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1.
Journal of Preventive Medicine ; (12): 799-802, 2022.
Article in Chinese | WPRIM | ID: wpr-936798

ABSTRACT

Abstract@#Bisphenols (BPs), which are mainly used in the production of polycarbonates and epoxy resins, are common endocrine disruptors (EDCs) in natural environments. Human mainly exposes to BPs via ingestion and skin. Previous studies have deteted BPs in human urine, serum, and milk samples, and children and pregnant women have a high level of exposure to to BPs. Based on international and national publications pertaining to BPs since 2009, this review describes the exposure to BPs in human urine, serum, and milk and summarizes neuroendocrine dysfunctions, oxidative stress injury and epigenetics changes caused by BPs, so as to provide insights into reducing the exposure to and health risk of BPs.

2.
Article in Chinese | WPRIM | ID: wpr-920363

ABSTRACT

Objective To compare the effects of random forest and SARIMA (Seasonal Autoregressive Integrated Moving Average) on predicting incidence rate of brucellosis. Methods Using Brucellosis cases reported in the China Disease Prevention and Control Information System from 2005 to 2017, two models, random forest and SARIMA, were established for training and forecasting, and the forecasting results of the two models were compared. Results The R2 (R Squared) and RMSE (Root Mean Squared Error) of SARIMA model and random forest model are 0.904, 0.034351, 0.927 and 0.03345 respectively. Conclusion Both models have high prediction accuracy and can predict the incidence of brucellosis. Random forest prediction is a little bit better than SARIMA model and has more practical value.

3.
Article in Chinese | WPRIM | ID: wpr-932671

ABSTRACT

The effect of radiotherapy on anti-tumor immunity is bidirectional, immunotherapy, especially the combination of immune checkpoint inhibitors (ICIs) and radiotherapy, can produce synergistic effects on anti-tumor immunity. Compared with conventional radiotherapy, stereotactic ablative body radiotherapy (SABR) can achieve high-precision and high-dose irradiation on target lesions, and has stronger anti-tumor immune activation effect. At the same time, due to the steep dose gradient, SABR can better protect the surrounding normal tissues, which is an effective means for the rapid control of local lesions in advanced non-small cell lung cancer (NSCLC). ICIs are an important component of standard treatment for advanced NSCLC. There is growing evidence that SABR in combination with ICIs can benefit patients with advanced NSCLC. This article reviews the biological basis and clinical research progress on the combination of these two therapies, aiming to provide reference for the domestic counterparts to better use this new treatment model.

4.
Article in Chinese | WPRIM | ID: wpr-932603

ABSTRACT

The cold source system of a nuclear power plant, as important part of a nuclear power project, is of great significance to guarantee the safe operation of a nuclear power plant. In recent years, there have been some cases of marine organism blockage at cold source intake at coastal nuclear power plants in China, which has adversely affected the safety and economy of nuclear power plants. According to the research result of cold source safety in coastal nuclear power plants in China and in compliance with the requirements of nuclear safety regulatory control and the engineering practice experience, the causes of, and countermeasures against, marine organism blockage at cold source intake are analyzed to further improve the safety and economy of nuclear power plants.

