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Objective:To study the effect of blood volume feedback control system on improving intradialytic-hypotension (IDH) in maintenance hemodialysis (MHD) patients.Methods:It was a prospective cohort study. Thirty MHD patients with recurrent IDH in the Dialysis Center of the First Affiliated Hospital of Zhejiang University School of Medicine from March 2021 to March 2022 were selected. A self-control study was conducted in MHD patients. The patients were treated with routine hemodialysis in both baseline phase (A1) and reversal phase (A2), while with hemodialysis under the blood volume feedback control system in intervention phase (B). Each phase lasted for 4 weeks (12 hemodialysis sessions). The average occurrences of IDH and IDH-related adverse events (IDH-RAE, stopping dehydration for more than 10 minutes or getting off the hemodialysis machine 10 minutes earlier due to IDH) of each patient between phase A1, B, and A2 were calculated and compared. In a total of 1 080 dialysis records, a logistic regression analysis model was established with age, sex and intervention as independent variables and with the occurrence of IDH-RAE as the outcome.Results:A total of 30 eligible patients were included in the study, including 14 males (46.7%) and 16 females (53.3%), aged 63.0 (56.5, 72.5) years old, with a median dialysis age of 84.0 (37.2, 120.0) months. The average times of IDH in 30 MHD patients decreased from 1.17 (0.83, 1.67) in stage A1 (before intervention) to 0.33 (0.25, 0.58) in stage B (after intervention) ( P<0.05). The frequency of IDH-RAE decreased significantly from 0.29 (0.19, 0.47) in stage A1 to 0.17 (0,0.25) in stage B ( P<0.05). Logistic regression analysis results indicated that the use of blood volume feedback control system reduced the risk of IDH-RAE by 53% ( OR=0.47, 95% CI 0.34-0.64, P<0.001). Conclusions:The application of blood volume feedback control system can effectively reduce the occurrences of IDH and the risk of IDH-RAE in MHD patients.
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Objective:To evaluate the diagnostic value of multiparametric cardiac magnetic resonance(CMR)or detecting the occurrence of acute rejection(AR)after heart transplantation(HT).Methods:From 2019 to 2021, 44 HT recipients are prospectively recruited from Guangdong Provincial People's Hospital.Another 51 healthy volunteers are recruited from a local community as healthy controls.CMR studies are performed for obtaining baseline parameters.According to the clinicopathological diagnostic criteria of AR by the consensus of International Society for Heart and Lung Transplantation, 81 CMR studies of 44 HT recipients are further divided into two groups of AR (18 cases)and non-AR(71 cases). CMR parameters includ global ventricular structure/function, T2, T1, extracellular volume(ECV)and late gadolinium enhancement(LGE). A combined model is established by binary Logistic regression and receiver operator characteristic curve(ROC)constructed.Results:The age range is(41.8±16.8)years in 44 HT recipients and(41.8±9.7)years in 51 healthy controls.T1 mapping indicated that myocardial global ECV of left ventricle is significantly higher in AR patients than non-AR controls(32.4%±6.0% vs 28.5%±2.4%; P<0.001 9). Global native T1 is higher in AR group than that in non-AR group(49.8±3.1 vs 47.5±2.8 ms, P=0.009)and the difference is statistically significant.The cutoff value of global ECV is 30.62% with a sensitivity of 61% and a specificity of 86% for detecting AR.And T2 mapping reveale that T2 value of global left ventricle is significantly higher in AR group than that in non-AR group(49.8±3.1 vs 47.5±2.8 ms, P=0.009). LGE extent is significantly higher in AR group than those in non-AR group( P=0.004). Through including global native T1 and ECV into a logistic regression model, multiparametric CMR can yield an area under curve(AUC)of 0.794.It hints at the potential of CMR for detecting AR. Conclusions:Multiparametric cardiac magnetic resonance offers an excellent predictive capacity for a noninvasive detection of AR.
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Androgen deprivation therapy is one of the main treatments for prostate cancer patients. In recent years, many studies have revealed that androgen deprivation therapy increases the risk of cardiovascular disease, which leads to the cause of death alongside tumor-related deaths. The mechanism may be related to the elevation of testosterone levels, follicle-stimulating hormone levels and unstable atherosclerotic plaque. Standardized cardiovascular disease management in this population is a key issue to improve survival and prognosis. This paper summarizes a management plan covering 5 areas, including history collecting and data examination, assessment, referral, health education, and regimen selection.
