目的:探讨聚焦超声治疗慢性宫颈炎的安全性和有效性。方法:回顾性分析2003年1月至2006年12月我院门诊诊断治疗的慢性宫颈炎患者,行聚焦超声治疗后并于3月内随访的574例患者,分析其安全性及有效性。结果:574例中,痊愈 378例(65.9%),显效155例(27.0%),总有效率96.7%。治愈率与糜烂面积及深浅程度有关(Plt;0.05)。超声治疗后部分患者出现阴道少量流液及血性分泌物。结论:聚焦超声应用于慢性宫颈炎的治疗安全有效,疗效确切,不良反应及并发症小,值得推广。
Tuberculosis remains a major public health problem. Genetic epidemiological studies have shown that the differences in host genes partly determine the susceptibility to tuberculosis. The occurrence of tuberculosis is the result of the joint action of Mycobacterium tuberculosis and host gene regulation immune response. The study of susceptibility candidate genes has differences in race, population and region, and the study of susceptibility gene polymorphism still has a long way to go in clinical precision diagnosis and treatment. The study and clinical application of mendelian susceptibility to mycobacterial disease can be used as a classic application of precision medical treatment in tuberculosis; although it is a rare case, this model is worthy of reference.
ObjectiveTo evaluate the effectivity and safety of posterior osteotomy for thoracolumbar stress fracture in ankylosing spondylitis (AS) through the gap of a pathological fracture.MethodsBetween April 2012 and August 2015, 8 patients with AS combined with thoracolumbar stress fracture were treated with posterior osteotomy through the gap of a pathological fracture to correct the kyphosis. There were 7 males and 1 female, with an average age of 51 years (range, 37-74 years). The history of AS was 1-40 years (mean, 21.7 years) and disease duration of stress fracture was 2-60 months (mean, 18.5 months). The segmental lesions included T8, 9 in 1 case, T10, 11 in 2 cases, T11 in 2 cases, T12, L1 in 1 case, L1, 2 in 1 case, and L2, 3 in 1 case. The nerve function before operation according to Frankel grading was grade D in 3 cases and grade E in 5 cases. The pre- and post-operative X-ray films, CT three-dimensional reconstruction, and MRI were collected to measure the global kyphosis (GK), local kyphosis (LK), angle of the fusion levels (AFL), pelvic incidence (PI), pelvic tilt (PT), and sagittal vertical axis (SVA). Visual analogue scale (VAS) score was used to assess the back pain intensity.ResultsThe operation time was 210-320 minutes (mean, 267 minutes), and the intraoperative blood loss was 400-2 000 mL (mean, 963 mL). Cerebrospinal fluid leakage was found in 3 patients, and the wound healed by removal of drainage tube and suturing drainage outlet after 5-7 days of operation. The wounds of the rest patients healed by first intention. Lower extremity numbness occurred in 1 case and recovered after 1 month of postoperative administration of oral mecobalamin. All the patients were followed up 20-43 months (mean, 28.4 months). No internal fixator loosening, fracture, and other complications occurred. All the fractures healed with the healing time of 3-12 months (mean, 6.8 months). At 3 months after operation, 3 cases with spinal cord injury of preoperative Frankel grade D recovered to grade E. The GK, LK, AFL, PI, PT, SVA, and VAS scores at 1 week after operation and at last follow-up were significantly improved when compared with preoperative ones (P<0.05). Except for VAS score at last follow-up was significantly improved when compared with that at 1 week after operation (P<0.05), there was no significant difference in the other indexes between at 1 week after operation and at last follow-up (P>0.05).ConclusionPosterior osteotomy through the gap of a pathological fracture is a safe and effective surgical procedure for kyphosis correction and relief of back pain in AS patients combined with thoracolumbar stress fracture. Successful bony fusion and good clinical outcomes can also be achieved by this surgical procedure.
ObjectiveTo investigate the negative emotions of patients before cardiac surgery in West China Hospital in order to analyze the related factors.MethodsThe Huaxi emotional-distress index (HEI), a screening tool for mood disorders developed by the Mental Health Center of West China Hospital, was used for preoperative psychological evaluation of 1 968 adult patients hospitalized in cardiac surgery from March 2016 to July 2014. There were 835 males and 1 133 females at age of 49±13 years.Results Fifty-one patients (2.6%) had negative emotions, among whom 6 patients were screened for suicide risk. After intervention, none of them had serious consequences caused by adverse emotions, such as automatic discharge from hospital, avoidance of surgery and suicide.ConclusionThis study found that most of the cardiac surgery patients in West China Hospital have good psychological status before surgery, and a few suffered from negative emotions. “Huaxi emotional-distress index” is simple, effective and worth promoting.