5.
Journal of Preventive Medicine ; (12): 914-918, 2022.
Article in Chinese | WPRIM | ID: wpr-940866

ABSTRACT

Objective@#To investigate the status of iodine nutrition and prevalence of goiter among children at ages of 8 to 10 years in Zhejiang Province in 2021, so as to provide insights into the management of iodine deficiency in children.@*Methods @#A total of 90 counties (districts) were sampled as field survey sites from 11 cities of Zhejiang Province using a multi-stage stratified random sampling method in 2021, and non-residential children at ages of 8 to 10 years in these sites were sampled as study subjects. Subjects' household edible salt samples and random urine samples were collected. The iodine content in salt and urinary iodine level were determined using the direct titration method and arsenic-cerium catalytic spectrophotometry for evaluation of iodine nutrition among children. In addition, the lateral lobe of the thyroid gland was measured using ultrasound, and the prevalence of goiter was estimated. @*Results@#A total of 19 363 children were recruited, including 9 710 male children and 9 653 female children, with a male to female ratio of 1.01︰1, and there were 10 704 urban children (55.28%) and 8 659 rural children (44.72%), 9 149 children living in coastal areas (47.25%) and 10 214 children in inland regions (52.75%). The mean iodine content was (19.79±9.25) mg/kg in salt, and the coverage of qualified iodized salt (15 252) was 78.77%. The coverage of qualified iodized salt was significantly lower in urban children than in rural children (76.70% vs. 81.21%; χ2=68.301, P<0.001), and was lower in children living in coastal regions than in inland regions (68.05% vs. 88.27%; χ2=1 270.769, P<0.001). The median urinary iodine concentration was 195.1 μg/L, and the household iodine content in salt correlated positively with urinary iodine concentration in children (rs=0.383, P<0.001). There were 2 885 children with iodine deficiency (14.90%), 7 137 children with adequate iodine (36.86%), 5 414 children with excessive iodine intake (27.96%), and 3 927 children with iodine overdose (20.28%), and the distribution of iodine nutrition in children varied significantly in regions (χ2=283.277, P<0.001) and gender (χ2=126.349, P<0.001). The prevalence of goiter was 2.45% among 7 195 children receiving ultrasound examinations, and a higher prevalence rate of goiter was detected in urban children than in rural children (2.76% vs. 2.00%; χ2=3.962, P=0.047). @*Conclusions @#The overall urinary iodine nutrition was adequate among children at ages of 8 to 10 years in Zhejiang Province in 2021, and the prevalence of goiter in children fell within the threshold defined in the criteria of elimination of iodine deficiency. However, the supervision of the iodized salt quality remains to be improved and iodine deficiency control remains to be reinforced.

6.
Journal of Preventive Medicine ; (12): 902-905, 2022.
Article in Chinese | WPRIM | ID: wpr-940864

ABSTRACT

Abstract:@#With the increasing rise in antidepressant consumption, more and more antidepressants and their metabolic products enter into water and soil environments. This will cause toxicity to animals living in these environments, and antidepressants may be transferred to humans via food chain, leading to human health risks. Based on national and international publications pertaining to environmental pollution and toxic effects of antidepressants during the period between 2005 and 2021, this review summarizes the biological accumulation, acute toxicity, reproductive and developmental toxicity, metabolic effects and biological behavior changes of antidepressants, so as to provide insights into the elucidation of the impact of antidepressants on human health risks.

7.
Article in Chinese | WPRIM | ID: wpr-910496

ABSTRACT

Objective:To explore the genes and molecular markers related to the sensitivity to concurrent chemoradiotherapy in patients with locally advanced esophageal squamous cell carcinoma.Methods:The peripheral blood sample of 31 patients with locally advanced esophageal squamous cell carcinoma receiving radical concurrent chemoradiotherapy was collected and the plasma circulating free DNA (cf-DNA) was extracted before treatment. The target gene capture sequencing technology based on NovaseQ6000 high-throughput sequencing platform was employed to detect the changes of target genes and tumor mutation burden (TMB). According to the short-term efficacy of chemoradiotherapy, all patients were divided into the chemoradiotherapy-sensitive group (CR+ PR) and chemoradiotherapy-resistant group (SD+ PD). Bioinformatics and clinical data were adopted to analyze the differences of gene mutation and TMB between two groups.Results:In the sequencing data of 31 patients, the tumor-related genes with a mutation frequency above 10% were Tp53, Notch1, BRAF, FGFR4, CDKN2A, ATRX and Axin2, which were almost equally distributed between the CR+ PR and SD+ PD groups. High-frequency mutant genes were associated with 7 signaling pathways, mainly involved in the RTK/RAS signaling pathways. The TMB value in the CR+ PR group was higher than that in the SD+ PD group ( P=0.04), however, the mutation rate of GXYLT1 and KRT18 genes in the SD+ PD group was higher than that in the CR+ PR group ( P<0.05). Conclusions:Tp53, Notch1 and CDKN2A may be the high-frequency mutant genes associated with the incidence and progression of esophageal squamous cell carcinoma. KRT18, GXYLT1 and TMB are closely correlated with the sensitivity to concurrent chemoradiotherapy of patients with locally advanced esophageal squamous cell carcinoma.

