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Objective:To investigate the relationship between embryo implantation site and adenomyotic lesions in pregnant patients with adenomyosis and its effects on pregnancy outcomes.Methods:Between January 2018 and December 2020, the clinical data of 95 pregnant patients with adenomyosis who were hospitalized in the Women′s Hospital, School of Medicine, Zhejiang University, which could identify the implantation site of embryo or placenta (≥11 weeks of pregnancy) through the nuchal translucency test under ultrasonography were analyzed retrospectively. According to the relationship between embryo implantation site and adenomyotic lesions, 95 patients were divided into two groups:short-distance group ( n=59, the embryo or placenta implantation was very close to or over the adenomyotic lesion), and long-distance group ( n=36, the implantation site of embryo or placenta was far away from the lesion, or the implantation site and the adenomyotic lesion were on different sides of the uterus). Next, taking 28 weeks of pregnancy as cut-off value, 95 patients were divided into <28 weeks of pregnancy group (pregnancy was terminated because of adverse pregnancy outcome before 28 weeks) and ≥28 weeks of pregnancy group (pregnancy lasted to 28 weeks and later), the differences of pregnancy outcomes between the two groups in different gestation times were analyzed. Results:(1) The age of 95 pregnant patients with adenomyosis was (34.8±3.5) years. There were no significant differences with regard to age, uterine size before pregnancy, the proportions of primipara, assisted reproductive technology conception, endometriosis, history of estrogen and progesterone treatment, diffuse adenomyotic lesions between the short-distance group and the long-distance group (all P>0.05). (2) Among the 95 patients, 12 patients (13%, 12/95) had adverse pregnancy outcomes before 28 weeks of pregnancy (i.e. pregnancy <28 weeks), including 11 cases (19%, 11/59) in the short-distance group and 1 case (3%, 1/36) in the long-distance group, there was significant difference between the two groups ( χ2=5.100, P=0.027). Among the 11 patients with adverse pregnancy outcomes at <28 weeks of gestation in the short-distance group, 1 case had threatened rupture of uterus before delivery of twin pregnancy at 26 weeks of gestation, 5 cases had intra uterine fetal death in the second trimester of pregnancy, 4 cases had late inevitable abortion, and 1 case had live birth of singleton at 26 weeks of gestation. In the long-distance group, one patient with adverse pregnancy outcome less than 28 weeks of pregnancy was late inevitable abortion. (3) Of the 95 patients, 83 cases were pregnant for ≥28 weeks (48 cases in the short-distance group and 35 cases in the long-distance group), and their final pregnancy outcome was all live birth. Compared with the long-distance group, the incidence of placental abnormalities (60% vs 14%), fetal distress (27% vs 6%), preterm delivery (67% vs 23%) and intrapartum bleeding [median 350 ml (range: 100-1 500 ml) vs 300 ml (range: 100-800 ml)] in the short-distance group were significantly higher (all P<0.05). While the gestational weeks in the short-distance group [median 37 weeks (range: 30-41 weeks) vs 38 weeks (range: 28-41 weeks)] and neonatal birth weight [median 2 790 g (range: 1 170-4 040 g) vs 3 010 g (range: 980-4 320 g)] decreased significantly (all P<0.05), compared with those in the long-distance group. Conclusion:Patients with pregnancy complicated with adenomyosis are prone to adverse pregnancy outcomes if the embryo implantation is located on or very close to adenomyotic lesions, so close monitoring and early intervention should be carried out to improve pregnancy outcomes.
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Objective To evaluate the effectiveness of the integrated schistosomiasis control measures in Changzhou City from 2015 to 2020, so as to provide insights into the formulation of the strategy used to consolidate the schistosomiasis elimination achievements. Methods The annual schistosomiasis control working report and integrated schistosomiasis control data were collected in Changzhou City from 2015 to 2020, and the prevalence of Schistosoma japonicum infections in humans and livestock and snail status were analyzed to evaluate the effectiveness of the integrated schistosomiasis control measures. Results During the period from 2015 to 2020, a total of 112 061 person-time individuals received serological tests for S. japonicum infections in Changzhou City, and the sero-prevalence was 0.15% to 1.09% during the 6-year period, with a significant difference seen among years (χ2 = 288.11, P < 0.05). From 2015 to 2020, a total of 13 435 person-time individuals received stool examinations, with no egg-positives identified; among 5 840 herd-time livestock receiving schistosomiasis examinations, no positives were detected, while a 100% coverage of fencing livestock was seen each year. During the 6-year period, a total of 38.40 hm2 snail habitats were found, including 8.97 hm2 emerging snail habitats, and among the 2 344 snails dissected, no S. japonicum infection was found. Chemical treatment covered an area of 385.71 hm2, and environmental improvements covered an area of 200.39 hm2. The mean density of living snails was less than 0.1 snails/0.1 m2 in snail habitats found in Changzhou City each year from 2015 to 2020, and the coverage of harmless toilets was 100% in 2020. During the 6-year period, a total of 3.740 6 million person-time individuals were given schistosomiasis health education in Changzhou City. Conclusions Changzhou City is now at the post-elimination surveillance stage; however, there are still factors affecting schistosomiasis transmission. The schistosomiasis surveillance system remains to be improved to consolidate the schistosomiasis elimination achievements in Changzhou City.
