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Orbital fracture often leads to facial collapse, diplopia, enophthalmos, and even blindness. Traditional surgery relies on the experiences of physicians to achieve fracture reduction and orbital wall reconstruction, but the repair effect is not satisfactory. In recent years, with the development of digital technology, technologies such as computer-assisted surgery, 3D printing, surgical navigation systems, and intraoperative CT imaging have become increasingly widespread in the field of orbital reconstruction. Such techniques can avoid dependence on physicians′ experiences and make it easy for estimating and positioning the implantation sites, which subsequently contributes to better surgery efficiency and precise reconstruction of the orbit, improving aesthetics and visual function of patients. To this end, the authors reviewed the recent progress in application of digital technology for orbital fracture reconstruction, so as to provide reference and theoretical basis for clinical practice.
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Objective To explore the clinical effect of indobufen combined with clopidogrel on acute cerebral infarction and analyze the drug safety.Methods Using a randomized and controlled clinical study method,72 patients with acute cerebral infarction selected in Wenzhou Central Hospital from June 2021 to December 2022 were included in the study.They were randomly divided into control group and experimental group.The experimental group was given indobufen tablets 200mg(twice daily),and clopidogrel 75mg every day.The control group was treated with clopidogr el 75mg every day.The two groups were treated with conventional internal medicine in the department of neurology.They were given Xingnaojing Injection 20mg every day,and Butylphthalide Injection 100ml(twice daily).And they were given symptomatic support treatment with drugs to improve cerebral circulation and drugs to reduce blood fat and stabilize plaque.In addition,we control patients'basic diseases such as hypertension and hyperglycemia.The indexes of cerebral infarction related scale were evaluated before treatment and after 3 weeks.Results After 3 weeks of treatment,the scores of stroke scale in the experimental group and the control group were lower than those before treatment.The total effective rate in the experimental group was higher than that in the control group,the difference was statistically significant(P<0.05).The score of Quality of Life in the experimental group was significantly higher than that before treatment(P<0.001).The score of Quality of Life in the control group was higher than that before treatment(P<0.05).Compared with the control group,the Quality of Life score of the experimental group was higher,with statistical significance(P<0.05).The incidence of stomachache and acid reflux in the two groups was low,and there was no statistically significant difference between the two groups(P>0.05).No gastrointestinal bleeding and intracranial hemorrhage occurred in the two groups.Conclusion Indobufen combined with clopidogrels can improve the treatment effect and Quality of Life score of patients with acute cerebral infarction,and is more obvious than clopidogrel alone.In addition,compared with clopidogrel monotherapy,indobufen combined with clopidogrel did not significantly increase the incidence of adverse reactions in patients.
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OBJECTIVE@#To review targeted muscle reinnervation (TMR) surgery for the construction of intelligent prosthetic human-machine interface, thus providing a new clinical intervention paradigm for the functional reconstruction of residual limbs in amputees.@*METHODS@#Extensively consulted relevant literature domestically and abroad and systematically expounded the surgical requirements of intelligent prosthetics, TMR operation plan, target population, prognosis, as well as the development and future of TMR.@*RESULTS@#TMR facilitates intuitive control of intelligent prostheses in amputees by reconstructing the "brain-spinal cord-peripheral nerve-skeletal muscle" neurotransmission pathway and increasing the surface electromyographic signals required for pattern recognition. TMR surgery for different purposes is suitable for different target populations.@*CONCLUSION@#TMR surgery has been certified abroad as a transformative technology for improving prosthetic manipulation, and is expected to become a new clinical paradigm for 2 million amputees in China.
