Objective: This study aims to evaluate the safety and efficacy of PETD combined with nerve root water imaging of MRI for the treatment of lumbar disc herniation. Methods: A retrospective review was performed on 62 pat...Objective: This study aims to evaluate the safety and efficacy of PETD combined with nerve root water imaging of MRI for the treatment of lumbar disc herniation. Methods: A retrospective review was performed on 62 patients with lumbar disc herniation from March 2019 to March 2021. The study included an experimental group of 30 patients and a control group of 32 patients. The experimental group underwent PETD combined with nerve root water imaging of MRI, while the control group received traditional PETD treatment. The visual analogue scoring method (VAS score), and JOA lumbar spine function score before and after surgery were compared between the two groups, and efficacy was assessed and compared using the MacNab score. Results: The mean operation time was significantly reduced in the experimental group (56.43 ±10.40 minutes) compared to the control group (65.69 ±14.12 minutes). The VAS score was compared between the two groups with preoperative (p = 0.624), one month after surgery (p = 0.325), three months after surgery (p = 0.676), one year after surgery (p = 0.341);The JOA score was compared between the two groups with preoperative (p = 0.961), one month after the surgery (p = 0.266), three months after surgery (p = 0.185), one year after surgery (p = 0.870), they were no significant statistical difference;The efficacy evaluation of the last follow-up Macnab showed that all the 30 patients in the experimental group were excellent, 31 of 32 patients in the control group were excellent, 1 case was good;There was no statistical difference in the comparison between the two groups (p > 0.05). Conclusion: The study concludes that the combined approach of PETD with nerve root water imaging of MRI is a safe, effective, and more efficient alternative to conventional PETD for treating lumbar disc herniation.展开更多
AIM:To investigate the effect of bicanalicular silicone tube intubation(BSTI)in the treatment of functional epiphora after endoscopic dacryocystorhinostomy(En-DCR).METHODS:Clinical data of 84 patients(95 eyes)with fun...AIM:To investigate the effect of bicanalicular silicone tube intubation(BSTI)in the treatment of functional epiphora after endoscopic dacryocystorhinostomy(En-DCR).METHODS:Clinical data of 84 patients(95 eyes)with functional epiphora after En-DCR were retrospectively analyzed.Functional epiphora was confirmed as persistent or recurrent epiphora by fluorescein dye disappearance test(FDDT),lacrimal irrigation test,as well as endoscopic examination.Secondary BSTIs were recommended for patients with functional epiphora.These tubes were removed 1mo after surgery.Functional success and associated complications were assessed after 2y of follow-up.RESULTS:Seven patients(9 eyes)refused intervention,5 patients(6 eyes)did not complete postoperative followup,and 1 patient(1 eye)developed tube prolapse within 1mo after surgery.Seventy-one patients(79 eyes)were included at last.Functional success ratios at six months,one year,as well as two years post-operation were 94.9%(75/79),92.4%(73/79),and 91.1%(72/79),respectively.Three eyes presented with punctal slitting(2 eyes without epiphora),1 eye with proximal canaliculus slitting,1 eye with canaliculus stenosis and 4 eyes with still present functional epiphora without detectable abnormal at the last follow-up.CONCLUSION:Secondary intubation is an effective procedure with low recurrence probability for functional epiphora after En-DCR.Punctal and canaliculus injury are the main tube-associated complications after secondary intubation.展开更多
BACKGROUND Postherpetic neuralgia(PHN)is a typical neuropathic pain condition that appears in the lesioned skin regions following the healing of shingles.The pain condition tends to persist,which is often accompanied ...BACKGROUND Postherpetic neuralgia(PHN)is a typical neuropathic pain condition that appears in the lesioned skin regions following the healing of shingles.The pain condition tends to persist,which is often accompanied by negative emotions(e.g.,anxiety and depression)and substantially reduces the quality of life.In addition to analgesia(e.g.,pregabalin and gabapentin),nerve radiofrequency technology is an effective treatment for intractable PHN.However,there is still a significant portion of patients who do not benefit from this treatment.As a non-invasive form of brain stimulation,repetitive transcranial magnetic stimulation(rTMS)targeting the motor cortex is able to reduce neuropathic pain with grade A evidence.CASE SUMMARY Here we report two cases in which motor cortex rTMS was used to treat intractable PHN that did not respond to initial drug and radiofrequency therapies.Moreover,we specifically investigated rTMS efficacy at 3 mo following treatment.CONCLUSION Motor cortex rTMS can treat intractable PHN that did not respond to initial drug and radiofrequency therapies.展开更多
BACKGROUND Acupuncture promotes the recovery of gastrointestinal function and provides analgesia after major abdominal surgery.The effects of transcutaneous electrical acupoint stimulation(TEAS)remain unclear.AIM To e...BACKGROUND Acupuncture promotes the recovery of gastrointestinal function and provides analgesia after major abdominal surgery.The effects of transcutaneous electrical acupoint stimulation(TEAS)remain unclear.AIM To explore the potential effects of TEAS on the recovery of gastrointestinal function after gastrectomy and colorectal resection.METHODS Patients scheduled for gastrectomy or colorectal resection were randomized at a 2:3:3:2 ratio to receive:(1)TEAS at maximum tolerable current for 30 min immediately prior to anesthesia induction and for the entire duration of surgery,plus two 30-min daily sessions for 3 consecutive days after surgery(perioperative TEAS group);(2)Preoperative and intraoperative TEAS only;(3)Preoperative and postoperative TEAS only;or(4)Sham stimulation.The primary outcome was the time from the end of surgery to the first bowel sound.RESULTS In total,441 patients were randomized;405 patients(58.4±10.2 years of age;247 males)received the planned surgery.The time to the first bowel sounds did not differ among the four groups(P=0.90;log-rank test).On postoperative day 1,the rest pain scores differed significantly among the four groups(P=0.04;Kruskal–Wallis test).Post hoc comparison using the Bonferroni test showed lower pain scores in the perioperative TEAS group(1.4±1.2)than in the sham sti-mulation group(1.7±1.1;P=0.04).Surgical complications did not differ among the four groups.CONCLUSION TEAS provided analgesic effects in adult patients undergoing major abdominal surgery,and it can be added to clinical practice as a means of accelerating postoperative rehabilitation of these patients.展开更多
BACKGROUND In addition to the non-specific symptomatology of ocular rosacea,currently,there are no reliable diagnostic tests for the disease,which may lead to its misdiagnosis.Here,we report a case of ocular rosacea p...BACKGROUND In addition to the non-specific symptomatology of ocular rosacea,currently,there are no reliable diagnostic tests for the disease,which may lead to its misdiagnosis.Here,we report a case of ocular rosacea presenting with multiple recurrent chalazion on both eyelids.CASE SUMMARY A 63-year-old female patient presented with multiple chalazion and dry eyes in both eyes,with no facial erythema.Initial management done were application of steroid eye ointment on both eyelids,hot compresses,and eyelid margin cleaning;noting that there was no relief of symptoms.Surgical excision of the chalazion was done on both eyes,however,bilateral recurrence occurred post-operatively.The pathological studies showed infiltration of a small amount of fibrous tissue with many chronic inflammatory cells.Immunohistochemistry studies were positive for LL-37.Resolution of the chalazion occurred after oral administration of doxycycline and azithromycin.CONCLUSION Our findings show that ophthalmologists should recognize the ocular manifestations of skin diseases.展开更多
