Objective To explore the efficacy of guizhi shaoyao zhimu decoction in acute attack of gouty arthritis.Methods 80 cases of acute gouty arthritis patients admitted to our hospital from January 2020 to December 2021 were selected as the research object,and were divided into the control group and the observation group by random number table method,40 cases in each group.The control group was treated with conventional western medicine,and the observation group was treated with guizhi shaoyao zhimu decoction plus or minus treatment.The clinical efficacy,symptoms and signs,erythrocyte sedimentation rate(ESR),C-reactive protein and the incidence of adverse reactions were compared between the two groups.Results The total effective rate of the observation group was higher than the control group,the difference was statistically significant(P<0.05).Before treatment,there were no significant differences in joint swelling socre,ESR and C-reactive protein between the two groups(P>0.05).After treatment,joint swelling score,ESR and C-reactive protein levels in 2 groups were lower than before,and the observation group was lower than the control group,the difference was statistically significant(P<0.05).The incidence of adverse reactions in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusion Guizhi shaoyao zhimu decoction is effective in the treatment of acute gouty arthritis,and can promote the improvement of symptoms and signs of patients,with less adverse reactions and high safety,which is worthy of extensive clinical promotion and application.
Objective To investigate factors associated with change in total hip bone mineral density(THBMD)after zoledronic acid(5mg)infusion in elderly osteoporosis(OP)women.Methods A total of 122 elderly OP women were recruited into the study,their THBMD,bone metabolism markers and blood biochemistry were tested,and THBMD was reviewed 12 months after receiving zoledronic acid(5mg).Multiple regression analysis was applied to screen for independent associated factors of △THBMD.Results Serum C-terminal cross-linking telopeptide of type 1 collagen(CTX,β=0.031,P<0.01)and body mass index(BMI,β=0.001,P<0.05)were independent factors associated with △THBMD in elderly osteoporosis women.Conclusion The △THBMD after zoledronic acid infusion in elderly osteoporosis women is affected by multiple factors,and the patients with higher serum CTX and BMI have a higher △THBMD.
Objective To investigate the current status of stress urinary incontinence among middle-aged and elderly women in Hangzhou,and analyze the influencing factors.Methods From June 2021 to May 2022,a convenience sampling method was used to select 625 middle-aged and elderly women>45 years old in 16 communities in Hangzhou city to conduct a questionnaire survey to learn about their underlying diseases,stress urinary incontinence,medical consultation,and quality of life,and to analyze their influencing factors.Results The prevalence of stress urinary incontinence among middle-aged and elderly women in Hangzhou was 24.96%,and the consultation rate was 24.36%.Logistic regression analysis revealed that age,education,constipation,chronic respiratory disease,and the number of pregnancies were the risk factors for stress urinary incontinence in middle-aged and elderly women(P<0.05).Quality of life rating analysis showed that middle-aged and elderly women with stress urinary incontinence had higher scores in somatic function,social function,somatic pain,energy,and mental health than middle-aged and elderly women without stress urinary incontinence,and the difference was statistically significant(P<0.05).Conclusion Middle-aged and elderly women have a higher prevalence of stress urinary incontinence,a lower rate of consultation,and a lower quality of survival than middle-aged and elderly women who do not have stress urinary incontinence.Therefore,middle-aged and older women should be screened early and provided with targeted educational guidance and intervention.
近些年,越来越多的研究在乳腺领域取得了突破性进展,但乳腺癌(breast cancer,BC)全球发病率仍在上升,已成为导致女性疾病负担的主要癌症.三阴性乳腺癌(triple-negative breast cancer,TNBC)是目前乳腺癌分子分型中最具侵袭力的类型,其异质性高、预后差,在我国乳腺癌综合治疗及预后因素分析中尚具挑战.
