June 2017, Volume 20, No.18 Abstracts
Author：尹鹏 Source：CGP Published： [07-13] views： 123
Implications of Updated Points of GOLD 2017 for the Hierarchical Diagnosis and Treatment of COPD in China LI Hai-ling1，LI Fan2*
1.Yangpu Hospital,Tongji University,Shanghai 210030,China
2.Songjiang Central Hospital Affiliated to Nanjing Medical University,Shanghai 201600,China
*Corresponding author:LI Fan,Chief physician;E-mail:email@example.com
【Abstract】 Global Initiative for Chronic Obstructive Lung Diseases(GOLD) is a global guiding document on the standardized prevention and control of chronic obstructive pulmonary disease(COPD).On the basis of the previous versions,there is a major adjustment in definition,diagnosis,illness evaluation and treatment plan for COPD,and a more detailed instructions in follow-up criteria and treatment regimen of patients after discharge in GOLD 2017 report.It provides a good reference for the development of hierarchical diagnosis and treatment of COPD,and is contribute to the prevention and control of COPD in primary care.
【Key words】 Pulmonary disease,chronic obstructive;Guideline;Disease management;Hierarchical diagnosis and treatment
Recent Developments in the Application of Pulmonary Rehabilitation in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease HUANG Fei-fei1,ZHANG Wen2，CHEN-Lian3，ZHANG Yi-fan4*，LI Fan5*
1.Department of Geriatrics,Shanghai Fifth Rehabilitation Hospital,Shanghai 201600,China
2.Department of Rehabilitation Medicine,Shanghai General Hospital,Shanghai 200080,China
3.Department of Rehabilitation Medicine，Shanghai Fifth Rehabilitation Hospital,Shanghai 201600,China
4.Emergency and Critical Care Medicine Department,Shanghai Songjiang Central Hospital,Shanghai 201600,China
5.Respiratory Department，Shanghai Songjiang Central Hospital,Shanghai 201600,China
*Corresponding author:ZHANG Yi-fan,Chief physician;E-mail：firstname.lastname@example.org
LI Fan，Associate professor，Chief physician;E-mail:email@example.com
【Abstract】 Pulmonary rehabilitation is widely regarded as an effective treatment for patients with chronic obstructive pulmonary disease(COPD) in addition to oxygen therapy and pharmacologic therapy.However,there are few studies about pulmonary rehabilitation applied to patients with acute exacerbation of COPD(AECOPD).We reviewed the articles about early application of pulmonary rehabilitation in AECOPD patients or discharged AECOPD patients in recent years,interpreted the common methods of pulmonary rehabilitation used for the patients,with a view to increasing the awareness of pulmonary rehabilitation in health care providers,and promoting the development of pulmonary rehabilitation for COPD.
【Key words】 Pulmonary disease,chronic obstructive;Rehabilitation;Review
Recent Developments in Autophagy in the Pathogenesis of Chronic Obstructive Pulmonary Disease JIANG Ming*,WANG Peng-yan
Department of Respiration,Affiliated Hospital of Guilin Medical University,Guilin 541004,China
*Corresponding author:JIANG Ming,Associate chief physician;E-mail:firstname.lastname@example.org
【Abstract】 Chronic obstructive pulmonary disease(COPD) is a progressive and irreversible lung disease due to airflow limitation with high disability and morbidity rates.Autophagy is a degradation process of cytoplasmic proteins and organelles through lysosomal pathway,in which the damaged cell structure,aging organelles and no longer needed biomacromolecules are cleaned out.Recently,it has been found that autophagy is closely related to the pathogenesis of COPD,and the autophagy activity is enhanced in COPD patients.In this paper,the recent developments in the role of autophagy in airway,pulmonary vascular disease and lung parenchyma is reviewed.
【Key words】 Pulmonary disease,chronic obstructive;Autophagy
Assessment of Acute Exacerbation and Mortality Risk in Patients with Stable COPD by Serum GRO-α and MRpro-ADM WANG Qun-zhi,SHENG Mei-ling,SONG Yu-chen,ZHAO Mei-fang,GUO An*
Department of Respiratory Medicine,Jinhua People′s Hospital,Jinhua 321000,China
*Corresponding author:GUO An，Chief physician;E-mail:Drwqz82@sina.com
【Abstract】 Objective To estimate the acute exacerbation and mortality risk in patients with stable chronic obstructive pulmonary disease(COPD) by serum growth-regulated oncogene α(GRO-α) and midregional pro-adrenomedullin(MRpro-ADM),so as to provide a basis for clinically identifying the high-risk ones among these patients as early as possible.Methods A total of 160 stable COPD patients enrolled were all from Department of Respiratory Medicine of Jinhua People′s Hospital,including outpatients who received medical care and inpatients who were discharged between January and February 2016.Measurement of serum GRO-α and MRpro-ADM was performed in all the participants.The values of median of these two biomarkers,73.5 ng/L for GRO-α,and 0.69 nmol/L for MRpro-ADM,were taken as the criterion for grouping them,respectively.Patients with GRO-α level≥73.5 ng/L and those with GRO-α level<73.5 ng/L,were assigned to the high-level GRO-α group and low-level GRO-α group,respectively;patients with MRpro-ADM level≥0.69 nmol/L and those with MRpro-ADM level<0.69 nmol/L were set as the high-level MRpro-ADM group,and low-level MRpro-ADM group,respectively.One hundred and fifty-three of them completed the 12-month follow-up,the other 7 were missed.The attacking time of first acute exacerbation of COPD(AECOPD) after grouping,incidence of AECOPD,length of stay and mortality in the 153 participants during the follow-up period were recorded.ROC curve was used to study the optimal cut-off value and the corresponding sensitivity and specificity of GRO-α and MRpro-ADM in predicting the risk of AECOPD and mortality.Results Compared with the low-level GRO-α group,high-level GRO-α group had higher incidence of AECOPD and higher mortality,shorter period between the attacking time of first AECOPD and grouping time,and longer length of stay(P＜0.05) in the follow-up period.High-level MRpro-ADM group had higher incidence of AECOPD and higher mortality,shorter period between the attacking time of first AECOPD and grouping time,and longer length of stay(P＜0.05) than the low-level MRpro-ADM group during the follow-up period.For predicting the risk of AECOPD by serum GRO-α,the area under the ROC curve(AUC) was 0.866〔95%CI( 0.785,0.948）〕,the optimal cut-off value was 74.5 ng/L with a sensitivity of 93%,specificity of 74% and Youden′s index of 0.67.For predicting the risk of mortality by serum GRO-α,the AUC was 0.833 〔95%CI(0.729，0.937）〕,the optimal cut-off value was 93.5 ng/L with a sensitivity of 94%,specificity of 69% and Youden′s index of 0.62.For predicting the risk of AECOPD by serum MRpro-ADM,the AUC was 0.846 〔95%CI(0.762，0.930）〕,the optimal cut-off value was 0.70 nmol/L with a sensitivity of 80%,specificity of 78% and Youden′s index of 0.58.For predicting the risk of mortality by serum MRpro-ADM,the AUC was 0.871 〔95%CI(0.770，0.973）〕,the optimal cut-off value was 0.81 nmol/L with a sensitivity of 69%,specificity of 89% and Youden′s index of 0.58.Conclusion Serum GRO-α and MRpro-ADM can be used as the biological markers for predicting the risk of AECOPD and mortality in stable COPD patients.
