1.The past, present and future of hepatitis C treatment
Journal of Clinical Hepatology 2017;33(6):1079-1081
Hepatitis C and its complications are one of the highlights in liver disease prevention and control in China,and from the clinical practice 20 years ago to a cure rate of nearly 100% at present,standardized diagnosis and treatment of hepatitis C,a large number of scientific studies,and drug research and development are the basis for the clearance of HCV.Direct-acting antiviral agents play an important role in the clearance of HCV,and the clearance of HCV does not equal to the cure of chronic hepatitis C.For patients with hepatitis C who have achieved a high sustained virologic response rate after using direct-acting antiviral agents,their long-term prognosis should be taken seriously.Correct and reasonable application of hepatitis C treatment is still a hot issue that needs to be discussed at present.
3.Obesity parameters and obstructive sleep apnea-hypopnea syndrome in aircrew
Gumi LIANG ; Ning SHANG ; Weihua FAN
Chinese Journal of Health Management 2009;3(2):88-91
Objective To investigate the relationship between obesity parameters and obstructive sleep apnea-hypopnea syndrome (OSAHS) in aircrew. Methods A questionnaire survey in aircrew members was performed. Outcome measurement included body height, body weight, neck circumference ( NC), waist circumference (WC), and body mass index (BMI). Those with snoring during sleep and/or Epworth sleepiness scale (ESS)score ≥ 9 were screened with pulse oxygen saturation test during overnight sleep. Those with oxygen saturation decrease index ≥ 10 times/h and suspected OSAHS were tested by polysomnography (PSG). The objects were then assigned to three groups: the OSAHS group,the snore group and the normal group. The relationship between obesity parameters and OSAHS was analyzed. Results There were 399 ( 37. 54% ) overweight, 36 ( 3. 39% ) obesity, 130 ( 12. 23% ) increased NC, and 354 (33.30%)increased WC in 1063 aircrew members (OSAHS group > snore group > normal group; P<O. 05). The mean value of BMI, NC and WC in the three groups were dittos. Multiple logistic regression analysis showed that overweight, obesity and increased WC were significantly associated with snoring (P <0.05) and snoring enlarged NC was significantly correlated with OSAHS (P< 0.05). Conclusion Increased BMI, NC and WC may be risk factors of OSAHS among aircrew. Effective prevention and treatment of OSAHS should be needed.
4.Analysis on relationship between Schatzker types and knee function in tibial plateau fractures
Ning ZHANG ; Hongtao SHANG ; Mishan WU
Chongqing Medicine 2016;45(12):1629-1631
Objective To investigate the relationship between the Schatzker types and postoperative knee function in tibial plateau fractures .Methods Totally 120 patients with tibial plateau fracture from January 2010 to December 2014 were selected and performed the Schatzker classification according to the X‐ray film ,CT and three dimensional reconstruction .They were divided into 6 groups .The postoperative knee function in each group was followed up and the statistical analysis was conducted .Results The excellent grade distribution of knee function by Kruskal‐Wallis test had statistical difference among 6 groups(P<0 .05) ,in the fur‐ther pairwise comparison ,the significant differences were found between the group 1 and 2 with the group 4 ,5 and 6(P<0 .05) . Conclusion The Schatzker types of tibial plateau fractures is closely correlated with the postoperative knee function .The knee function scores of type Ⅳ ,Ⅴ and Ⅵ are obviously poor .
5.Clinical analysis of 49 cases of necrotizing pneumonia in children
Nan YANG ; Ning CHEN ; Yunxiao SHANG
Chinese Journal of Applied Clinical Pediatrics 2017;32(4):280-283
Objective To explore the clinical characteristics,pathogens,inflammatory biomarkers,therapeutic methods and prognosis of necrotizing pneumonia (NP) in children.Methods The clinical data of children with NP who were admitted to the Department of Pediatrics of Shengjing Hospital of China Medical University from October 2010 to October 2015 were collected.The data included demographic data,laboratory test results,intrapulmonary complications,therapeutic methods and so on were analyzed,retrospectively.Results Forty-nine pediatric patients with NP were enrolled,31 cases were boys,18 cases were girls;the average age of the patients were 2.5 years (4 months-13 years).The average febrile time were (15.08 ± 5.92) d,and the hospital stay was (21.19 ± 10.83) d,respectively.The median value of peripheral blood leukocyte count was 17.7 × 109/L,the average of neutrophils ratio was (67.62 ± 18.52)%,and the median value of C-reactive protein (CRP) and procalcitonin (PCT) was 97.9 mg/L and 0.54 μg/L,respectively.Nineteen cases had Mycoplasma pneumoniae (MP) infection,16 cases with pneumonia chlamydia infection,9 cases complicated with MP and chlamydia pneumoniae infection,and 8 cases with positive bacterial culture,and 10 cases suffered from the intrapulmonary complications.Forty-seven cases got better prognosis with the treatment of antibiotics,glucocorticoids,intravenous immunoglobulin and other comprehensive therapeutic methods such as bronchoalveolar lavage with fiber bronchoscope and closed thoracic drainage.Conclusions NP is a severe complication of community-acquired pneumonia in children,and the occurrence of NP should be alerted in the children who have persistent high fever,higher inflammatory index and pleural effusion,but the great majority of patients do recover fully after comprehensive treatment.
