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Introduction: Assisted reproductive technology has been developed significantly throughout the past few years, particularly diagnosing and treating male infertility. Many studies have been performed showing that Intracytoplasmic Sperm Injection (ICSI) is a successful method to attain clinical pregnancy and live birth through impaired spermatozoa characteristics or low sperm count, such as severe oligospermia. Severe oligospermia indicates low sperm count, which in some cases leads to azoospermia. Severe oligospermia can be caused by several factors such as genetics or medication. In search of efficient treatment for couples with Severe oligospermia, numerous retrospective and prospective researches have reported high pregnancy and live birth rates through testicular sperm for men with severe oligospermia and cryptozoospermia with or without high sperm DNA damage. The research showed that the use of testicular sperm in combination with ICSI yielded a high pregnancy rate and live births over another source of sperm, such as ejaculated sperms. Moreover, the use of ICSI in severe oligospermia has shown successful fertilization and pregnancy. Methods: In search for effective treatment for couples with severe male factor, a number of small retrospective and prospective studies have reported high pregnancy and live birth rates using testicular sperm for men with necrozoospermia, cryptozoospermia and oligozoospermia with or without elevated sperm DNA damage. Although the data suggest that there may be some benefit in performing testicular sperm retrieval (TSR)-ICSI in select groups of non-azoospermic infertile men, there are potential risks involved with TSR. Clinicians should balance these risks prior to the recommendation of TSR-ICSI on the result of a semen analysis or sperm DNA test alone. Careful evaluation and management of male factor infertility is important. The use of TSR-ICSI in the absence of specific sperm DNA defects is still experimental. Discussion: In 1992 and subsequently, several reports indicated that ICSI was a successful technique to achieve clinical pregnancy and live birth using spermatozoa with severely impaired characteristics. The initial optimism over the ability of ICSI to overcome significant sperm abnormalities was later tempered by the findings of more recent publications suggesting that some sperm deficits may not be as effectively treated with ICSI. Conclusion: Severe oligospermia indicates low sperm count, which can lead to male infertility; severe oligospermia which can be overcome through ICSI. Genetic factors like microdeletions of the Y chromosome (Yq) can cause severe oligospermia or chemotherapy molecules, affecting the sperm count directly.
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【Objective】 To investigate the transfusion ratio of plasma to RBC suspension during DIC caused by sever postpartum hemorrhage, so as to improve the clinical blood transfusion protocol. 【Methods】 A total of 82 parturients, who gave birth in our obstetrics department from January 2008 to December 2019 and treated successfully for DIC due to sever postpartum hemorrhage, were selected for the study. According to the plasma/RBC suspension ratio range (from 0.4 to 2.0) during DIC rescue, the included population was divided into four groups according to the ratio interval of 0.4: Group 1: 0.4~0.8 (13 people, median 0.7), Group 2 : 0.8~1.2(30 people, median 1.0), Group 3: 1.2~1.6(30 people, median 1.3), and Group 4: 1.6~2.0 (9 people, median 1.8). The general conditions, way of delivery, number of uterine artery perfusion embolization and surgical operations performed in the 4 groups were recorded. Once spontaneous postpartum hemorrhage occurred, blood cell analysis and coagulation function examinations were carried out every 1 to 2 hours until the condition was stable. The 24-hour blood loss, transfusion units of RBC suspension, fresh frozen plasma(FFP), platelet apheresis and fibrinogen during DIC and throughout the rescue of 4 groups were recorded and compared. Locally Weighted Regression (Lowess) method was applied to analyze the nonlinear association between the plasma/RBC suspension ratio and the duration of DIC, according to the duration of DIC in 4 groups. 【Results】 1) The shortest duration of DIC (326.15 min) was observed in DIC patients transfused with a plasma/ red blood cell suspension ratio=1.8. The duration of DIC (min) in the four groups were 505.21±259.53, 435.67±307.18, 420.93±259.43, and 247.86±215.77, respectively (P<0.05). 2) The coagulation indexes PT(s), INR, APTT(s) and Fib(g/L) gradually recovered between 2.9~13.9 h after transfusion in all four groups, especially in group 4 (median plasma/RBC suspension ratio of 1.8), whose changes were most pronounced in PT, INR, and Fib at 4.3 h, 2.9 h, and 5 h, respectively (P<0.05). 【Conclusion】 Fresh frozen plasma should be given as early as possible during blood transfusion treatment of DIC rescue. The increase of the ratio of plasma/RBC suspension is beneficial to the early recovery of DIC, and the optimal ratio of plasma to RBC suspension is 1.8.
