OBJECTIVETo investigate the aortic elastic properties and its clinical significance in intracranial aneurysms (IAs).

METHODSOne hundred and seven IAs patients (57 with hypertension) and 108 healthy subjects were recruited. The internal aortic diameters in systole and diastole were measured by the M-mode echocardiography, the aortic elasticity indexes were calculated and compared.

RESULTSThe aortic distensibility (DIS) was lower and the aortic stiffness index (SI) was higher in IAs patients than those in controls (both P <0.001). DIS was lower and SI was higher in IAs patients with hypertension (IAs-HP) than those in IAs with no hypertension (P <0.001). Similar results were obtained when the aortic elasticity index were adjusted for body surface area and body mass index.

CONCLUSIONAbnormal aortic elasticity is a common finding in IAs patients and hypertension is closely related to the severity of aortic elasticity.

Adult ; Aged ; Aorta ; diagnostic imaging ; physiopathology ; Case-Control Studies ; Elasticity ; Female ; Humans ; Intracranial Aneurysm ; physiopathology ; Male ; Middle Aged ; Ultrasonography

Objective To assess the effectiveness of nocturnal splinting on carpal tunnel syndrome (CTS) by clinical scores and nerve conduction studies (NCS), and explore their correlations.Methods Forty-one patients (64 wrists), chosen from 66 consecutive patients with CTS from April 2009 to January 2010 meeting the inclusion criteria, were enrolled. The enrolled subjects were clinically evaluated by symptom severity scale (SSS) and functional status scale (FSS), and electrophysiologically evaluated by conventional nerve conduction studies (NCS); distal motor latency (DML) of wrist-abductor pollicis brevis, sensory conduction velocity (SCV) of wrist-index finger and wrist-ring finger, and the differences of distal sensory latency between the median and ulnar nerves (△DSL) were measured. The patients were instructed to use each splint on dorsal and palmar surface of the hand, centered at the distal wrist crease, to fix the wrist in neutral posture at bedtime. SSS, FSS and NCS were evaluated before splinting and (3.03±1.16) months after splinting; the follow-up was completed in 29 patients (31 wrists).Results (1) The abnormality rates of DML, wrist-index finger SCV, wrist-ring finger SCV and△DSL were 85.9%, 78.1%, 81.3% and 96.9%, respectively. (2) The SSS scores (1.55±0.38), FSS scores (1.40±0.27) and△DSL (1.24±0.61) after splinting was significantly decreased as compared with those before splinting (1.77±0.38, 1.53±0.31, 0.97±0.60); and the DML [4.14±0.76 (ms)] after splinting was significantly shortened as compared with that before splinting [4.53±1.25 (ms)]. No improvement of clinical scores was noted in 9 patients (14 wrists, 45.8%) after splinting. (3) The SSS scores were less significantly correlated to DML (r=0.420, P=0.019), wrist-index finger SCV (r=-0.425, P=0.017),wrist-ring finger SCV (r=-0.519, P=0.003), and no correlation between SSS scores and△DSL was noted (r=0.189, P=0.309); no correlation between FSS scores and the parameters of NCS was found either (P＞0.05). Conclusions Splinting is effective at least in a short-term in more than halfpatients with CTS.Little correlation is noted between clinical scores and NCS, suggesting that utilization both approaches to assess the therapeutic effect is of more significance. △DSL is the most sensitive parameter in the electrodiagnosis of CTS.

OBJECTIVETo study the reasonable dosage for paraplatin according to different dosage calculations.

METHODSA prospective, randomized, single-blinded study on 54 patients with advanced non-small-cell lung cancer (NSCLC) treated with paraplatin was conducted. Patients were divided to 2 groups. In group A, paraplatin dosage was calculated according to patients' body surface, and in group B, it was calculated according to the area under the curve (AUS). Hematological toxicity, response rate and survival rate in the two groups of patients were compared.

RESULTSNeutropenia in group A and group B was seen in 77.8% and 37.0% (P < 0.05), and thrombocytopenia in 18.5% and 3.7% (P > 0.05) of patients, respectively. Hemoglobin decrease was seen in 48.2% of patients in both groups. The average quantity of paraplatin given in one cycle of treatment was 535.93 +/- 106.71 mg and 398.52 +/- 71.72 mg (P < 0.01) respectively. The average time interval between treatment cycles was 27.04 +/- 5.30 d and 22.85 +/- 2.80 d (P < 0.05). The response rate and survival rate of patients in group A and B were 22.2% versus 48.2% (P < 0.05), and 40.7% versus 44.4% (P > 0.05) respectively, but the median survival time was identical (12 months) in the two groups.