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Objective@#To identity patterns of psychological abuse and neglect among male and female adolescents, and to examine the relationship between psychological abuse and neglect with mobile phone dependence.@*Methods@#A total of 1 070 adolescents from 5 middle schools in Ganzhou and Wuhan were investigated with Child Psychological Abuse and Neglect Scale (CPANS), Mobile Phone Addiction Index Scale (MPAI) and demographic questionnaire. Latent profile analysis (LPA) was used to construct typologies of psychological abuse and neglect involvement in male and female adolescents.@*Results@#Three latent classes were identified for boys: low level psychological abuse and neglect group (56.68%), medium level psychological abuse and neglect group ( 29.80 %), high level psychological abuse and neglect group (13.52%). For girls, four latent classes were identified including low level psychological abuse and neglect group (49.38%), medium level psychological abuse and neglect group (29.01%), high level psychological abuse and neglect group (11.12%); high level psychological abuse group (10.49%). Adolescents who suffered from psychological abuse and neglect were more likely to be dependent on mobile phones. Among them, boys dependence on mobile phones was manifested as out of control, withdrawal, escape and inefficiency[Medium level： B(95%CI )=0.28(0.12-0.44)，0.29(0.11-0.46)，0.35(0.16-0.53)，high level： B(95%CI )=0.37(0.16-0.59)，0.42(0.19-0.65)，0.33(0.07-0.59)，0.50(0.25- 0.74 )， P ＜0.05], while girls showed evasion and inefficiency in high levels of psychological abuse[ B(95%CI )=0.34(0.01-0.67)，0.46(0.14-0.78)， P ＜0.05].@*Conclusion@#There are heterogeneous differences in psychological abuse and neglect between male and female adolescents, and the relationship between each category and mobile phone dependence varies. The results provide suggestions for adolescent mental health intervention.
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Objective:To investigate the effect of miRNA-186-3p (miR-186-3p) on the apoptosis, immigration and invasion of cervical cancer CaSki cells and its relationship with transforming growth factor-β (TGF-β)-Smad signaling pathway.Methods:Plasmids containing miR-186-3p suppressor gene and miR-186-3p mimics were transfected into cervical cancer CaSki cells, namely miR-186-3p-I group and miR-186-3p-M group, respectively. In addition, CaSki cells transfected with empty plasmids were used as control (miR-186-3p-group C). Flow cytometry was used to detect the apoptosis rate of each group, and Transwell method was used to detect the migration and invasion ability of each group. Western blotting was used to detect the expression level of TGF-β-Smad signaling pathway related proteins. The target genes of miR-186-3p were predicted by using Starbase software and verified by using dual luciferase reporter gene assay.Results:The apoptosis rate of miR-186-3p-M group was lower than that of miR-186-3p-I group and miR-186-3p-C group [(7.5±3.2)% vs.(13.9±0.7)%, (12.7±0.6)%, all P < 0.05]. The number of migrating cells in miR-186-3p-M group [(218±25) vs. (168±13), (175±13), both P < 0.001] and the number of invasive cells in miR-186-3p-I group and miR-186-3p-C group were higher than those in miR-186-3p-I group and miR-186-3p-C group [(165±21) vs. (130±11), (142±12), all P < 0.001]. The relative expression levels of TGF-β, Smad2, Smad3, phosphorylated Smad2 (p-Smad2) and phosphorylated Smad3 (p-Smad3) in miR-186-3p-M group were the lowest, and the differences were statistically significant compared with the other two groups (all P < 0.001). Starbase software was used to predict the complementary binding of miR-186-3p to XIST RNA. Dual luciferase reporter assay showed that the relative luciferase activity of cells co-transfected with XIST wild-type vector and miR-186-3p mimic plasmid was lower than that of cells co-transfected with XIST wild-type vector and miR-186-3p empty plasmid ( P < 0.001). Conclusion:miR-186-3p may directly bind to XIST RNA and down-regulate the activity of TGF-β-Smad signaling pathway, thereby enhancing the immigration, apoptosis and invasion activities of cervical cancer CaSki cells.