Sujets)
Humains , Membres artificiels , Muscles squelettiques , Procédures de neurochirurgie , , Implantation de prothèseRésumé
Objective:To analyze the clinical effect of navigation-assisted cosmetic incision for reduction and internal fixation in treating unilateral B-type zygomatic fracture.Methods:A retrospective cohort study was performed on clinical data of 35 patients with unilateral type B zygomatic fracture treated from January 2018 to December 2019 in First Affiliated Hospital of Fujian Medical University. There were 20 males and 15 females at age range of 5-62 years [(38.7±11.3)years]. Navigation-assisted cosmetic incision for reduction and internal fixation was performed for 17 patients (navigation group), and empirical incision to reduction and internal fixation was performed for 18 patients (convention group). The length of bony zygomatic process (zygomatic process) and width of zygomatic temporal point (frontal width) of the bilateral zygomatic bone were measured on the horizontal axis of CT at 1 week after operation. The absolute values of the difference of bony zygomatic process degree and frontal bony width between affected side and the healthy side were compared between the two groups. The patients′ satisfaction and occurrence of complications such as lower eyelid ectropion, incision infection and facial nerve injury were compared between the two groups at half a year after operation.Results:All patients were followed up for 6-24 months [(9.3±1.2)months]. The absolute difference of bony zygomatic process was 0.60(0.25, 0.85) mm in navigation group, and was 0.75 (0.20, 1.98)mm in convention group ( P>0.05). The absolute difference of frontal bony width was (0.37±0.11)mm in navigation group, and was (2.47±0.63)mm in convention group ( P<0.01). Satisfaction rates by both objective evaluation and subjective evaluation in navigation group were better than that in convention group at half a year after operation (both P<0.05). Navigation group showed lower eyelid ectropion in 1 patient and incision infection in 1 patient. Convention group showed facial nerve injury in 1 patient and incision infection in 2 patients. There was no significant difference in the incidence of complications between navigation group [12%(2/17)] and conventional group [17%(3/18)] ( P>0.05). Conclusion:For unilateral type B zygomatic fracture, navigation-assisted cosmetic incision for reduction and internal fixation can more accurately restore the frontal width, and improve satisfaction rate as compared with empirical reduction and internal fixation.
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Objective:To explore the application of enhanced recovery around surgery (CMERAS) by integrated Traditional Chinese Medicine & western medicine in perioperative period of laparoscopic anterior resection for rectal cancer patients.Methods:100 patients with rectal cancer who were treated by laparoscopic anterior resection in Shuguang Hospital from July 2017 to July 2019 were divided into two groups with random number table method, 50 patients in each group. The control group received enhanced recovery after surgery (ERAS) perioperative treatment and the observation group received CMERAS perioperative treatment. Both groups were treated for 7 days. The degree of intestinal cleansing during the operation and postoperative rehabilitation quality were observed of the two groups, including the time of first exhaust, hospitalization time and the incidence of complications. Serum CRP level was detected by immunoturbidimetry, serum IL-6 level was detected by chemiluminescence immunoassay and peripheral blood CD4, CD8 and CD4/CD8 were detected by flow cytometry. Adverse reactions were recorded for the two groups.Results:There was no significant difference in the degree of intestinal cleansing between the two groups during operation ( Z=-1.140, P=0.254). The first postoperative exhaust time in the observation group (29.7 ± 4.6 h vs. 36.1 ± 3.8 h, t=7.590) was earlier than that of the control group, the hospitalization time (4.2 ± 0.5 d vs. 4.7 ± 0.6 d, t=4.379) was less than that of the control group, and the incidence of complications [8.0% (4/50) vs. 30.0% (15/50), χ2=6.498] was lower than that of the control group ( P<0.01). On the third day after the operation, serum CRP (11.84 ± 4.69 mg/L vs. 23.63 ± 5.04 mg/L, t=12.106) and IL-6 (34.31 ± 5.93 ng/L vs. 44.39 ± 8.81 ng/L, t=6.714) in the observation group were lower than those in the control group ( P<0.05). CD4 levels [(37.74 ± 7.28)% vs. (33.55 ± 5.07)%, t=-3.344], CD4/CD8 ratio (1.36 ± 0.27 vs. 1.13 ± 0.22, t=-4.920) were higher than those in the control group ( P<0.01), and CD8 levels [(28.04 ± 4.68)% vs. (30.22 ± 4.04)%, t=2.487] was lower than that of the control group ( P<0.05). There were no adverse reactions in two groups during the treatment. Conclusion:CMERAS could promote the perioperative recovery of patients with rectal cancer if treated with laparoscopic anterior resection and fewer complications would occur.
