Objective To explore the effect of dressing techniques under Orem self-care theory on the ability of daily living of stroke patients with hemiplegia. Methods About 96 stroke patients with hemiplegia were randomly divided into an experimental group and a control group, 48 cases in each group. The patients in the experimental group received training on dressing techniques under Orem self-care theory, while those in the control group received routine training on dressing techniques.The daily life ability of both groups was comfared. Result After one month, the Barthel scores in the experimental group were higher than those of the control group (P<0.05). Conclusion Dressing techniques under Orem self-care theory can improve the ability of daily living of stroke patients with hemiplegia.

Objective To explore the operative method and clinical effect of total hip arthroplasty with normal prosthesis in treatment of the advanced stage avascular necrosis of femoral head combined with severe femoral anteversion. Methods There were 15 patients ( 15 hips) including nine males and six females, at age range of 30-42 years (mean 37 years). The femoral anteversion was 40°-50° and Harris score of (59 ± 8) points. Total hip arthroplasty with normal prosthesis was performed to reduce the femoral anteversion for 20°-30° and increase the acetabulum anteversion for 10°-15°so as to recover a good involution relationship of the femoral head and the acetabulum and avoid anterior dislocation. The imaging examination and Harris scoring were performed regularly postoperatively. Results A follow-up for mean 2.9 years (2.5-3.7 years) in 15 patients showed that all patients obtained good range of joint motion and good stability of all the hip prostheses. Harris score was (88±6) points at 2 years post-opera-tively, which was significantly better than preoperation (P < 0.01 ). Conclusions Total hip arthro-plasty with normal prosthesis can obtain good involution of the femoral head and the acetabulum in patients with advanced stage avascular necrosis of femoral head combined with severe femoral anteversion by simul-taneously regulating implant angle of femoral prosthesis and acetabular cup, which helps avoid use of small or specially made femoral stem or subtrochanteric derotational osteotomy.

OBJECTIVETo evaluate the effect of annular electrode lacrimal duct reconstruction in improving the safety and efficacy of nasolacrimal duct stent implantation for treatment of nasolacrimal duct obstruction.

METHODSThis randomized clinical trial was performed to compare the efficacy, success rate of intubation, time used for stent implantation, intraoperative pain, and extubation-assciated complications between nasolacrimal stent implantation with and without annular electrode lacrimal duct reconstruction.

RESULTSA total of 119 eligible patients were enrolled in this trial. The total curative rate at 6 months of follow up after extubation was 70.9% (83/117) in these patients, and was significnatly higher in pateinets with lacrimal duct reconstruction than in those without [80.6% (54/67) vs 58.0% (29/50); χ(2)=7.093, P<0.05]. The total success rate of stent implantation was 98.3% (117/119) in all the patients initially enrolled, and two patients experienced failure of stent implantation and were excluded; the success rate was signfiicantly higher in patients initially enrolled in the lacrimal duct reconstruction group (χ(2)=6.282, P<0.05). The median time required for intubation was shorter in lacrimal duct reconstruction group (12 s vs 33 s; Z=-36.722, P<0.05). The intendity of intraoperative pain was comparable between the two groups (t=0.833, P=0.405). The total rate of puncta injury was 43.6% (51/117) in these patients and similar between the two groups (χ(2)=1.459, P=0.227). The total rate of extubation difficulty was 9.4% (11/117) in all the patients, and was lower in lacrimal duct reconstruction group [4.5% (3/67) vs 16% (8/50); χ(2)=4.463, P<0.05]. Stent breakage in extubation occurred in 4.3% (11/117) of the patients with similar rates between the two groups (χ(2)=2.964, P=0.085). Spearman bivariate correlation analysis showed that the time required for intubation was inversely correlated with the treatment efficacy (r=-0.584, P<0.05) and positively with the occurrence of extubation difficulty (r=0.491, P<0.05); extubation difficulty was inversely correlated with the curative effect (r=-0.511, P<0.05).

CONCLUSIONAnnular electrode nasolacrimal duct reconstruction can increase the safety and efficacy of nasolacrimal duct stent implantation for treatment of nasolacrimal duct obstruction.

