Objective:To explore the risk factors for malnutrition after a tracheotomy and to construct a predictive model useful for its prevention through early intervention.Methods:Clinical data describing 440 tracheotomy patients were subjected to a retrospective analysis. The variables examined were age, sex, etiology, Glasgow Coma Score (GCS), activities of daily living (ADL) score, age-corrected Charlson comorbidity index (aCCI), food intake, swallowing function, incidence of infections, as well as any history of diabetes mellitus, hypertension, smoking or alcohol consumption. Patients identified as being at risk of malnutrition (NRS-2002≥3) were screened using the Nutritional Risk Screening tool (NRS-2002) and the European Society of Clinical Nutrition and Metabolism′s ESPEN2015 criteria. The subjects were thus categorized into a malnutrition group of 343 and a control group of 97. Unifactorial and multifactorial logistic regression analyses were performed, and stepwise regression was applied to include the factors found significant in the unifactorial analysis into the multifactorial logistic regression analysis, and to construct a column-line graph prediction model. The clinical utility of the model was assessed by applying the receiver operator characteristics (ROC) curves, calibration plots and decision curve analysis (DCA).Results:Of the 440 persons studied, 343 (78%) were malnourished. The multivariate logistic regression analysis showed that pulmonary infection, dysphagia, low GCS score and high aCCI score were significant risk factors for malnutrition after a tracheotomy. A prediction nomograph was constructed. After fitting and correcting, the area under the curve (AUC) of the prediction model′s ROC curve was 0.911, the specificity was 80.4%, and the sensitivity was 91.3%. That was significantly higher than the AUCs for pulmonary infection (0.809), dysphagia (0.697), aCCI (0.721) and GCS (0.802). Bootstrap self-sampling was used to verify the model internally. After 1000 samples the average absolute error between the predicted risk and the actual risk was 0.013, indicating good prediction ability. The DCA results demonstrated that the model has substantial clinical applicability across a range of nutritional interventions, particularly for threshold probability values ranging from 0 to 0.96.Conclusion:Pulmonary infection, dysphagia, low GCS score, and high aCCI score are risk factors for malnutrition among tracheotomy patients. The nomogram model constructed in this study has good predictive value for the occurrence of malnutrition among such patients.

Humans ; Tuberculosis, Extrapulmonary ; Retrospective Studies ; Paraffin Embedding ; Tuberculosis/diagnosis* ; Mycobacterium tuberculosis/genetics* ; Formaldehyde ; Sensitivity and Specificity ; Sputum

