Humans ; Integrative Medicine ; Medicine, Chinese Traditional ; Occupational Diseases ; therapy ; Osteoarthritis, Knee ; therapy

ObjectivePresent treatment in plastic surgery on giant congenital melanocytic nevus has always been a tough practice because it is difficult to achieve balance between effects and costs of treatment.This paper aimed to explore the concrete procedure of tangential excision and dermabrasion in treatment of adult giant congenital melanocytic nevus. Methods Taking into consideration pathological examination results before surgery,diseased regions,psychological expectancy and other factors,we used a humby knife or globe grinding head to remove giant congenital relanocytic nevus by wiping off the surface of it in 10 cases.After operation,the operated area of the skin underwent a process of healing in a moisturized state.In each case,surgical procedure was carried out by 1 2 sta ges,with the interval period ranges from 3 months to 6 months.ResultsOne to 3 years follow-ups showed that among those cases,5 cases obtained good results in which skin color of surgical area turned to normal and pathological examination showed that nevus cells disappeared,4 cases achieved improvement,and 1 case was relapsed.ConclusionsThe two alternative methods for treatment of giant congenital melanocytic nevus,either tangential excision or dermabrasion,with combination of pathological examination results,diseased regions,and psychological expectancy should be taken into consideration,which can remain a maximum balance between effects and costs of treatments.Tangential excision and dermabrasion are effective in some cases of giant congenital nevus where traditional methods do not work,or in order to reduce the cost of body appearance in treatment.Therefore,these two methods deserve to be adopted extensively in clinical therapy.But it still needs further accumulation of experience in practice and longer period of follow-up after operation.

One hundred and twenty four patients with type 2 diabetes mellitus (T2DM) admitted to the Department of Endocrinology of Chuzhou First People's Hospital from April to October 2019 whose blood glucose levels were not controlled after treatment with metformin (2.0 g/d) for more than 3 months were enrolled in the study. The patients were randomly divided into oral drug group and liraglutide group with 62 cases in each group. On the basis of metformin, the oral drug group was treated with acarbose (300 mg/d); the liraglutide group was treated with liraglutide (1.2 mg/d). The course of treatment was 3 months. The body weight, fasting blood glucose (FPG), 2-h postprandial blood glucose (2 hPG), glycosylated hemoglobin (HbA1c), cholesterol (TC) and triglyceride (TG) levels were compared between the two groups before and after treatment, and the gastrointestinal symptoms and the incidence of hypoglycemia were analyzed. After 3-month treatment the body weight, FPG, 2 hPG, HbA1c of the two groups were lower than the baseline levels ( P<0.05). Compared with the oral group, the body weight, FPG, 2 hPG, HbA1c and TG in liraglutide group were more markedly decreased ( P<0.05). The gastrointestinal reaction of liraglutide group was significantly higher than that of the oral drug group, and there was no hypoglycemia in both groups. The data indicate that liraglutide combined with metformin can significantly improve the blood glucose, blood lipid and body weight of T2DM patients and no hypoglycemia occurs during the treatment.

OBJECTIVE: To explore the relationship of the local recurrence with the expression of protein Survivin and MMP-2 in the primary lesions and the surgical margins of laryngeal carcinoma. METHOD: The primary lesions and the surgical margins of laryngeal carcinoma of 48 patients were made into serial sections. Immunochemical methods was used to detect the expression of protein Survivin and MMP-2 in the primary lesion and the surgical margins of laryngeal carcinoma of 48 patients. RESULT: The positive expression for Survivin and MMP-2 in the primary lesion was 70.83% (34/48) and 66.67% (32/48) respectively, and the positive expression of Survivin and MMP-2 in the surgical margins of laryngeal carcinoma was 47.92% (23/48) and 37.50% (18/48), which in the primary lesion was significantly higher than those of the surgical margins of laryngeal carcinoma (P < 0.05). The recurrence rates of primary lesion positive for Survivin (34 cases) and MMP-2 (32 cases) were 26.47% (9/34) and 25.00% (8/32), which were higher than negative for them 7.14%(1/14) and 12.50% (2/16) (P > 0.05). The recurrence rates of those with Survivin (23 cases) and MMP-2 (18 cases) positive surgical margins were 34.78% (8/23) and 38.89% (7/18) respectively, which were significantly higher than those with negative ones 8.00% (2/25) and 10.00% (3/30) (P < 0.05). Logistic analysis showed that the expression of Survivin and MMP-2 protein in the surgical margins of laryngeal carcinoma was positively associated with the recurrence rates. CONCLUSION Laryngeal carcinoma patients with Survivin-positive or MMP-2-positive margin would have a higher recurrence rate. Survivin and MMP-2 protein can be used as biomarkers for local recurrence of laryngeal carcinoma after operation.
Biomarkers, Tumor ; metabolism ; Humans ; Inhibitor of Apoptosis Proteins ; metabolism ; Laryngeal Neoplasms ; metabolism ; Matrix Metalloproteinase 2 ; metabolism ; Neoplasm Recurrence, Local ; Survivin

