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Objective:To explore the relationship between smoking and the effect of antipsychotics in schizophrenics.Methods:From July 2017 to July 2019, 142 schizophrenics in the mental health center were treated with olanzapine, and the serum drug concentration and concentration/dose ratio (C/D) were calculated.The age, sex, liver function, smoking, combined medication and other clinical data of the two groups were collected, and the influencing factors of serum olanzapine concentration in schizophrenic patients were analyzed by multivariate logistic regression.Results:Forty-four patients were in the non-compliance group(serum olanzapine concentration <20ng/mL), and 98 patients were in the compliance group(serum olanzapine concentration 20-80ng/mL). In the non-compliance group, males accounted for 72.2%, the average age was (61.6±10.5)years old, smoking history accounted for 90.1%, and serum C/D was (2.5±1.1)ng·mL -1·mg -1·d -1, and in the compliance group, males accounted for 51.0%, the average age was (57.9±9.6)years old, smoking history accounted for 41.8%, and serum C/D was (3.2±1.8)ng·mL -1·mg -1·d -1, and there were statistically significant differences in sex, age, smoking history and serum C/D between the two groups ( t=5.86, χ 2=2.06, χ 2=5.43, t=2.38, all P<0.05). Multivariate logistic regression analysis showed that smoking and CYP1A2 genes were independently related to whether the plasma concentration of olanzapine was up to standard in schizophrenic patients.Compared with non-smokers, previous smoking increased the probability of blood concentration non-compliance by 11% and current smoking by 15% respectively( OR=1.15, P=0.001). And compared with CYP1A2 gene AA, CYP1A2 gene AC reduced the probability of blood concentration non-compliance by 15% and CYP1A2 gene CC by 13%( OR=0.87, P=0.002). Conclusion:There is an independent correlation between smoking and serum C/D value of olanzapine in schizophrenics.Quitting smoking can reduce the probability of substandard blood concentration.
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Objective:To investigate the clinical effect of oxcarbazepine combined with ziprasidone in the treatment of acute excitatory agitation in patients with schizophrenia.Methods:From January 2016 to January 2019, a total of 110 patients with acute excitatory schizophrenia who admitted in the Third Hospital of Quzhou were enrolled, and they were divided into observation group and control group according to the random digital table method, with 55 cases in each group.The control group was given ziprasidone capsule, and the observation group was given oxcarbazepine combined with ziprasidone capsule treatment for 4 weeks.The PANSS excitatory agitation factor(PANSS-EC), explicit aggressive behavior scale(MOAS), clinical efficacy rating scale(CGI-SI) score, serum neurocytokines[brain-derived nutritional factors(BDNF), nerve growth factor(NGF), glial-derived neurotrophic factor(GDNF)], homocysteine (Hcy), inflammatory factors[interleukin 1β(IL-1β), interleukin 6(IL-6), interleukin 12(IL-12), tumor necrosis factor α(TNF-α)] before and after treatment and the incidence of adverse reactions were compared between the two groups.Results:After treatment, the PANSS-EC, MOAS, CGI-SI scores, Hcy, IL-1β and TNF-α levels were decreased in the two groups( t=7.829, 14.952, 3.417, 15.511, 18.948, 7.193, 18.453, 24.161, 1.995, 3.378, 3.968, 6.820, all P<0.05), which of the observation group were lower than those of the control group[(15.34±3.56)points vs.(11.08±3.17)points, (5.36±1.68)points vs.(4.15±1.46)points, (5.56±1.21)points vs.(4.18±1.35)points, (14.29±2.42)μmol/L vs.(10.63±2.24)μmol/L, (48.15±15.63)ng/L vs.(42.18±10.51)ng/L, (29.57±8.76)ng/L vs.(23.48±6.76)ng/L]( t=6.628, 4.032, 5.645, 8.231, 2.351, 4.082, all P<0.05), while the BDNF, NGF, GDNF levels were increased( t=6.253, 6.346, 3.513, 13.906, 15.874, 7.507, all P<0.05), which of the observation group were higher than those of the control group[(9.34±1.23)μg/L vs.(11.35±1.34)μg/L, (21.37±2.85)μg/L vs.(26.87±3.21)μg/L, (439.51±56.42)ng/L vs.(489.63±58.15)ng/L], the differences were statistically significant( t=2.351, 3.523, 3.204, all P<0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groups[25.45%(14/55) vs.12.73%(7/55), χ 2=2.884, P=0.089]. Conclusion:Oxcarbazepine combined with ziprasidone in the treatment of acute excitatory patients with schizophrenia can control the clinical symptoms, improve the serum levels of cytokines, Hcy and inflammatory factors, and has high safety.