Dacryocystorhinostomy ; methods ; Electrodes ; Humans ; Intubation ; Lacrimal Duct Obstruction ; Nasolacrimal Duct ; surgery ; Pain ; Reconstructive Surgical Procedures ; methods ; Stents ; Treatment Outcome

Objective:To summarize the clinical manifestations, gene variations, diagnosis and treatment of 3 cases with SLC35A2 variations characterized by congenital glycosylation disorder Ⅱm (CDG Ⅱm). Methods:A total of 3 patients admitted to the Department of Pediatrics of Xiangya Hospital of Central South University in China from 2018 to 2020 were examined in detail. The studies till January 2022 were searched with key words of "congenital disorders of glycosylation Ⅱm", " SLC35A2" and "CDG Ⅱm" in both English and Chinese in the databases of China National Knowledge Infrast Ructure (CNKI), Wanfang, Online Mendelian Inheritance in Man and PubMed, and the clinical manifestations, genetic variation, treatments and prognosis of patients with SLC35A2 mutation were summarized. Results:The patients all presented with intractable infantile spasm and global developmental delay, onset in infancy. A variety of antiepileptic treatments had temporary and partial efficacy. Otherwise, proband 2 and 3 presented with abnormal glutamic-pyruvic transaminase and increased platelets. Funduscopy showed dysplasia of the retinal pigment epithelium in both eyes, and they both received D-galactose treatment. A total of 22 relevant case reports, including 99 patients, were collected. The 99 patients all were heterozygous mutations, and a total of 75 different variation sites were reported. The clinical manifestations were characterized by global developmental delay or mental retardation ( n=89), epileptic seizure ( n=75), hypotonia ( n=57), facial deformity ( n=57), skeletal abnormality ( n=50), visual impairment ( n=42), elevated glutamic-pyruvic transaminase ( n=31), gastrointestinal symptoms ( n=28), skin deformity ( n=26), microcephaly ( n=23) and congenital heart disease ( n=12). Craniocerebral magnetic resonance imaging may be normal in the early stage. With age, magnetic resonance imaging may show abnormal white matter signals, brain atrophy, dysplasia of corpus callosum, delayed myelination, enlargement of lateral ventricle, brain stem atrophy and so on. Studies have shown that galactose treatment may be effective. Conclusions:SLC35A2 variants lead to CDG Ⅱm, whose clinical manifestations mainly include epileptic encephalopathy and global developmental delay. Multiple antiepileptic therapies can temporarily or partially control seizures, while oral galactose may improve the clinical symptoms, showing its prospect as a dietary therapy.

Objective:To analyze the risk factors of recurrence and canceration for premalignant vocal fold lesions after surgery, and to provide a reasonable basis for preoperative evaluation and postoperative follow-up. Methods:This study retrospective analyzed the relationship between clinicopathological factors and clinical outcome（recurrence, canceration, recurrence-free survival, and canceration-free survival） in 148 patients undergoing surgical treatment in Chongqing General Hospital from 2014 to 2017. Results:The five-year overall recurrence rate was 14.86% and the overall recurrence rate was 8.78%. Univariate analysis showed that smoking index, laryngopharyngeal reflux and lesion range were significantly associated with recurrence（P<0.05）, and smoking index and lesion range were significantly associated with canceration（P<0.05）. Multivariate logistic regression analysis showed that smoking index ≥600 and laryngopharyngeal reflux were independent risk factors for recurrence（P<0.05）, and smoking index ≥600 and lesion range ≥1/2 vocal cord were independent risk factors for canceration（P<0.05）. The mean carcinogenesis interval for the postoperative smoking cessation group was significantly longer（P<0.05）. Conclusion:Excessive smoking, laryngopharyngeal reflux and a wide range of lesions may be related to postoperative recurrence or malignant progression of precancerous lesions in the vocal cord, and further large-scale multi-center prospective randomized controlled studies are needed to clarify the effects of the above factors on recurrence and malignant changes in the future.
Humans ; Vocal Cords/pathology* ; Retrospective Studies ; Laryngopharyngeal Reflux/complications* ; Prospective Studies ; Precancerous Conditions/pathology* ; Risk Factors

OBJECTIVE: To assess the effect of shift work on hypertension in petrochemical production workers. METHODS: Totally 2573 workers were recruited from a petrochemical company by convenience sampling method. We collected the basic information of participants via questionnaire and made occupational physical examination in these subjects to evaluate the relationship shift work with hypertension. RESULTS: The results showed that the prevalence of hypertension in the present study was 15. 1%,and the shift workers were with significant higher prevalence compared with the non-shift workers( 15. 9% vs 10. 7%,P < 0. 05). The systolic blood pressure levels were significant higher in shift work group than that in non-shift work group [( 119. 8 ± 14. 9) vs( 116. 6 ± 13. 7) mmHg,P < 0. 01]. After adjusted for age,gender,education,body mass index,family history of hypertension,and other confounding factors,multiple logistic regression analysis showed that the risk of hypertension in shift work group was 1. 49 times( 95% confidence interval was 1. 05-2. 12)than that of non-shift work group( P < 0. 05). By using stratified analysis by the duration of shift work in the shift workers,the risk of hypertension in the duration of 10-year and 20-year groups were higher than that of the duration less than 10-year group( P < 0. 05). CONCLUSION: Shift work exposure increases the prevalence of hypertension by affecting systolic blood pressure,and this risk can be enhanced with increasing duration of shift work.