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Objective:Rapid assessment of the outcome after percutaneous coronary intervention (PCI) in patients with acute coronary syndrome (ACS) is an important clinical issue. In this study, an electrocardiogram (ECG) analysis method based on dynamic learning was proposed.Methods:A total of 203 patients with ACS after successful PCI were enrolled for prospective analysis at the Emergency Department of Qilu Hospital of Shandong University from April 2019 to December 2020. All patients were divided into group without ≥70% postoperative stenosis ( n=72) and group with ≥ 70% postoperative stenosis ( n=131) according to the presence of 70% or more stenosis after PCI. The clinical data of ACS patients were collected and analyzed by χ2 test, t-test, or Mann-Whitney test. ECGs were recorded before and 2 h after PCI, and were dynamically analyzed to generate cardiodynamicsgram (CDG) using dynamic learning. In the group without ≥ 70% postoperative stenosis, the model and CDG index for evaluating myocardial ischemia were obtained by training support vector machine (SVM) using 10 times 10-fold cross-validation. Results:There was no significant difference in clinical data between the two groups. The prediction accuracy and sensitivity of the support vector machine model for myocardial ischemia in group without≥70% postoperative stenosis were 73.61%, and 84.72% respectively. CDG transformed from disorderly to regular after PCI, and CDG index decreased significantly ( P<0.001): 90.28% (65) patients in group without≥70% postoperative stenosis, and 79.39% (104) patients in group with≥70% postoperative stenosis had lower CDG indexes than before PCI. Conclusions:In this study, CDG obtained by dynamic learning can intuitively and effectively evaluate the changes of myocardial ischemia before and after PCI, which is helpful to assist clinicians to formulate the next treatment plan.
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Thirteen patients with colorectal lesions underwent laparoscopic surgery from January to December 2019. Before surgery, 5.0 ml autogenous blood was injected under colonoscopy into the inferior margin and opposite sides of the lesion for localization. The operation time，success rate，complications，location efficiency and postoperative pathology were evaluated. The autologous blood tattooing was easily applied for all patients without complication. At laparoscopic surgery，the lesions of all patients were clearly visualized except one obese patients with rectal tumors, because the tumor was located below the retroperitoneal fold. No blood diffusion and leakage，and local inflammatory responses were observed. The surgical margins of all samples were tumor negative. Preoperative tattooing with autologous blood is recommended as an easy，safe and economical procedure for colonoscopic surgery in patients with colorectal lesions.
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Objective@#To evaluate the association of short-term fine particulate matters (PM2.5) exposure and blood pressure in children and adolescents.@*Methods@#A total of 144 813 junior and senior middle school students who participated in the physical examination in the 2017-2018 academic year in a northern city of China, with complete record of demographic characteristics, blood pressure and no history of heart and other important organ diseases were selected as the study subjects. Data on PM2.5 and other pollutants and meteorological data were obtained from the nearest air quality and meteorological monitoring stations of each schools. A generalized linear mixed effect model was used to analyze the association between short-term exposure of PM2.5 and blood pressure.@*Results@#The 6 day average concentration of PM2.5 (lag05) increased by 10 μg/m 3 was associated with an increase of 0.177(95%CI=0.148-0.207)mm Hg (1 mm Hg=0.133 kPa) in systolic blood pressure and 4.4%(OR=1.044, 95%CI=1.030-1.058) increase of the prevalence of high systolic blood pressure. And it was also associated with -0.021(95%CI=-0.040--0.002)mm Hg decrease in diastolic blood pressure, but had no significant correlation with the prevalence of high diastolic blood pressure. In general, a 10 μg/m 3 increase of PM2.5 was associated with 3.3% increase in the prevalence of high blood pressure (OR=1.03, 95%CI=1.02-1.05), and difference of boys and girls were found in different lagged days (P<0.05).@*Conclusion@#Short-term exposure of PM2.5 is associated with increased systolic blood pressure and prevalence of high blood pressure among children and adolescents. Attention should be paid to the prevention of short-term exposure of PM2.5 to protect the health of children and adolescents.
