Objective To study the effect of the surgical procedure of primary incision & thread-drawing for behind abscess and drainage for left and right abscess in the treatment of high horsc-shoe Abscess. Methods Clinical data from 45 patients with this disease were retrospectively analysed. Results 43 cases were cured primarily, the cure rate was 96 %, among the 45 patients, 2 cases were formed anal fistula, accounted for 4 %. No anal incontinence, anorectal stenosis,and anal deformation,etc. Conclusion This surgical procedure can ensure primary cure. It is re- vealed that the procedure is of many advantages,including shorten treatment course, less lession, no malformation.

Objectives To investigate the effects of phytosterol intensive diet intervention on blood glucose, blood lipid and liver function in patients with type 2 diabetes mellitus combined with nonalcoholic fatty liver disease(NAFLD). Methods Patients with NAFLD admitted to the department of endocrinology, the Affiliated Hospital of Jiangsu University from January 2016 to June 2016 were recruited.We divided the groups according to the order of patient admission,with patients admitted from January to March who received conventional diabetes mellitus low-fat diet enrolled as control group,and patients admitted from April to June received extra phytosterol intensive diet on the basis of conventional diabetes mellitus diet as treatment group. The changes of blood glucose, blood lipid and liver function between two groups with a follow-up of six months before and after intervention were compared and analyzed. Results After intervention,the levels of fasting blood sugar(FPG)and blood glucose(2hPG), glycosylated hemoglobin (HbA1c), cholesterol (TG), triglyceride (TC), alanine aminotransferase (ALT) of patients in control group(11.13 ± 3.17)mmol/L,(18.65 ± 6.21)mmol/L,(9.82 ± 1.69)%,(2.81 ± 1.43) mmol/L、(5.40 ± 1.14)mmol/L,77.27%(51/66),which were lower than those before intervention((8.51 ± 2.83)mmol/L,(10.39 ± 3.62)mmol/L,(7.78 ± 1.46)%,(2.18 ± 1.13)mmol/L,(4.99 ± 1.04)mmol/L, 90.91%(60/66),P<0.05,and FPG,2 hPG,HbA1c,TG,TC,LDL-C,ALT and aspartate aminotransferase (AST) in the experimental group were(11.32 ± 3.64)mmol/L,(20.09 ± 4.83)mmol/L,(9.70 ± 2.12)%, (2.68 ± 1.74)mmol/L,(5.16 ± 1.10)mmol/L,(3.18 ± 0.92)mmol/L,(70.27)%(52/74),(86.49)%(64/74), which were significantly lower than those before intervention((7.37 ± 2.08)mmol/L,(9.20 ± 3.35)mmol/L, (6.75 ± 0.99)%,(1.86 ± 1.13)mmol/L,(4.69 ± 1.06)mmol/L,(2.67 ± 0.72)mmol/L, 91.89%(68/74), 98.65%(73/74), P<0.05, and the differences was statistically significant(t=4.584,9.329,7.349,2.823, 2.140,χ2=4.587, P<0.01 or 0.05 in control group;t=8.106,15.715, 10.826,3.393,2.651,3.755,P<0.01 in experimental group). The levels of FPG, 2 hPG and HbA1c were significantly lower in the experimental group compared with those in control group after intervention(P<0.05),and the positive-to-negative rate of fatty liver were found to be significantly higher (33.8%,25/74) than that (9.1%,6/66) in controls(P<0.05).There were not significantly differences in the level of TG,TC,high density lipoprotein(HDL-C), LDL-C, ALT and AST between the control group and experimental group(P>0.05). Conclusions Phytosterol intensive diet intervention can effectively reduce LDL-C,AST and the blood glucose level of type 2 diabetes patients with NAFLD, improving the positive-to-negative rate of fatty liver. Phytosterol intensive diet intervention can effectively reduce LDL-C, AST and the blood glucose level of type 2 diabetes patients with NAFLD,improve the positive-to-negative rate of fatty liver.

