Leukoaraiosis(LA)results from ischemic injury in small cerebral vessels,which may be attributable to decreased vascular density,reduced cerebrovascular angiogenesis,decreased cerebral blood flow,or microcirculatory dy...Leukoaraiosis(LA)results from ischemic injury in small cerebral vessels,which may be attributable to decreased vascular density,reduced cerebrovascular angiogenesis,decreased cerebral blood flow,or microcirculatory dysfunction in the brain.In this study,we enrolled 357 patients with mild intracerebral hemorrhage(ICH)from five hospitals in China and analyzed the relationships between LA and clinical symptom severity at admission,neurological function prognosis at 3 months,and 1-year stroke recurrence.Patients were divided into groups based on Fazekas scale scores:no LA(n=83),mild LA(n=64),moderate LA(n=98)and severe LA(n=112).More severe LA,larger hematoma volume,and higher blood glucose level at admission were associated with more severe neurological deficit.More severe LA,older age and larger hematoma volume were associated with worse neurological function prognosis at 3 months.In addition,moderate-to-severe LA,admission glucose and symptom-free cerebral infarction were associated with 1-year stroke recurrence.These findings suggest that LA severity may be a potential marker of individual ICH vulnerability,which can be characterized by poor tolerance to intracerebral attack or poor recovery ability after ICH.Evaluating LA severity in patients with mild ICH may help neurologists to optimize treatment protocols.This study was approved by the Ethics Committee of Ruijin Hospital Affiliated to Shanghai Jiao Tong University(approval No.12)on March 10,2011.展开更多
BACKGROUND Hypothyroidism is an endocrine disorder that has worldwide prevalence and can affect multiple organ systems.We report a case of hypothyroidism with elevated pancreatic amylase and trypsin without acute panc...BACKGROUND Hypothyroidism is an endocrine disorder that has worldwide prevalence and can affect multiple organ systems.We report a case of hypothyroidism with elevated pancreatic amylase and trypsin without acute pancreatitis.No such case has been previously reported.CASE SUMMARY A 29-year-old woman did not pay much attention to a fever 4 d prior.During this time,she experienced anorexia and only drank a small amount of water every day.She did not present with abdominal distension,postprandial nausea,vomiting,cough or expectoration.After physical and laboratory examinations,the patient was diagnosed with hypothyroidism.During the course of the disease,hypothyroidism was generally accompanied by constantly increased pancreatic amylase and trypsin.After admission,the possible etiology of the patient was excluded and the concentrations of pancreatic lipase and amylase in serum were>2000U/L(reference range 23-300 U/L)and 410 U/L(reference range 30-110 U/L),respectively.So we highly suspected that it may be acute pancreatitis.Interestingly,she never developed any complications associated with acute pancreatitis despite high levels of serum pancreatic amylase and trypsin,and she reported no symptoms of abdominal pain.Serum amylase and lipase decreased gradually after active thyroxine supplementation,and the patient was discharged from the hospital after active treatment.CONCLUSION This case suggests that clinicians should pay attention to hypothyroidism with elevated pancreatic amylase and trypsin,even if no complications of acute pancreatitis are reported.展开更多
AIM: To evaluate the feasibility of a new clinical rating scale for a standardized assessment of cirrhosis-associated neuro-psychiatric symptoms.METHODS: Forty patients with liver cirrhosis (LC, with or without low-gr...AIM: To evaluate the feasibility of a new clinical rating scale for a standardized assessment of cirrhosis-associated neuro-psychiatric symptoms.METHODS: Forty patients with liver cirrhosis (LC, with or without low-grade hepatic encephalopathy) were invest-igated using a clinical neuro-psychiatric rating scale based on a comprehensive list of neurological, psychomotor,cognitive, affective, behavioral symptoms, and symptoms of disturbed bioregulation.RESULTS: The analysis revealed that the majority of cirrhotic patients showed, besides characteristic neurological symptoms of hepatic encephalopathy, various psychomotor,affective and bioregulatory symptoms (disturbed sleep and sexual dysfunction). Patients were impaired in the following subscales: sleep and biorhythm disorder (75.0% of patients), Parkinsonoid symptoms (25.0%), affective symptoms (17.5%), and psychomotor retardation (12.5%).The increase of total neuro-psychiatric clinical score was significantly associated with the degree of hepatic enceph-alopathy.CONCLUSION: This study suggests that a substantial number of patients with LC and low-grade hepatic encephalopathy manifest various clinical neuro-psychiatric symptoms. The use of a rating scale, which explores clinical dimensions of hepatic encephalopathy, would improve the management of patients with LC.展开更多