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Objective:To explore the effect of Baduanjin functional exercise on the motor ability and self-management of the elderly patients with chronic knee osteoarthritis.Methods:From June 2018 to June 2019, 120 cases of elderly patients with chronic knee osteoarthritis who were treated in Ningbo Traditional Chinese Hospital were randomly divided into a control group and an experimental group with 60 cases each. The control group was given routine functional exercise, while the experimental group was given Baduanjin exercise. Three months later, isokinetic muscle strength (including peak torque and average power) of quadriceps femora was compared before and after exercise. After exercise, the motor ability was measured by the simple Fugl-Meyer motor function rating scale (FM), and the self-management efficacy was assessed by the general self-efficacy scale (GSES).Results:A total of 11 cases were lost in 120 patients, and 54 cases were included in the control group and 55 cases in the experimental group.After exercise, the peak torque and average power of quadriceps femoris in the experimental group were significantly higher than those in the control group [(75.5±5.4) vs.(68.9±5.6) N·m, (73.9±2.0) vs. (68.3±4.4) W], and the scores of part of lower limbsin the FM and GSEs were also significantly higher than those in the control group [(24.3±2.9) vs. (22.1±2.6) points, (3.1±0.4) vs. (2.7±0.4) points] (all P<0.001). Conclusion:Baduanjin functional exercise can improve the motor ability and self-management of elderly patients with chronic knee osteoarthritis.
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Twelve patients with complex anal fistulas were treated in the Affiliated Hospital of Medical School of Ningbo University from June to December 2018. All the patients were successfully operated, and after the operation the wound was rinsed twice a day by buried drainage tube. Patients were followed up for 3 months, the wound was healed in 11 cases and relapsed in 1 case with a mean wound healing time of (25.2±7.0) d; the pain scores at 1 d, 3 d and 5 d after surgery were 3.21±1.27, 2.34±1.22 and 1.89±0.78, respectively. There was no significant difference in preoperative and postoperative Wexner scores, anal resting pressure, and anal maximum systolic pressure (P>0.05).This innovative technique with buried drainage tube is safe and effective, which can shorten the recovery time and reduce the recurrence rate.
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Twelve patients with complex anal fistulas were treated in the Affiliated Hospital of Medical School of Ningbo University from June to December 2018. All the patients were successfully operated, and after the operation the wound was rinsed twice a day by buried drainage tube. Patients were followed up for 3 months, the wound was healed in 11 cases and relapsed in 1 case with a mean wound healing time of (25.2±7.0) d; the pain scores at 1 d, 3 d and 5 d after surgery were 3.21±1.27, 2.34±1.22 and 1.89±0.78, respectively. There was no significant difference in preoperative and postoperative Wexner scores, anal resting pressure, and anal maximum systolic pressure ( P>0.05).This innovative technique with buried drainage tube is safe and effective, which can shorten the recovery time and reduce the recurrence rate.
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Objective:To describe a new technique for chronic anal fissure surgery aimed at minimal invasion and reducing pain, and to evaluate the preliminary results concerning non-healing and intact anal function.Methods:A prospective observational study in twenty-five chronic anal fissure patients treated by Intersphincteric Lateral Internal Sphincterotomy (ILIS) technique from February to June 2018 in the Affiliated Hospital of Medical School of Ningbo University were conducted.Results:Chronic anal fissure in twenty-five patients healed primarily (96%, 24/25). There was one non-healing case. The mean healing time was(14.66 ± 5.63) d. Pain scores of 1, 3 and 5 d after surgery were (2.32 ± 0.82), (1.66 ± 0.74), (1.22 ± 0.63) scores. None had disturbance in clinical anal continence. Wexner score was 0.Conclusions:The early outcome of the ILIS technique is quite impressive. This technique is minimally invasive, with shorter healing time and less pain. It has the potential to become a viable option for chronic anal fissure surgery.