【Key words】 Pulmonary disease,chronic obstructive;Forecasting;Growth-regulated oncogene α;Midregional pro-adrenomedullin
Correlation between Cognitive Impairment and Motor Function in the Elderly LI Shu-juan1,LIU Qian1,LI Yan-xun1,JIANG Xiao-yan2,WANG Xiao-feng3,HU Zhi-hao1,HU Wen-li1*
1.Department of Neurology,Beijing Chao-Yang Hospital,Capital Medical University,Beijing 100020,China
2.Department of Pathology and Pathophysiology,School of Medicine,Tongji University,Shanghai 200092,China
3.College of Life Sciences,Fudan University,Shanghai 200433,China
*Corresponding author:HU Wen-li,Professor,Chief physician;E-mail:email@example.com
【Abstract】 Background The cognitive and motor functions in the elderly decrease in different degree,but the relationship between them has been seldom reported.
Objective To investigate the correlation between cognitive impairment(CI) and motor function in the elderly.Methods The participants were 1 788 70-84-year-old elderly people recruited from Jiang′an Town,Rugao City of China between November 13th and December 21st,2014.Based on the scores of Hasegawa′s Dementia Scale-Revised(HDS-R),they were divided into normal group(≥31.0),conditions between the normal and suspected dementia group（22.0-30.5）,suspected dementia group(10.5-21.5) and dementia group(≤10.0).The body movement function of the elderly population was measured by timed up and go(TUG) test.The time needed to complete the TUG test,status of gait stability and the risk of falling were recorded.Results A total of 1 655 participants completed the assessment of cognitive function with the HDS-R,and TUG test,including 109 in the normal group,674 in conditions between the normal and suspected dementia group,833 in suspected dementia group and 39 in dementia group.Among the four groups,participants in the normal group used the least time to complete the TUG test,and they had the highest gait stability rate,and lowest risk of falling(P＜0.05).Compared with the suspected dementia group and dementia group,conditions between the normal and suspected dementia group used less time to finish the TUG test,owned higher gait stability rate,and lower risk of falling(P＜0.05).Suspected dementia group used less time to complete the TUG test,and owned lower risk of falling than the dementia group(P＜0.05).The score of HDS-R presented a negative correlation with the time needed to complete the TUG test,with a correlation coefficient of-0.243,P＜0.001.The score of HDS-R was negatively correlated with the status of gait stability with a correlation coefficient of-0.120,P＜0.001.The score of HDS-R was negatively associated with the risk of falling with a correlation coefficient of-0.163，P＜0.001.Conclusion The cognitive and the body movement function in the elderly are found to be decreased,and the risk of CI grows with the increase of gait instability and risk of falling.
【Key words】 Cognition disorders;Movement disorders;Exercise test;Aged
Effect of Different Right Ventricular Pacing Sites on Emotional State in Patients with Atrioventricular Block after Implantation of Permanent Cardiac Pacemaker ZHAO Qing-zhen*,LIU Gang,LIU Chao,DUAN Li-nan,LI Li-zhuo,ZHENG Ming-qi
Department of Cardiology,the First Hospital of Hebei Medical University,Shijiazhuang 050031,China
*Corresponding author:ZHAO Qing-zhen,Associate chief physician；E-mail:firstname.lastname@example.org
【Abstract】 Objective To investigate the effect of different right ventricular pacing sites on anxiety and depression in patients with atrioventricular block after implantation of permanent cardiac pacemaker,so as to emphasize the importance of psychological status in such patients with physical diseases.Methods The participants enrolled in this study were 78 cases with high degree or complete atrioventricular block,who were admitted in Department of Cardiology of the First Hospital of Hebei Medical University,and treated by implantation of DDD/DDDR pacemakers from December 2012 to December 2014.They were divided into right ventricular apex(RVA) group(n=38) and right ventricular outflow tract septum(RVOTs) group(n=40) by random number table method.Baseline characteristics of them were collected.QRS duration before surgery and at the 4th week after surgery,Self-Rating Anxiety Scale（SAS）and Self-Rating Depression Scale(SDS) scores before surgery,at the 1st and the 4th weeks after surgery were recorded.Results QRS duration in RVA group was longer than that in RVOTs group at the 4th week after surgery(P＜0.05).QRS durations at the 4th week after surgery of both groups were longer than those before surgery(P＜0.05).Pacing sties and implantation duration of the artificial cardiac pacemaker did not exert interaction effect on the SAS and SDS scores(P＞0.05).Implantation duration of the artificial cardiac pacemaker had significant major effect on SAS and SDS scores in both groups(P＜0.05),while pacing sites did not(P＞0.05).The SAS and SDS scores at the 4th week after surgery were lower than those before surgery and at the 1st week after surgery in both groups(P＜0.05).Conclusion RVA pacing and RVOTs pacing both can reduce the symptoms of anxiety and depression,and there is no difference between them.
【Key words】 Emotions;Anxiety;Depression;Pacemaker,artificial;Right ventricular apex;Right ventricular outflow tract septum
Clinical Features and Associated Factors of Rheumatoid Arthritis with Comorbidities in 223 Cases ZHOU Zhen-ni1,LI Fang2,HUANG De-yi2,QIAN Xu-heng3,WANG Shi-jia3,XIA Xiao-ru4*
1.Department of Internal Medicine,Yueqing People′s Hospital,Yueqing 325600,China
2.Department of Medical Imaging,the People′s Hospital of Yuhuan,Yuhuan 317600,China
3.Wenzhou Medical University,Wenzhou 325000,China
4.Department of Rheumatism and Immunology,the First Affiliated Hospital of Wenzhou Medical University,Wenzhou 325000,China
*Corresponding author:XIA Xiao-ru,Attending physician；E-mail:email@example.com
【Abstract】 Objective To explore the clinical features and associated factors in rheumatoid arthritis(RA) patients with comorbidities,so as to provide a reference for comprehensively assessing the prognosis and delivering medical services for these patients.Methods The enrolled participants were 223 cases with RA diagnosed and treated in Department of Rheumatism and Immunology of the First Affiliated Hospital of Wenzhou Medical University between January and December 2013.We reviewed their clinical data,recorded their baseline characteristics(results of laboratory and imaging examinations),status of comorbidities,and analyzed the associated factors of RA and the correlations between them.Results Comorbidities were found in 84.8%(189/233) of the participants,which mainly included 16 different diseases,such as hyperlipidemia(41.3%,92/233),hypertension(40.8%,91/233),osteoporosis or osteopenia(24.7%,55/233),diabetes(17.5%,39/233),hyperuricemia(13.9%,31/233),urinary calculi(13.5%,30/233) and so on.Hyperlipidemia in RA had straight line correlation with Disease Activity Score 28(DAS28) （rs=-0.146,P＜0.05）,ESR （rs=-0.153,P＜0.05）,blood pressure （rs=0.194,P＜0.05）,serum uric acid （rs=0.216,P＜0.05） ;hypertension in RA had straight line correlation with age （rs=0.353,P＜0.05）,TJC （rs=0.161,P＜0.05）,SJC （rs=0.148,P＜0.05）,fasting blood glucose （rs=0.290,P＜0.05）,blood lipid （rs=0.194,P＜0.05）,serum uric acid （rs=0.220,P＜0.05）,abnormal bone mineral density （rs=0.202,P＜0.05）;osteoporosis or osteopenia in RA had linear correlation with male （rs=-0.173,P＜0.05）,age （rs=0.362,P＜0.05）,blood pressure （rs=0.202,P＜0.05）;diabetes in RA had straight line correlation with age （rs=0.245,P＜0.05）,TJC （rs=0.145,P＜0.05）,DAS28 （rs=0.182,P＜0.05）,CRP （rs=0.195,P＜0.05）,blood pressure （rs=0.290,P＜0.05）;hyperuricemia in RA had straight line correlation with male（rs=0.141,P＜0.05）,age （rs=0.172,P＜0.05）,blood pressure （rs=0.220,P＜0.05）,blood lipid （rs=0.216,P＜0.05）;urinary calculi in RA had straight line correlation with CRP （rs=0.135,P＜0.05）.Multivariate Logistic regression analysis showed that blood pressure and serum uric acid were the risk factors of RA combined with hyperlipidemia （P＜0.05）;age,fasting blood glucose,blood lipid and serum uric acid were the risk factors of RA with hypertension（P＜0.05）;female and age were the risk factors of RA with osteoporosis or osteopenia （P＜0.05）;course of RA,CRP and blood pressure were the risk factors of diabetes in RA （P＜0.05）;male,blood pressure and blood lipid were the risk factors of RA and hyperuricemia coexistence（P＜0.05）.Conclusion Due to gender,age,abnormal blood pressure and blood lipid,patients with RA are prone to such comorbidities as hyperlipidemia,hypertension,osteoporosis,diabetes,hyperuricemia and so on,which would worsen the outcome and decrease the quality of life.Therefore,in order to better improve the prognosis of RA and reduce the associated consequences of comorbidities,a ample understanding,screening and effective management are needed in comorbidities in RA besides the clinical active treatment of RA.