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Objective To assess the state of schistosomiasis elimination in 6 districts of Changzhou City, Jiangsu Province, so as to provide the evidence for the formulation of consolidation measures. Methods Three towns (streets) were selected according to the schistosomiasis epidemic degree in each district, and one village was sampled from each town. The on-site assessment was carried out between 2016 and 2017, including Oncomelania hupensis snail survey, population investigation and domestic animal investigation. In addition, the related data and materials were evaluated and the monitoring ability was assessed. Results In the history, there were 54 endemic towns, 368 endemic villages in Changzhou City, with a total area of 3 934.79 hm2 of historic snail spots, and 114 990 schistosomiasis cases so far. In the field assessment in 6 districts, a total of 26 environments were surveyed, with the surveyed area of 36.23 hm2, and there were no living snails captured in each village. A total of 18 199 people were examined for schistosome infection, 255 were blood test positive, and the sero-positive rate was 1.40%. The stool examination was done in 255 sero-positive cases, and no cases were stool-positive. A total of 779 domestic animals were investigated, including 200 cattle, 179 sheep and 400 pigs, and no infections were detected. The files regarding the snail status and schistosomiasis epidemic situation, and the monitoring data were complete and accurate in 6 districts. The annual investment funds for schistosomiasis prevention were 3 120 000 Yuan in Changzhou City, and the number of staff working for schistosomiasis prevention was 86 totally, which could meet the requirements of high quality monitoring. Conclusions All 6 districts of Changzhou City have met the requirements of schistosomiasis elimination.
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Objective To assess the state of schistosomiasis elimination in 6 districts of Changzhou City, Jiangsu Province, so as to provide the evidence for the formulation of consolidation measures. Methods Three towns (streets) were selected according to the schistosomiasis epidemic degree in each district, and one village was sampled from each town. The on-site assessment was carried out between 2016 and 2017, including Oncomelania hupensis snail survey, population investigation and domestic animal investigation. In addition, the related data and materials were evaluated and the monitoring ability was assessed. Results In the history, there were 54 endemic towns, 368 endemic villages in Changzhou City, with a total area of 3 934.79 hm2 of historic snail spots, and 114 990 schistosomiasis cases so far. In the field assessment in 6 districts, a total of 26 environments were surveyed, with the surveyed area of 36.23 hm2, and there were no living snails captured in each village. A total of 18 199 people were examined for schistosome infection, 255 were blood test positive, and the sero-positive rate was 1.40%. The stool examination was done in 255 sero-positive cases, and no cases were stool-positive. A total of 779 domestic animals were investigated, including 200 cattle, 179 sheep and 400 pigs, and no infections were detected. The files regarding the snail status and schistosomiasis epidemic situation, and the monitoring data were complete and accurate in 6 districts. The annual investment funds for schistosomiasis prevention were 3 120 000 Yuan in Changzhou City, and the number of staff working for schistosomiasis prevention was 86 totally, which could meet the requirements of high quality monitoring. Conclusions All 6 districts of Changzhou City have met the requirements of schistosomiasis elimination.
