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Objective:To analyze the prognosis of glucose metabolism and its impacting factors at 6-12 weeks postpartum in patients with abnormal blood glucose during pregnancy.Methods:In this cross-sectional study, a total of 192 patients with abnormal blood glucose during pregnancy enrolled and delivered in the maternity clinic of Daxing Teaching Hospital of Capital Medical University from December 1, 2019 to December 31, 2020 were collected. The 75 g oral glucose tolerance test (OGTT) was applied for diabetes screening at 6-12 weeks after delivery. According to the results of postpartum blood glucose, the patients were divided into two groups: postpartum normal blood glucose group (148 cases) and abnormal blood glucose group (44 cases). Hypothesis testing was used to compare the clinical data before, during and after the pregnancy between the two groups. Multi-factor logistic regression was performed to analyze the influencing factors of postpartum abnormal blood glucose in patients with abnormal blood glucose during pregnancy.Results:Among the 192 patients with abnormal blood glucose during pregnancy, the incidence of postpartum abnormal blood glucose was 22.92% (44/192), including 6 cases of diabetes mellitus (DM) (13.64%), 38 cases of impaired glucose tolerance (IGT) (86.36%). Neck circumference, waist circumference, multiparous women and insulin use during pregnancy in postpartum abnormal blood glucose group were all significantly higher than those in postpartum normal blood glucose group [34.25(33.00, 36.00) vs 33.55 (32.00, 35.00) cm, 87.00 (82.00, 93.00) vs 84.00 (78.00, 90.00) cm, 54.55% vs 37.16%, 18.18% vs 6.76%] (all P<0.05). Neck circumference ( OR=1.315, 95% CI: 1.026-1.685), multiparous women ( OR=2.261, 95% CI: 1.057-4.836), insulin use during pregnancy ( OR=3.767, 95% CI: 1.236-11.478) were positively correlated with the occurrence of postpartum abnormal blood glucose (all P<0.05). Conclusions:The incidence of postpartum abnormal blood glucose is high at 6-12 weeks postpartum in patients with abnormal blood glucose during pregnancy. Neck circumference, waist circumference, parity and insulin use during pregnancy are important impacting factors of postpartum abnormal blood glucose.
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Objective: To compare effectiveness between sequestrum clearance and impacting bone graft and rotational osteotomy on the base of femoral neck via surgical hip dislocation approach for avascular necrosis of femoral head (ANFH) at Association Research Circulation Osseous (ARCO ) stage Ⅲ. Methods: A clinical data of 24 patients (27 hips) with ANFH at ARCO stage Ⅲ, who met the inclusion criteria between June 2012 and November 2017, was retrospectively analysed. Of all patients, 12 patients (14 hips) were treated with sequestrum clearance and impacting bone graft via surgical hip dislocation approach (group A); and 12 patients (13 hips) were treated with rotational osteotomy on the base of femoral neck via surgical hip dislocation approach (group B). There was no significant difference in gender, age, disease duration, and affected side, type, and stage of the ANFH between 2 groups ( P>0.05). The operation time of each hip and hospitalization stays of each patient in 2 groups were recorded and compared. Imaging examination was performed to observe the blood supply around femoral head, healing of the osteotomy, and the femoral head collapsed. The function of the hip was evaluated by Harris score. Results: There was no significant difference in operation time and hospitalization stays ( t=-0.262, P=0.797; t=-0.918, P=0.411). All patients were followed up, the follow-up time of group A was 12-28 months (mean, 19.7 months), and the follow-up time of group B was 14-24 months (mean, 17.8 months). The Harris score in groups A and B increased significantly at 6 months and 12 months after operation when compared with preoperative ones ( P0.05). At 12 months after operation, according to the Harris scoring, there were 3 hips of excellent, 7 hips of good, and 4 hips of poor, with the excellent and good rate of 71.4% in group A; there were 5 hips of excellent, 7 hips of good, and 1 hip of poor, with the excellent and good rate of 92.3% in group B. Digital substraction angiography was performed at 1 week after operation and indicated that the blood supply around the femoral head was not destroyed during the operation. Imaging examination after operation showed that the osteotomy of the greater trochanter all healed in 2 groups and the osteotomy of the femoral neck healed in group B. Hip collapse occurred in 2 patients (2 hips) of group A at 12 months after operation. No hip collapse occurred in group B. Conclusion: The rotational osteotomy on the base of femoral neck via surgical hip dislocation approach is superior to sequestrum clearance and impacting bone graft in delaying the collapse and improving the hip function for patients with ANFH at ARCO stage Ⅲ.