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Objective To investigate the resection of chest wall tumor and the reconstruction of it.Methods Retrospectively summarize the diagnosis and treatment of 91 cases of chest wall tumors in our hospital from January 2008 to November 2017.There are 55 males and 36 females and the ages ranged from 7 to 78 years,with a median age of 43 years.82 cases were operated for the first time,and 9 cases were reoperated.The postoperative pathology showed that the benign were 52 cases and malignant were 39 cases.The largest benign tumor was 15 cm × 10 cm × 3 cm and the largest malignant tumor was 30 cm × 20 cm × 15 cm.Local excision was performed in 66 cases and extended resection in 25 cases.After the resection,ilium,titanium mesh,Dacron mesh and Matrix reconstruction system were selected for reconstruction of chest wall respectivly.Results All the operation was successful and without death.Local resection was performed in all of benign tumor and in 15 cases of malignant tumor,extended resection was performed in the other 24 malignant tumor cases.After the local resection,the soft tissue was sutured directly to reconstruct the chest wall.The enlarged resection of the bone was performed by reconstructing the bony chest with different materials.In the soft tissue reconstruction,1 cases were treated with myocutaneous flap,and the other 23 cases were sutured directly.Postoperative chest wall integrity is stable,no chest wall floating and abnormal breathing.1 patients received ventilator supportion,and 2 patients had wound infection.The chest wall defect caused by benign tumor has good quality of life,no recurrence.After resection of the malignant tumor of the chest wall,2 died,and the rest were still alive.Conclusion Local resection is the main therapeutic method of benign chest wall tumor,and malignant chest wall tumor is mostly enlarged excision.Bone remodeling after extended resection plays an important role in the reconstruction of chest wall.It is necessary to select appropriate materials for reconstruction.Matrix titanium sternal or rib reconstruction system fixed reliably and the follow-up in a short term were also satisfactory.
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Seventy seven patients with complicated anal fistula were randomly assigned to receive tunnel fistulectomy with multiseton drainage (group A, n=38) or traditional fistulectomy (group B, n=39) for treatment.The clinical data and the treatment outcomes of two groups were compared.There was no significant difference in operation time between two groups (P>0.05). However, group A was significantly superior to group B in postoperative pain Numerical Pain Rating Scak (NPRS) score [(2.2±0.84) vs. (4.2±1.3), P<0.05)], wound surface area [(3.7±0.84) cm2 vs. (7.28±1.83) cm2, P<0.05], wound healing time [(23.4±2.41) d vs. (38.8±3.49) d, P<0.05 ], cure rate(97.4% vs. 79.5%, P<0.05) and recurrent rate 1 year after surgery(5.3% vs. 25.6%, P<0.05). The postoperative anorectal dynamic parameters of group A were also better than those of group B (P<0.05). Compared to traditional fistulectomy, the tunnel fistulectomy with multiseton drainage has advantages of less pain, faster recovery, less disturbance in anal function and better long-term clinical effect in treatment of complicated anal fistula.
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Objective To investigate the clinical significance of IL -2 and IL-6 detection in the diagnosis and treatment of patients with condyloma acuminatum .Methods 45 patients with condyloma acuminatum were selected,and 45 healthy people were selected as control .Enzyme linked immunosorbent assay (ELISA) and transcrip-tion polymerase chain reaction ( RT-PCR) were used to detect the levels of IL -2 and IL-6 in patients before and after treatment,and the levels of IL-2 and IL-6 were detected in healthy controls .Results Before treatment,the serum contents of IL-2 and IL-6 in patients with condyloma acuminatum ,after treatment were (3.28 ±0.97)μg/L, (4.98 ±1.83)pg/L,respectively,the serum IL-2,IL-6 contents were (6.01 ±0.42)μg/L,(7.05 ±1.94)pg/L, respectively.The serum IL-2 and IL-6 levels of control group were (8.09 ±1.36)μg/L,(9.12 ±2.51) pg/L, respectively,the differences between the two groups were statistically significant (t=5.82,5.46,P<0.05,0.01). Before treatment ,the IL-2 and IL-6 mRNA expression in skin tissue of patients with condyloma acuminatum after treatment were (0.327 ±0.048),(0.457 ±0.093),which were (0.512 ±0.021),(0.641 ±0.154),respectively. The IL-2 and IL -6 mRNA expression in skin tissue of the control group were (0.859 ±0.125),(0.932 ± 0.063),the differences between the two groups were statistically significant ( t =4.68,6.74;P <0.05,0.01). Conclusion There are serious defects in the cellular immune function of patients with condyloma acuminatum .The detection of IL-2 and IL-6 levels in patients with condyloma acuminatum has important clinical value for the occur -rence,treatment and prognosis of the disease .