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Objective To investigate the prevalence of major parasitic diseases and related knowledge,attitude and practice among rural residents in Liyang City,so as to provide the evidence for formulating appropriate preventive strategies and mea-sures.Methods Three villages were selected from three towns as survey sites,and the residents who were above three years old and had been in the village for over six months were investigated.The Kato-Katz technique was applied to detect intestinal para-site eggs in residents'feces,and the cellophane anal swab was used to detect Enterobius vermicularis eggs among children aged 3-6 years. The iodine liquid smear and saline smear methods were used to examine intestinal protozoa cysts or trophozoites. Hookworm species were identified by the tube filter paper culture method.A structured questionnaire was used to collect the in-formation on residents'knowledge,attitude and practice of the prevention and control of major parasitic diseases.Results To-tally 759 residents were investigated and tested at the three rural survey sites,and only 2 cases were detected of parasitic infec-tion and the total infection rate was 0.26%.Both cases were mild infections without mixed infection.The total awareness rate of knowledge on ascariasis,trichuriasis and ancylostomiasis was 37.9%,while the awareness rate of knowledge on clonorchiasis was 13.8%.The age and educational level were important factors of the knowledge on prevention and control of parasitic diseases among the residents.The formation rates of washing hands before meal and after using the toilet,and never drinking unboiled wa-ter were 83.8% and 92.1%,respectively. Totally 11.6% of the residents usually ate raw or half-cooked freshwater fishes and shrimps,and 53.0% had not the behavior to prepare raw and cooked food using the different chopping boards.The proportions of residents using fresh feces as manure and working in the field with bare feet were 13.8% and 22.8% respectively.The proportions of residents who thought they could,could not,or were not sure to change the risk behaviors and habits of parasitic infections were 40.2%,28.5% and 31.4%,respectively.Conclusions The infection rate of major parasitic diseases among the rural resi-dents in Liyang City is low,and the awareness rate of knowledge on preventing parasitic diseases is also low. Therefore,the health education on the prevention and control of parasitic diseases should be strengthened to guide them to develop good hy-giene,diet and farming habits.The environmental sanitation should be continuously improved to block the endemic of parasitic infection.
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<p><b>OBJECTIVE</b>To investigate clinical effect of vacuum sealing drainage(VSD) with anterolateral thigh perforator flap for repair foot soft tissue defect.</p><p><b>METHODS</b>From September 2014 to September 2016, 45 patients with foot soft tissue defect repaired by VSD with anterolateral thigh perforator flap, including 31 males and 14 females aged from 17 to 55 years with an average of 36 years old. Thirty patients were dorsal soft tissue defects, and 15 patients were plantar soft tissue defects. Sizes of soft tissue defect ranged from 7 cm×10 cm to 11 cm×18 cm, the wound was contaminated seriously and assisted with deep soft tissue exposure. Emergency surgical wound debridement with VSD treatment were performed, and wound surface was cleaned after 5 to 7 days, free anterolateral thigh flap were repaired. Sizes of flap ranged from 9 cm×12 cm to 13 cm×21 cm. Appropriate method was used to repair flap donor area.</p><p><b>RESULTS</b>All 45 free propeller flap were survived without skin edge necrosis, ulcerative infection. Forty patients were followed up from 3 to 24 months with an average of 13 months. Flap showed good color, beautiful appearance, good elasticity, soft texture, but without obvious bloated, the wood of leg healed well.</p><p><b>CONCLUSIONS</b>VSD with anterolateral thigh perforator flap for repair foot soft tissue defect could effective control wound soft tissue infection, receive reliable flap blood supply and skin flap could repaired at stage I. It is an effective method for repairing foot soft tissue defects.</p>
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<p><b>OBJECTIVE</b>To investigate the incidence rate of anterior knee pain after total knee arthroplasty (TKA) and identify the related factors.</p><p><b>METHODS</b>This prospective, double-blind clinical trial involved a total of 128 patients scheduled for primary ipsilateral cemented three-component TKA for osteoarthrosis. The patients were randomized into two groups to receive operations for TKA with patellar resurfacing (experimental group) or not (control). The incidence of anterior knee pain was observed in these patients and the factor affecting the occurrence of anterior knee pain and knee was analyzed.</p><p><b>RESULTS</b>The patients were followed up for a mean of 16.5 months (range 6~24 months). The incidence rate of anterior knee pain was 10.9% (7/64) in the experimental group, showing no significant difference from the rate of 14.1% (9/64) in the control group. But the 52 patients with varus or valgus knee showed a significantly higher incidence rate of anterior knee pain (21.2%, 11/52).</p><p><b>CONCLUSION</b>TKA with patellar resurfacing can not decrease the incidence of anterior knee pain, and varus or valgus before the operation is associated with a higher risk of anterior knee pain.</p>
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Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Artroplastia do Joelho , Métodos , China , Epidemiologia , Denervação , Métodos , Método Duplo-Cego , Articulação do Joelho , Osteoartrite do Joelho , Cirurgia Geral , Patela , Cirurgia Geral , Síndrome da Dor Patelofemoral , Epidemiologia , Fatores de RiscoRESUMO