【Key words】 Arthritis，rheumatoid;Comorbidity;Root cause analysis
Etiological and Prognostic Factors of Acute Kidney Injury in Children Secondary to Intrinsic Renal Diseases ZHANG Xiao-ge1,LI Zhe2,LI Zhi-juan3*,CHEN Guo-qiang1,HUANG Hui-mei3,TANG Yun3
1.Department of Nephrology,Northwest Women and Children′s Hospital,Xi′an 710061,China
2.No.3 Department of Cadre Ward,Shaanxi Provincial People′s Hospital,Xi′an 710061,China
3.Department of Nephrology,Xi′an Children′s Hospital,Xi′an 710003,China
*Corresponding author:LI Zhi-juan,Attending physician；E-mail:firstname.lastname@example.org
【Abstract】 Background Acute kidney injury(AKI) is a common clinical syndrome characterized by high rates of morbidity and mortality and poor prognosis.However,there are no wonder drugs for this disease.Recently,AKI,especially AKI in children has gradually attracted widespread attention,but there is still lack of articles about analyzing the etiological and prognostic factors of AKI in children.
Objective To explore the associated factors for etiology and prognosis of AKI in children secondary to intrinsic renal diseases,with a view to further improving the clinical research level of the disease.Methods The participants enrolled in this study were 108 children with AKI secondary to intrinsic renal diseases,primary nephrotic syndrome(PNS),IgA nephropathy(IgAN),or purpura nephritis(PN),and so on,treated in Xi′an Children′s Hospital between June 2014 and April 2016.We did a review of the data of the children,and divided them into age groups of infancy,early childhood,preschool age,school age according to the age,and assigned them to groups of stage 1,2,and 3 AKI according to the staging system for AKI,respectively.Follow-up and efficacy assessment were performed after discharge.The associated factors for etiology and prognosis of the children were analyzed.Results Of the 108 cases with AKI，51.9%(56/108) were caused by PNS,24.1%(26/108) by glomerulonephritis due to acute streptococcal infection;27.8%(30/108) were in infancy〔93.4%(28/30) of them were caused by PNS〕;18.5%(20/108) were in early childhood〔70.0%(14/20) of them were caused by PNS〕;25.9%(28/108) were in preschool age〔35.7%(10/28) were caused by glomerulonephritis due to acute streptococcal infection,and 28.6%(8/28) were by PNS〕;27.8%(30/108) were in school age〔50.0%(15/30) of them were caused by glomerulonephritis due to acute streptococcal infection,and 20.0%(6/30) were due to PNS〕;64.8%(70/108) had stage 1 AKI〔60.0%(42/70) were caused by PNS,22.8%(16/70) were by glomerulonephritis due to acute streptococcal infection〕;25.0%(27/108) had stage 2 AKI〔37.0%(10/27) were caused by PNS,and 25.9%(7/27) were by glomerulonephritis due to acute streptococcal infection〕;10.2%(11/108) had stage 3 AKI〔36.3%(4/11) were caused by PNS,and 27.3% were by glomerulonephritis due to acute streptococcal infection〕.The overall response rate(RR) was 83.3%(90/108).The RR in patients with stage 3 AKI was much lower than that in those with stage 1 or stage 2 AKI(P＜0.05).The RR differed significantly between AKI children with massive proteinuria or hypoproteinemia or hypertension(P＜0.05).Multivariate Logistic regression analysis indicated that massive proteinuria,hypoproteinemia,and hypertension were the factors affecting the prognosis of AKI in children(P＜0.05).Conclusion AKI in children secondary to intrinsic renal diseases can be caused by many reasons,but it mainly by PNS and glomerulonephritis due to acute streptococcal infection.Infants,preschool-age children and school-age children are prone to AKI.Good prognosis can be achieved in most of children after active treatment,but it is affected by many factors such as massive proteinuria,hypoproteinemia,hypertension and so on.
【Key words】 Acute kidney injury;Child;Prognosis;Root cause analysis;Etiology
Identification of Tumor Biomarkers for Retinoblastoma LIU Zhi-ping*,LI Bo,CHEN Li-li,ZHANG Zhao-xia,CHEN Yan-zhao,TANG Fang-zheng
Department of Pediatrics,Shenzhen People′s Hospital,2nd Clinical Medical College of Jinan University,Shenzhen 518020,China
*Corresponding author:LIU Zhi-ping,Associate chief physician;E-mail:email@example.com
【Abstract】 Background Retinoblastoma(RB) is more common in infants and young children.In general,it is diagnosed at an advanced stage and is prone to recurrence and metastasis and difficult to treat.
Objective To identify the tumor biomarkers for RB diagnosis and treatment.Methods From Shenzhen People′s Hospital between August 2014 and August 2016,we recruited the participants of this study〔20 children with RB and complete clinical data undergoing chemotherapy(RB group),and other 20 healthy children undergoing physical examination(control group)〕.The measurement of levels of serum alpha fetoprotein(AFP),carcinoembryonic antigen(CEA),neuron-specific enolase(NSE),carbohydrate antigen(CA) 125,CA153,CA199 and CA724 was performed in the control group during physical examination,and in the RB group before chemotherapy,at the time of completing the third and sixth cycles of chemotherapy,respectively.Results There was no significant difference in AFP,CEA,CA125 and CA724 levels before chemotherapy,at the time of completing the third and sixth cycles of chemotherapy between RB group and the control group(P>0.05). There was no significant difference in NSE level at the time of completing the sixth cycles of chemotherapy between RB group and the control group(P>0.05). NSE level before chemotherapy and at the time of completing the third cycles of chemotherapy in RB group was higher than that in the control group(P<0.05). CA153 and CA199 levels before chemotherapy,at the time of completing the third and sixth cycles of chemotherapy in RB group were higher than those in the control group(P<0.05). There was no significant difference in AFP,CEA,CA125,CA153,CA199 and CA724 levels before chemotherapy,at the time of completing the third and sixth cycles of chemotherapy in RB group(P>0.05). NSE level at the time of completing the sixth cycles of chemotherapy was lower than that before chemotherapy and at the time of completing the third cycles of chemotherapy in RB group(P<0.05).
