目的:探讨婴儿肝炎综合征临床表现、治疗及护理。方法:对我院收治的260例婴儿肝炎综合征临床表现、治疗及护理进行回顾性分析、总结。结果:70例患儿痊愈出院,175例患儿好转出院,11例患儿经保肝治疗后肝功能及一般情况逐渐变差自动出院,4例于医院因肝功能衰竭死亡。结论:婴儿肝炎综合征住院时间长,治疗及护理的配合非常重要。
ObjectiveTo investigate the association between IL-1β gene-511C/T polymorphisms and the risk of chronic obstructive pulmonary disease (COPD). MethodsSuch databases as PubMed, EMbase, CNKI, CBM, VIP and WanFang Data were searched for the studies on the association between IL-1β gene-511C/T polymorphisms and the risk of COPD up to May 2014. According to inclusion and exclusion criteria, two reviewers independently screened literature, extracted data, and assessed methodological quality of included studies. Then meta-analysis was performed using RevMan 5.0 software. ResultsA total of 10 case-control studies from 9 articles involving 1 171 cases and 1 268 controls were included. The results of meta-analysis showed that, no significant association was found between IL-1β gene-511C/T polymorphisms and the risk of COPD:TT+CT vs. CC:OR=1.06, 95%CI 0.66 to 1.70, P=0.82; TT vs. CT+CC:OR=0.87, 95%CI 0.60 to 1.26, P=0.32; TT vs. CC:OR=0.95, 95%CI 0.51 to 1.75, P=0.86; CT vs. CC:OR=1.10, 95%CI 0.71 to 1.70, P=0.15; T vs. C:OR=0.97, 95%CI=0.72 to 1.30, P=0.84. The results of subgroup analysis by ethnicity showed that, no significant association was found between IL-1β gene-511C/T polymorphisms and the risk of COPD among Caucasians and Asians. ConclusionIL-1β gene-511C/T polymorphisms might not contribute to the risk of COPD.
ObjectiveTo systematically evaluate the association between Toll like receptor 2 (TLR2) gene I/D polymorphism and the risk of cancer. MethodsWe searched PubMed, EMbase, The Cochrane Library (Issue 7, 2015), CBM, CNKI, VIP and WanFang Data to collect case-control studies about the association between TLR2 gene I/D polymorphism and the risk of cancer from inception to July 2015. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was conducted using RevMan 5.3 software. ResultsA total of 11 case-control studies involving 3 250 cancer patients and 4 332 controls were included. The results of meta-analysis showed that significant association was found between TLR2 gene I/D polymorphism and the risk of cancer (DD+DI vs. Ⅱ:OR=1.60, 95%CI 1.13 to 2.27, P=0.009; DD vs. Ⅱ+DI:OR=1.73, 95%CI 1.13 to 2.66, P=0.01; DD vs. Ⅱ:OR=1.99, 95%CI 1.22 to 3.24, P=0.006; DI vs. Ⅱ:OR=1.52, 95%CI 1.09 to 2.11, P=0.01; D vs. I:OR=1.54, 95%CI 1.14 to 2.09, P=0.005). ConclusionTLR2 gene L/D polymorphism may be associated with cancer risk. Due to the limited quantity and quality of included studies, the conclusion should be verified in further studies.
Objective To evaluate the relationship between the single nucleotide polymorphisms (SNPs) of the adiponectin gene +45 in exon 2 and type 2 diabetes mellitus (T2DM) in Chinese population via meta-analysis. Methods Databases including PubMed, Ovid, CBM, VIP, CNKI, and WanFang Data were searched from inception to June 2012, and the references of articles were also retrieved to collect case-control studies about the correlation of SNPs of the adiponectin gene +45 in exon 2 and T2DM in Chinese population. According to the self-designed inclusion and exclusion criteria, two reviewers screened articles, extracted data, and assessed the quality of the included studies independently. Then meta-analysis was performed STATA 11.0, with stability evaluated by both stratified analysis and sensitivity analysis. Moreover, Begg’s funnel plot and Egger’s method were used to assess the published bias of articles. Results 21 articles involving 22 studies were included (3272 T2DM cases and 2597 controls). There were significant differences between the two groups in dominant, recessive and addictive genetic models, and the pooled ORs (95% CI) were 1.36 (1.04, 1.78), 2.07 (1.55, 2.75), and 2.44 (1.59, 3.75), respectively. Conclusion The genetic single nucleotide polymorphisms of the adiponectin +45 in exon 2 is associated with type 2 diabetes in Chinese population. G allele of APM1 is a risk factor for type 2 diabetes, no matter in dominant, recessive or addictive genetic models.
