Objective To observe the effect of acupressure to relieve the adverse effect of patients and success rate of intubation during gastric tube insertion. Methods We divided 90 pancreatitis patients into the observation group and the control group randomly with 45 cases in each group.Routine intubation method was used in the control group.While in the observation group we gave acupressure of Neiguan and Hegu point based in the routine method.Then we compared the changes in heart rate,bucking,nausea,vomiting and other adverse effect as well as the one-time success rate of intubation.Results Changes in heart rate before and after intubation in the control group were significantly different(P<0.05).The incidence rate of adverse effect in the control group was 51.1%and rate of repeated intubation was 26.7%.In the observation group changes in heart rate was not evident(P>0.05).The incidence rate of adverse effect in the observation group was 4.4%and the one-time success rate of intubation was 97.8%.Conclusion It proved effective to use acupressure of Neiguan and Hegu point during gastric intubation for gastrointestinal decompression.

Objective To compare the efficacy of laparoscopic appendectomy(LA) and open appendectomy(OA) for perforated appendicitis.Methods From January 2002 to December 2005,40 patients with perforated appendicitis were treated at Xuanwu Hospital,20 of them received LA,and the others underwent OA.The clinical data of the patients were retrospectively analyzed.Results The operative time in the LA group was significantly longer than that in the OA group [(75.8?11.6) min vs(54.8?9.5) min,t=6.264,P=0.000)].And the patients in the LA group returned to oral intake earlier than those in the OA group [(1.8?0.5) d vs(2.6?0.5) d,t=-5.060,P=0.000].Moreover,the periods of antibiotic use and hospital stay in the LA group were significantly shorter than those in the OA group [(3.8?0.7) d vs(6.3?1.2) d,t=-8.048,P=0.000;and(5.8?1.1) d vs(11.6?1.6) d,t=-13.359,P=0.000].Although 3 patients had incision infection in the OA group,while none of the LA group had such a complication,no significant difference was detected in the complication rate between the two groups(Fisher's exact test,P=0.115).Conclusions Laparoscopic appendectomy is superior to open surgery for perforated appendicitis because of its advantages of quick recovery,short hospitalization,less antibiotic use,and minimal invasion.LA is a safe,effective,and feasible procedure for perforated appendicitis.

OBJECTIVE: Applying Chinese version of categories of auditory performance (CAP) to assess cochlear implant (CI) recipients of prelingual deaf and test the reliability of Chinese version of CAP. METHOD: Fifty CI recipients of prelingual deaf were interviewed by a parent and a speech therapist using Chinese version of CAP. Kappa coefficient analysis was applied to test the reliability of Chinese version of CAP. RESULT: Thirty-five of 50 cases (70%) were found completely coincident, 12 cases (24%) were one category different, 3 cases (6%) were 2 categories different. Kappa coefficient was 0.624. CONCLUSION Chinese version of CAP was found reliable and useful to evaluate auditory performance of prelingual deaf pediatric after cochlear implantation.
Asian Continental Ancestry Group ; Child ; Cochlear Implantation ; Cochlear Implants ; Deafness ; therapy ; Hearing Tests ; Humans ; Reproducibility of Results ; Speech Perception ; Treatment Outcome

Objective To analyze the influence of radial neck fracture on the upper limb function in older children,and to evaluate the curative effect of plate fixation in the treatment of Salter-Harris Ⅱ type of radial neck fracture.Methods The clinical data of 16 older children with radial neck fractures who treated by T plate internal fixation were retrospectively analyzed.16 cases were closed fractures,merging radial nerve injury in 1 case,3 cases of distal humerus fractures,1 case with rib fractures,fractures were Salter-Harris Ⅱ type,adopt steel plate internal fixa tion.Results 1 6 patients were followed up for 9-1 8 months.X-ray healing time was 6-9 weekson average 7.6 weeks.No malunion and no healing,no case of epiphyseal injuries.1 patient appeared steel block forearm supination.Postoperative patients with forearm pronation were greater than 90° supination were greater than 60 °.No radial nerve injury.Evaluation results were good.Conclusion Clinical treatment effect of open reduction and plate internal fixation in the treatment of older children with Salter-Harris Ⅱ type of radial neck fracture is satisfactory.Surgical treatment not only can enhance the fracture stability,but also can do the elbow joint function exercise to prevent dysfunction much earlier.