Conclusion Serum NSE,CA153 and CA199 levels are of great significance in the diagnosis and treatment of RB,which can be used as the tumor biomarkers of RB. The level of NSE decreased relatively early,which is more conducive to the early diagnosis of RB recurrence.
【Key words】 Retinoblastoma;Tumor markers,biological;Alpha-fetoproteins;Carcinoembryonic antigen;Neuron-specific enolase;Carbohydrate antigen
Research on the Relationship between Cumulative Dose of Dust and Cumulative Abnormal Rate of Pulmonary Function in Coal Mine Drillers QIAN Qing-zeng1*,CAO Xiang-ke2,SHEN Fu-hai1,WANG Qian1,LIU Tie-jun3
1.Central Laboratory for College of Public Health,North China University of Science and Technology,Tangshan 063000,China
2.Central Laboratory for College of Life Sciences,North China University of Science and Technology,Tangshan 063000,China
3.Department of Anesthesiology,Affiliated Hospital of North China University of Science and Technology,Tangshan 063000,China
*Corresponding author:QIAN Qing-zeng，Laboratory technician；E-mail:firstname.lastname@example.org
【Abstract】 Objective To investigate the relationship between cumulative dose of dust and cumulative abnormal rate of pulmonary function in coal mine drillers.Methods A total of 376 coal mine drillers were selected from a coal mine in Tangshan from December 2014 to December 2015 as the observation group,and 179 no-dust exposed workers were taken as the control group,using pulmonary function〔forced vital capacity(FVC),forced expiratory volume in the first second(FEV1),FEV1/FVC〕 as an index.The observation group was divided by work seniority as a coal mine driller into 4 groups:less than 10 working years group,10 to 20 working years group,20 to 30 working years group and more than 30 working years group.The pulmonary functions were compared between the control group and the observation group and among work seniority groups to analyze the relationship between cumulative dose of dust and cumulative abnormal rate of pulmonary function.Results The abnormal rate of pulmonary function in observation group(51.6%,194/376) was higher than control group(12.8%,23/179)(P＜0.05).FVC,FEV1,and FEV1/FVC in observation group were lower than control group(P＜0.05).FVC,FEV1,and FEV1/FVC in less than 10 working years group in observation group were higher than 10 to 20 working years group,20 to 30 working years group and more than 30 working years group(P＜0.05).FVC,FEV1,and FEV1/FVC in 10 to 20 working years group were higher than 20 to 30 working years group and more than 30 working years group(P＜0.05).FVC,FEV1,and FEV1/FVC in 20 to 30 working years group were higher than more than 30 working years group(P＜0.05).Cumulative dose of dust was positively correlated with cumulative abnormal rate of pulmonary function(r=0.763,P＜0.001).Conclusion Cumulative dose of dust has positive correlation with cumulative abnormal rate of pulmonary function in coal mine drillers.The longer the working time,the higher the cumulative dose of dust is.The higher the cumulative abnormal rate of pulmonary function,the more obvious the change of the pulmonary function index is.Monitoring the cumulative dose of dust can be used to predict abnormal pulmonary function and high-risk group of pulmonary diseases among coal mine drillers.
【Key words】 Respiratory function tests；Dust；Occupational medicine；Driller
Platelet Count Change Rule in Medium-advanced Primary Hepatic Carcinoma Treated by Argon-helium Cryosurgery DENG Li-ping*,CHENG Rui-wen,LI Qiu-guo，LI Ping
Vascular and Oncology Interventional Department，the First Hospital of Hunan University of Chinese Medicine,Changsha 410007,China
*Corresponding author:DENG Li-ping，Associate chief physician；E-mail:email@example.com
【Abstract】 Objective To explore the platelet count change rule of medium-advanced primary hepatic carcinoma treated by argon-helium cryosurgery.Methods Sixty cases with medium-advanced primary hepatic carcinoma admitted in the First Hospital of Hunan University of Chinese Medicine from July 2013 to June 2016 were selected as the participants.All of them had preoperative platelet count equal to or greater than 50×109/L,and received argon-helium cryosurgery.Based on the number of cryoneedles used in the surgery,they were divided into group A(using 1-3 cryoneedles),group B(using 4-10 cryoneedles),group C(using 11-15 cryoneedles ).The postoperative platelet count change rules in groups A,B and C were summarized.Results Platelet count measured before the surgery,at 3,7,14 d after the surgery differed significantly in groups B and C(P＜0.05),but not in group A(P＞0.05).Platelet count measured before the surgery was obviously different from that measured at 3 d after the surgery in both groups B and C(P＜0.01).As the change of platelet count was obvious in groups B and C,so we further studied the change of it in them.Patients with platelet count level lower than 100×109/L but equal to or greater than 50×109/L and those with it equal to or greater than 100×109/L in group B and group C were assigned to the observation group and control group,respectively.Platelet count measured before the surgery,at 3,7,14 d after the surgery differed significantly in both the observation group and control group(P＜0.05).Significant differences were found between the platelet count measured before the surgery and that measured at 3 d after the surgery in both the observation group and control group(P＜0.01).Conclusion During the perioperative period of argon-helium cryosurgery for medium-advanced primary hepatic carcinoma patients whose preoperative platelet count levels were equal to or greater than 50×109/L,platelet count did not change significantly in those used 1-3 cryoneedles,but in those used 4～15 cryoneedles,it dropped by almost half of the preoperative level at the 3rd day after surgery,then elevated to the preoperative level at the 7th day after surgery,and remained stable at the 14th day after surgery.