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Objective@#To investigate the relationship between physical activity (PA) and the risk of incident hypertension among population in rural areas of China.@*Methods@#The Community Intervention of Metabolic Syndrome in China & Chinese Family Health Study (CIMIC) was conducted in 2007-2008. Data on PA, smoking, drinking, blood pressure and other variables were obtained at baseline. Then the follow-up study of incident hypertension was performed during 2012-2015. A total of 41 457 participants aged ≥18 years and free from hypertension at baseline were included in the final analyses. PA was calculated as metabolic equivalent (MET) for each participant. Cox proportional hazard models were used to explore the relationship of PA with incident hypertension according to the quartiles of PA.@*Results@#A total of 6 780 participants developed hypertension during an average follow up of 5.8 years. The annual incidence of hypertension was 2.80%. Compared to participants in the first quartile of PA, HR (95%CI) of incident hypertension decreased with the level of PA of 0.92 (0.86, 0.99), 0.72 (0.67, 0.77) and 0.70 (0.65, 0.75) for the 2nd, 3rd and 4th quartile, respectively (Ptrend<0.001). In subgroup analyses, compared to the first quartile, hazards of hypertension among normotensive participants (systolic blood pressure less than 120 mmHg (1 mmHg=0.133 kPa) and diastolic blood pressure less than 80 mm Hg) in the 2nd, 3rd and 4th quartile were 0.82 (0.70, 0.95), 0.73 (0.63, 0.85) and 0.78 (0.67, 0.90), respectively (Ptrend=0.002). Among participants with prehypertension (systolic blood pressure from 120 to 139 mmHg and/or diastolic blood pressure from 80 to 89 mmHg), similar trend for the relationship of PA and incident hypertension was also found with HR (95%CI) of 0.94 (0.87, 1.01), 0.71 (0.65, 0.77) and 0.66 (0.61, 0.71) for the 2nd, 3rd and 4th quartile, respectively (Ptrend<0.001).@*Conclusion@#There was linear trend association between PA and incident hypertension. Increased PA in daily life may be a protective factor against hypertension.
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Objective To explore the death risk factors of septic myocardial depression (SMD) and their predictive effect, and to set up a death early-warning model. Methods A retrospective analysis was conducted. The patients with SMD admitted to emergency department and rescue room of Beilun Branch of the First Affiliated Hospital of Zhejiang University Medical College from January 2015 to November 2017 were enrolled. The patients were divided into survival group and non-survival group according to 28-day outcome, and the gender, age, and the initial examination parameters [white blood cell (WBC) count, neutrophil (Neut) count, activated partial thromboplastin time (APTT), procalcitonin (PCT), D-dimer, C-reactive protein (CRP), cardiac troponin I (cTnI), N-terminal pro-brain natriuretic peptide (NT-proBNP), left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter (LVEDD), and left atrium diameter (LAD)] of both groups were compared. Binary logistic regression analysis was conducted on the factors with statistically significant difference analyzed in univariate analysis, and death early-warning model was set up subsequently. For parameters in early-warning model after variable screening, receiver operating characteristic curve (ROC) was applied to evaluate the predictive effect of death. Results A total of 129 patients were enrolled, 34 patients died within 28 days with the mortality of 26.4%. Univariate analysis showed that the PCT, cTnI and NT-proBNP in non-survival group were significantly higher than those of the survival group. However, there was no statistical difference in gender, age, WBC, Neut, APTT, D-dimer, CRP, LVEF, LVEDD or LAD between the two groups. Logistic stepwise regression analysis showed that PCT and cTnI were the independent factors influencing the death of patients with SMD [PCT: odds ratio (OR) =1.495, 95% confidence interval (95%CI) = 1.192-1.876, P = 0.001; cTnI: OR = 11.154, 95%CI = 5.709-17.264, P = 0.004], and the death early-warning model was logP =-3.737+0.402×PCT+2.412×cTnI. According to the statistics of Homser-Lemeshow, the effect of this model was good (χ2= 6.258, P = 0.617). The analysis of ROC displayed that the area under ROC curve (AUC) of the combination of PCT and cTnI for predicting the prognosis of SMD patients was 0.851, and it was significantly higher than that of PCT and cTnI alone (0.738 and 0.719, respectively, both P < 0.05). When the combination of PCT and cTnI was 0.26, the sensitivity was 79.97%, the specificity was 87.01%, the positive predictive value was 71.3%, and the negative predictive value was 91.7%. Conclusions PCT and cTnI are independent factors influencing the death of SMD patients. The combination of PCT and cTnI has predictive value for the prognosis of SMD patients. The death early-warning model of SMD patients can be used to predict the prognosis of SMD patients.