8.
Chinese Journal of Endemiology ; (12): 670-673, 2021.
Article in Chinese | WPRIM | ID: wpr-909075

ABSTRACT

Objective:To investigate the effect of amphotericin B or its liposomes combined with antimony sodium gluconate (antimonial) in the treatment of refractory Kala-azar.Methods:Four patients with Kala-azar who relapsed or were resistant to antimony after treatment were admitted to the First Hospital of Lanzhou University. The clinical medical records were retrospectively analyzed, including the general information (gender, age, etc), diagnosis and treatment process, clinical manifestations, treatment methods and treatment effect.Results:The clinical symptoms of four patients were relieved after treatment with amphotericin B or its liposomes combined with antimonial. Reexamination of bone marrow smear showed no Leishman-Donovan body. There was no recurrence after six months of follow-up.Conclusion:Amphotericin B or its liposomes combined with antimonial can be used in the treatment of refractory Kala-azar.

9.
Article in Chinese | WPRIM | ID: wpr-908664

ABSTRACT

Objective:To study the application value of flexible endoscopic examination of swallowing(FEES) for the aspiration screening, the diagnosis of dysphagia and evaluation of the therapeutic effectin acute stroke patients with dysphagia.Methods:Three hundred and seventy-three patients with acute stroke who hospitalized from October 2015 to January 2020 in Dalian Municipal Central Hospital Affiliated of Dalian Medical University and underwent FEES for analyzing the characteristic performance were enrolled, and 11 cases of them were examined by video fluoroscopic swallowing study (VFSS). The results of the reliability of diagnosis dysphagia of the two methods were compared. The results of FEES for assessing the recovery effect after treatment were evaluated.Results:In 373 patients, the FEES revealed 268 cases(71.85%) of aspiration (99 cases) were recessive aspiration, which was better than that in water swallow test (50.94%, 190/373). Patients with potential cricopharyngeus achalasia got the same results through both of VFSS and FEES. FEES could provide more positive indicators and guide clinical rehabilitation treatment and objective assessment of rehabilitation effectiveness.Conclusions:Acute stroke patients with dysphagia have characteristic laryngeal performance. FEES is simple to operate and has high application value.

10.
Article in Chinese | WPRIM | ID: wpr-906596

ABSTRACT

@#Objective    To explore the hemodynamic effects of inhaled nitric oxide (iNO) on postoperative hemodynamic in patients with cyanotic congenital heart disease (CHD) combined with decreased pulmonary blood flow. Methods    From 2014 to 2018, there were 1 764 patients who received corrective repair of cyanotic CHD with decreased pulmonary blood flow in the Department of Pediatric Cardiac Surgery of Fuwai Hospital. We included 61 patients with the ratio of right ventricular systolic pressure to systolic blood pressure (SBP) ≥75% after weaning from cardiopulmonary bypass. There were 41 males and 20 females, with the age of 20.5 (9.0, 39.0) months and weight of 12.5±7.8 kg. The patients were divided into two groups: a conventional group (33 patients, conventional therapy only) and a combined therapy group (28 patients, iNO combined with conventional therapy). The hemodynamics during the first 24 hours after iNO therapy and the in-hospital outcomes of the two groups were investigated and compared. Results    There was no statistical difference between the two groups in demographic characteristics and surgical parameters (P>0.05). The hemodynamic effects of iNO within 24 hours included the decrease in the vasoactive inotropic score (VIS, 21.6±6.6 vs. 17.3±7.2, P=0.020) along with the increase in blood pressure (SBP: 73.7±9.7 mm Hg vs. 90.8±9.1 mm Hg, P<0.001) , the decrease in central venous pressure (10.0±3.1 mm Hg vs. 7.9±2.1 mm Hg, P=0.020), the decrease in lactate (2.2±1.7 mmol/L vs. 1.2± 0.5 mmol/L, P<0.001) and increase in urine output [2.8±1.7 mL/(kg·h) vs. 4.9±2.2 mL/(kg·h), P<0.001]. The decrease of VIS at 24 h after the surgery in the conventional therapy group was not statistically significant (22.1±7.9 vs. 20.0±8.5, P=0.232). Besides, we discovered that the need for renal replacement therapy (RRT) was less in the combined therapy group than that in the conventional therapy group, especially in the moderate complicated surgery [risk adjustment in congenital heart surgery (RACHS-1) ≤3] subgroup (9.5% vs. 40.7%, P=0.016). Conclusion    In pediatric patients after corrective repair of cyanotic and pulmonary blood follow decreased CHD with increased pulmonary vascular resistance, iNO combined with conventional therapy can improve the hemodynamics effectively. Compared with the conventional therapy, the combined therapy with iNO can decrease the VIS and the need for RRT, which is beneficial to the postoperative recovery of patients.

