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The establishment of a nutritional pathway is the premise and basis of nutritional therapy for patients with malignant tumor. The nasogastric tube, nasoenteric tube, and percutaneous endoscopic gastric/jejunostomy are commonly used clinical pathways for enteral nutrition (EN) therapy. However, these EN pathways are often difficult to establish in patients with malignant obstructive jaundice (MOJ) with pyloric or duodenum primary obstruction. For this reason, a new type biliary-intestinal nutrient tube placed through percutaneous transhepatic cholangiography drainage (PTCD) pathway was designed by the medical staff of hepatobiliary surgery department of Yinchuan First People's Hospital, and National Utility Model Patent of China were obtained (ZL 2020 2 0283951.5, ZL 2020 2 0288938.9). The new biliary-intestinal nutrient tube has two types: double-lumen tube and single-lumen tube, which consists of tube head, tube body, tail ring and developing ring. The double lumen tube realizes bile internal drainage and EN simultaneously through the double lumen structure of the tube body. The single-lumen tube is used for nutrient infusion after bile duct metal stent implantation, which is not limited by the type of nutrient solution. The tail ring of the two types of nutrient tube is placed in the upper jejunum to reduce retrograde infection and unexpected extubation. Compared with the prior art, the utility model has the advantages of simple structure, reasonable design, safe and effective placement through PTCD pathway, and opens up a new EN path for MOJ patients.
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Objective To investigate the effect of recombinant human growth hormone (rhGH) on the growth rate, glucose and lipid metabolism and bone metabolism in children with idiopathic short stature (ISS). Methods The clinical data of 150 children with ISS admitted to the hospital from January 2010 to January 2015 were collected. The children were divided into the routine group (68 patients) and rhGH group (82 patients) according to the treatment methods. The routine group was given enhanced nutritional guidance, enhanced protein and calcium intake, and guidance for exercise. On this basis, rhGH group was additionally treated with rhGH. The intervention lasted for 12 months, and changes of height, weight, bone age (BA) and growth velocity (GV) in two groups were statistically analyzed. Changes in fasting blood glucose (FBG), insulin (INS), total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) and other glucose and lipid metabolism indicators before and after treatment were detected. The insulin sensitivity index (ISI) was calculated, and changes in serum insulin-like factor 1 (IGF-1), osteocalcin (OC), bone alkaline phosphatase (BAP), typeⅠprocollagen amino-terminal propeptide (PINP), β-collagen degradation products (β-CTX) and other bone metabolism parameters before and after treatment were determined. The incidence of adverse reactions in both groups was statistically analyzed. Results There were no significant differences in height, weight, BA or GV between two groups before treatment (P>0.05). After 12 months of treatment, the above indicators in both groups were increased (P<0.05). The height, weight, BA and GV were (132.12 ± 7.26) cm, (26.21 ± 1.74) kg, (9.41 ± 0.37) years old and (10.03 ± 2.41) cm/year of the rhGH group, which were significantly higher than those of the routine group [(124.22 ± 6.31) cm, (24.13 ± 1.92) kg, (8.96 ± 0.42) years old and (5.85 ± 1.76) cm/year (P<0.05)]. There were no significant differences in glucose and lipid metabolism levels between two groups before and after treatment (P>0.05). There was no statistical difference in bone metabolism indexes between two groups before treatment (P>0.05). After 12 months of treatment, PINP, IGF-1, OC and BAP in both groups increased while β-CTX decreased (P<0.05). PINP, IGF-1, OC and BAP in rhGH group [(598.21 ± 78.57) μg/L, (301.23 ± 51.45) μg/L, (78.52 ± 12.65) μg/L, (171.26 ± 42.17) U/L] were higher than those in routine group [(520.14 ± 47.55)μg/L, (244.35 ± 46.38)μg/L, (70.25 ± 9.77) μg/L, (120.55 ± 38.42) U/L] (P<0.05), whileβ-CTX was lower than that in routine group [(0.48 ± 0.26)μg/L vs (0.63 ± 0.24) μg/L] (P<0.05). There were no significant difference in adverse reaction between two groups [3.66％(3/82) vs. 0, P>0.05]. Conclusions The rhGH treatment of children with ISS can obviously promote the growth and improve bone metabolism and growth rate of children, without significant adverse effect on their glucose and lipid metabolism and with certain safety.
