Objective:To observe the clinical effect of mind-refreshing and orifice-opening needling method plus swallowing disorder therapeutic apparatus for deglutition disorder of stroke patients in convalescence stage.Methods:A total of 136 patients conforming to the inclusion criteria were randomized into three groups by the random number table,including group A of 46 cases,group B of 44 cases and group C of 46 cases.Patients in group A received swallowing disorder therapeutic apparatus treatment,patients in group B received mind-refreshing and orifice-opening needling method treatment,and patients in group C received mind-refreshing and orifice-opening needling method plus swallowing disorder therapeutic apparatus treatment.The treatment was given once a day for 10 d as a course,the whole treatment lasted for 4 courses.Therapeutic evaluation items including water-swallowing test (WST),standardized swallowing assessment (SSA) and modified Barthel index (MBI) were measured before treatment,after treatment and at follow-up visit (2 months after treatment).Results:After treatment,scores of WST and MBI in all three groups increased significantly (all P＜0.05),while the SSA score dropped significantly (all P＜0.05).After treatment and during follow-up visit period,score of WST in group C was significantly higher than that in group A and group B (both P＜0.05),while the difference between group A and group B showed no statistical significance (P＞0.05);the SSA score in group C was substantially lower than that in group A and group B (all P＜0.05),the difference between group A and group B showed no statistical significance (P＞0.05);the MBI scores in group B and group C were substantially higher than that in group A (all P＜0.05),the difference between group B and group C showed no statistical significance (P＞0.05).After treatment and during follow-up visit period,the differences in overall therapeutic effect between group A and group B showed no statistical significance (P＞0.05),while the overall therapeutic effect in group C was substantially better than that in group A and group B (all P＜0.05).Conclusion:Both mind-refreshing and orifice-opening needling method and swallowing disorder therapeutic apparatus can alleviate symptoms of deglutition disorder of stroke patients respectively,and the combination of two methods can improve the therapeutic effect.

Objective : To understand the current situation and characteristics of narcotic drugs and psychotropic drugs abuse or dependence among hospital patients and to provide reference for strengthening the management of narcotic drugs and psychotropic drugs. Methods : We collected clinical data from hospitals in Shandong and Guizhou provinces in 2016 and selected patients with history of narcotic drugs and psychotropic drugs. We investigated them through telephone or face-to-face interview,then described the characteristics of demographic information and abuse or dependence of narcotic drugs and psychotropic drugs in diagnosed drug abusers. Results : A total of 280 patients with drug abuse or dependence were recruited,of which 223 cases from nine hospitals in Shandong and 57 cases from five hospitals in Guizhou. There were 170 male patients,accounting for 60.71%; 193 patients aged 45 years and above,accounting for 68.93%; 223 married patients,accounting for 80.51%; 166 patients with a education level of junior high school and below,accounting for 61.25%; 125 patients engaged in agriculture,accounting for 48.64%. Benzodiazepine was the main drugs abused or dependenced by hospital patients,accounting for 73.57%（206 cases）. There were also 83 cases of polydrug abuse,accounting for 29.64%. Among the patients with drug abuse or dependence,45.71% had no special feelings,41.07% had symptoms or felt uncomfortable after withdrawal; 64.64% was for improving their sleep quality. Conclusion Most patients with abuse or dependence of narcotic drugs and psychotropic drugs are middle- or senior-aged and have polydrug abuse. Benzodiazepine are the main abused drugs. The common reason for narcotic and psychotropic drug abuse or dependence is to have a good sleep.

OBJECTIVETo explore the therapeutic effects of internal fixation with Herbert screws for the treatment of Pipkin type I and type II femoral head fractures.

METHODSFrom January 2008 to December 2012, 23 patients with Pipkin type I and type II femoral head fractures were treated with open reduction and internal fixation by Herbert screws through Kocher-Langenbeck approach. Twenty-three patients (aged 18 to 52 years with a mean of 35.5 years, including 18 males and 5 females patients, 8 left hips and 15 right hips) with femoral head fractures and posterior hip dislocation. The fracture was classified according to Pipkin classification based on the radiographic findings, 5 patients had type I and 18 had type II fractures. The duration time from admission to the operation ranged from 6 to 72 h (averaged 32 h). The clinical and radiographic outcomes of the patients were measured using Thompson-Epstein scoring scale. The Harris hip score(HHS) was used to evaluate and compare hip functions at the latest follow-up between affected and healthy sides.

