Objective To analyze the relevant factors of early warning in emergency patients with high risk of acute sores, explore the application value of transcutaneous oxygen pressure(TcPO2) and transcutaneous carbon dioxide pressure(TcPCO2)monitoring in the early warning of emergency patients with pressure ulcers. Methods This was a study of 186 consecutive emergency patients who were under care in the emergency department. The transcutaneous oxygen/carbon dioxide pressure monitor was used in monitoring the oxygen saturation of the skin of sacrococcygeal region and the chest. Meanwhile,the Braden scale was used in assessing risk factors for pressure ulcers and the receiver operating characteristic curve (ROC curve) was applied to evaluate the early prediction of pressure sore with TcPO 2/TcPCO2 monitor. Results Implementing the logistic regression model with six indicators, this research concluded that TcPO2 CV and PO2 were independent risk factors for the development of Braden scale in patients with high risk. The area under the ROC curve showed that TcPO2 CV had a excellent predictive value for the high-risk group and determined its cut-off value to be 20％. Which means patient with both a value of TcPO2CV over 20％ and a high risk of Braden scale had a larger possibility of pressure ulcers. Conclusions TcPO2 CV was an independent risk factor for patients under emergency care to develop pressure ulcers. A value of TcPO2CV over 20％indicated a high risk of pressure ulcers.

OBJECTIVES: Some changes are found in the labyrinth anatomy during postnatal development. Although the spatial orientation of semicircular canals was thought to be stable after birth, we investigated the age-related orientational changes of human semicircular canals during development. METHODS: We retrospectively studied the computed tomography (CT) images of both ears of 76 subjects ranged from 1 to 70 years old. They were divided into 4 groups: group A (1-6 years), group B (7-12 years), group C (13-18 years), and group D (>18 years). The anatomical landmarks of the inner ear structures were determined from CT images. Their coordinates were imported into MATLAB software for calculating the semicircular canals orientation, angles between semicircular canal planes and the jugular bulb (JB) position. Differences between age groups were analyzed using multivariate statistics. Relationships between variables were analyzed using Pearson analysis. RESULTS: The angle between the anterior semicircular canal plane and the coronal plane, and the angle between the horizontal semicircular canal plane and the coronal plane were smaller in group D than those in group A (P<0.05). The JB position, especially the anteroposterior position of right JB, correlated to the semicircular canals orientation (P<0.05). However, no statistically significant differences in the angles between ipsilateral canal planes among different age groups were found. CONCLUSION: The semicircular canals had tendencies to tilt anteriorly simultaneously as a whole with age. The JB position correlated to the spatial arrangement of semicircular canals, especially the right JB. Our calculation method helps detect developmental and pathological changes in vestibular anatomy.
Ear ; Ear, Inner ; Humans* ; Methods ; Parturition ; Retrospective Studies ; Semicircular Canals* ; Tomography, X-Ray Computed

Female ; Heart Atria ; diagnostic imaging ; surgery ; Heart Neoplasms ; diagnostic imaging ; surgery ; Humans ; Leiomyomatosis ; diagnostic imaging ; surgery ; Magnetic Resonance Imaging ; Middle Aged ; Ultrasonography

OBJECTIVE: To observe the effect of anti-osteoporosis drugs on the curative effect of femoral head replacement in the elderly patients with proximal humerus fracture. METHODS: From November 2012 to June 2016, 38 patients with proximal humeral fractures received humeral head replacement were divided into the treatment group and the control group according to whether the anti-osteoporosis drugs were used after the operation. The treatment group included 19 cases, of which 11 cases were three part fractures, 18 cases were four part fractures, and bone density was(0.58±0.14) g/cm²; the control group involved 19 cases, of which 10 cases were the three part fractures, 9 cases were four part fractures, and bone density was(0.58±0.11) g/cm². Periprosthetic bone mineral density(BMD) was measured at 4, 8, 12, 24 and 48 weeks after operation, and visual analogue scale(VAS) was used to evaluate the pain and Neer score was used to evaluate the function of the shoulder joint. RESULTS: The incisions of all patients were healed with grade A and no complications occurred. Thirty-five patients were followed up for 1 year. The bone density around the prosthesis of treatment group was higher than that of control group, the difference was statistically significant(<0.05);VAS in two groups had no statistical significance(>0.05). The total score and functional score of Neer in the treatment group were better than those in the control group, the difference was statistically significant(<0.05), and there was no significant difference in pain and activity score between the two groups(>0.05). According to the Neer score, the results of treatment group was excellent in 10 cases, good in 5 cases, fair in 3 cases;in the control group, 3 cases were excellent, 9 cases were good, and 5 cases were fair;the difference between the two groups was statistically significant(<0.05). CONCLUSIONS Artificial humeral head replacement combined with anti-osteoporosis drugs in the treatment of proximal humeral fractures in elderly patients can effectively improve the bone density around the prosthesis and restore shoulder function. The early clinical effect is satisfactory.
Aged ; Calcitonin ; therapeutic use ; Fracture Fixation, Internal ; Humans ; Humeral Head ; Postoperative Period ; Shoulder Fractures ; prevention & control ; Shoulder Joint ; Treatment Outcome