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Objective To investigate the clinicopathological features and treatment of children with C3 glomerulopathy (C3 G).Methods Seven children diagnosed as C3 G by clinical and pathological characteristics were enrolled in this study.The clinicopathological data and the prognosis were analyzed.Results Of the 7 cases,4 cases were female and 3 cases were male,with the mean age of (7.7-± 3.1) years old (1.5-10.4 years old) at onset,the duration from onset to renal biopsy was (3.4 ± 2.4) months (1-6 months) and 1 of them had a second renal biopsy 4.2 years later,and mean age was (8.4 ± 3.6) years old (1.8-13.3 years old) on diagnosis.Clinical features:among the 7 patients,6 cases had hematuria,among them 1 case had gross hematuria and 5 cases had microscopic hematuria;6 cases had low level of serum complement C3,5 cases had heavy proteinuria and low serum albumin,and anemia was observed in 2 cases respectively.Five cases had complement factor H and H factor antibody by examination,and 1 of them had low serum factor H,but none of them had serum antibody to factor H.Four cases had genetic evaluation,and only 1 case revealed risk variants in the C3 gene(R304R,T612T,V807V,A915A,P1632P)and CFH gene(p.H402Y,p.E936D).Clinically,4 cases were diagnosed as nephrotic syndrome of nephritis type,2 cases were diagnosed as nephritic syndrome,and 1 case was diagnosed as nephrotic syndrome of simple type.Immunofluorescence study showed that all the cases had intense deposition of C3,and 6 cases were accompanied by the deposition of immunoglobulin.Under light microscopy,3 cases showed the feature of membrane proliferative glomemlonephritis,2 cases with endocapillary prolifera-tive glomerulonephritis,1 case with mesangial proliferative glomerulonephritis,and 1 case with endoeapillary proliferative IgA nephropathy.Under electron microscopy,3 cases who had typical ribbon-like dense deposits in glomerular basement membrane were of dense deposit disease,and the rest were C3 glomerulonephritis.All patients had steroid and immune inhibitor treatment,and during the follow-up stage of (2.6 ± 1.8) years(1.1-5.6 years),4 cases showed normal urinalysis,2 cases had microproteinurine and microscopic hematuria,and 1 case had urinary protein ± to + + and microscopic hematuria.Conclusions C3G has variety of pathological-clinical manifestation.Interpretation of individual cases depends on integration of information from the biopsy together with clinical,serological,and genetic features.Patients with steroid and immune inhibitor treatment had some clinical improvement of their urinalysis.
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Objective To investigate the characteristic of lipoprotein(a)[Lp(a)]in different phases of chronic kidney disease (CKD ),to provide the basis for clinical prevention and treatment of CKD.Methods 200 patients with CKD in the Republic Hospital of Shifang were collected as study group,including 5 phases (every phase had 40 cases),and 100 healthy people were selected as control group.Measured the serum Lp(a)of both study and control group,analyzed the correlations between Lp(a)and different phase of CKD.All data were analyzed by SPSS version 17.0.The significant level was established at 0.05.Results CKD1 [(146.0 ±95.5)mg/L]and all CKD group [(231.5 ±133.2)mg/L]had higher level of serum Lp(a)than the control group [(115.5 ±70.2)mg/L] (Z=-2.800,P<0.05 and Z=-7.922,P<0.05).CKD3 had higher Lp(a)level than CKD2(Z=-2.069,P<0.05 ),while there were no significant differences between each of the other two groups.CKD4 -5 [(325 .0 ± 194.7)mg/L]also had higher Lp(a)level than CKD1 -3 [(182.0 ±110.5)mg/L](Z=-4.439,P<0.05). Conclusion Patients with CKD always have high level of serum Lp(a),which have been slowly increased since CKD1 ,meanwhile the level of Lp(a)may have a certain correlation with the stage of CKD development,since Lp(a) is an important promoting factor in the progress of CKD.