Objective:To explore the application effect of target management model based on standardized Metabolic Management Center (MMC) in newly diagnosed diabetic patients.Methods:A total of 80 inpatients who were newly diagnosed as diabetes mellitus in Department of Endocrinology and Metabolism in Affiliated Hospital of Jiangsu University from October 2018 to March 2019 were selected as the convenient sampling method. According to the random number table method, they were divided into the observation group and the control group, with 40 cases in each group. The control group was given routine nursing management while the observation group was given target management by using supporting facilities of MMC based on the control group. The changes of fasting plasma glucose (FPG) , 2 h postprandial blood glucose (2hPG) , glycated hemoglobin (HbA1c) , body mass index (BMI) and self-management behavior scores before and after 6 months of intervention were compared between the two groups.Results:There were no statistically significant differences in blood glucose index, BMI and self-management behavior score between the two groups before the intervention ( P>0.05) . After intervention, the blood glucose and self-management behavior scores of the observation group were better than those of the control group, and the differences were statistically significant ( P<0.05) . The BMI of observation group after intervention was lower than that before intervention, and the difference was statistically significant ( P <0.05) . There was no statistically significant difference before and after intervention in the control group ( P>0.05) . Conclusions:Target management based on the MMC is conducive to improving the self-management ability of newly diagnosed diabetic patients and helps them to effectively control blood glucose and body weight.

Objective:To analyze the main risk factors of recurrence after wound healing in patients with diabetic foot ulcer (DFU) , so as to provide a basis for clinical prevention of DFU recurrence.Methods:Cochrane Library, PubMed, Embase, Web of Science, CNKI, Wanfang Database, VIP Chinese Science and Technology Journal Full-text Database, and China Biomedical Literature Database were searched by computer, and the risk factors for recurrence of DFU patients were collected from the establishment of the databases to July 10, 2021. Meta-analysis was performed using RevMan 5.3 software.Results:Finally, 12 articles were included, with a total of 2 585 patients, including 982 cases in the recurrence group and 1 603 cases in the non-recurrence group. Meta-analysis results showed that Wagner grade (gradeⅢ, Ⅳ) ( OR=4.40, 95% CI: 2.21-8.78, P<0.01) , accompanied by peripheral neuropathy ( OR=5.69, 95% CI: 4.53-7.14, P<0.01) , accompanied by peripheral vascular disease ( OR=3.54, 95% CI: 3.05-4.11, P<0.01) , multidrug-resistant infection ( OR=3.61, 95% CI: 3.13-4.17, P<0.01) , history of amputation ( OR=19.18, 95% CI: 10.69-34.42, P <0.01) , duration of previous DFU greater than or equal to 60 days ( OR=1.02, 95% CI: 1.00-1.03, P<0.01) , poor blood glucose control ( OR=3.39, 95% CI: 2.67-4.31, P<0.01) , underlying osteomyelitis ( OR=2.86, 95% CI: 2.29-3.58, P<0.01) , initial ulcer on the sole of the foot ( OR=2.80, 95% CI: 2.10-3.73, P<0.01) , smoking ( OR=2.30, 95% CI: 1.18-4.48, P=0.01) were risk factors for DFU recurrence. Conclusions:Based on the available evidence, Wagner grade (gradeⅢ, Ⅳ) , accompanied by peripheral neuropathy, accompanied by peripheral vascular disease, multidrug-resistant infection, history of amputation, duration of previous DFU greater than or equal to 60 days, poor blood glucose control, underlying osteomyelitis, initial ulcer on the sole of the foot and smoking are risk factors for DFU recurrence. Medical staff should pay attention to these influencing factors and take corresponding measures for targeted prevention, so as to improve the quality of diabetic foot care services.

Objective:To retrieve, review and summarize the best evidence on nonpharmacologic prevention and management of venous thromboembolism (VTE) in patients with ischemic stroke (IS) .Methods:According to the "6S" model, Best Practice, UpToDate, Joanna Briggs Institute (JBI) Evidence-Based Health Care Center Database, PubMed, CINAHL, SinoMed, CNKI, Wanfang, VIP Databases, and dedicated stroke websites in China and abroad were searched for the evidence of nonpharmacologic prevention and management of VTE in IS patients, including clinical decision-making, best practice, evidences summary, guidelines, systematic reviews, expert consensus and randomized controlled trials published up to March 20, 2022. Evidence was extracted and summarized after quality assessment of the literature.Results:A total of 19 articles were included, including 2 clinical decision-making articles, 2 evidences summaries, 8 guidelines, 3 systematic reviews, and 4 expert consensus. A total of 38 pieces of best evidence were collected from 6 aspects: organizational security, risk assessment, screening and diagnosis, basic prevention, mechanical prevention and health education.Conclusions:This study summarizes the best evidence for nonpharmaceutical prevention and management of VTE in IS patients. It is recommended to promote the clinical application of this evidence scientifically and in a planned way through multidisciplinary collaboration in combination with clinical situations, factors promoting and hindering the application of evidences, and patient wishes.