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The main impacting factors on implementing clinical pathway were analyzed by applying fishbone diagram.The factors include policy factors,organizational factors and personal factors.It was suggested to improve the trial work of implementing clinical pathway management by reforming the medical care payment system,putting the clinical pathway management into the evaluation system,building up medical information system,putting more efforts on promotion and enhancing cooperation among related departments.
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To study the current situation and affecting factors of bilingual teaching for Neurology,we investigated the students of a five-year medical undergraduade in clinical medicine with a questionaire.It will provide the data and reference to effectively improve bilingual teaching program for Neurology.
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[Objective]To research the influence of spinal cord blood flow(SCBF) and the evoked potential(EP) by the extramarrow impacting and to explore the correlation and regularity between the spinal cord blood flow and evoked potential after spinal cord injury.[Method]Normal 120 SD rats were randomized into 4 groups,with 30 in each.Group A was the control group.In groups B,C,D,impacts of 10,15,20N were given to lamina respectively.The blood flow of impacting position and evoked potential were observed at different time points including 0 min,1 h,6 h,1 d,6 d,12 d,24 d.[Result]The blood flow of spinal cord represents a dimning trend with the impacting load raising.The blood flow of group A,had no marked change,the SEP and MEP also.The blood flow of group B represented a temporaly lowing,then recovered normal,the SEP and MEP also.The blood flow of group C and D represented a continuous lowing,then slowly raising.The group C recovered normal at 24d,the group D still lower than normal.[Conclusion]The impact load to lamina can influence the spinal cord function through altering the spinal cord blood flow.There is evident correlation between the SCBF and EP.
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Sixty-eight revisions of total hip arthroplasties from sixty-one patients were performed using allogenic cancellous chip bone and fine granules of HA for bone deficiencies of the acetabulum at two hospitals in Seoul since September 1992. In our practice, acetabular deficiencies were classified into two broad categories, which were based on our provisional treatment protocol. For the segmental deficiencies of the acetabulum, we employed the method of using the cemented acetabular component. In the mean time, Ling technique of impaction graft with PMMA cement were also employed. For the cavitary deficiencies of the acetabulum, we used several types of uncemented ingrowth cups with HA granules and Tutoplast was used to further ameliorate the bony integration. In addition, we obtained good results in cavitary deficiencies of the acetabulum with C.L.S. Expansion Cup and Ringloc fin Cups which seem that initial stability during the cup installation were remarkable. Unfortunately, we had 5 cases of clinical failure, which consist of bone graft incorporation, where eventual resorption of the graft and implant migration were resulted. Nevertheless electromicroscopic finding of interface taken from failure showed partial new trabecular formation and physicochemical bonding near the host bone bed in some cases. Although primary stability of reconstructive surgery was acceptable, Tutoplast - HA granule composites have similar effect of incorporation to host bone compared with other method of allogenic bonegraft storage, which remodeled after 5 years. Thus, this phenomenon requires further investigation of molecular biological role of tissue substance known as cytokine, as well as microscopic histology.
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Humanos , Acetábulo , Artroplastia , Protocolos Clínicos , Cadera , Polimetil Metacrilato , Seúl , TrasplantesRESUMEN
Objective To explore the effects of two air sampling methods including natural precipitation method and impacting method for detecting the bacterial count of indoor air of workplace of cosmetic plants. Methods The diameters of 44 glass bacteria-culture plates for those two sampling methods were measured. The indoor air of workplace of cosmetic plants were sampled by those two sampling methods simultaneously. The natural precipitation method was performed for 5- minute exposure ,the impacting method was performed by MAS-100 airborned bacteria sampler at flow rate of 100 L/min for 30 s,2 min,8 min respectively.All of the data on the bacterial counts of air obtained from various sampling ways were statistically analyzed.The measures for quality control of air sampling progress were put forward also. Results The diameters of 44 glass bacteria-culture plates were 8.39-8.70 cm,which were lower than the standard(9 cm?雪. The bacterial counts of air samples collected by natural precipitation method at the same location showed higher coefficient of variation,higher median,lower qualified rate compared with those by impacting method. The bacterial counts of air decreased,when the impacting sampling method was performed for 8 min continuously with sampling volume of 800 L. Conclusion The impacting method with advantages including mere influence from external environment and better precision could be primarily applied for air sampling in general condition,but it might show lower efficiency of collecting the airborne bacteria during the longer sampling period with higher sampling volume. The natural precipitation method with poor precision was suitable for longer term (8-30 min)air sampling in the relatively static environment with lower air flow and highly cleaned air. The bacterial counts of air obtained from natural precipitation method should be corrected if the diameters of glass bacteria-culture plates weren't meet the requirement of the national standard (9 cm?雪.