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Objective To evaluate the clinical efficacy of dexmedetomidine given intranasally for day surgery recovery period.Methods 60 pediatric patients who were treated for elective day surgery were selected as study objects,and they were randomly divided into control group and observation group according to the digital table,30 cases in each group.During operation, after induction of 8% sevoflurane inhalation at 8 L/min,3% of sevoflurane was maintained at 1 L/min.After intubation,0.5 g dexmedetomidine was given intranasally in the observation group, 0.9% NaCl saline was given to the control group.Mean arterial pressure (MAP),heart rate (HR),oxygen saturation (SpO2) were observed at different time points.The recovery time, number of cases of agitation, Aono agitation scale, children anesthesia delirium PAED score and the incidence of adverse reactions were observed in the two groups.Results As the time passed by, the MAP,HR,SpO2 in the two groups stabilized, except HR of the observation group at T0 time was higher than the control group[(92.92±3.22)beats/min vs.(89.32±3.22) beats/min], the difference was statistically significant(t=2.34,P0.05).The overall incidence of adverse reactions was similar in the two groups, there was no statistically significant difference (13.33% vs.10.00%,x2=0.12,P>0.05).Conclusion Dexmedetomidine given intranasally for the children underwent day surgery can significantly improve the quality of children awakeness, reduce the incidence of postoperative delirium, and without significant side effects.
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Objective To explore the clinical treatment of Doppler guided hemorrhoid artery ligation (DG-HAL) combined with ultrasound-knife excision for severe hemorrhoids. Methods Eighty-seven patients with sever hemorrhoids were divided into 2 groups by the different admission months, the patients in group A (odd-numbered month) were treated by DG-HAL combined with ultrasound-knife excision, and the patients in Group B (bimonthly) were treated by procedure for prolaps and hemorrhoids. The clinical date were compared between 2 groups. Results There were no statistical differences in postoperative pain score and total efficient rate between 2 groups (P>0.05). The operating time, total hospitalization expenses and the incidences of postoperative bleeding, long term postoperative anal discomfort in group A were significantly lower than those in group B: (25.5 ± 2.8) min vs. (36.8 ± 4.6) min, (7 859 ± 564) yuan vs. (10 728 ± 733) yuan, 0 vs. 12.8%(5/39) and 2.1%(1/48) vs. 17.9%(7/39), the patient satisfaction score was significantly higher than that in group B: (9.3 ± 0.7) scores vs. (8.1 ± 0.6) scores, and there were statistical differences (P<0.05). Conclusions DG-HAL combined with ultrasound-knife excision to treat severe hemorrhoids has the definite treatment, less trauma, fewer complications and cheaper hospitalization expenses.
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BACKGROUND:It is particularly important to establish an ideal animal model of pulmonary fibrosis to investigate the underlying pathogenesis and screen effective drugs to prevent and control pulmonary fibrosis. OBJECTIVE: To establish a modified scheme of establishing mouse models that can reflect pulmonary fibrosis formation in humans. METHODS: Fifty-six male C57BL/6 mice were randomly divided into two groups: A (a single large-dose injection) and B (multiple smal-dose injections). Mice in group A were subjected to a single intravenous injection of bleomycin 200 mg/kgviathe tail vein; and mice in group B received intravenous injections of bleomycin 50 mg/kg via the tail vein per week, totaly for 6 weeks.
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Objective To explore the clinical treatment of procedure for prolapse and hemorrhoids (PPH) combined with transrectal Block for rectocele (Block procedure).Methods Eighty-six hospitalized patients with rectocele were divided into two groups according the odevity of month:A group (odd month,PPH combined with Block procedure group,49 cases) and B group [even month,stapled trans-anal rectal resection (STARR),37 cases].The treatment conditions were compared between two groups.Results There were no statistical differences in degree of postoperative pain,healing rate between two groups (P ＞ 0.05).The operating time,postoperative hemorrhage rate,cost of hospitalization,patient satisfaction score and rectocele depth after 1 year in A group were significantly better than those in B group [(25.5 ± 2.8) min vs.(36.8 ± 4.6) rmin,2.0％(1/49) vs.13.5％(5/37),(7 359 ± 580) yuan vs.(10 928 ± 610) yuan,(9.1 ± 0.8) scores vs.(8.2 ± 0.7) scores,(5.02 ± 0.71) mm vs.(9.73 ± 1.31) mm],there were statistical differences (P ＜ 0.05).Conclusions PPH combined with Block procedure for rectocele had a significant clinical effect,it is a safe new method with small surgical trauma,a better choice to prevent the recurrence of rectocele,reduces the patients economic pressure obviously.So it is worth to clinical promotion.