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SUMMARY: Sever acute respiratory syndrome SARS-CoV-2 which is coronavirus disease-2019. It is transmitted by droplet transmission and other methods such aerosols transmission and faecal-oral transmission. The clinical features of Sever acute respiratory syndrome SARS-CoV-2 are fever, cough, dyspnea and gastrointestinal symptoms which present based on affected organ. The current study is anatomical study and provide interpretation of transmission and clinical features as well as the clinical investigation. Further, current study explains complication of coronavirus disease-2019. With explanation of COVID-19 which includes spread clinical features and investigations as well as the consequences by using anatomical clarification result in the intensification of understanding infection and provide high quality in teaching and medical services in future. Therefore, the new disease is a start to learn basic and clinical skills to encourage scientist and physician to improve medical education.
RESUMEN: El síndrome respiratorio agudo grave (SARS CoV-2) es una enfermedad por coronavirus-2019. Se transmite por transmisión de gotitas y otros métodos como la transmisión por aerosoles y la transmisión fecal-oral. Las características clínicas del síndrome respiratorio agudo severo SARS-CoV-2 son fiebre, tos, disnea y síntomas gastrointestinales y se presentan según el órgano afectado. El reporte actual es un estudio anatómico y proporciona una interpretación de la transmisión y las características clínicas, así como la investigación clínica. Además, el estudio explica la complicación de la enfermedad por COVID-19, que incluye las características clínicas y las investigaciones difundidas, así como las consecuencias. Mediante la aclaración anatómica, se profundiza la comprensión de la infección y se proporciona una alta calidad en la enseñanza y los servicios médicos en el futuro. Por lo tanto, la nueva enfermedad es un comienzo para aprender habilidades básicas y clínicas para alentar a los científicos y médicos a mejorar la educación médica.
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Humans , COVID-19/complications , COVID-19/pathology , COVID-19/transmission , Pandemics , SARS-CoV-2ABSTRACT
The outbreak of novel coronavirus pneumonia(NCP) caused by 2019 novel coronavirus has become a global public health challenge. Some patients accompany with liver function damage in addition to the main typical respiratory symptom. Here we analyzed the clinical features, susceptible population, potential causes and therapeutic strategies of NCP related liver injury.
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The outbreak of novel coronavirus pneumonia(NCP) caused by 2019 novel coronavirus has become a global public health challenge. Some patients accompany with liver function damage in addition to the main typical respiratory symptom. Here we analyzed the clinical features, susceptible population, potential causes and therapeutic strategies of NCP related liver injury.
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Background: India especially Andhra Pradesh is endemic for dengue, in dengue fever mortality and morbidity is more in children when compare to adults. Authors objective was to assess the clinical profile of the Dengue fever in children.Methods: Children below 14 years with serologically positive for dengue included in this study from June 2017 to June 2018, data was collected and analyzed with MS office 2016.Results: In 100 children 84 were suffering with Non Sever dengue , 16 were suffering with severe dengue. In the study population 68 were male children and 32 were female children, more children 68 were in the above 11 age group, 52 children stay in hospital for 3-6 days.Conclusions: Health education and anti-larval measures and anti-adult measures for mosquito control is effective measures.
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Patient with Down's syndrome (DS) are found to have an increased risk of developing various hematological disorders. There is 46 to 83 fold increased risk of acute myeloid leukemia (AML) and 10 to 27 fold increased risk of acute lymphoid leukemia (ALL). One of the most characteristics feature of Down syndrome associated AML (DS-AML) is that vast majority of case (70%) of AML in DS are megakaryoblastic leukemia i.e. M7 as per FAB classification (DS- AMKL). Virtually, all cases of DS-AMKL occur within the first 5 years of life. The median age of presentation of AMKL is 1.8 years. We report a case of AMKL in a newborn with Down's syndrome.