Objective To observe the clinical and pathological characteristics of choroidal metastatic carcinoma from lung carcinoma.Methods The clinical and pathological data of 6 patients with choroidal metastatic carcinoma from lung carcinima were analysed retrospectively.Results All the 6 patients had severe visual impairment, including 3 with severe ophthalmalgia. Flat neoplasm were seen in the posterior pole of the eyes in all the 6 patients and retinal detachment were found in 5 patients. Fundus fluorescein angiography (FFA) examination had been performed on 1 patient and blocked fluorescence and hyperfluorescence were seen in the lesion with pinpoint fluorescein leakage loop around it. CT examination had been performed on 3 patients and the shadow of flat homogenous tumor was seen. MRI examination had been performed on 1 patient and high signal intensit ies on T1W and low signal intensities on T2W were found. In all the 6 patients with primary lung carcinoma, 5 were diagnosed with adenocarcinoma and 1 with cellule carcinoma through pathological examination, and 5 patients were diagnosed with choroidal metastatic carcinoma from adenocarcinoma and 1 with choroidal metastatic carcinoma from cellule carcinoma through pathological examination.Conclusion Rapid visual acuity decrease, severe ophthalmalgia, flat neoplasm in ocular fundus and secondary retinal detachment are the main clinical characteristics of the choroidal metastatic carcinoma from lung carcinoma. Most histopathologica l manifestations of the metastatic carcinoma like that of the primary focus, and adenocarninoma is the most common histoclassification. (Chin J Ocul Fundus Dis，2003，19：333-404)
Atrial fibrillation (AF) and breast cancer are common diseases with high incidence, which can be promoted and maintained by a wide range of regulatory factors (changes of hormone secretion, chronic inflammation, dysfunctions in autonomic nervous system, coagulation system and endothelia). There may be a consistent pathophysiological link between the increased incidence of breast cancer and AF, which is currently seldomly reported. The development process of these two diseases are complex, and the occurrence of breast cancer may increase the incidence of AF. In this paper, we reviewed the relationship between breast cancer and AF based on the latest reports.
Circular RNA (circRNA) is a non-coding RNA which exists widely in eukaryotic cells with a structure of covalently closed continuous loop. Its generation, characteristics and functions have received extensive attention, making it one of the hot spots in the field of non-coding RNA research. Many studies have found that circRNA plays an important role in the development of various diseases including cardiovascular disease, nervous system disease and cancer. Cardiovascular disease is a worldwide common disease with high incidence and poor prognosis. Its exact pathogenesis has not been found, which blocks the development of cardiovascular disease treatment. In this review, we summarize the loop-forming mechanisms, the functions and the progress of current researches of circRNA in cardiovascular diseases.
Objective To investigate the short-term effectiveness of the anterior and middle columns in thoracolumbar tuberculosis reconstructed with whole autogenous spinous process-laminar bone through posterior approach. Methods The retrospective study included 78 patients with thoracolumbar tuberculosis who underwent posterior approach surgery and anterior and middle column bone graft reconstruction between January 2012 and May 2023. Based on the type of autogenous bone graft used, patients were divided into group A (whole autogenous spinous process-laminar bone graft, 38 cases) and group B (autogenous structural iliac bone graft, 40 cases). There was no significant difference of baseline data, such as age, gender, disease duration, involved segment of spinal tuberculosis, and preoperative erythrocyte sedimentation rate (ESR), C reactive protein (CRP), Oswestry disability index (ODI), visual analogue scale (VAS) score, the American Spinal Injury Association (ASIA) grade, segmental kyphotic angle, and intervertebral height between the two groups (P>0.05). The operation time, intraoperative blood loss, postoperative drainage, hospital stays, ESR, CRP, VAS score, ODI, bone fusion time, ASIA grade for neurological status valuation, postoperative complications, change of segmental kyphotic angle, change of intervertebral height were recorded and compared between the two groups. Results The operation time in group A was significantly shorter than that in group B (P<0.05); there was no significant difference in intraoperative blood loss, postoperative drainage, and hospital stays between the two groups (P>0.05). All patients in the two groups were followed up 14-110 months (mean, 64.1 months); there was no significant difference in the follow-up time between the two groups (P>0.05). The ESR, CRP, ODI, and VAS score at each time point after operation in both groups significantly improved when compared with those before operation, and further improved with the extension of time, the differences were significant (P<0.05). There was no significant difference between the two groups (P>0.05) except that the VAS score of group A was significantly better than that of group B at 3 days after operation (P<0.05). There was no significant difference in fusion time between the two groups (P>0.05). The neurological function of most patients improved after operation, and there was no significant difference in ASIA grade between the two groups at last follow-up (P>0.05). There was no significant difference in segmental kyphosis angle and intervertebral height between the two groups at each time point (P>0.05), and no significant difference in segmental kyphosis angle, intervertebral height correction and loss were found between the two groups (P>0.05). In group A, there was 1 case of incision fat liquefaction and 1 case of incision infection; in group B, there was 1 case of deep venous thrombosis, 2 cases of pleural effusion, and 10 cases of pain in bone harvesting area; in both groups, there were 2 cases of gout caused by hyperuricemia. There was a significant difference in the incidence of pain in bone harvesting area between the two groups (P<0.05), and there was no significant difference in the incidence of other complications between the two groups (P>0.05). ConclusionWhole autogenous spinous process-laminar bone grafting is equivalent to structural iliac bone graft in reconstruction of the anterior and middle columns in thoracolumbar tuberculosis through posterior approach, effectively supporting the stability of the anterior and middle columns of the spine, while resulting in shorter operation time and less postoperative pain in bone harvesting area.