The present study aims to investigate the effectiveness of dialectical behavior therapy in clinical symptoms, anger control and emotional regulation of bully children. This research is a pretest-posttest quasi-experim...The present study aims to investigate the effectiveness of dialectical behavior therapy in clinical symptoms, anger control and emotional regulation of bully children. This research is a pretest-posttest quasi-experimental study design with a nonequivalent control group. The research sample comprises 24 bully children who were purposefully selected from among the students who had responded positively to the researcher’s call. The participants were randomly assigned into two experimental and control groups. Group therapy intervention was conducted on the experimental group during ten sessions. The tools applied in this study consisted of Cognitive Emotion Regulation Questionnaire by Garnefski et al., State-Trait Anger Expression Inventory by Spielberger and Bullying Scale by Illinois, Espelage and Holt and the subjects answered to their questions in the stage of pretest and posttest. In this research, the data was analyzed based on the analysis of covariance test and with the aid of SPSS software. The findings demonstrated that dialectical behavior therapy has a significant impact on clinical symptoms, anger control and its components and emotional regulation and its components (P < 0.01).展开更多
Objective:To explore the effects of bronchoscopy alveolar lavage in the treatment of severe pneumonia caused by multiple drug bacterial infection.Methods:A total of 84 patients with severe pneumonia infected by multi-...Objective:To explore the effects of bronchoscopy alveolar lavage in the treatment of severe pneumonia caused by multiple drug bacterial infection.Methods:A total of 84 patients with severe pneumonia infected by multi-drug resistant bacteria were randomly selected from Kunming Second People's Hospital,which is our hospital from January 2019 to December 2020 for this research.They were divided into a reference group and a study group using a digital table method,with 42 cases in each group.The reference group was given the routine treatment,the research group performed bronchoscopy alveolar lavage on this basis to observe the curative effect.Results:Before treatment,there was no significant difference in serum factor indexes and blood gas analysis indexes between the two groups of patients,P>0.05.After treatment,the time of fever,cough,moist rales disappearing and infection control time in the study group were shorter than those in the reference group,P<0.05.Serum tumor necrosis factorα(TNF-α),interleukin-6(IL-6)and interleukin-8(IL-8)levels were lower than the reference group,and the arterial partial pressure of oxygen(PO2)and oxygen saturation(SO2)were both lower than the reference group,P<0.05.The effective rate of the treatment in the study group was higher than that in the reference group,P<0.05.Conclusion:Bronchoscopic alveolar lavage treatment can effectively improve the clinical symptoms of patients with severe pneumonia caused by multi-drug resistant bacterial infection,and the effects are significant.展开更多
OBJECTIVE: To explore the effects of Tanshinone combined with western medicine on clinical symptoms and cardiac function in patients with acute heart failure. METHODS: The medical records of 96 patients with acute hea...OBJECTIVE: To explore the effects of Tanshinone combined with western medicine on clinical symptoms and cardiac function in patients with acute heart failure. METHODS: The medical records of 96 patients with acute heart failure were randomly divided into 2 groups(48 cases in observation group and 48 cases in control group). The control group was treated with conventional western medicine, and the observation group was treated with Tanshinone IIA sulfonic acid natrium on the basis of western medicine. The traditional Chinese medicine(TCM) syndromes scores before and after treatment(after 28 d of treatment), clinical efficacy, and cardiac echocardiographic indexes and serum biochemical indicators before and after treatment were observed in the 2 groups. RESULTS: After treatment, the scores of TCM syndromes in the 2 groups were significantly decreased(P < 0.05), and the change in observation group was significantly greater than that in control group(P < 0.05). The total clinical effective rate in observation group was significantly higher than that in control group(91.67% vs 75.00%)(P < 0.05). After treatment, the echocardiographic indexes of left ventricular end-diastolic diameter(LVEDD) and left ventricular end-systolic diameter(LVESD) values were significantly reduced in the 2 groups while the left ventricular ejection fraction(LVEF) and stroke volume(SV) value were significantly increased, and the changes in observation group were significantly larger than those in control group(P < 0.05). After treatment, the levels of serum nuclear factor-kappaB(NF-KB), interleukin-1β(IL-1β) and N-terminal pro-brain natriuretic peptide(NT-proBNP) were significantly decreased in the 2 groups(P < 0.05), while the 6-keto-prostaglandin F1α(6-ketoPGF1α) level was significantly increased. And the changes in observation group were significantly greater than those in control group(P < 0.05). CONCLUSION: Tanshinone combined with western medicine can significantly improve the clinical symptoms of patients with acute heart failure, improve cardiac function, reduce the myocardial damage degree, and effectively reduce the risk of short-term recurrence and death, and it has exact clinical efficacy.展开更多
