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Objective To compare the differences in kinematic parameters and plantar pressures for two types of knee varus with tibial and femoral origins in gait analysis, so as to provide biomechanical theoretical basis for different types of genu varus. Methods Twenty-six patients with unilateral knee osteoarthritis (KOA) varus genu were enrolled, with 13 from femoral and 13 from tibial sources. Using Noraxon MyoMotion three-dimensional (3D) motion capture system and Footscan plantar pressure test system, the gait of the subjects during natural walking was measured, the temporal and spatial parameters of the gait, the kinematics parameters of lower limb joints and plantar pressures were collected, to make comparative analysis between the two groups. Results The range of knee flexion and extension of tibial varus, the peak of hip abduction, the range of motion (ROM) of hip adduction and abduction and the peak of ankle pronation were larger than those of femoral lateral genu varus. The peak of knee flexion and hip adduction was smaller than that of femoral lateral genu varus. Compared with femoral varus, subjects with tibial varus had increased stress time and peak pressure on the plantar of the 4th and 5th metatarsals (P<0.05). In the 3rd metatarsal region, the impulse of healthy femoral limb was greater than that of healthy limb with tibial deformity. While in the medial calcaneal region, the impulse of healthy femoral limb was smaller (P<0.05). Conclusions There are some differences in kinematic parameters and plantar pressures between two different types of unilateral genu varus patients. The results of this study are helpful to understand the abnormal gait caused by genu varus, and provide reliable reference for postoperative rehabilitation and limb exercise for different types of genu varus.
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Background The incidence rate of missed abortion is increasing year by year, but the etiology has not been fully elucidated. Adverse pregnancy history and exposure to polycyclic aromatic hydrocarbons (PAHs) may increase the risk of missed abortion. Objective To investigate the interaction between adverse pregnancy history and PAHs exposure on missed abortion in early pregnancy, and to provide evidence for the etiologic research of missed abortion. Methods A total of 114 pregnant women diagnosed with missed abortion in the Department of Obstetrics of the First Hospital of Shanxi Medical University from March to December 2019 were selected as the case group, and 139 pregnant women who visited the same hospital for voluntary induced abortion in the same period as the control group, to collect basic information and medical information of abortion, stillbirth, intrauterine growth retardation, and other adverse pregnancy history. Abortion villus tissues were collected to detect PAH-DNA adducts levels, stratified by pregnancy and adverse pregnancy history and grouped by quartile method: Q1 (< 404.61 ng·L−1), Q2 (404.61−453.75 ng·L−1), Q3 (453.76−506.72 ng·L−1), and Q4 (≥506.73 ng·L−1). SPSS 25.0 statistical software was used for χ2 test and multiple logistic regression, and additive and multiplicative models were used to investigate the interaction between adverse pregnancy history and PAH-DNA adducts level on missed abortion. The PAH-DNA adducts were grouped by tertiles and quartiles, and P33, P50, P67 and P75 were used as data cut points for sensitivity analysis. Results The proportion of adverse pregnancy history in the case group (32.46%) was higher than that in the control group (12.23%) (P < 0.001). Among 160 subjects with≥2 pregnancies, the proportion of adverse pregnancy history in the case group (57.81%) was higher than that in the control group (17.71%) (P < 0.001). The results of χ2 test stratified by pregnancy for different PAH-DNA adducts levels between the two groups showed that the PAH-DNA adducts level was associated with missed abortion in subjects with≥2 pregnancies (χ2=10.14, P=0.017). Being further stratified by adverse pregnancy history, the PAH-DNA adducts level in subjects with no adverse pregnancy history was associated with missed abortion (χ2=9.70, P=0.021). The results of logistic regression analysis showed that adverse pregnancy history (OR=5.88, 95%CI: 2.79−12.39) and PAH-DNA adducts (OR=3.01, 95%CI: 1.22−7.40) increased the risk of missed abortion, but no interaction between them was found. The relative excess risk of interaction (RERI), the attributable percentage of interaction (AP), and the synergy index (SI) and its 95%CI were 0.60 (95%CI: −0.58−1.77), 0.74 (95%CI: −0.83−2.30), and 0.20 (95%CI: 0.01−5.43), respectively. Conclusions Adverse pregnancy history and PAH-DNA adducts in pregnant women may increase the risk of missed abortion. The effect of the interaction between them on the occurrence of missed abortion is not supported by the current study.