RESULTSAll the patients were followed up, and the duration ranged from 20 to 48 months (averaged 30 months). According to Thompson-Epstein system, 12 patients got an excellent result, 6 good, 4 fair and 1 poor. The average HHS at the finial follow-up was 87.80 ± 8.46 (ranged from 66 to 95), which is similar to that in the healthy side 90.10 ± 6.35 (ranged from 72 to 98) (t = 1.044, P = 0.302). The complications such as deep infection, and deep vein thrombosis were not found. At the 3rd year during follow-up,4 patients had avascular necrosis of femoral head. At the 1st year of follow-up, 1 patient had hip pain after walking,screws loosening and shift after trauma,and serious complications of traumatic arthritis. All the 5 patients were treated with total hip arthroplasties.

CONCLUSIONThe treatment of internal fixation with Herbert screws through the Kocher-Langenbeck approach is effective for Pipkin type I and type II femoral head fracture. The method is reliable and valuable for recommendation. However, such fracture may have avascular necrosis of femoral head and complication of traumatic arthritis, which should be observed carefully in clinic with preparation of the prevention and treatment measures.

Adolescent ; Adult ; Bone Screws ; Female ; Femoral Neck Fractures ; surgery ; Fracture Fixation, Internal ; adverse effects ; methods ; Humans ; Male ; Middle Aged

OBJECTIVETo examine the effect of pre-surgical orthodontics on the outcome of the secondary alveolar bone grafting in the patients with complete cleft lip and palate.

METHODSSixteen complete cleft lip and palate patients (9 males and 7 females) with collapsed upper arch or severe mal-positioned upper incisors were selected. The cleft was not easily grafted because of the poor access. The total cleft sites were 22 (10 patients with UCLP and 6 patients with BCLP). The age range of the patients was from 8 to 22 years. Pre-surgical orthodontic treatment was mainly to expand the collapsed upper arch and correct the mal-positioned upper incisors. After the secondary alveolar bone grafting, the patients were followed up and anterior occlusal radiograph/intraoral panograph were taken regularly. The observation period was from 6 months to 4 years. Bergland criteria were used to evaluate the interdental septal height.

RESULTSUpper arch expansion and the correction of the mal-positioned upper incisors done by the orthodontic treatment made the bone grafting procedure easier. The clinically successful rate reached 86%.

CONCLUSIONThe severe upper arch collapse and mal-positioned upper incisors in the patients with complete cleft lip and palate should be corrected orthodontically before the secondary alveolar bone grafting.

Abnormalities, Multiple ; surgery ; therapy ; Adolescent ; Adult ; Alveolar Process ; abnormalities ; surgery ; Bone Transplantation ; Child ; Cleft Lip ; complications ; surgery ; Cleft Palate ; complications ; surgery ; Female ; Humans ; Male ; Malocclusion ; complications ; surgery ; therapy ; Orthodontic Appliances ; Orthodontics, Corrective

Objective To explore the role of infection control nurses in healthcare-associated infection(HAI)man-agement,and provide basis for HAI management.Methods Through setting up infection control nurses in clinical departments of the whole hospital,clarifying their responsibilities and duties,training,and supervising them,the effect of infection control nurses on HAI management was observed.Results A total of 67 infection control nurses were set up in the clinical departments of the whole hospital,HAI management knowledge among health care work-ers (HCWs)in 26 departments improved significantly,scores of HAI management knowledge among HCWs in April and December was compared,difference was statistically significant (Z = - 2.193,unilateral P = 0.014). Hand hygiene compliance rate of HCWs improved from 83.35%(1817/2180)in April to 89.53% (2002/2236)in December,difference was statistically significant(χ2 =36.13,P <0.01).A total of 56670 hospitalized patients were monitored from April to December 2015,the total length of hospital stay was 411164 days,utilization rate of three catheters was 27.18%,three catheter-related infection rate was 0.74‰.The median scores of supervision on HAI management in clinical departments improved from 95.30 in May to 97.70 in September(P <0.05).Conclusion Setting up infection control nurses is of great significance to strengthen the HAI management organization and pro-mote the quality of HAI management.

OBJECTIVETo evaluate the accuracy of mammography in breast cancer screening in Asian women.