<p><b>OBJECTIVE</b>To evaluate the efficacy and optimal re-implantation time of two-stage revision for management of periprosthetic infection following hip arthroplasty.</p><p><b>METHODS</b>We retrospectively analyzed the clinical data of 15 patients (15 hip joints) undergoing two-stage ipsilateral total hip arthroplasty (THA) revision from January, 2006 to January, 2010. In the first stage, after surgical debridement and thorough removal of all the implants, a self-made Vancomycin-loaded cement spacer was implanted. The second stage operation was performed 3-6 months later for debridement and removal of the antibiotic-loaded spacer, followed by re-implantation of Vancomycin-loaded bone cement prosthesis in 9 cases and cementless prosthesis in 6 cases. The patients were followed up for 9-46 months (mean 25 months) after the operation.</p><p><b>RESULTS</b>No reinfection or prosthesis loosening/displacement was found in these cases after the operation. The Harris score increased from 40.3 before the operation to 54.0 after the first-stage operation, and to 88.2 at the last follow-up.</p><p><b>CONCLUSION</b>Two-stage revision is effective for treatment of periprosthetic infection following hip arthroplasty, and 3-6 months can be the optimal interval between the two the first-stage and second-stage operation for re-implantation.</p>
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Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Artroplastia de Quadril , Métodos , Prótese de Quadril , Infecções Relacionadas à Prótese , Cirurgia Geral , Reoperação , Estudos Retrospectivos , Resultado do TratamentoRESUMO
Objective To explore the qualification and consuming of iodized salt at wholesale and household levels after Salt Iodization.Methods Iodized salt surveillance at wholesale and household levels every year by detecting iodine content.Direct titration method(GB/T 13025.7-1999)was used for salt iodjne detecting and arbitration method was used for Sichuan salt and special salt.Results Five thousand six hundred and seventy five samples of 227 batches from 3 wholesale industries were detected during 1996-2000,batch qualification rate was 60.79%(138/227)and iodized salt qualification rate was 61.83%(3509/5675).During 2001-2007,2556 samples of 252 batches from wholesale levels were detected.The batch qualification rate and iodized salt qualification rate were 1 00%(252/252)and 99.88%(2553/2556),respectively.At household level.1583 samples from 236 villages were detected during 1996-2000.Iodized salt qualification rate was 74.24%(1 170/1576)and consuming rate of qualified iodized salt was 73.91%(1 170/1583)and iodine median was 45.14 mg/kg.During 2001-2007,13 140 samples from 1656 villages were detected.Iodized salt qualification rate,consuming rate 0f qualified iodized salt and iodine median were 98.03%(12 830/13 088),97.64%(12 830/13 140)and 30.13 mg/kg,respectively. The most difference of iodine content was 3.46 mg/kg in 3 wholesale industries.At household level there was a 4.95%reduction in comparison with at wholesale level.Conclusions Salt iodization level and edible iodine salt reach the national requirements of iodine deficiency control from the starting stage.The quality 0f iodized saIt at household level related to the exclusive wholesale industry and loss phenomenon maybe existed when salt was sold from wholesale industries to residents.
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<p><b>OBJECTIVE</b>To evaluate the impact of universal salt iodization using monitoring data on correctional status of iodine deficiency and hospitalized thyroid diseases.</p><p><b>METHODS</b>Retrospective survey was conducted to collect medical records of hospitalized thyroid disease cases. Routine monitoring data on population iodine nutrition status and goiter prevalence were analyzed.</p><p><b>RESULTS</b>The coverage of adequately iodized salt was consistently above 95%. Hospitalization rate of thyroid diseases rose steadily, and peaked at 54.5 per 100,000. The proportion of hospitalized thyroid disease among hospitalized diseases also rose with female and those aged above 40 years old mostly affected. The proportion of hospitalized hyperthyroidism among total hospitalized thyroid disease rose from 13.6% to 34.7%.</p><p><b>CONCLUSIONS</b>Universal salt iodization might eliminate iodine deficiency while other impact still exists. However, the benefits of universal salt iodization should be far overweight the adverse effects.</p>
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Feminino , Humanos , Masculino , China , Epidemiologia , Iodo , Usos Terapêuticos , Cloreto de Sódio na Dieta , Usos Terapêuticos , Doenças da Glândula Tireoide , EpidemiologiaRESUMO
<p><b>AIM</b>To study the NMR phenomena of cetirizine hydrochloride and assign all proton and carbon signals in NMR spectra.</p><p><b>METHODS</b>To record the 1D and 2D NMR spectra of cetirizine hydrochloride while changing the experimental temperature and adding D2O into the solution.</p><p><b>RESULTS</b>More than one NMR signal or broad peak resulting from piperazine and the attached groups with N atom were given in DMSO-d6 solution at room temperature. "Coalescence" or narrowing had occurred for the proton and carbon signals when the experimental temperature was increased or D2O was added into the solution.</p><p><b>CONCLUSION</b>Compared with the NMR "time scale", there are more than one conformation of cetirizine hydrochloride in DMSO-d6 solution at room temperature. The different conformation will be exchanged fast while temperature rise and the stable conformation will be existed while D2O was added into the solution.</p>