Objective To evaluate the predictive value of neutrophil to lymphocyte ratio(NLR) and B-type natriuretic peptide (BNP) in elderly patients with heart failure complicated with pulmonary infection. Methods 178 heart failure patients in our hospital from June 2018 to May 2020 were selected as the research objects, and they were divided into pulmonary infection group (n=92) and non-pulmonary infection group (n=86) according to whether they were complicated with pulmonary infection. The differences of NLR and BNP levels and other clinical indicators between the two groups were compared. Univariate and multivariate Cox regression were used to analyze the influence of NLR and BNP levels on heart failure complicated with pulmonary infection. The predictive value of NLR combined with BNP on heart failure complicated with pulmonary infection was analyzed by receiver operating characteristic (ROC) curve. Results Multivariate logistic regression analysis showed that NLR (OR=7.606, 95% CI: 3.123-18.526) and BNP (OR=4.264, 95% CI: 1.682-10.811) were independent risk factors of elderly heart failure complicated with pulmonary infection after adjusting for other related variables. Pearson correlation analysis showed that BNP level was positively correlated with NLR level (r=0.400, P<0.001). The area under ROC curve of NLR, BNP and NLR+BNP in predicting pulmonary infection in elderly patients with heart failure was 0.810, 0.756 and 0.838, respectively. Conclusion BNP and NLR are independent risk factors of elderly patients of heart failure with pulmonary infection .The combined detection of BNP and NLR has predictive value for those patients.

Objective To investigate the clinical outcomes of hemiarthroplasty with Wagner SL prosthesis in treating failed internal fixation of intertrochanteric fractures of elderly patients.Methods Aretrospective case series study was conducted on the clinical data of 14 patients with failed internal fixation of intertrochanteric fractures admitted between March 2015 to April 2018.There were seven males and seven females with a mean age of 82.2 years (range,75-94 years).The primary internal fixators were proximal femoral nail anti rotation in nine patients,dynamic hip screw in three patients,and proximal femoral locking plate in two patients.The main causes of internal fixation failure were screw loosening in six patients,cutting out of screws in five patients,nonunion in two patients,and plate breakage with nonunion in one patient.Affected limb shortening and coxa varus deformity to various degrees were seen in all the patients before operation.The mean interval from internal fixation to hemiarthroplasty was 6.6 months (range,2-12 months).All patients received hemiarthroplasty using Wagner SL prosthesis,of which nine patients had additional trochanter claw plate with titanium cable fixation and two patients had tension band wire fixation.The operation time,intraoperative,and postoperative complications were recorded.Harris hip scores were measured before operation and at the last follow up to evaluate hip function.Radiographs were performed to assess the fracture healing,prosthesis position,and biological fixation.Results All patients were followed up for 6-30 months (mean,14.5 months).The mean operation time was (108.0 ± 12.4) minutes (range,88-130 minutes).No iatrogenic fracture occurred during the operation.One patient was seen contralateral intertrochanteric fracture during follow-up,and no complications such as periprosthetic fracture,prosthetic sinking,and infection occurred in the 13 patients.The Harris score increased from (26.1-±7.5)points before operation to (83.1 ±4.1)points after operation (P ＜ 0.01).All patients were able to stand and walk,of which four needed crutch assistance.At the last follow-up,X-ray film showed that the prosthesis was well positioned and that all of them reached bony fixation.Fourteen cases of greater trochanteric fracture were healed,with two cases of slight displacement.Conclusions Hemiarthroplasty is an effective remedial treatment for failed internal fixation of intertrochanteric fractures in the elderly,which can improve hip function and enhance the life quality of patients.Wagner SL prosthesis can obtain stable fixation.