OBJECTIVE: To observe the effect of acupuncture at "Feishu" (BL 13) + "Dingchuan" (EX-B 1) and "Kongzui" (LU 6) + "Yuji" (LU 10) for the airway remodeling in asthma rats based on the transforming growth factor-β1 (TGF-β1)/ Smad family member 3 (Smad3) signaling pathway; and explore the efficacy difference between the two acupoint combinations. METHODS: Forty SPF male SD rats, aged 4 weeks, were randomly divided into a blank group (n = 10) and a modeling group (n = 30). The ovalbumin (OVA) sensitization method was used to establish asthma model in the modeling group. After successful model preparation, the rats of the modeling group were randomized into a model group, an acupuncture at "Feishu" (BL 13) + "Dingchuan" (EX-B 1) (AAF) group, and acupuncture at "Kongzui" (LU 6)+"Yuji" (LU 10) (AAK) group, with 10 rats in each one. Starting from day 15 of the experiment, 5 min after motivating, acupuncture was applied to "Feishu" (BL 13) + "Dingchuan" (EX-B 1) and "Kongzui" (LU 6)+"Yuji" (LU 10) in the AAF group and the AAK group respectively. The intervention was delivered for 30 min each time, once daily, lasting 3 weeks consecutively. Using lung function detector, the airway resistance (RL) and dynamic compliance (Cdyn) of the lungs were detected. The histomorphology of lung tissues was detected with HE staining and Masson staining, and the mRNA and protein expression of TGF-β1 and Smad3 in lung tissues was detected with the real-time PCR and Western blot methods. RESULTS: Compared with the blank group, RL was increased and Cdyn was decreased in the rats of the model group (P<0.01); and RL was reduced and Cdyn was increased in the AAF group and the AAK group when compared with those in the model group (P<0.01, P<0.05). The rats of the model group had bronchial lumen stenosis, inflammatory cell infiltration, collagen fibre hyperplasia and thickened smooth muscle in the lung tissues when compared with those in the blank group; and in comparison with the model group, all of the above morphological changes were attenuated in the AAF group and the AAK group. Besides, these morphological changes of the lung tissues were more alleviated in the AAF group when compared with those in the AAK group. In comparison with the blank group, the mRNA and protein expression of TGF-β1 and Smad3 of the lung tissues was increased in the model group (P<0.01), and it was reduced in the AAF group and the AAK group when compared with that in the model group (P<0.05, P<0.01). The mRNA expression of TGF-β1 and Smad3 was lower in the AAF group when compared with that in the AAK group (P<0.05). CONCLUSION Acupuncture at either "Feishu" (BL 13)+"Dingchuan" (EX-B 1) or "Kongzui" (LU 6)+"Yuji" (LU 10) reduces the airway remodeling in the rats with asthma, which may be related to the down-regulation of mRNA and protein expression of TGF-β1 and Smad3. The better efficacy is obtained with acupuncture at "Feishu" (BL 13)+"Dingchuan" (EX-B 1).
Male ; Animals ; Rats ; Rats, Sprague-Dawley ; Transforming Growth Factor beta1/genetics* ; Airway Remodeling ; Acupuncture Therapy ; Signal Transduction ; Asthma/therapy* ; Constriction, Pathologic ; Anti-Asthmatic Agents

Objective:To evaluate the efficacy and long-term effect of functional electrical stimulation (FES) on cerebral palsy. Methods:Literature retrieval was carried out in the electronic databases of PubMed, Embase, Web of Science, Cochrane Library, China Biology Medicine Disc (CBM), CNKI, Wanfang Database and VIP. The time limit was from the establishment of these databases to March 26th, 2020. According to the inclusion and exclusion criteria, randomized controlled trials about FES for children with cerebral palsy were included. At least two evaluators extracted the data independently and used Cochrane 5.1.0 bias risk assessment tool to evaluate the quality of included studies. The data was analyzed with Review Manager 5.3 software. Results:A total of eleven studies with 513 children were included. The Gross Motor Function Measure-88 (GMFM-88) D/E scores (MD = 8.14, 95%CI 6.26 to 10.02, P < 0.001), GMFM-88 B score (MD = 8.77, 95%CI 4.00 to 13.53, P < 0.001), modified Ashworth Scale (MAS) score (MD = -1.05, 95%CI -1.25 to -0.84, P < 0.001), Kyphosis angle (MD = -10.67, 95%CI -12.21 to -9.13, P < 0.001), Cobb's angle (MD = -2.66, 95%CI -3.38 to -1.93, P < 0.001), step length (MD = 3.35, 95%CI 1.81 to 4.90, P < 0.001), walking speed (MD = 0.09, 95%CI 0.05 to 0.14, P < 0.001) and GMFM score at six weeks follow-up (MD = 4.84, 95%CI 1.90 to 7.77, P = 0.001) were better in FES group than in the control group. There was no significant difference in MAS score between two groups after six weeks of follow-up (MD = 0.04, 95%CI -0.30 to 0.37, P = 0.84). Conclusion:FES could improve the lower-limb and trunk function of children with cerebral palsy, however, the long-term effect of relieving muscle spasm was not significant.