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Objective To understand the effect of astragalus on insulin resistance and plasma amylin levels in newly diagnosed type 2 diabetic patients.Methods 88 patients of newly diagnosed type 2 diabetes were randomly divided into three groups:Group A (lifestyle intervention group) contained 30 patients,Group B (metformin treatment group) also contained 30 Patients,and Group C (astragalus and metformin treatment group) contained 28 Patients.Patients in group A were intervened with the control of diet,blood pressure and lipids level; patients in group B were additionally treated with metformin on the basis of group A; patients in group C were additionally treated with metformin and astragalus on the basis of group A.The course for both treatments were 8 weeks.Various clinical and biochemical parameters were detected before and after the treatment in all three groups and enzyme-linked immunosorbent assay was adopted for the detection of plasma amylin.Results Fasting blood glucose levels were significantly decreased after treataent in the three groups (t=-2.696、-4.029、-3.995,P＜0.05) ; insulin resistance index reduced in group B and group C (t=-2.599、-3.813,P＜0.05),the difference between group C and group B was statistically significant (t=-2.334,P＜0.05) ;treatments of group B and group C could improve the beta cell function index (t=2.303、2.384,P＜0.05),and they also could increase the plasma amylin level (t=2.341、3.045,P＜0.05).Conclusion Astragalus and metformin can improve insulin resistance index and increase plasma amylin levels in newly diagnosed type 2 diabetic patients.
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Objective To understand the serum levels of advanced glycation end products (AGEs),soluble receptor for advanced glycation end products (sRAGE) in newly diagnosed patients with type 2 diabetes.Methods 60 patients of newly diagnosed type 2 diabetes were chosen from 2010 September to 2011 December in Department of Endocrinology Changshou Chinese medicine hospital in Jiangsu Province,and 30 healthy people were screened as control group.Various clinical and biochemical parameters were detected,using enzyme-linked immunosorbent assay for the detection of serum AGEs and sRAGE levels.Results The levels of serum AGEs in newly diagnosed type 2 diabetic patients and control group were (1379.2 ± 431.8) and (1154.5 ±326.4) pg/ml,and there were significant differences between two groups (P＜0.05).The levels of serum sRAGE in newly diagnosed type 2 diabetic patients and control group were (14.6± 9.3)and (19.5 ± 8.9)ng/ml,and there were also significant differences between two groups (P＜0.05).The level of serum AGEs in newly diagnosed type 2 diabetic patients was positive correlation with glycosylated hemoglobin (HbA1c),and the level of serum sRAGE was associated with low density lipoprotein cholesterol (LDL-C) negative correlation.Conclusion The level of serum AGEs increase in newly diagnosed type 2 diabetic patients,and the level of serum sRAGE decrease in newly diagnosed type 2 diabetic patients.
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Objective To understand the effect of astragalus on serum levels of advanced glycation end products (AGEs),soluble receptor for advanced glycation end products (sRAGE) in newly diagnosed patients with type 2 diabetes.Methods 60 patients of newly diagnosed type 2 diabetes were randomly divided into control group (28 patients) and treatment group (28 patients),the control group was given control of blood glucose,blood pressure,lipids and other necessary treatment,and the treatment group was additionally treated with astmgalus granule based on the control group.The course for both treatments is 12 weeks.Various clinical and biochemical parameters were tested before and after treatment in both groups with enzyme-linked immunosorbent assay for the detection of serum AGEs,sRAGE levels.Results ① Glycosylated hemoglobin (HbA1c) in the control group after treatment (7.28± 0.83)％ was significantly decreased than before treatment (9.57±1.14) ％,the difference was statistically significant (t＝5.75,P＜0.05); glycerin three greases (TG) in the control group after the treatment (1.45± 0.39)mmol/L decreased significantly compared with those before treatment (1.92± 1.01)mmol/L,the difference was statistically significant(t＝2.79,P＜0.05); ② HbA1c (7.16± 0.88) ％ in the treatment group after treatment was significantly decreased than before treatment (9.29± 1.62)％,the difference was statistically significant (t＝6.08,P＜0.05) ; TG (1.53 ± 0.41) mmol/L in the treatment group after treatment was significantly decreased compared with those before treatment (2.11 ± 0.79)mmol/L,the difference was statistically significant (t ＝ 2.40,P ＜ 0.05) ; the levels of serum sRAGE (20.38 ± 8.01) ng/ml in the treatment group after treatment increased obviously compared with those before treatment (15.10 ± 9.22)ng/ml,the difference was statistically significant (t＝-2.29,P＜0.05); ③ The level of serum sRAGE (20.38 ± 8.01) ng/ml in the treatment group after treatment increased obviously than the levels of serum sRAGE (15.13 ± 9.27)ng/ml in the control group after treatment,the difference was statistically significant (t＝-1.17,P＜0.05).Conclusion Astragali can increase serum sRAGE expression in newly diagnosed type 2 diabetic patients.