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Objective To understand the condition of tick carrying CRT(Candidatus rickettsia tarasevichiae) and compound infection with SFTSV(Sever fever thrombocytopenia syndrome virus) in Yanbian area of Jilin province. Methods Free ticks were collected from 6 counties including Yanji, Wangqing, Hunchun, Dunhua, Antu and Helong in the Korean Autonomous Prefecture of Jilin Province(Yanbian Prefecture) by using the flagging, and they were classified morphologically. The CRT and SFTSV in ticks were detected by Nest PCR(Nested polymerase chain reaction) and Real Time RT-PCR(Real-time Quantitative polymerase chain reaction) methods. Target DNA sequencing was performed for CRT positive products, and the homology of gene sequence and phylogenetic relationship were analyzed. Results A total of 1032 ticks were collected in this study, including ixodes persulcatus (35.56%) and dermacenter silvarum (20.64%). haemaphysalis japonica (20.45%), haemaphysalis longicornis (10.47%), haemaphysalis concinna (8.33%),others( 4.55%). The CRT was detected from the Ixodes persulcatus, Haemaphysalis longicornis, Haemaphysalis japonica Dermacentor silvarum. The MIR(Minimum infection rate per 100 ticks) of CRT was 10.47%.The SFTSV was detected from the Haemaphysalis-concinna, Haemaphysalis-japonica,Ixodes-persulcatus,Haemaphysalis-longicornis,Dermacentor-silvarum. The MIR of SFTSV was 2.52 %. Three species of ticks, including Ixodes persulcatus(2.45%), Haemaphysalis japonica(1.42%), and dermacentor silvarum(0.47%), had CRT and SFTSV compound infections, and the MIR of two pathogens compound infections was 1.26 %. In this study, the gene sequence of CRT positive PCR products ompA and 17kDa with nucleotide sequence of Xinyang plant of HeNan XinYang strain (KX365196.1),had homology of 100%. Phylogenetic analysis showed that CRT ompA and the HeNan XinYang strain (KX365196.1) gene sequences formed a cluster in Yanbian, while the 17 kDa gene formed an independent branch. Conclusions For the first time, CRT was detected from free ticks in Yanbian area of Jilin Province, and it was found that Ixodes persulcatus may be the main medium of transmission of the pathogen. At the same time, it was found that CRT and SFTSV have compound infection in ticks of Yanbian area. Therefore, it can be clearly identified that Yanbian area in Jilin Province is the natural source of CRT, and there are two pathogenic compound infections in the local ticks.
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Objective To compare the clinical efficacy of refined mirabilite vs.Chaishao Chengqi Decoc-tion in treating sever acute pancreatitis(SAP) complicated with abdominal compartment syndrome(ACS). Methods 60 cases of SAP complicated with ACS were divided into treatment group(n = 32) and control group (n=28) with random number table.The treatment group was given the nasal feeding and enema with refined mira-bilite base on routine western medicine treatment. The control group was given the nasal feeding and enema with Chaishao Chengqi Decoction. The 2 groups were compared with respect to the changes of the APACHEⅡ scores, intra-abdominal pressure,endotoxin,calcitonin(PCT),tumor necrosis factor alpha(TNF-α),recovery time of bowel sound,self-defecation recovery time,length of stay and hospitalization expenses. Results After 7 days of treatment,the intestinal permeability index(endotoxin) and the related indicators(PCT,TNF-α) were significantly lower than before treatment in both groups(P<0.05).The abdominal pressure of both groups at days 1,3 and 7 days after treatment was significantly lower than before treatment(P < 0.05) but the difference between the two groups had no statistical significance(P > 0.05). In the 3rd and 7th days of the treatment,APACHEⅡ scores were significantly lower than before treatment(P<0.05),but the difference between the two groups was not statis-tically significant in the score(P>0.05).The two groups showed no significant difference in the recovery time of bowel sound,self-defecation recovery time,length of stay and hospitalization expenses(P > 0.05). Conclusions Refined mirabilite as adjuvant therapy in SAP with ACS,can effectively reduce the internal pressure,promote the intestinal function recovery,protect the intestinal mucosal barrier function,reduce intestinal bacteria and endotox-in translocation and the complications of infection.It has a similar clinical effect as Chaishao Chengqi Decoction to the recovery of the disease.
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Objective To explore the effects of heating intravenous fluid infusion and blood transfusion based on guidelines in severe trauma patients with hypothermia. Methods A total of 40 severe trauma patients with hypothermia admitted from July 2014 to December 2015 were enrolled as the control group treated with routine measures to maintain the body temperature at normothermia by such as electrical heating blanket; other 40 severe casualties with hypothermia admitted from January 2016 to July 2017 were recruited as the warming up group treated with heating intravenous fluid infusion and blood transfusion by hot water bath in addition to the routine measures for keeping body temperature at normothermia. The differences in core body temperature, prothrombin time, activated partial thromboplastin time, incidence of shivering and mortality rate were compared between the two groups. Results There was statistically signifi cant difference in core body temperature at 0.5 h, 1.0 h, 1.5 h, 3.0 h between the two groups (P<0.05). Though the prothrombin time and shivering were improved after warming up in both groups, and there were significant differences in prothrombin time at 3.0 h after warming up and the incidence of shivering between two groups(P<0.05).There was no signifi cant difference in mean arterial pressure at all seven intervals between two groups. Conclusion The heating intravenous fl uid infusion and blood transfusion had remarkable effects to prevent hypothermia, improves blood coagulation and reduced the incidence of shivering to provide more simple and convenient warming up intervention for clinical practice.
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<p><b>OBJECTIVE</b>To explore the effect of acupuncture and moxibustion on severe obesity complicated with hyperlipidemia in different genders and their comprehensive effect, lipid indexes, and obesity indexes.</p><p><b>METHODS</b>A total of 264 patients of severe obesity complicated with hyperlipidemia were assigned into a male group (106 cases) and a female group (158 cases)．According to their clinical symptoms and patterns, acupuncture and moxibustion differentiation therapies were applied for stomach and intestine heat type, spleen deficiency and dampness resistance type, phlegm-dampness internal resistance type, liver depression and spleen deficiency type, spleen and kidney deficiency type and deficiency and blood stasis type．The obesity indexes were weight (W), obesity degree (A), body mass index (BMI) and body fat percentage (F); the blood lipid indexes were total cholesterol (TC)，triglyceride (TG)，low density lipoprotein (LDL-C) and high density lipoprotein (HDL-C). The comprehensive effect, obesity and blood lipid indexes were observed．.</p><p><b>RESULTS</b>The total effective rate of the male group was 91.5% (97/106), and the total effective rate of the female group was 85.4% (135/158) , without statistical significance (>0.05). After treatment, the obesity indexes of W, A, BMI and F and the blood lipid levels of TC, TG, LDL-C decreased, the levels of HDL-C increased compared with those before treatment in the two groups (<0.05, <0.01). The different values before and after treatment of the above all indexes in the male group were higher than those in the female group (all <0.05).</p><p><b>CONCLUSION</b>Acupuncture and moxibustion can both improve the obesity and blood lipid indexes for the patients with obesity complicated with hyperlipidemia. The effect is better for male than for female. The methods can prevent and treat hyperlipidemia.</p>
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Calcaneal apophysitis is a relatively common disease in young athletes. On the other hand, if not treated properly, it can lead to apophyseal avulsion fracture in rare cases. In the case of apophyseal avulsion fractures, it is often necessary to remove or preserve the bone fragment, which often requires a suture of the Achilles tendon. A 10-year-old badminton athlete visited the outpatients' clinic with pain in both heels from 10 months ago without any trauma history. After conservative therapy, the pain in the left heel was relived but the right heel pain persisted. After 10 months of conservative therapy, the patient visited the outpatients' clinic showing a calcaneal apophyseal avulsion fracture with a total rupture of the Achilles tendon. In the operation room, a bone fragment needed to be removed because of its poor viability and the fragment was too thin for fixation. After removing the bone fragment, the ruptured Achilles tendon was fixed with an anchor system.