Cerebral palsy is a common clinical syndrome of neurological disability in childhood, which seriously affects the quality of life of children and their families, and brings a heavy economic burden to the society. Domestic and foreign scholars had a long history of the application of selective posterior rhizotomy for the treatment of spastic cerebral palsy or mixed cerebral palsy with limb paralysis. It is effective in improving the lower extremity spasm of patients with cerebral palsy, and there are few cases with recurrences. After rehabilitation therapy, the muscle strength of patients with cerebral palsy was significantly improved compared with the previous one. The range of motion was significantly improved after operation, and there is no rebounded in aspect of joint activety in the long-term follow-up. The overall gait of the patient was significant improved. The author thought that selective posterior rhizotomy is effective in improving the motor function of lower limbs in patients with cerebral palsy, and it is worth being spread. However, it has to follow the principle of selecting appropriate cases before surgery, precise operation during operation, and timely and effective rehabilitation treatment after surgery, in order to achieve a better curative effect.
Cerebral Palsy ; Humans ; Lower Extremity ; Muscle Spasticity ; Quality of Life ; Rhizotomy ; Treatment Outcome

The stable quality of hospital preparations is the basis for their clinical efficacy. Gynecological antipruritic prescription is widely used in gynecology clinics of Chinese medicine hospitals. Therefore,in this study,the production process of gynecological antipruritic lotion was optimized based on the concept of quality by design( QbD). The production process of the gynecological antipruritic lotion was developed to ensure its process stability and reliable quality,and enhance its clinical applicability. With total amount of matrine and oxymatrine used as the critical quality attribute( CQA) of the production process,parameter levels were designed based on production practice of hospital preparations,and Plackett-Burman and Box-Behnken experiments were used to optimize the water extraction and alcohol precipitation process of antipruritic lotion based on CQA of intermediates and final product. The soaking time,the first extraction time,and the second extraction time were determined as the critical process parameters( CPPs) of the production process. The optimal preparation process was as follows: water volume of 8 times,soaking for 0. 5 h,extraction for 2 times,the first extraction for 30 min,the second extraction for 56 min,alcohol concentration of 50%,and alcohol precipitation for 3 h. Furthermore,the design space was established based on the binomial regress model between CPPs and CQA,so as to set the optimization target and risk range; and the control space was displayed by overlay plot. The results of three repeated experiments in the control space showed that the relative standard deviation( RSD) of CQA was 4. 70%,and the similarity of chromatogram for gynecological antipruritic lotion was 0. 978,0. 974,and 0. 998,respectively. The above results indicated that the operation in the control space can guarantee the quality and stability of gynecological antipruritic lotion,suitable for practical application.
Antipruritics ; Drugs, Chinese Herbal ; Water

OBJECTIVETo assess the association between I405V and D442G polymorphisms of the CETP gene with cerebral hemorrhage (CH) and a related lipid profile among ethnic Han Chinese from Changsha.

METHODSA case-control study was carried out, which enrolled 170 cerebral hemorrhage patients and 191 ethnicity-, age- and sex-matched health controls. Polymerase chain reaction-restricted fragments length polymorphism (PCR-RFLP) was used to determine the polymorphisms. Lipid profile was determined by means of oxidase method. Statistic analyses were performed with SPSS 16.0.

RESULTSNo significant difference was found in the CETP gene I405V and D442G genotypes and allelic distribution between the CH patients and controls (P>0.05). There was no association between CETP gene I405V polymorphism and lipid profile in both groups (P>0.05). CH patients with DG genotype of the D442G polymorphism had higher TC and low density lipoprotein-cholesterol (LDL-C) levels than those with a DD genotype(P<0.05).

CONCLUSIONCETP gene I405V polymorphism may not be associated with CH among ethnic Han Chinese from Changsha, while the D442G polymorphism of the CETP gene may be associated with TC and LDL levels in the same population.