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Objective To analyze the clinical effect of fluoxetine in the treatment of patients with post-cerebral infarction depression ( PSD) and its influence on neurological rehabilitation.Methods From February 2017 to February 2018,92 PSD patients received treatment in the department of neurology of the Third People ＇s Hospital of Quzhou were included in the study.The patients were randomly divided into two groups according to the digital table , with 46 cases in each group.The control group was treated with specialist symptomatic therapy ,while the study group was treated with fluoxetine intervention for 4 weeks.The Hamilton anxiety scale (HAMD),neurological deficit scale (NIHSS) and daily living capacity scale (ADL) were used to evaluate the clinical effects of the two groups ,and the adverse reactions of the two groups were observed.Results One week before treatment,the HAMD,NIHSS and ADL scores of the study group were (28.37 ±2.18)points,(23.10 ±3.16)points and (40.61 ±3.52)points,respectively, which of the control group were (28.30 ±2.24)points,(22.91 ±3.20)points and (41.15 ±3.35)points,respectively, there were no statistically significant differences between the two groups (t＝0.223,1.522,0.761,all P＞0.05). After 2 weeks of treatment ,the HAMD,NIHSS and ADL scores of the study group were (21.08 ±2.33) points, (19.27 ±2.89) points and (49.26 ±2.88) points,respectively,which were higher than those of the control group [(24.15 ±2.43)points,(21.16 ±2.18)points,(44.26 ±2.54)points](t＝4.384,10.216,8.276,all P＜0.05). After 4 weeks of treatment ,the HAMD,NIHSS and ADL scores of the study group were (12.61 ±1.87) points, (10.12 ±1.30 ) points, (70.13 ±2.16) points, respectively, which were higher than those of the control group [(15.20 ±2.06)points,(17.45 ±2.66)points,(51.19 ±2.46)points](t＝7.273,18.283,5.371,all P＜0.05). The total effective rate of neurological recovery in the study group was 91.30%(42／46),the total effective rate of depression treatment was 84.78%(39／46),which in the control group were 76.09%(35／46) and 65.22%(30／46),respectively,the differences were statistically significant (χ2 ＝3.903,4.696,all P＜0.05).Conclusion The application of fluoxetine in the treatment of PSD can effectively improve the patients ＇depressive symptoms,promote the recovery of neurological function ,improve self-care ability,and has high safety.It has important clinical value.
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Objective@#To analyze the clinical effect of fluoxetine in the treatment of patients with post-cerebral infarction depression (PSD) and its influence on neurological rehabilitation.@*Methods@#From February 2017 to February 2018, 92 PSD patients received treatment in the department of neurology of the Third People's Hospital of Quzhou were included in the study.The patients were randomly divided into two groups according to the digital table, with 46 cases in each group.The control group was treated with specialist symptomatic therapy, while the study group was treated with fluoxetine intervention for 4 weeks.The Hamilton anxiety scale (HAMD), neurological deficit scale (NIHSS) and daily living capacity scale (ADL) were used to evaluate the clinical effects of the two groups, and the adverse reactions of the two groups were observed.@*Results@#One week before treatment, the HAMD, NIHSS and ADL scores of the study group were (28.37±2.18)points, (23.10±3.16)points and (40.61±3.52)points, respectively, which of the control group were (28.30±2.24)points, (22.91±3.20)points and (41.15±3.35)points, respectively, there were no statistically significant differences between the two groups (t=0.223, 1.522, 0.761, all P>0.05). After 2 weeks of treatment, the HAMD, NIHSS and ADL scores of the study group were (21.08±2.33)points, (19.27±2.89)points and (49.26±2.88)points, respectively, which were higher than those of the control group[(24.15±2.43)points, (21.16±2.18)points, (44.26±2.54)points](t=4.384, 10.216, 8.276, all P<0.05). After 4 weeks of treatment, the HAMD, NIHSS and ADL scores of the study group were (12.61±1.87)points, (10.12±1.30)points, (70.13±2.16)points, respectively, which were higher than those of the control group[(15.20±2.06)points, (17.45±2.66)points, (51.19±2.46)points](t=7.273, 18.283, 5.371, all P<0.05). The total effective rate of neurological recovery in the study group was 91.30%(42/46), the total effective rate of depression treatment was 84.78%(39/46), which in the control group were 76.09%(35/46) and 65.22%(30/46), respectively, the differences were statistically significant (χ2=3.903, 4.696, all P<0.05).@*Conclusion@#The application of fluoxetine in the treatment of PSD can effectively improve the patients' depressive symptoms, promote the recovery of neurological function, improve self-care ability, and has high safety.It has important clinical value.