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Child , Humans , Achilles Tendon , Athletes , Hand , Heel , Racquet Sports , Rupture , SuturesABSTRACT
Severe acute pancreatitis (SAP) is accompanied with complex pathogenic course and high mortality. The imbalance of immune response is an important cause which leads the SAP patients to the severe situation and even death. The immunomodulatory therapy can regulate the imbalance of inflammation, alleviate SAP-associated organ injury, and improve the prognosis of patients. Previous immunomodulatory therapy had some problems, such as single-object and simple-method. In recent years, some new methods of immunomodulatory therapy, such as regulating the apoptosis and mature of immune cells, applying of mesenchymal stem cells (MSCs) and multi-regulation methods, provide some new ideas and hopes for SAP therapy. This paper reviewed the history and recent research progresses of SAP immunomodulatory therapy.
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Severe fever with thrombocytopenia syndrome virus( SFTSV) is a novel Bunyavirus which was first repor-ted in China in 2009. Tick is its important reservoir host and vector. Both wild and domestic animals can be naturally infec-ted. IFNAR-/ - immunodeficient mice are ideal experimental animal models. In this article, the research result of animal infection and animal models of SFTSV are summarized, which provide the basis for the control of SFTSV natural epidemic and for animal experiments.
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Severe acute pancreatitis (SAP) is accompanied with complex pathogenic course and high mortality. The imbalance of immune response is an important cause which leads the SAP patients to the severe situation and even death. The immunomodulatory therapy can regulate the imbalance of inflammation, alleviate SAP-associated organ injury, and improve the prognosis of patients. Previous immunomodulatory therapy had some problems, such as single-object and simple-method. In recent years, some new methods of immunomodulatory therapy, such as regulating the apoptosis and mature of immune cells, applying of mesenchymal stem cells (MSCs) and multi-regulation methods, provide some new ideas and hopes for SAP therapy. This paper reviewed the history and recent research progresses of SAP immunomodulatory therapy.
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Severe fever with thrombocytopenia syndrome virus( SFTSV) is a novel Bunyavirus which was first repor-ted in China in 2009. Tick is its important reservoir host and vector. Both wild and domestic animals can be naturally infec-ted. IFNAR-/ - immunodeficient mice are ideal experimental animal models. In this article, the research result of animal infection and animal models of SFTSV are summarized, which provide the basis for the control of SFTSV natural epidemic and for animal experiments.
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Objective To guide fluid management for sever heart failure patients by using PICCO indicators, in order to direct clinical fluid management and nursing care. Methods Sixty-four heart failure patients with level IV cardiac function were randomly divided into the control group and the experimental group according to random number table, and each one had 32 patients. Fluid management for patients in the control group was implemented with CVP monitoring technology, while the patients in the experimental group accepted PICCO monitoring technology as fluid management. Then compare these indicators between the two groups--length of stay in ICU, mortality rate of 28 days, daily fluid intake, output and time of achieving negative fluid balance, and observe the change of cardiac function index (CFI) and capacity indicators (ITBVI, GEDVI, EVLWI) in the experiment group before and after treatment. Results Indicators of ITBVI、GEDVI、EVLWI in the experiment group recovered to normal state and CFI improved. The indicators which had mentioned above was (1 203.41±111.08) ml/m2, (1 087.78±66.91) ml/m2, (12.91±3.54) ml/kg, (2.91±0.29) L·min-1·m-2 respectively when before the treatment, while the values after the treatment was (895.50 ± 50.27) ml/m2, (728.19 ± 73.33) ml/m2, (6.51 ± 0.75) ml/kg, (4.61 ± 0.69) L · min-1 · m-2, the difference was significant (t=-18.52-54.42, P<0.05). The length of stay in ICU, mortality rate of 28 days, daily fluid intake, output and time of achieving negative fluid balance of the experimental group were significantly lower than those in the control group(t=-17.19,-76.80,-12.38, χ2=3.26, P<0.05). Conclusions PICCO monitoring indicators are better than CVP method in the aspect of fluid management for patients with sever heart failure, which can increase the rescue success rate, promote the treatment effect, improve prognosis, and promote the rehabilitation of patients.