CONCLUSIONNSCLC patients given paraplatin with dosages calculated on the basis of AUC have higher response rate and less severe hematological toxicity than those given paraplatin with dosages on the basis of body surface. However, the median survival time and survival rate have no statistical differences between the two groups of patients.

Adenocarcinoma ; drug therapy ; Aged ; Antineoplastic Agents ; administration & dosage ; adverse effects ; Area Under Curve ; Carboplatin ; administration & dosage ; adverse effects ; Carcinoma, Non-Small-Cell Lung ; drug therapy ; Carcinoma, Squamous Cell ; drug therapy ; Female ; Humans ; Lung Neoplasms ; drug therapy ; Male ; Middle Aged ; Neutropenia ; chemically induced ; Prospective Studies ; Single-Blind Method ; Survival Rate ; Thrombocytopenia ; chemically induced

ObjectiveTo investigate a suspected outbreak of healthcare-associated infection （HAI） caused by carbapenem-resistant Klebsiella pneumonia （CRKP） in a secondary grade-A hospital， analyze the infection source and transmission route， and put forward corresponding preventive and control measures. MethodsEpidemiological investigation was conducted on 5 patients with CRKP infection in department of neurosurgery during December 23‒30， 2021. Specimens were collected with the environmental microbiology monitoring procedure. CRKP isolated from the environmental samples were analyzed by multilocus sequence typing （MLST） method. Comprehensive measures were taken to control the CRKP infection. ResultsThe 5 infected patients were located in 3 rooms， and all were diagnosed as HAI. The antimicrobial susceptibility testing results from the specimens of 3 CRKP infected patients were the same. Through environmental microbiology monitoring， CRKP strains were detected from the faucet handle and sink specimens in 3 rooms. The results of MLST analysis showed that the faucet handle and sink specimens in room 2 and 3 were ST11 type. The environmental specimen in room 1 was ST23 type. The suspected outbreak was effectively controlled after comprehensive interventions. ConclusionHAI suspected outbreak might be caused by the environmental contamination from the pathogens of CRKP-infected patients as well as the contaminated hands of medical staff and accompanying family members. Strengthening the publicity， education and management of medical staff and accompanying staff， early identification of infection outbreaks， and timely comprehensive control measures are the keys to controlling multidrug-resistant nosocomial infection outbreaks.

OBJECTIVETo assess biological response and health adverse effects of industrial dusts from pottery factories and tungsten mines on alveolar macrophages (AM) in vitro.

METHODSAM acquired from bronchoalveolar lavage of guinea pigs were used as the target cells. AM were then co-cultured with respirable dust particles (15, 30, 60 and 120 μg/10⁶) from pottery factories and tungsten mines. LDH activity, cell viability, the release of ROS and TNF-α were determined to assess the biological responses of the dusts. China Standard Quartz was used as control.

RESULTSDose- response relationships between the dust concentrations and the enhancement of LDH activity, the release of ROS and TNF-α were found in both dusts from pottery factories and tungsten mines. The cell viability decreased when the dusts' concentrations increased. Differences of biological response were observed in the dust particles from different mines or factories. Compared with the pottery dusts, higher LDH activity and the release of TNF-α induced by tungsten dust were observed. In the 120 μg/10⁶ group, the TNF-α induced by tungsten dust, pottery dusts and China Standard Quartz was (5.2 +/- 2.0) ng/ml, (3.3 +/- 1.6) ng/ml and (2.8 +/- 0.5) ng/ml respectively. However, the impact on the cell viability induced by pottery dust was higher than that by tungsten mine.

CONCLUSIONIndustrial dusts from various sources could induce different biological effects. The results of the biological effects of dusts in laboratory tests may be of potential use to provide base data for their adverse effects evaluation.

Animals ; Cell Survival ; Cells, Cultured ; Ceramics ; Dust ; Guinea Pigs ; Lactate Dehydrogenases ; metabolism ; Macrophages, Alveolar ; drug effects ; metabolism ; Mining ; Quartz ; toxicity ; Reactive Oxygen Species ; metabolism ; Tumor Necrosis Factor-alpha ; metabolism ; Tungsten ; toxicity

OBJECTIVETo evaluate the outcome of core decompression with bone impaction grafting for the treatment of osteonecrosis of femoral head.

METHODSTotally 39 cases (46 hips) of osteonecrosis of femoral head were treated with core decompression and impaction bone grafting. According to the Association Research Circulation Osseous (ARCO) system, 3 hips were graded for stage 1,16 for stage 2a,7 for 2b,11 for 2c, and 9 for 3.The Harris hip score (HHS) was evaluated before operation and at the latest follow-up.

