Objective: To analyze the epidemiological characteristics of pulmonary tuberculosis cases at ages of 60 years and older in Quzhou City, Zhejiang Province, so as to provide the evidence for formulating the pulmonary tuberculosis control strategy among the elderly. Methods: The data pertaining to pulmonary tuberculosis cases at ages of 60 years and older in Quzhou City from 2010 to 2020 were collected through the Tuberculosis Management Information System of the China Disease Prevention and Control Information System. The trends for incidence, population distribution, diagnosis and treatment of pulmonary tuberculosis cases aged 60 years and older were analyzed using a descriptive epidemiological method. Results: Totally 8 754 pulmonary tuberculosis cases aged 60 years and older were reported in Quzhou City from 2010 to 2020, accounting for 47.65% of all pulmonary tuberculosis cases, and the number of pulmonary tuberculosis appeared a tendency towards a rise ( χ2trend=173.320, P<0.001 ), while the incidence of pulmonary tuberculosis showed a tendency towards a decline ( χ2trend=389.820, P<0.001 ), with an annual decline rate of 177.11/105. There were 4 307 smear-positive pulmonary tuberculosis cases, accounting for 58.71% of all smear-positive cases, and the number of smear-positive pulmonary tuberculosis cases showed a tendency towards a rise ( χ2trend=126.320, P<0.001 ), while the proportion of smear-positive cases showed a tendency towards a decline ( χ2trend=21.680, P<0.001 ), with an annual smear-positive rate of 87.14/105. The incidence of pulmonary tuberculosis was 256.94/105 among males and 91.43/105 among females at ages of 60 years and older ( χ2=20.903, P<0.001 ). The highest incidence of pulmonary tuberculosis was seen in patients aged 80 to 84 years ( 235.17/105 ), and farmers were the predominant occupation ( 7 171 cases, 81.92% ), while the highest number of cases was reported in Quzhou City (8 676 cases, 99.11%). There were 7 752 treatment-naïve cases ( 88.55% ), while 5 830 cases with delay in seeking healthcare services, and the proportion of delay in seeking healthcare services showed a tendency towards a rise from 2010 to 2020 ( χ2trend=4.853, P=0.028 ), with an annual mean delay rate of was 66.60%. Conclusion The incidence of pulmonary tuberculosis appeared a tendency towards a decline among patients aged 60 years and older in Quzhou City from 2010 to 2020, and the elderly aged 80 years and older and farmers should be paid more attention.

After the current situation in medical information construction and the training of health information management undergraduates in Anhui Province were analyzed, suggestions were put forward, such as further strengthening the training of health information management professionals and establishing their positions in medical information construction, in terms of new student enrolment, offered curriculum, and graduate employment.

Objective: To compare the effects of general anesthesia, intraspinal anesthesia combined with general anesthesia and lumbar plexus block combined with general anesthesia on the volume load of lower limb joint replacement surgery in patients with coronary heart disease. Methods: One hundred and twenty patients (ASA classification Ⅱ-Ⅲ) with coronary heart disease who underwent selective lower extremity arthroplasty in Hubei Aerospace Hospital from January 2017 to November 2018 were randomly divided into three groups: general anesthesia group (group A), spinal canal combined with superficial general anesthesia group (group B) and lumbar plexus nerve block combined with superficial general anesthesia group (group C), with 40 cases in each group. The mean arterial pressure (MAP), heart rate (HR), cardiac index (CI), stroke volume index (SVI) and stroke volume variation (SVV) were observed and recorded at the time of entering operation room (T₀), immediate induction of anesthesia(T₁), immediately after the operation (T₂), 1 h after surgery (T₃) and at the end of the operation (T₄) in three groups. The operation time, anesthesia time and the incidence of complications of the three groups were recorded. Results: At T₁, HR, MAP, CI and SVV of the three groups were lower than T₀, and SVV were higher than T₀, and there were significant differences (P < 0.05). At T₁ and T₂, the MAP, CI and SVI in group B were significantly lower than those in group A and group C[T₁: (76.8 ± 5.4) mmHg (1 mmHg=0.133 kPa)vs. (84.4 ± 14.9) and (86.4 ± 19.1) mmHg, (1.9 ± 0.6) L/(min·m²) vs. (2.5 ± 0.7) and (2.3 ± 0.5) L/(min·m²), (35.5 ± 11.5) ml/m² vs.(40.5 ± 11.8) and (39.2 ± 10.3) ml/m²; T₂: (74.6 ± 6.7) mmHg vs. (89.9 ± 17.8) and (82.8 ± 19.7) mmHg, (2.6 ± 0.7) L/(min·m²) vs. (2.8 ± 0.7) and (2.6 ± 0.4) L/(min·m²), (38.2 ± 13.7) ml/m² vs. (44.9 ± 7.9) and (45.8 ± 8.3) ml/m²], and at T₁, the SVV of group B was significantly higher [(15.6 ± 2.1)% vs. (13.8 ± 4.3)% and (13.9 ± 2.9)%], and there were significant differences (P < 0.05). At T₂-T₄, the HR and MAP of group A were significantly higher than those of the other two groups (P < 0.05). The incidence of hypertension, hypotension and unstable angina pectoris in group C was significantly lower than that in group A and group B [5.0%(2/40) vs. 20.0%(8/40) and 35.0%(14/80)](P < 0.05). Conclusions Lumbar plexus block combined with shallow general anesthesia is safer for patients with coronary heart disease because of its smaller fluctuation of volume load index, more stable hemodynamics and lower incidence of cardiovascular adverse events.