Background: With the appearance of the SARS-CoV-2 Omicron variant the high rate of vaccination breakthroughs showed that current vaccines against COVID-19 can no longer provide adequate protection against infection. H...Background: With the appearance of the SARS-CoV-2 Omicron variant the high rate of vaccination breakthroughs showed that current vaccines against COVID-19 can no longer provide adequate protection against infection. However, it is still assumed that vaccination might have a positive effect on the course of the disease. In Germany, general practitioners and specialists are usually the first treatment providers for acute illnesses. In addition, patients with infections of the upper respiratory tract often primarily consult an ear, nose and throat specialist. Most of the Omicron-infected people have a mild course of the disease and, if necessary, receive medical care on an outpatient basis. Little is known about the effectiveness of corona vaccinations on Omicron infections in relation to the clinical symptoms. In our outpatient office, we recorded a sharp increase of corona positive Omicron-infections in the beginning of 2022, despite of vaccinations against COVID-19. In a retrospective analysis, we evaluated the data of our SARS-CoV-2 tested patients with regard to clinical symptoms reported and vaccination status. The focus was particularly on the question to what extent the vaccination status in the case of Omicron infections influences the symptoms of the disease. Methods: We retrospectively evaluated the data of all patients in the first quarter of 2022 who were suspected for COVID-19. At that time, the Omicron variant was dominant in Germany. Clinical symptoms, cycle threshold (Ct) values, and the vaccination status were recorded. Symptomatic patients who tested negative for SARS-CoV-2 served as a control group. Results: Of the total cohort (n = 353), 241 (68%) patients were tested SARS-CoV-2 positive. The symptoms of the corona-positive patients were essentially similar to those of a mild to moderate cold, but compared to SARS-CoV-2-negative patients (n = 69) with a clear shift in favor of fever (35% versus 16%), cough (76% versus 52%) and increased feeling of illness (59% versus 43%), respectively. Ct values revealed no difference between unvaccinated (mean 19.15;SD 3.52) and vaccinated cases (mean 18.15;SD 3.87;p = 0.272). There was no significant correlation between the vaccination status and clinical symptom score in different age groups (age 12 to 17, r (28) = 0.26, p = 0.26;age > 18 to 60, r (191) = 0.06, p = 0.378). Conclusions: According to our results with infections with the Omicron variant, there were no differences between unvaccinated and vaccinated patients concerning clinical symptoms or potential infectivity, especially in children and adolescents. This might have impact on further vaccination programs.展开更多
基金supported by the National Natural Science Foundation of China,Nos.81771281(to FXS),81471177(to FXS)the Natural Science Foundation of Shanghai of China,No.20ZR1434200(to YF)。
文摘Leukoaraiosis(LA)results from ischemic injury in small cerebral vessels,which may be attributable to decreased vascular density,reduced cerebrovascular angiogenesis,decreased cerebral blood flow,or microcirculatory dysfunction in the brain.In this study,we enrolled 357 patients with mild intracerebral hemorrhage(ICH)from five hospitals in China and analyzed the relationships between LA and clinical symptom severity at admission,neurological function prognosis at 3 months,and 1-year stroke recurrence.Patients were divided into groups based on Fazekas scale scores:no LA(n=83),mild LA(n=64),moderate LA(n=98)and severe LA(n=112).More severe LA,larger hematoma volume,and higher blood glucose level at admission were associated with more severe neurological deficit.More severe LA,older age and larger hematoma volume were associated with worse neurological function prognosis at 3 months.In addition,moderate-to-severe LA,admission glucose and symptom-free cerebral infarction were associated with 1-year stroke recurrence.These findings suggest that LA severity may be a potential marker of individual ICH vulnerability,which can be characterized by poor tolerance to intracerebral attack or poor recovery ability after ICH.Evaluating LA severity in patients with mild ICH may help neurologists to optimize treatment protocols.This study was approved by the Ethics Committee of Ruijin Hospital Affiliated to Shanghai Jiao Tong University(approval No.12)on March 10,2011.
基金Supported by Shanghai Shenkang Hospital Development Center,No.SHDC12016109.