Objective To explore the impacts of plasma 8-hydroxydeoxyguanosine(8-OHDG)and plasma malondialdehyde(MDA)on coronary arteries lesions(CAL)and vascular endothelial dysfunction in children with Kawasaki disease(KD).Methods The plasma 8-OHDG and plasma MDA were measured in KD children group at acute stage(n=60,12 cases had coronary artery lesions,48 coronary were normal),paracmastic and recovery stage(both 40 cases)by ELISA method.Measurement of vasodilator response(FMD%)mediated by brachial artery flow in paracmastic and recovery stage KD children group.Another 15 febrile children(the febrile group)and 15 healthy children(the control group)were selected.Results The plasma 8-OHDG and plasma MDA concentrations in acute and paracmastic and recovery stage of KD children group were all higher than those of normal control group(P<0.05).Plasma 8-OHDG and plasma MDA concentrations in acute stage were significandy higher than those of KD children group in paracmastic and recovery stage and the fever patients group(P<0.05).The CALs patients had higer plasma 8-OHDG and plasma MDA concentrations than the NCALs patients(P<0.05).Using plasma 8-OHDG concentration≥1.241 ng/mL,MDA concentration≥0.456nmol/mL as cut-off values for diagnosing CALs respectively,the areas under the ROC curves were 0.899 and 0.748,the sensitivity were 83.3%and 100%,the specificity were 91.7%and 39.6%,respectively.FMD of the brachial artery was significantly lower in both of KD children in paracmastic and recovery stage than that in the control group(P<0.05).KD children in paracmastic stage had lower FMD of the brachial artery than that in recovery stage group.The FMD of the brachial artery with KD children in paracmastic and recovery stage were negatively correlated with the plasma level of 8-OHDG and plasma MDA(r=-0.495,-0.357,P<0.05).Conclusion Oxidative stress maybe involve from the acute stage to the recovery stage with KD children.8-OHDG appears to be better in the diagnosis of coronary artery lesions than MDA.There are vascular endothelial dysfunction during the paracmastic and recovery stage with KD children.Increasing plasma 8-OHDG and MDA concentrations may impair the vascular endothelial function.
Objective To investigate the effect of indocyanine green assisted phacoemulsification(PHACO)and intraocular lens(IOL)implantation in the treatment of cataract and its effects on intraocular pressure and corneal endothelial cells.Methods Selected 86 cataract patients who received PHACO+IOL implantation in our hospital from January 2020 to October 2022,and divided them into the observation group and the control group by the random number table,43 patients in each group.Both groups were treated with PHACO+IOL implantation,and indocyanine green was used in the observation group,while indocyanine green was not used in the control group.The success rate of capsulorhexis during operation was compared between the two groups,and the best corrected visual acuity(BCVA),intraocular pressure and corneal endothelial cell number before operation,after operation 1 week and 1 months and postoperative complication rate were compared.Results The successful rate of capsulorhexis in the observation group was 93.02%,which was significantly higher than the control group 76.74%,with statistically significant(P<0.05);there was no significant difference in BCVA and intraocular pressure between the two groups at before operation,after operation 1 week and 1 months(P>0.05);at after operation 1 week and1 month,the number of corneal endothelial cells in the observation group were(2,194.34±173.09)number/mm2 and(2,214.39±155.81)number/mm2,which were significantly higher than those in the control group(1,991.84±157.03)number/mm2 and(2,021.23±163.42)number/mm2,and the difference were statistically significant(P<0.05);the reaction rate of operative eyes in the observation group was 23.26%,which was significantly lower than that in the control group 46.51%with statistically significant(P<0.05).Conclusion Indocyanine green assisted in PHACO+IOL implantation in cataract patients can improve the success rate of capsulorhexis,reduce corneal endothelial damage,and do not affect intraocular pressure,it's safe and reliable,and is worthy of clinical promotion.
Objective To use the cancer genome atlas(TCGA)to establish a prediction model to predict the overall survival(OS)of stomach adenocarcinoma(STAD)patients,and to construct a nomogram for predicting STAD OS according to A-to-I RNA editing(ATIRE)Riskscore and clinicopathological characteristics.Methods The RNA editing data,transcriptome data and corresponding clinical data of STAD patients were downloaded from the TCGA database to explore the survival related ATIRE.Patients were randomly divided into the training set(n=170)and the validation set(n=122).Dimensionality reduction was performed through univariate Cox hazard regression,Lasso regression,and multivariate stepwise Cox hazard regression analysis to identify survival related ATIRE sites and generate ATIRE Riskscore.A nomogram was then constructed to predict the OS of STAD patients.Analyzed the correlation between RNA editing and gene expression and the effect of ATIRE on transcriptome expression.Results Five ATIRE loci(ZNF91|chr19:23542060,RNF149|chr2:101891615,KRIT1|chr7:91829808,ARSD|chrX:2824214,OSGEPL1|chr2:190612029)were identified to generate a Riskscore,and OS in the high-risk group was significantly lower for the training set,the validation set,and all patient groups.Nomograms performed well in predicting OS rates in STAD.Furthermore,ATIRE loci were significantly associated with gene expression and affected several cancer-associated pathways.Conclusion The AITRE-based model can be used as a new tool for predicting STAD survival.