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Objective:To investigate the clinical features of obesity indicators in patients with endometrial atypical hyperplasia (EAH) and early endometrial cancer (EC) and analyze the relationship between these indexes and effect of fertility preservation therapy.Methods:The clinical data of patients with EAH, EC and endometrial benign lesions treated in Peking University People′s Hospital from January 1, 2018 to June 30, 2021 who required fertility-sparing treatment were collected, and obesity indicators were calculated and analyzed retrospectively.Results:(1) Obesity indicators: the obesity [body mass index (BMI) ≥28 kg/m 2] rate of patients with fertility preservation treatment was 40% (32/80), and abdominal obesity [waist circumference (WC) ≥80 cm] rate was 79% (63/80), and obesity indicators [BMI, WC, waist-hip ratio (WHR), weight height ratio (WHTR), body roundness index (BRI), lipid accumulation index (LAP), visceral adiposity index (VAI)] were higher than those with endometrial benign lesions (all P<0.001). (2) Related factors affecting the efficacy of fertility preservation treatment and their predictive value: EC, higher BMI, WC, WHR, WHTR and BRI were risk factors for lower complete remission rate after nine months′ treatment (all P<0.05). The predictive values of BRI and WHTR combined with pathological type were superior to other indicators [area under the curve (AUC)=0.716; AUC=0.714]. (3) Relation of obesity indicators and glucolipid indicators:BMI, WC, WHR, WHTR, BRI, LAP and VAI were positively correlated with homeostasis model assessment-insulin resistance index, glycosylated hemoglobin, and triacylglycerol (all P<0.05); while VAI was negatively correlated with high density lipoprotein cholesterol ( P<0.001). Conclusions:For patients with EAH and EC treated with fertility preservation therapy, abnormal obesity indexes affect the treatment effect. BRI and WHTR combined pathology have good predictive value for effect of fertility preservation treatment. In clinical practice, appropriate indicators could be selected to evaluate body shape, glucolipid metabolism and predict efficacy.
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Objective:To analyze the clinical characteristics of lung abscess related to adenovirus (ADV).Methods:The data of 5 cases suffering from pulmonary abscess by ADV in Guangzhou Women and Children′s Medical Center from January to December 2019 were collected, including general information, clinical characteristics, examination and follow up visits.Results:The age of the patients ranged from 4 months to 12 months and the mean age was 8.6 months.All of them had fever and the degree was more than 39 ℃.What′s more, they had the history of cough and sputum.Somebody had dyspnea and pleural effusion.The imaging examinations of 5 cases strongly suggested that the interstitial and parenchymal lung disease subsequently appeared different sized cystic shadow, liquid flat cystic shadow, thickened wall empty tissue image, while some cases displayed the pleural effusion.The ADV-PCR or ADV-IgM were positive in the children, while the C-reactive protein, white blood cells and neutrophile were higher than the normal, but some were not.All the platelet count and lactate dehydrogenase were higher than the normal.Three children experienced the surgical treatment and their pathologic result revealed lung abscess.All the children were cured after the treatment, with good prognosis.Conclusions:Lung abscess related to ADV was rare in children and its system was not clear.If children who suffered from ADV were not cured after the treatment for a long time, the CT scan can differentiate whether it was combined with the complication of lung abscess or not.Early therapy for these patients could obtain satisfactory prognosis.