Objective: This work aimed to study the safety and efficacy of preoperative intestinal stent decompression combined with laparoscopic surgery to treat left-sided colorectal cancer with obstruction (LCCO). Methods: Ret...Objective: This work aimed to study the safety and efficacy of preoperative intestinal stent decompression combined with laparoscopic surgery to treat left-sided colorectal cancer with obstruction (LCCO). Methods: Retrospective analysis was conducted on data obtained from 21 LCCO patients admitted to The First Affiliated Hospital of Zhejiang Chinese Medicine University during March 2008 and December 2011. To remove the intestinal obstruction, preoperative intestinal stent placement under colonoscopic guidance was performed. Approximately 7 to 10 days after the operation, laparoscopic radical surgery of colorectal cancer was conducted. Results: Among the 21 cases studied, laparoscopic surgery was successful in 20 patients. Emergent laparotomy was conducted in one patient because of tumor invasion in the ureter. The duration of the operation ranged from 180 to 320 min, and the average time was 220 min. The recovery time for bowel function ranged from 2 to 5 days with an average time of 3 days. Postoperative infection of the incision occurred in one case. No anastomotic leakage was observed in any of the cases. Conclusion: Preoperative intestinal stent decompression, combined with primary stage laparoscopic surgery, is a safe and effective method for the treatment of LCCO.展开更多
A protocol for the Knoevenagel condensation of aromatic aldehydes with methylene compounds catalyzed by task specifed ionic liquid 1,8-diazabicyclo[5.4.0]-undec-7-en-8-ium lactate under solvent-free conditions has bee...A protocol for the Knoevenagel condensation of aromatic aldehydes with methylene compounds catalyzed by task specifed ionic liquid 1,8-diazabicyclo[5.4.0]-undec-7-en-8-ium lactate under solvent-free conditions has been developed. The reactions proceed at ambient temperature and the work-up procedures are very simple. Good to excellent yields could be obtained. The ionic liuid could be simply prepared and recycled efficiently.展开更多
This study explores American patients’understanding of traditional Chinese medicine(TCM)in the late 19^(th) century by referring to letters from American patients recorded in The Science of Oriental Medicine,written ...This study explores American patients’understanding of traditional Chinese medicine(TCM)in the late 19^(th) century by referring to letters from American patients recorded in The Science of Oriental Medicine,written by Tan Fuyuan(谭富园),a Chinese medicine doctor working in the United States in the late Qing dynasty.Identifying a focus on significant effects,pulse diagnosis,herbal teas,dietary control,and long-term treatment,the results also discussed the differences between TCM and Western medicine in simple terms to show that the“ideological”spread of TCM was based on its curative effect.However,the“theoretical”spread of TCM requires more of intercultural exchanges.展开更多
The granular carbides formed from hot deformation in multiple alloying wear resistant cast iron were studied through the observation by means of optical microscope, SEM and TEM. The experimental results show that carb...The granular carbides formed from hot deformation in multiple alloying wear resistant cast iron were studied through the observation by means of optical microscope, SEM and TEM. The experimental results show that carbides with large size are formed from original short rhabdoid carbides existing in cast, those with small size directly nucleate in the matrix. Carbides with the size between the above are formed from precipitation induced by hot deformation. The bigger the deformation is, the larger the number of microsized granular carbides is. The mechanisms of nucleation and growth of granular carbides and the function of RE were discussed.展开更多
A series of 1,2,4-triazole derivatives were synthesized, and their abilities to inhibit the in vitro replication of Coxsackie B3/B6 were evaluated. Among the 1,2,4-triazole derivatives, compound 3 g displayed potent a...A series of 1,2,4-triazole derivatives were synthesized, and their abilities to inhibit the in vitro replication of Coxsackie B3/B6 were evaluated. Among the 1,2,4-triazole derivatives, compound 3 g displayed potent activity, with a high antiviral potency (IC50 = 1.71 μM (against CVB3), 1.43 μM (against CVB6)). The structures of all the new synthesized compounds were confirmed by 1H-NMR spectra, mass spectra and elemental analyses.展开更多
Objective: To study the correlativity between blood telomerase activity and Non-small cell lung carcinoma (NSCLC) through relative quantitative analysis of telomerase activity. Methods: Thirty-eight NSCLC and 25 inpat...Objective: To study the correlativity between blood telomerase activity and Non-small cell lung carcinoma (NSCLC) through relative quantitative analysis of telomerase activity. Methods: Thirty-eight NSCLC and 25 inpatients with benign lung disease were selected. Telomerase repeat amplification protocol was adopted. PCR products were assayed with ELISA. Results: (a) Blood telomerase activity during operation was higher than that before or after operation (P<0.01). (b) Blood telomerase activity after operation was higher in stage IIIa-IIIb than that in stage I-II (P<0.01). Blood telomerase activity before and during operation had no statistical difference between stage IIIa-IIIb and stage I-II (P>0.05). (c) Blood telomerase activity of adenocarcinoma during and after operation was higher than that before operation (P<0.01, P<0.05). Blood telomerase activity of squamous carcinoma during operation was higher than that before or after operation (P<0.01). (d) Blood telomerase activity after operation was higher in adenocarcinoma than that in squamous carcinoma (P<0.01). There was no statistical difference between that before and during operation (P>0.05). Conclusion: The qualitative assay of blood telomerase activity can be adopted as an assistant index for diagnosis of NSCLC. Postoperative blood telomerase activity of adenocarcinoma is higher than that of squamous carcinoma. It may be an evidence for the likelihood of adenocarcinoma to metastase through blood. Blood telomerase activity increases significantly during operation, suggesting that operation may cause more cancer cells entering into circulation.展开更多
Background:Currently,there are many meta-analyses on the correlation between alcohol conception and the risk of colorectal cancer,but the findings are inconsistent.We conducted a dose-response meta-analysis to investi...Background:Currently,there are many meta-analyses on the correlation between alcohol conception and the risk of colorectal cancer,but the findings are inconsistent.We conducted a dose-response meta-analysis to investigate the association between alcohol intake and the risk of colorectal cancer.Methods:A literature search was performed on PubMed and EMBASE databases to identify relevant articles published before December 09,2019.Summarized relative risks(RRs)and 95%confidence intervals(CIs)were calculated using a fixed or random-effects model for the dose-response meta-analysis.The Cochran Q and I2 statistics were used to assess statistical heterogeneity among studies.Results:Five cohort and 19 case-control studies were included in the meta-analysis.An increased intake of 15-39.9g of daily alcohol was related to a 21%growth risk of CRC(RR=1.21,95%CI:1.05-1.38).Our dose-response analysis indicated that for drinkers of light,moderate and heavy level of alcohol drinking,the estimated RRs of CRC were 0.94(95%CI:0.69-1.27),1.08(95%CI:0.93-1.26)and 1.90(95%CI:1.29-2.97)respectively and for drinkers of moderate beer,heavy beer,moderate wine and heavy wine intake,the estimated RRs of CRC were 0.98(95%CI:0.72-1.34),1.48(95%CI:1.05-2.07),0.86(95%CI:0.56-1.34)and 1.04(95%CI:0.83-1.29)respectively.The risks with no significant association were consistent in the subgroup analyses of general alcohol consumption status and frequency.Conclusions:Heavy level of alcohol consumption,especially heavy beer intake seems to be associated with an increased the risk of CRC.展开更多
