目的 探讨新生儿Pierre-Robin综合征的护理经验和方法。 方法 回顾分析2005年2月－2011年7月收治的9例Pierre-Robin综合征新生儿的临床资料。 结果 2例好转出院，7例治疗4～17 d后均有所好转，但因家庭原因自动放弃出院。 结论 对Pierre-Robin综合征的患儿保持合适体位、加强呼吸道管理、合理喂养、预防感染是护理的关键。
ObjectiveTo systematically review the comprehensive evaluation methods applied to estimate the medical service performance based on diagnosis-related groups (DRGs) in China and to provide suggestions for the promotion of methods in further studies.MethodsLiterature published before May 2019 were searched in China National Knowledge Infrastructure, WanFang Data, CQVIP and PubMed for studies about DRGs-based comprehensive evaluation. After literature screening and information extracting by two reviewers independently, qualitative approaches were used to describe the application of DRGs-based comprehensive evaluation methods in the performance evaluation of medical services.ResultsA total of 24 articles were included in the systematic review. Different indexes were used to evaluate the medical service performance. Delphi Method, expert discussion, Saaty’s Method and some other means were applied to determine the weights of indexes in 8 articles. Rank-sum ratio method, Technique for Order Preference by Similarity to an Ideal Solution and synthetic index method were proposed for the comprehensive evaluation in 9, 7 and 9 articles, respectively; besides, analytic hierarchy process and combination evaluation were also used.ConclusionsBased on DRGs, the choose of indicators, weighting approaches, and calculation methods of comprehensive values vary richly in different studies. More attention should be paid to weight using and combination of comprehensive evaluation methods in further studies. Meanwhile, the quality of information source used for estimation and the rationality of results application are supposed to be emphasized.
Objective To explore effects of edaravone on apoptosis and expressions of apoptotic proteins Smac and XIAP in hippocampal CA1 pyramidal cell of rats under intermittent hypoxia. Methods A total of 96 adult male Wistar rats were randomly divided into control group, 5% intermittent hypoxic group and edaravone group, and each group was divided into 4 time groups at 7 d, 14 d, 21 d and 28 d, respectively, with 8 rats in each subgroup. The content of reactive oxygen species (ROS) in hippocampal tissues of the experimental rats was detected by the reactive oxygen species detection kit. Immunohistochemistry and Western blot were used to detect the expressions of Smac and XIAP protein in hippocampal CA1 region. The Tunel method detected the apoptosis of neurons. Results Compared with the control group, the content of ROS, the expressions of Smac and XIAP proteins and the neuronal apoptosis index in the hippocampus were increased in the 5% intermittent hypoxia group and the edaravone group at each time point (all P<0.05). The content of ROS, the Smac protein expression and the neuronal apoptosis index in the edaravone group were significantly lower than those in the 5% intermittent hypoxia group (all P<0.05). The expression of XIAP protein in the edaravone group was significantly higher than that in the 5% intermittent hypoxia group (P<0.05). Conclusion Edaravone may improve the antioxidant capacity of the body by scavenging oxygen free radicals and regulate Smac and XIAP- mediated apoptosis, thus playing a protective role on neurons.
Objective To explore the effect of total glucosides of Cistanche deserticola on oxidative stress and cognitive function in rats with intermittent hypoxia. Methods Adult male Wistar rats (n=72) were randomly divided into three groups: a blank control group, a 5% intermittent hypoxia group (IH group) and a total glucosides of Cistanche deserticola intervention group (TGs intervention group). The 5% intermittent hypoxia rat model was simulated by using the self-made cabin of intermittent hypoxia. The rats in the IH group and the TGs intervention group were given 5% intermittent hypoxia respectively, and the rats in the TGs intervention group were treated with total glucosides of Cistanche deserticola simultaneously. Learning and memory function was tested by Morris water maze in three groups at the 2nd, 4th, 6th and 8th week respectively. The expressions of superoxide dismutase (SOD) and malondialdehyde (MDA) in hippocampus were detected by test kit. Results Compared with the blank control group, the escape latency time of the rats in the IH group and the TGs intervention group was significantly prolonged at the 2nd, 4th, 6th and 8th week respectively (P<0.05). The time to cross the target quadrant in the IH group and the TGs intervention group was gradually shortened at the 2nd, 4th, 6th and 8th week respectively (P<0.05). Compared with the IH group, the escape latency gradually shortened at the 2nd, 4th, 6th and 8th week in the TGs intervention group (P<0.05), while the time to cross the target quadrant was gradually prolonged at the 2nd, 4th, 6th and 8th week (P<0.05). The expressions of MDA in hippocampal tissue in the IH group and the TGs intervention group increased at the 2nd, 4th, 6th and 8th week (P<0.05), which were significantly higher than those in the blank control group; and the expressions of SOD at the 2nd, 4th, 6th, and 8th week were all lower than those in the blank control group(P<0.05). Compared with the IH group, the expression of MDA protein in hippocampal tissue in the TGs intervention group decreased at the 2nd, 4th, 6th and 8th week, while the expression of SOD protein at the 2nd, 4th, 6th and 8th week increased, and the differences were statistically significant (P<0.05). Conclusion The total glycosides of Cistanche deserticola can improve the learning and memory function of intermittent hypoxia rats by inhibiting oxidative stress.