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Objective:To investigate the current situation of telephone cardiopulmonary resuscitation (T-CPR) in China, and analyze the reasons for the low implementation rate of T-CPR.Methods:This was a multicenter cross-sectional survey. Twenty cities were selected from six geographical regions of China by convenient sampling method. Anonymous online electronic questionnaires were sent to emergency medical service staffs in each city. All respondents were divided into the routine T-CPR group and control group. Student's t test and Chi-square test were used to analyze the difference between groups. Multivariate logistic regression was used to analyze the influencing factors of T-CPR. Results:⑴A total of 1 191 questionnaires were collected. 80.94% of respondents knew T-CPR. Nine hundred and sixty respondents, who knew T-CPR and completed the questionnaires, were included in the study, and were divided into the routine T-CPR group ( n=401) and control group ( n=559). Nine hundred and thirty-nine (97.81%) responders believed that T-CPR should be implemented for cardiac arrest patients that could be confirmed by telephone.⑵Four hundred and one (41.77%) responders routinely implemented T-CPR. Among them, 237 (24.68%) responders always did and 164 (17.08%) responders often did. ⑶Multivariate logistic regression analysis showed that male ( OR=1.787, 95% CI: 1.235-2.587, P=0.002), age ( OR=1.025, 95% CI: 1.004-1.047, P=0.020), clinical medicine background ( OR=2.926, 95% CI: 1.387-6.171, P =0.005), dispatcher ( OR=5.305, 95% CI: 3.463-8.126, P<0.01), using medical priority dispatch system (MPDS) system ( OR=1.941, 95% CI: 1.418-2.656, P<0.01), and T-CPR policy or procedure ( OR=3.879, 95% CI: 2.652-5.674, P<0.01) were favorable factors for T-CPR. ⑷The top three reasons for implementing T-CPR in the routine T-CPR group were that they had received T-CPR training (67.08%), believed that T-CPR could improve survival rate (63.59%), and had standard T-CPR process (63.09%). The top three reasons for not implementing T-CPR in the control group were that worrying about bystander compliance (42.04%), worrying about the quality of bystander cardiopulmonary resuscitation (CPR) (38.28%), and worrying about medical dispute (36.14%). Conclusions:The awareness and implementation of T-CPR among emergency medical service staffs need to be improved. The implementation of T-CPR depend on telephone dispatchers with clinical medicine background, clear T-CPR policy, standardized operation procedure, and professional assistant tools. To improve the public's awareness of cardiac arrest and cardiopulmonary resuscitation, and to improve the supporting legal system are also conducive to the implementation of T-CPR.
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Objective:To analyze the epidemiological and clinical characteristics of human brucellosis in Enshi Tujia and Miao Autonomous Prefecture (Enshi Prefecture) of Hubei Province, and to provide a basis for prevention and control of local brucellosis.Methods:Using descriptive epidemiological methods, the data of reported cases of brucellosis in Enshi Prefecture from 2012 to 2019 (from the "Enshi Infectious Disease Reporting Information Management System" and the medical record system of hospitals in counties and cities within the jurisdiction of Enshi Prefecture) were collected, and the three distributions (population, time, region distributions) and clinical manifestations of human brucellosis cases were statistically described and analyzed.Results:A total of 78 brucellosis cases were reported in Enshi Prefecture from 2012 to 2019, with an average annual incidence rate of 0.193 5/100 000. Among the 78 cases of brucellosis reported, the sex ratio of men to women was 2.12∶1.00 (53∶25); the age of onset was mainly from 30 to 59 years old, accounting for 75.64% (59/78); the occupation was mainly farmer, accounting for 88.46% (69/78); the main contact animal was sheep, accounting for 80.77% (63/78). There were reported cases of brucellosis throughout the year, and the main onset months were May, June, September, November, and December, accounting for 55.13% (43/78) of the total number. From 2012 to 2019, all counties and cities in Enshi Prefecture except Xianfeng County and Hefeng County had reported cases. Among them, Lichuan City had the most cases, with 55 cases (70.51%). The main clinical manifestations of reported cases of brucellosis were fever, fatigue, hyperhidrosis, and muscle and joint pain, which accounted for 98.72% (77 cases), 89.74% (70 cases), 79.49% (62 cases), and 69.23% (54 cases), respectively.Conclusions:The majority of patients with brucellosis in Enshi Prefecture are young and middle-aged male farmers, with the highest incidence in Lichuan City. Relevant departments should increase the propaganda of brucellosis, increase the people's awareness of disease prevention, and strengthen the prevention and control measures of high-risk groups and regions to reduce the incidence of brucellosis.