11.
Article in Chinese | WPRIM | ID: wpr-885527

ABSTRACT

Objective:To analyze the applicability and feasibility of a cell-free DNA barcode-enabled single-molecule test (cfBEST) in non-invasive prenatal diagnosis of phenylketonuria.Methods:This study recruited four pregnant women who were prenatally diagnosed as heterozygous carriers of hot spot mutations in the PAH gene from pedigrees with phenylketonuria at the First Affiliated Hospital of Zhengzhou University from July to September 2019. The frequency of mutations in maternal plasma cell-free DNA and the fetuses' genotypes were analyzed by cfBEST. Nested polymerase chain reaction primers were designed to amplify the mutation sites in each pedigree. The results of cfBEST were compared with those of invasive prenatal diagnosis. Descriptive analysis was used for data analysis. Results:In pedigree 1, the frequency of c.603T>G and c.842+2T>A mutations in maternal plasma cell-free DNA were 48.40% (291/601) and 9.70% (61/628), which was detected by cfBEST. The fetus was diagnosed with phenylketonuria with two heterozygous mutations. In pedigree 2, the frequency of c.1238G>C and c.842+2T>A mutations in maternal plasma cell-free DNA was 43.70% (786/1 798) and 0% (0/1 550), respectively. Both mutations were wild-type, and the fetus was neither phenylketonuria nor a carrier. In pedigree 3, the frequency of c.1045T>G and c.728G>A mutations in maternal plasma cell-free DNA was 44.00% (930/2 112) and 0% (0/705), respectively, suggesting that both mutations in the fetus were wild-type, and the fetus was neither phenylketonuria nor a carrier. In pedigree 4, the frequency of c.755G>A and c.728G>A mutations were 45.40% (743/1 637) and 4.50% (28/849), respectively, which indicated that the former was wild-type, and the latter was heterozygous; namely the fetus was a carrier of phenylketonuria. The results of cfBEST were consistent with those of invasive prenatal diagnosis. Three pedigrees (Pedigree 2, 3 and 4) continued the pregnancy to full-term, and the phenylalanine levels in the neonates were all below 120 μmol/L. No abnormalities were reported in those three infants during follow-ups at one, three, and six months after birth.Conclusions:The cfBEST could be used for non-invasive prenatal diagnosis of phenylketonuria caused by PAH gene mutation, but further studies with a larger sample size are needed.

12.
Article in Chinese | WPRIM | ID: wpr-884581

ABSTRACT

Radiotherapy is one of the most important treatment methods for esophageal carcinoma. However, radiation resistance is the biggest problem and obstacle for patients with esophageal carcinoma treated with radiotherapy. Radiosensitivity is the focus and difficulty in the study of tumor radiobiology. A variety of genes and their expression products affect the radiosensitivity of esophageal carcinoma. Consequently, if the genes and biomarkers that determine radiosensitivity can be detected before radiotherapy, it will play a vital role in investigating the mechanism of radiotherapy sensitization, targeted therapy and radiotherapy efficacy prediction to guide individual therapy. In this article, major genes and biomarkers associated with esophageal carcinoma radiosensitivity in recent years were reviewed from different signal transduction pathways.

13.
Article in Chinese | WPRIM | ID: wpr-879576

ABSTRACT

OBJECTIVE@#To assess the value of non-invasive prenatal testing based on cfDNA barcode-enabled single-molecule test (cfBEST) for the prenatal diagnosis of oculocutaneous albinism type I in a family.@*METHODS@#Prenatal genetic diagnosis was carried out by using the cfBEST-based method as well as invasive prenatal diagnosis through amniocentesis. The outcome of the pregnancy was followed up.@*RESULTS@#Non-invasive prenatal testing based on cfBEST showed a fetal DNA concentration of 6.6%, with the proportion of c.929_930insC (p.Arg311Lysfs*7) and c.1037-7T>A mutations being 45.7% and 0%, respectively. The posterior frequency of the negative results was 1, suggesting that the fetus carried neither of the two mutations. The result was consistent with that of invasive prenatal diagnosis, and the follow-up found that the fetus was normal.@*CONCLUSION@#Non-invasive prenatal testing based on cfBEST can be used to detect maternal and fetal genotypes in maternal cell-free DNA, which is clinically feasible.