Objective To explore the effectiveness of the combined anteversion angle technique in total hip arthroplasty (THA) for treating ankylosing spondylitis (AS) affecting the hip joint. Methods A retrospective analysis was conducted on the clinical data of 73 patients with AS affecting the hip joint who underwent THA between August 2018 and August 2021. According to whether the combined anteversion angle technique was used in THA, the patients were divided into study group (37 cases, combined anteversion angle technique was used in THA) and control group (36 cases, traditional THA). There was no significant difference in baseline data such as gender, age, body mass index, disease duration, preoperative Harris score, range of motion (ROM), acetabular anteversion angle, acetabular abduction angle, femoral anteversion angle, and combined anteversion angle between the two groups (P>0.05). The operation time, hospital stay, and complications of the two groups were recorded and compared. The Harris score and hip ROM were compared between the two groups before operation, at 1, 3, 6, 12 months after operation, and at last follow-up. The acetabular component anteversion angle, femoral component anteversion angle, acetabular component abduction angle, and component combined anteversion angle were measured postoperatively. ResultsThe operation time in the study group was significantly shorter than that in the control group (P<0.05), and there was no significant difference in hospital stay between the two groups (P>0.05). There was no intraoperative complication such as acetabular and proximal femoral fractures, neurovascular injuries in both groups, and the incisions healed by first intention. All patients were followed up 2-3 years, with an average of 2.4 years; there was no significant difference in the follow-up time between the two groups (P>0.05). During the follow-up period, there was no complication such as hip dislocation, wound infection, delayed wound healing, deep venous thrombosis, and hip dislocation in both groups. The hip Harris score and ROM of the two groups gradually increased with time after operation, and the differences were significant when compared with those before operation (P<0.05); the above two indicators of the study group were significantly better than those of the control group at each time point after operation (P<0.05). Extensive bone ingrowth on the surface of the components could be observed in the anteroposterior X-ray films of the hip joint of the two groups at 12 months after operation, and the acetabular components was stable without femoral stem subsidence, osteolysis around the components, and heterotopic ossification. At last follow-up, the acetabular component anteversion angle, femoral component anteversion angle, and component combined anteversion angle in the study group were significantly superior to those in the control group (P<0.05), except that there was no significant difference in the acetabular component abduction angle between the two groups (P>0.05). Conclusion For patients with AS affecting the hip joint, the use of the combined anteversion angle technique during THA effectively promotes the recovery of hip joint function and enhances the postoperative quality of life of patients when compared to traditional THA.