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Objective To evaluate the skeletal stability of joint orthognathic and orthodontic treatment for cleft patients compared with non-cleft patients.Methods Fifteen cleft patient diagnosed with dental facial deformities underwent joint orthognathic and orthodontic treatment.Cephalometric analysis was carried out at T0 (before treatment),T1 (2 weeks after surgery),T2 (6 months after surgery) and T3 (24 months after surgery).The comparison of maxillary anterior-posterior and superiorinferior movement was performed with non-cleft orthognathic group (n =15) at the same follow-up time point.Results The maxilla was move forward for (3.8 ± 1.5) mm and downward for (2.4± 0.8) mm of cleft group.The relapse distance was (1.2±-0.7) mm (T1-T2:31.6％) in AP direction and (0.9±0.6) mm (T1-T2:37.5％) in vertical direction.At the time of 24 months after operation,the relapse distance was (1.0±0.5) mm (T1-T3:26.0％) in AP direction and (0.8±0.8) mm (T1-T3:33.3％) vertically.In non-cleft group,the maxilla was move (4.3±1.2) mm anteriorly and (2.2± 1.9) mm vertically.The relapse distance was (0.9±1.2) mm (T1-T2:20.9％) anteriorly and (0.8± 0.9) mm (T1-T2:36.6％) vertically at 6 months post-operatively.At 24 months after surgery the relapse distance was (1.1±0.6) mm (T1-T3:25.6％) anteriorly and (0.9±0.5) mm (T1-T3:40.9％) vertically.There were no statistical significant in both 6 months and 24 months follow-up between cleft and non-cleft group (P＞0.05).Conclusions There is no statistic difference of post-surgical relapse rate between cleft and non-cleft orthognathic and orthodontic treatments,although the relapse distances are greater than that in cleft group.
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Objective@#To measure and analyze the bone volume and thickness of mandibular angle area by computer-assisted CT.@*Methods@#From January 2010 to January 2016, 94 female patients with mandibular angle hypertrophy and bilateral mandibular angle osteotomy were selected. Twenty female patients with non-mandibular surgery were selected as control group (patient examined after nasal augmentation surgery), aged 18 to 37 years, with an average of 27.5 years. Three dimensional CT data of maxillofacial bone of patients were collected. The three dimensional reconstruction and measurement software Mimics 16.0 was used. A three-dimensional model of mandibular angle region was established. The thickness and volume of mandibular angle were measured and analyzed. The total difference between hypertrophic group and normal group was compared by two independent t-test.@*Results@#The thickness of mandibular angle area and mandibular angle area in hypertrophic group were (9.39±1.48) mm and (3 065.25±720.1) mm3 respectively, and the thickness of mandibular angle area and mandibular angle region in control group were (7.48±0.92) mm and (1 276.57±265) mm3, respectively. There was a significant difference between the two groups (P < 0.05).@*Conclusions@#Based on CT scanning data, a method of measuring the bone volume and thickness of mandibular angle region is established, which is helpful to the three-dimensional measurement and analysis of mandibular shape in patients with mandibular angle hypertrophy.
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Objective To investigate the clinical effect and safety of EEG biofeedback therapy combined with mirtazapine in the treatment of depressive disorder.Methods 124 patients with depressive disorder were selected and randomly divided into the observation group and the control group,62 cases in each group.The control group was given mirtazapine treatment,while the observation group was given EEG biofeedback therapy combined with mirtazapine.All the two groups were treated for 8 weeks.Before and 2,4,8 weeks after treatment,the clinical effects in the two groups were evaluated by Hamilton depression scale (HAMD),Montgomerie depression rating scale (MADRS) and the clinical global impression scale (CGI).The side effects scale(TESS) assessment was used to assess the side effects.And the serum norepinephrine (NE),5-hydroxytryptamine (5-HT) and dopamine (DA) levels were measured before and 8 weeks after treatment.Results The total effective rate of the observation group was 87.5％,which was significantly higher than 66.1％ in the control group (x2 =7.213,P ＜ 0.05).In the two groups,2,4,8 weeks after treatment,the HAMD scores were significantly lower than those before treatment (t =9.391,19.349,26.349,5.026,12.610,19.518,all P ＜ 0.05),the M ADRS scores were significantly lower than those before treatment (t =8.646,22.190,33.101,4.986,13.185,25.959,all P ＜ 0.05),and the CGI scores were significantly lower than those before treatment(t =17.471,29.482,42.256,13.136,28.358,35.661,all P ＜ 0.05).In the observation group,after treatment for 2,4,8 weeks,the HAMD scores were significantly lower than those in the control group(t =4.093,4.537,5.655,all P ＜ 0.05),and the MADRS scores were significantly lower than those in the control group (t =3.622,9.740,7.490,all P ＜ 0.05),while the CGI scores were significantly lower than those in the control group(t =8.608,11.024,12.598,all P ＜ 0.05).After treatment,the levels of 5-HT,NE and DA were (148.5 ± 4.9) ng/mL,(60.6 ± 4.2) ng/L and (78.0 ± 4.1) ng/L in the observation group,which were significantly higher than before treatment [(79.8 ± 4.3) ng/mL,(30.3 ± 4.0) ng/L and (43.5 ± 4.0) ng/L,t =82.977,41.134,46.837,all P ＜ 0.05].In the control group after treatment,the levels of 5-HT,NE and DA were (125.4 ± 4.1) ng/mL,(40.2 ± 4.0)ng/L and (50.3 ± 4.3)nig/L,which were significantly higher than those before treatment [(79.2 ± 3.9)ng/mL,(30.5 ±4.1)ng/L and (43.2 ±3.6)ng/L,t =64.287,13.334,9.969,all P ＜0.05],but which those in the observation group increased more significantly (t =28.469,27.695,36.286,all P ＜ 0.05).4 weeks and 8 weeks after treatment,the TESS scores in the observation group were (3.0 ± 1.0) points and (4.3 ± 1.2) points,which in the control group were (2.8 ± 1.2) points and (4.1 ± 1.3) points,there were no significant differences in terms of TESS scores (t =1.150,0.846,all P ＞ 0.05).Conclusion EEG biofeedback therapy combined with mirtazapine in the treatment of depression is better,the adverse reactions is not significantly increased,and it also has higher clinical safety compared with mirtazapine alone.
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AIM:To investigate the antagonism mechanism of benazepril on renal fibrosis of unilateral uretreal obstructire (UUO).METHODS:Fiftyfour Sprague-Dawley (SD) rats were randomly divided into three groups:sham operation group,model group,benazepril group.All the other groups were treated with surgery method of unilateral ureteral ligation to establish a rat model of renal fibrosis except the sham operation group.The pathological changes were observed by Masson staining;the positive staining expression of TGF-β1,Col-Ⅳ,Wnt1,Wnt4 in frozen sections were observed by immunofluorescence staining;the expressions TGF-β1,Col-Ⅳ,Wnt1 and Wnt4 mRNA in renal tissues were detected by real time fluorescence quantitative PCR.RESULTS:Masson staining results:compared with the sham group,the parts of blue dye collagen fiber and the degree of renal fibrosis increased significantly in all modeled groups;compared with the model group,the parts of blue dye collagen fiber and the degree of renal fibrosis decreased significantly in benazepril group.Immunofluorescence and PCR results:compared with the model group,the positive expression of Wnt1,Wnt4,TGF-β1,Col-Ⅳ and mRNA in the benazepril group decreased significantly.CONCLUSION:Benazepril can improve renal fibrosis by inhibiting the expression of TGF-β1,Col-Ⅴ,Wnt1,Wnt4 and ameliorating the level of renal fibrosis.
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A high performance liquid chromatography-tandem mass spectrometric ( HPLC-MS / MS) method coupled with an immunoaffinity clean-up column was successfully developed for determination of aflatoxins (AFB1 , AFB2 , AFG1 , AFG2 , AFM1 and AFM2 ) and zeranols ( α-zeranol, β-zeranol, α-zearalenol,β-zearalenol, zearalanone and zearalenone ). The sample was extracted with methanol-acetonitrile (20∶ 80, V/ V) after enzymatic digestion by β-glucuronidase / sulfatase, and the extraction solution was passed through glassy fiber filter paper and then diluted with phosphate buffer solution (PBS). The reconstituted solution was cleaned up with IAC-AZ immunoaffinity column, and then analyzed by HPLC-MS / MS in multiple reaction monitoring (MRM) mode. The results indicated that the linear detection range was 0. 03-6. 0 μg / L for AFB2 and AFG2 , and 0. 05-20 μg / L for the rest compounds. The correlation coefficients were above 0. 999. The limits of detection (LOD) and limits of quantitation (LOQ) were 0. 01-0. 03 μg / kg and 0. 04-0. 09 μg / kg, respectively. The recoveries of the aflatoxins and zeranols were in the range of 73. 6% -98. 4% at the spiked levels of 0. 5, 1 and 5 μg / kg, and the relative standard deviations (RSDs) were in the range of 1. 9% -11. 2% . The method was proved to be simple and accurate, and suitable for the rapid determination of aflatoxins and zeranols in animal-originated foods.