METHODS8718 community women in Chengdu were examined by mammography during the routine physical examination from Mar. 2002 to Sep. 2007. Pathological diagnosis and following up results were used as the gold standards for X-ray-positive and -negative findings. The sensitivity, specificity and diagnosis odds ratio were calculated as accuracy indexes. Large scale follow-up studies of breast cancer screening in community in Asian women were collected to evaluate the pooled accuracy of mammography. Diagnosis meta-analysis was conducted with Meta-Disc software to estimate the pooled sensitivity, specificity and DOR, and draw the summary receiver operating characteristic (SROC).

RESULTSThe data of seven studies were included with a total of 223 619 women received mammography for screening breast cancer. The sensitivity (95%CI) and specificity (95%CI) of mammography of community-based follow-up study in Chengdu were 0.889 (0.741 - 0.970) and 0.991 (0.987 - 0.993), respectively. Referring to meta-analysis, random effects models were adopted due to existed heterogeneity among studies. The pooled sensitivity, specificity, DOR with their 95% confidence intervals were 0.845 (0.821 - 0.870), 0.930 (0.929 - 0.931) and 117.271 (65.060 - 211.412), respectively. The Area Under the Curve (AUC) of SROC was 0.9144.

CONCLUSIONDue to its high accuracy, mammography deserves to be recommend in breast cancer screening in Asian women.

Adult ; Aged ; Area Under Curve ; Asia ; epidemiology ; Breast Neoplasms ; diagnosis ; diagnostic imaging ; epidemiology ; pathology ; Carcinoma in Situ ; diagnosis ; diagnostic imaging ; epidemiology ; pathology ; Early Detection of Cancer ; Female ; Follow-Up Studies ; Humans ; Mammography ; Mass Screening ; Middle Aged ; Neoplasm Staging ; Odds Ratio ; Sensitivity and Specificity

OBJECTIVETo observe the short-term clinical results of the adjacent segment degeneration after the implantation of Coflex system at the interspinous space of adjacent segment to lumbar fusion.

METHODSFifty patients with grade III disc (Thompson MRI classification) of adjacent segment to lumbar fusion were included and divided alternately into two groups according to the order of hospitalization from January to November 2009. Coflex system was implanted at the interspinous space of adjacent segment to lumbar fusion in 25 patients as Coflex group, the other 25 patients did not have any surgical treatment were as control group. The followed up time was 2 years. Visual analogue scale (VAS) score of low back pain, changes of disc height and motion range of adjacent segment to lumbar fusion on X-ray imaging were evaluated by independent sample t-test or paired samples t-test.

RESULTSThere were 22 patients in Coflex group and 21 patients in control group were followed up 2 years post-operation. The difference of VAS score between two groups was no significance (P > 0.05). In Coflex group, the change of postoperative disc height was no significance (P > 0.05), but the motion range was significantly reduced to 47% of the preoperative value (t = 7.99, P < 0.05). In control group, the postoperative disc height decreased slightly, without significant difference to the preoperative value (P > 0.05). Between the two groups, no differences of the disc height and motion range were found before operation, but the differences of the disc height changes (t = 6.7, P < 0.05) and motion rang (t = -14.5, P < 0.05) were significant in 2 years post-operation. No complications such as Coflex system loosen, immigration and spinal process fracture were occurred.

CONCLUSIONSCoflex system can obviously limit the motion range and maintain the disc space height of adjacent segment to lumbar fusion, and prevent its degeneration in some degree.

Adult ; Female ; Follow-Up Studies ; Humans ; Internal Fixators ; Lumbar Vertebrae ; surgery ; Male ; Middle Aged ; Postoperative Complications ; prevention & control ; Prospective Studies ; Spinal Fusion ; adverse effects ; instrumentation ; methods ; Treatment Outcome

OBJECTIVETo observe the expression of Schwann cell marker GFAP and myoepithelial cell marker alpha-SMA in salivary adenoid cystic carcinoma (ACC), and to evaluate the relationship of GFAP, alpha-SMA and perineural invasion in ACC.

METHODSImmunohistochemical SABC method, double-label immunofluorescence and CLSM were used to detect the expression of GFAP and alpha-SMA proteins in salivary ACC tissue samples.

RESULTSIn salivary ACC tissue samples, both GFAP and alpha-SMA proteins were positive, which were coexpressed in cytoplasm of the same onco-myoepithelial cells.

CONCLUSIONSThere may be Schwann cell differentiation in onco-myoepithelial cell of salivary ACC, and it may be the pathological base of perineural invasion in salivary ACC.

