1.Research foundation of antioxidant therapy in cervical cancer
Chinese Journal of Postgraduates of Medicine 2016;39(3):286-288
Cervical cancer was the most common gynecological malignant tumor, and endanger the lives of women. In recent years, research on antioxidant system confirmed that the antioxidant system of defects was closely related with the risk factors of cervical cancer. The lack of antioxidants that generates excessive reactive oxygen species, damaged the cervix cells. Human papilloma virus (HPV) infection was the main pathogenic factor of cervical cancer.Epidemiological studies had shown that including oxidative stress and antioxidant defects may prompt some auxiliary factors of HPV infection were finally for the development of cervical cancer. Because the oxidation has small side effects, safety, etc, so its anti-tumor effect was becoming more and more attention. Recently, on the antioxidant therapy in the treatment of cervical cancer research has made great achievements. This article expounds the antioxidant system defects and relationship between occurrence and development of cervical cancer, also reviewed the antioxidant therapy of cervical cancer research foundation and the latest clinical research.
2.Polyethylene ethanol hydration seaweed salt for vacuum sealing drainage in repair of orthopedic wounds
Lingjiang LI ; Heng CHANG ; Jingjing CHANG ; Chuanjiang CHEN ; Long YUAN ; Jirong WANG ; Jianghong ZHANG ; Yongliang PAN ; Youhui LIU
Chinese Journal of Tissue Engineering Research 2013;(47):8282-8287
BACKGROUND:In recent years, vacuum sealing drainage technology has been widely used in the treatment of orthopedic wounds or to facilitate skin graft survival, both of which have achieved good results.
OBJECTIVE:To observe the curative effects of vacuum sealing drainage technology in the wound healing after limb open fractures, soft tissue defects, pressure sores, and chronic osteomyelitis.
METHODS:Fifty-four patients of fractures combined with soft tissue defects, postoperative exposed bone, osteomyelitis, a large area of pressure ulcers or severe infections, selected from the 273rd Hospital of PLA, were randomly divided into test and control groups according to the wishes of patients. The test group included 36 patients who were treated with vacuum sealing drainage using polyethylene ethanol hydration seaweed salt after debridement, and the control group included 18 patients who were treated with conventional dressing. Wound cleaning time, number of dressings, and wound healing time were detected and compared in the two groups.
RESULTS AND CONCLUSION:Compared with the control group, the wound cleaning time and wound healing time were shorter in the test group, and the number of dressings was also decreased in the test group (P<0.05). After removal of sponge dressings, in the test group, wound granulation was fresh and grew obviously with no exudates after the necrotic residue was removed and vacuum sealing drainage was changed. For the bone exposure patients, the wound area was reduced, or even there was no exposed bone any more. After skin grafting, vacuum suction and pressure due to vacuum sealing drainage technology made al skin grafts survive. In the patients with chronic osteomyelitis, the exudates were gradual y reduced until disappeared after vacuum sealing drainage was exchanged three or four times, and pathogens were not found in bacterial culture. After combined treatment of debridement and vacuum sealing drainage, there were many fresh granulations in the patients with large areas of pressure sores;after replacement of vacuum sealing drainage several times, the granulation grew to the same height with the surrounding skin.
3.Risk factors of postoperative mortality of femoral neck fractures in elderly patients and construction of a nomogram predictive model
Zhipeng LI ; Dawei HUAN ; Zhaofeng YUAN ; Yue QIU ; Chao ZHANG ; Tianwei XIA ; Jirong SHEN
Chinese Journal of Tissue Engineering Research 2024;28(21):3361-3366
BACKGROUND:With a gradually aging population,improving the ability to screen for the risk of death after arthroplasty and implementing timely personalized intervention programs for the increasing number of elderly patients with femoral neck fractures is key to improving the postoperative status of patients and prolonging survival expectations. OBJECTIVE:To investigate the risk factors for postoperative mortality in elderly patients with femoral neck fractures and to construct a nomogram predictive model to predict their mortality risk. METHODS:The study was conducted on 155 elderly patients(≥65 years old)who underwent arthroplasty for femoral neck fracture from January 2016 to January 2021,and 147 patients who met the inclusion criteria were analyzed to collect clinical data that may affect the patients'postoperative mortality.Single-factor and multi-factor Cox regression analyses were successively used to screen independent risk factors associated with postoperative mortality.The column line graph model was constructed and validated using Rstudio software. RESULTS AND CONCLUSION:(1)Age,frailty(age-adjusted Charlson comorbidities score),preoperative activity status,osteoporosis,and postoperative serum albumin level were five independent risk factors for postoperative mortality in elderly patients with femoral neck fractures(P<0.05).(2)The nomogram predictive model was constructed based on the results of multifactorial analysis,with a consistency index of 0.819(95%CI:0.771-0.868).Receiver operating characteristic curve analysis showed that the area under curve for 1-year and 3-year survival prediction was 0.8543 and 0.7263,respectively,indicating that the nomogram predictive model has good discriminatory and predictive power;calibration curve and decision curve analysis also showed good model discriminative power and clinical utility value.(3)The constructed nomogram predictive model has good diagnostic efficacy and accuracy,and can effectively assess the risk of postoperative death of patients.