Objective To explore the early effectiveness and influence on cartilage of local injection of multimodal drug cocktail (MDC) during anterior cruciate ligament reconstruction (ACLR). Methods Between February 2022 and August 2023, patients undergone arthroscopic ACLR using autologous hamstring tendons were selected as the study subjects. Among them, 90 patients met the selection criteria and were randomly divided into 3 groups (n=30) according to the different injection drugs after ligament reconstruction. There was no significant difference in baseline data such as gender, age, body mass index, surgical side, disease duration, preoperative thigh circumference, and preoperative levels of tumor necrosis factor α (TNF-α), interleukin 6 (IL-6), IL-1, matrix metalloproteinase 3 (MMP-3), MMP-13, and aggrecan (ACAN) in synovial fluid between groups (P>0.05). After the ligament reconstruction during operation, corresponding MDC (consisting of ropivacaine, tranexamic acid, and betamethasone in group A, and ropivacaine, betamethasone, and saline in group B) or saline (group C) were injected into the joint and tendon site, respectively. The length of hospital stay, postoperative tramadol injection volume, incidence of complications, degree of knee joint swelling and range of motion, visual analogue scale (VAS) score, International Knee Documentation Committee (IKDC) score, Lyshlom score, and Hospital for Special Surgery (HSS) score were recorded and compared between groups. The T2* values in different cartilage regions were detected by MRI examination and the levels of TNF-α, IL-6, IL-1, MMP-3, MMP-13, and ACAN in synovial fluid were detected by ELISA method. Results The patients in group A, B, and C were followed up (12.53±3.24), (13.14±2.87), and (12.82±3.32) months, respectively. All incisions healed by first intention. Compared with group C, group A and group B had shorter length of hospital stay, less tramadol injection volume, and lower incidence of complications, showing significant differences (P<0.05); there was no significant difference between group A and group B (P>0.05). The degree of knee swelling in group A was significantly less than that in group B and group C (P<0.05), but there was no significant difference between group B and group C (P>0.05). At 3, 6, 12, 24, and 48 hours after operation, VAS scores of group A and group B were significantly lower than those of group C (P<0.05); at 72 hours after operation, there was no significant difference among the three groups (P>0.05). At 3 days, 14 days, and 1 month after operation, the range of motion of knee joint in group A were significantly better than those in group C (P<0.05), and there was no significant difference between the other groups (P>0.05). At 1 month after operation, the IKDC score of group A and group B was significantly higher than that of group C (P<0.05); there was no significant difference among the three groups at other time points (P>0.05). There was no significant difference in Lyshlom score and HSS score among the three groups at each time point (P>0.05). At 14 days after operation, the levels of IL-1 and IL-6 in the synovial fluid in groups A and B were significantly lower than those in group C (P<0.05). There was no significant difference in the levels of TNF-α, MMP-3, MMP-13, and ACAN between groups A and B (P>0.05). At 1 month after operation, there was no significant difference in the above indicators among the three groups (P>0.05). At 3, 6, and 12 months after operation, there was no significant difference in the T2* values of different cartilage regions among the three groups (P>0.05). ConclusionInjecting MDC (ropivacaine, tranexamic acid, betamethasone) into the joint and tendon site during ACLR can achieve good early effectiveness without significant impact on cartilage.