Background:Missed diagnosis rate of spiral tibia shaft fracture with posterior malleolus crack fracture(PMCF)is high in the clinical.However,the mechanism and related factors of fracture are still unclear.Moreover,PMC...Background:Missed diagnosis rate of spiral tibia shaft fracture with posterior malleolus crack fracture(PMCF)is high in the clinical.However,the mechanism and related factors of fracture are still unclear.Moreover,PMCF has been observed in other types of tibial shaft fractures.Objective:To explore the correlative factors of tibial shaft fracture with ipsilateral PMCF,decrease the rate of clinical missed diagnosis,strengthen the effective fixation of PMCF,and reduce the incidence of traumatic arthritis.Methods:From September 2014 to May 2019,we collected 137 tibiofibular fracture.Only 68 cases involved in ankle joint CT examination and were retrospectively analyzed.The patients were divided into posterior malleolus group(30 cases)and non-posterior malleolus group(38 cases)according to whether come up PMCF or not.The posterior malleolus group contained 24 males and 6 females,27-77(47.57±11.79)years old,the non-posterior malleolus group contained 23 males and 15 females,18-85(48.71±13.84)years old.The gender,age,location,fibula fracture and tibial shaft fracture classification were observed for univariate and multivariate analysis.Results:The probability of PMCF was higher with right tibial shaft fracture(OR=3.6995%CI:1.13-12.08 P<0.05);the probability of PMCF following distal fibular fracture was higher than that without fibular fracture(OR=11.3695%CI:1.72-75.05 P<0.05);the probability of PMCF with type A tibial shaft fracture was higher than type C(OR=4.8295%CI:1.19-19.58 P<0.05).Conclusion:Right type A tibial shaft fracture accompanied by distal fibular fracture are very important factors related to PMCF,which needs highly attention to avoid clinical missed diagnosis.展开更多
Objective:Rising cesarean section rates have led to an increase in cesarean scar defects.However,there is no consensus regarding the gold standard for treating cesarean scar defects.This study aims to compare the effi...Objective:Rising cesarean section rates have led to an increase in cesarean scar defects.However,there is no consensus regarding the gold standard for treating cesarean scar defects.This study aims to compare the efficacy of laparoscopy combined with hysteroscopy and hysteroscopy in treating cesarean scar defects.Methods:An electronic search of the MEDLINE,EMBASE,and Clinical Trials.gov databases was conducted in May 2020,utilizing combinations of relevant medical subject headings for“cesarean scar defect”,“laparoscope”,and“hysteroscope”.Reference lists of relevant articles and reviews were hand-searched for additional reports.Observed outcomes included menstruation after surgery,blood loss,operative time,and further fertility.Results:Eight studies with 467 patients were included.The menstruation duration after surgery for the laparoscopy combined with hysteroscopy group and hysteroscopy group was comparable.While the laparoscopy combined with hysteroscopy group trended to have less blood loss(mean difference 49.60,95%CI:42.12e57.09,p<0.05)and shorter operative time(mean difference 60.40,95%CI:53.33e67.48,p<0.05)compared to hysteroscopy group.And 26 out of 51 patients were able to achieve pregnancy for those choosing the laparoscopy combined with hysteroscopy.Conclusions:Patients with cesarean scar defect should choose the appropriate technique considering their age,residual myometrial thickness,desire for further fertility,and gynecological inflammation.The current study lacked evidence to prove that laparoscopy combined with hysteroscopy is superior to hysteroscopy.展开更多
BACKGROUND Peroral endoscopic myotomy(POEM)has been demonstrated to be safe and effective in the treatment of achalasia.Longer myotomy is the standard POEM procedure for achalasia but when compared with shorter myotom...BACKGROUND Peroral endoscopic myotomy(POEM)has been demonstrated to be safe and effective in the treatment of achalasia.Longer myotomy is the standard POEM procedure for achalasia but when compared with shorter myotomy,its effectiveness is not as well known.AIM To compare the clinical effectiveness of longer and shorter myotomy.METHODS PubMed,EmBase,Cochrane Library,web of science and clinicaltrials.gov were queried for studies comparing shorter and longer POEM for achalasia treatment.The primary outcome was clinical success rate.Secondary outcomes comprised of operative time,adverse events(AEs)rate,gastroesophageal reflux disease(GERD)and procedure-related parameters.The Mantel-Haenszel fixed-effects model was primarily used for the analysis.Publication bias was assessed.RESULTS Six studies were included in this analysis with a total of 514 participants.During the follow-up period of 1-28.7 mo,longer and shorter myotomy in treating achalasia showed similar excellent effectiveness[overall clinical success(OR=1,95%CI:0.46-2.17,P=1,I2:0%;subgroup of abstract(OR=1.19,95%CI:0.38 to 3.73;P=0.76;I2:0%);subgroup of full text(OR=0.8695%CI:0.30 to 2.49;P=0.78;I2:0%)].Shorter myotomy had significantly reduced mean operative time compared with the longer procedure.There were no statistically significant differences in AEs rates,including GERD(overall OR=1.21,95%CI:0.76-1.91;P=0.42;I2:9%;subgroup of abstract OR=0.77,95%CI:0.40-1.47;P=0.43;I2:0%;subgroup of full text OR=1.91,95%CI:0.98-3.75;P=0.06;I2:0%),hospital stay(overall MD=-0.07,95%CI:-0.30 to 0.16;P=0.55;I2:24%;subgroup of abstract MD=0.20,95%CI:-0.25 to 0.65;P=0.39;I2:0;subgroup of full text MD=-0.16,95%CI:-0.42 to 0.10;P=0.23;I2:42%),and major bleeding(overall OR=1.25,95%CI:0.58-2.71;P=0.56;I2:0%)between the two procedures.These differences remained statistically non-significant in all sensitivity analyses.CONCLUSION POEM was effective in treating achalasia.Shorter and longer myotomy procedures provided similar therapeutic effects in terms of long-term effectiveness.In addition,shorter myotomy reduced the operative time.展开更多
BACKGROUND Paragangliomas are rare neuroendocrine tumors.We hereby report a case of a localized paraganglioma found in the abdominal cavity,and review the relevant literature to improve the understanding of this disea...BACKGROUND Paragangliomas are rare neuroendocrine tumors.We hereby report a case of a localized paraganglioma found in the abdominal cavity,and review the relevant literature to improve the understanding of this disease.CASE SUMMARY A 29-year-old Chinese female patient was referred to our hospital due to an abdominal mass found on physical examination.Imaging revealed a mass in the left upper abdomen,suggestive of either a benign stromal tumor or an ectopic accessory spleen.Laparoscopic radical resection was subsequently performed,and histopathological analysis confirmed the diagnosis of a paraganglioma.The patient was followed up 3 months post-operation,and reported good recovery with no metastasis.CONCLUSION Radical resection can effectively treat intra-abdominal paragangliomas,with few side effects and low recurrence risk.In addition,early and accurate diagnosis and timely intervention are essential for the prognosis of this disease.展开更多
