Acupuncture Points ; Acupuncture Therapy ; Burning Mouth Syndrome ; therapy ; Female ; Humans ; Middle Aged

Objective To explore the effect of comprehensive intervention measure on antimicrobial use and incidence of healthcare-associated infection(HAI)in patients in sports medicine department.Methods Antimicrobial use and incidence of HAI in hospitalized patients in the surgical departments (sports medicine department and other surgical departments)of a hospital between January 2006 and December 2010 were analyzed retrospectively(before intervention),from January 2011, comprehensive intervention based on clinical-centered multi-department cooperation was adopted by sports medicine depart-ment,the other surgical departments over the same period were not comprehensively intervened;antimicrobial use and inci-dence of HAI in patients in surgical departments between January 2012 and December 2013 were monitored prospectively (after intervention ),effectiveness of intervention was evaluated.Results Antimicrobial use and incidence of HAI in pa-tients in sports medicine department after intervention were both lower than before intervention (55.75% vs 95.26%,χ2=753.42;0.10% vs 0.32% ,χ2 =15.13,both P <0.01).Antimicrobial use in patients in other surgical departments after intervention was lower than that before intervention(65.63% vs 73.79% ,χ2 =251.57,P <0.01 );incidence of HAI was higher than that before intervention(0.55% vs 0.42% ,χ2 =19.04,P <0.01).Conclusion Comprehensive in-tervention measure based on clinical-centered multi-department cooperation is safe and effective,it can reduce antimicrobial use and incidence of HAI in patients in sports medicine department.

Objective To discuss the necessity and rationality of regional pancreatoduodenectomy combined vas-cular reconstruction in the treatment of chronic pancreatitis with lump in the head. Methods Thirteen patients who suffered from pancreas with lump in the head, were operated in our department from January 2000 to March 2006. The clinical data were analyzed retrospectively,there were 10 men and 3 women with an age ranging from 37 to 71 (mean = 51 ), all the patients underwent pancreatoduodenectomy combined PV and SMV reconstruction. Results All thirteen patients were pathologically confirmed chronic pancreatitis without postoperative deaths, in which stom-ach empty disorder and pancreatic fistula occurred and were cured conservatively in one case. All the 13 patients who were followed up 19～86 months had no pain and jaundice at all after the operation. Conclusion Combined vascular reconstruction to treat the lump in the head of the pancreas that packages blood vessel and hard to separa-tion is proved to be a safe and reliable method, being capable of raising lump resection rate, which can improve quality of life of patients remarkably to avoid omit minimum cancer in lump to result in lose the curative opportunity.

Objective To evaluate improved effect for deep venous valve function after superficial vein surgery of lower extremity in the intermediate stage.Methods Totally 43 patients (55 limbs) with varicose veins of lower extremity were enrolled to accept surgical management of vein systems in our department from March 2006 to October 2006.All patients were respectively followed up after 6 months and 4 years about the changes of deep venous valve function with color Doppler ultrasonography.Results Thirty-nine patients’ deep venous valve function kept well up to now,and there was no significant difference between the two results.Four patients without proximal saphenous vein ligation recurred,and there was reflux in deep venous.Conclusion Endovenous laser treatment and ablation of varicose veins of lower extremity with deep venous insufficiency could improve deep venous valve function effectively.Proximal great saphenous vein ligation is important for successful operation.

Objective To investigate the relationship between renal vascular resistance index( RI) and serum Apelin level in type 2 diabetic mellitus ( T2DM )?Methods Seventeen cases newly diagnosed T2DM patients with RI increased but without microalbuminuraia in Minhang Hospital Affiliated to Fudan University from December 2011 to December 2014 were selected as observation group,17 newly diagnosed T2DM patients with RI normal during the same period were selected as control group?Fasting plasma glucose(FPG),glycosylated hemoglobin A1C(HbAlC),blood lipids and fasting insulin(FINS),hepatic functional and renal function were tested in all the subjects?Serum Apelin level was detected by enzyme?linked immunosorbent assay?Results Compared with control group,serum Apelin level was significantly higher in observation group((179?2±122?4)μg/L vs?(56?7±50?6) μg/L,t=3?814,P<0?05)?Partial correlation analysis showed that the RI was positive correlated with Apelin ( r= 0?364, P= 0?040 )?Conclusion The serum Apelin levels elevated in newly diagnosed T2DM patients with RI increased, and RI is positively correlated with Apelin, which indicate that Apelin play an important role in the pathophysiology of early renal damage in patients with TsDM.