文摘BACKGROUND Hypothyroidism is an endocrine disorder that has worldwide prevalence and can affect multiple organ systems.We report a case of hypothyroidism with elevated pancreatic amylase and trypsin without acute pancreatitis.No such case has been previously reported.CASE SUMMARY A 29-year-old woman did not pay much attention to a fever 4 d prior.During this time,she experienced anorexia and only drank a small amount of water every day.She did not present with abdominal distension,postprandial nausea,vomiting,cough or expectoration.After physical and laboratory examinations,the patient was diagnosed with hypothyroidism.During the course of the disease,hypothyroidism was generally accompanied by constantly increased pancreatic amylase and trypsin.After admission,the possible etiology of the patient was excluded and the concentrations of pancreatic lipase and amylase in serum were>2000U/L(reference range 23-300 U/L)and 410 U/L(reference range 30-110 U/L),respectively.So we highly suspected that it may be acute pancreatitis.Interestingly,she never developed any complications associated with acute pancreatitis despite high levels of serum pancreatic amylase and trypsin,and she reported no symptoms of abdominal pain.Serum amylase and lipase decreased gradually after active thyroxine supplementation,and the patient was discharged from the hospital after active treatment.CONCLUSION This case suggests that clinicians should pay attention to hypothyroidism with elevated pancreatic amylase and trypsin,even if no complications of acute pancreatitis are reported.
文摘AIM: To evaluate the feasibility of a new clinical rating scale for a standardized assessment of cirrhosis-associated neuro-psychiatric symptoms.METHODS: Forty patients with liver cirrhosis (LC, with or without low-grade hepatic encephalopathy) were invest-igated using a clinical neuro-psychiatric rating scale based on a comprehensive list of neurological, psychomotor,cognitive, affective, behavioral symptoms, and symptoms of disturbed bioregulation.RESULTS: The analysis revealed that the majority of cirrhotic patients showed, besides characteristic neurological symptoms of hepatic encephalopathy, various psychomotor,affective and bioregulatory symptoms (disturbed sleep and sexual dysfunction). Patients were impaired in the following subscales: sleep and biorhythm disorder (75.0% of patients), Parkinsonoid symptoms (25.0%), affective symptoms (17.5%), and psychomotor retardation (12.5%).The increase of total neuro-psychiatric clinical score was significantly associated with the degree of hepatic enceph-alopathy.CONCLUSION: This study suggests that a substantial number of patients with LC and low-grade hepatic encephalopathy manifest various clinical neuro-psychiatric symptoms. The use of a rating scale, which explores clinical dimensions of hepatic encephalopathy, would improve the management of patients with LC.
文摘The present study aims to investigate the effectiveness of dialectical behavior therapy in clinical symptoms, anger control and emotional regulation of bully children. This research is a pretest-posttest quasi-experimental study design with a nonequivalent control group. The research sample comprises 24 bully children who were purposefully selected from among the students who had responded positively to the researcher’s call. The participants were randomly assigned into two experimental and control groups. Group therapy intervention was conducted on the experimental group during ten sessions. The tools applied in this study consisted of Cognitive Emotion Regulation Questionnaire by Garnefski et al., State-Trait Anger Expression Inventory by Spielberger and Bullying Scale by Illinois, Espelage and Holt and the subjects answered to their questions in the stage of pretest and posttest. In this research, the data was analyzed based on the analysis of covariance test and with the aid of SPSS software. The findings demonstrated that dialectical behavior therapy has a significant impact on clinical symptoms, anger control and its components and emotional regulation and its components (P < 0.01).
基金Fund project no.:2020-SW(reserved)-52Kunming Health Commission 1000 project reserved candidates:Study on the diagnostic value of BALF solution acer sequencing and culturing in difficult and severe respiratory infections.
文摘Objective:To explore the effects of bronchoscopy alveolar lavage in the treatment of severe pneumonia caused by multiple drug bacterial infection.Methods:A total of 84 patients with severe pneumonia infected by multi-drug resistant bacteria were randomly selected from Kunming Second People's Hospital,which is our hospital from January 2019 to December 2020 for this research.They were divided into a reference group and a study group using a digital table method,with 42 cases in each group.The reference group was given the routine treatment,the research group performed bronchoscopy alveolar lavage on this basis to observe the curative effect.Results:Before treatment,there was no significant difference in serum factor indexes and blood gas analysis indexes between the two groups of patients,P>0.05.After treatment,the time of fever,cough,moist rales disappearing and infection control time in the study group were shorter than those in the reference group,P<0.05.Serum tumor necrosis factorα(TNF-α),interleukin-6(IL-6)and interleukin-8(IL-8)levels were lower than the reference group,and the arterial partial pressure of oxygen(PO2)and oxygen saturation(SO2)were both lower than the reference group,P<0.05.The effective rate of the treatment in the study group was higher than that in the reference group,P<0.05.Conclusion:Bronchoscopic alveolar lavage treatment can effectively improve the clinical symptoms of patients with severe pneumonia caused by multi-drug resistant bacterial infection,and the effects are significant.