Adult ; Aged ; Asian Continental Ancestry Group ; ethnology ; genetics ; Base Sequence ; Case-Control Studies ; Cerebral Hemorrhage ; blood ; ethnology ; genetics ; China ; ethnology ; Cholesterol Ester Transfer Proteins ; genetics ; metabolism ; Cholesterol, HDL ; blood ; Female ; Humans ; Lipids ; blood ; chemistry ; Male ; Middle Aged ; Molecular Sequence Data ; Mutation, Missense ; Polymorphism, Single Nucleotide

ObjectiveTo assess the effect of corporoplasty with autologous tunica vaginalis graft in the treatment of Peyronie's disease.

METHODSTen patients with Peyronie's disease underwent plaque excision and corporoplasty with autologous tunica vaginalis graft. We obtained and compared IIEF-5 scores of the patients before and at 1 and 5 years after operation.

RESULTSAfter surgery, penile curvature was obviously relieved and all the patients achieved normal penile erection and satisfactory sexual intercourse without erection-related pain or recurrent erectile dysfunction. The mean IIEF-5 score was significantly improved at 1 year (22.40±1.08) and 5 years postoperatively (23.00±1.14) as compared with the baseline, (19.20±2.28) (P<0.05 or 0.01).

CONCLUSIONSCorporoplasty with autologous tunica vaginalis graft is a safe, simple and effective option for the treatment of Peyronie's disease, though its definite efficiency is to be further supported by large-sample clinical studies.

Erectile Dysfunction ; Humans ; Male ; Penile Erection ; Penile Induration ; surgery ; Penis ; surgery ; Postoperative Period ; Testis ; transplantation

Objective: To compare the efficacy and outcomes of gamma knife stereotactic radiosurgery and microsurgery in small- and medium-sized acoustic neuroma. Methods: The medical records of 87 patients with unilateral acoustic neuroma less than 3 cm were retrospectively collected. These 87 patients were divided into two groups: gamma knife stereotactic radiosurgery (GSR) group (n = 42) and microsurgery (MS) group (n = 45). The local control rate of tumor, preservation rate of cranial nerve function, hospitalization cost in first admission, length of stay in hospital, and the complications were campared between the two groups. Results: The difference in local control rate of tumor was not significant (GRS group vs MS group: 88.1% vs 97.8%; P = 0.102). In respect of preservation of facial nerve function and hearing, GRS was more effective than MS (87.2% vs 66.7%, P = 0.029; 68.2% vs 30.0%, P = 0.013). The rate of complications in the MS group was much higher than that in the GRS group (22.2% vs 7.1%). As compared with the GRS group, the hospitalization cost in first admission of the MS group was higher and the length of stay in hospital was prolonged. Conclusion: GSR has much more advantages in treatment of small- and medium-sized acoustic neuroma as compared with MS. Copyright © 2014 by TUMOR.

OBJECTIVE: To explore the association between apolipoprotein AI (ApoAI) gene rs12721026 polymorphism and cerebral hemorrhage (CH) in Changsha Han population, and to evaluate the effect of rs12721026 polymorphism on plasma lipid levels. METHODS: A total of 273 patients with CH and 140 healthy controls were collected. The rs12721026 polymorphism of ApoAI was analyzed by SNaPshot genotyping analysis and DNA sequencing. The total cholesterol (TG), triglyceride (TC), HDL-C and LDL-C were examined by oxidase method. RESULTS: There was no significant difference in the genotype and allele frequencies of rs12721026 polymorphism between the CH group and the control group (P>0.05). Both in the CH group and in the control group, the level of HDL-C of the TT gene type of rs12721026 was significantly higher than that of the GT/GG gene type (P<0.05). There was no significant difference in the levels of TG, TC and LDL-C among different subgroups of gene types. CONCLUSION There may be no association between apoAI gene rs12721026 polymorphism with CH in Changsha Han population, which may still influence the HDL-C levels.
Apolipoprotein A-I ; genetics ; Asian Continental Ancestry Group ; Case-Control Studies ; Cerebral Hemorrhage ; blood ; genetics ; Cholesterol ; blood ; Gene Frequency ; Genotype ; Humans ; Lipids ; Polymorphism, Single Nucleotide ; Sequence Analysis, DNA ; Triglycerides ; blood