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Objective@#To observe and analyze the clinical effects of invasive and non-invasive sequential mechanical ventilation in the treatment of respiratory failure in patients with chronic pulmonary heart disease.@*Methods@#A total of 70 patients with chronic pulmonary ill heart disease and respiratory failure admitted to the First Hospital of Shanxi Medical University from January 2018 to March 2018 were enrolled in this study.The patients were randomly divided into control group and observation group according to the digital table, with 35 cases in each group.The control group received invasive mechanical ventilation treatment.The observation group used the " pulmonary infection control window (PIC)" as the switching point of invasive ventilation and non-invasive ventilation, and invasive and non-invasive sequential mechanical ventilation were given.The clinical indicators, blood gas indicators, respiratory rate and heart rate changes of the two groups were compared.The clinical efficacy of the two groups were observed to analyze.@*Results@#The invasive mechanical ventilation time, total ventilation time and hospitalization days in the observation group were (5.16±0.83)d, (7.79±0.63)d and (8.95±0.62)d, respectively, which were significantly shorter than those in the control group [(8.42±0.91)d, (11.48±0.95)d, (14.17±0.65)d], the differences were statistically significant(t=15.659, 19.151, 34.379, all P<0.05). After treatment, the PaO2 of the observation group was significantly higher than that of the control group[(85.19±5.07)mmHg vs.(79.95±4.68)mmHg], while the PaCO2[(49.85±4.17)mmHg vs.(53.36±4.82)mmHg], respiratory rate[(24.43±3.17)times/min vs.(31.19±4.08)times/min]and heart rate[(94.43±13.36)times/min vs.(113.36±17.13)times/min] in the observation group were significantly lower than those in the control group, and the total effective rate of the observation group (91.43%) was significantly higher than that of the control group(54.29%), the differences were statistically significant(t=4.493, 3.258, 7.740, 4.338, χ2=12.209, all P<0.05).@*Conclusion@#The clinical efficacy of invasive and non-invasive sequential mechanical ventilation in the treatment of patients with respiratory failure due to chronic pulmonary heart disease is significant, which can improve the clinical symptoms of patients and reduce the time of hospitalization.
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Psychological suboptimal health status is an intermediate state between mental health and mental disease.Without timely intervention,psychological suboptimal health may develop into serious diseases that pose a threat to human physical and mental health,such as depression,anxiety disorders and high blood pressure.This review summarizes the scientific concepts,diagnostic Criteria,intervention and pharmacological research of psychological suboptimal health from the perspective of both modern medicine and traditional Chinese medicine and proposes possible solutions to existing problems in order to contribute to the identification,diagnosis,prevention and treatment of psychological suboptimal health.
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Objective To investigate the therapeutic effect of levosimendan on acute decompensated heart failure and its effect on SDNN and SDANN values.MethodsThe clinical data of patients with acute decompensated heart failure treated in Zhejiang Greentown Cardiovascular Hospital from January 2014 to August 2016 were retrospectively analyzed.According to their treatment methods, they were divided into control group and observation group.There were 49 cases in the control group and 71 cases in the observation group.The control group was given conventional drug treatment, the observation group was given levosimendan treatment on the basis of the control group.The therapeutic effects of the two groups were observed.The difference of cardiac function, SDNN, SDANN value and adverse reaction between the two groups were compared before and after treatment.ResultsAfter treatment, the observation group efficiency was 98.59%, significantly higher than the control group;the observation group LAD, RAD, LVESD, LVEDD and BNP lower than the control group, the level of LVEF was higher than the control group, the difference was statistically significant (P<0.05);the observation group SDNN, SDANN, RMSSD and PNN50 (%) was higher than that of the control group, the difference was statistically significant (P<0.05).ConclusionLevosimendan has good therapeutic effect on acute decompensated heart failure, can significantly improve the level of SDNN, SDANN, and the incidence of adverse reactions is low.
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Objective To investigate curative efficacy of ginkgo biloba extract dripping pills in treatment of acute coronary syndrome(ACS) after percutaneous coronary intervention(PCI) and its effects on platelet aggregation rate(PAR), activated clotting time(ACT) and antithrombin(AT)Ⅲ. Methods 90 patients of ACS treated with PCI who received therapy from January 2014 to October 2016 in Zhejiang green town cardiovascular hospital were selected and randomly divided into the observation group and the control group , 45 cases in each group.The control group was treated with routine treatment after PCI, while the observation group was combined with ginkgo biloba extract dripping pills.After treatment of seven days, the changed of PAR, ACT, ATⅢ and adverse cardiovascular events were compared, after treatment three months, the seattle angina scale were compared. Results After treatment, the levels of PAR in the observation group were significantly lower than that of the control group, and the levels of ACT and ATⅢ were significantly higher than that of the control group, the difference was statistically significant (P<0.05), the total incidence of adverse cardiovascular events in the observation group was significantly lower than that of the control group , the difference was statistically significant ( P<0.05), in the seattle angina scale, the scores of stable state of angina pectoris, the attack of angina pectoris, physical activity limitation, treatment satisfaction in the observation group were significantly better than that of the control group, the difference was statistically significant (P<0.05). Conclusion Ginkgo biloba extract dripping pill is well for ACS after PCI, which can effectively relieve clinical symptoms, to improve the expression of PAR, ACT and ATⅢ, helps to reduce the incidence of adverse cardiovascular events.