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Objective:To investigate the relation among platelet activation marker(GPⅡb/Ⅲa,CD62p) and amounts of fibrinogen (FG) and of D-dimer (DD) in elderly patients with chronic cor pulmonale exacerbation.Methods:Subjects were divided into four groups (42 elderly patients with chronic cor pulmonale exacerbation,42 elderly patients with chronic cor pulmonale remission stage,30cases of healthy elderly controls and 30 cases of healthy non-elderly controls).Positive rates of GPⅡb/Ⅲa and CD62p were measured with tricolor flow cytometry.We also determined FG and DD in patients with chronic cor pulmonale and in normal controls.Results:Compared with those of chronic cor pulmonale remission stage group,healthy elderly group and healthy non-elderly group,the levels of GPⅡb/Ⅲa,CD62p,FG and DD increased significantly in elderly patients with chronic cor pulmonale exacerbation (all P<0.001).There was a positive correlation between the amount of GPⅡb/Ⅲa or CD62p and the amount of FG and DD in elderly patients with chronic cor pulmonale exacerbation.Conclusion:There is increased coagulation and platelet activity in elderly patients with chronic cor pulmonale exacerbation,and there is a significant correlation between platelet activity and hypercoagulability.
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Objective To investigate the relationshp among Gp Ⅱ b/ⅡⅢ a、CD62p in platelet activation mark-er and high-sensitivity C-reactive protein (hs-CRP) in elderly patients with chronic cor pulmonary exacerbation. Methods The subjects were divided into four groups (42 elderly patients with cor pulmonary exacerbation,42 eld-erly patients with cot pulmonary remission,30 cases of healthy elderly subjects and 30 cases of healthy non-elderly subjects) . The expression of Gp Ⅱ b/Ⅲ a and CD62p were measured with tricolor flow cytometry. Hs-CRP levels were measured by nephelometry and turbidimetry in patients and normal controls. Results Compared with cor pul-monary remission group,healthy elderly group and healthy non-elderly group, the levels of Gp Ⅱ b/Ⅲ a, CD62p and hs-CRP increased significantly in patients with chronic cor pulmonary exacerbation ( all P < 0.001 ). Gp Ⅱ b/Ⅲ a and CD62p results of the elderly patients with cot pulmonary remission were higher than those in healthy elderly subjects (P <0.05) and healthy non-elderly subjects (P < 0. 001 ) . The expressions of both Gp Ⅱ b/Ⅲa and CD62p in healthy elderly subjects were statistically higher than that in healthy non-elderly subjects ( P < 0.05 ). There was a positive con'elation between the Gp Ⅱ b/Ⅲ a、CD62p and hs-CRP in elderly patients with chronic cot pulmonary exac-erbation(r =0.59,P<0.01 ; r=0.54,P<0.01 ). Conclusions The platelet in elderly patients with chronic cot pulmonary exacerbation is overactivated,which is correlated with hs-CRP.
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Objective To investigate the clinical significance of piatelet activity in patients with chronic cor Dulmonale.Methods PAC-1 and CD62p was measured with flow cytometry in whole blood samples from 40 patients and 30 normal controls.The pulmonary arterial pressure was detected through Doppler echocardiography.The arterial partial pressure of oxygen and the carbon dioxide were also analyzed.Results PAC-1 and CD62p increased significantiy (P<0.01).Conclusion Platelet activity is positively related to pulmonary artrial systolic pressure,CO2 partial pressure,and negatively related to O2 partial pressure.