RESULTSIn all these patients, 22 hips had hormone-related lesions, 11 had alcohol-related lesions, and 13 had idiopathic lesions. The average HHS was changed from (66 ± 6.6) before surgery to (80.2 ± 9.7) after surgery during an average follow-up of 26 months(from 9 to 48 months). The postoperative HHS showed no significant difference among osteonecrosis of femoral head due to different etiologies.Also,the postoperative HHS and clinical effectiveness were not significantly different among patients with different preoperative stages.The postoperative outcome was excellent in 7 cases, good in 23 cases, mild in 4 cases,and poor in 12 cases. The rate of excellent and good was 65% in this series,with 78% for patients with early stages and 52.6% for those with grade 2c or higher lesions. The femoral head collapsed in 7 cases,and 5 of which were preoperatively graded as in stage 2c and higher. The postoperative complications included intertrochanteric fracture (n=1) and infection (n=1). Four hips were converted to total hip arthroplasty. All of other hips had no obvious progression of osteonecrosis.

CONCLUSIONSCore decompression with bone impaction allografting is effective for the treatment of osteonecrosis of femoral head. Patients with lesions in earlier ARCO stages can have better outcomes.

Arthroplasty, Replacement, Hip ; Bone Transplantation ; Decompression, Surgical ; Femur Head ; Femur Head Necrosis ; Humans ; Postoperative Complications ; Postoperative Period ; Treatment Outcome

ObjectiveTo analyze the clinical characteristics of 151 local COVID-19 patients in Shanghai， 2022. MethodsThe clinical data of 151 COVID-19 patients admitted to a district-level designated hospital in Shanghai from April 13 to May 10， 2022 were reviewed， and their clinical manifestations， laboratory tests， lung imaging， treatment and outcomes were analyzed. ResultsThe 151 patients ranged from 3 to 97 years old， with a median age of 72 years. Most of them were clustered cases in the communities and families. The main clinical types were mild （95 cases， 62.9%） and general （47 cases， 31.1%）. Most of the 9 severe/critical patients （6.0%） were elderly and complicated with multiple comorbidities. The proportion of people who had not been vaccinated was as high as 66.9%， and the proportion of those among severe/critically ill patients who had not been vaccinated was even higher. The most common first symptoms were expectoration in 71 cases （47.0%）， fever in 51 cases （33.8%） and dry cough in 30 cases （19.9%）. The counts of white blood cells and neutrophils in mild or general group were mostly normal or decreased， and in the severe/critical group increased significantly （P<0.001）. Increase of troponin， D-dimer， creatinine， and myoglobin； and decrease of lymphocytes in severe/critical group were more common than the other clinical types （P<0.05）. The proportions of use of antibiotics， antiviral drugs， thymalfasin and heparin in severe/critical and general patients were significantly higher than those in mild patients （P<0.05）. Among the cured and discharged patients （138 cases， 91.4%）， the median number of days for COVID-19 viral nucleic acid to turn negative after treatment was 12 days. The negative conversion days of mild patients were significantly shorter than those of general patients and severe/critical patients （P<0.01）. Four （2.6%） death patients were all over 80 years old， unvaccinated， combined with multiple comorbidities， and eventually died of those serious comorbidities. ConclusionCOVID-19 patients at the district-level designated hospital are mainly clustered cases， and the proportion of patients who do not receive COVID-19 vaccine is high. Most of the hospitalized patients are mild， but advanced age， multiple underlying diseases， and lack of vaccination are high-risk factors for developing severe disease. Early assessment and comprehensive treatment are the key to improve prognosis.