【Key words】 Liver neoplasms;Cryosurgery;Blood platelet
1Predictors for Mechanical Ventilation Management and 6-month Outcome in Patients with Severe Guillain-Barre Syndrome HE Yan-bo1，2,ZHANG Yan1*,SU Ying-ying1
1.Department of Neurology,Xuanwu Hospital,Capital Medical University，Beijing 100053,China
2.Department of Encephalopathy,Beijing Moslem People′s Hospital，Beijing 100054,China
*Corresponding author:ZHANG Yan,Associate chief physician；E-mail:firstname.lastname@example.org
【Abstract】 Objective To explore the predictors for mechanical ventilation(MV) management and long-term outcome in patients with severe Guillain-Barre syndrome(GBS),so as to provide a reference for clinical treatment of the disease.Methods A retrospective study was conducted in 50 patients with severe GBS,who admitted to the Neurocritical Care Unit(NCU),Xuanwu Hospital,Capital Medical University from January 1st,2009 to December 31st,2015.We collected the patients′ clinical data and Hughes GBS Disability Scale(H-GBS-DS) score before immunization therapy,at discharge from NCU,at the 6th month after discharge from the hospital,and divided them into MV group and non-MV group based on the status of undergoing MV,good treatment outcome group and poor treatment outcome group based on the status of outcome,and group with good outcome and group with poor outcome within 6 months after discharge based on the status of outcome at the 6th month after discharge.We analyzed the predictive effects of sex,age,history of infections before the onset of GBS,the duration from onset to admission,cranial nerve involvement,autonomic dysfunction,axonal degeneration/axonal degeneration and demyelination found in electromyography(EMG) on MV,the effects of above 7 factors combined with the duration from onset to the start of immunization treatment on the response to treatment,the effects of the above 7 factors combined with the duration from onset to the start of immunization treatment,status of MV management,more than 1 cycle of immunoglobulin(IVIG) treatment,the response to treatment,hypoalbuminemia,hyponatremia and length of stay in the NCU on the outcome at the 6th month after discharge.Results Of the 50 cases,2 died during hospitalization，7 were lost to follow-up,the rest 41 completed the 6-month follow-up,63.4% of whom(26/41) had a good prognosis.The proportion of GBS patients with autonomic dysfunction with MV management was higher than that of those without(P＜0.05).Participants with good response to treatment were more likely to have infections before the onset of GBS than those with poor response to treatment(P＜0.05).Compared with those with poor outcome at the 6th month after the discharge,participants with good outcome had better response to treatment,and shorter length of stay in the NCU(P＜0.05).Multivariate Logistic regression analysis showed that autonomic dysfunction was an independent predictor for MV management 〔OR=5.573,95%CI（1.027,30.242），P＜0.05〕;history of infections before the onset of GBS was an independent predictor for a good response to treatment〔OR=4.743,95%CI（1.003,22.442），P＜0.05〕;the response to treatment〔OR=59.720,95%CI（4.411,809.698），P＜0.05〕 and length of stay in the NCU were the independent predictors for the outcome at the 6th month after discharge 〔OR=1.069,95%CI（1.007,1.135），P＜0.05〕.Conclusion More severe GBS patients with automatic dysfunction compared with that without would need MV;severe GBS patients who has preceding infections before onset of severe GBS compared with that without would have better response to treatment; severe GBS patients with good response to treatment would have a good 6-month outcome and severe GBS patients with longer stay in the NCU would have a poor 6-month outcome;the most of patients with severe GBS would have a good 6-month outcome after immunotherapy,MV and good supportive care in our NCU .
【Key words】 Guillain-Barre syndrome;Respiration,artificial；Prognosis；Root cause analysis
Mechanism of Palosuran in the Improvement of CCl4-induced Liver Fibrosis in Rats LIU Dian-gang1*，ZHANG Yu-xian2,ZHANG Ruo-xi1,ZHANG Chao1,LI Fei1,WANG Yu3
1.Department of General Surgery,Xuanwu Hospital,Capital Medical University,Beijing 100053,China
2.Department of Gastroenterology,Beijing Moslem Hospital,Beijing 100054,China
3.Department of General Surgery,Beijing Friendship Hospital,Capital Medical University，Beijing 100069,China
*Corresponding author:LIU Dian-gang,Associate chief physician,Associate professor;E-mail:email@example.com
【Abstract】 Objective To investigate the effects of urotensin Ⅱ receptor antagonist palosuran on the improvement of CCl4-induced liver fibrosis in rats.Methods This study was conducted between January and December 2015.Thirty-two SPF/VAF grade male Wistar rats were randomly divided into four groups,normal control group〔receiving intragastric administration of sodium chloride solution(0.9%) 0.2 ml/100 g for 8 weeks〕;4-week CCl4 cirrhotic model group(receiving intragastric administration of CCl4 solution 0.2 ml/100 g for 4 weeks),8-week CCl4 cirrhotic model group(receiving intragastric administration of CCl4 solution 0.2 ml/100 g for 8 weeks) and palosuran-treated group(receiving intraperitoneal injection of CCl4 0.2 ml/100 g for 4 weeks,then intragastric administration of palosuran 300 mg·kg-1·d-1 for another 4 weeks) with 8 rats in each.After the intervention,the rats in all groups were sacrificed and the liver tissues were taken out.The pathological manifestations in the liver tissue specimens with sirius red staining were detected，and semiquantitative scores of hepatic fibrosis was recorded.Hydroxyproline(Hyp) content in the liver tissue specimens was determined.Collagen type Ⅰ(ColⅠ) mRNA levels in the liver tissue specimens were assessed by RT-qPCR.Serum levels of ColⅠ were assessed by ELISA.The expressions of α-SMA-positive cells in liver tissue specimens were determined by means of immunohistochemistry.Results The pathological manifestations found：the normal control group exhibited only a small amount of collagen expression in the surrounding area of hepatic portal vein and hepatic portal area;the 4-week cirrhotic model group presented disordered structure of liver,proliferation of fibrous tissue and formation of pseudolobuli;the 8-week cirrhotic model group displayed destroyed hepatic lobular structure,marked proliferation of fibrous tissues,liver cell clusters separating the hepatic lobules into different sizes,diffusely arranged hepatic cords,massive balloon-like liver cells appearing in the central vein area,loosened and slightly colored cell cytoplasm,and narrowed liver sinusoid due to compression;the palosuran-treated group showed tiny fiber interval and significantly reduced proliferation of fibrous tissue.Compared with the 8-week cirrhotic model group,the palosuran-treated group had much lower degree of liver fibrosis showed by the semiquantitative scores 〔（8.6±2.5）vs.（16.1±2.2）,P＜0.05〕,significantly lower Hyp content〔（135.6±20.9）ng/g vs.（332.4±2.6）ng/g,P＜0.05〕,obviously lower ColⅠ mRNA levels 〔(103.63±7.96) vs.(160.00±17.85),P＜0.05 〕,substantially lower serum ColⅠ levels〔(8.75±1.67) vs.(16.13±2.03),P＜0.05 〕,much less α-SMA-positive cells in liver〔（110.35±11.09）vs.（210.57±38.09）,P＜0.05〕.Conclusion Paolsuran could relieve the CCl4-induced liver fibrosis in rats.The mechanism may be associated with the reduction of expressions of α-SMA-positive cells in liver.
【Key words】 Liver cirrhosis,experimental；Urotensin Ⅱ antagonist；Carbon tetrachloride
Minocycline-based Quadruple Therapy in the Retreatment of Helicobacter pylori Infection ZHANG Ling-yun,LAN Yu*,FAN Yu-jing,ZHANG Yue-xia,WANG Qi
Department of Gastroenterology,Beijing Jishuitan Hospital,Beijing 100096,China
*Corresponding author:LAN Yu,Chief physician,Professor;E-mail:firstname.lastname@example.org
【Abstract】 Objective To observe the safety,compliance,success rate of Helicobacter pylori(H.pylori) eradication and associated factors of minocycline-based quadruple therapy in the retreatment of H.pylori infection,so as to provide a new regimen for the retreatment of H.pylori infection.Methods One hundred and eighty patients retreated for H.pylori infection in Beijing Jishuitan Hospital from August 2013 to August 2015 were selected as the subjects.Patients were assigned to a 14-day treatment with minocycline-based quadruple therapy comprising of rabeprazole(twice a day,10 mg each time),amoxicillin(twice a day,1.0 g each time),minocycline(twice a day,0.1 g each time),colloidal bismuth subcitrate(twice a day,220 mg each time).The adverse reactions and compliance were observed 3-7 days after treatment and eradication rate of H.pylori was evaluated by intention to treat(ITT) analysis and per-protocol(PP) analysis 4-12 weeks after treatment.Results ITT analysis included 180 patients.PP analysis enrolled in 170 patients,the other 10 were excluded due to loss to follow-up and untimely reviewing(6 cases),and poor compliance(4 cases).There were 31.1% patients(56/180) with adverse reactions.Among them,55.4%(31/56) had diarrhea,50.0%(28/56) had dizziness and insomnia,41.1%(23/56) with epigastric discomfort and 41.1%(23/56) with nausea.All of the adverse reactions completely disappeared after treatment.One hundred and sixty-five(91.7% of 180) cases had good compliance.The success rate of H.pylori eradication by the treatment was 79.4%(143/180) showed by ITT analysis,and 84.1%(143/170) revealed by PP analysis.Female patients had higher eradication rate of H.pylori by the treatment than male patients demonstrated by PP analysis(P<0.05).PP analysis found that,age,history of smoking,number and regimens of previous eradication treatment of H.pylori did not cause the differences in the success rate of H.pylori eradication between the subjects(P>0.05).PP analysis with multivariate Logistic regression models showed that gender,age,history of smoking,the number and regimen of previous eradication treatment of H.pylori were not the associated factors for the success rate of H.pylori eradication(P>0.05).Conclusion For patients with retreatment of H.pylori infection,minocycline-based quadruple therapy can be a new regimen for selection,for it has a relatively good eradication rate of H.pylori with fair safety and compliance.