Objective To investigate the effectiveness of arthroscopic suspension fixation with Endobutton in the treatment of tibial insertion avulsion fractures of posterior cruciate ligament (PCL). Methods A retrospective analysis was conducted on the clinical data of 52 patients (52 knees) with tibial insertion avulsion fractures of PCL, who were treated by arthroscopic suspension fixation with Endobutton between June 2017 and October 2022. There were 29 males and 23 females, with an average age of 40.6 years (range, 19-66 years). There were 24 cases of traffic accident injuries, 17 cases of sports injuries, and 11 cases of fall injuries. The time from injury to operation ranged from 6 to 19 days (mean, 13.3 days). According to the Meyers-McKeever classification, there were 30 cases of type Ⅱ and 22 cases of type Ⅲ fractures. All patients exhibited positive posterior drawer test results. Preoperative knee joint function was assessed with Lysholm score (21.3±6.7), International Knee Documentation Committee (IKDC) score (20.7±5.8), and visual analogue scale (VAS) score (5.3±0.7); and knee joint range of motion was (41.73±3.17)°. Based on preoperative CT three-dimensional reconstruction measurements, the longitudinal diameter of the avulsed bone fragment ranged from 13 to 25 mm (mean, 18.1 mm). Operation time and occurrence of complications were recorded, and postoperative imaging was used to assess fracture healing. Knee joint function and pain severity were evaluated using knee joint range of motion, Lysholm score, IKDC score, and VAS score. Results The operation time ranged from 46 to 81 minutes (mean, 56.2 minutes). All patients were followed up 12-28 months (mean, 20.1 months). The iatrogenic fractures of bone fragments occurred during operation in 4 cases; and knee effusion occurred in 2 cases and anterior knee pain in 1 case after operation. All incisions healed by first intention. Imaging evaluations at 3 months after operation showed the fracture healing and no internal fixation failure. All patients demonstrated good knee function and had returned to normal activities at 12 months after operation. At last follow-up, the knee joint range of motion was (133.44±4.17)°, Lysholm score 93.6±3.1, IKDC score 93.4±2.5, and VAS score 1.0±0.6, with significant differences compared to preoperative scores (P<0.05). Conclusion Arthroscopic suspension fixation with Endobutton in the treatment of tibial insertion avulsion fractures of PCL is simple to operate, and the knee joint function recovers well.
ObjectiveTo investigate the correlation and clinical significance of 8-hydroxydeoxyguanosine (8-OHdG) and endothelin-1 (ET-1) levels with cognitive dysfunction in patients with chronic obstructive pulmonary disease (COPD), and provide new idea for the prevention and treatment for cognitive dysfunction in COPD patients.MethodsA total of 103 COPD patients, according to the Montreal cognitive assessment scale standard for evaluation, were divided into a cognitive dysfunction group and a cognitive normal group. Serum 8-OHdG and ET-1 levels were compared between the two groups and their correlations with cognitive function were analyzed with the receiver operating characteristic (ROC) curve.ResultsThe levels of serum 8-OHdG and ET-1 in the COPD patients with cognitive impairment were significantly higher than those in the cognitive normal group ［8-OHdG: (13.91±9.04) ng/ml vs. (7.28±3.00) ng/ml; ET-1: (95.64±57.66)pg/ml vs. (69.20±7.89)pg/ml］ (both P<0.05). The levels of 8-OHdG (OR=22.94, 95%CI 7.06-74.53) and ET-1 (OR=19.76, 95%CI 6.59-59.31) were associated with cognitive impairment in the COPD patients. The areas under ROC curve of serum 8-OHdG and ET-1 levels to predict cognitive dysfunction in the COPD patients were 0.786 (95%CI 0.691-0.881) and 0.790(95%CI 0.695-0.885).ConclusionsThe serum levels of 8-OHdG and ET-1 are associated with cognitive impairment in COPD patients. The levels of 8-OHdG and ET-1 in serum can predict cognitive impairment with high specificity.
ObjectiveTo investigate the effects and clinical significance of edaravone on serum tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6) and intercellular adhesion molecule-1 (ICAM-1) in elderly patients with obstructive sleep apnea hypopnea syndrome (OSAHS).MethodsA total of 90 elderly patients with moderate to severe OSAHS confirmed by polysomnography were recruited from North China University of Science and Technology Affiliated Hospital in February 2016 to October 2017. According to random number table method the OSAHS patients were randomly divided into group A (n=30), group B (n=30) and group C (n=30). Group A received continuous positive airway pressure treatment for six months, group B received edaravone therapy and continuous positive airway pressure treatment for six months, and group C only received edaravone therapy for six months. The changes of serum TNF-α, IL-6 and ICAM-1 were detected by enzyme-linked immunosorbent assay before and after treatment.ResultsThe differences of serum TNF-α, IL-6 and ICAM-1 before treatment in the three groups were not statistically significant (P>0.05). Compared with before treatment, the levels of serum TNF-α, IL-6 and ICAM-1 decreased in the three groups (P<0.05). After six months of treatment, the levels of serum TNF-α, IL-6 and ICAM-1 decreased in group A and group B compared with group C (P<0.05), and decreased significantly in group B compared with group A (P<0.05).ConclusionEdaravone can inhibit the expressions of serum TNF-α, IL-6 and ICAM-1 in elderly patients with moderate to severe OSAHS, and thereby reduce vascular endothelial dysfunction and injury.