文摘OBJECTIVE: To explore the effects of Tanshinone combined with western medicine on clinical symptoms and cardiac function in patients with acute heart failure. METHODS: The medical records of 96 patients with acute heart failure were randomly divided into 2 groups(48 cases in observation group and 48 cases in control group). The control group was treated with conventional western medicine, and the observation group was treated with Tanshinone IIA sulfonic acid natrium on the basis of western medicine. The traditional Chinese medicine(TCM) syndromes scores before and after treatment(after 28 d of treatment), clinical efficacy, and cardiac echocardiographic indexes and serum biochemical indicators before and after treatment were observed in the 2 groups. RESULTS: After treatment, the scores of TCM syndromes in the 2 groups were significantly decreased(P < 0.05), and the change in observation group was significantly greater than that in control group(P < 0.05). The total clinical effective rate in observation group was significantly higher than that in control group(91.67% vs 75.00%)(P < 0.05). After treatment, the echocardiographic indexes of left ventricular end-diastolic diameter(LVEDD) and left ventricular end-systolic diameter(LVESD) values were significantly reduced in the 2 groups while the left ventricular ejection fraction(LVEF) and stroke volume(SV) value were significantly increased, and the changes in observation group were significantly larger than those in control group(P < 0.05). After treatment, the levels of serum nuclear factor-kappaB(NF-KB), interleukin-1β(IL-1β) and N-terminal pro-brain natriuretic peptide(NT-proBNP) were significantly decreased in the 2 groups(P < 0.05), while the 6-keto-prostaglandin F1α(6-ketoPGF1α) level was significantly increased. And the changes in observation group were significantly greater than those in control group(P < 0.05). CONCLUSION: Tanshinone combined with western medicine can significantly improve the clinical symptoms of patients with acute heart failure, improve cardiac function, reduce the myocardial damage degree, and effectively reduce the risk of short-term recurrence and death, and it has exact clinical efficacy.
文摘Background: With the appearance of the SARS-CoV-2 Omicron variant the high rate of vaccination breakthroughs showed that current vaccines against COVID-19 can no longer provide adequate protection against infection. However, it is still assumed that vaccination might have a positive effect on the course of the disease. In Germany, general practitioners and specialists are usually the first treatment providers for acute illnesses. In addition, patients with infections of the upper respiratory tract often primarily consult an ear, nose and throat specialist. Most of the Omicron-infected people have a mild course of the disease and, if necessary, receive medical care on an outpatient basis. Little is known about the effectiveness of corona vaccinations on Omicron infections in relation to the clinical symptoms. In our outpatient office, we recorded a sharp increase of corona positive Omicron-infections in the beginning of 2022, despite of vaccinations against COVID-19. In a retrospective analysis, we evaluated the data of our SARS-CoV-2 tested patients with regard to clinical symptoms reported and vaccination status. The focus was particularly on the question to what extent the vaccination status in the case of Omicron infections influences the symptoms of the disease. Methods: We retrospectively evaluated the data of all patients in the first quarter of 2022 who were suspected for COVID-19. At that time, the Omicron variant was dominant in Germany. Clinical symptoms, cycle threshold (Ct) values, and the vaccination status were recorded. Symptomatic patients who tested negative for SARS-CoV-2 served as a control group. Results: Of the total cohort (n = 353), 241 (68%) patients were tested SARS-CoV-2 positive. The symptoms of the corona-positive patients were essentially similar to those of a mild to moderate cold, but compared to SARS-CoV-2-negative patients (n = 69) with a clear shift in favor of fever (35% versus 16%), cough (76% versus 52%) and increased feeling of illness (59% versus 43%), respectively. Ct values revealed no difference between unvaccinated (mean 19.15;SD 3.52) and vaccinated cases (mean 18.15;SD 3.87;p = 0.272). There was no significant correlation between the vaccination status and clinical symptom score in different age groups (age 12 to 17, r (28) = 0.26, p = 0.26;age > 18 to 60, r (191) = 0.06, p = 0.378). Conclusions: According to our results with infections with the Omicron variant, there were no differences between unvaccinated and vaccinated patients concerning clinical symptoms or potential infectivity, especially in children and adolescents. This might have impact on further vaccination programs.