Objective To observe the clinical efficacy of electroacupuncture combined with transcranial direct current stimulation(tDCS)on stage I complex regional pain syndrome(CRPS)after stroke.Methods Sixty patients with post-stroke CRPS stage I were randomly divided into the observation group and the control group,with 30 patients in each group.The control group received conventional drugs combined with electroacupuncture treatment,while the observation group received tDCS treatment on this basis.Comparison of Fugl-Meyer upper extremity score(UEFM),numerical rating scale(NRS),and clinical efficacy between two groups before and after treatment.Results After treatment,the UEFM of the two groups of patients increased,and the NRS scores were lower than before(P<0.05),and the observation group was better than the control group,the difference was statistically significant(P<0.05).Conclusion Electroacupuncture combined with tDCS can significantly improve clinical efficacy and shorten the course of stroke complicated CRPS stage I compared to conventional western medicine treatment combined with electroacupuncture.
Objective To study the intussusception rate after successful enema diagnosed by ultrasound and provide suggestions for clinical treatment.Methods 144 children with intussusception admitted to Jinhua Central Hospital of Zhejiang Province from January 2019 to January 2020 were retrospectively analyzed.The recurrence rate after successful intussusception enema diagnosed by ultrasound and the admission rate of clinical children with intussusception were analyzed.Results Among the 144 children with intussusception,25 cases had intussusception within 48 hours,including 17 cases with intussusception twice,6 cases three times,and 2 cases four times.Among the 25 children who had been re-coated,18 cases were not admitted to the hospital at the first time of intussusception,and one of them was not admitted to the hospital for 4 times within 48 hours,seven children were admitted to the hospital at the first intussusception.The proportion of children with intussusception within 48 hours after successful enema was 17.4%,while 72%of the children with intussusception were not admitted to hospital for the first time.Conclusion The condition of infant intussusception is critical.Ultrasound can be the first imaging choice for the diagnosis of infantile intussusception.The repeat rate of intussusception is high within 48 hours after successful enema,but the admission rate is low.If the children with intussusception can be admitted for observation for 48 hours,ultrasound diagnosis and clinical treatment can be carried out in time within the high-risk period of intussusception to ensure a good prognosis.
Objective To explore the clinical effect of blade needle combined with bone-setting massage in the treatment of anterior scalene syndrome.Methods A total of 72 outpatients and inpatients with anterior scalene syndrome from September 2021 to September 2022 in the massage department of Hangzhou Hospital of Traditional Chinese Medicine were randomly divided into the treatment group and the control group.The treatment group was treated with blade needle combined with bone-setting massage,and the control group was treated with oral Voltaren capsules and Miaona tablets for two weeks.The clinical efficacy,pain visual analogue scale(VAS)and cervical range of motion were compared between the treatment group and the control group before and after treatment.Results In terms of cure rate,the treatment group was significantly higher than the control group.The overall therapeutic effect of the treatment group was significantly better than that of the control group(P<0.05).The improvement of VAS pain score in the treatment group was significantly better than that in the control group(P<0.05).The improvement of cervical spine range of motion in the treatment group was better than that in the control group(P<0.05).Conclusion Although oral drugs can temporarily and quickly play a role in relieving pain,the effect of blade needle combined with bone-setting massage is better,which can significantly reduce the symptoms of patients with anterior scalene syndrome,and has no adverse drug reactions and side effects.It is worthy of clinical application and promotion.
Objective To compare the value and influencing factors of esophageal atrial pacing(TEAP)and intracardiac electrophysiological examination(EPS)in the diagnosis of parparal ventricular hypervelocity(PSVT).Methods A retrospective analysis was performed on 436 patients who underwent TEAP,EPS and radiofrequency ablation due to PSVT from January 2017 to March 2022.According to whether intravenous antiarrhythmic drugs had been used in the short time(2.17±1.63)d before the examination,the patients were divided into the medication group and the non-medication group,among which medication group had stopped more than 5 half-lives before examination.PSVT was divided into two atrioventricular node paths,left side bypass and right side bypass.According to the stimulation method,they were divided into TEAP and EPS.The final successful ablation target was used as the gold standard for PSVT typing.Results There was a statistically significant difference in TEAP induction rate between the untreated group(72%)and the treated group(56.5%)(P<0.05).There was a statistically significant difference(P<0.05)in the induction of TEAP on dual pathway,left side pathway,and right side pathway.The difference in TEAP induction rate compared to EPS was statistically significant(P<0.05).The accuracy of TEAP in diagnosing PSVT was 83.9%.Isoprenephrine can increase the induction rate of EPS from 76.8%to 94.7%.Conclusion TEAP is an effective method for preoperative diagnosis of PSVT.Withdrawal of intravenous antiarrhythmic drugs over 5 half-life periods still has a certain effect on TEAP induction.Isoproterenol can improve the induction rate of EPS.