8.Treatment of mid-upper thoracic spine fracture with posterior decompression and pedicle crew fixation and reduction
Hua YANG ; Weiping XING ; Xu NING ; Xianwen SHANG ; Hao ZHANG
Chinese Journal of Trauma 2011;27(9):779-782
ObjectiveTo analyze and summarize the feasibility and characteristics of the posterior spinal canal reduction and fixation in treating mid-upper thoracic spine facture.MethodsA retrospective study was made on 17 patients with mid-upper thoracic spine facture to record the complication, compare the functions of the patients with complete and incomplete spinal cord injuries before and after surgery and examine the iatrogenic injury in patients without spinal cord injuries.ResultsNo complication happened after surgery.Incomplete injury was found in six patients, whose ASIA scales were found to be increased for 1-3 levels during the follow-up.While the complete injury was found in eight patients,whose ASIA scale remained unchanged during the follow-up.The sensory scores of both the incomplete injury group and complete injury group were processed with variance analysis and the results showed a significant difference between pre-operation and post-operation (F = 476.47, P = 0.000).The mean value between complete injury group and incomplete group was with high statistical difference (F = 31.46, P =0.000).The variance analysis of the motor scores showed a significant difference between before and after operation (F=46.75, P =0.000) and the mean value between complete and incomplete injury groups was with statistical difference (F = 158.59, P = 0.000).There were three patients with normal spinal cord function, with no decrease of ASIA scale or no change of the sensory and motor scores.ConclusionsFor patients with mid-upper thoracic spine fracture, posterior spinal surgery is conducive to the recovery of spinal function, for it can safely and effectively avoid worsening the thoracic and other combined injuries and release spinal pressure including the pressure in front part of the spinal cannal.
9.Clinical features and prognostic risk factor analysis for female patients with acute myocardial infarc-tion
Ning YANG ; Dingran SI ; Huiping SHANG ; Hengliang WANG
Chinese Journal of cardiovascular Rehabilitation Medicine 2015;24(5):522-525
Objective:To analyze the clinical features and prognostic risk factors of female patients with acute myo‐cardial infarction (AMI) .Methods :From Apr 2011 to Oct 2014 ,a total of 97 female AMI patients treated in our hospital were enrolled as female group ,meanwhile 120 male AMI patients were regarded as control group (male group) .All patients received three‐month follow‐up after hospitalization .Baseline data ,clinical features and prog‐nosis were compared between two groups ,and prognostic risk factors of female patients were analyzed at the same time .Results:Compared with male group ,there were significant rise in percentages of cardio‐and cerebrovascular diseases ,diabetes mellitus and hyperlipidemia ,and significant reductions in red blood cell count ,hemoglobin level , and percentages of smoking&drinking history , digestive&urinary system diseases in female group , P<0.05 or <0.01. Compared with male group , there were significant rise in percentages of Killip class Ⅳ (14.17% vs . 24.74% ) ,three‐vessel coronary disease (3.33% vs . 12.37% ) , therapeutic rate of reperfusion (51.67% vs . 73.20% ) ,mortality (2.50% vs .9.28% ) and incidence of complications (19.17% vs .31.96% ) in female group ,P<0.05 all .Logistic analysis of regression showed that age ,previous cardio‐ and cerebrovascular diseases ,diabetes mellitus ,hyperlipidemia ,Killip cardiac function class and number of diseased coronary vessels were significantly cor‐related with prognosis (OR=0.176~4.931 , P<0.05 all) .Conclusion:Prognosis of female AMI patients is poorer than that of males .Prognosis is related to age ,cardio‐ and cerebrovascular diseases ,diabetes mellitus ,hyperlipi‐demia ,Killip cardiac function class ,and number of diseased coronary vessels .
10.Clinical Characteristics of Invasive Pulmonary Aspergillosis
Ning SHANG ; Jie CHANG ; Yingna LIU ; Xinping YUAN
Chinese Journal of Nosocomiology 1994;0(04):-
OBJECTIVE To study the clinical characteristics of invasive pulmonary aspergillosis(IPA).METHODS Based on the clinical data from 14 IPA cases identified by pathologic examination in the 454th Hospital,the characteristics of IPA were discussed,including the underlying diseases,symptoms,X-ray,CT,the treatment methods and the curative effect.The related literatures were also reviewed.RESULTS All of the 14 patients had underlying diseases.From them 5 were with pulmonary cancer(35.7%),3 with chronic obstructive pulmonary disease(21.4%),2 with pulmonary abscess(14.3%),2 were after chemotherapy for leukemia(14.3%),1 with pulmonary tuberculosis(7.1%)and 1 with diabetes(7.1%).The common symptoms of the 14 cases were febricity,productive cough and hemoptysis.Some of them also suffered with short of breath,night sweat,fatigue,chest pain and losing weight.The air crescent sign showed on X-ray and CT.Soft tissue masses with halo-sign on the margin,dense shadow of small masses within the alveoli,and multi-nodular shadows were also observed.Among 10 patients treated by antifungal medications,only 4 treated otherwise with operation were cured,4 patients died,and 2 patients did not complete the treatment scheme.CONCLUSIONS The patients with immunodeficiency are susceptible to IPA.The clinical manifestations of IPA are non-specific.The final diagnosis depends on the pathologic examination.The only medication is not sufficient for IPA patients.Pulmonary resection should be considered if the prolonged illness or frequent hemoptysis exist.