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ObjectiveTo test the inter-tester reliability and test-retest reliability of MyotonPRO for evaluating neck and shoulder muscle performance parameters in patients with unilateral chronic neck pain, observe the difference of muscle performance between the healthy and affected sides of patients with chronic neck pain, and analyze the factors that cause the imbalance of muscle performance in patients with chronic neck pain. MethodsFrom January to June, 2023, 32 patients with unilateral chronic neck pain in Guangdong Second Traditional Chinese Medicine Hospital were selected. Two testers used the same MyotonPRO equipment to measure the muscle tone, muscle hardness and muscle elasticity on both sides of the sternocleidomastoid muscle and the upper trapezius muscle in the relaxed position. Tester 1 repeated the measurement after an interval of 30 minutes, and Tester 2 was measured within the time interval between the two measurements of Tester 1. The intraclass correlation coefficient (ICC), standard error of mean (SEM) and minimum detectable change (MDC) were calculated simultaneously. The measurement results were plotted into Bland-Altman diagram and systematic bias analysis was performed. The difference in muscle characteristics between the affected side and the healthy side was compared. At the same time, the Visual Analogue Scale (VAS) score and body mass index (BMI) of the subjects were collected for correlation analysis. ResultsExcept the sternocleidomastoid muscle elasticity of the affected side (ICC = 0.697), the inter-tester reliability of all other parameters was high to very high (ICC = 0.719 to 0.952, SEM = 0.04 to 6.53, MDC = 0.12 to 18.11). The test-retest reliability of all parameters was high (ICC = 0.883 to 0.981, SEM = 0.03 to 5.72, MDC = 0.09 to 15.84). Bland-Altman plot analysis showed that the scatter distribution was consistent. The muscle tone, muscle hardness and muscle elasticity of sternocleidomastoid muscle and upper trapezius muscle were higher on the affected side than on the healthy side (t > 2.846, P < 0.05). The asymmetry index of tension, hardness and elasticity of upper trapezius muscle and sternocleidomastoid muscle was significantly positively correlated with VAS score and BMI (r > 0.385, P < 0.05). ConclusionMyotonPRO has good inter-tester reliability and retest reliability in evaluating the muscle performance of both sides of patients with chronic neck pain. The muscle tone, muscle hardness and muscle elasticity of sternocleidomastoid muscle and upper trapezius muscle on the affected side were higher than on the healthy side, and the difference of muscle performance was positively correlated with pain and BMI.
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Objective:To systematically assess the risk factors for acute pancreatitis in pregnancy (APIP) in China in recent 10 years.Methods:Acute pancreatitis, pregnancy, risk factors and clinical features were used as search terms. Case-control studies on APIP in China were retrieved by computer from PubMed, Cochrane Library, Embase, CNKI, Wanfang, VIP and Chinese Biomedical Literature Database from December 2011 to December 2021. RevMan 5.4 software was utilized for Meta analysis.Results:A total of 1525 APIP patients (645 severe cases and 880 mild cases) were included in 26 literatures. Meta analysis showed that early pregnancy, late pregnancy, hyperlipidemia and biliary etiology were the risk factors for APIP. In the early pregnancy, 4.22% of patients were in the severe group and 10.43% were in the mild group; In the late pregnancy, 81.95% of the patients were in the severe group and 69.72% were in the mild group. The causes of hyperlipidemia accounted for 52.16% in the severe group and 22.69% in the mild group. The causes of biliary disease accounted for 27.96% in the severe group and 41.71% in the mild group. All the differences of the above indicators between groups were statistically significant (all P value <0.05). The age at onset, body mass index, serum C-reactive protein and triacylglycerol levels of severe patients were higher than those of mild patients, and were positively correlated with the severity of APIP ( MD values were 0.99, 65.97, 1.33, 6.44, 95% CI values were 0.03-1.96, 0.59-2.08, 23.43-108.50, 4.49-8.39, P values were 0.04, 0.0005, 0.002, <0.001). The levels of blood calcium and serum albumin were lower than those of mild patients, and were negatively correlated with the severity of APIP ( MD values were -0.37, -5.93, 95% CI values were -0.50--0.24, -9.11--2.75, P values were <0.001, 0.003). Conclusions:Acute pancreatitis can occur in all stages of pregnancy. Early pregnancy is mainly mild, and severe cases are more common in late pregnancy. Hypertriglyceridemic pancreatitis progresses rapidly, and tends to become more severe in China.