OBJECTIVE: To detect the expression of plasma exosomal microRNA (miRNA) in systemic sclerosis (SSc), and to investigate its clinical significance. METHODS: A total of 20 patients who were initially diagnosed with SSc and did not receive medication in Department of Rheumatology and Immunology of Meizhou People' s Hospital from January 2020 to January 2022 were recruited, as well as 15 healthy individuals whose gender and age matched with those of the SSc patients. Plasma exosomes were isolated using ultracentrifugation method. The expression levels of exosomal miR-34-5p, miR-92-3p and miR-142-3p were detected by quantative real-time polymerase chain reaction (qRT-PCR). Correlations between the expression levels of exosomal miRNAs and clinical characteristic were analyzed by Spearman's rank correlation coefficient test. RESULTS: The mean age of 20 patients with SSc was (52.6±12.6) years, including 7 males and 13 females. Among the 20 SSc patients, 13 cases were diagnosed as limited cutaneous systemic sclerosis (lcSSc) and 7 cases were diagnosed as diffuse cutaneous systemic sclerosis (dcSSc) according to the extent of skin involvement. According to the findings of high resolution chest CT, 7 of 20 SSc patients were diagnosed with interstitial lung disease (ILD) and 13 SSc patients were diagnosed with non-ILD. The expression levels of exosomal miR-34-5p, miR-92-3p and miR-142-3p were significantly elevated in the SSc patients compared with those in the healthy controls group (P=0.003, P=0.000 1, and P=0.016, respectively). Compared with the SSc patients without ILD, the expression levels of miR-34-5p and miR-142-3p were significantly lower in the SSc patients with ILD (P=0.037 and P=0.015, respectively). The expression levels of exosomal miR-34-5p and miR-142-3p showed negative correlation with ILD (r=-0.48, P=0.031 and r=-0.55, P=0.011, respectively), and arthritis (r=-0.46, P=0.040 and r=-0.48, P=0.032, respectively). The expression levels of exosomal miR-142-3p showed a negative correlation with erythrocyte sedimentation rate (ESR) (r=-0.55, P=0.012). CONCLUSION Plasma exosomal miR-34-5p, miR-92-3p and miR-142-3p were dysregulated in SSc. The dyregulation of exosomal miR-34-5p and miR-142-3p showed correlation with SSc associated ILD (SSc-ILD).
Male ; Female ; Humans ; Young Adult ; Adult ; Clinical Relevance ; MicroRNAs/genetics* ; Scleroderma, Systemic/genetics* ; Lung Diseases, Interstitial

Crohn's disease (CD) is a chronic relapsing and remitting inflammatory disease of the gastrointestinal tract. CD is rare in Taiwan and other Asian countries, but its prevalence and incidence have been steadily increasing. A steering committee was established by the Taiwan Society of Inflammatory Bowel Disease to formulate statements on the diagnosis and management of CD taking into account currently available evidence and the expert opinion of the committee. Thorough clinical, endoscopic, and histological assessments are required for accurate diagnosis of CD. Computed tomography and magnetic resonance imaging are complementary to endoscopic evaluation for disease staging and detecting complications. The goals of CD management are to induce and maintain remission, reduce the risk of complications, and improve quality of life. Corticosteroids are the mainstay for inducing re-mission. Immunomodulating and biologic therapies should be used to maintain remission. Patients should be evaluated for hepatitis B virus and tuberculosis infection prior to treatment and receive regular surveillance for cancer. These consensus statements are based on current local evidence with consideration of factors, and could be serve as concise and practical guidelines for supporting clinicians in the management of patients with CD in Taiwan.
Adrenal Cortex Hormones ; Asian Continental Ancestry Group ; Biological Therapy ; Consensus* ; Crohn Disease* ; Diagnosis ; Disease Management ; Expert Testimony ; Gastrointestinal Tract ; Hepatitis B virus ; Humans ; Incidence ; Inflammatory Bowel Diseases* ; Magnetic Resonance Imaging ; Prevalence ; Quality of Life ; Taiwan* ; Tuberculosis

Ulcerative colitis (UC) is an inflammatory bowel disease characterized by chronic mucosal inflammation of the colon, and the prevalence and incidence of UC have been steadily increasing in Taiwan. A steering committee was established by the Taiwan Society of Inflammatory Bowel Disease to formulate statements on the diagnosis and management of UC taking into account currently available evidence and the expert opinion of the committee. Accurate diagnosis of UC requires thorough clinical, endoscopic, and histological assessment and careful exclusion of differential diagnoses, particularly infectious colitis. The goals of UC therapy are to induce and maintain remission, reduce the risk of complications, and improve quality of life. As outlined in the recommended treatment algorithm, choice of treatment is dictated by severity, extent, and course of disease. Patients should be evaluated for hepatitis B virus and tuberculosis infection prior to immunosuppressive treatment, especially with steroids and biologic agents, and should be regularly monitored for reactivation of latent infection. These consensus statements are also based on current local evidence with consideration of factors, and could be serve as concise and practical guidelines for supporting clinicians in the management of UC in Taiwan.
Biological Factors ; Colitis ; Colitis, Ulcerative* ; Colon ; Consensus* ; Diagnosis ; Diagnosis, Differential ; Disease Management ; Expert Testimony ; Hepatitis B virus ; Humans ; Incidence ; Inflammation ; Inflammatory Bowel Diseases* ; Prevalence ; Quality of Life ; Steroids ; Taiwan* ; Tuberculosis ; Ulcer*