【Key words】 Helicobacter infections;Helicobacter pylori;Minocycline;Retreatment
Effect of Nitrofurantoin on Lower Urinary Tract Infection Due to Enterococcus in Old People ZHU Dong-ju1*,WU Xiang2,YANG Ke3
1.Department of Nephrology,the Affiliated Hospital of Clinical Medical College of Panzhihua University,Panzhihua 617000,China
2.Department of Paediatrics,Central Hospital of Panzhihua,Panzhihua 617067,China
3.Department of Oncology,Pangang Group General Hospital,Panzhihua 617000,China
*Corresponding author:ZHU Dong-ju,Lecturer;E-mail:email@example.com
【Abstract】 Background Urinary tract infection(UTI) can be commonly caused by enterococcus which is a type of gram-positive bacteria with high antibiotic resistance.Vancomycin(VAN) or linezolid(LZD) is often used for clinical treatment of UTI,but the economic burden is heavy to the individuals.In contrast,nitrofurantoin(NIT) is an effective,inexpensive and easily available drug for acute and chronic UTI basically without causing the resistance of enterococcus proved by a 50-year history of clinical application.However,there are few reports about using NIT to treat lower urinary tract infection(LUTI) due to enterococcus in old people.
Objective To evaluate the clinical efficacy and safety of NIT in the treatment of elderly patients with LUTI due to enterococcus,so as to provide an evidence for clinical treatment of the disease.Methods This retrospective study was conducted between July 2009 and July 2015.The participants recruited were 92 consecutive LUTI outpatients and inpatients meeting the inclusion criteria from the Affiliated Hospital of Clinical Medical College of Panzhihua University,Central Hospital of Panzhihua,and Pangang Group General Hospital,including 52 cases of simple LUTI and 40 cases of complicated LUTI.The results of bacterial culture and drug sensitivity test were recorded.All patients were given the 7-14 d treatment of orally taking NIT enteric coated tablets 100 mg,qid.The clinical treatment response,status of enterococcus eradication and adverse reactions in the patients were recorded.Results It was found that 60 patients(65.2%) were infected by enterococcus faecalis,and other 32(34.8%) were infected by enterococcus faecium.Both kinds of bacteria were not resistant to NIT,VAN,and LZD,and they had no significant difference in the rate of resistance to ampicillin(AMP),penicillin G(PEN),ampicillin/sulbactam(SAM),erythromycin(ERY),levofloxacin(LEV) and high-concentration gentamicin(GEN)(P＞0.05).The overall response rate was 84.8%(78/92).Patients with simple LUTI had higher response rate than those with complicated LUTI 〔96.2%(50/52) vs.70.0%(28/40),χ2=11.987，P＜0.001〕.The overall enterococcus eradication rate was 81.5%(75/92).Patients with simple LUTI had higher enterococcus eradication rate than those with complicated LUTI 〔96.2%(50/52) vs.62.5%(25/40),χ2=11.256,P=0.027〕.Of the 92 patients,22 cases(23.9%) had nausea,vomiting,and mild diarrhea,but relieved after symptomatic treatment without stopping the NIT treatment.No patients had cough,asthma,rash,peripheral neuritis and other adverse reactions.Conclusion NIT has good clinical efficacy in the treatment of elderly patients with LUTI due to enterococcus without heavy economic burden and many adverse reactions during short-term oral administration.It is especially suitable for elderly patients with simple LUTI and can be used as the first-choice drug for these patients.
【Key words】 Nitrofurantoin;Enterococcus;Urinary tract infections;Aged;Treatment outcome
Curative Effect of Acupressure on the Dysphagia after Acute Phase of Ischemic Stroke XU Wei1，YU Min-jie2*,LE Jia-yi2，LIAN Yuan-yuan3，YAO Hui-jia4
1.Ward Department,Ruijin Second Road Community Health Service Center,Shanghai 200020，China
2.Administration Department,Ruijin Second Road Community Health Service Center,Shanghai 200020，China
3.Department of General Practice,Ruijin Second Road Community Health Service Center,Shanghai 200020，China
4.Clinical Laboratory，Ruijin Second Road Community Health Service Center,Shanghai 200020，China
*Corresponding author:YU Min-jie，Nurse-in-charge；E-mail:firstname.lastname@example.org
【Abstract】 Objective To discuss the curative effect of acupressure combined with rehabilitation nursing on the dysphagia after acute phase of ischemic stroke.Methods One hundred and twenty patients with dysphagia after acute phase of ischemic stroke admitted in Ruijin Second Road Community Health Service Center from July 2015 to July 2016 were selected as the participants,and divided into the acupressure group(n=60) and control group(n=60) by drawing lots.Both groups received the conventional neurology treatment and comprehensive rehabilitation nursing(direct swallowing training,indirect swallowing training,mental nursing and health education),the acupressure group also received the acupressure treatment(massaging the acupoints of Yifeng,Lianquan,Tiantu and Taixi once daily in the morning and once daily in the evening),for 3 courses of treatment(90-day treatment was considered as a course of treatment).Results The dysphagia was improved more significantly in the acupressure group than in the control group（u=5.069，P＜0.05）,specifically,in the control group,the improvement of dysphagia was markedly excellent in 21.7%(13/60) of the patients,fair in 48.3%(29/60),invalid in 30.0%(18/60),while in the acupressure group,it was markedly excellent in 68.3%(41/60) of the patients,fair in 23.3%(14/60) and invalid in 8.3%(5/60).The acupressure group had lower incidence rates of malnutrition and electrolyte disturbance than the control group(P＜0.05).Conclusion For patients with dysphagia after acute phase of ischemic stroke,the treatment of acupressure and rehabilitation nursing can significantly improve the swallowing function,and reduce the incidence rates of malnutrition and electrolyte disturbance.