OBJECTIVE To investigate the effect of amifostine(Amf)on the differentiation of human megakaryocyte cell line-Dami. METHODS Dami cells were treated with Amf 0.01-5.0 mmol · L-1 for 12 d. Dami cells were counted every day for the growth curve:only cells with a diameter>20μm. The platelet demarcation membrane system was observed by transmission electron microscopy. The expression of CD33,CD34,CD41a and DNA ploidy was detected by flow cytometry. RESULTS Amf 0.1-1.0 mmol · L-1 promoted the differentiation of Dami cells ,but inhibited their proliferation at a concentration>1.0 mmol · L-1. When these cells were treated with Amf 1.0 mmol · L-1 for 12 d,the platelet demarcation membrane system was observed,the percentage of cells with a diameter >20 μm was increased by 24.6%(P<0.01),the expression of CD41a was increased by 11.9%,while the expression of CD33 was decreased by 13.6%(P<0.05). Polyploidy cells(16N)were observed,and 4N,8N and 16N cells were increased to 31.56%,8.83% and 3.43%,respectively(P<0.05). CONCLUSION Amf 0.1-1.0 mmol · L-1 can promote the differentiation of Dami cells,but inhibit their proliferation at a high concentration(>1.0 mmol·L-1).

OBJECTIVE: To study the reference ranges of platelet and related parameters within 24 hours after birth in preterm infants with different gestational ages. METHODS: According to the inclusion and exclusion criteria, a retrospective analysis was performed for the chart review data of 1 070 preterm infants with a gestational age of 23-36 weeks who were admitted to the neonatal intensive care unit from January to December in 2018. The reference ranges of platelet parameters were calculated for the preterm infants within 24 hours after birth. RESULTS: There were no significant differences in platelet count (PLT) and plateletcrit (PCT) among the preterm infants with different gestational ages (P>0.05). The late preterm infants (34-36 weeks; n=667) had significantly lower mean platelet volume (MPV) and platelet distribution width (PDW) than the extremely preterm infants (23-27 weeks; n=36) and the early preterm infants (28-33 weeks; n=367) (P<0.05). There were no significant differences in these platelet parameters between the preterm infants with different sexes (P>0.05). The reference ranges of platelet parameters in preterm infants were calculated based on gestational age. The reference ranges of PLT and PCT were (92-376)×10/L and 0.1%-0.394% respectively, for the preterm infants with a gestational age of 23-36 weeks. The reference ranges of MPV and PDW were 9.208-12.172 fl and 8.390%-16.407% respectively, for the preterm infants with a gestational age of 23-36 weeks; the reference ranges of MPV and PDW were 9.19-11.95 fl and 9.046%-15.116% respectively, for the preterm infants with a gestational age of 34-36 weeks. CONCLUSIONS The MPV and PDW of preterm infants with different gestational age are different within 24 hours after birth, and it is more helpful for clinical practice to formulate the reference range of MPV and PDW according to gestational age.
Blood Platelets ; Gestational Age ; Humans ; Infant, Newborn ; Mean Platelet Volume ; Reference Values ; Retrospective Studies

BACKGROUNDSurgical resection is generally considered the main curative treatment for intrahepatic biliary cystadenocarcinoma (IBCA) or suspected IBCAs, but controversy exists regarding the prognosis for IBCAs. This study aimed to describe the clinicopathological characteristics of IBCA and identify prognostic factors that may influence the survival of patients treated with surgical procedures.

METHODSThirty-four patients with histologically confirmed IBCA treated between January 2000 and June 2014 were included. The clinical characteristics of patients with IBCA were compared with those of 41 patients with intrahepatic biliary cystadenoma (IBC); factors that significant difference were analyzed for prognosis analysis of IBCA using multivariate/univariate Cox proportional hazards regression models. Survival curves were constructed using the Kaplan-Meier method and compared using the log-rank test.

RESULTSIBCAs had a strong female predominance, and the most common presenting symptoms were abdominal pain or discomfort. Compared with IBCs, IBCAs occurred in older patients, in more male patients, and were associated statistically significant abnormal increase in alanine aminotransferase (P = 0.01) and total bilirubin (P = 0.04). Mural nodules were more frequently seen with IBCAs and may associate with malignancy. It was difficult to differentiate between IBC and IBCA based on laboratory examination and imaging findings. Although complete resection is recommended, enucleation with negative margins also achieved good outcomes. Median overall patient survival was 76.2 months; survival at 1, 3, and 5 years was 88.0%, 68.7%, and 45.8%, respectively. Radical resection and noninvasive tumor type were independent prognostic factors for overall survival.

CONCLUSIONSIt remains difficult to distinguish between cystadenomas and cystadenocarcinomas based on laboratory examination and image findings. Complete resection is recommended for curative treatment, and patients should be closely followed postoperatively, particularly those with invasive tumors.