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Objective:To investigate the immediate bond strength and surface structure of resin and the tooth enamel which treated by cold plasma.Methods:In the study,40 bovine incisors were divided into two equal parts.In this sense,all enamel adhesive samples were prepared and then randomly divided into 4 groups(n =20).group 1:acid +single bond 2 +resin composite(control group);group 2:beyond bleaching+acid+single bond 2+resin composite;group 3:treated by cold plasma for 5 minutes+acid+single bond 2+resin composite;group 4:treated by cold plasma for 5 minutes+single bond 2+resin composite.Single bond 2 bonding system and Filtek Z250 resin were used in this experiment.The shear bond strength was tested by universal testing machine.The surface of the enamel in different processes was observed by scanning electron microscope (SEM).Statistical analyses by the single factor analysis of variance and multiple pairwise comparisons were performed with SPSS 1 7 .0 .Results:The shear bond strength of group 4 (8.60 MPa)was significantly lower than that of the other three groups (P<0.05). The shear bond strength of group 2 (1 7.89 MPa)was higher than that of group 4,but lower than group 1 and group 3 (P<0.05).There was no significant difference between group 1 (34.82 MPa)and group 3 (34.69 MPa).Scanning electron microscope indicated that the enamel treated by cold plasma had slight molten form,which was different from etched enamel surface.The fractured surface of group 3 was mix fracture,which was similar to the control group (group 1 ).Conclusion:Compared with the conven-tional clinic bleaching,immediate bond strength of resin-enamel that treated by cold plasma has not been affected.
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Objective To evaluate the clinic value of multiple tumor markers plus PSA in diagnosing prostate cancer.Methods We collected serum samples of 140 prostate cancer patients with average age of 68 (48-82) years,104 benign prostate hyperplasia patients with average age of 70 (52-87) years,and 162 healthy people with average age of 38 (23-49) years.We had detected PSA levels and also the protein expressions of XAGE-1b,SSX-2,AM ACR and AKAP4.In healthy people,the ranges of the normal values with 95％ data range were determined.Multiple tumor markers and PSA were calculated their positive rate,specificity and sensitivity in diagnosing prostate cancer.We had randomly chosen one positive serum,and analyzed the 4 protein expressions by Western bolt.We detected the serum with the four markers plus PSA by Luminex medthod,then drew ROC curve and calculated AUC area according to the results.Results Among all those samples,PSA levels of 266 samples were under 4tμg/L,86 samples were between 4-10 μg/L,and 54 samples were above 10 μg/L.The positive rates of XAGE-1b,SSX-2,AMACR and AKAP4 in prostate cancer patients were 53.6％ (75/140),34.3％ (48/140),27.9％ (39/140),44.3％ (62/140) respectively.The AUC of XAGE-1b,SSX-2,AMACR,AKAP4 and PSA were 0.666,0.615,0.551,0.768,0.675 respectively.The AUC of their combination was 0.887; The specificity and sensitivity of single PSA detection and combination detection were 60.0％,46.2％ and 80.0％,82.2％.Among those whose PSA value was between 4-10 μg/L,the AUC of single PSA detection was 0.505,the specificity and sensitivity of single PSA detection were 43.2％ and 31.8％; the AUC of the combination detection was 0.803; their specificity and sensitivity were 83.7％ and 73.2％.Conclusions Compared with the single PSA detection,the combination of XAGE-1b,SSX-2,AMACR,AKAP4 and PSA has been greatly improved the specificity and sensitivity in prostate cancer detection.This tool still has significant value even in patients with PSA value between 4-10 μg/L.
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Objective To investigate the relationship between metabolic syndrome (MS) and recurrence of urolithiasis.Methods A retrospective analysis was performed in urinary stone patients from March 2008 to February 2012.Patients were divided into MS group and non-MS group according to the diagnose criteria of metabolic syndrome (2007 version) by the joint committee for developing Chinese guidelines on prevention and treatment of dyslipidemia in adults.The patients were followed up for 24-72months (median 47 months) since operation.The difference of stone recurrence was compared between the 2 groups.Results Two hundred and eighteen patients with urinary stone disease were enrolled.Of them,52 patients were diagnosed with MS.Stone recurrence occurred in 29 patients (55.8％) of MS group,whereas 66 patients (39.8％) of non-MS group suffered stone recurrence.It demonstrated the median recurrence free survival of group MS and non-MS was 36 months and 59 months by Kaplan-Meier analysis,respectively (Log-rank test,P =0.019).Multivariate Cox regression analysis results revealed that MS was significantly associated with stone recurrence (HR 1.817,95％ CI 1.105-2.988,P =0.011),however,the gender (P =0.336),age (P =0.246) and recurrence urolithiasis at first visit (P =0.051) were not associated with stone recurrence.Conclusions MS is an independent risk factor for urinary stone recurrence.It is suggested that the treatment of MS may have a important role in prevention of stone recurrence in MS patients with urolithiasis.