【Key words】 Stroke；Acupoint therapy；Deglutition disorders；Rehabilitation nursing
Value and Feasibility of Auricular Point Sticking with the Medicinal Herb Seed in Relieving Cancer Pain GU Liang-liang 1*，YAO Lan-hong 1，GONG Ai-qin 1，LU Shi-yin1,ZHANG Hai-sheng2
1.Songjiang District Zhongshan Community Health Service Center,Shanghai 201600,China
2.Shanghai Songjiang Fangta Hospital of TCM,Shanghai 201600,China
*Corresponding author:GU Liang-liang，Attending physician；E-mail:email@example.com
【Abstract】 Objective To investigate the value and feasibility of auricular point sticking with the medicinal herb seed in relieving cancer pain.Methods The participants met the inclusion criteria were 160 randomly selected inpatients with cancer treated between November 1st,2015 and December 16th,2016,including 80 from Department of Oncology of Shanghai Songjiang Fangta Hospital of TCM(control group),and 80 from Department of Palliative Care of Songjiang District Zhongshan Community Health Service Center(experimental group).For relieving the cancer pain,the conventional three-step analgesic ladder was given to both groups,and auricular point sticking with the medicinal herb seed using auricular point stickers with the cowherb seed was given to the experimental group additionally,for 2 courses of treatment.Numerical Rating Scale(NRS) was used to evaluate the cancer pain in both groups before the treatment,and at the time of completing 2 course of treatment.The EORTC QLQ-C30(version 3) was adopted to evaluate the quality of life.The level of patient satisfaction with the treatment and adverse reactions in both groups were assessed at the time of completing 2 courses of treatment.Results The pain relief rate was higher in the experimental group than in the control group〔96.3%(77/80) vs. 87.5%(70/80),χ2=4.103，P=0.043〕.Higher proportion of patients with improved quality of life was found in the experimental group than in the control group〔83.8%(67/80) vs. 70.0%(56/80),χ2=4.254,P=0.039〕.The experimental group had higher level of patient satisfaction with the treatment than the control group(u=-2.473，P=0.013).Adverse reactions occurred more frequently in the control group than in the experimental group(χ2=9.425，P=0.002）.Conclusion Compared with the three-step analgesic ladder alone,three-step analgesic ladder combined with auricular point sticking with the medicinal herb seed can achieve better pain relief effect,higher level of patient satisfaction but with less adverse reactions.Therefore,auricular point sticking with the medicinal herb seed can be applied in cancer pain relief.
【Key words】 Pain management；Canerous pain；Auricular point sticking sv；Three ladders pain analgesic
Status and Associated Factors of Effective Exercises Undertaken in Occupational Populations in Spare Time in Chaoyang District,Beijing TAO Li-li,WANG Yin-hui,LI Zhe,WANG Xiao-ning,QI Zhi,XU Zhi-yuan,HAN Xiao-yan*,LIU Ying-jie
Department of Chronic Disease Prevention and Control,Beijing Chaoyang District Centre for Disease Control and Prevention,Beijing 100021,China
*Corresponding author:HAN Xiao-yan,Chief physician;E-mail：firstname.lastname@example.org
【Abstract】 Objective To investigate the status and associated factors of effective exercises undertaken in occupational populations in spare time in Chaoyang District,Beijing,so as to provide reference for the development of health strategies for these people.Methods Using cluster random sampling,we selected 17 506 18-60-year-old occupational residents from 12 residential districts/towns in Chaoyang District,Beijing as the participants in 2014.They were surveyed by means of a combination of centralized and household questionnaire surveys.The contents of the questionnaire include status of effective exercise undertaken in spare time,residence,gender,age,educational attainment,occupation,marital status,race and chronic disease history.The associated factors for the effective exercise undertaken in the participants in spare time were analyzed.Results The 91.5%(16 018/17 506) of the participants returning responsive questionnaires were selected as the final participants.Among them,5 486 undertook effective exercises in their spare time.Residence,gender,age,educational attainment,occupation,marital status,and chronic disease history were significantly associated with the rate of undertaking effective exercises in spare time(P＜0.05),while race was not(P＞0.05).The participants in age group of 18-29 undertook less effective exercises in spare time than those in other age groups(P＜0.05).Unmarried participants did less effective exercises in spare time than married/cohabited,widowed and divorced participants(P＜0.05).Multivariate Logistic analysis found that,age between 40 and 60,junior college degree or above and chronic disease history were the protective factors for the participants undertaking effective exercises in their spare time(P＜0.05);living in the urban area,male,occupations such as production/transportation,commercial/service industry,business management,general office affairs,professional and technical work and others were more likely to undertake less effective exercises in their spare time(P＜0.05).Conclusion The rate of undertaking effective exercise in spare time is low among the occupational populations in Chaoyang District,Beijing.The key groups who should do more physical exercise for the health are men who live in the urban area and engage in the occupations except farming,forestry,husbandry and fishing.
【Key words】 Exercise movement techniques;Occupational groups;Beijing；Questionnaires；Root cause analysis
Utilization of the Postnatal Care Services among Married Women of Childbearing Age in Migrant Population GONG Shuang-yan*,WANG Hui,LIU Dong-mei
China Population and Development Research Center,Beijing 100081,China
*Corresponding author:GONG Shuang-yan,Associate researcher;E-mail:email@example.com
【Abstract】 Objective To investigate the current status of utilization of the postnatal care services among married women of childbearing age in migrant population and analyze the relevant influencing factors,so as to provide reference for improving the level of postnatal care services in migrant population.Methods From February to September 2016,3 270 married women,aging from 16 to 49,having a delivery history in 2012 and 2013,having experiences outside before pregnancy and not living in hometown after delivery,were selected as research subjects.There were 3 334 births totally,3 334 people were recorded.The delivery age,nationality,educational level,household type,marital status,seniority of children,whether this fertility was in line with childbearing policy,and whether receiving visits within 28 days after delivery,and whether having a physical examination at the 42nd day after delivery in the big data of married women of childbearing age in migrant population were extracted.The influencing factors of receiving visits within 28 days after delivery and having a physical examination at the 42nd day after delivery.Results There were 2 766(82.96%) married women of childbearing age in migrant population had received visits within 28 days after delivery or having a physical examination at the 42nd day after delivery.There were 1 977(59.30%) married women of childbearing age in migrant population had received visits within 28 days after delivery,1 138(34.13%) did not,and 219(6.57%) were not so sure about this.There were 2 578(77.32%) had a physical examination at the 42nd day after delivery,659(19.77%) did not,97(2.91%) were not so sure about this.The rates of visits within 28 days after delivery and physical examination at the 42nd day after delivery were significantly different among married women of childbearing age in migrant population with different delivery age,educational level,household type,marital status,seniority of children,and whether this fertility was in line with childbearing policy(P＜0.05).The rates of visits within 28 days after delivery and physical examination at the 42nd day after delivery were not significantly different among subjects with different nationality(P＞0.05).Multivariate Logistic regression analysis showed that delivery age,educational level,household type,marital status,seniority of children were the influencing factors of married women of childbearing age in migrant population receiving visits within 28 days after delivery and having a physical examination at the 42nd day after delivery(P＜0.05).Conclusion In both 2012 and 2013,most of married women of childbearing age in migrant population have received visits within 28 days after delivery or having a physical examination at the 42nd day after delivery.Among them,more than half have received visits within 28 days after delivery,most have a physical examination at the 42nd day after delivery.It is more likely for married women of childbearing age in migrant population whose delivery age ≥20,and with high level of education,non-agricultural residence registration and production of the first child to utilize postnatal care services.