To evaluate the efficacy and safety of comprehensive prophylaxis for deep venous thrombosis(DVT) after proximal femur fractures in geriatric patients. Methods From July 2003 to May 2006, 157 geriatric patients with proximal femur fractures treated with operation were divided into prophylaxis group and control group randomly. There were 82 patients (34 males, 48 females, aged 65-97 years) in prophylaxis group, 30 with femoral neck fracture and 52 with intertrochanteric fracture of femur. There were 75 patients (33 males, 42 females, aged 65-94 years) in control group, 28 with femoral neck fracture and 47 with intertrochanteric fracture of femur. In the prophylaxis group, comprehensive prophylaxis for DVT which included Aspirin, fibrinolytic enzyme, passive and active circumduction of the foot and ankle, CPM management wasappl ied. In the control group, no thromboproxylaxis was taken. All patients in the both groups received color doppler flow imaging (CDFI) examination before operation and on the 7th and 14th days after operation. Results CDFI found 2 cases of DVT in the prophylaxis group 7 and 14 days after operation respectively, while 21 and 15 cases of DVT in the control group respectively. The incidence of DVT was 48.0% in the control group compared with 4.9% in the prophylaxis group and the reduction was significant (P lt; 0.01). One patient gave up the intervention due to Melena 3 days after operation in the prophylaxis group. In the control group, 1 patient died 8 days after operation and another died 11 days after operation. Both died of acute pulmonary embol ism confirmed by autopsy. Conclusion The comprehensive prophylaxis can significantly decrease the incidence of DVT in geriatric patients after proximal femur fractures. There is no significant adverse effect during the intervention.
Objective To study the ectopic osteogenesis and vascularization ofthe tissue engineered bone promoted by an artificial bone composite that consists of coral hydroxyapatite (CHA), 1,25-(OH)2 D3, human marrow stromal osteoblast (hMSO), and human umbilical vein endothelial cell (hUVEC).Methods After the isolation and the culture in vitro, hMSO and hUVEC were obtained. Then, hMSO (5×105/ml) and hUVEC (2.5×105/ml) were seeded at a ratio of 2∶1 onto the CHA scaffolds coated with 1,25-(OH)2 D3 (the experimental group) or onto the CHA scaffolds without 1,25-(OH)2 D3 (the control group). The scaffolds were culturedin vitro for 3 days, and then the scaffolds were implanted into the pockets that had beenmade on the backs of 18 nude mice. Then, 6 of the mice were implanted with one experimental engineered bone bilaterally; another 6 mice were implanted with onecontrol engineered bone bilaterally; the remaining 6 mice were implanted with one experimental engineered bone and one control engineered bone on each side. At4, 8 and 12 weeks after operation, the retrieved scaffolds and cells were examined by the nake eye and histology as well as by the scanning electron microscopy. The quantitative assessment of the newly-formed bone and the quantitative analysis of the newly-formed blood vessels were performed. Results The evaluationsby the histology revealed that at 4 weeks the original bone tissues grew into the scaffolds in all the groups, but significantly more newly-formed bone tissuesand newly-formed blood vessels were found in the experimental group. At 12 weeks the newly-formed bone tissues were found in all the groups, but there was a typical bone unit found in the experimental group. There was a significantly smaller amount of capillary vessels in the control group than in the experimental group at all the time points. The evaluations by the scanning electron microscopy revealed that at 4 weeks in the experimental group there were great amounts of extracelluar matrix that embedded the cells, and plenty of capillary vessels were found on the surface of the implanted bone materials and some of them grew into the materials; however, in the control group there was a smaller amount of capillary vessels although much extracelluar matrix was still found there. At 8 weeks sarciniform osteoids were found on some of the implanted materials, with much extracelluar matrix and many newly-formed capillary vessels in the experimental group; however, in the control group there were fewer capillary vessels and lower degrees of the bone maturity. The quantitative assessment of the newly-formed bone showed that the newformed bones were 3.1±0.52 in the experimental group but2.30±0.59 in the control group at 8 weeks (Plt;0.05), and 4.63±0.55 vs. 3.53±0.62 at 12 weeks. There was a significant difference at these two time points between the two groups (Plt;0.05). The quantitative analysis of the newly-formed blood vessels showed that the vascular areas were 28.74％±7.81％i n the experimental group but 19.52％±4.57% in the control group at 4 weeks (Plt;0.05), and 24.66％±7.38％ vs. 1784%±5.22% at 12 weeks. There was a significant difference at these two time points between the two groups (Plt;0.05). Conclusion 1,25-(OH)2 D3 as an active factor can increase the interaction between hMSO and hUVEC, and thus promote the ectopic osteogenesis and vascularization in the tissue engineered bone.