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Objective To report our experience of nephron sparing surgery (NSS) with mini-incision approach.Methods Sixty-one mini-incision NSS were analyzed retrospectively from 2005 to 2011 in our department.Demographic and clinical data,complications,histologic and oncologic data were analyzed.There were 35 males and 26 females with average age of 41 years.B ultrasound and CT scan were performed in all cases and MR was performed in 23 cases.CT angiography was performed in 10 cases.Renal cell cancer was diagnosed in 38 cases,angiomyolipoma in 14 cases,complicated renal cyst or duplicated kidney in 6 cases and no definite diagnosis in 3 cases.All the lesions were single with 21 in the right side and 40 in the left side.The average diameter of the lesions was 3.2 (2.3-8.8) cm.The mini-flank supra-12th rib incision was performed in all cases.The renal artery was clamped with bulldog clamp,all transected blood vessels on the renal incisal surface were sutured with 3-0 Vicryl sutures,and collecting system was closed with continuous' 3-0 Vicryl suture.Results The average length of incision was 8.1 (6.5-11.0) cm.The average operative time was 93 (70-140) min.The average warm ischemia time was 19 (12-32) min.The average blood loss was 72 (20-300) ml and the average hospital stay was 6 (5-15) d.The delayed hemorrhage was occurred in 1 patient who was treated with conservative treatment.Clear cell carcinoma was found in 28 cases,chromophobe carcinoma was found in 6 cases,papillary carcinoma was found in 5 cases,angiomyolipoma was found in 16 cases,complicated cyst was found in 3 cases and renal duplication was found in 3 cases.Fortyfive patients were followed up from 28 to 82 months with no delayed complication and no recurrence or metastasis in 35 malignant cases.Conclusions The approach of mini-incision NSS can duplicate the procedure of traditional open NSS.This approach can also couple the benefits of both laparoscopic and open NSS techniques with a smaller incision which can be used to remove the specimen.
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Objective To explore the clinical features, diagnosis and treatment of Wunderlich syndrome (WS).Methods Fifteen patients with WS were included from September 2008 to February 2014, and their clinical features, diagnosis and treatment were retrospectively reviewed.The most common clinical manifestations were flank or abdominal pain (15/15), hypovolemic shock (5/15), gross hematuria (4/15) and percussion pain on kidney region ( 15/15 ) .Laboratory tests showed anemia ( 9/15 ) and coagulation abnormalities (5/15).Five of 15 cases were critical patients with moderate to severe shock ( systolic blood pressure≤90 mmHg, 1 mmHg =0.133 kPa ) accompanied with severe anemia ( Hb <60 g/L ) and coagulation abnormalities.Results In the acute stage, the diagnostic ratios of ultrasonography and contrast enhanced CT for WS were 11/15 and 15/15, and cause determination ratios were 4/15 and 10/15, respectively.The latter was significantly higher than the former ( P <0.05 ) .Contrast enhanced MRI was performed in 5 cases, and the results were identical to those of CT.According to the causes made by emergent imaging, critical patients underwent emergent operations or renal arteriography plus selective arterial embolization, and the other patients underwent conservative management, emergency operations, or renal arteriography plus selective arterial embolization, respectively.The causes of WS included angiomyolipoma (8 cases), renal cell carcinoma (3 cases), metastatic tumor of lung cancer (1 case) and renal cyst (3 cases) in this study.The mean follow-up period was 34 months.One critical patient died, and all the other patients were cured or relieved.Conclusions WS has no specific clinical features.Contrast enhanced CT or MRI is the main approach for diagnosis and cause determination, which is superior to ultrasonography.Treatments for WS vary according to severity classification and imaging diagnosis.