Actins ; metabolism ; Carcinoma, Adenoid Cystic ; metabolism ; pathology ; Epithelial Cells ; metabolism ; pathology ; Glial Fibrillary Acidic Protein ; metabolism ; Humans ; Muscle Cells ; metabolism ; pathology ; Salivary Gland Neoplasms ; metabolism ; pathology ; Schwann Cells ; metabolism ; pathology

OBJECTIVETo study the combined effect of gestational age and birth weight on metabolites related to inherited metabolic diseases (IMD).

METHODSA total of 3 381 samples ruled out of IMD by follow-up were randomly selected from 38 931 newborns who participated in the neonatal IMD screening during 2014-2016. The 3 381 neonates were categorized into seven groups according to their gestational age and birth weight: extremely preterm appropriate-for-gestational age (AGA) group (n=12), preterm small-for-gestational age (SGA) group (n=18), preterm AGA group (n=219), preterm large-for-gestational age (LGA) group (n=18), full-term SGA group (n=206), full-term AGA group (n=2 677), and full-term LGA group (n=231). Heel blood samples were collected from each group on postnatal days 3-7 after adequate breastfeeding. Levels of 17 key IMD-related metabolic indices in dried blood spots were measured using tandem mass spectrometry. Spearman′s correlation analysis was used to investigate the relationships between 17 IMD-related metabolic indices and their influencing factors, while covariance analysis was used to compare the metabolic indices between these groups.

RESULTSAfter adjusting the influencing factors such as physiological and pathological status, compared with the full-term AGA group, the extremely preterm AGA, preterm SGA, and preterm AGA groups had significantly reduced levels of leucine\isoleucine\hydroxyproline and valine (P<0.05); the preterm AGA group had a significantly decreased ornithine level (P<0.05); the extremely preterm AGA and preterm AGA groups had a significantly reduced proline level (P<0.05). Besides, the phenylalanine level in the extremely preterm AGA and preterm AGA groups, the methionine level in the preterm SGA group, and the tyrosine level in the preterm AGA group all significantly increased (P<0.05). The increased levels of free carnitine, acetylcarnitine, and propionylcarnitine were found in the preterm SGA and preterm AGA groups. The oleylcarnitine level also significantly increased in the preterm SGA group (P<0.05). Most carnitine indices showed significant differences between the SGA group and the AGA/LGA group in both preterm and full-term infants (P<0.05).

CONCLUSIONSLow gestational age and low birth weight may result in abnormal results in IMD screening. Therefore, gestational age and birth weight should be considered to comprehensively judge the abnormal results in IMD screening.

Birth Weight ; Female ; Gestational Age ; Humans ; Infant, Newborn ; Infant, Small for Gestational Age ; Male ; Metabolic Diseases ; metabolism

OBJECTIVETo investigate the clinical outcomes of surgical treatment of fracture of the fifth metatarsal base combined with degree III lateral ligament injury of ankle.

METHODSFrom January 2008 to December 2011, 32 patients with fracture of the fifth metatarsal base combined with degree III lateral ligament injury of ankle were treated with surgery. Fractures were fixed with compressed canulated screw and ligaments were repaired with suture anchors. After operation, ankle joints were fixed in neutral position and slightly valgus position by plaster slab. Taking out stitch was performed at 2 weeks after operation and non-weight loading walking by double crutches support started; after the 6 weeks, remove the gypsum and part-weight loading walking by brace protection; at the 8 weeks after operation, completely weight loading walking was permitted. American Orthopaedic Foot and Ankle Society (AOFAS) was used to evaluate the clinical effect.

RESULTSThirty-two patients were followed up from 8 to 18 months with an average of 12 months. All fractures obtained healing with an average time of 12.5 weeks (ranged, 8 to 24 weeks). According to the standard of AOFAS, 18 cases got excellent results and 14 good.

CONCLUSIONThe method that fracture fixation with compressed canulated screw and ligament repair with suture anchors can obtain satisfactory effects in treating fracture of the fifth metatarsal base and degree III lateral ligament injury of ankle.

Adult ; Aged ; Ankle Injuries ; surgery ; Bone Screws ; Collateral Ligaments ; injuries ; surgery ; Female ; Fracture Fixation, Internal ; methods ; Fractures, Bone ; surgery ; Humans ; Male ; Metatarsal Bones ; injuries ; surgery ; Middle Aged