood were used for PRF1 mutation detection by the PCR-sequencing method. RESULTS: Eleven novel PRF1 mutations were found in 8 of the 77 patients with lymphoma. Biallelic or compound monoallelic missense mutations in 3 patients indicated the severe impairment of perforin function, monoallelic missense mutations in 3 patients possibly contributed a genetic predisposition to malignancies, and synonymous mutations in 2 patients showed unknown significance. CONCLUSIONS: The frequency of EBV infection was similar in lymphoma patients with PRF1 mutations and those without the mutations. The same PRF1 mutations were also found in DNA samples from nails or hair follicles from 4 patients with PRF1 mutations, suggesting that these mutations may be of germ-line origin.

20.
Article in Chinese | WPRIM | ID: wpr-636191

ABSTRACT

Background Trans-scleral fixation of intraoculalen(IOL) hamade greaprogress,buthe long-term stability of the implanposition of IOL aftesurgery inoideal.Objective Thistudy wato investigate the relevanfactorof IOL dislocation aftetrans-scleral fixation of IOL.Methodrespective case-observational study wadesigned.The clinical datfrom 321 eyeof 321 patientwho had received trans-scleral fixation of IOL were collected.total of 263 patientcompleted the effeetive follow-up,and 164 patientwith the follow-up fomore than 5 years.No IOL dislocation occurred within 5 yearin all 263 eyes.The relationship between IOL material,IOL implantation location,the time of IOL dislocation and the intraoculapressure with IOL dislocation were analyzed.ResultIOL dislocation appeared 7-10 yearaftesurgery in 9 eyewith an incidence rate of 5.49%.Breakage of IOL suture wafound in all the eyewith IOL dislocation.Dislocation wamore frequently found in IOL performed in the oblique position than thain the horizontal position (10.0% vs.3.5%).The rate of IOL dislocation wahighesin traumatiretinal detachmeneyes,apercentage of 33.33%.Single piece IOL wamore easily dislocated.ConclusionThe breakage of anchosuturein IOL ileading cause of IOL dislocation aftetrans-scleral fixation of intraoculalens,which may be associated with the weighresulting from the fixation procesin non-level angulaIOL.Iirecommended thaIOL should be fixed in the horizontal position.

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