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ObjectiveTo investigate the significance of hearing screening combined with gene screening for neonates with high-risk of hearing impairment.MethodsNeonates admitted to the Neonatal Department of Guangdong Women and Children Hospital between July 2013 and June 2014 were enrolled in this study. They were divided into high-risk group (with high-risk for hearing impairment) (n=3 129), and control group (n=5 106). Neonate hearing screening was carried out using otoacoustic emission and automated auditory brainstem response. Blood samples were collected using a standard protocol for detecting the mutations of four common deafness genes, includingGJB2,GJB3,SLC26A4 and mitochondrial 12s rRNA.Chi-square test was used to compare the differences of the pass rate of hearing screening and positive rate of gene mutations between the two groups.ResultsThe rates of failure on otoacoustic emission, automated auditory brainstem response or both in the high-risk group were 11.92% (373/3 129), 10.32% (323/3 129) and 4.83% (151/3 129), respectively, higher than those in the control group [5.03%(257/5 106), 6.56%(335/5 106) and 2.02% (103/5 106)] (χ2=130.265, 37.354 and 51.196, allP=0.000). In the high-risk group, the overall positive rate of gene mutations was 5.63% (176/3 129), and theGJB2 andSLC26A4 gene mutation rates were 3.04% (95/3 129) and 2.40% (75/3 129)], all higher than the control group [3.15% (161/5 106), 2.04% (104/5 106) and 1.06% (54/5106)] (χ2=30.301, 8.216 and 22.517, allP0.05]. The rates of failure on otoacoustic emission and automated auditory brainstem response of the neonates with deafness gene mutations were 9.50% (32/337) and 10.39% (35/337), respectively, higher than the neonates without [1.14% (90/7 898) and 1.29% (102/7 898)] (χ2=154.621 and 163.399, both P=0.000).ConclusionCombined hearing screening is of clinical significance for neonates with high-risk of hearing impairment.
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Objective To compare the masticatory efficiency of alveolar ridge restored by thermosetting resin full denture base and cast resin full denture base.Methods 30 patients with alveolar ridge were selected and divided intothe two groups by random number table and 15 cases in each group.Full denture with thermosetting resin base was worn in the first month in one group,and masticatory efficiency was measured.Then no false tooth was worn for a week,then full denture with cast resin base for a month,then masticatory efficiency was measured.In the other group,full denture with cast resin base was worn in the first month,and then masticatory efficiency was measured.Then no false tooth was worn for a week,then full denture with thermosetting resin base was worn for a month,then masticatory efficiency was measured.OD value as masticatory efficiency was measured by absorption spectrophotometry.Results The masticatory efficiency(OD value) of full denture with thermosetting resin base was (0.608 ± 0.124),and full denture with cast resin base was (0.885 ± 0.071).The masticatory efficiency of full denture with cast resin base was higher than that with thermosetting resin base (t =14.845,P ＜ 0.05).There was 13 cases of increased masticatory efficiency with hot coagulation resin base denture repair,the improved rate was 43.33 ％,while 24 cases with injection molding denture base denture repair,and the improved rate was 80.00％.The rate with injection molding denture base denture repair was higher than that with hot coagulation resin base denture repair(x2 =31.582,P ＜ 0.05).There was no significant adverse reaction in duration of test among all the patients.Conclusion The definition of full denture with cast resin base manufacture was high,and the masticatory efficiency of full denture with cast resin base is higher than that with thermosetting resin base,and the repair effects is better.It is worth of clinical application.
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Objective To learn the present situation and bottlenecks of human resources at private hospitals in Sichuan province.Methods Questionnaires,discussions and in-depth interviews were used to learn human resources of 35 private hospitals in the province.Results The findings indicate significant differences among doctors at such hospitals,most of whom age 30-40 years old(45.13％) ; technical titles of the medical workers are low in general,as only 20.08％ of them have vice-senior titles or above; employees are dissatisfied with the remuneration,training setup and culture of their hospitals.Conclusion Private hospitals must enhance training of professionalism,raise payment,improve training setup,and create a positive hospital culture if they want sustained development.In the meantime,hospital regulators should enhance supervision and provide supportive policies.