Aged ; Bile Duct Neoplasms ; pathology ; Bile Ducts, Intrahepatic ; pathology ; Cystadenocarcinoma ; pathology ; Female ; Humans ; Liver Neoplasms ; pathology ; Male ; Middle Aged ; Prognosis ; Proportional Hazards Models

OBJECTIVETo explore the feasibility of intraperitoneal injection of isoproterenol (ISO) to induce cardiac remodeling in FVB/N mice.

METHODSForty-eight FVB/N mice were divided into back subcutaneous saline group (subcutaneous saline group), intraperitoneal saline group, back subcutaneous ISO group (subcutaneous ISO group), and intraperitoneal ISO group according to the route of administration of saline or ISO. ISO (30 μg/g body weight/day) was given to the subcutaneous ISO group and the intraperitoneal ISO group, twice daily with an interval of 12 hours, for 14 consecutive days. The subcutaneous saline group and the intraperitoneal saline group were injected with an equal volume of saline. The left ventricular end-diastolic posterior wall thickness was measured by echocardiography, and the ratio of heart weight to tibia length was determined. Hematoxylin-eosin staining was used to determine the myocardial fiber diameter. Picric-sirius red staining was used to determine the myocardial collagen deposition area. Quantitative real-time PCR was used to measure the mRNA expression of collagen I.

RESULTSCompared with the subcutaneous ISO, subcutaneous saline, and intraperitoneal saline groups, the intraperitoneal ISO group had increased sizes of the cardiac cavity and the heart. Compared with the subcutaneous saline and intraperitoneal saline groups, the subcutaneous ISO group showed no significant changes in the gross morphology of the cardiac cavity and the heart. The intraperitoneal ISO group showed significant increases in the ratio of heart weight to tibia length, myocardial fiber diameter, left ventricular end-diastolic posterior wall thickness, myocardial collagen area percentage, and the mRNA expression of collagen I compared with the subcutaneous ISO, subcutaneous saline, and intraperitoneal saline groups (P<0.01). There were no significant differences in the above five indices between the subcutaneous ISO group and the subcutaneous saline and intraperitoneal saline groups (P>0.05). No significant difference in the mortality rate was found between the subcutaneous ISO and intraperitoneal ISO groups (P>0.05).

CONCLUSIONSIntraperitoneal injection of ISO can induce cardiac hypertrophy and fibrosis in FVB/N mice.

Animals ; Atrial Remodeling ; drug effects ; Cardiovascular Diseases ; drug therapy ; metabolism ; pathology ; physiopathology ; Collagen ; metabolism ; Disease Models, Animal ; Humans ; Injections, Intraperitoneal ; Isoproterenol ; administration & dosage ; Male ; Mice ; Myocardium ; metabolism ; pathology

Objective To study the correlation between traditional Chinese medicine(TCM)constitution and pathogenic factors in patients with ankylosing spondylitis(AS).Methods One hundred patients of AS and their family members who had medical consultation in the Fifth Hospital of Xi'an(i.e.,Shaanxi Hospital of Integrated Traditional Chinese and Western Medicine)in August 2019 and September 2020 were selected as the study subjects.The guidelines of Classification and Determination of Traditional Chinese Medicine Constitution issued by the China Association of Chinese Medicine were adopted to determine the traditional Chinese medicine(TCM)constitution types of the study subjects.The sociodemographic information,living habits,clinical symptoms,and TCM constitution types of the AS patients and their family members were collected by means of questionnaires and clinical investigations,and then the pathogenic factors of the patients with AS were investigated.The binomial Logistic regression model was used to analyze the correlation between TCM constitution types and pathogenic factors in patients with AS.Results(1)Among the 100 AS patients,the majority of them had the biased constitutions,and the biased constitutions with the occurrence frequency in descending order were yang deficiency constitution,qi deficiency constitution,and damp-heat constitution,which accounted for 33.00%,14.00%,and 18.00%,respectively.(2)The prevalence rates of AS in the first-,second-,and third-degree relatives of AS patients were 56.25%,40.00%and 25.00%,respectively.For the positive rates of human leukocyte antigen B27(HLA-B27)in AS patients and their family members,HLA-B27 in AS patients was all positive,while the positive rates of HLA-B27 in the first-,second-,and third-degree relatives of AS patients were 44.31%,30.67%and 15.63%,respectively.(3)The results of regression analysis showed that the disease duration of AS patients was significantly correlated with qi deficiency constitution,the grading of sacroiliac arthritis was correlated with qi stagnation constitution,and age was correlated with blood stasis constitution(P＜0.05 or P＜0.01).The results indicated that disease duration and age were the important factors affecting the constitution types of AS patients,and disease duration was closely related to qi deficiency while age was closely related to blood stasis.Conclusion AS is a highly hereditary autoimmune disease,and its onset is associated with HLA-B27.Yang deficiency is the basic constitution type of AS,and damp-heat constitution is the main constitution type in the progression of AS(especially in the active stage of the disease).The prolongation of the disease will exacerbate the illness condition of AS and then the manifestations of qi deficiency will be more obvious.

Child ; Humans ; Circulating Tumor DNA ; Lymphangioma ; Family ; Hemangioendothelioma ; Sarcoma, Kaposi