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Objective To evaluate the application value of combination of low kV,low mAs,and iterative model reconstruction (IMR) in carotid CT angiography.Methods Forty patients (BMI 20-25 kg/m2) were enrolled and randomly divided into routine dose group(20) and low dose group(20),The parameters in routine dose group were 120 kV,automatic mAs,and filter back projection(FBP);and that in low dose group were 80 kV,automatic mAs but upper limit 150 mAs,and FBP or IMR.All patients received the injection of 32 ml of iopamidol(370 mg I/100 ml) at a flow rate of 4 ml/s,followed by 50 ml normal saline at the same rate.The CT value and image noise(SD)of the aortic arch,left carotid artery bifurcation,and right carotid artery of rock bone were measured with region of interest(ROI) method,and then signal to noise ratios (SNR) and contrast to noise ratio (CNR)of image were calculated.The image quality was evaluated by two radiologists using a subjective four points scale on multiplanar reformated (MPR),maximum density projected (MIP) and volume rendered (VR) images.Volume CT dose index (CTDIvol),dose length product (DLP),and the effective dose (E) of each patient were recorded.Results CT values of carotid artery[(479.87 ± 70.28),(514.78 ± 82.69),(436.50 ± 89.87) HU] in low dose group were significantly higher than those in routine dose group [(295.63 ± 34.75),(325.09 ± 37.81),(286.93±36.46)HU](t =-6.47,-5.76,-3.66,P＜0.05).The SNR and CNR of IMR reconstructed image in low dose group were significantly higher than those of FBP reconstructed image in routine dose group (t =-7.54,-3.55,-5.31,-7.13,-5.28,-8.35,P＜0.05).The image quality of FBP reconstructed images in routine dose group and IMR reconstructed images in low dose group were all enough for diagnosis.The image quality of FBP reconstructed images in low dose group was significantly poorer than that in routine dose group and IMR reconstructed images in low dose group (Z =-2.87,-3.69,P ＜0.05).The effective dose in low dose group (0.57 ±0.13) mSv was 73％ less than that in routine dose group (2.22 ± 0.36) mSv.Conclusions Using low kV,low mAs,and IMR would help to obtain good carotid CT angiographic images and low radiation dose.
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Objective To evaluate the correlation between CT perfusion blood volume (Lung PBV)and the degree of pulmonary embolism by CT pulmonary angiography (CTPA).Methods 1 65 patients with suspected pulmonary embolism underwent dual-ener-gy CT angiography,then the Lung PBV iodine distribution was analyzed by using a software algorithm.Consistent CTPA results evaluated by two experienced radiologists were taken as standard reference.After two months,the CTPA images were assessed by other two radiologists at random.The position and the number of perfusion defects,and (or)hypoperfusion were recorded.Results Of all 1 65 suspected patients,41 were diagnosed as pulmonary embolism with involved 1 64 segment arteries including part occlusion in 56 and complete occlusion in 108.Lung PBV showed perfusion defect in 141 pulmonary segment including 42 in patients with part occlusion and 99 in ones with complete occlusion.1 7 pulmonary segments were misdiagnosed with part occlusion in 9 and complete ones in 8.23 segments were misdiagnosed including part occlusion in 14 and complete ones in 9.The perfusion defect of Lung PBV was correlated to CTPA moderately or well (to part occlusion with r =0.508 and P =0.022;to complete ones with r =0.905 and P =0.000).Conclusion Dual-energy lung perfusion imaging is helpful for accurate assessment of abnormal blood flow distribution caused by pulmonary embolism,and improve the diagnosis.
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ObjectiveTo investigate response monitoring function in individuals with pathological internet use(PIU) using the modified Eriksen flanker task by event-related potentials(ERPs).Methods23 individuals met Young's diagnostic questionnaire (YDQ) criteria for PIU were enrolled as research group and 23 sexual-and age matched healthy persons enrolled as control group.EEG was recorded during participants performed the modified Erikson flanker task.Reactive time (RT) and error rates were compared between two groups. BESA 5.2.0was used to perform data analysisand theerror-related negativity(ERN)amnplitudeswereanalyzed.Results False alarm rate of PIU group was higher than that of control group.A repeated measure ANOVA revealed a significant group,frontal electrode sites and group × frontal electrode sites main effect for ERN amplitudes ( for group:F =768,df=1,P =0.000 ; for frontal electrode sites:F =615,df=2,P =0.000 ; for group × frontal electrode sites:F =516,df=2,P=0.000),and a significant group,central electrode sites and group × central electrode sites main effect for ERN amplitudes ( for group:F=768,df=1,P =0.000 ; for central electrode sites:F =599,df=2,P =0.000 ; for group × central electrode sites:F =483,df=2,P =0.000).ERN amplitudes of PIU group were lower than those at control group.ConclusionIndividuals with PIU present response monitoring dysfunctions and share neuropsychological and ERPs characteristics of compulsive-impulsive spectrum disorder,which supports that PIU is an impulse disorder or at least related to impulse control disorder.