Objective To compare the effectiveness of I.D.E.A.L technique and transtibial (TT) technique in anterior cruciate ligament (ACL) reconstruction. Methods A clinical data of 60 patients with ACL injury, who were admitted and met the selection criteria between January 2020 and September 2022, was retrospectively analyzed. All patients underwent arthroscopic ACL reconstruction with autologous tendon. During operation, the femoral tunnel was prepared by using I.D.E.A.L technique in 30 cases (I.D.E.A.L group) and using TT technique in 30 cases (TT group). There was no significant difference in baseline data such as age, gender, body mass index, cause of injury, injured side, interval from injury to operation, constituent ratio of combined cartilage and meniscus injury, and preoperative Lysholm score, International Knee Documentation Committee (IKDC) score, visual analogue scale (VAS) score, anterior tibial translation difference, and Blumensaat angle between the two groups (P>0.05). The length of hospital stay and the occurrence of early and late complications were recorded. During follow-up, the Lysholm score, IKDC score, and VAS score were used to evaluate knee joint function and pain degree, and the anterior tibial translation difference was measured. MRI reexamination was performed to observe the healing of the graft, and the signal to noise quotient (SNQ) values of the femoral end, middle section, and tibial end of the graft, as well as the Blumensaat angle of the knee joint were measured. The differences in tibial anterior translation difference and Blumensaat angle before and after operation (change values) were calculated and compared between the two groups. Results The incisions in both groups healed by first intention after operation, and there was no significant difference in the length of hospital stay between the two groups (P>0.05). All patients were followed up 12-18 months, with an average of 14.9 months. The Lysholm score and IKDC score of the knee joint in both groups after operation increased when compared with those before operation, and the VAS score decreased. Compared to preoperative scores, except for the VAS score of the TT group at 1 week after operation (P>0.05), there were significant differences in all scores at different time points postoperatively in the two groups (P<0.05). The above scores in both groups showed a further improvement trend with the prolongation of time after operation. There were significant differences in Lysholm score and VAS score among 1 week, 1 month, 3 months, 6 months, and 12 months after operation in the two groups (P<0.05). The IKDC score of both groups at 1 month after operation was significantly different from that at 1 week after operation (P<0.05). At 1 week after operation, the Lysholm score and IKDC score in the I.D.E.A.L group were significantly higher than those in the TT group (P<0.05), and the VAS score was significantly lower (P<0.05); there was no significant difference between the two groups at 1, 3, 6, and 12 months after operation (P>0.05). At 12 months after operation, the anterior tibial translation differences in both groups were significantly lower than those before operation (P<0.05); and the change value in the I.D.E.A.L group was significantly higher than that in the TT group (P<0.05). The incidences of early and late complications in the I.D.E.A.L group were significantly lower than those in the TT group (P<0.05). At 12 months after operation, MRI examination showed that the grafts of the knee joint in both groups survived well, and the Blumensaat angles of both groups were significantly smaller than those before operation (P<0.05). The change value of the Blumensaat angle in the I.D.E.A.L group was significantly higher than that in the TT group (P<0.05). The SNQ values of the femoral end, middle section, and tibial end of the graft in the I.D.E.A.L group were significantly higher than those in the TT group (P<0.05). Conclusion The early effectiveness of ACL reconstruction by using the I.D.E.A.L technique is better, the knee joint is more stable, and the incidence of postoperative complication is lower. However, the maturity of the graft after reconstruction using the TT technique is higher.
ObjectiveTo observe the effect of thermal damage in the fresh isolated kidneys of New Zealand white rabbits caused by domestic holmiumlaser. MethodsIn the operation room (constant temperature 22℃, humidity 60%), Guangdong electric (POTENT) domestic holmium laser equipment was chosen. The fresh isolated kidney of New Zealand white rabbit was put into a disposable sterilized syringe with 50 mL normal saline, then the holmium laser optical fiber (550 μm) was put into it, and the temperature of normal saline was measured by a mercury thermometer. The parameters of holmium laser were setted as frequency 20 Hz, energy 2 J, stimulating time 15 seconds, intermittent time 5 seconds, which was repeated. The temperature was measured 2, 5 and 7 minutes after stimulation. Then the kidney was dissected, phtographed, haematoxylin-eosin stained, and pathologically examined.ResultsAt the 2nd minute of stimulation, the temperature of normal saline in the syringe increased from 22℃ to 38℃; the cortex and medulla of rabbit kidney were ruddy, and the cortex, medulla and ureter were almost normal in pathological section. At the 5-minute point, the temperature increased to 57℃, and the cortex turned to be white, while the medulla remained ruddy, but the demarcation between the cortex and medulla was not very clear. At the 7th minute, the temperature was 78℃, and the cortex and medulla were both white and solidification with no clear demarcation. Pathological examination showed severe degeneration and necrosis of glomerulus and renal tubule.ConclusionCommon power of domestic holmium laser would produce increasing thermal damage, which may cause tissue damage in the human body when the temperature increases above 50℃.