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Objective:To investigate the reproducibility of inflow-based vascular-space-occupancy (iVASO)-MRI in quantifying skeletal muscle perfusion and its potential clinical value in patients with dermatomyositis (DM).Methods:Totally 15 consecutive patients with DM and 15 healthy volunteers were enrolled in this prospective study from December 2018 to April 2019 at Nanfang Hospital, Southern Medical University. All subjects underwent T 1WI, short-tau inversion recovery (STIR) T 2WI, and iVASO-MRI of thigh on a 3.0 T MR scanner. According to findings on T 1WI and STIR T 2WI, the muscles were divided into normal, unaffected, edematous and atrophic or fat-infiltrated groups. Maximum arteriolar muscular blood volume (MBVa_max) and mean MBVa (MBVa_mean) of these 4 groups of muscles were obtained by 2 radiologists independently. In order to evaluate the reproducibility of iVASO, the repeated scan was performed 3 days later in 17 subjects (12 healthy volunteers and 5 DM patients), and the MBVa values were measured to calculate the intraclass correlation coefficients (ICC). The MBVa_max and MBVa_mean among the 4 groups were compared by using Kruskal-Wallis H test and the differences of each 2 groups was compare by using Mann-Whitney U test. Results:The ICC between the 2 observers was 0.95 and 0.96 for MBVa_max and MBVa_mean, respectively. The ICC between repeated tests was 0.87 and 0.89 for MBVa_max and MBVa_mean, respectively.There was significant difference among normal muscles, unaffected muscles, edematous muscles and atrophic or fat-infiltrated muscles ( P<0.001). Post hoc comparisons of MBVa_max and MBVa_mean showed that compared to normal muscles, unaffected muscles, edematous muscles and atrophic or fat-infiltrated muscles had a significant decrease of MBVa ( P<0.05). Unaffected muscles and edematous muscles showed no significant difference in terms of MBVa_max and MBVa_mean (both P=0.99), which were significantly higher than those of atrophic or fat-infiltrated muscles ( P<0.05). Conclusions:iVASO-MRIcan reliably quantify the MBVa of thigh muscular arteriolar, and it is potentially valuable in the diagnosis of DM.
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Objectives To investigate the cognition of dispatcher-initiated telephone cardiopulmonary resuscitation (TCPR) among emergency medical system(EMS) personnel and compare the cognition of TCPR among EMS personnel in different economic status,and to understand the current situation of TCPR cognition of EMS personnel in China.Methods This study is a multicenter crosssectional survey.The method of multi-level convenient sampling was adopted,and the test reliability and split half reliability of the questionnaire was tested.Questionnaire survey and data collection were conducted from December 2018 to June 2019.The ethical approval number is M2018264.SPSS 20.0 was used for analysis.x2 test was used to analyze the differences between groups.Results A total of 1191 electronic questionnaires were collected.Of them,80.94％ respondents knew TCPR,97.82％ respondents thought that TCPR should be implemented in cardiac arrest,36.62％ respondents thought that bystander cardiopulmonary resuscitation quality monitoring was needed in TCPR,and TCPR training courses were set up in the emergency department which recruited 25.83％ respondents.Emergency personnel in developed areas had a better understanding of the criteria for judging patients' breathlessness (11.69％ vs 7.89％,P=0.048),of TCPR need ncluding guidance of chest compression (92.45％ vs 87.49％,P=0.012) and of bystander cardiopulmonary resuscitation (BCPR) quality monitoring including the frequency of artificial respiration (84.42％ vs 74.87％,P=0.029) than those in underdeveloped areas,but there was no significant difference in other indicators (P＞0.05).Conclusions TCPR knowledge of EMS personnel in China is unsatisfactory.Further training is needed to improve their understanding of the criteria for judging cardiac arrest in out-of-hospital cardiac arrest patients via telephone,TCPR content and bystander cardiopulmonary resuscitation quality monitoring.There is difference in TCPR knowledge between the EMS personnel in developed and undeveloped areas in China.
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Objective@#To investigate the treatment of protrusion deformity of the concha cavity with cartilage excision and turning over of the concha cavity, and to evaluate its advantages, disadvantages and indications.@*Methods@#Eight patients with protrusion deformity of the concha cavity were treated by this method in Wuhan Union Hospital from January 2010 to January 2018.An incision was made in the auriculocephalic angle to expose the dorsal side of the anterior concha cartilage. An elliptical incision was made on the edge of the protrusion area of concha cavity and stripped. The cartilage slices were turned over after crossing scratches and re-implanted into the corresponding area of the concha cavity and sutured with absorbable suture. Then packing with a gauze ball in front of the concha cavity. To observe the healing of incision and the occurrence of hematoma 10 days postoperative. The skin shrinkage of concha cavity and the secondary deformity of concha cavity were evaluated 6-12 months later when the patients were followed-up.@*Results@#The protrusion deformity of concha cavity was corrected in all patients. The incision healed well without local hematoma. There was no obvious distortion of the concha cavity after 6-12 months follow-up.@*Conclusions@#Harvesting and in situ turning over of cartilage slices can effectively treat the protrusion deformity of the concha cavity. There is no skin shrinkage and deformation in the concha cavity after operation.
