【摘要】 目的 探讨男性和女性糖尿病肾病患者危险因素之间的差异。方法 收集2004年1月—2008年12月以糖尿病肾病为诊断的住院患者1 300例,根据入院日期以系统的方法随机纳入650例患者,排除20例尿常规正常和血肌酐值正常的患者,共630例,其中男342例,女288例,平均年龄65岁。288例女性患者中有271例为绝经后妇女,平均年龄48岁。比较女性和男性糖尿病肾病患者危险因素的差别。结果 ①绝经后糖尿病肾病患者占女性患者的94.1%；②女性糖尿病肾病患者组收缩压、脉压及糖化血红蛋白水平高于男性糖尿病肾病患者组,两者有统计学意义(Plt;0.05)；③两组患者在发病年龄,病程,糖尿病家族史,空腹血糖水平,低密度脂蛋白,高密度脂蛋白,血肌酐,24 h尿蛋白定量、是否使用血管紧张素转换酶抑制剂,血管紧张素受体拮抗剂,胰岛素,是否透析,死亡率均无统计学意义(Pgt;0.05)。结论 在女性糖尿病肾病患者中绝经后妇女所占比例较高,女性糖尿病肾病患者收缩压、脉压及糖化血红蛋白水平均高于男性糖尿病肾病患者,雌激素的水平可能导致差异的产生。
Objective To investigate the iron regulated locus in Klebsiella pneumoniae isolates from blood culture of liver abscess patients in Sichuan Provincial People’s Hospital. Methods From January to December of 2015, a total of 10 isolates of Klebsiella pneumoniae were collected from blood culture of liver abscess patients from Sichuan Provincial People’s Hospital. The genomic DNA was extracted to identify the genes of iroB, iroC, and iroD by PCR, and data was further analyzed by Graphpad Prism 5 software. Results Among the 10 Klebsiella pneumoniae clinical strains, 9 strains were iroB positive strains, 9 strains were iroC positive strains, and 10 strains were iroD positive strains, 9 strains were iroB/C/D triple positive. Conclusion The current study suggests that the frequency of triple positive of iroB/C/D in Klebsiella pneumoniae is high in isolates from liver abscess patients, the triple positive of iroB/C/D may contribute to liver abscess.
ObjectiveTo summarize strategy of diagnosis and treatment of thrombotic iliac vein stenosis in recent years.MethodThe relevant literatures in recent 5 years on the current status and trend of diagnosis and treatment of the thrombotic iliac vein stenosis were reviewed.ResultsAt present, the diagnostic methods of thrombotic iliac vein stenosis mainly included that the multi-slice spiral CT, venography, intracavitary ultrasound, magnetic resonance imaging, color Doppler ultrasound and other imaging examinations, each of which had its advantages and disadvantages. There were still no uniform criteria whether a filter should be placed, whether the stents should and how to be placed, and when to intervene in the patients with acute thrombotic iliac vein stenosis. There was no definite conclusion when and how to effectively intervene in the patients with chronic thrombotic iliac vein stenosis.ConclusionsIncidence of thrombotic iliac vein stenosis is high and sequela is severe. Early diagnosis and reasonable treatment are very important. Only strictly grasping indications, combining medical technology and patient’s condition, and adopting appropriate treatment strategy, can make patients’ maximal benefit.