Objective: To investigate the application and feasibility of PDCA circulation method in the treatment of patients with severe neurological diseases in Internet + smart first aid, with a view to promoting the sustainab...Objective: To investigate the application and feasibility of PDCA circulation method in the treatment of patients with severe neurological diseases in Internet + smart first aid, with a view to promoting the sustainable construction of smart first aid. Methods: A total of 105 patients with severe neurological diseases in Zhuji people’s Hospital and cooperative units were selected, and 52 cases in the research group and 53 cases in the control group were divided according to the single and double number visiting time: In this paper, through reading the literature, the development of Internet + wisdom first aid treatment of patients with severe neurological diseases was investigated, and the common problems were analyzed and summarized, and the research group used the PDCA circulation method to sort out the existing problems, analyze the causes of the problems and improve them. The difference in treatment time between the two groups was compared, and the patient’s satisfaction was evaluated for the time of being transferred to the hospital emergency room by 120 ambulances, the time from emergency admission to surgery (Cath lab), and the satisfaction of the patient. Results: The time from emergency treatment to the operation room (catheter room) in the study group was significantly shortened, and patient satisfaction was significantly improved compared with that in the control group, with a statistically significant difference (P Conclusion: Through the application of PDCA circulation method in the Internet + smart emergency treatment of neurologically severe preoperative patients, the Internet + smart emergency mode can be continuously improved, the treatment process can be significantly optimized, the first aid time can be shortened, and the treatment efficiency of neurocritical ill patients can be improved. Therefore, it has been expected to improve the success rate of treatment and improve the success rate of neurological patients.展开更多
With the development of medical level, specialized, refined and multidisciplinary collaborative therapy is the requirement and main development direction of neurosurgery. With the improvement of people’s medical awar...With the development of medical level, specialized, refined and multidisciplinary collaborative therapy is the requirement and main development direction of neurosurgery. With the improvement of people’s medical awareness, people cannot meet the simple surgical treatment, and there is a great demand for nursing treatment. At the same time, the demand for efficiency and convenience of medical nursing practice teaching continues to improve, and the multi-functional medical nursing training innovation platform has been paid more and more attention. The rapid development of material technology as well as digitalization has brought about a huge change, and we have created a multifunctional, spatially efficient and easy-to-transfer information platform for medical care training. A base box, placement drawer, platform board and display are used as the base module and the base module is filled with specific functional components. Lifting and lowering using motors and spiral base, moving using universal wheels. These devices together constitute the training platform. A survey of students and teachers was conducted through a questionnaire, and they all gave very good feedback that the multi-functional platform was very practical and useful. This platform effectively solves the drawbacks of the original training platform which is time-consuming, laborious and inconvenient, and is worthy of further promotion and research.展开更多
Background:The resurgence of seasonal influenza virus circulation has been seen in 2021-2022 after the tempo-rary suppression in 2020-2021.Neuraminidase inhibitors(NAIs)are widely applied in the clinical treatment of ...Background:The resurgence of seasonal influenza virus circulation has been seen in 2021-2022 after the tempo-rary suppression in 2020-2021.Neuraminidase inhibitors(NAIs)are widely applied in the clinical treatment of influenza A despite several limitations.Objective:To access the efficacy of Xu’s influenza decoction(XID)in combination therapy with oseltamivir for the treatment of influenza A.Methods:In this retrospective cohort study,the eligible participants were diagnosed with influenza A between June 1,2018,and May 30,2022,in the First Affiliated Hospital of Zhejiang Chinese Medical University.According to whether Xu’s influenza decoction was applied,patients were divided into two groups:treated with or without XID.Propensity score matching(PSM)was used to further adjust the covariates between groups.The primary outcome was to compare time to defervescence via K-M curves,Breslow tests,and Cox regression analysis.In Cox proportional hazards model,a univariate analysis was performed to obtain preliminary results,while a further multivariate analysis was conducted to study the independent factors that influence defervescence.Subgroup analysis was conducted according to body temperature and time from onset to admission.The secondary outcome consisted of routine blood and C-reactive protein(CRP),length of stay,and medical costs.Results:A total of 336 patients with influenza A were enrolled in this study(i.e.,163 patients in the XID+oseltamivir group;173 patients in the oseltamivir group).After 1:1 matching via PSM,230 patients meeting the criteria were included in the analysis,with 115 in each arm.The XID+oseltamivir group had shorter time to defervescence(36 h vs 44 h,P=0.011),shorter length of stay(3 days vs 4 days,P=0.018),and higher defervescence possibility(HR=1.384,95%CI:1.054-1.818).Subgroup analysis indicated that for patients during non-window period(≥48 h)with medium-grade fever(38.1℃-39℃),the XID+oseltamivir combination therapy reduced time to defervescence(P=0.04995/0.004)with a higher defervescence possibility(HR=1.524/1.683).Meanwhile,there’s no statistical significance but observable trends of the XID+oseltamivir group in the lower medical costs(3068.07 yuan vs 3120.68 yuan),the lower neutrophils%(48.53%vs 51.00%)and the higher lymphocyte%(39.83%vs 37.72%).Conclusion:The combination of XID and oseltamivir can shorten the time to defervescence and length of stay in influenza A.Its antipyretic effect is mainly reflected in the medium-grade and non-window periods.展开更多
AIM: To investigate the dynamic expression of p-signal transducer and activator of transcription 3 (STAT3) and vascular endothelial growth factor (VEGF) in the formation of gastric tumors induced by drinking water con...AIM: To investigate the dynamic expression of p-signal transducer and activator of transcription 3 (STAT3) and vascular endothelial growth factor (VEGF) in the formation of gastric tumors induced by drinking water containing N-methyl-N’-nitro-N-nitrosoguanidine (MNNG) in Wistar rats. METHODS: One hundred and twenty Wistar rats were randomly divided into two groups (60 in each group): Control group and Model group. The rats in each group were then randomly divided into three groups (20 in each group): C/M15, C/M25 and C/M40 (15, 25 and 40 represent the number of feeding weeks from termination). Rats in the control group received normal drinking water and rats in the model group received drinking water containing 100 μg/mL MNNG. Stomach tissues were collected at the end of the 15<sup>th</sup>, 25<sup>th</sup> and 40<sup>th</sup> week, respectively, for microscopic measurement using hematoxylin and eosin staining. The expression of p-STAT3 and VEGF in different pathological types of gastric tissue, including normal, inflammation, atrophy, hyperplasia and gastric stromal tumor, was observed by