With the prevalence of cardiovascular diseases, the development of cardiac rehabilitation is an inevitable trend. Cardiac rehabilitation is a comprehensive and long-term plan including medical assessment, exercise prescription, correction of cardiovascular risk factors, education, counseling, and behavioral intervention. Evidence-based medical evidence confirms that cardiac rehabilitation plays an important role in the three level prevention of cardiovascular disease. In this paper, we searched the literature in recent 10 years to explain the current situation and future research direction of cardiac rehabilitation, and explore the best mode of cardiac rehabilitation.
Objective To investigate the characteristics of congenital retinoschisis of optical coherence tomography(OCT) and its clinical application. Methods Eight cases(15 eyes) which were diagnosed as or suspected to retinoschisis in clinic were examined by OCT,direct ophthalmoscopy and color fundus photograph.Three cases(6 eyes) were examined by electroretinogram(ERG) and fundus fluorescein angiography(FFA). Results The typical characteristic OCT images of congenital retinoschisis were cystic maculopathy with tilted and vertical connective filaments,typical split in innner retinal layers in posterior retina and thickening of neurosensory retina with the split of outer retinal layers in membranous remnants. Conclusions OCT can display the characteristics of congenital retinoschisis．It is potentially useful as a new technique for the diagnosis of congenital retinoschisis. (Chin J Ocul Fundus Dis, 1999, 15: 209-211)
目的 探讨心脏机械瓣膜置换术后患者出院指导的综合方法，评价其效果。 方法 将2010年9月－2011年1月242例心脏机械瓣膜置换术患者按入院先后顺序随机分成试验组和对照组。试验组患者采用综合出院指导方案，对照组采用常规宣教方法，在6个月后对两组患者进行调查，评价综合指导方案的效果，并进行统计学分析。 结果 试验组患者均未出现不良并发症，对照组有1例出院后未遵医嘱服药及定期复查，死于血管栓塞；有2例出现血管栓塞，2例牙龈出血，经及时治疗后好转。 结论 对心脏机械瓣膜置换术患者出院时，发放健康教育资料及定期随访指导的综合出院指导方案，可以降低术后并发症，提高患者认知水平和满意度，帮助患者提高依从性，提高生存质量。
We reported one case of MTX-induced aplastic anemia and reviewed related literature to investigate the mechanism of action of MTX, and summarize the clinical feature, diagnostic criteria, risk factor, and interventions. These were hoped to arouse the attention of clinicians and clinical pharmacists, in order to effectively prevent, diagnose, and treat MTX-induced aplastic anemia.
With the continuous development of modern laboratory medicine, the intersection of laboratory medicine and multi-disciplines such as chemistry, physics, and biology has become an inevitable trend, and received extremely extensive attention. As a new nanomaterial with great application prospect in the field of chemistry, quantum dots have brought a new idea for medical laboratory research. This paper summarizes the research status and progress of quantum dots in the diagnosis of infectious diseases, tumors and other diseases. The advantages and disadvantages of existing detection techniques based on quantum dots are discussed in order to provide theoretical thinking for the application of this nanomaterials in laboratory medicine in the future.
Objective To explore the therapeutic effect of rehabilitation therapy combined with computer-aided design and computer-aided manufacture (CAD/CAM) of orthopedic insoles on deputy scaphoid inflammation. Methods We selected the patients with deputy scaphoid inflammation who had treated in Sichuan Province Orthopedic Hospital between July 2018 and February 2020. The patients were randomly divided into control group and experimental group by drawing lots. The control group received rehabilitation therapy, while the experimental group received rehabilitation therapy combined with CAD/CAM orthopedic insoles. The clinical efficacy was tested at the 5th and 12th weeks after treatment, and the foot pain was assessed by Visual Analogue Scoring (VAS), and the foot function was assessed by the American Orthopaedic Foot and Ankle Association (AOFAS) scale. Results A total of 78 patients were included, and 3 patients dropped out. There was no significant difference in sex, age, weight or course of disease between the two groups (P>0.05). Before treatment, there was no statistically significant difference in VAS score (t=0.329, P=0.743) or AOFAS score (t=0.431, P=0.668) between the two groups. At the 5th and 12th weeks after treatment, the VAS score of the experimental group was lower than that of the control group (t=4.517, 5.299; P<0.001), and the AOFAS score was higher than that of the control group (t=6.239, 5.779; P<0.001). Over time, the VAS score of the two groups decreased (P<0.05), while the AOFAS score increased (P<0.05). Conclusion Rehabilitation therapy combined with CAD/CAM of orthopedic insoles have better curative effect than traditional rehabilitation therapy for deputy scaphoid inflammation.