OBJECTIVE: To analyze the effects of Astragalous Injection on oxidative stress and micro-inflammatory status in patients undergoing maintenance hemodialysis (MHD). METHODS: Sixty MHD patients were included and randomized into treatment group and control group, with another 10 healthy volunteers as normal control. The patients in the treatment group were treated with Astragalous Injection and the patients in the control group were treated with normal saline for 12 weeks. A spectrophotometric method was used for the measurement of plasma concentrations of oxidative parameters including advanced glycation end products (AGEs), advanced oxidation protein product (AOPP), malondialdehyde (MDA) and vitamin E (Vit E). The content of C-reactive protein (CRP) was evaluated by enzyme-linked immunosorbent assay. RESULTS: Compared with the normal control group, the plasma levels of AGEs, AOPP, MDA and CRP were significantly increased, while plasma level of Vit E was significantly decreased in MHD patients ( P<0.01). After Astragalous Injection treatment, the plasma levels of AGEs, AOPP, MDA and CRP were decreased as compared with the control group ( P<0.01), while there was no significant difference in plasma Vit E level between the treatment group and control group. CONCLUSION: There exist oxidative stress and micro-inflammation in MHD patients. Astragalous Injection can ameliorate the accumulation of oxidative products and micro-inflammatory status, but it has no significant effect on plasma Vit E level.

[Abstract] Objective To explore the feasibility of fractional exhaled nitric oxide (FeNO) dynamic changes in guiding stepped treatment of patients with chronic persistent asthma. Methods From Jan. 2016 to Dec. 2017, chronic persistent asthma patients, who were admitted to Shanghai Dahua Hospital of Xuhui District, were enrolled and randomly divided into study and control groups. All patients were given standardized treatment according to Global Initiative for Asthma in 2014 (GINA 2014) and evaluated every 3 months to adjust their medications. The control group was adjusted according to the recommended protocol from GINA 2014, while the study group was adjusted according to the results of FeNO on the basis of the recommended protocol from GINA 2014. All patients were followed for 1 year. The complete control rate, failure rate of de-escalation treatment, Asthma Control Questionnaire (ACQ) score and lung function were compared between the two groups. Results Atotal of 207 patients were enrolled in this study, including 103 cases in the control group and 104 cases in the study group. The condition of the patients was effectively controlled in both study and control groups. There were no significant differences in total control rate, ACQ score or lung function between the two groups (all P0.05), while the failure rate of de-escalation therapy was significantly lower in the study group than that in the control group (7.28% [11/151] vs 13.66% [25/183], P0.05). In addition, the doses of controlled drugs and short-acting on-demand remission drugs in 4-6 months, 7-9 months and 10-12 months were significantly less in the study group than those in the control group (all P 0.05). Conclusion In the treatment of chronic persistent asthma, the dynamic monitoring of FeNO can effectively guide the medication, decrease the failure rate of treatment, and reduce the doses of controlled drugs and short-acting on-demand remission drugs.