Objective To investigate the expressions of β1, 3-N-acetyl glucosaminyl transfrases ( Fringe) ( RFNG, LFNG and MFNG) in lung tissues and lung T cells isolated from asthmatic mice, and to explore the role of Fringe in pathogenesis of asthma. Methods Asthmatic BALB/ c mouse model was established by inhalation of ovalbumin after intraperitoneal injection. Meanwhile, the control groups were established by normal saline. Lung tissues were sampled after 24 hours since the last stimulation. T cells were isolated from the lung tissues using percol and NylonFiber. The mRNA expressions of three kinds of Fringe in the lung tissues and lung T cells were examined by reverse transcription-PCR ( RT-PCR) . The protein expressions of Fringe in the lung tissues were detected by Western blot. Results The mRNA expressions of RFNG, LFNG and MFNG were detectable in the lung tissues and lung T cells. The mRNA expressions of RFNG increased in the asthmatic group compared with the control group( lung tissues: 0. 92 ±0. 35 vs 0. 51 ±0. 13, P lt; 0. 01; lung T cells: 0. 33 ±0. 06 vs 0. 18 ±0. 07, P lt; 0. 01) . LFNG mRNA had lower expression level in the asthmatic group( lung tissue: 0. 77 ±0. 32 vs 1. 61 ±0. 31, P lt; 0. 01; lung T cells: 0. 49 ±0. 19 vs 0. 71 ±0. 03, P lt;0. 01) . No difference on the mRNA expression of MFNG was found in the lung tissues( 1. 44 ±0. 29 vs 1. 70 ±0. 44, P gt; 0. 05) . MFNG mRNA expression decreased in the asthmatic group compared with the control group in the T cells( 1. 17 ±0. 04 vs 0. 68 ±0. 07, P lt;0. 05) . The results of western blot were consistent with RT-PCR results of the lung tissues. The expressions of RFNG increased in the asthmatic group( 1. 17 ±0. 04 vs 0. 68 ±0. 07, P lt;0. 05) . The expression of MFNG has no difference between two groups( 8. 10 ±0. 60 vs 9. 12 ±0. 07, P gt;0. 05) . LFNG had a lower expression in the asthmatic group( 4. 11 ±0. 38 vs 6. 41 ±0. 11, P lt; 0. 05) . Conclusion The abnormal expressions of three kinds of Fringe may be involved in the pathogenesis of asthma.
ObjectiveTo investigate the etiology of patients with convulsive status epilepticus (CSE).MethodsBy taking epilepsy, seizure, status epilepticus, and epileptic seizure as keywords, the clinical data of epilepsy patients hospitalized in the First People’s Hospital of Longquanyi District of Chengdu and the People’s Hospital of Leshan from January, 2012 to December, 2017 were retrospectively collected from a retrieval system for electronic patient records. The collected CSE cases were screened by trained epilepsy specialists in strict accordance with inclusion criteria and exclusion criteria. The etiology of CSE, and the pathogenetic distinctions among patients with different ages, sexes, educational levels, places of residence, and histories of epilepsy were analyzed based on medical histories and accessory examinations. The prognostic factors for epilepsy were determined using logistic regression analysis.ResultsIn this study, a total of 852 hospitalized epilepsy cases were retrieved, among which 104 cases were CSE cases aged between 18 and 86, including 75 males and 29 females. There were 13 CSE deaths (12.5%). There were significant differences in the pathogeneses among CSE patients with different ages and histories of epilepsy (χ2=52.396, 18.354; P<0.05). However, no significant difference in CSE pathogeneses was observed among patients with different sexes, educational levels, or places of residence (P>0.05). Drug withdrawal or dose reduction was the leading cause of CSE in patients with a history of epilepsy (n=28, 57.1%), while cerebrovascular diseases (n=19, 34.5%) were common causes among those without a history. Among patients aged over 65, cerebrovascular diseases (n=17, 43.6%) were determined as the major causes of CSE, while for those aged under 65, drug withdrawal or dose reduction was the main pathogeny (n=20, 30.8%). Results obtained from multivariate logistic regression analysis on the prognostic factors for epilepsy showed that the duration of epileptic seizure significantly influenced the prognosis of patients [odds ratio=1.299, 95% confidence interval (1.074, 1.571), P=0.007], while there were no significant correlations between other factors and epilepsy prognosis (P>0.05).ConclusionsCerebrovascular diseases are the leading causes of geriatric CSE. Irregular medication of epilepsy patients is a prominent avoidable trigger for CSE.
【摘要】 目的 对住院的手足口病患儿，在相同治疗和护理基础上，应用复方黄连素片剂融入复方炉甘石洗剂外用观察其疗效和安全性，为传染病的防制提供临床经验。 方法 2008年5月-2010年5月收治手足口病患儿184例，采用随机分组法，以复方黄连素片剂融入复方炉甘石洗剂外用92例为治疗组，未用复方黄连素片剂融入复方炉甘石洗剂外用92例为对照组，进行疗效比较。 结果 治疗组5 d痊愈率为94%，总有效率为100%，与对照组比较差异有统计学意义（Plt;0.01）。 结论 应用复方黄连素片剂融入复方炉甘石洗剂外用治疗手足口病安全可靠。【Abstract】 Objective To observe the therapeutic and nursing effect on hand-foot-mouth disease (HFMD) with infection after medication for external use. Methods A total of 184 patients with HFMD from May 2008 to May 2010 were randomly divided into two groups: 92 patients in the treatment group underwent medication for the external use topical with berberine tablet blending in calamine lotion for, and another 92 patients in the control group didn’t undergone the medication for the external use. Results The total cure rate within 5 days in treatment group was 94% and the total effective rate was 100%, which was significantly different from that in the control group (Plt;0.01). Conclusion Berberine tablet blending in calamine lotion application is safe and effective on patients with HFMD with infection.