Objective To retrieve,appraise and summarize the best evidence of risk assessment for PICC-related venous thrombosis and provide references for establishing relevant assessment tools.Methods British Medical Journal Best Practice,Cochrane Library,JBt Library,Registered Nurses' Association of Ontario (RNAO),National Guideline Clearinghouse (NGC),International Practice Guideline Registry Platform,China Guideline Clearinghouse (CGC),PubMed,EMbase,CNKI and CBM were searched from inception to March,2017,to collect literatures including clinical practice guideline,best practice information sheet,recommended practice and systematic review regarding risk assessment for PICC-related venous thrombosis.Results Eight studies were recruited,including five clinical practice guidelines,and three systematic reviews.Three categories (individual factors,iatrogenic factors,and catheterrelated factors)and totally 18 items of best evidence were summarized.Conclusion It is critical to perform individualized risk assessment for preventing PICC-related venous thrombosis before PICC placement.Medical institutions should establish principles,procedures and practice guidelines for PICC-related venous thrombosis assessment based on best evidence.

OBJECTIVE: To noninvasively assess the neurodegenerative changes in the brain of patients with Niemann-Pick type C (NPC) disease by measuring the lesion tissue with the iterative decomposition of water and fat with echo asymmetry and least square estimation-iron quantification (IDEAL-IQ). MATERIALS AND METHODS: Routine brain MRI, IDEAL-IQ and 1H-proton magnetic resonance spectroscopy (1H-MRS, served as control) were performed on 12 patients with type C Niemann-Pick disease (4 males and 8 females; age range, 15–61 years; mean age, 36 years) and 20 healthy subjects (10 males and 10 females; age range, 20–65 years; mean age, 38 years). The regions with lesion and the normal appearing regions (NARs) of patients were measured and analyzed based on the fat/water signal intensity on IDEAL-IQ and the lipid peak on 1H-MRS. RESULTS: Niemann-Pick type C patients showed a higher fat/water signal intensity ratio with IDEAL-IQ on T2 hyperintensity lesions and NARs (3.7–4.9%, p < 0.05 and 1.8–3.0%, p < 0.05, respectively), as compared to healthy controls (HCs) (1.2–2.3%). After treatment, the fat/water signal intensity ratio decreased (2.2–3.4%), but remained higher than in the HCs (p < 0.05). The results of the 1H-MRS measurements showed increased lipid peaks in the same lesion regions, and the micro-lipid storage disorder of NARs in NPC patients was detectable by IDEAL-IQ instead of 1H-MRS. CONCLUSION: The findings of this study suggested that IDEAL-IQ may be useful as a noninvasive and objective method in the evaluation of patients with NPC; additionally, IDEAL-IQ can be used to quantitatively measure the brain parenchymal adipose content and monitor patient follow-up after treatment of NPC.
Brain ; Female ; Follow-Up Studies ; Healthy Volunteers ; Humans ; Magnetic Resonance Imaging ; Magnetic Resonance Spectroscopy ; Male ; Methods ; Niemann-Pick Diseases ; Proton Magnetic Resonance Spectroscopy ; Water

OBJECTIVETo know how Shenfu injection is used in clinical practice and to provide a reference for guiding clinical use of Shenfu injection.

METHODExtract Shenfu injection's post-marketing re-evaluation data from the hospital information system (HIS) of 20 national grade III-A General Hospitals, use basic statistical analysis methods to analyze Shenfu injection's indications, usage and dosage, treatment course etc. in clinical practice.

