Human immunodeficiency virus (HIV) infection mainly attacks the human immune system, causing a variety of opportunistic infections and tumors, among which neoplastic diseases are serious and life-threatening. In recent years, with the popularization of highly effective anti-retroviral virus, the disease spectrum of HIV infected people has changed greatly, the incidence of non-acquired immune deficiency syndrome (AIDS) related tumors has increased significantly, and the diagnosis rate of esophageal cancer patients with HIV/AIDS has also increased. However, there is no consensus on how to standardize the diagnosis and treatment of esophageal cancer patients with HIV/AIDS. This article reviews the epidemiological characteristics, diagnosis and treatment of esophageal cancer patients with HIV/AIDS.
ObjectivesTo explore if epilepsy and idiopathic hypoparathyroidism could be coexisted in one patient.MethodsCollected clinical data of two epilepsy children with idiopathic hypoparathyroidism from the Second Affiliated Hospital of Xi’an Jiaotong University in January 2009. We record the clinical material in detail. The follow-up of two cases is oven 9 years. The diagnosis of idiopathic hypothyroidism is mainly based on the typical history, hypocalcemia, hyperphosphatemia, and hypoparathyroid hormone concentrations. The CT scans show calcifications at the junction of the basal ganglia and cortex and medulla.ResultsDuring 9 years of follow-up, both cases had recurred of convulsions due to reduced use of anti-epileptic drugs under conditions of normal serum calcium and phosphorus levels. Spontaneous slow wave can be found during 24 hours of EEG monitoring in the awake or sleep period. They continue oral antiepileptic drugs.ConclutionsWe suggested that children with idiopathic hypoparathyroidism can be combined with epilepsy. And the mechanism may be related to abnormal intracranial calcification. In addition to calcium and active vitamin D, anti-epileptic drugs which have little effect on metabolism of calcium and phosphorus should be selected for treatment.
Objective To investigate the iron deficiency (ID) in children with congenital heart disease (CHD) and find high risk factors of ID. Methods The clinical data of 227 pediatric patients with CHD from February to June 2016 were retrospectively analyzed. The incidence of ID according to the result of iron metabolism examination (serum ferritin <12 μg/L as the diagnostic criteria) was investigated. According to their basic CHD types, patients were divided into a cyanotic group and an acyanotic group. We tried to find the high risk factors of ID in those pediatric CHD patients by comparing their age, gender, growth condition and blood routine test results. Results There were 19.8% pediatric CHD patients complicated by ID. The incidence of ID in the cyanotic patients was higher than that in the acyanotic patients (31.0% vs. 17.3%, P=0.045). In both groups, ID patients presented the characteristics of younger age, higher anemia rate, lower mean corpuscular volume (MCV), lower mean corpuscular hemoglobin (MCH), lower mean corpuscular-hemoglobin concentration (MCHC) and longer red blood cell distribution width (RDW). