Desarrollo del dolor fetal y neonatal / Development of fetal and neonatal pain

Resumen: El dolor es el principal síntoma reportado a nivel mundial, es la principal causa de sufrimiento humano. Se considera que para que un individuo sienta dolor deben estar presentes: nociceptores, neurotransmisores del dolor, vías que llevan el estímulo al cerebro, el tálamo y conexión con la corteza. Por un tiempo se consideró que en esta etapa no se contaba con la madurez suficiente del sistema nervioso para sentir dolor; sin embargo, en la actualidad hay evidencia de que el feto presenta dolor; y su presencia altera el desarrollo del sistema nervioso. La presente revisión proporciona una visión actualizada de la ontogenia del dolor fetal y neonatal.

Abstract: Pain is the main symptom reported worldwide, it is the main cause of human suffering. It is considered that for an individual to feel pain, the following must be present: nociceptors, pain neurotransmitters, pathways that carry the stimulus to the brain, the thalamus and connection with the cortex. For a time it was considered that at this stage the nervous system was not mature enough to feel pain, however, there is currently evidence that the fetus has pain; and its presence alters the development of the nervous system. This review provides an updated view of the ontogeny of fetal and neonatal pain.

Effect of sports training on the rehabilitation of hypertensive patients / Efeitos de treino esportivo na reabilitação de pacientes hipertensos / Efectos de entrenamiento deportivo en la rehabilitación de pacientes hipertensos

ABSTRACT Introduction: Hypertension is one of the most common cardiovascular and cerebrovascular diseases and a major public health problem. Although, through the rational use of drugs, the blood pressure of hypertensive patients can be better controlled, a series of side effects of drugs and expensive medical expenses limit the ability of patients to comply with the demands of hypertension. Objective: To explore the effect of long-term exercise training on the rehabilitation of hypertensive patients. Methods: The patients were divided into a control group and an exercise group, and we used multiple measurements of blood pressure, a questionnaire, and registered the situation of each patient, after what results were compared and analyzed. Results: After 12 weeks of training, the subject's blood pressure has dropped significantly. The systolic blood pressure dropped by an average of 15.5mmHg compared to before the exercise prescription was implemented, diastolic blood pressure dropped by an average of 10.6mmHg. Conclusions: Continuous physical exercise in hypertensive patients has medium- and long-term effect on blood pressure control. Level of evidence II; Therapeutic studies - investigation of treatment results.

RESUMO Introdução: A hipertensão é uma das doenças cardiovasculares e cerebrovasculares mais comuns e um importante problema de saúde. Embora a pressão de pacientes hipertensos possa ser melhor controlada através do uso racional de medicamentos, seus efeitos colaterais e os elevados custos médicos limitam a habilidade dos pacientes de atender às demandas da hipertensão. Objetivo: Explorar o efeito a longo prazo de exercícios na reabilitação de pacientes hipertensos. Métodos: Dividiram-se os pacientes em um grupo controle e um grupo de exercícios e realizaram-se múltiplas avaliações de sua pressão sanguínea. Além disso, foi aplicado um questionário e a situação de cada paciente foi registrada. Em seguida, os resultados foram comparados e analisados. Resultados: Depois de 12 dias de treino, a pressão sanguínea dos pacientes caiu significativamente. A pressão sanguínea sistólica após a implementação dos exercícios caiu em média 15.5mmHg, e a pressão diastólica caiu em média 10.6mmHg. Conclusões: Atividade física continua em pacientes hipertensos tem efeitos de médio e longo prazo no controle da pressão sanguínea. Nível de evidência II; Estudos terapêuticos - investigação de resultados de tratamento.

RESUMEN Introducción: La hipertensión es una de las enfermedades cardiovasculares y cerebrovasculares más comunes y un importante problema de salud. Aunque la presión de pacientes hipertensos pueda ser mejor controlada a través del uso racional de medicamentos, sus efectos colaterales y los elevados costos médicos limitan la habilidad de los pacientes de atender a las demandas de la hipertensión. Objetivo: Explorar el efecto a largo plazo de ejercicios en la rehabilitación de pacientes hipertensos. Métodos: Los pacientes fueron divididos en un grupo control y un grupo de ejercicios y realizaron múltiples evaluaciones de su presión sanguínea. Además, fue aplicado un cuestionario y la situación de cada paciente fue registrada. Luego, los resultados fueron comparados y analizados. Resultados: Después de 12 días de entrenamiento, la presión sanguínea de los pacientes disminuyó significativamente. La presión sanguínea sistólica, después de la implementación de los ejercicios, descendió en promedio 15.5mmHg, y la presión diastólica descendió en promedio 10.6mmHg. Conclusiones: La actividad física continua en pacientes hipertensos tiene efectos de medio y largo plazo en el control de la presión sanguínea. Nivel de evidencia II; Estudios terapéuticos - investigación de resultados de tratamiento.

Trends in Patients with Long COVID (COVID-19 Long-Term Effects) in the Kampo Outpatient Department of Infectious Diseases at Our Clinic — From Early Cases / 日本東洋医学雑誌

In response to the increasing numbers of patients with long-term effects of coronavirus disease 2019 (COVID-19), we started using Kampo (traditional Japanese) medicine for some outpatients. We analyzed the patients' characteristics and the treatments used in each case. Our subjects were 9 patients who visited our clinic between May and September 2021. All subjects provided their written informed consent and were followed for several months. Decoctions or extract formulations were prescribed for treatment based on pattern identification, and general guidance related to lifestyle habits based on traditional thought was also provided. Fatigue, lifestyle of intemperance (due to excessive amounts of cold foods and drinks), and mental/physical stress were present in each patient. Some patients also felt strong anxiety about the lack of any established Western medical treatment and insufficient follow-up systems for patients with long-term effects of COVID-19 (long COVID). Tonic formulas and formulas of involving Bupleuri radix were often used. All 9 patients showed a tendency to improve their symptoms within 4 or 5 weeks of treatment. Our impression is that the prompt effect of Kampo medicine was achieved by combining the use of Kampo medicines with instructions to stop eating excessive amounts of cold foods and/or drinks. Further study is needed in the future. For long COVID, no Western medical treatment has yet been established. On the other hand, in our experience with these patients, Kampo medicine based on the concept of mind-body unity was useful.

Long-term effects of the implantation of human umbilical cord-derived mesenchymal stem cells for type 1 diabetes mellitus / 中华内分泌代谢杂志

Objective:To investigate the long-term effect of the implantation of human umbilical cord-derived mesenchymal stem cells (HUC-MSCs) for type 1 diabetes mellitus.Methods:Fifteen patients with type 1 diabetes mellitus were treated with HUC-MSCs from September 2009 to December 2011 at Department of Endocrinology and Metabolism, the Second People′s Hospital. Patients were followed-up for 10 years and the parameters were collected including fasting blood glucose, HbA 1C, mean amplitude of glycemic excursions (MAGE), fasting C-peptide, daily insulin doses and glutamic acid decarboxylase antibody (GADA). Results:Among 15 patients, 1 patient (6.67%) was found with breast cancer. All patients with type 1 diabetes mellitus decreased daily insulin doses due to frequent hypoglycemia one week later. Six months later, 4 patients (26.67%) stopped insulin injection. While among the 4 patients, 1 patient (6.67%) had not yet used insulin until today and GADA was negative, the other 3 patients (20.00%) restarted insulin within 3-5 years after implantation with significantly less daily insulin doses [(18.00±1.00)U vs (29.00±1.73)U, P<0.01]. The remaining 11 patients (73.33%) with type 1 diabetes mellitus who did not stop insulin also had significantly lower daily insulin doses [(18.09±0.83)U vs (29.64±0.89)U, P<0.01]. The level of MAGE was signicantly decreased compared to those of pre-implantation [(6.14±0.25)mmol/L vs (9.72±0.32)mmol/L, P <0.01], while fasting C-peptide level was significantly improved[(0.91±0.03)nmol/L vs (0.11±0.01)nmol/L, P <0.01]. There were no significant differences in fasting blood glucose and HbA 1C before and after implantation. Conclusions:The implantation of HUC-MSCs for the treatment of type 1 diabetes mellitus can restore the function of islet β cells, decrease daily insulin doses and reduce blood glucose fluctuations in the long term. Although precise mechanisms are unknown, this therapy is expected to be an effective strategy for treatment of type 1 diabetes mellitus.

Chronic kidney failure following lancehead bite envenoming: a clinical report from the Amazon region

Snakebite envenoming can be a life-threatening condition, for which emergency care is essential. The Bothrops (lancehead) genus is responsible for most snakebite-related deaths and permanent loss of function in human victims in Latin America. Bothrops spp. venom is a complex mixture of different proteins that are known to cause local necrosis, coagulopathy, and acute kidney injury. However, the long-term effects of these viper envenomings have remained largely understudied. Case presentation: Here, we present a case report of a 46-years old female patient from Las Claritas, Venezuela, who was envenomed by a snake from the Bothrops genus. The patient was followed for a 10-year period, during which she presented oliguric renal failure, culminating in kidney failure 60 months after the envenoming. Conclusion: In Latin America, especially in Brazil, where there is a high prevalence of Bothrops envenoming, it may be relevant to establish long-term outpatient programs. This would reduce late adverse events, such as chronic kidney disease, and optimize public financial resources by avoiding hemodialysis and consequently kidney transplantation.(AU)

Long-term effects of GnRHa on central precocious puberty or early and fast puberty children / 中华内分泌代谢杂志

Objective@#To investigate the long-term effects of GnRHa treatment on final height gain, gonadal function, and body mass index(BMI) in children with central precocious puberty(CPP) or early and fast puberty(EFP), and to explore the influencing factors of height gain and early predictors.@*Methods@#Fifty patients with CPP and 44 patients with EFP who were treated with GnRHa for more than 2 years were enrolled(80 females and 14 males). Body height, bone age, BMI, gonads hormone, uterus and ovarian volumes(female), testicular volume(male), and other parameters before and after treatment were measured.@*Results@#(1)For girls: GnRHa plus GH treatment gained more final height compared with GnRHa treatment [(10.69±5.73) cm vs (7.42±5.76) cm, P<0.05]. Height lost >5cm at the initial treatment benefited much more for the final height compared with height lost<5cm [(10.65±3.32) cm vs (6.51±3.40) cm, P<0.01]. The proportion of overweight/obesity decreased when reaching the final height compared with the initial treatment and stopping the treatment. Serum LH level, uterine and ovarian volume were significantly decreased after stopping treatment compared with before treatment, and increased half a year to 1 year after stopping treatment.100% of girls had menarche and 95% reached the regular cycle 3 years after stopping treatment.(2)For boys: GnRHa plus GH treatment and GnRHa treatment gained height by(8.78±5.2) and(7.99±4.82) cm, respectively. Serum LH level and testicular volume were significantly decreased after stopping treatment as compared with those before treatment, and increased for half a year to 1 year after stopping treatment.@*Conclusion@#GnRHa treatment can significantly improve the final height for girls with CPP and EFP. The patients with more height lost could gain more height, which can be used as a predictor of height gain.

Evolución ponderal y de comorbilidades a largo plazo en pacientes intervenidos de cirugía bariátrica / Long-term outcome of weight and comorbidities in patients undergoing bariatric surgery

Objetivo: analizar la evolución de las comorbilidades mayores e índice de masa corporal a largo plazo en pacientes intervenidos de cirugía bariátrica. Material y métodos: estudio retrospectivo transversal sobre una muestra de 38 pacientes intervenidos de cirugía bariátrica entre los años 2008 y 2011. La muestra se compone de 32 mujeres y 6 varones, con una media de edad de 43,52 años. Las intervenciones quirúrgicas realizadas fueron 8 bandas gástricas, 8 gastrectomías verticales y 22 by-pass. Resultados: la DM mejora en un 71,43% de los casos, la HTA en 47,05%, la DL en un 75% y el SAOS en un 70%. Por encima de los 5 años de seguimiento, el 28,9% de los pacientes presenta obesidad tipo I, el 23,7% presenta sobrepeso, el 23,7% obesidad tipo II y el 23,7% obesidad tipo III. Conclusión: la cirugía bariátrica consigue la resolución de comorbilidades asociadas a la obesidad en un porcentaje muy elevado de casos, siendo la más efectiva la dislipemia. La reganancia de peso a largo plazo sigue siendo un problema en estos pacientes así como su seguimiento por encima de los 5 años.

Objective: The aim of this paper is to analyze the outcome of major comorbidities and body mass index during long-term follow-up in patients undergoing bariatric surgery. Material and methods: A retrospective cross-sectional study was conducted on a sample of 28 patients (32 women and 6 men; mean age: 43.52 years) undergoing bariatric surgery between 2008 and 2011. The surgical procedures performed were adjustable gastric banding (n =8), sleeve gastrectomy (n = 8) and gastric bypass (n = 22). Results: Diabetes mellitus was resolved in 73.43% of cases, hypertension in 47.05%, dyslipidemia in 75% and obstructive sleep apnea syndrome in 70%. Five years after surgery, 28.9% of the patients had obesity class I, 23.7% had overweight, 23.7% had obesity class II and 23.7% had obesity class III. Conclusion: bariatric surgery achieves resolution of comorbidities associated with obesity in a high percentage of cases. This effect is more effective in dyslipidemia. Weight regain in the long-term and follow-up beyond five years after surgery are still pending issues.

Long-term effects of early-life disaster exposure on mental health during the whole life cycle / 中华疾病控制杂志

Early nutritional status, lifestyle and life experiences are critical to the health and development of one’s whole life. Previous studies on the effect of earthquake, flood, ice storm and hurricane, famine on population health were reviewed and sorted out from a perspective of life cycle. It turned out that catastrophic events exposure during the fetus period could have some adverse effects on the growth and development of fetuses, newborns and children, and also on mental health during the life cycle from newborns to adults. Based on the research results at home and abroad, future research on the long-term impacts of early-life adverse events on mental health could be further explored from such aspects as expanding research objects, improving research methods, and extending research content.

Osmf: Long Term Study Of Treated Patients

Background and Objective: Oral Submucous fibrosis (OSMF) is a chronic debilitating disease and a well recognized premalignant condition of oral cavity. The exact pathogenesis is not well established but the cause is believed to be multifactorial. The most commonly used treatment regimen is combination of Hydrocortisone acetate or Triamcinolone Acetonide with hyaluronidase and recently oral Pentoxifylline, but studies of its long term effect are lacking. The present study was therefore conducted to evaluate the long term effectiveness of afore said drugs. Material & methods: In the present study 60 previously treated patients of OSMF were registered. Out of which 34 patients had received Inj. Hydrocortisone acetate (1.5ml) mixed with Hyaluronidase (1500 I.U.) at weekly interval for 22 weeks, 15 patients had received Inj. Triamcinolone Acetonide (10mg/ml) mixed with Hyaluronidase (1500 I.U.) at biweekly interval for 22 weeks and 11 patients were given Tab Pentoxifylline (Trental) 400mg three times daily for a period of 7 months. Long term outcome was evaluated on the basis of symptom score and sign score. Results: There was statistically significant improvement between long term follow up score and immediate Post-treatment symptom score ( p value < 0.05 ) Interpretation and Conclusion: It was concluded that the improvement in symptoms and signs following treatment increased further or maintained in long term follow up

Acupuncture combined with medication for morning blood pressure of essential hypertension / 中国针灸

<p><b>OBJECTIVE</b>Based on the western medication, to evaluate the advantages in the morning blood pressure treated with acupuncture at Fengchi (GB 20) and Neck-Jiaji (EX-B 2) combined with acupuncture technique for activating blood circulation, eliminating wind and regulating the liver and spleen in the patients with essential hypertension.</p><p><b>METHODS</b>A total of 90 patients of essential hypertension of the mild and moderate degrees were randomized into a medication group (30 cases, 3 dropping), No.1 acupuncture group (30 cases, 2 dropping) and No.2 acupuncture group (30 cases, 1 dropping). In the medication group, adalat was prescribed for oral administration, 30 mg at 7 am every day, continuously for 6 weeks. In the No.1 acupuncture group, on the basis of the treatment as the medication group, the acupuncture technique for activating blood circulation, eliminating wind and regulating the liver and spleen was applied and the acupoints were Renying (ST 9), Hegu (LI 4), Taichong (LR 3), Quchi (LI 11) and Zusanli (ST 36). In the No.2 acupuncture group, on the basis of the treatment as the No.1 acupuncture group, Fengchi (GB 20) and Neck-Jiaji (EX-B 2) were added in acupuncture. Acupuncture was given in the time zone from 8 am through 10 am every day, once a day, 5 times a week, totally for 6 weeks. Separately, before treatment and in 2, 4 and 6 weeks of treatment, the morning blood pressure, the control rate and the symptom score were observed in the patients of the three groups. The morning blood pressure was followed up in 3 and 6 months separately.</p><p><b>RESULTS</b>Compared with those before treatment, in 2, 4 and 6 weeks of treatment, the levels of blood pressure reduced in the patients of the three groups (<0.05, <0.01). After 2-week treatment, the differences were not significant in the morning blood pressure and its control rate in the patients of the three groups (all >0.05). In 4 and 6 weeks of treatment, the levels of the morning blood pressure in the No.2 acupuncture group were lower than those in the No.1 acupuncture group, and the results in the No.1 and No.2 acupuncture groups were all lower than those in the medication group (all <0.05). In the follow-up visit for 3 and 6 months separately, the differences were not significant in the morning blood pressure among the three groups (all >0.05). In 2, 4 and 6 weeks of treatment, the symptom scores reduced as compared with those before treatment in the three groups (all <0.05). The symptom scores in the No.1 and No.2 acupuncture groups were all lower than those in the medication group (all <0.05). The differences were not significant between the No.1 acupuncture group and the No.2 acupuncture group (all >0.05).</p><p><b>CONCLUSION</b>The comprehensive treatment of acupuncture at Fengchi (GB 20) and Neck-Jiaji (EX-B 2) combined with acupuncture technique for activating blood circulation, eliminating wind and regulating the liver and spleen achieve the effects of reducing the morning blood pressure in the patients with essential hypertension, relieving the symptoms of hypertension such as headache, vertigo and tinnitus and the effects are better than those of the acupuncture technique for activating blood circulation, eliminating wind and regulating the liver and spleen.</p>

An analysis on related influence factors of the long-term curative effect of 3D conformal radiotherapy for patients with esophagus cancer / 中国医学装备

Objective: To explore related influence factors of the long-term curative effect of 3D conformal radiotherapy for patients with esophagus cancer. Methods: 472 patients with esophageal cancer were carried out simulative location by using CT, and they were implemented radical operative 3D conformal radiotherapy. And their basic documents and image documents were analyzed by using single factor analysis, and then these screened factors were token into Cox model to carry out multiple-factor analysis so as to seek the influence factor of long-term curative effect. Results: The 1 year, 3-year and 5-year survival rate of all of patients were 71.0%, 33.1% and 26.2%, respectively. The results of single factor analysis showed that series of factors, included parts of stratification, length of lesion, the longest diameter of the lesion, largest anteroposterior diameter of lesion, the largest transverse diameter of lesion, wall thickness of lesions, GTV-E, GTV-LN, GTV-T, whether out invasion, whether lymph node metastasis, lymph node metastasis model and the number of lymph nodes under X-ray, were significantly relative with long-term prognosis of patients. And then, the multiple-factor analysis of Cox model showed that the longest diameter of the lesion and GTV-T were the independent factor that can influence the long-term prognosis (OR=1.647, OR=1.379, P<0.05). Conclusion:GTV-T and the longest diameter of lesion on the CT image of patients with esophagus cancer can influence the long-term curative effect of 3D conformal radiotherapy for esophagus cancer. Therefore, they should be applied as the important evaluation index in formulating therapeutic schedule.

Long-term effects of kidney transplantation in children / 中华器官移植杂志

Objective To explore the long-term clinical effect of kidney transplantation in children.Methods The clinical data of 53 children with kidney transplantation from March 2008 to September 2014 were retrospectively analyzed.The influence of the dependent factors on the estimated glomerular filtration rate (eGFR) (greater than 90 mL/min/1.73 m2 or ＜90 mL/min/1.73 m2) was estimated in the three years after the operation,and the influencing factors were analyzed by the dual logistic regression equation.Results There were 19 cases of living donors,17 cases of organ donors after death,and 6 others.The 53 patients were followed up for 3-9 years.The level of blood creatinine was decreased from the preoperative (820.1 ± 323.1) μmol/L to (51.6 ± 24.9) μmol/L 3 years after the operation (P＜0.05).eGFR was increased to (103.5 ± 11.4) mL/min/1.73 m2at 3rd year after the operation from the preoperative (17.1 ± 7.8) mL/min/1.73 m2 (P＜0.05).The age of recipients,preoperative dialysis time,number of HLA mismatching and postoperative delayed graft function healing (DGF),rejection and infection were the influencing factors of eGFR at 3rd year postoperation (P＜0.05).The multi-factor binary logistic regression equation analysis showed that only rejection was the risk factor for eGFR at 3rd year p0ostoperation.Eight cases of DGF (8/53,15.1％) recovered rapidly.There were 6 cases of acute rejection (6/47,12.8 ％) and 1 case of chronic rejection (1/47,2.1％).There were 9 cases of infection (9/47,19.1％).There were 6 cases of recurrence after surgery.The 3-year recipient and kidney survival rate was 94.3％ (50/53) and 88.7％ (47/53) respectively.The average height of the patients in the first,second and third year after the surgery was increased by (4.6 ± 1.9) cm (0.5-19.1 cm),(3.7 ± 1.8) cm (0.7-14.3 cm) and (2.8± 1.2) cm (0.3-8.7 cm) respectively.Conclusion The long-term effect of children kidney transplantation is satisfactory.

Prognostic factors and treatment of pediatric acute lymphoblastic leukemia / 소아과

The event-free survival (EFS) for pediatric acute lymphoblastic leukemia (ALL) has shown remarkable improvement in the past several decades. In Korea also, a recent study showed 10-year EFS of 78.5%. Much of the improved outcome for pediatric ALL stems from the accurate identification of prognostic factors, the designation of risk group based on these factors, and treatment of appropriate duration and intensity according to risk group, done within the setting of cooperative clinical trials. The schema of first-line therapy for ALL remains mostly unchanged, although many groups have now reported on the elimination of cranial irradiation in all patients with low rates of central nervous system relapse. Specific high risk subgroups, such as Philadelphia chromosome-positive (Ph+) ALL and infant ALL continue to have significantly lower survival than other ALL patients. The introduction of tyrosine kinase inhibitors into therapy has led to enhanced outcome for Ph+ ALL patients. Infant ALL patients, particularly those with MLL rearrangements, continue to have poor outcome, despite treatment intensification including allogeneic hematopoietic cell transplantation. Relapsed ALL is a leading cause of mortality in pediatric cancer. Recent advances in immunotherapy targeting the CD19 of the ALL blast have shown remarkable efficacy in some of these relapsed and refractory patients. With improved survival, much of the current focus is on decreasing the long-term toxicities of treatment.

Efficacy and safety of entecavir versus lamivudine over 5 years of treatment: A randomized controlled trial in Korean patients with hepatitis B e antigen-negative chronic hepatitis B

BACKGROUND/AIMS: Long-term data on antiviral therapy in Korean patients with hepatitis B e antigen (HBeAg)-negative chronic hepatitis B (CHB) are limited. This study evaluated the efficacy and safety of entecavir (ETV) and lamivudine (LAM) over 240 weeks. METHODS: Treatment-naive patients with HBeAg-negative CHB were randomized to receive ETV 0.5 mg/day or LAM 100 mg/day during the 96 week double-blind phase, followed by open-label treatment through week 240. The primary endpoint was the proportion of patients with virologic response (VR; hepatitis B virus [HBV] DNA16 years old) were included (ETV, n=56; LAM, n=64). Baseline characteristics were comparable between the two groups. A significantly higher proportion of ETV-treated patients achieved VR compared to LAM at week 24 (92.9% vs. 67.2%, P=0.0006), week 96 (94.6% vs. 48.4%, P < 0.0001), and week 240 (95.0% vs. 47.6%, P < 0.0001). At week 96, ALT normalization was observed in 87.5% and 51.6% of ETV and LAM patients, respectively (P < 0.0001). Virologic breakthrough occurred in one patient (1.8%) receiving ETV and 26 patients (42.6%) receiving LAM (P < 0.0001) up to week 96. Emergence of resistance to ETV was not detected. The incidence of serious adverse events was low and unrelated to the study medications. CONCLUSIONS: Long-term ETV treatment was superior to LAM, with a significantly higher proportion of patients achieving VR. Both treatments were well tolerated.

Factors influencing long-term effects of interventional therapy on diabetic lower extremity vascular disease / 中国综合临床

Objective To investigate the influencing factors involved in the long-term effect after interventional treatment of diabetic lower extremity vascular disease.Methods The data of 358 diabetic patients with lower extremity vascular disease were collected retrospectively.The ankle-brachial index (ABI) values at the 6th, 12th and 24th month after interventional treatment were documented and the factors may influence ABI value werc analyzed.Results Single factor analysis showed that after 24 months treatment, the proportion of ABI＜0.5 (severe ischemia) in the patients combined with obesity, smoking, older age were 15.0％ (31/206), 18.4％ (25/136) , 12.1％(19/157) ,7.5％(15/200) ,while non obesity,younger age,no smoking,no hypertension were 6.6％ (10/152), 14.8％ (33/222), 6.5％ (13/201), 1.9％ (3/158), and the differences were significant (P ＜0.05).Logistic regression analysis showed that old age (OR =1.341,95％ CI: 1.281-1.496, P =0.045), smoking(OR=2.301,95％ CI: 1.903-4.844,P=0.028) and obesity(OR=1.299,95％ CI: 1.270-1.588,P =0.038) were the independent factors influence the long-term therapeutic effects on diabetic lower extremity vascular disease.Conclusion Obesity, smoking, old age are the main factors influence the long-term therapeutic effects on diabetic lower extremity vascular disease.

The age changes of family parenting styles in China and its influence on mental health / 中华行为医学与脑科学杂志

Objective To investigate changes of family parenting styles after the reforn and opening in China and its influence on mental health.Methods On the base of stratified convenience sampling,a valid sample of 429 were recruited from Wuxi and Hefei city residents:1960s group 103 persons,1970s group 107 persons,1980s group 116 persons,and 1990s group 103 persons.Subjects' childhood parenting styles were surveyed with the family upbringing style questionnaire(FUSQ) and their current mental health status was rated with the psychological symptom inventory-100 (PSI-100).Results (1) Except understanding-blame,and expects-demanding,and mother respect-humiliation and mother warmth-wildness,there were significant age differences on other parenting styles (P＜ 0.05),their scores were gradually increased from 1960s group ((38.29± 6.30)-(44.99± 7.36)) to 1980s group ((40.96±6.05)-(48.53±7.91)),1990s group declined((40.13±7.27)-(46.97±6.61)).(2) Most parenting style dimensions were significantly negatively correlated with symptom total score (r=0.095-0.308) and mental symptom scores (r=0.090-0.330).(3) The family parenting styles had significantly effects on the symptom total score (explained variance of 20.3％) and mental symptom scores (explained variance of 12.4％-21.5％).Conclusion There have been some positive,open and scientific changes on the family parenting styles after the reform and opening in China,childhood family parenting styles have long-term effects on mental health of youth and adult.

Long-term effects of L-T4 treatment on physical and intellectual development for congenital hypothyroidism / 中华内分泌代谢杂志

To explore the long-term effects of L-T4 treatment on physical and intellectual development in neonatal congenital hypothyroidism(CH) patients during adolescence and adulthood.14 out of 15 patients,aged 15-31 years old,including 9 males and 6 females,were diagnosed by neonatal screening for congenital hypothyroidism.(1) By treatment for 10 years until adolescence,return visit ages were 12.6-18.1 years old,the height of patients were normal in 14 cases,weight normal in 8 cases,and overweight in 6 cases.Only the first patient of neonatal screening for congenital hypothyroidism height 154 cm,weight of 43.5 kg,which were below the standard.Bone age by X-ray showed 9 normal,1 case of rapid development,4 cases with left wrist bone age retardation.IQ combined Raven's test(CRT) showed 3 cases excellent,7 cases normal,3 cases borderline,and 2 cases low.(2)Treatment for more than 20 years to adulthood,9 cases of return visits (8 cases were screened out) by 23-31 years of age,with 5 males and 4 females,height and bone age were all normal,normal weight,only 2 cases BMI slightly overweight.As to IQ,good were in 7 cases,mild retardation in 2 cases.7 patients received above average education;they were all employed except one.The employed patients were all capable for their jobs.In summary,screening out of 8 patients,1 case were of mild mental retardation (12.5％);while 7 patients(87.5％),both in physical and intellectual levels were as those of the normal population.

Treatment and medical follow-up of three cases with acute radiation-induced skin injury / 中华放射医学与防护杂志

Objective To discuss diagnosis,treatment and late effects of three patients with acute radiation-induced skin injury after an accident.Methods Medical history collection and physical examination were made in a manner of one or several doctors to one patient.The general health condition was evaluated through laboratory studies,including complete blood count,liver and kidney function,thyroid function and humoral immunity measurement.The genetic analysis of radiation damage was performed by using chromosomal aberrations and micronucleus assay (CB method).The psychological status of the patients was evaluated during medical follow-up.Results Among the three patients,two were diagnosed with degree Ⅲ acute radiation-induced skin injury and one with degree Ⅱ.The medical follow-up showed that two patients had syndrome of neurasthenia.The two cases with degree Ⅲ acute radiation-induced skin injury then became chronic radiation-induced skin damage.Conclusions Acute radiation-induced skin injury could be persistent and become chronic radiation skin damage.It is important for long-term medical follow-up to be taken for patients with acute radiation-induced skin injury.

Combined intervention treatment of descending thoracic aortic dissection with coronary heart disease / 中国介入心脏病学杂志

Objective To evaluate the effectiveness of combination technique in treating descending thoracic aortic dissection with coronary heart disease by endovascular graft exclusion (EVGE) and percutaneous coronary intervention(PCI). Methods From April, 2002 to October, 2013, a total of 40 in-hospital patients with descending thoracic aortic dissection and coronary heart disease who underwent EVGE and PCI were analyzed for outcomes. All patients were performed EVGE before they underwent PCI in 3~7days of time. Long-term treatment were observed. Results For dissection tears, 40 trunk tectorial membrane stents were used. The rate of success of EVGE implantation was 100%. No paraplegia, death and other complications. 59 stents were placed to 54 target vessels of 40 patients. The success rate of PCI procedure was 100%and no severe complication occurred. All patients were followed up for average 56±31 months. The rate of followed up was 92.5%(37/40). During follow-up, 3 patients died including two patients died of cerebral hemorrhage and one case of malignant tumor. The major adverse cardiac events (MACE) rate was 6.9% in the 29 cases of patients who underwent EVGE and PCI during the clinical follow-up. Conclusions It is safe and feasible that treating descending thoracic aortic dissection with coronary heart disease by combination technique of EVGE and PCI.

A Study about Long-Term Effects of Attention-Deficit Hyperactivity Disorder Medication on Height and Weight in the Korean School-Aged Boys with Attention-Deficit Hyperactivity Disorder Based on Observation of Natural Course

OBJECTIVES: This study was conducted naturalistically in order to observe the long-term effects of attention-deficit hyperactivity disorder (ADHD) medications on growth rates among Korean school-aged boys with ADHD. METHODS: Participants in the study were boys with ADHD aged 6 to 11 years who have taken ADHD medication, methylphenidate (extended release) or atomoxetine. They attended scheduled visits monthly or bimonthly for clinical assessment with measurement of height and weight. In this study, 35 boys with ADHD (mean age at baseline=7.90+/-1.77 years ; mean age at endpoint= 12.54+/-1.91 years) were included, with a mean follow-up period of 4.64 years (+/-1.62 years), ranging from 2 to 9.7 years. Height, weight, and body mass index (BMI) measurements were converted to "age-corrected Z-scores" using data from Growth Charts provided by the Korean Center for Disease Control and Prevention from 2007. RESULTS: Age-corrected endpoint growth parameters (height, weight, BMI Z-scores) did not differ significantly from the baseline values (height t=0.027 ; weight t=-0.61 ; BMI t=-1.86, in paired t-test). Especially high correlation was observed between the baseline and endpoint height Z-scores (r=0.876, p<.001), for which the coefficient of determination r2 was 0.767, meaning that the amount of variability in endpoint height Z-scores explained by the baseline height Z-scores was 76.7%. CONCLUSION: Our results suggested that the long-term effects of ADHD medications on growth parameters to be tolerable in Korean school-aged boys with ADHD.