Objective To explore the clinical effect of peroneal artery perforator flap for the treatment of serious heel spoke injuries in children.Methods From July,2014 to September,2017,13 children with severe heel and ankle injuries were treated by peroneal artery perforator flap.There were 9 males and 4 females,with an average age of 6.5 years (ranged from 3 to 11 years).The size of flaps ranged from 10.0 cm×3.0 cm to 14.5 cm×5.0 cm.The donor sites were sutured directly or covered with skin grafting.Regular follow-up was performed to observe the survival status of the flap and the functional recovery of the ankle joint.Results Twelve flaps survived completely.One flap had partial marginal necrosis in the distal portion,which was healed after dressing.Partial inadequate venous return happened in 1 case,which also recovered by the removal of part of the suture.All cases were followed-up for 3 months to 20 months.The appearance,texture,and color of the flaps were similar to the surrounding skin.No ulcer occurred.All case acquired normal gait.Conclusion The peroneal artery perforator flap is a good option for reconstruction of serious heel spoke injuries in children.The flap has consistent blood supply while leaving minimal morbidity at donor site.

OBJECTIVETo evaluate the effects of tramadol on the proinflammatory responses in a rat model of incisional pain by investigating its effects on nociceptive thresholds and serum interleukin-6 (IL-6) and IL-2 levels.

METHODSForty-two male Sprague-Dawley (SD) rats scheduled for plantar incision were randomly divided into 7 groups (n=6 in each group). Rats in Group 1 receiving general anesthesia with no incision were served as control; At 30 min before skin incision, Groups 2 to approximately 5 were given 5 ml normal saline or 1, 10, and 20 mg/kg tramadol, respectively, intraperitoneally (i.p.); Group 6 received 10 mg/kg tramadol after operation; Group 7 received 10 mg/kg tramadol before incision, followed by 200 microg/kg naloxone after operation. Mechanical allodynia was measured by electronic von Frey filament to evaluate the nociceptive thresholds 1 h before incision, and 1 h and 2 h after operation. Serum IL-6 and IL-2 levels were measured by enzyme-linked immunosorbent assay (ELISA) 2 h after operation.

RESULTSMechanical thresholds decreased significantly and serum IL-6 level increased significantly after operation in Group 2 compared with control (P<0.01), and these changes were reversed respectively by tramadol in a dose-dependent manner (P<0.05 and P<0.01, respectively). IL-2 level remained unchanged after operation in Group 2, but decreased in Group 3 (P<0.05), then gradually returned to the normal level in Groups 4 and 5. The intraperitoneally injected tramadol (10 and 20 mg/kg) produced a potent and dose-dependent antinocicptive effect on the lesioned paw. The antinocicptive effects of tramadol were partially antagonized by naloxone (200 microg/kg), suggesting an additional non-opioid mechanism.

CONCLUSIONThe results suggest that tramadol could be a good choice for the treatment of pain under the conditions that immunosuppression may be particularly contraindicated.