immunohistochemistry and Western blot, and the corelation between p-STAT3 and VEGF was analyzed. RESULTS: (1) The expression of p-STAT3 in tissue with gastritis, atrophy, dysplasia and gastric stromal tumor were significantly increased in the model group compared with the control group (2.5 ± 1.0, 2.75 ± 0.36, 6.2 ± 0.45, 5.67 ± 0.55 vs 0.75 ± 0.36, P = 0.026, 0.035, 0.001, 0.002, respectively); the expression of p-STAT3 in tissue with dysplasia was higher than that in samples with gastritis or atrophy (6.2 ± 0.45 vs 2.5 ± 1.0, P = 0.006; 6.2 ± 0.45 vs 2.75 ± 0.36, P = 0.005, respectively); however, the expression of p-STAT3 in gastritis and atrophy was not significantly different (P > 0.05); (2) the expression of VEGF in tissue with gastritis, atrophy, dysplasia and gastric stromal tumor was significantly increased in the model group compared with normal gastric mucosa; and the expression of VEGF in tissue with dysplasia was higher than that in tissue with inflammation and atrophy (10.8 ± 1.96 vs 7.62 ± 0.25, P = 0.029; 10.8 ± 1.96 vs 6.26 ± 0.76, P = 0.033, respectively); similarly, the expression of VEGF in tissue with gastritis and atrophy was not significantly different (P > 0.05); and (3) the expression of VEGF was positively correlated with p-STAT3. CONCLUSION: p-STAT3 plays an important role in gastric cancer formation by regulating the expression of VEGF to promote the progression of gastric tumor from gastritis.展开更多
文摘Objective: This study aims to evaluate the safety and efficacy of PETD combined with nerve root water imaging of MRI for the treatment of lumbar disc herniation. Methods: A retrospective review was performed on 62 patients with lumbar disc herniation from March 2019 to March 2021. The study included an experimental group of 30 patients and a control group of 32 patients. The experimental group underwent PETD combined with nerve root water imaging of MRI, while the control group received traditional PETD treatment. The visual analogue scoring method (VAS score), and JOA lumbar spine function score before and after surgery were compared between the two groups, and efficacy was assessed and compared using the MacNab score. Results: The mean operation time was significantly reduced in the experimental group (56.43 ±10.40 minutes) compared to the control group (65.69 ±14.12 minutes). The VAS score was compared between the two groups with preoperative (p = 0.624), one month after surgery (p = 0.325), three months after surgery (p = 0.676), one year after surgery (p = 0.341);The JOA score was compared between the two groups with preoperative (p = 0.961), one month after the surgery (p = 0.266), three months after surgery (p = 0.185), one year after surgery (p = 0.870), they were no significant statistical difference;The efficacy evaluation of the last follow-up Macnab showed that all the 30 patients in the experimental group were excellent, 31 of 32 patients in the control group were excellent, 1 case was good;There was no statistical difference in the comparison between the two groups (p > 0.05). Conclusion: The study concludes that the combined approach of PETD with nerve root water imaging of MRI is a safe, effective, and more efficient alternative to conventional PETD for treating lumbar disc herniation.
文摘AIM:To investigate the effect of bicanalicular silicone tube intubation(BSTI)in the treatment of functional epiphora after endoscopic dacryocystorhinostomy(En-DCR).METHODS:Clinical data of 84 patients(95 eyes)with functional epiphora after En-DCR were retrospectively analyzed.Functional epiphora was confirmed as persistent or recurrent epiphora by fluorescein dye disappearance test(FDDT),lacrimal irrigation test,as well as endoscopic examination.Secondary BSTIs were recommended for patients with functional epiphora.These tubes were removed 1mo after surgery.Functional success and associated complications were assessed after 2y of follow-up.RESULTS:Seven patients(9 eyes)refused intervention,5 patients(6 eyes)did not complete postoperative followup,and 1 patient(1 eye)developed tube prolapse within 1mo after surgery.Seventy-one patients(79 eyes)were included at last.Functional success ratios at six months,one year,as well as two years post-operation were 94.9%(75/79),92.4%(73/79),and 91.1%(72/79),respectively.Three eyes presented with punctal slitting(2 eyes without epiphora),1 eye with proximal canaliculus slitting,1 eye with canaliculus stenosis and 4 eyes with still present functional epiphora without detectable abnormal at the last follow-up.CONCLUSION:Secondary intubation is an effective procedure with low recurrence probability for functional epiphora after En-DCR.Punctal and canaliculus injury are the main tube-associated complications after secondary intubation.
文摘BACKGROUND Postherpetic neuralgia(PHN)is a typical neuropathic pain condition that appears in the lesioned skin regions following the healing of shingles.The pain condition tends to persist,which is often accompanied by negative emotions(e.g.,anxiety and depression)and substantially reduces the quality of life.In addition to analgesia(e.g.,pregabalin and gabapentin),nerve radiofrequency technology is an effective treatment for intractable PHN.However,there is still a significant portion of patients who do not benefit from this treatment.As a non-invasive form of brain stimulation,repetitive transcranial magnetic stimulation(rTMS)targeting the motor cortex is able to reduce neuropathic pain with grade A evidence.CASE SUMMARY Here we report two cases in which motor cortex rTMS was used to treat intractable PHN that did not respond to initial drug and radiofrequency therapies.Moreover,we specifically investigated rTMS efficacy at 3 mo following treatment.CONCLUSION Motor cortex rTMS can treat intractable PHN that did not respond to initial drug and radiofrequency therapies.
基金National Basic Research Program of China(Project 973)from The Ministry of Science and Technology of the People's Republic of China,No.2013CB531900。
文摘BACKGROUND Acupuncture promotes the recovery of gastrointestinal function and provides analgesia after major abdominal surgery.The effects of transcutaneous electrical acupoint stimulation(TEAS)remain unclear.AIM To explore the potential effects of TEAS on the recovery of gastrointestinal function after gastrectomy and colorectal resection.METHODS Patients scheduled for gastrectomy or colorectal resection were randomized at a 2:3:3:2 ratio to receive:(1)TEAS at maximum tolerable current for 30 min immediately prior to anesthesia induction and for the entire duration of surgery,plus two 30-min daily sessions for 3 consecutive days after surgery(perioperative TEAS group);(2)Preoperative and intraoperative TEAS only;(3)Preoperative and postoperative TEAS only;or(4)Sham stimulation.The primary outcome was the time from the end of surgery to the first bowel sound.RESULTS In total,441 patients were randomized;405 patients(58.4±10.2 years of age;247 males)received the planned surgery.The time to the first bowel sounds did not differ among the four groups(P=0.90;log-rank test).On postoperative day 1,the rest pain scores differed significantly among the four groups(P=0.04;Kruskal–Wallis test).Post hoc comparison using the Bonferroni test showed lower pain scores in the perioperative TEAS group(1.4±1.2)than in the sham sti-mulation group(1.7±1.1;P=0.04).Surgical complications did not differ among the four groups.CONCLUSION TEAS provided analgesic effects in adult patients undergoing major abdominal surgery,and it can be added to clinical practice as a means of accelerating postoperative rehabilitation of these patients.
基金Supported by National Natural Science Foundation of China,No.82104862Scientific Research Project Foundation of Zhejiang Chinese Medical University,No.2023FSYYZZ01Zhejiang Provincial Traditional Chinese Medicine Science and Technology Plan Project,No.2024ZL451.