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Objective@#To investigate the sleep quality of children in Beijing and to analyze the related factors.@*Methods@#The data were collected from the survey of 3-14 years old children in 7 urban districts of Beijing in 2015. By using multi-stage stratified cluster random sampling method, 26 kindergartens and primary and secondary schools in 7 districts and counties, including Xicheng, Chaoyang, Changping, Shunyi, Fangshan, Huairou and Mentougou, were randomly selected, with a total of 11 420 children. Children′s sleep status was investigated with Children′s Sleep Questionnaire (PSQ), and the proportion of children with sleep quality problems when the PSQ score was greater than 7. Various sleep related factors were investigated with self-made questionnaire. A multilevel model was used to analyze the relationship between PSQ score and related factors.@*Results@#The average PSQ score of the children was 3.60±2.69. The proportion of children with sleep quality problems was 8.87%(816/9 198). Multilevel model analysis showed that the younger the children, the higher the PSQ score (<6 years old vs. 6~12 years old vs. >12 years old: 3.94±2.58 vs. 3.58±2.66 vs. 3.30±2.84, F=33.015, P<0.001); male PSQ score higher than female (3.89±2.75 vs. 3.30±2.60, t=10.560, P<0.001); and snoring, obesity, father/mother snoring, playing games before bed, surfing the internet, eating and other factors were statistically related to PSQ.@*Conclusions@#Sleep quality of children in Beijing should not be neglected, especially preschool children with high PSQ scores. Parents should pay attention to children′s snoring problems and try to reduce some pre-sleep behaviors that may affect sleep quality.
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Objective@#To investigate the snoring status and related family factors of children from 3 to 14 years old in Beijing.@*Methods@#From May to July, 2015, data of children from 3 to 14 years old were obtained from a status survey from 7 districts(Xicheng, Chaoyang, Changping, Shunyi, Fangshan, Huairou and Mentougou) in Beijing. A total of 11 420 children from 25 primary and middle schools were randomly selected. Pediatric Sleep Questionnaire (PSQ) and a self-administered questionnaire were carried out for the adopted children. Self-administered questionnaire included the snoring related family factors. Logistic regression was used to estimate the odd ratio(OR) with 95% confidence intervals for variables.@*Results@#A total of 9 198 children meet the inclusion criteria and are analyzed in the study, of whom 901 (9.80%) were found with snoring behavior. The incidence of boys is higher than girls. Obese children take higher risk of snoring. Compared with younger children (≤6 years old), older children (≥12 years old) have a significantly lower risk of snoring (OR=0.464, 95%CI 0.368-0.585). There is no statistical association between full-term infants, infant feeding pattern, parental cigarette smoking and child snoring.The children with family history of snoring have a significantly higher risk of snoring occurrence. The educational background of mother is statistically related to children snoring (OR=1.241, 95%CI 1.058-1.457).@*Conclusions@#The incidence of children snoring in Beijing is 9.80%, male gender, obesity, and young age are all risk factors for children snoring. There is a significantly statistical relationship between snoring and related family factors, such as family snoring history and education experience.
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The chin, located in the most prominent part of the lower facial profile, maintains the balance and coordination of the face. The chin size, shape, spatial position and proportion can all give rise to various chin malformations. Chin plasty plays an important role in improving facial appearance. Recent studies indicate that it’s difficult to completely meet the mental aesthetic requirements with a single procedure. The combination of different chin plastic surgery has become a hot spot in plastic surgery. In this paper, the morphological analysis of chin, the surgical progress in Chin plasty, the advantages and adverse effects of these methods, and the synthetic application of various surgeriesis were reviewed.