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Objective To investigate the expression of serum 25(OH)D,vitamin D receptor (VDR)and vitamin D1-α hydroxylase (CYP27B1) in intestinal mucosa tissues of patients with inflammatory bowel disease (IBD).Methods From January 1st to December 31st in 2014,105 patients with IBD were enrolled,among them there were 49 cases of ulcerative colitis (UC) and 56 cases of Crohn's disease (CD);there were 20 cases in remission,26 cases in mild active phase,37 cases in moderate active phase and 22 cases in severe active phase;and 50 cases with lesions located in the left colon and 55 cases with lesions located in the right colon.At the same period,45 healthy individuals were also recruited as controls,whom were suspected as IBD but at last proved healthy.The lactulose and mannitol absorption ratio (LMR),serum endotoxin,tumor necrosis factor-α (TNF-α) and 25(OH)D levels,and the expressions of VDR and CYP27B1 in the intestinal mucosa tissues were detected in all the subjects.T test,one-way analysis of variance and chi square test were used for statistical analysis.Results The LMR,endotoxin and TNF-α levels of UC group were (63.2 ± 13.9)％,(118.9 ± 19.7) EU/mL,and (109.6 ± 18.4) ng/L,respectively,which were higher than those of the healthy control group ((3.3 ± 1.2)％,(34.2 ±5.6) EU/mL,and (0.6±0.3) ng/L);the level of 25 (OH)D was (36.6± 9.7) nmol/L,which was lower than that of healthy control group ((49.6± 10.9) nmol/L),and all the differences were statistically significant (t =28.796,29.284,27.817 and 6.118,all P＜0.05).LMR,endotoxin and TNF-α levels of CD group were (52.9±11.3)％,(96.4±10.6) EU/mL and (83.0±16.1) ng/L,respectively,which were higher than those of the healthy control group,25(OH)D level was (44.4±9.4) nmol/L,which was lower than that of healthy control group,and all the differences were statistically significant (t=34.555,39.716,34.293 and 0.012,all P＜0.05).The differences in LMR,endotoxin,TNF-α and 25 (OH)D levels among healthy control group,remission group,mild active group,moderate active group and severe active group were statistically significant (F=286.731,385.690,657.830 and 18.932,all P＜0.01) which was dependent on the disease activity.Compared with those of the healthy controls,the levels of LMR,endotoxin and TNF-α of the left colon group and the right colon group increased,and 25(OH)D levels decreased.The high expression rates of VDR in UC group and CD group were 36.7％ (18/49) and 55.4％ (31/ 56),respectively,which were both lower than that of healthy control group (80.0％ (36/45)),and the differences were statistically significant (x2 =38.574 and 13.837,both P＜0.05).The high expression rates of CYP27B1 of UC group and CD group were 26.5％ (13/49) and 35.7％ (20/56),respectively,which were both higher than that of healthy control group (22.2％ (10/45)),and the differences were statistically significant (x2=6.499 and 4.430,both P＜0.05).The differences in the high expression rates of VDR and CYP27B1 among healthy control group,remission group,mild active group,moderate active group and severe active group were statistically significant (F=33.470 and 27.142,both P＜0.01),which was dependent on the disease activity.Compared with that of the healthy control group,the high expression rates of VDR of the left colon group and the right colon group decreased,and the high expression rates of CYP27B1 increased.Conclusion There is vitamin D metabolic imbalance in IBD patients,as well as low serum 25(OH)D level,low rate of high VDR expression in colonic mucosa tissues and high rate of high CYP27B1.
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OBJECTIVE:To investigate the clinical effects of pidotimod in the bronchial asthma complicated with recurrent re-spiratory tract infection,and its effects on immunoglobulin and related indexes. METHODS:A total of 120 bronchial asthma pa-tients with recurrent respiratory tract infection selected from our hospital during Mar. 2011-May 2013 were divided into trial group and control group according to random number table,with 60 cases in each group. Control group received routine corticosteroid therapy,and trial group was additionally given Pidotimod oral solution 0.4 g,po,bid,for 14 d,on the basis of control group. Clinical indexes(the times of respiratory infection,the duration of fever,cough,wheezing attack and antibiotics use),serum in-dexes [β-defensin-1(hBD-1),immunoglobulin A(IgA),IgG,IgM,UREA,ALT],the results of pharynx test before and after treatment,and the occurrence of ADR were observed in 2 groups. RESULTS:Before treatment,there was no statistical signifi-cance in clinical indexes,serum indexes,the results of pharynx test between 2 groups(P>0.05). After treatment,clinical indexes of trial group were significantly lower or shorter then before treatment or control group,while serum levels of hBD-1,IgA and IgG were significantly higher than before treatment or control group,with statistical significance(P0.05). The types and number of pathogenic bacteria of respiratory tract infection were decreased significantly in 2 groups,and the trial group was significantly less then the control group,with statistical significance(P<0.05). No obvious ADR was found in 2 groups. CONCLUSIONS:Pidotimod shows good clinical effects on bronchial asthma complicated with recurrent re-spiratory tract infection,can improve immunity and reduce the types and number of pathogenic bacteria with good safety.