文摘BACKGROUND In addition to the non-specific symptomatology of ocular rosacea,currently,there are no reliable diagnostic tests for the disease,which may lead to its misdiagnosis.Here,we report a case of ocular rosacea presenting with multiple recurrent chalazion on both eyelids.CASE SUMMARY A 63-year-old female patient presented with multiple chalazion and dry eyes in both eyes,with no facial erythema.Initial management done were application of steroid eye ointment on both eyelids,hot compresses,and eyelid margin cleaning;noting that there was no relief of symptoms.Surgical excision of the chalazion was done on both eyes,however,bilateral recurrence occurred post-operatively.The pathological studies showed infiltration of a small amount of fibrous tissue with many chronic inflammatory cells.Immunohistochemistry studies were positive for LL-37.Resolution of the chalazion occurred after oral administration of doxycycline and azithromycin.CONCLUSION Our findings show that ophthalmologists should recognize the ocular manifestations of skin diseases.
文摘Objective: This work aimed to study the safety and efficacy of preoperative intestinal stent decompression combined with laparoscopic surgery to treat left-sided colorectal cancer with obstruction (LCCO). Methods: Retrospective analysis was conducted on data obtained from 21 LCCO patients admitted to The First Affiliated Hospital of Zhejiang Chinese Medicine University during March 2008 and December 2011. To remove the intestinal obstruction, preoperative intestinal stent placement under colonoscopic guidance was performed. Approximately 7 to 10 days after the operation, laparoscopic radical surgery of colorectal cancer was conducted. Results: Among the 21 cases studied, laparoscopic surgery was successful in 20 patients. Emergent laparotomy was conducted in one patient because of tumor invasion in the ureter. The duration of the operation ranged from 180 to 320 min, and the average time was 220 min. The recovery time for bowel function ranged from 2 to 5 days with an average time of 3 days. Postoperative infection of the incision occurred in one case. No anastomotic leakage was observed in any of the cases. Conclusion: Preoperative intestinal stent decompression, combined with primary stage laparoscopic surgery, is a safe and effective method for the treatment of LCCO.
基金Supported by the National Natural Science Foundation of China(No.20776127)the National Key Technology Research and Development Program of China(No.2007BAI34B07)
文摘A protocol for the Knoevenagel condensation of aromatic aldehydes with methylene compounds catalyzed by task specifed ionic liquid 1,8-diazabicyclo[5.4.0]-undec-7-en-8-ium lactate under solvent-free conditions has been developed. The reactions proceed at ambient temperature and the work-up procedures are very simple. Good to excellent yields could be obtained. The ionic liuid could be simply prepared and recycled efficiently.
基金This study was financially supported by the Key Programme of National Social Science Fund of China(NO.18ZDA175).
文摘This study explores American patients’understanding of traditional Chinese medicine(TCM)in the late 19^(th) century by referring to letters from American patients recorded in The Science of Oriental Medicine,written by Tan Fuyuan(谭富园),a Chinese medicine doctor working in the United States in the late Qing dynasty.Identifying a focus on significant effects,pulse diagnosis,herbal teas,dietary control,and long-term treatment,the results also discussed the differences between TCM and Western medicine in simple terms to show that the“ideological”spread of TCM was based on its curative effect.However,the“theoretical”spread of TCM requires more of intercultural exchanges.
文摘The granular carbides formed from hot deformation in multiple alloying wear resistant cast iron were studied through the observation by means of optical microscope, SEM and TEM. The experimental results show that carbides with large size are formed from original short rhabdoid carbides existing in cast, those with small size directly nucleate in the matrix. Carbides with the size between the above are formed from precipitation induced by hot deformation. The bigger the deformation is, the larger the number of microsized granular carbides is. The mechanisms of nucleation and growth of granular carbides and the function of RE were discussed.
文摘A series of 1,2,4-triazole derivatives were synthesized, and their abilities to inhibit the in vitro replication of Coxsackie B3/B6 were evaluated. Among the 1,2,4-triazole derivatives, compound 3 g displayed potent activity, with a high antiviral potency (IC50 = 1.71 μM (against CVB3), 1.43 μM (against CVB6)). The structures of all the new synthesized compounds were confirmed by 1H-NMR spectra, mass spectra and elemental analyses.
基金This work was supported by ZhejiangProvincial Natural Science Foundation (No. M303778).
文摘Objective: To study the correlativity between blood telomerase activity and Non-small cell lung carcinoma (NSCLC) through relative quantitative analysis of telomerase activity. Methods: Thirty-eight NSCLC and 25 inpatients with benign lung disease were selected. Telomerase repeat amplification protocol was adopted. PCR products were assayed with ELISA. Results: (a) Blood telomerase activity during operation was higher than that before or after operation (P<0.01). (b) Blood telomerase activity after operation was higher in stage IIIa-IIIb than that in stage I-II (P<0.01). Blood telomerase activity before and during operation had no statistical difference between stage IIIa-IIIb and stage I-II (P>0.05). (c) Blood telomerase activity of adenocarcinoma during and after operation was higher than that before operation (P<0.01, P<0.05). Blood telomerase activity of squamous carcinoma during operation was higher than that before or after operation (P<0.01). (d) Blood telomerase activity after operation was higher in adenocarcinoma than that in squamous carcinoma (P<0.01). There was no statistical difference between that before and during operation (P>0.05). Conclusion: The qualitative assay of blood telomerase activity can be adopted as an assistant index for diagnosis of NSCLC. Postoperative blood telomerase activity of adenocarcinoma is higher than that of squamous carcinoma. It may be an evidence for the likelihood of adenocarcinoma to metastase through blood. Blood telomerase activity increases significantly during operation, suggesting that operation may cause more cancer cells entering into circulation.
基金supported by the National Natural Science Foundation of China(Grant No:81973805)Zhejiang Provincial Project for the Key Discipline of Traditional Chinese Medicine(Yong GUO,Grant No.2017-XK-A09,http://www.zjwjw.gov.cn/)+1 种基金Zhejiang Provincial TCM Science and Technology Project(Grant No:2015ZA088)Project of Academic Experiences Inheritance from the Famous Traditional Chinese Medicine Doctor of Zhejiang Province,Yong Guo and Construction of Specialized Subject(Grant No.2A11543).
文摘Background:Currently,there are many meta-analyses on the correlation between alcohol conception and the risk of colorectal cancer,but the findings are inconsistent.We conducted a dose-response meta-analysis to investigate the association between alcohol intake and the risk of colorectal cancer.Methods:A literature search was performed on PubMed and EMBASE databases to identify relevant articles published before December 09,2019.Summarized relative risks(RRs)and 95%confidence intervals(CIs)were calculated using a fixed or random-effects model for the dose-response meta-analysis.The Cochran Q and I2 statistics were used to assess statistical heterogeneity among studies.Results:Five cohort and 19 case-control studies were included in the meta-analysis.An increased intake of 15-39.9g of daily alcohol was related to a 21%growth risk of CRC(RR=1.21,95%CI:1.05-1.38).Our dose-response analysis indicated that for drinkers of light,moderate and heavy level of alcohol drinking,the estimated RRs of CRC were 0.94(95%CI:0.69-1.27),1.08(95%CI:0.93-1.26)and 1.90(95%CI:1.29-2.97)respectively and for drinkers of moderate beer,heavy beer,moderate wine and heavy wine intake,the estimated RRs of CRC were 0.98(95%CI:0.72-1.34),1.48(95%CI:1.05-2.07),0.86(95%CI:0.56-1.34)and 1.04(95%CI:0.83-1.29)respectively.The risks with no significant association were consistent in the subgroup analyses of general alcohol consumption status and frequency.Conclusions:Heavy level of alcohol consumption,especially heavy beer intake seems to be associated with an increased the risk of CRC.