RESULTIn patients using Shenfu injection, the average age was 62. 15, and patients mainly concentrated in cardiovascular medicine. In clinical practice, Shenfu injection was used mainly for treatment of coronary heart disease (diagnosed as chest obstruction in traditional Chinese medicine). The treatment course mainly ranged from 3 to 7 days, and the dosage was within the limits prescribed by the instruction.

CONCLUSIONShenfu injection was mainly used for elderly patients, and has been used according to instruction in practice almostly.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Clinical Trials as Topic ; Databases, Factual ; Drug Therapy ; Drugs, Chinese Herbal ; administration & dosage ; Female ; Hospital Information Systems ; Humans ; Male ; Middle Aged ; Outcome Assessment (Health Care) ; Young Adult

OBJECTIVETo explore the characteristics of severe acute respiratory syndrome (SARS) transmission in the population base on analyzing the first imported case and the chains of transmission.

METHODSFor the first imported SARS case and cases who were transmitted by the index case, epidemiological investigations were conducted using the guidelines for surveillance and case investigation issued by the Ministry of Health. Data as the date of onset of symptoms, date of hospitalization, contact history etc. for each of the cases and their close contacts were collected and analyzed.

RESULTSThe first imported SARS case introduced to Beijing had infected 9 people within the family and at the hospital, with two of whom died of the same disease. The incubation period for that index case was 4 days, and that for the cases considered to be the secondary and tertiary generations were 7 and 8 days, respectively. The shorter the incubation period, the longer the fever would last and clinically more severe.

CONCLUSIONOne of the epidemiological characteristics of SARS in Beijing was noticed that the disease clustered in families and hospitals. Infection through droplets and close contact has been viewed as the primary mode of transmission.

Adult ; China ; epidemiology ; Contact Tracing ; Cross Infection ; transmission ; Family Health ; Female ; Humans ; Infectious Disease Transmission, Patient-to-Professional ; Male ; Middle Aged ; Severe Acute Respiratory Syndrome ; epidemiology ; transmission

OBJECTIVETo analyze the changes in the cardiac function after St. Jude Regent mechanical valve replacement and assess the prosthesis-patient matching.

METHODSFrom October 2007 to March 2009, 44 patients received implantation of 17 mm St. Jude aortic prostheses in our hospital. The patients were followed up for clinical symptoms, signs, electrocardiogram (ECG), echocardiogram and cardiac functions, and the results were compared with those of randomly selected 44 patients receiving 21 mm St. Jude aortic prostheses.

RESULTSIn 17 mm St Jude Medica Regent valve group, 8 patients presented with ECG ST segment changes, 3 complained of chest tightness, 3 had occasional chest pain and discomfort, and 8 had grade II and 4 grade III cardiac function. In 21 mm St Jude Medical Regent valve group, 6 patients had ECG ST segment changes, 2 complained of chest tightness, 2 reported occasional chest pain and discomfort, 11 had grade II and 2 grade III cardiac function. No significant differences were found in these indices between the two groups (P=0.32). Compared with those before operation, the two groups showed significant improvements in the left ventricular end-diastolic diameter, left ventricular posterior wall thickness, left ventricular mass index, and aortic pressure gradient (P<0.05). A significant increase in the left ventricular ejection fraction occurred 6-12 months after operation, but without statistical difference between the two groups (P>0.05).

CONCLUSIONFor underweight patients (<60 kg) and those with small body surface area (<1.6 cm(2)), 17 mm St. Jude Medical Regent valve prosthesis may produce good therapeutic effect, and some indices are even close to those after placement of 21 mm St. Jude Medical Regent valve prosthesis. No obvious prosthesis-patient mismatch occurs after the placement of the 17 mm valve prosthesis and aortic valve ring expansion is not necessary.

Adolescent ; Adult ; Aortic Valve ; diagnostic imaging ; surgery ; Aortic Valve Stenosis ; diagnostic imaging ; surgery ; Child ; Child, Preschool ; China ; epidemiology ; Female ; Follow-Up Studies ; Heart Valve Prosthesis ; Heart Valve Prosthesis Implantation ; adverse effects ; methods ; Humans ; Male ; Middle Aged ; Postoperative Complications ; epidemiology ; Treatment Outcome ; Ultrasonography ; Young Adult