OBJECTIVE:To investigate the acid rebound in proton pump inhibitors (PPIs) and its influential factors. METH-ODS:Totally 109 patients who treated with PPIs for 1 month in our hospital during Jan.-Dec. 2015 were collected,and telephone visit was conducted after 1 week withdrawal to the data of dyspeptic symptoms were input and scored by modified Glasgow Dyspepsia Sere-rity Score,then divided into no phenomenon group(<5 scores)and acid rebound in proton pump inhibitors group(≥5 scores). All patients were classified by basic diseases,age,gender,whether smoking and alcohol drinking,and phenomenon of acid rebound in PPIs were observed and analyzed. RESULTS:Totally 91 patients were observed,49 were classified as acid rebound in PPIs group. χ2 test showed elderly patients(χ2=5.350,P=0.021)and people with smoking and alcohol drinking(χ2=4.351,P=0.037)were associat-ed with the increased risk of acid rebound in PPIs;exclusion of the effects of gender and basic disease,Logistic regression analysis showed the risk of acid rebound in PPIs in elderly patients were 5.708 times to non-elderly patients [OR=5.708,95%CI(1.946, 16.746),P=0.002];people with smoking and alcohol drinking was 15.281 times to non-smoking and alcohol drinking [OR=15.281, 95%CI(2.748,84.965),P=0.002],the difference was statistically significant(P<0.05). CONCLUSIONS:Parts of patients show ac-id rebound after stopping PPIs,while elderly patients and patients with smoking and alcohol drinking are the high-risk population, which should be paid attention to.

Objective To investigate the effects of different clipping time of first time using permanent aneurysm clips on common carotid artery wall in rabbitsMethods Sixty healthy male Japanese white rabbits were selected.The first time permanent aneurysm clips were used to clip common carotid artery for 30 min or 60 min respectively according to the random number method (n=30 in each group).Thirty segments of common carotid artery specimens clipped by aneurysm clips were collected respectively.Mean-Whitney U test was used to conduct the comparison of histopathological damage grade of vascular wall.Results The aneurysm clips were use to clip 30 min and 60 min caused vascular wall injury could observe the middle elastic plastic plate deformation and endothelial denudation.The vascular walls in the clipping 60 min group had local necrosis with inflammatory response,and even rupture of vascular wall.There were significant differences in overall damage degree of vascular wall (U=324.00,P=0.045) and severe injury rate (0%[0/30] vs.20.0%[6/30],P=0.031) between the clipping 30 min group and the clipping 60 min group (all P<0.05).Conclusion The vascular wall injury of using disposable permanent aneurysm clips for clipping 60 min was more severe than 30 min.Attention should be paid to shortening the time of carotid artery occlusion in operation.