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Fecal microbiota transplantation(FMT) is a new treatment method for intestinal diseases, especially for recurrent Clostridium difficile infection(CDI), which is very effective.It can reconstruct the intestinal flora of patients and effectively correct the disorder of intestinal flora.In recent years, the clinical application of fecal transplantation has been more and more extensive.This paper reviews the development history, operation process, clinical application and adverse reactions of fecal transplantation.
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Objective To learn about the antibiotic resistance status of methicillin resistant coagulase negative staphylococcus(MRCNS),and to investigate the distribution and resistant feature of different staphylococcal chromosomal cassette mec(SCCmec) genotypes of children in Anhui,so as to guide clinical medication.Methods Resistance phenotype screening was conducted in coagulase negative staphylococcus,which were isolated from clinical strains in children in Anhui from 2010 to 2014 each year in September.MecA gene was detected by using PCR method in order to collect MRCNS.Minimal inhibitory concentrations (MIC) of 16 antibiotics were determined by adopting agar dilution method.Vacomycin-resistant strains were identified with population analysis and the Brain Heart Infusion vancomycin screen agar dilution method recommended by Clinical and Laboratory Standards Institute in 2013.Van gene and SCCmec types were detected by using PCR method.Results A total of 148 MRCNS strains were detected through the resistance phenotype screening and the detection of mecA gene.There were methicillin resistant staphylococcus epidermidis,methicillin resistant staphylococcus haemolyticus,methicillin resistant staphylococcus hominis,and other kinds of MRCNS,and the proportions of them were 44.59％ (66/148 cases),25.68％ (38/148 cases),19.59％ (29/148 cases) and 10.14％ (15/148 cases),respectively.The analysis of antibiotic resistance showed the antimicrobial resistant rates of MRCNS to Penicillin,Cefoperazone,Cefotaxime,Ceftriaxone,lmipenem and Meropenem were all 100％,to Erythromycin and Azithromycin,Ciprofloxacin,Clindamycin,Gentamicin,Lewofloxacin,Rifampincin,Chloramphenicol,Teicoplanin and Vancomycin were 92.57％,97.98％,83.78％,79.05％,43.24％,35.81％,24.32％,8.78％,2.03％ and 0.68％,respectively.There was 1 heterogeneous Vancomycin-resistant strain,which was resistant to both Vancomycin and Teicoplanin (with MIC 32.00 mg/L and 64.00 mg/L).No vanA,vanB,vanC1 or vanC2/3 gene was detected from heterogeneous Vancomycin-resistant strain by PCR.Ⅰ to Ⅴ SCCmec genotypes were detected from 148 MRCNS strains,and the major SCCmec type was SCCmec type Ⅲ,which was followed by hybrid type.Three subtypes of SCCmec type Ⅳ were identified,including Ⅳa,Ⅳc and Ⅳd.There were 148 MRCNS strains that showed different resistant phenotypes to various antibiotics.Conclusions The MRCNS strains of children in Anhui province showed multiple resistance to antibiotics.It should be on alert when heterogeneous Vaneomycin-resistant strain appeared.There were several different SCCmec types among several kinds of MRCNS,and SCCmec Ⅲ genotype was the major epidemic isolate.There was no significant correlation between the different resistance rates of non-β-lactamase antibiotics and SCCmec genotypes in MRCNS.
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Objective To evaluate the clinical application of computer-aided electromagnetic imaging navigation in nasal endoscopic surgery.Methods Twenty-two cases of nasal endoscopic surgery with intraoperative imaging navigation were retrospectively reviewed,including 16 cases of sinusitis with or without polyp;5 cases of nasal inverting papilloma; 1 case of maxillary capillary hemangioma.All cases were operated with computer-aided electromagentic imaging navigation and nasal endoscope.Results The preoperative preparing time would take 4-10 minutes.In 22 cases,the localization accuracy between 3-D image landmarks of navigation system and actual anatomical landmarks was less than 1 mm.The optic nerve and other anatomical landmarks could be orientated accurately in intraoperative procedures.No complication occurred.Conclusions Nasal endoscope combined with computer-aided electromagnetic imaging navigation provides accurate anatomical localization of nasal cavity,sinuses and anterior skull base.It could improve the effectiveness and decrease surgical complications,especially in complicated cases.