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Objective To investigate deficient inhibitory control in individuals with IAD using a visual go/no-go task by ERPs. Methods 26 individuals met YDQ criteria for IAD were enrolled as research group and marched sexual and age 26 healthy person enrolled as control group. BIS-11 was used for measures of impulsivity.A go/no-go task involved eight different two-digit numerical stimuli. The response window was 1000 ms and the ITIwas 1500 ms. EEG was recorded during participants performed the task. BESA 5.2.0 was used to perform data analysis and the no-go N2 amplitude was analyzed for investigation of inhibitory control. Results BIS-11 total scores, attentional key scores and motor key in IAD group were higher than that of control group. In the go/no-go task, false alarm rate of IAD group was higher and hit rate was lower than that of control group. A repeated measure ANOVA revealed a significant group, frontal electrode sites and group × frontal electrode sites main effect for N2amplitudes of no-go conditions ( for group: F= 3953, df= 1, P= 0.000;for frontal electrode sites: F= 541, df= 9, P= 0.000;for group × frontal electrode sites: F = 306, df = 9, P = 0. 000 ), and a significant group, central electrode sites and group × central electrode sites main effect for N2 amplitudes of no-go conditions ( for group: F=9074, df= 1, P = 0. 000;for central electrode sites: F = 163, df= 2, P = 0.000;for group × central electrode sites: F = 73, df= 2, P = 0.000). N2 amplitudes of no-go conditions were lower than those at control group. Conclusions Individuals with IAD were more impulsive than controls and shared neuropsychological and ERPs characteristics of compulsive-impulsive spectrum disorder, which supports that IAD is an impulse disorder or at leastrelated to impulse control disorder.
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BACKGROUND:Hereditary factor occupies a certain position in suicidal behavior of depression. The researches in the past are focused on the hereditary effect on bipolar depression suicide.How do hereditary patterns and effects work in suicidal behavior in unipolar depression?OBJECTIVE: To probe into hereditary patterns and effects on suicidal behavior in unipolar depression.DESIGN:Retrospective investigation.SETTING:A municipal psychiatric hygienic centerPARTICIPANTS:Unipolar depression group included 115 outpatients and inpatients diagnosed in Wuxi Psychiatric Hygienic Center from June 1st 1983 to May 31st 2002.The diagnosis tallied with Standards on Depression Onset in Categories and Diagnostic Standards on Psychiatric Disturbance in China of 3rd Edition and with Standards on Severe Depression Onset in Manual of Diagnosis and Statistics of Psychiatric Disturbance in America of 4th Edition.The attack frequency of all the cases ≥ 3 times or the cases had been relieved ≥8 years after a couple of attacks.METHODS:The patients who tallied with the standards on unipolar depression received the investigation in every family tree under the instruction of 2 physicians-in-charge and more than 2 physicians and filled up the self-made investigation form of psychiatric family tree,including mainly the data of social demography of patients and their first grade relatives,characters of disease onset,frequency of attack,history of treatment and suicide. After re-diagnosed by 2 physicians-incharge and more than 2 physicians and checked by one physician-incharge,the cases were collected in patient group. The interview was carried on for the patients with suicidal behavior among all of the survived patients (107 cases) and first grade relatives (14 cases).The interview (337 cases) and investigation with letter (380 cases) were carried on for the first grade relatives without suicidal behavior. The investigation forms of 13 dead cases (8 cases of patients, 5 cases of first-grade relatives) were provided and filled-up by one or two first grade relatives. Two researchers interviewed the cases in the control,inquired the first grade relatives and filled up the investigation form of family tree.Single factor analysis was used for all the data and Falconer pattern of polygenetic threshold-value theory was used to estimate hereditary rate and standard error in suicidal behavior.Separation analysis in medical hereditary mathematic method and polygenetic threshold-value theory were applied to discuss the hereditary patterns.MAIN OUTCOME MEASURES:Hereditary effects and patterns of suicidal behavior in unipolar depressed patients.RESULTS:Suicidal risk of unipolar depressed patients(51.30%,59/115)was higher than their first grade relatives (2.58%,19/736) (x2=283.16,P ＜ 0.01).Suicidal risk of the first grade relatives (2.58%,19/736) of unipolar depressed patients was higher than the control (0.12%,3/2469)(x2=50.36,P ＜ 0.01).Suicidal risk of the first grade relatives of the patients with suicidal behavior (3.8%,14/372) was higher than that of the first grade relatives of the patients without suicidal behavior (1.4%,5/363)(x2=4.14,P＜ 0.05).The weighted average hereditary rate and standard error was (70.16±0.79)% for suicidal behavior in unipolar depression.The predictive morbidity of suicidal behavior in the first grade relatives was 3.1% and the real morbidity was 2.6%,which did not indicate significant difference (u =0.766, P ＞ 0.05).CONCLUSION:Suicidal behavior of unipolar depression presents obvious hereditary effects and its hereditary patterns tally with polygenetic inheritance.
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Objective To analyze the epidemiological trends of leprosy and evaluate the effectiveness of control in Zhejiang Province. Methods A retrospective study was conducted. Results By the end of 1999, 16 262 leprosy patients had been registered, of them 11 935 had been cured and only 97 were still remained. In 1999, active cases decreased by 99.02％ over 1973. The epidemiological trends of leprosy showed the increase of mean age at onset and type ratio, and the decrease of incidence in children. Conclusion The epidemicity of leprosy has been continuously dropping in Zhejiang Province due to the sustained effort and effective control.