Objective: To evaluate the prevalence and risk factors of microalbuminuria (MAU) in hospitalized patients. Methods: A total of 1 259 hospitalized patients undergoing detection of urinary microalbumin in 2012 were recruited from Tongji Hospital. They were divided into two groups according to the level of urinary microalbumin, with 907 cases in the normal albuminuria (NAU) group and 352 in the MAU group. The clinical data of the two groups were compared and the risk factors of MAU were analyzed. Results: The MAU prevalence was 27.9% in our study. Patients in the MAU group had an elder age and higher prevalence rates of type 2 diabetes mellitus, hypertension, and type 2 diabetes combined with hypertension compared with the NAU group (P<0.01). Multivariate analysis with logistic regression showed that age and type 2 diabetes were the independent risk factors of MAU. Advanced age (>80 years old,OR=1.668,95%CI 1.185-2.348) and type 2 diabetes mellitus (OR=1.718,95%CI 1.334-2.211) increased the risk for MAU in hospitalized patients. Conclusion: MAU is closely related to age and type 2 diabetes mellitus in hospitalized patients, which suggests that strict control of blood glucose and timely treatment can slow down diabetic nephropathy and cardiovascular disease in hospitalized patients.

Objective To compare the clinical efficacy of primary closure versus T-tube drainage after laparoscopic common bile duct exploration in acute cholangitis cases.Methods The clinical data of 100 patients with acute cholangitis undergoing laparoscopic common bile duct exploration from January 2012 to December 2014 were reviewed.54patients received primary closure of the common bile duct and 46 patients were subjected to T-tube drainage after choledochotomy.Results One hundred patients underwent the surgery successfully.Compared with the T-tube group,the operation time(96.72 min vs 123.00 min,P =0.001),intraoperative blood loss(27.13 ml vs 38.48 ml,P =0.009),postoperative gastrointestinal function recovery time(1.57 d vs 2.33 d,P=0.003) and postoperative hospital stay(6.19 d vs 9.20 d,P=0.000) were significantly less in the primary closure group.There were no statistical differences in the incidence of postoperative drainage (309.22 ml vs 212.46 ml,P =0.070),drainage time (3.96 d vs 4.02 d,P =0.875),incidence of bile leakage(9.3％ vs 0,P =0.060) and postoperative bleeding rate(5.1％ vs 2.2％,P =0.622) between these two groups.Conclusion Laparoscopic common bile duct exploration with primary closure of the common bile duct is an effective and safe procedure in acute cholangitis cases compared with T-tube drainage.

Objective:To explorethe relationship between internet use and loneliness among the elderly,as well as the moderating role of physical health.Methods:Data from the 2018 China Longitudinal Aging Social Sur-vey(CLASS2018)were analyzed,including 8 260 older adults.Loneliness was measured withthe UCLA Loneliness Scale-3-item short version(UCLA-3),Internet use was measured with whether or not participants used the internet and for what purposes(Latent class analysis identified three types of internet users,namely multi-functional use group,communication group,and information acquisition group),and physical health was assessed with activities of daily living and chronic disease status.Results:Multiple linear regression analysis revealed that the elderly who used the internet had significantly lower scores on the loneliness scale than those who did not use the internet(β=-0.08).Multi-functional use group had significantly lower loneliness scores than information acquisition group and communication group(β=0.06,0.12).Two-way ANOVA found that physical health moderated the association be-tween internet use,internet use type,and loneliness(Ps＜0.05).Conclusion:Internet use helps the elderly to allevi-ate loneliness,and the use of multiple Internet functions has a cumulative effect on reducing loneliness.However,the relationship between internet use and loneliness among the elderly may vary depending on their physical health status.

Triple-negative breast cancer(TNBC)is one of the prognosis poorer molecular subtypes of breast cancer with limited conventional treatments,however,it is characterized by a strong immune microenvironmental activity,which provides a certain biological basis for immunotherapy as well as antibody-drug conjugates(ADCs).Nowadays,the combination of immune checkpoint inhibitors and chemotherapy,as well as the successive introduction of ADCs such as sacituzumab govitecan and trastuzumab deruxtecan,has changed the therapeutic pattern of TNBC and provided new ideas for the development of new drugs for TNBC.In this paper,the clinical research progress of immunotherapy and ADCs for the treatment of TNBC is reviewed,in order to provide a reference for the strategy selection of clinical drugs,that is,the future research and development trend.