Objective To study the differences of obstructive sleep apnea hypopnea syndrome (OSAHS)-related indexes between Uyghur and Han, and to provide evidence for the development of individualized treatment measures for different ethnic groups. Methods 224 Han OSAHS patients were collected from Guangdong Provincial Hospital of Chinese Medicine, and 178 Uygur OSAHS patients were collected from The First People’s Hospital of Kashi between January 2018 and December 2019. The collected data information included age, sex, nationality, body mass index (BMI), apnea hypopnea index (AHI), lowest oxygen saturation (LSaO2), OSAHS stage, mean corpuscular hemoglobin concentration (MCHC), triglyceride (TG), total cholesterol (TC), high density lipoprotein (HDL), low density lipoprotein (LDL), fasting blood glucose (FBG), and glycosylated hemoglobin (HbAlc). After using propensity matching scores to reduce confounding factors, differences in above indicators between different nationalities were compared. Results The mean values of MCHC, TC and HDL in Uygur OSAHS patients were lower than those in Han patients at the same stage, and the mean values of LSaO2 and LDL in mild and severe Uygur OSAHS patients were lower than those in Han patients at the same stage, with statistically significant differences (all P<0.05). There were no significant differences in AHI, TG, FBG or HbAlc between Uygur and Han patients with OSAHS. Conclusion There are significant differences in LSaO2, LDL, MCHC, TC and HDL between Uygur and Han Chinese patients with OSAHS.
ObjectiveTo summarize the early postoperative pain management strategies for anterior cruciate ligament reconstruction (ACLR), and to select a reasonable and effective pain management plan to promote functional rehabilitation after ACLR. MethodsThe literature about the early postoperative pain management strategies of ACLR both domestically and internationally in recent years was extensiverly reviewed, and the effects of improving postoperative pain were reviewed. ResultsCurrently, physical therapy and oral medication have advantages such as economy and simplicity, but the effect of improving postoperative pain is not satisfactory, often requires a combination of intravenous injection or intravenous pump, which is also a common way to relieve pain. However, in order to meet the analgesic needs of patients, the amount of analgesic drugs used is often large, which increases the incidence of various adverse reactions. Local infiltration analgesia (LIA), including periarticular or intra-articular injection of drugs, can significantly improve the early postoperative pain of ACLR, and achieve similar postoperative effectiveness as nerve block. LIA can be used as an analgesic technique instead of nerve block, and avoid the corresponding weakness of innervated muscles caused by nerve block, which increases the risk of postoperative falls. Many studies have confirmed that LIA can alleviate postoperative early pain in ACLR, especially the analgesic effects of periarticular injection are more satisfactory. It can also avoid the risk of cartilage damage caused by intra-articular injection. However, the postoperative analgesic effect and timeliness still need to be improved. It is possible to consider combining multimodal mixed drug LIA (combined with intra-articular and periarticular) with other pain intervention methods to exert a synergistic effect, in order to avoid the side effects and risks brought by single drugs or single administration route. LIA is expected to become one of the most common methods for relieving postoperative early pain in ACLR. ConclusionEarly pain after arthroscopic ACLR still affects the further functional activities of patients, and all kinds of analgesic methods can achieve certain effectiveness, but there is no unified standard at present, and the advantages and disadvantages of various analgesic methods need further research.