Objective To explore the factors influencing the success of terbutaline sulfate in single fetal breech external inversion(ECV).Methods Pregnant women who voluntarily received external cephalic version(EVC)and gave birth in Shangyu People's Hospital of Shaoxing city with complete maternity and perinatal health records during December 2018 to December 2021 in the department of Obstetrics were enrolled in the study.Subjects were divided into the successful group and the failed group.The related factors were analyzed by univariate analysis and multivariate Logistic regression analysis.Results Among the 72 pregnant women who underwent ECV,47 cases(65.3%)were successful.The results of monofactor analysis between the successful group and the failure group showed that factors influencing the success of the operation were amniotic fluid index,the buttock type,the position of placenta and tension of the uterus(all P<0.05).Multivariate analysis showed that the success rate was dependent on the low tension of the uterus,amniotic fluid index≥10 cm,single breech presentation,non-anterior wall placenta(OR>1,P<0.05).In the 47 cases successful EVC cases,89.4%of women(42cases)delivered vaginally.Conclusion The low tension of the uterus,non-anterior wall placenta,amniotic fluid index≥10 cm and single breech presentation are the main influencing factors of the success rate of ECV.EVC has high reliability and safety,which can effectively reduce the cesarean section rate and delivery cost in Shangyu area.Pregnant women who are willing can try to perform it after evaluation.
Objective To investigate the therapeutic effects of using short stick pressure therapy to eliminate trigger points in the neck and shoulder region of neck type of cervical spondylosis.Methods A total of 80 cases of neck type of cervical spondylosis patients admitted to our hospital from September 2021 to September 2022 were selected as the research objects.According to the random number table method,they were treated with basic drugs and divided into two groups,each of the 40 cases.The control group was treated with placebo,and the observation group was treated with trigger stick therapy with short stick.Results Visual analogue scale(VAS)score and number of cervical spine dysfunction index charts(NDI)score in both groups decreased after treatment compared with before treatment(P<0.05),and the scores of the observer group were lower than those of the control group(P<0.05).At the end of treatment course,the total effective rate of the observation group(92.50%)was higher than that of the control group(75.00%),and the difference was statistically significant(P<0.05).Conclusion The short stick therapy with trigger point has a good clinical effect on neck type of cervical spondylosis,could effectively relieve the pain and improve the clinical symptoms,and is worthy of clinical application.
Objective To analyze the effect of the Labour-Delivery-Recovery-Postpartum(LDRP)delivery model in primiparous women by propensity score matching.Methods The primiparous women in our hospital were selected as survey objects.The LDRP group was parturients living in the LDRP care unit,while parturients in the general medical wards were the general group.We compared the characteristics of the two groups by propensity score matching method.Results A total of 1192 participated in the study,including 161 in the LDRP group and 1031 were in the general group.After propensity score matching,156 cases in each of the two groups had a balanced baseline characteristics.The first stage of labor time of the LDRP group was shorter than the ordinary group.Meanwhile,the LDRP group had fewer premature rupture of membranes(10.3%VS.19.2%).There was a statistical difference in the early sucking.The rate of early sucking was 100%in the LDRP group,which was higher than the ordinary group(96.8%).Conclusion LDRP delivery model could improve obstetric quality and promote postpartum rehabilitation and breastfeeding effectively.This model has clinical application value and deserves the promotion.
脓毒症(sepsis)是一种机体对感染反应失调导致的器官功能障碍综合征[1],其发病机制极为复杂,涉及炎症、免疫、凝血等系统.当病情进展至严重脓毒症或脓毒症性休克时,危重症患者的死亡风险明显升高[2].