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Objective@#To evaluate the safety and effectiveness of repeated transcranial magnetic stimulation (rTMS) for treating non-fluent aphasia after stroke.@*Methods@#Forty-five stroke survivors with non-fluent aphasia were randomly divided into a 0.5 Hz group, a 1 Hz group and a sham group, each of 15. In addition to routine linguistic training, the three groups were given rTMS over the inferior frontal gyrus of the right hemisphere at the corresponding frequency or sham stimulation. Before as well as 5 and 10 days after the treatment, all of the subjects were evaluated using the Chinese version of the Western Aphasia Battery (WAB). The occurrence of adverse events was also observed.@*Results@#Before treatment, no significant differences were observed in the groups′ average aphasia ratio, spontaneous speech, listening comprehension, retelling and naming using the WAB. After 5 and 10 days significant increases were observed in the average WAB scores of all three groups, but the listening comprehension of the 0.5 Hz group was significantly better than that of the sham group 10 days later, as was the spontaneous speech of the 1 Hz group.@*Conclusion@#rTMS at either 1 Hz or 0.5 Hz can improve the linguistic functioning of stroke survivors with non-fluent aphasia. Both 0.5 Hz and 1 Hz rTMS are safe, but the latter is more effective.
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Objective@#To study the correlation between fractional exhaled nitric oxide (FeNO) and lung function in young children for acute attack of wheezing, and to compare the FeNO in different stages in order to explore the best suitable time for the experiment of FeNO in young children by the method of on-line tidal breathing.@*Methods@#Recurrent wheezing children aged 1-5 year old were selected who were underwent the test at lung function laboratory from January 2016 to March 2018, at Guangzhou Women and Children′s Medical Center.The children aged less than 5 years old were detected for FeNO in both stages of acute exacerbation and 2 weeks after treatment, and the children aged less than 3 years were also detected for the tidal lung function in the acute exacerbation stage.According to time ratio of reaching tidal peak flow to total expiratory time(TPTEF/TE )and ratio of volume at tidal peak flow to total tidal volume (VPEF/VE), the children aged less than 3 years were divided into 4 groups (normal group, mild group, moderate group and severe group).@*Results@#The FeNO of the normal group[9.85(5.17, 19.62) ppb] and mild group[13.00(7.00, 23.30) ppb] were significantly higher than that of the severe group [3.10(2.20, 5.25) ppb], and the differences were statistically significant(all P<0.05). And there was a positive correlation between TPTEF/TE and FeNO(r=0.304, P<0.05), VPEF/VE and FeNO(r=0.320, P<0.05), tidal volume per kilogram(VT/kG)and FeNO(r=0.293, P<0.05)and a negative correlation between respiration rate(RR)and FeNO(r=-0.449, P<0.05). The FeNO in the stage of acute exacerbation was significantly lower than that in the stage of 2 weeks after treatment[(10.49±8.49) ppb vs.(20.41±9.13) ppb], and there was a significant difference among them(t=-5.79, P<0.01).@*Conclusions@#If researchers want to use the method of on-line breathing to test FeNO in young children with wheezing, they should choose the time of 2 weeks after treatment, and analyze the results combined with the lung function.
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Objective To evaluate the safety and effectiveness of repeated transcranial magnetic stimulation ( rTMS) for treating non-fluent aphasia after stroke. Methods Forty-five stroke survivors with non-fluent aphasia were randomly divided into a 0.5 Hz group, a 1 Hz group and a sham group, each of 15. In addition to routine lin-guistic training, the three groups were given rTMS over the inferior frontal gyrus of the right hemisphere at the corre-sponding frequency or sham stimulation. Before as well as 5 and 10 days after the treatment, all of the subjects were evaluated using the Chinese version of the Western Aphasia Battery ( WAB) . The occurrence of adverse events was al-so observed. Results Before treatment, no significant differences were observed in the groups' average aphasia rati-o, spontaneous speech, listening comprehension, retelling and naming using the WAB. After 5 and 10 days signifi-cant increases were observed in the average WAB scores of all three groups, but the listening comprehension of the 0.5 Hz group was significantly better than that of the sham group 10 days later, as was the spontaneous speech of the 1 Hz group. Conclusion rTMS at either 1 Hz or 0.5 Hz can improve the linguistic functioning of stroke survivors with non-fluent aphasia. Both 0.5 Hz and 1 Hz rTMS are safe, but the latter is more effective.