Analgesics, Opioid ; pharmacology ; Animals ; Dose-Response Relationship, Drug ; Interleukin-2 ; biosynthesis ; blood ; Interleukin-6 ; biosynthesis ; blood ; Male ; Pain Measurement ; methods ; Pain Threshold ; drug effects ; Pain, Postoperative ; blood ; drug therapy ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Tramadol ; pharmacology

OBJECTIVETo investigate effect of tramadol on c-fos expression in spinal cord dorsal horn and serum IL-6 levels induced by plantar incision in rats.

METHODSThe Brennan pain model was induced by incision on the planter surface of left hind paw in rats. Forty-eight rats were randomly divided into six groups: Sham group (Group C), control group (Group I,pretreatment with saline 5 ml), three tramadol pretreatment groups (Group T1, T10 and T20,pretreated with 1 mg/kg, 10 mg/kg and 20 mg/kg tramadol, respectively) and one tramadol treatment group (Group PT10, treated with tramadol 10 mg/kg immediately after operation). Pain behavior was assessed by withdrawal threshold to von Frey filament stimulation intensity, response latency of the hind paw to radiant thermal and a cumulative pain score 2 h after incision. Fos-positive neurons in spinal cord were identified by the immunohistochemical technique. Serum IL-6 levels were measured by enzyme-linked immunosorbent assay (ELISA).

RESULTSWithdrawIal threshold to von Frey filament stimulation intensity and response latency of the hind paw to radiant thermal in Group I were significantly lower than those in Group C (P<0.01). Cumulative pain score in Group I was significantly higher than that in Group C (P<0.01). In Groups of T10 and T20, withdrawal threshold to von Frey filament stimulation intensity and response latency of the hind paw to radiant thermal were significantly higher than those in Group I (P<0.01), cumulative pain score was significantly lower than that in Group I in a dose-dependent manner (P<0.01), and were also those in Group PT10. The greatest density of Fos-positive neurons was located in lamine I-II in Group I. Serum IL-6 levels were significantly elevated in Group I. Pretreatment with tramadol showed a dose-depended inhibitory effect on c-fos expression and serum IL-6 production,but not in Group T1. Administration of tramadol postoperatively also suppressed the c-fos expression and serum IL-6 production as showed in PT10 but were weaker than those in Group T10.

CONCLUSIONPretreatment with tramadol can produce dose-dependent inhibitory effect on c-fos expression in spinal cord dorsal horn and then suppress the inflammatory response to the trauma.

Analgesics, Opioid ; pharmacology ; therapeutic use ; Animals ; Interleukin-6 ; blood ; Male ; Pain Threshold ; drug effects ; Pain, Postoperative ; drug therapy ; metabolism ; Posterior Horn Cells ; drug effects ; metabolism ; Proto-Oncogene Proteins c-fos ; metabolism ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Tramadol ; pharmacology ; therapeutic use

OBJECTIVEThe purpose of this study was to qualitatively and quantitatively analyze the initial force system of "rocking-chair archwire" on every tooth.

METHODSThree-dimensional finite element model of "rocking-chair archwire" was set up, and nonlinear method was used to analyze the force system.

RESULTSThe archwire exerted intruding force, labial force, lingual-root torque and mesial-labial moment on incisors; Extruding force, lingual-root torque and mesial-labial moment were applied on canines and premolars; The archwire also created intruding force, buccal force, buccal-root torque and mesial-labial moment on molars.

CONCLUSIONS"rocking-chair archwire" produced a complicated force system. While intruding incisors, molars and extruding premolars. It has a tendency to induce tooth rotation and tipping.

Dental Stress Analysis ; Finite Element Analysis ; Humans ; Malocclusion ; therapy ; Orthodontic Appliance Design ; Orthodontic Wires ; Orthodontics, Corrective ; methods

OBJECTIVETo evaluate the safety and effectiveness of magnesium sulphate for reducing the incidence of the emergence agitation in patients undergoing surgery for esophageal carcinoma with general anesthesia.

METHODSThis randomized, double-blind, controlled clinical trial was conducted in patients undergoing elective radical resection of esophageal carcinoma in Sichuan Provincial People's Hospital between October, 2015 and March, 2016. The patients underwent surgeries under general intravenous anesthesia, and after anesthesia induction, the patients were infused with magnesium sulphate at the rate of 0.1 mL·kg·h(2.5 g magnesium sulphate in 50 ml saline pumped at 5 mg·kg·h) or saline (control group) at the same speed until the end of the surgery. The Riker's sedation agitation scale, pain score, muscle tension score, extubation time, residence time in the postanesthesia care unit (PACU), and adverse reactions were recorded.