ObjectiveTo investigate the effectiveness of percutaneous endoscopic posterior cervical Key-Hole fenestration decompression and nucleus pulposus extirpation in the treatment of paracentral cervical disc herniation.MethodsBetween December 2015 and October 2018, 29 cases of paracentral cervical disc herniation were treated with percutaneous endoscopic posterior cervical Key-Hole fenestration decompression and nucleus pulposus extirpation. There were 16 males and 13 females, with an average age of 49.7 years (range, 39-78 years). The disease duration was 3.5-15.0 months (mean, 6.2 months). The herniated disc located at C3, 4 in 2 cases, C4, 5 in 5 cases, C5, 6 in 9 cases, C6, 7 in 12 cases, and C7, T1 in 1 case. The main symptoms were radiculopathy symptom. The operation time, intraoperative blood loss, hospital stay, and complications were observed and recorded. Visual analogue scale (VAS) score, Japanese Orthopaedic Association (JOA) score, cervical range of motion (ROM), Macnab standard, and cervical segment stability were used to evaluate the efficacy and safety of the operation.ResultsAll patients were followed up 11-43 months, with an average of 19.4 months. The operation time was 67-89 minutes (mean, 73.3 minutes); the intraoperative blood loss was 18-30 mL (mean, 22.9 mL); the hospital stay was 5-10 days (mean, 7.3 days). All the incisions healed by first intention. There was 1 case of hypodynia and hyperalgesia in the affected limb after operation,1 case of decreased limb muscle strength. The VAS scores and JOA scores at each time point after operation were superior to those before operation (P<0.05). There was no significant difference between the time points after operation (P>0.05). At last follow-up, the effectiveness was rated according to the Macnab standard as excellent in 11 cases, good in 15 cases, fair in 2 cases, and bad in 1 case, with an excellent and good rate of 89.7%. The CT and MRI showed the decompression of spinal canal and nerve canal. There was no significant difference in cervical ROM between pre- and post-operation (t=1.427, P=0.165), and no surgical segment instability occurred by X-ray films of flexion and extension of cervical vertebrae.ConclusionFor the paracentral cervical disc herniation with simultaneous compression of nerve roots and spinal cord, percutaneous endoscopic posterior cervical Key-Hole fenestration decompression and nucleus pulposus extirpation has the advantages of small trauma, quick recovery, and satisfactory effectiveness, and can be used as a safe and effective minimally invasive procedure.
Objective To explore a scientific disease cost accounting. Method Disease cost accounting = disease cost accounting of clinic pathway + disease basis cost accounting. Conclusions It is the tendency with the medical reform for the social security department to pay by disease for the hospitals, as a result, both social security department and hospitals have to resort to the scientific way in terms of cost accounting of disease. And it is practical and effective by means of cost accounting for clinic pathway.
Objective To review the research progress of the skin flap, fascial flap, muscle flap, and myocutaneous flap for repairing soft tissue defects around the knee so as to provide information for clinical application. Methods Domestic and abroad literature concerning the methods of soft tissue repair around the knee in recent years was reviewed extensively and analyzed. Results Fascial flaps meet the requirements of thin, pliable, and tough skin in the soft tissue repair around the knee. Myocutaneous flaps and muscle flaps have more abundant blood supply and anti-infection function. Free skin flaps are the only option when defects are extensive and local flaps are unavailable. Conclusion Suitable flaps should be chosen for soft tissue repair around the knee according to defect position, depth, and extent. Fascial flaps may be selected as the first flaps for defects repair because of excellent aesthetic results and less injury at the donor site.
Objective To compare and research the process of woundhealing in occlusive moist environment and dry environment on the skin donor site. Methods The wound healing of adult skin donor site was studied by clinical observation, histological and electromicroscopical examinations on the operative day and the 1st, 2nd, 3rd, 4th, 7th days postoperatively, each skin donor site was divided into two parts: occlusive environment and dry environment. Results The wounds of occlusive moist environment healed faster than those of dry environment; thefibroblasts were more active and activated earlier, revascularization and re-epithelialization happened earlier and more quickly. Conclusion In occlusive environment, more active fibroblasts can accelerate granulation growth; quicker regenerative capillaries bring more nourishment; quicker re-epithelialization accelerates the wound healing.