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Objective To investigate the influence of conventional preoperative intestinal preparation and unplanned preparation on the visual field of pelvic organ prolapse repair surgery. Methods The patients who underwent transvaginal pelvic organ prolapse repair surgery in Peking University People′s Hospital from September 2017 to July 2018 were selected as the research objects except those who had undergone colorectal surgery and chronic constipation. The surgery doctor was blinded by intestinal preparation. There was no intestinal preparation in non intestinal preparation group and polyethylene glycol was taken orally in intestinal preparation group. The main outcome measures were the effect of intestinal contents on the surgical field, the presence of fecal leakage, and the nature and volume of fecal leakage. The standard of fecal contamination was: mild, less than 15 ml, moderate, 15-30 ml, and severe,>30 ml. Secondary indicators were patient satisfaction and symptoms of routine bowel preparation. Results A total of 120 patients (60 cases of non intestinal preparation group, 60 cases of intestinal preparation group) were selected, including transvaginal hysterectomy, vaginal anterior or posterior colporrhaphy (some patients with anterior prolapse repair with mesh), sacrospinal ligament suspension, total colpectomy and colpocleisis, laparoscopic sacral colpopexy, anti-incontinence surgery. The median age of the patients in non intestinal preparation group was 62 years, and the median age of intestinal preparation group was 60 years. There were no significant differences in median age, anesthesia, operation method, blood loss, operation time and perioperative infection between the two groups (all P>0.05). Fecal contamination occurred in 10％(6/60) of the patients without intestinal preparation and 32％ (19/60) of the patients with intestinal preparation (P=0.042). Comparing the two groups, 10％(6/60) of the patients with intestinal preparation had moderate and severe contamination, and the patients without intestinal preparation was only 2％ (1/60), there was significant difference (P=0.017). In intestinal preparation group, nausea (8％, 5/60), vomiting (5％, 3/60), abdominal distension (22％, 13/60), fatigue (5％, 3/60) and palpitation (2％, 1/60) were higher than those in non intestinal preparation group. Conclusions Intestinal preparation with oral laxatives before pelvic organ prolapse repair surgery is not beneficial to the cleaning of the surgical field and increases the discomfort of intestinal preparation. It is safe and feasible for most patients with pelvic organ prolapse to perform pelvic organ prolapse repair surgery without intestinal preparation.
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Objective To study the correlation between fractional exhaled nitric oxide (FeNO) and lung function in young children for acute attack of wheezing,and to compare the FeNO in different stages in order to explore the best suitable time for the experiment of FeNO in young children by the method of on-line tidal breathing.Methods Recurrent wheezing children aged 1-5 year old were selected who were underwent the test at lung function laboratory from January 2016 to March 2018,at Guangzhou Women and Children's Medical Center.The children aged less than 5 years old were detected for FeNO in both stages of acute exacerbation and 2 weeks after treatment,and the children aged less than 3 years were also detected for the tidal lung function in the acute exacerbation stage.According to time ratio of reaching tidal peak flow to total expiratory time(TPTEF/TE) and ratio of volume at tidal peak flow to total tidal volume (VPEF/VE),the children aged less than 3 years were divided into 4 groups (normal group,mild group,moderate group and severe group).Results The FeNO of the normal group [9.85 (5.17,19.62) ppb] and mild group[13.00 (7.00,23.30) ppb] were significantly higher than that of the severe group [3.10 (2.20,5.25)ppb],and the differences were statistically significant (all P ＜ 0.05).And there was a positive correlation between TPTEF/TE and FeNO(r =0.304,P ＜ 0.05),VPEF/VE and FeNO(r =0.320,P ＜ 0.05),tidal volume per kilogram (VT/kG) and FeNO(r =0.293,P ＜ 0.05)and a negative correlation between respiration rate(RR) and FeNO (r =-0.449,P ＜ 0.05).The FeNO in the stage of acute exacerbation was significantly lower than that in the stage of 2 weeks after treatment[(10.49± 8.49) ppb vs.(20.41 ± 9.13) ppb],and there was a significant difference among them(t =-5.79,P ＜ 0.01).Conclusions If researchers want to use the method of on-line breathing to test FeNO in young children with wheezing,they should choose the time of 2 weeks after treatment,and analyze the results combined with the lung function.