Subject(s)
Albinism , Albinism, Oculocutaneous/genetics , Amniocentesis , Cell-Free Nucleic Acids , Female , Humans , Pregnancy , Prenatal Diagnosis
14.
Article in Chinese | WPRIM | ID: wpr-872198

ABSTRACT

In hospital performance evaluation, significant differences in the work objects, work content and economic operation of various departments result in the lack of indicators comparability between different departments. This has become a prominent problem that hospitals have been unable to effectively solve for a long time, and has also affected the fairness of performance distribution to a certain extent. Starting from the dilemma of cost-benefit evaluation, the authors put forward the basic concepts of the sequence advance and retreat method, and comprehensively elaborated the implementation steps and operating points of the performance assessment using the sequence advance and retreat method. It is pointed out that the sequence advance and retreat method has four characteristics: weakening the differences between departments by vertical and horizontal combination, avoiding the deviation of guidance by scientific comparison, highlighting the incentive effect by grade differentiation, and reflecting the advantages and disadvantages by end adjustment. The value of this method in the hospital performance appraisal system is discussed from three aspects: promoting the de-profitization process of hospitals, achieving fair distribution of hospital performance, and strengthening the guidance of hospital performance management. Based on such studies, this article provides new methods and ideas for building a more scientific and fair performance evaluation system.

15.
Chinese Journal of Microsurgery ; (6): 481-485, 2020.
Article in Chinese | WPRIM | ID: wpr-871564

ABSTRACT

Objective:To investigate the microsurgical anatomy of thoracodorsal artery perforators, and the clinical effect in repairing the soft tissue defect of hand with the thoracodorsal artery perforator flap (TAP).Methods:From October, 2014 to November, 2014, the axillary arteries in 10 thoracodorsal specimens were perfused with red latex. The number and diameter of the perforators of the thoracodorsal arteries were mearsured. From January, 2015 to February, 2019, 52 cases of soft tissue defects in hand combined with bone and extensor tendon exposure were repaired with TAP. The patients were followed-up in outpatient department to observe the clinical efficacy.Results:The number of perforators of thoracodorsal artery was 2-4 mostly, and 3 perforators was the most. The diameter of perforators was 0.22-0.68 mm, and the distance between the perforating point and the posterior axillary wall was 5.2-11.8 cm. All the operations were completed successfully, and the donor sites were closed directly. In 52 cases, 48 flaps survived, 2 had partially necrosis, and 2 had completely necrosis. The patients were followed-up for 5 to 24 months. The blood supply of the flaps was good with soft texture and good appearance.Conclusion:The TAP is an ideal flap because of its thin in thickness, concealed donor area and no obvious scar after direct suture.

16.
Chinese Journal of Microsurgery ; (6): 248-253, 2020.
Article in Chinese | WPRIM | ID: wpr-871540

ABSTRACT

Objective:To report the effect of a new method to reconstruct the sensory function of sural flap and to share the experience.Methods:From May, 2018 to November, 2019, 12 patients with hand and foot injuries were treated with sural flap. Blood vessel CDFI examination was performed on 24 shanks of 12 patients before operation. The perforator site was 6.8 -20.5 cm from the lateral malleolus apex, with an average of 12.5 cm. The inner diameter of the root was 1.0-1.8 mm, with an average of 1.35 mm. Before operation, the velocity of blood flow velocity at the vascular root was 28.7-51.6 m/s, with an average of 38.8 m/s. In order to reconstruct the sensation of flap, in the design of free sural skin flaps of 8 patients, the distal sural nerve or medial and lateral sural cutaneous nerve of the perforating branch was anastomosed with the cutaneous nerve of the recipient region. In 2 cases of propeller sural flap, the severed end of sural nerve on the small propeller side was directly anastomosed or bridged with the cutaneous nerve on at the proximal edge of the skin flap donor site. In 2 cases of distal fascial-pedicled sural flap, the lateral malleolus was cut in a distal longitudinal shape to separate the sural nerve and accompanying blood vessels. After distal cutting and rotation, the sural flap was anastomosed with the superficial peroneal nerve in the recipient site or the medial cutaneous nerve of the dorsum of the dorsal foot. This method of reconstructing sensory function by anastomosing the original distal cutaneous nerve of the flap was defined as retrograde neurorrhaphy.Results:All patients were followed-up for 6 months to 1.5 years. The mechanism recovery of the peripheral pathway was excluded in the sensory function examination of flap. According to the evaluation standard for sensory function established by the British Medical Research Council in 1954, sensory recovery was as follows: 1 case for S 4; 8 cases for S 3+; 2 cases for S 3; and 1 case for S 2. Conclusion:Retrograde neurorrhaphy has definite therapeutic effects in reconstructing the sensory function of sural skin flap, and can be able to significantly increase the chances of sensory function reconstructing reconstruction the sensory function of such kind of flaps.