基金13th five-year plan Key specialty of Zhejiang Provincial Administration of Chinese medicine。
文摘Background:Missed diagnosis rate of spiral tibia shaft fracture with posterior malleolus crack fracture(PMCF)is high in the clinical.However,the mechanism and related factors of fracture are still unclear.Moreover,PMCF has been observed in other types of tibial shaft fractures.Objective:To explore the correlative factors of tibial shaft fracture with ipsilateral PMCF,decrease the rate of clinical missed diagnosis,strengthen the effective fixation of PMCF,and reduce the incidence of traumatic arthritis.Methods:From September 2014 to May 2019,we collected 137 tibiofibular fracture.Only 68 cases involved in ankle joint CT examination and were retrospectively analyzed.The patients were divided into posterior malleolus group(30 cases)and non-posterior malleolus group(38 cases)according to whether come up PMCF or not.The posterior malleolus group contained 24 males and 6 females,27-77(47.57±11.79)years old,the non-posterior malleolus group contained 23 males and 15 females,18-85(48.71±13.84)years old.The gender,age,location,fibula fracture and tibial shaft fracture classification were observed for univariate and multivariate analysis.Results:The probability of PMCF was higher with right tibial shaft fracture(OR=3.6995%CI:1.13-12.08 P<0.05);the probability of PMCF following distal fibular fracture was higher than that without fibular fracture(OR=11.3695%CI:1.72-75.05 P<0.05);the probability of PMCF with type A tibial shaft fracture was higher than type C(OR=4.8295%CI:1.19-19.58 P<0.05).Conclusion:Right type A tibial shaft fracture accompanied by distal fibular fracture are very important factors related to PMCF,which needs highly attention to avoid clinical missed diagnosis.
文摘Objective:Rising cesarean section rates have led to an increase in cesarean scar defects.However,there is no consensus regarding the gold standard for treating cesarean scar defects.This study aims to compare the efficacy of laparoscopy combined with hysteroscopy and hysteroscopy in treating cesarean scar defects.Methods:An electronic search of the MEDLINE,EMBASE,and Clinical Trials.gov databases was conducted in May 2020,utilizing combinations of relevant medical subject headings for“cesarean scar defect”,“laparoscope”,and“hysteroscope”.Reference lists of relevant articles and reviews were hand-searched for additional reports.Observed outcomes included menstruation after surgery,blood loss,operative time,and further fertility.Results:Eight studies with 467 patients were included.The menstruation duration after surgery for the laparoscopy combined with hysteroscopy group and hysteroscopy group was comparable.While the laparoscopy combined with hysteroscopy group trended to have less blood loss(mean difference 49.60,95%CI:42.12e57.09,p<0.05)and shorter operative time(mean difference 60.40,95%CI:53.33e67.48,p<0.05)compared to hysteroscopy group.And 26 out of 51 patients were able to achieve pregnancy for those choosing the laparoscopy combined with hysteroscopy.Conclusions:Patients with cesarean scar defect should choose the appropriate technique considering their age,residual myometrial thickness,desire for further fertility,and gynecological inflammation.The current study lacked evidence to prove that laparoscopy combined with hysteroscopy is superior to hysteroscopy.
基金Supported by the National Natural Science Foundation of China,No. 8177030774
文摘BACKGROUND Peroral endoscopic myotomy(POEM)has been demonstrated to be safe and effective in the treatment of achalasia.Longer myotomy is the standard POEM procedure for achalasia but when compared with shorter myotomy,its effectiveness is not as well known.AIM To compare the clinical effectiveness of longer and shorter myotomy.METHODS PubMed,EmBase,Cochrane Library,web of science and clinicaltrials.gov were queried for studies comparing shorter and longer POEM for achalasia treatment.The primary outcome was clinical success rate.Secondary outcomes comprised of operative time,adverse events(AEs)rate,gastroesophageal reflux disease(GERD)and procedure-related parameters.The Mantel-Haenszel fixed-effects model was primarily used for the analysis.Publication bias was assessed.RESULTS Six studies were included in this analysis with a total of 514 participants.During the follow-up period of 1-28.7 mo,longer and shorter myotomy in treating achalasia showed similar excellent effectiveness[overall clinical success(OR=1,95%CI:0.46-2.17,P=1,I2:0%;subgroup of abstract(OR=1.19,95%CI:0.38 to 3.73;P=0.76;I2:0%);subgroup of full text(OR=0.8695%CI:0.30 to 2.49;P=0.78;I2:0%)].Shorter myotomy had significantly reduced mean operative time compared with the longer procedure.There were no statistically significant differences in AEs rates,including GERD(overall OR=1.21,95%CI:0.76-1.91;P=0.42;I2:9%;subgroup of abstract OR=0.77,95%CI:0.40-1.47;P=0.43;I2:0%;subgroup of full text OR=1.91,95%CI:0.98-3.75;P=0.06;I2:0%),hospital stay(overall MD=-0.07,95%CI:-0.30 to 0.16;P=0.55;I2:24%;subgroup of abstract MD=0.20,95%CI:-0.25 to 0.65;P=0.39;I2:0;subgroup of full text MD=-0.16,95%CI:-0.42 to 0.10;P=0.23;I2:42%),and major bleeding(overall OR=1.25,95%CI:0.58-2.71;P=0.56;I2:0%)between the two procedures.These differences remained statistically non-significant in all sensitivity analyses.CONCLUSION POEM was effective in treating achalasia.Shorter and longer myotomy procedures provided similar therapeutic effects in terms of long-term effectiveness.In addition,shorter myotomy reduced the operative time.
基金Supported by Jiaxing Science and Technology Planning Project,No.2020AY30017.
文摘BACKGROUND Paragangliomas are rare neuroendocrine tumors.We hereby report a case of a localized paraganglioma found in the abdominal cavity,and review the relevant literature to improve the understanding of this disease.CASE SUMMARY A 29-year-old Chinese female patient was referred to our hospital due to an abdominal mass found on physical examination.Imaging revealed a mass in the left upper abdomen,suggestive of either a benign stromal tumor or an ectopic accessory spleen.Laparoscopic radical resection was subsequently performed,and histopathological analysis confirmed the diagnosis of a paraganglioma.The patient was followed up 3 months post-operation,and reported good recovery with no metastasis.CONCLUSION Radical resection can effectively treat intra-abdominal paragangliomas,with few side effects and low recurrence risk.In addition,early and accurate diagnosis and timely intervention are essential for the prognosis of this disease.