目的 应用基于链式方程的填补方法处理医学研究中的数据缺失，并以填补后完全数据构建联合指标的logistic判别函数，判断其在前列腺癌的预测诊断中的应用价值。 方法 采用模拟研究，针对现实数据缺失情况模拟不同填补集结果，并以此对现实数据进行填补，以完整数据构建logistic判别，进行分析预测。 结果 填补结果随着填补次数的增加而逐渐接近真实值并趋于稳定。联合年龄、血清前列腺特异性抗原值、血流阻力指数及经直肠前列腺超声检查指标的logistic判别分析结果的灵敏度为82.39%，特异度为74.86%。 结论 联合指标分析可提高前列腺癌的诊断预测水平，以减轻患者穿刺痛苦。
Objective To explore the clinical effect of hemoperfusion (HP) in cardiopulmonary bypass (CPB) on postoperative inflammation in patients with acute type A aortic dissection (AAD). MethodsAdult patients with AAD who planned to undergo total aortic arch replacement from July 2020 to November 2021 were continuously enrolled in our heart center. Patients were randomly divided into a HP group and a control (C) group. The HP group was treated with disposable HP device (Model: HA380, Zhuhai Jafron Biomedical, China) in CPB during the operation. ResultsFinally, 70 patients were included with 59 males and 11 females at an age range of 21-67 years. There were 35 patients in both groups. In this study, 3 patients died within 3 days after surgery, 2 in the HP group and 1 in the C group, and the remaining 67 patients survived to the follow-up end point (30 days after surgery). There was no statistical difference in preoperative baseline data, operative method, CPB time, block time, or other intraoperative data between the two groups. Blood product dosage, intubation time, hospital stays, and hospitalization expenses were similar between the two groups. Intraoperative hemoglobin (82.70±2.31 g/L vs. 82.50±1.75 g/L, P=0.954] and platelet concentration [(77.87±7.99)×109/L vs. (89.17±9.99)×109/L, P=0.384] were not statistically different between the HP group and C group. In the HP group, postoperative (ICU-12 h) interleukin-6 (IL-6) [338.14 (128.00, 450.70) pg/mL vs. 435.75 (180.50, 537.00) pg/mL, P=0.373], IL-8 [35.04 (18.02, 40.35) pg/mL vs. 43.50 (17.70, 59.95) pg/mL, P=0.383], and IL-10 [21.19 (6.46, 23.50) pg/mL vs. 43.41 (6.34, 50.80) pg/mL, P=0.537] were slightly lower than those in the C group, and the difference was not statistically different. The incidences of pulmonary infection (0.00% vs. 11.76%, P=0.042) and liver injury (2.94% vs. 20.58%, P=0.027) in the HP group were significantly lower than those in the C group, and the incidence of other postoperative complications, such as arrhythmia, nervous system complications and urinary system complications, showed no statistical difference between the two groups. Conclusion HP therapy in CPB is safe, but its effect on reducing postoperative inflammatory factors, postoperative inflammatory reactions and postoperative complications in the patients with AAD is limited, and it may be of application value to some high-risk patients with lung and liver injury.
Objective To research in vitro biocompatibility of silicon containing micro-arc oxidation (MAO) coated magnesium alloy ZK60 with osteoblasts. Methods The surface microstructure of silicon containing MAO coated magnesium alloy ZK60 was observed by a scanning electron microscopy (SEM), and chemical composition of the coating surface was determined by energy dispersive spectrum analysis. The experiments were divided into 4 groups: silicon containing MAO coated magnesium alloy ZK60 group (group A), uncoated magnesium alloy ZK60 group (group B), titanium alloy group (group C), and negative control group (group D). Extracts were prepared respectively with the surface area to extraction medium ratio (1.25 cm2/ mL) according to ISO 10993-12 standard in groups A, B, and C, and were used to culture osteoblasts MC3T3-E1. The α-MEM medium supplemented with 10% fetal bovine serum was used as negative control in group D. The cell morphology was observed by inverted phase contrast microscopy. MTT assay was used to determine the cell viability. The activity of alkaline phosphatase (ALP) was detected. Cell attachment morphology on the surface of different samples was observed by SEM. The capability of protein adsorption of the coating surface was assayed, then DAPI and calcein-AM/ethidium homodimer 1 (calcein-AM/EthD-1) staining were carried out to observe cell adhesion and growth status. Results The surface characterization showed a rough and porous layer with major composition of Mg, O, and Si on the surface of silicon containing MAO coated magnesium alloy ZK60 by SEM. After cultured with the extract, cells grew well and presented good shape in all groups by inverted phase contrast microscopy, group A was even better than the other groups. At 5 days, MTT assay showed that group A presented a higher cell proliferation than the other groups (P lt; 0.05). Osteoblasts in groups A and C presented a better cell extension than group B under SEM, and group A exhibited better cell adhesion and affinity. Protein adsorption in group A [ (152.7 ± 6.3) µg/mL] was significantly higher than that of group B [(96.3 ± 3.9) µg/mL] and group C [ (96.1 ± 8.7) µg/mL] (P lt; 0.05). At each time point, the adherent cells on the sample surface of group A were significantly more than those of groups B and C (P lt; 0.05). The calcein-AM/EthD-1 staining showed that groups A and C presented better cell adhesion and growth status than group B. The ALP activities in groups A and B were 15.55 ± 0.29 and 13.75 ± 0.44 respectively, which were significantly higher than those in group C (10.43 ± 0.79) and group D (10.73 ± 0.47) (P lt; 0.05), and group A was significantly higher than group B (P lt; 0.05). Conclusion The silicon containing MAO coated magnesium alloy ZK60 has obvious promoting effects on the proliferation, adhesion, and differentiation of osteoblasts, showing a good biocompatibility, so it might be an ideal surface modification method on magnesium alloys.
Under the background of a series of national policies, various forms of medical association have been established in recent years. The purpose of the medical association is to promote the coordination and integration of medical services and the rational distribution of medical resources. However, the implementation effect varies greatly. In the process of construction, there are problems such as the unsynchronized coordination and operation between the upper and lower levels, the inadequate integration of resources, the differences and conflicts in information standards and even cultural concepts, which limit the construction effect of the medical association to a certain extent. In order to solve these problems and explore a better path for the construction of medical association, this paper summarizes and analyzes the integrated development and construction measures of “discipline+operation” of the First People’s Hospital of Ziyang under the “government-hospital cooperation”, hoping to provide experience and reference for the construction of medical association to a certain extent through the summary and analysis, thus contributing to the better development of the construction of medical association.