RESULTSA total of 108 patients were enrolled including 57 in magnesium sulphate group and 51 in the control group. Riker's sedation agitation scale in the PACU, pain score, and muscle tension score were all significantly lower but the extubation time was longer in magnesium sulphate group than in the control group (P<0.05). In all the patients, blood Calevel was reduced significantly after the operation; blood Mglevel was significantly lowered postoperatively in the control group, and the postoperative Mglevel was significantly higher in magnesium sulphate group than in the control group (P<0.05). Mglevel underwent no significant variations in magnesium sulphate group after the operation (P>0.05). The residence time in the PACU, postoperative Riker's sedation agitation scale score, and blood Klevel were all similar between the two groups(P>0.05).

CONCLUSIONInfusion of magnesium sulphate at 5 mg·kg·hcan significantly reduce the incidence of emergence agitation in patients undergoing esophageal carcinoma under general anesthesia without causing such complications such as muscle recovery delay or electrolyte disorder.

BACKGROUNDThe aim of this study was to clarify the electrocardiographic characteristics of repetitive monomorphic ventricular tachycardia (RMVT) originating from the left ventricular outflow tract, and to describe the results of treatment with radiofrequency catheter ablation (RFCA).

METHODSRoutine 12-lead surface electrocardiography and electrophysiological studies were performed on 11 RMVT patients with no organic heart disease, who were subsequently treated with RFCA directed at targets identified by pace mapping.

RESULTSThe surface electrocardiogram QRS characteristics of RMVT included an atypical left bundle branch block and right axis deviation, with a low amplitude "rs" or "rS" pattern in lead I, an "rS" or "RS" pattern in V1, and a precordial R wave transition zone in V2 or V3. In 1 patient, a small S wave was observed in V5. Using pace mapping techniques, we selected the left coronary cusp as the ablation target. RMVT was eliminated in all 11 patients immediately after radiofrequency energy delivered. During a follow-up of 13 +/- 7 months, RMVT recurred in only 1 patient.

CONCLUSIONRMVT originating from the left ventricular outflow tract has specific electrocardiographic characteristics, and can be successfully and safely cured using RFCA directed at the left coronary cusp.

Adolescent ; Adult ; Catheter Ablation ; Electrocardiography ; Female ; Humans ; Male ; Middle Aged ; Tachycardia, Ventricular ; physiopathology ; surgery ; Treatment Outcome

BACKGROUNDGastroesophageal reflux disease with extra-esophageal symptoms, especially those with respiratory distress was attracting more and more attention. The related mechanisms were still in controversy. The purpose of the work was to explore airway inflammation triggered by gastroesophageal reflux.

METHODSSixteen Sprague-Dawley rats were used as study group and 9 as control. In the study group, a plastic extender with a trumpet-shaped distal end was inserted into the lower esophagus to dilate the cardia, the pylorus was ligated. One ml of 0.1 mol/L hydrochloric acid was injected into the stomach. While a simple laparotomy was performed for control animals. All animals from two groups were sacrificed 24 hours after operation. Then tracheotomy was carried and the bronchoalveolar lavage fluid was collected in all animals. Cells in the fluid were counted and levels of interleukin (IL)-5, -6, -8 in it were measured.

RESULTSCompared with control group, the study group presented a neutrophil pattern of airway inflammation and an elevated concentration of IL-5, -6, -8 with no significant difference regarding eosinophil count.

CONCLUSIONThe gastroesophageal reflux-triggered airway inflammation is characterized by a neutrophilic airway inflammation which differed from that caused by asthma, and enhanced levels of IL-5, -6 and -8, which are similar to that caused by asthma.

Animals ; Asthma ; etiology ; Bronchoalveolar Lavage Fluid ; immunology ; Disease Models, Animal ; Female ; Gastroesophageal Reflux ; complications ; Inflammation ; etiology ; Interleukin-5 ; analysis ; Interleukin-6 ; analysis ; Interleukin-8 ; analysis ; Male ; Rats ; Rats, Sprague-Dawley