文摘Objective: To investigate the application and feasibility of PDCA circulation method in the treatment of patients with severe neurological diseases in Internet + smart first aid, with a view to promoting the sustainable construction of smart first aid. Methods: A total of 105 patients with severe neurological diseases in Zhuji people’s Hospital and cooperative units were selected, and 52 cases in the research group and 53 cases in the control group were divided according to the single and double number visiting time: In this paper, through reading the literature, the development of Internet + wisdom first aid treatment of patients with severe neurological diseases was investigated, and the common problems were analyzed and summarized, and the research group used the PDCA circulation method to sort out the existing problems, analyze the causes of the problems and improve them. The difference in treatment time between the two groups was compared, and the patient’s satisfaction was evaluated for the time of being transferred to the hospital emergency room by 120 ambulances, the time from emergency admission to surgery (Cath lab), and the satisfaction of the patient. Results: The time from emergency treatment to the operation room (catheter room) in the study group was significantly shortened, and patient satisfaction was significantly improved compared with that in the control group, with a statistically significant difference (P Conclusion: Through the application of PDCA circulation method in the Internet + smart emergency treatment of neurologically severe preoperative patients, the Internet + smart emergency mode can be continuously improved, the treatment process can be significantly optimized, the first aid time can be shortened, and the treatment efficiency of neurocritical ill patients can be improved. Therefore, it has been expected to improve the success rate of treatment and improve the success rate of neurological patients.
文摘With the development of medical level, specialized, refined and multidisciplinary collaborative therapy is the requirement and main development direction of neurosurgery. With the improvement of people’s medical awareness, people cannot meet the simple surgical treatment, and there is a great demand for nursing treatment. At the same time, the demand for efficiency and convenience of medical nursing practice teaching continues to improve, and the multi-functional medical nursing training innovation platform has been paid more and more attention. The rapid development of material technology as well as digitalization has brought about a huge change, and we have created a multifunctional, spatially efficient and easy-to-transfer information platform for medical care training. A base box, placement drawer, platform board and display are used as the base module and the base module is filled with specific functional components. Lifting and lowering using motors and spiral base, moving using universal wheels. These devices together constitute the training platform. A survey of students and teachers was conducted through a questionnaire, and they all gave very good feedback that the multi-functional platform was very practical and useful. This platform effectively solves the drawbacks of the original training platform which is time-consuming, laborious and inconvenient, and is worthy of further promotion and research.
基金This work was financially supported by the General Project of Zhe-jiang Provincial Department of Education[Number:Y202248699]the Science and Technology Project of Zhejiang Provincial Administra-tion of Traditional Chinese Medicine[Number:2023ZL049].
文摘Background:The resurgence of seasonal influenza virus circulation has been seen in 2021-2022 after the tempo-rary suppression in 2020-2021.Neuraminidase inhibitors(NAIs)are widely applied in the clinical treatment of influenza A despite several limitations.Objective:To access the efficacy of Xu’s influenza decoction(XID)in combination therapy with oseltamivir for the treatment of influenza A.Methods:In this retrospective cohort study,the eligible participants were diagnosed with influenza A between June 1,2018,and May 30,2022,in the First Affiliated Hospital of Zhejiang Chinese Medical University.According to whether Xu’s influenza decoction was applied,patients were divided into two groups:treated with or without XID.Propensity score matching(PSM)was used to further adjust the covariates between groups.The primary outcome was to compare time to defervescence via K-M curves,Breslow tests,and Cox regression analysis.In Cox proportional hazards model,a univariate analysis was performed to obtain preliminary results,while a further multivariate analysis was conducted to study the independent factors that influence defervescence.Subgroup analysis was conducted according to body temperature and time from onset to admission.The secondary outcome consisted of routine blood and C-reactive protein(CRP),length of stay,and medical costs.Results:A total of 336 patients with influenza A were enrolled in this study(i.e.,163 patients in the XID+oseltamivir group;173 patients in the oseltamivir group).After 1:1 matching via PSM,230 patients meeting the criteria were included in the analysis,with 115 in each arm.The XID+oseltamivir group had shorter time to defervescence(36 h vs 44 h,P=0.011),shorter length of stay(3 days vs 4 days,P=0.018),and higher defervescence possibility(HR=1.384,95%CI:1.054-1.818).Subgroup analysis indicated that for patients during non-window period(≥48 h)with medium-grade fever(38.1℃-39℃),the XID+oseltamivir combination therapy reduced time to defervescence(P=0.04995/0.004)with a higher defervescence possibility(HR=1.524/1.683).Meanwhile,there’s no statistical significance but observable trends of the XID+oseltamivir group in the lower medical costs(3068.07 yuan vs 3120.68 yuan),the lower neutrophils%(48.53%vs 51.00%)and the higher lymphocyte%(39.83%vs 37.72%).Conclusion:The combination of XID and oseltamivir can shorten the time to defervescence and length of stay in influenza A.Its antipyretic effect is mainly reflected in the medium-grade and non-window periods.
文摘AIM: To investigate the dynamic expression of p-signal transducer and activator of transcription 3 (STAT3) and vascular endothelial growth factor (VEGF) in the formation of gastric tumors induced by drinking water containing N-methyl-N’-nitro-N-nitrosoguanidine (MNNG) in Wistar rats. METHODS: One hundred and twenty Wistar rats were randomly divided into two groups (60 in each group): Control group and Model group. The rats in each group were then randomly divided into three groups (20 in each group): C/M15, C/M25 and C/M40 (15, 25 and 40 represent the number of feeding weeks from termination). Rats in the control group received normal drinking water and rats in the model group received drinking water containing 100 μg/mL MNNG. Stomach tissues were collected at the end of the 15<sup>th</sup>, 25<sup>th</sup> and 40<sup>th</sup> week, respectively, for microscopic measurement using hematoxylin and eosin staining. The expression of p-STAT3 and VEGF in different pathological types of gastric tissue, including normal, inflammation, atrophy, hyperplasia and gastric stromal tumor, was observed by immunohistochemistry and Western blot, and the corelation between p-STAT3 and VEGF was analyzed. RESULTS: (1) The expression of p-STAT3 in tissue with gastritis, atrophy, dysplasia and gastric stromal tumor were significantly increased in the model group compared with the control group (2.5 ± 1.0, 2.75 ± 0.36, 6.2 ± 0.45, 5.67 ± 0.55 vs 0.75 ± 0.36, P = 0.026, 0.035, 0.001, 0.002, respectively); the expression of p-STAT3 in tissue with dysplasia was higher than that in samples with gastritis or atrophy (6.2 ± 0.45 vs 2.5 ± 1.0, P = 0.006; 6.2 ± 0.45 vs 2.75 ± 0.36, P = 0.005, respectively); however, the expression of p-STAT3 in gastritis and atrophy was not significantly different (P > 0.05); (2) the expression of VEGF in tissue with gastritis, atrophy, dysplasia and gastric stromal tumor was significantly increased in the model group compared with normal gastric mucosa; and the expression of VEGF in tissue with dysplasia was higher than that in tissue with inflammation and atrophy (10.8 ± 1.96 vs 7.62 ± 0.25, P = 0.029; 10.8 ± 1.96 vs 6.26 ± 0.76, P = 0.033, respectively); similarly, the expression of VEGF in tissue with gastritis and atrophy was not significantly different (P > 0.05); and (3) the expression of VEGF was positively correlated with p-STAT3. CONCLUSION: p-STAT3 plays an important role in gastric cancer formation by regulating the expression of VEGF to promote the progression of gastric tumor from gastritis.