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Objective To observe the clinical effect of digital acupoint pressure on sensory dysfunction in hemiplegic patients after stroke. Methods From March to December, 2015, 60 hemiplegic patients with sensory dysfunction after stroke were randomly divided into control group and observation group with 30 cases in each group. The control group received routine rehabilitation exercise, while the obser-vation group received digital acupoint pressure in addition. Fugl-Meyer Assessment for Sense (FMA-S), Fugl-Meyer Assessment for Motor (FMA-M) and modified Barthel index (MBI) were used to evaluate the sensory dysfunction, motor function and activities of daily living be-fore and eight weeks after treatment. Results After treatment, the scores of FMA-S, FMA-M and MBI increased in both groups (t>6.430, P2.100, P<0.05). Conclusion Digital acupoint pressure can facilitate the recovery of sensory dysfunction, improve the motor function and the activties of daily living in hemiplegic patients after stroke.
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Objective To observe the clinical efficacy of deproteinized calf blood extractive injection combined with hyperbaric oxygen in patients with severe traumatic brain injury.Methods 74 patients with severe traumatic brain injury from January 2013 to March 2015 in Wenzhou hospital of Chinese traditional medicine were randomly divided into observation group and control group, 37 cases in each group.The control group received hyperbaric oxygen on the basis of conventional therapy, the observation group received deproteinized calf blood extractive injection on the basis of control group.The Glasgow coma scale ( GCS) , Barthel, hs-CRP, TNF-α, IL-6 and prognosis were compared between two groups.Results The GCS score and Barthel index scores post-treatment in observation group were (13.67 ±1.73),(65.73 ±4.02) points, which were higher than (9.66 ±1.24), (50.69 ± 3.76) points in control group, and the difference was significant (P<0.05).The serum hs-CRP, TNF-α, IL-6 post-treatment in observation group were (4.55 ±0.76)mg/L,(1.21 ±0.05)μg/L,(0.21 ±0.01)μg/L, which were better than those of control group (6.43 ±1.01)mg/L,(1.36 ±0.06)μg/L,(0.28 ±0.02)μg/L (P<0.05).The rate of favorable prognosis in observation group was 48.65%, which was higher than that of control group (P<0.05).Conclusion The deproteinized calf blood extractive injection combined with hyperbaric oxygen has the exact efficacy, which was better than hyperbaric oxygen alone in the treatment of severe traumatic brain injury.
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Objective To investigate the drug effect of children with Dent disease who received therapy of po-tassium citrate and thiazide diuretics and angiotensin -converting enzyme inhibitors(ACEI),and to provide the refe-rence for the clinical treatment.Methods Dent disease patient who were followed -up in Bayi Children′s Hospital Af-filiated to Beijing Military Region General Hospital during the period of July 2006 and March 201 4 were selected.The patients were administered a therapy of potassium citrate associated with thiazide diuretics and ACEI according to the level of proteinuria and calciuria and serum potassium.The underlying changes before and after the treatment were com-pared and analyzed.Results In 1 5 children with Dent disease,they were all male cases,onset age ranged from 3 months to 1 1 years old[(2.62 ±3.1 1 )years old],and the disease duration ranged from 0.50 to 9.50 years old [(2.81 ±2.34)years].The patients were followed up for 0.50 to 7.50 years[(3.61 ±2.62)years].There was a sig-nificantly statistical difference in calcium/creatinine and daily Ca -creat ratio in contrast to before treatment[(0.41 ± 0.1 9)mg/mg vs(0.26 ±0.1 2)mg/mg,t =2.603,P =0.021 ;(6.76 ±2.0)mg/kg vs (4.34 ±1 .97)mg/kg,t =5.265,P =0.000],there was no significantly statistical difference in 24 -hour urinary protein quantity in contrast to before treatment[(0.96 ±0.62)g/24 h vs (0.87 ±0.44)g/24 h,t =1 .01 6,P =0.327].One case with kidney stone and 5 cases with nephrocalcinosis had a negative result of renal ultrasound after treatment.Conclusions Treatment of potassium citrate combination with thiazide diuretics and ACEI can significantly decrease urinary calcium excretion, make a disappearance of kidney stone and nephrocalcinosi,and it may have a role in protecting renal function.Treat-ment of benazepril can not significantly decrease the proteinuria and has no substantial improvement in low molecular weight protein urine.