【Key words】 Residential mobility;Women;Postnatal care;Maternal health services
Clinical Characteristics of Mild Encephalitis/Encephalopathy with a Reversible Splenial Lesion of the Corpus Callosum Secondary to Pulmonary Infection JIANG Yi-qing1，JIN Guo-fei1，ZHOU Ling-fang2,LIU Su-zhi1*
1.Department of Neurology,Taizhou Hospital Affiliated to Wenzhou Medical University,Linhai 317000,China
2.Department of Geriatrics,Taizhou Hospital Affiliated to Wenzhou Medical University,Linhai 317000,China
*Corresponding author:LIU Su-zhi,Chief physician；E-mail:firstname.lastname@example.org
【Abstract】 Objective To analyze the clinical characteristics of mild encephalitis/encephalopathy with a reversible splenial lesion(MERS) of the corpus callosum secondary to pulmonary infection.Methods We summarized the clinical characteristics of 2 cases with MERS of the corpus callosum secondary to pulmonary infection admitted in Department of Neurology of Taizhou Hospital Affiliated to Wenzhou Medical University in 2016 based on reviewing their clinical and imaging data.Results Both the 2 cases were young males who had prodromal symptoms of MERS of the corpus callosum(lung infection symptoms such as fever,cough,followed by nervous system symptoms such as headache,nausea and vomiting and mental abnormalities),and were given levofloxacin as the early treatment against infections.Brain magnetic resonance imaging(MRI) findings of them showed a splenial lesion of the corpus callosum that was characterized by low signals on T1WI,high signals on T2WI and high signals on deffusion-weighted imaging(DWI).Their cerebrospinal fluid(CSF) pressure measured during lumbar puncture was high,but laboratory results of CSF were normal.After receiving the treatment of anti-infection,nourishment of the nerves by taking B vitamins,dehydration and reduction of intracranial pressure by mannitol,all the conditions of them were improved,and the splenial lesions of the corpus callosum disappeared found by the brain MRI reexamination.Conclusion The prodromal symptoms(pulmonary infection,followed by neurological symptoms) of MERS of the corpus callosum,clinical features and auxiliary examination results of the 2 cases in this study are consistent with the records in the previous related literature.Pulmonary infection is one of the secondary causes of MERS of the corpus callosum,which may be related to the early levofloxacin treatment.
【Key words】 Lung inflammation；Corpus callosum；Encephalitis；Signs and symptoms
Clinical Manifestations in Five Cases of Hand-foot Syndrome Induced by Apatinib Mesylate LU Shu-jiao1，MAO Shi-wang1，SHI Yong2*
1.Department of Dermatology and Venereology， Lishui People′s Hospital，Lishui 323000，China
2.Center for Breast Disease Diagnosis and Treatment/Department of Thyroid and Breast Surgery，Lishui People′s Hospital，Lishui 323000，China
*Corresponding author:SHI Yong,Associate chief physician；E-mail：email@example.com
【Abstract】 Objective To analyze the clinical manifestations of five cases of hand-foot syndrome(HFS) induced by Apatinib mesylate,so as to provide a reference for clinical diagnosis and treatment of the disease.Methods We collected the clinical data of five patients with HFS induced by Apatinib mesylate diagnosed and treated in Department of Dermatology of Lishui People′s Hospital between 2015 and 2016,and reviewed their demographic data,clinical manifestations,treatment recommendations and follow-up results.Results Of the five cases(two males and three females;four cases of gastric cancer,and one case of breast cancer),the dose of Apatinib mesylate administered was 750-850 mg/d;the incubation period of HFS induced by Apatinib mesylate was 16-35 d.The status of HFS was assessed by Common Terminology Criteria for Adverse Events(CTCAE).Three of the five cases had staging 1 HFS with the clinical manifestations of erythema scattering on palms and soles without subjective symptoms;one case had staging 2 HFS with edematous erythema appearing on palms and soles accompanied by numbness and mild pain;one case had staging 3 HFS with erythema appearing on palms and soles accompanied by desquamation,blisters and intolerable tingling.All of them were treated with health education,reducing the irritation on hands and feet,vitamin B supplements,Celecoxib for easing the pain based on the subjective symptoms,and external moisturizer for moisturizing and caring the skin.HFS was well controlled by the above treatment without affecting the antineoplastic therapy with Apatinib mesylate in three patients with staging 1 HFS and one patient with staging 2 HFS.However,the above treatments were ineffective for the one patient with staging 3 HFS whose HFS even aggravated.In such conditions,the dose of Apatinib mesylate for the patient was reduced to 500 mg/d,and the HFS symptoms were relived significantly.Conclusion HFS is a common side effect of antineoplastic therapy with Apatinib mesylate in recent years.In general,it can be controlled by symptomatic treatment or reducing the dose of Apatinib mesylate without affecting the further antineoplastic therapy.
【Key words】 Hand-foot syndrome；Antineoplastic agents；Apatinib mesylate
Clinical Features of One Case of Schwartz-Jampel Syndrome Type 1A HUANG Chao1,ZHOU Hai-tao1,REN Xiang-yang1,MA Cong-min1,TENG Jun-fang2*
1.Department of Neurology,Luoyang Central Hospital Affiliated to Zhengzhou University,Luoyang 471000,China
2.Department of Neurology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052，China
*Corresponding author:TENG Jun-fang,Chief physician；E-mail:firstname.lastname@example.org
【Abstract】 Objective To discuss the clinical features of one child patient with Schwartz-Jampel syndrome(SJS) type 1A.Methods From June 15th to August 15th,2016,we did a review of the clinical data of one child patient with SJS type 1A from Luoyang Central Hospital Affiliated to Zhengzhou University.We summarized the patient′s main clinical features,pathological finding of biopsy specimens from the left biceps brachii muscle stained by HE stain,and results of genetic testing.Results The major clinical features of the patient were fixed facial expression,blepharophimosis,difficulty in opening eye,narrowed mouth,difficulty in opening mouth,micrognathia,slightly rigid gait and mildly elevated creatine kinase(CK) levels.Electromyogram(EMG) showed impaired myogenic response and high-frequency myotonic discharges at rest.Muscle biopsy found connective tissue slight proliferation in muscle sleeve,mildly enlarged muscle fiber diameter,a few scattered and grouped old necrotic muscle fibers with inflammatory cells infiltration,the basophilic fibers with hypertrophic nuclei,few splitted fibers and a small number of muscle fibers with nuclei immigrating to the center.The genetic analysis showed that there were compound heterozygous mutations in HSPG2 gene:c.10736T>G(p.Ile3579Ser) in exon 10,c.9963C>A(p.Cys3321Ter) in exon 73 and c.1208G>A(p.Cys403Tyr) in exon 77.Conclusion The diagnosis of SJS type 1A is determined based on the patient′s clinical features,pathological findings of muscle biopsy specimens and results of genetic testing.Special facial changes are the prominent clinical feature,and myodystrophy is the pathological change in muscles.
【Key words】 Osteochondrodysplasias；Myotonia； HSPG2 gene
Clinical Value of Three-dimensional Speckle Tracking Echocardiography Combined with Adenosine Stress Test in Early Diagnosis of Coronary Heart Disease WU Bi-jun1,HUANG Hong-yan1*,ZHOU Su-jin1,XIE Jia-jia2,CUI Nan1,WANG Zhen1,LIU Wen-fen1
1.Department of Ultrasound,Guangdong No.2 Provincial People′s Hospital,Guangzhou 510317,China
2.Cardiovascular Department,Guangdong No.2 Provincial People′s Hospital,Guangzhou 510317,China
*Corresponding author:HUANG Hong-yan,Associate chief physician;E-mail: email@example.com
【Abstract】 Objective To assess the three-dimension