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Objective To compare outcomes of laparoscopic radical prostatectomy (LRP) and open radical prostatectomy (ORP) performed in our hospital.Methods A non-randomized,retrospective comparative study was performed to analysis 302 prostate cancer patients from January 2011 to June 2014.One hundred and ten patients underwent LRP and 192 underwent ORP.There were no significant differences between the LRP and ORP groups with respect to patient age,body mass index,PSA level,Gleason Score,clinical T stage and transrectal ultrasonography prostate volume (P ＞ 0.05).The operating time,estimated blood loss,catheter retaining time,hospital stay time,positive surgical margin rate and urinary control rate were compared between the 2 groups.Results The median operative time of the ORP group and the LRP group was 95 min and 120 min,the difference between groups was significant (P ＜ 0.01).The median duration of hospitalization of the 2 groups was 9 d and 6 d,the difference between groups was significant (P＜0.01).ORP group and LRP group's estimated blood loss was 350 ml and 250 ml.Days of tube drainage were 3 d in both groups.Days of urinary catheterization drainage after surgery were 16 d and 15 d,respectively.Positive margin rate was 10.4％ and 12.7％.Urinary continence recovery rates at 3 month were 80.2％ and 70.8％.Urinary continence recovery rates at 6 month were 85.9％ and 87.3％.No significant difference was observed in the above index (P ＞ 0.05).Conclusions Compared with ORP,LRP has shorter hospital stay time and longer operating time.Both LRP and ORP have good outcomes in oncological control and function rehabilitation.Both of them are important procedures to treat localized prostate cancer.
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Objective To investigate clinical efficacy and adverse reactions of Citric acid tandospirone in treating generalized anxiety neurosis.By doing this study,we provide clinical evidence for citric acid tandospirone in treating generalized anxiety neurosis.Methods 92 patients with generalized anxiety were randomly divided into the control group and observation group according to the random number table.There were 46 cases in each group.In the observation group,the patients were given acid citrate edge tandospirone.At the starting the patients were taken 15mg/d. After 3 days the dose increased to 35mg/d by 5mg.The average dose was (31 ±3.4)mg/d.In control group,accord-ing to different patients sleep condition,oxazepam tablets were taken.The daily dosage does not exceed 30mg/d.After two weeks,the dose was gradually reduced to the end.The clinical efficacy,HAMA score and adverse reactions in the two groups were compared.Results Compared to prior treatment,after 2 weeks and 4 weeks the HAMA score in the two groups were significantly different (P0.05).The rate of adverse reaction in the observation group was 32.6%.The rate of adverse reaction in the control group was 63%.The rate of adverse reaction in the control group and observation group had sig-nificantly different (χ2 =8.58,P<0.05) .Conclusion Acid citrate edge tandospirone on the treatment of general-ized anxiety neurosis showed obviously effect and had fewer adverse reactions.The clinical program is worth of further study and clinical application.
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<p><b>OBJECTIVE</b>To investigate the duration of speech therapy of patients with or without velopharyngeal insufficency after palatoplasty.</p><p><b>METHODS</b>One hundred and one cleft-palate patients with velopharyngeal incompetence (VPI) and eighty-seven without VPI were selected in the study. The treatment times of the patients who completed the speech therapy were counted and analyzed.</p><p><b>RESULTS</b>The mean treatment frequency in VPI group was 17 times, and in the group without VPI this number was 13 (P < 0.05). In 39 VPI patients with signs of velocardiofaical syndrome, the mean treatment frequency was 19 times, and the mean treatment frequency of the other 62 patents with nonsyndromic VPI was 15 times (P < 0.05).</p><p><b>CONCLUSIONS</b>The duration of speech therapy in VPI patients is longger than that in patients without VPI after palatoplasy, but individualized treatment is necessary.</p>
Sujet(s)
Femelle , Humains , Mâle , Fente palatine , Chirurgie générale , Thérapeutique , Orthophonie , Facteurs temps , Insuffisance vélopharyngée , ThérapeutiqueRÉSUMÉ