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Objective To analyze the changes of serum amyloid A (SAA) ,C reactive protein (CRP) ,procalcitonin(PCT) and trypsin activated peptide(TAP) in the patients with acute pancreatitis (AP) ,and to evaluate the above 4 indexes combined detection in the diagnosis and treatment of AP .Methods The levels of SAA ,CRP ,PCT and TAP were detected in 21 cases of severe AP (SAP) and 49 cases of mild AP(MAP) .The detection results were compared with those in the healthy control group (n=50) .Re‐sults The levels of SAA ,CRP ,PCT and TAP had statistical differences between the patients with acute stage of SAP and MAP groups with the healthy control group(P<0 .01);the levels of SAA ,CRP ,PCT and TAP in the SPA group were significantly high‐er than those in the MAP group with statistical difference(P<0 .01) .The diagnostic efficiency of 4‐index combined detection was higher than that of single index detection .Conclusion The combined detection of SAA ,CRP ,PCT and TAP is conducive to early diagnosis and disease condition judgement of AP ,and has an important significance to the diagnosis and treatment of SAP .
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Objective To explore the requirement of on-site first-aid knowledge of sever hand in workers,and evaluate the corresponding training effect.Methods Through the questionnaire survey in 120 workers,making the sever hand on-site first-aid knowledge courseware,during the one-year training,we sent two teachers to give lectures,provided tools for workers to practice every week.At the end of training,we examined workers through the written and practical examination and made the statistical analysis.Results 97.5％ workers presented training needs,54.2％ workers had mastered sever hand onsite first-aid knowledge compared with that before training.Conclusions Workers have higher rates of accidents,however,there is lack of knowledge of first aid in general,and they have training requirement.We take the form of participative training and give the workers both theoretical and technique training,and this can effectively improve the awareness rate of on-site sever hand first-aid knowledge and technique.
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Objetivos: determinar las conductas sexuales asociadas a preeclampsia severa en pacientes hospitalizadas. Material y Métodos: se realizó una encuesta a 41 pacientes con preeclampsia severa para obtener datos con respecto a edad de primera gestación y de primera relación sexual (RS), número de parejas sexuales, hijos con parejas diferentes, frecuencia de coito, duración de RS previa al embarazo, exposición a semen y tiempo de cohabitación con la pareja. Resultados: Se encontró una edad promedio de 19 años para la primera gestación y de 17 para la primera RS, el 63% refirió más de 1 pareja sexual. El 15% presentaba relaciones sexuales durante menos de 6 meses antes del embarazo y el 90% y 22% presentaba exposición a semen según método anticonceptivo usado y sexo oral respectivamente. Conclusiones: las conductas sexuales asociadas con preeclampsia severa, estuvieron presentes en nuestra población con variable correlación a los hallazgos de otros estudios.
Objectives: to determine the presence of pre-eclampsia-associated sexual behaviors in our environment.Material and Methods: Forty-one patients were surveyed in order to obtain the results for age of first pregnancy and first sexual intercourse, number of sexual partners, children with different partners, sexual intercourse frequency, duration of sexual relationship, semen exposure and partner cohabitation period. Results: a mean age of 19 years-old was found for the first pregnancy and of 17 for the first sexual intercourse, 63% had more than 1 total sexual partners. Sexual relationship shorter than 6 months was present in 15% or the surveyed and semen exposure according to contraceptive methods and oral sex was of 90% and 22% respectively. Conclusions: sexual behaviors associated with pre-eclampsia were found in our population with a variable co-relation to the findings of other studies.