17.
Article in Chinese | WPRIM | ID: wpr-871093

ABSTRACT

We report a case of non-invasive prenatal diagnosis of fetal ectodermal dysplasia caused by EDA gene mutations. The pregnant woman underwent prenatal diagnosis at 11 gestational weeks because of a childbearing history of ectodermal dysplasia. Cell-free DNA barcode-enabled single-molecule test (cfBEST) was used to detect the ectodermal dysplasia gene mutation, and chorionic villus sampling was also performed. The cfBEST results showed that the genotype of maternal EDA gene c.340C> T(p.Gln114*) was heterozygous, while the genotype of fetal EDA was normal wild-type (C/C), which were consistent with the results of villus sampling, suggesting that cfBEST can be used for non-invasive prenatal diagnosis of ectodermal dysplasia caused by EDA gene mutation.

18.
Chinese Journal of Urology ; (12): 846-850, 2020.
Article in Chinese | WPRIM | ID: wpr-869760

ABSTRACT

Objective:To explore the efficacy and safety of one-stage transurethral ureteroscopic lithotripsy for the management of ureteral calculi with secondary silent obstructive pyonephrosis.Methods:Retrospective analysis was performed on the clinical data of 32 cases who had ureteral calculi with secondary silent obstructive pyonephrosis and underwent one-stage transurethral ureteroscopic lithotripsy in Peking University International Hospital from January 2018 to May 2020. Of all the 32 patients, 27 were males and 5 were females, with median age of 39.5 years, ranged from 18 years to 76 years.The distribution of stone location included left side in 23 cases and right side in 9 cases.The median stone volume was 138.84 mm 3, ranged from 33.28 mm 3 to 866.32 mm 3.All patients had no fever before surgery, and no obvious infection was indicated by preoperative blood routine, urine routine and urine bacterial culture.All patients underwent one-stage transurethral ureteroscopic lithotripsy and the dignosis of pyonephrosis was made intraoperatively.Purulent urine was collected during the operation for urine routine and bacterial culture test.We first suck out the pus at low pressure through an aspirator, and then turned down the perfusion pressure and flow to the lowest value of the pump.Intermittent low pressure and low flow perfusion combined with negative pressure suction were maintained during the subsequent lithotriptic operation.The double J stent must be indwelt routinely at the end of the operation, and anti-infective drug therapy was started postoperatively.We evaluated the stone free rate by rechecking KUB on the second day after the operation, and urinary CT scan or color ultrasound examination 4-6 weeks after the double J stent was removed.Postoperative infection was evaluated according to the incidence of systemic inflammatory response syndrome(SIRS) and the score of sequential organ failure assessment (SOFA) scale.Complications were graded by a Clavein-Dindo system to evaluate the safety of surgery. Results:All 32 patients underwent one-stage ureteroscopic lithotripsy, and 28 of them completed successfully, with a single-stage stone free rate of 87.5%. The operation time was 11 to 66 minutes, with a median of 28 minutes.During the operation, there were two patients calculi returned to the kidney, one patient had a too narrow ureter, and one patient had a unclear intraoperative visual field to continue the operation.Double J stents were indwelt in all of them at the end of the first stage surgery, and secondary ureteroscopic lithotripsy or flexible ureteroscopic lithotripsy was performed several weeks later. Calculi were cleared in all of them, with a second-stage stone free rate of 100%.Urine routine tests of pyuria collected during the operations showed that the bacterial count was 46-2 488/μl with a median of 295/μl and white blood cell count 57-7 863/μl with a median of 160.5/μl.The bacterial culture results of the pus showed that 22 cases had no bacterial growth and 10 cases had bacterial growth. One patient had fever on the first day after surgery, but the blood culture was negative. The temperature returned to normal after antibiotic treatment and symptomatic treatment for 1 day.There were 6 cases developed to SIRS but no sepsis occurred.No Clavein-Dindo Ⅲ or Ⅳ grade of operative complications occured.Conclusions:Transurethral ureteroscopic lithotripsy is clinically feasible with high stone free rate and no serious postoperative complications for one-stage treatment of ureteral calculi with secondary silent obstructive pyonephrosis for selected cases.Operation time should be shortened and the perfusion pressure and flow should be turned down as low as possible.