Objective To compare the perioperative outcomes of robot-assisted partial nephrectomy (RAPN) with transperitoneal laparoscopic partial nephrectomy (LPN).Methods From July 2009 to March 2013,114 patients were treated in our hospital due to renal carcinoma,including RAPN in 45 patients and LPN in 69 patients.Their data were retrospectively reviewed.Clinical and pathological variables,R.E.N.A.L nephrometry score,operation time (OT),warm ischemia time (WIT),estimated blood loss (EBL),drainage volume,the length of hospitalization,estimated glomerular filtration rate (eGFR) outcomes,and complications were analyzed.Results There were no significant differences between the RAPN and LPN group with respect to patient age,sex,tumor laterality,size,R.E.N.A.L nephrometry score,the rate of hilar tumor and preoperative eGFR (P＞0.05).The median OT was shorter in the RAPN group than that in LPN group (165 min vs.196 min,P＜0.05).The median WIT was shorter in the RAPN than that in LPN group (21 min vs.25 min,P＜0.05).However,there were no significant differences in the postoperative eGFR and changing of eGFR within the 2 groups (P＞0.05).The rate of transfusion was similar between the RAPN (2/45) and LPN (4/69) group (P=0.72).There was also no significant difference in EBL (P=0.16).The drainage volume was also similar within two groups (167 ml vs.163 ml,P=0.81).The length of hospitalization was more favorable in the RAPN group (6.5 d vs.8.0 d,P=0.01).In RAPN group,27 cases were clear-cell carcinoma,5 cases were papillary cell carcinoma,2 cases were chromophobe cell carcinoma and 1 1 cases were angioleiomyolipoma.In LPN group,45 cases were clear-cell carcinoma,9 cases were papillary cell carcinoma,3 cases were chromophobe cell carcinoma and 12 cases were angioleiomyolipoma.There was no difference of pathological types between LPN and RAPN groups (P＞0.05).The rate of positive surgical margins was 0％ (0/45) in RAPN group and 1.4％ (1/69) in LPN group (P=0.69).The rates of complication requiring intervention (Clavien grade Ⅲ) were 2.2％ (1/45) and 2.9％ (2/69) in the RAPN and LPN group,respectively (P＞0.05).Median follow up was 12 (4-36) months in the RAPN and 13 (5-34) months in the LPN group.No local recurrence or metastasis occurred in two groups.Conclusions Early comparative outcomes suggest that RAPN has a significant benefit over the LPN in terms of OT,WIT and hospital stay.Meanwhile,it offers equivalent prognosis and postoperative renal function preservation compared with LPN.
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Objective To reassess the treatment of Bosniak category Ⅱ-Ⅲ renal cyst.Methods Sixty-eight cases of Bosniak category Ⅱ-Ⅲ renal cyst were operated from 2005 to 2008 in our institute.The average patient age was 40 years with the average renal cyst diameter of 5.1 cm.There were 37 left lesions and 31 right lesions with 31 cases of category Ⅱ (including 13 cases of category Ⅱ F) and 37 cases of category Ⅲ.Renal unroofing were performed in 49 cases with 9 cases found malignant and followed by radical nephrectomy,19 cases were diagnosed as malignancy preoperatively and nephron sparing surgery or radical nephrectomy were performed in these cases.Results Malignant lesions were found in 21 cases and benign lesions were found in 47 cases.The malignant rate was 9.7％ in category Ⅱ (15.4％ in category Ⅱ F),48.6％ in category Ⅲ.Nine cases were diagnosed benign preoperatively but confirmed malignancy after operation; 7 cases were diagnosed malignancy preoperatively but confirmed benign after operation.Forty-two cases were followed up for 8-65 months with 15 cases of malignancy and 27 cases of benign lesions.The recurrence of renal cyst occurred in 6 cases of benign lesions and recurrence and metastasis occurred in 3 cases of malignancy in 1-5 years.Conclusions It is difficult to draw a therapeutic principle for Bosniak category Ⅱ-Ⅲ renal cyst because of the uncertainty of the lesion.Partial nephrectomy or renal cystectomy is a good choice in the treatment of Bosniak category Ⅱ-Ⅲ renal cysts.
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Objective To investigate the effect of stellate ganglion block combined with morphine sustainedrelease tablets for controlling pain of advanced lung cancer.Methods 90 cases with advanced lung cancer were randomly divided into the observation group and control group with 45 cases in each group.The control group was givenmorphine sustained-release tablets,the observation group received combination therapy with stellate ganglion block and morphine sustained-release tablets.The analgesic effects,quality of life scores and adverse reactions of two groups were compared.Results The effective rate of observation group was 93.33 ％ (42/45),which was significantly higher than that of control group 77.78％ (35/45),the difference was statistically significant (x2 =4.54,P ＜ 0.05).The morphine consumption of observation group was significantly less than that of control group(t =9.11,P ＜ 0.05),duration of analgesia was significantly longer than that of control group (t =6.72,P ＜ 0.05).Quality of life score in the observation group was significantly higher than that in the control group,the difference was statistically significant(Z =3.61,P ＜ 0.05).The incidence rate of adverse reactions was 17.78％ (8/45),which was significantly lower than that of the control group 46.67％ (21/45),the difference was statistically significant (x2 =4.54,P ＜ 0.05).Conclusion Stellate ganglion block combined with morphine sustained-release tablets for controlling pain of advanced lung cancer can significantly improve analgesia,reduce morphine consumption and adverse reactions,is worthy of clinical application.