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Background and purpose:With lifestyle shifts, incidence and mortality patterns for cancers have changed. In order to provide scientiifc basis for the government to control the diseases, this study investigated the can-cer mortality among residents of Rugao city for the period 2008 through 2012.Methods:The epidemiological study of cancer mortality rates among residents of Rugao city was carried out. The results were analyzed with Excel and SPSS software.Results:Cancer was the leading cause of death. The crude mortality rate was 264.55/100 000 and the SMR (standardized mortality ratio) was 155.04/100 000. The mortality of cancer was higher in the male than in the female patients. The top 5 causes of cancer death among residents of Rugao city were esophageal cancer, liver cancer, lung cancer, gastric cancer, and pancreatic cancer for the period 2008 through 2012. Pancreatic cancer and colon, rectum and anus cancer were the iffth and sixth leading causes of cancer death in both male and female, respectively. Nervous system tumor was the eight leading cause of cancer death, whereas osteosarcoma was the tenth. Prostate cancer was the ninth leading cause of cancer death in men. The mortality of cancer was signiifcantly higher in the elderly group than in any other age group. The most common causes of cancer death in adolescents and young adults were leukemia,nervous system tumor and osteosarcoma. The top ifve of potential years of life lost (PYLL) were liver cancer, esopha-geal cancer, lung cancer, gastric cancer and leukemia. The top ifve of average years of life lost (AYLL) were leukemia, nervous system tumor, liver cancer, breast cancer and osteosarcoma.Conclusion:Cancer has been the major cause of death in residents of Rugao city. The mortality of cancer was higher in the male than in the female. Cancer mortality was also higher in the elderly group than in any other age group. Pancreatic cancer was the iffth leading cause of cancer death. Researchers should raise awareness of cancer prevention in the residents. Treatment and prevention of pancreatic cancer, nervous system tumor and osteosarcoma should be emphasized in the prevention of the most common types of cancer. Besides, researchers should focus on early diagnosis, early treatment of cancer and screening of high-risk groups to improve the quality of life of cancer patients.
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Objective The health risk behaviors of undergraduates exist universally, which can induce other social problems. The aim of this study was to describe the present situation and analyze the influencing factors of health risk behaviors of 404 undergradu-ates. Methods Adolescent Health Related Behaviors Questionnaires were conducted in 404 undergraduates chosen from a University in Nantong by stratified cluster sampling method.Logistic regression and multiplicative interactive effects were adopted to analyze the influ-encing factors. Results Health risk behaviors were common among college students.In the past 30 days, 33.4%of students had rule-breaking behaviors in bicycle riding and 45.3%had rule breaking behaviors in walking.In the past 12 months, 2.7%of students had in-tentionally hurt themselves, 2.5%had suicidal inclination, 19.8%had smoking history, 69.3%had drinking history, 7.4%participa-ted in the gambling, 7.7%and 11.9%played video games and surfed online over 4 hours everyday, respectively, and 4.5%of students have had sex.In the past 30 days, 94.3% of students lost their weight through the unhealthy way, and 37.8%of students participated physi-cal exercise over 60 minutes for at least 3 days in the past 7 days.Lo-gistic regression indicated that male, higher grade and higher education level of the student′s mother were the risk factors of some health risk behaviors.Interactive effect was not found between the different influencing factors. Conclusion Health risk behaviors exist widely a-mong college students and more attention should be paid to risk behaviors of college students.Health behaviors should be trained among adolescents to improve their overall health level.
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Desmoplastic small round cell tumor( DSRCT) is a kind of highly uncommon malignant tumor which is reported in very recent years.Since it has been firstly reported by Gerald in 1991,DSRCT has only a-round one hundred reported cases globally, and very limited cases domestically.This report illustrates the first case of DSRCT in our hospital so as to share and to discuss with clinicians.