4.Mid-and long-term state after total hip arthroplasty versus hemiarthroplasty for femoral neck fractures in the elderly:evaluation using propensity score matching method
Zhipeng LI ; Dawei HUAN ; Zhaofeng YUAN ; Kai DING ; Yue QIU ; Tianwei XIA ; Jirong SHEN
Chinese Journal of Tissue Engineering Research 2024;28(24):3839-3844
BACKGROUND:Arthroplasty is the primary treatment for displaced femoral neck fractures in the elderly,and the choice of total hip arthroplasty versus hemiarthroplasty is currently the subject of considerable debate. OBJECTIVE:To compare the mid-and long-term survival status of total hip arthroplasty versus hemiarthroplasty under a direct anterior approach for displaced femoral neck fractures in the elderly based on the propensity score matching method. METHODS:One hundred and forty-seven elderly patients(≥65 years of age)with displaced femoral neck fractures were admitted from January 2016 to January 2021,of whom 88 had total hip arthroplasty(total hip arthroplasty group)and 59 had artificial femoral head replacement(hemiarthroplasty group).For the patients'preoperative comorbidities,the age-corrected Charlson Comorbidity Scale was used to quantify the scores and calculate patient frailty.The propensity score matching method was used to match the two groups 1:1 and to compare the operation time,bleeding,postoperative hospitalization time,hospitalization cost,nutritional index,postoperative complications,and mortality between the two groups after matching.Postoperative survival time was determined by Kaplan-Meier Survival analysis. RESULTS AND CONCLUSION:(1)After propensity score matching,a total of 42 matched pairs were successful in both groups,and the preoperative data of patients in both groups were balanced and comparable after matching(P>0.05).(2)Compared with the hemiarthroplasty group,operation time(79.71 minutes vs.59.07 minutes,P<0.001),bleeding volume(839.64 mL vs.597.83 mL,P=0.001),and hospitalization cost(56 508.15 yuan vs.41 702.85 yuan,P<0.001)were significantly higher in the total hip arthroplasty group.However,the mortality rate was lower in the total hip arthroplasty group than in the hemiarthroplasty group(36%vs.57%,HR=0.44,95%CI:0.23-0.87,P=0.018),and the mean survival time was longer in the total hip arthroplasty group than in the hemiarthroplasty group(59.4 months vs.43.7 months,P=0.024).(3)There were no statistically significant differences in postoperative hospitalization time,preoperative and postoperative nutritional indicators,and overall postoperative complication rate between the two groups(P>0.05).However,in terms of postoperative pain,the incidence of pain was significantly higher in the hemiarthroplasty group than that in the total hip arthroplasty group(24%vs.7%,P=0.035).(4)Overall,total hip arthroplasty has a better prognosis for survival,while hemiarthroplasty is more appropriate for patients with poor physical fitness.At the same time,postoperative pain may largely affect the quality and survival time of patients after hip arthroplasty.
5. Guidance on strengthening the management processes of children′s fever in outpatient department during the novel coronavirus pneumonia epidemic period (First Edition)
Guocheng ZHANG ; Xiaoning CHENG ; Hui DING ; Zhaoling SHI ; Ruying LI ; Zhou FU ; Qiang CHEN ; Dongchi ZHAO ; Runming JIN ; Guoming NIE ; Jirong LU ; Changshan LIU ; Deyu ZHAO ; Jiahua PAN ; Zhichun FENG ; Yuan SHI ; Zhengkun XIA ; Chengzhong ZHENG ; Jinjin JIANG ; Junxia WANG ; Yuejie ZHENG ; Yunxiao SHANG ; Wei XIANG ; Baoping XU ; Kunling SHEN ; Tianyou WANG ; Yonghong YANG ; Quan LU
Chinese Journal of Applied Clinical Pediatrics 2020;35(2):97-104
Novel Coronavirus Pneumonia (NCP) is a class B infectious disease, which is prevented and controlled according to class A infectious diseases. Recently, children′s NCP cases have gradually increased, and children′s fever outpatient department has become the first strategic pass to stop the epidemic. Strengthening the management of the fever diagnosis process is very important for early detection of suspected children, early isolation, early treatment and prevention of cross-infection. This article proposes prevention and control strategies for fever diagnosis, optimizes processes, prevents cross-infection, health protection and disinfection of medical staff, based on the relevant diagnosis, treatment, prevention and control programs of the National Health and Health Commission and on the diagnosis and treatment experience of experts in various provinces and cities. The present guidance summarizes current strategies on pre-diagnosis; triage, diagnosis, treatment, and prevention of 2019-nCoV infection in common fever, suspected and confirmed children, which provide practical suggestions on strengthening the management processes of children′s fever in outpatient department during the novel coronavirus pneumonia epidemic period.