Objective To analyze the diagnosis and treatment of intestinal obstruction patients caused by intra-abdominal hernia with no abdominal surgery history ,in order to raise awareness .Methods Clinical data of 23 intestinal obstruction patients caused by intra-abdominal hernia with no abdominal surgery history were retrospectively analyzed.The clinical manifestations ,type,and risk factors were analyzed .And its diagnosis and prevention was dis-cussed.Results 23 patients were caused by intestinal blood circulation disorders ,in which there were 11 cases small intestine mesentery hernia ,2 cases duodenal hernia ,2 cases pericecal hernia ,3 cases omentum hernia ,1 case obturator hernia,2 cases congenital dysplasia and intestinal mesenteric torsion induced small hernia ,2 cases formation of intra-abdominal pressure alone belted intestine ,8 cases of intestinal necrosis .22 patients were cured after surgery ,1 case died,12 cases had postoperative complications .The incidence rate of postoperative complications of patients with in-testinal necrosis was 59.3%( wound infection 37.1%, pneumonia 22.2%), which was significantly higher than 11.8%of patients without intestinal necrosis (wound infection 5.9%,pneumonia 5.9%)(χ2 =3.861,3.861,all P<0.05).Conclusion The intestinal obstruction caused by intra-abdominal hernia with no abdominal surgery history is closed loop obstruction , preoperative diagnosis is difficult , with the rapid progression of the disease , and intestinal strangulation ,intestinal necrosis can occur in the short term whithout timely surgical treatment .Therefore ,early diagno-sis and prompt surgical treatment is the key to the diagnosis and treatment of intestinal obstruction caused by intra -ab-dominal hernia with no abdominal surgery history .

Objective To observe the incidence of adverse reactions and short-term efficacy of S-1 and concurrent intensity-modulated radiotherapy ( IMRT) for locally advanced gastric cancer in a phase Ⅱclinical trial based on the phase I clinical trial.Methods Patients pathologically diagnosed with stage TN (+) gastric adenocarcinoma with local or distal metastasis after R0 resection were enrolled as subjects.IMRT was delivered 5 times per week with a total dose of 45 Gy in 25 fractions.S-1 was orally administered on the day of radiotherapy at a dose of 80 mg/m2 .Results A total of 40 patients, consisting of 6 patients from the phase I trial and 34 patients from the phaseⅡtrial, were enrolled in this study.In those patients, the age ranged between 27 and 73 years ( median age 50 years) and the male-to-female ratio was 3:1.Thirty-nine ( 98%) out of the forty patients completed radiotherapy and thirty-five ( 88%) completed concurrent chemotherapy.The most common grade 3-4 adverse reactions were nausea/anorexia ( 13%) , leukopenia ( 10%) , vomiting ( 8%) , radiation esophagitis ( 5%) , and neutropenia ( 5%) .There was no perioperative death.The 2-year overall survival and disease-free survival rates were 74% and 77%, respectively. Conclusions Postoperative S-1 and concurrent IMRT achieve satisfactory outcomes and tolerable toxicity in patients with locally advanced gastric cancer.

Objective:To investigate the effect of sakubatril/valsartan on left ventricular systolic dyssynchrony in young patients with dilated cardiomyopathy (DCM).Methods:Forty-nine patients with left ventricular systolic asynchronism DCM from July 2017 to July 2018 in Guangdong Medical University Affiliated Hospital were randomly divided into two groups. The experimental group was treated with sakubatra valsartan and the control group was treated with lotensin for 12 months. Left ventricular end-diastolic diameter (LVEDd), left ventricular end-systolic diameter (LVESd) and ejection fraction (EF) were measured by two-dimensional color Doppler echocardiography. The left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV), ejection fraction (EF) and systolic dyssynchrony index (SDI) of 16 segments were measured by three-dimensional color Doppler ultrasound. Plasma NT-proBNP was tested before and after treatment.Results:After treated for 12 months, three-dimensional color Doppler ultrasonography showed the LVEDV in the experimental group decreased significantly: (180.5 ± 42.7) ml vs. (160.5 ± 45.6) ml, P<0.05. The left ventricular systolic asynchronism (SDI) of 16 segments in the experimental group significantly improved, and the value of left ventricular SDI significantly decreased compared with that of the control group: (8.2 ± 3.6)% vs. (10.8 ± 4.1)%, P<0.05. Plasma NT-proBNP decreased more significantly in the experimental group compared with that in the control group: (105.54 ± 13.25) ng/L vs. (137.27 ± 14.36) ng/L, P<0.05. Conclusions:Sakubatril/valsartan can effectively improve left ventricular systolic dyssynchrony in young patients with dilated cardiomyopathy.