19.
Chinese Journal of Orthopaedics ; (12): 719-725, 2020.
Article in Chinese | WPRIM | ID: wpr-869015

ABSTRACT

Objective:To describe the treatment of the first carpometacarpal arthritis in Eaton Ⅱ, Ⅲ combining the hemi excision of trapezium with tendon ball and evaluate its clinical efficacy.Methods:Data of patients with the first carpometacarpal arthritis who were treated by hemi excision of trapezium and tamponade of the tendon ball from March 2013 to October 2018 were retrospectively analyzed. Twelve patients were all females with an average age of 55±2.8 years (range, 48-61 years). There were 3 cases of left thumbs and 9 cases of right. The study was only researched with primary osteoarthritis patients, preoperative imaging Eaton stages, including 8 cases inⅡstage, 4 cases in Ⅲ stage. Postoperative X-ray examination was performed, and the subsidence rate of the first metacarpal bone was evaluated according to height of arthroplasty. Preoperative and postoperative pain was evaluated according to visual analogue scales (VAS) score and DASH score. Preoperative and postoperative finger movement was evaluated according to the changes in preoperative and postoperative grip and pinch force.Results:The average follow-up period was 12±4.8 months (range, 6-17 months). The mean score of VAS after operation was 1.2±1.0 which was lower than 6.3±1.5 before operation ( t=13.4, P=0.0001); DASH score after operation was 26.2±9.6 which was lower than 48.9±13.0 before operation ( t=5.7, P=0.0001); Grip force after operation was 25.5±6.8 kg which was higher than 15.0±2.9 kg before operation ( t=7.3, P=0.0001); Pinch force after operation was 3.2±0.8 kg which was higher than 2.1±0.4 kg before operation ( t=3.6, P=0.0045), and all of these four above data has statistic difference. At the latest postoperative follow-up, the height index of arthroplasty was 0.299±0.022, and there was no significant change ( F=1.337, P=0.276) when compared with 0.306±0.021 before surgery and 0.313±0.024 after surgery. After the operation, 2 patients presented with incision redness and swelling and exudation. It was considered that local hematoma in the intra-articular operation could not be completely absorbed. After several dressing changes, the redness and swelling subsided and the exudation was controlled. Conclusion:Preserving the proximal joint surface of trapezium and tamponading tendon ball, could reduce the subsidence rate of the first metacarpal bone and alleviate the pain of the first carpometacarpal joint, thus may effectively improve the joint function. It has a significant effect on the treatment of Eaton Ⅱ,Ⅲ stage of the first carpometacarpal arthritis.

20.
Article in Chinese | WPRIM | ID: wpr-798671

ABSTRACT

In hospital performance evaluation, significant differences in the work objects, work content and economic operation of various departments result in the lack of indicators comparability between different departments. This has become a prominent problem that hospitals have been unable to effectively solve for a long time, and has also affected the fairness of performance distribution to a certain extent. Starting from the dilemma of cost-benefit evaluation, the authors put forward the basic concepts of the sequence advance and retreat method, and comprehensively elaborated the implementation steps and operating points of the performance assessment using the sequence advance and retreat method. It is pointed out that the sequence advance and retreat method has four characteristics: weakening the differences between departments by vertical and horizontal combination, avoiding the deviation of guidance by scientific comparison, highlighting the incentive effect by grade differentiation, and reflecting the advantages and disadvantages by end adjustment. The value of this method in the hospital performance appraisal system is discussed from three aspects: promoting the de-profitization process of hospitals, achieving fair distribution of hospital performance, and strengthening the guidance of hospital performance management. Based on such studies, this article provides new methods and ideas for building a more scientific and fair performance evaluation system.

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