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<p><b>OBJECTIVE</b>To investigate the mortality rates of hepatocellular carcinoma (HCC) in Nantong,China from 1999 to 2011, in order to uncover dynamic trends and provide reasoned advice on intervention strategies to decrease HCC incidence and mortality in Nantong in the future.</p><p><b>METHODS</b>Versions 10 and 9 of the WHO International Classification of Diseases (ICD-10 and ICD-9) were used to determine the number of HCC deaths in Nantong,China for the study's range of years. Thex2 test was applied to compare the HCC mortality rates according to sex and age. The Grey system GM(1,1) model was used to predict the next-5-year HCC mortality for Nantong.</p><p><b>RESULTS</b>Analysis of the standardized mortality in Nantong showed a slight decreasing trend from 1999 to 2011 (x2=57 545.98, P less than 0.001),with males showing a steeper decrease than females. The total mortality of HCC during these years was 53.41 per 100,000 people,with mortality among males being significantly higher than that among females (80.81 per 100,000 people vs. 26.94 per 100,000 people; x2=13 625.42, P less than 0.001). In general, HCC mortality increased with increase in age (general trend:x2=57 545.98, P less than 0.001; male trend: x2=39 878.8, P less than 0.001; female trend: x2=20 105.3, P less than 0.001). However,HCC mortality increased significantly in women after the age of 40 and in men after the age of 35. The GM(1,1) equation was: Yt=-1265.28e(-0.0375t)+1315.5, which predicted that the HCC mortality will decrease to 25.56 per 100,000 people in 2016.</p><p><b>CONCLUSION</b>Although HCC mortality generally decreased from 1999 to 2011, the rate remained high. Public health intervention strategies may be more effective if they focus on males over the age of 35 and females over the age of 40.</p>
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Femelle , Humains , Mâle , Carcinome hépatocellulaire , Mortalité , Chine , Épidémiologie , Incidence , Tumeurs du foie , MortalitéRésumé
ObjectiveTo investigate the mechanism, diagnosis and treatment of membrane proliferative glome-rulo-nephritis (MPGN) transitioned from endocapillary proliferative glomerulonephritis (EnPGN).Methods The clinical data and the results of pathological examination of one case of MPGN transitioned from EnPGN were retrospectively analyzed.Results The child was presented with proteinuria, microscopic hematuria, and persistent low level of complement C3. The type of renal pathology was transitioned from EnPGN to MPGN. Complete remission was achieved in this child with the treatment of oral prednisolone and tacrolimus, but the level of plasma complement C3 remained low.Conclusions The type of renal pathology in children with persistent low level of complement C3 could make a transition, and the early diagnosis, timely and effective treat-ment are important.
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ObjectiveTo observe the effect of combined acupuncture-medication anesthesia on visceral function of patients undergone laparoscopic cholecystectomy, and to furtherexplore its clinical and theoretical significance.MethodSixty patients who were going to receive laparoscopic cholecystectomy were enrolled and randomized into an observation group (combined acupuncture-medication anesthesia) and a control group (conventional general anesthesia) by the random number table, 30 subjects in each group. The total bilirubin (TBIL), alanine aminotransferase (ALT), aspertate aminotransferase (AST), urea nitrogen, creatinine, and Mini-Mental State Examination (MMSE) were observed to evaluate the effect of combined acupuncture-medication anesthesia on visceral function of patients undergone laparoscopic cholecystectomy.ResultBefore operation, there were no significant differences in TBIL, ALT, urea nitrogen, creatinine, and MMSE between the observation group and the control group (P>0.05), while the AST level of the observation group was significantly higher than that of the control group before operation(P0.05); the TBIL level in the observation group was significantly lower than that in the control group (P0.05). The MMSE score of the observation group was significantly higher than that of the control group 6 h after the operation (P0.05).ConclusionThe combined acupuncture-medication anesthesia and conventional general anesthesia play equal effects on liver and kidney functions in laparoscopic cholecystectomy, thus the two anesthesia methods are both safe andeffective. The combined acupuncture-medication anesthesia has certain protective effects on brain function in early stage, and possibly produces certain protective effectson liver function.