Objective To explore curative effect of"Erhuotongqu Method"in treatment of knee osteoarthritis cold dampness syndrome.Methods In the Quzhou Hospital of Chinese Medicine between December 2021 and March 2022,48 cases of patients with knee osteoarthritis were divided into two groups.The control group(24 cases)was treated with oral celecoxib capsules,the experimental group(24 cases)was treated with celecoxib capsule combined with"Erhuotongqu Method"from Quzhou Leishi.Visual Analogue Scale(VAS)and Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC)scores were evaluated before,1,3,and 6 months after,as well as total response rate before and 6 months after treatment.Results The differences of VAS and WOMAC scores at 1,3 and 6 months after medication between the two groups were statistically significant(P<0.05).At 6 months after treatment,the total effective rate of the experimental group and the control group were 91.67%and 66.67%,respectively,and the difference of treatment effect between the two groups was statistically significant(P<0.05).Conclusion The treatment of cold and dampness type knee osteoarthritis with"Erhuotongqu Method"from Quzhou Leishi can improve the knee bone pain of patients,restore joint activity function,and has certain clinical efficacy.
Objective To observe the changes of testicular calcification in patients with testicular microlithiasis.Methods A retrospective study was performed on 37 patients with testicular microlithiasis,and the changes in the degree of testicular calcification were compared.Results Among 20 patients with diffuse testicular microlithiasis,12 patients had increased calcification,4 patients had decreased calcification,and 4 patients had no significant change;17 patients had focal testicular microlithiasis,of which 6 patients had increased calcification and 11 patients had no calcification;16 cases of juvenile patients developed testicular development during the follow-up period,of which 11 cases increased the degree of calcification,2 case decreased the degree of calcification,and 3 cases did not change significantly.Conclusion Patients with diffuse testicular microlithiasis have increased testicular calcification,and minors with testicular microlithiasis are at risk of increased calcification during testicular development.Follow-up should be paid attention to in these two types of patients.
Objective To explore the risk factors affecting the failure of endoscopic gastrointestinal bleeding hemostasis and vascular intervention hemostasis for acute non-varicose upper gastrointestinal bleeding(ANVUGIB).Methods 108 patients with ANVUGIB hospitalized in the Affiliated Hospital of Hangzhou Normal University were collected and all of them received endoscopic hemostasis.According to the success of the first endoscopic treatment,they were divided into the successful group and the failed group.Univariate analysis of the factors of failure of endoscopic hemostasis therapy.Factors with statistical significance were included as independent variables,and endoscopic hemostasis was successful as the dependent variable.Multivariate Logistic regression was performed to analyze the risk factors of endoscopic treatment failure.Vascular interventional hemostasis was performed after endoscopic treatment failed,and subgroups were classified into the successful interventional hemostasis group and the failed group,and the differences of clinical conditions,laboratory examination,endoscopic performance and other variables between the two groups were compared.Results 20.4%(22/108)of the patients with endoscopic hemostasis failed.The comparison between the two groups showed statistically significant differences in age,history of non-steroidal drug use,history of hormone use,total bleeding,cause of bleeding,hemorrhagic shock,ulcer diameter,hemoglobin,albumin,prothrombin time,D-dimer and C-reactive protein.Multivariate Logistic regression analysis showed that hemorrhagic shock(OR 78.45,95%CI:6.484～949.105)and ulcer diameter(OR 3.873,95%CI:1.275～11.772)were risk factors for hemostasis failure under ANVUGIB endoscopy.Compared with the two groups,the risk factors albumin and platelet were statistically different.Conclusion There are many factors influencing endoscopic hemostasis in ANVUGIB,among which hemorrhagic shock and large ulcer diameter are risk factors for rebleeding after endoscopic hemostasis.Vascular intervention to stop bleeding after endoscopic hemostasis failure,low albumin and low platelet levels can lead to increased risk of interventional therapy failure.
迄今为止,已有多种牙源性间充质干细胞(mesenchymal stem cells,MSCs)从具有外胚间充质来源的牙齿和牙周组织中分离出来,主要包括牙髓干细胞(dental pulp stem cells, DPSCs)、脱落乳牙干细胞(stem cells from human exfoliated deciduous teeth,SHED)、牙周膜干细胞(periodontal ligament stem cells,PDLSCs)、根尖乳头干细胞(stem cells from apical papilla,SCAP)、牙囊干细胞(dental follicle stem cells,DFSC)、唾液腺干细胞(salivary gland stem cells,SGSCs)等.
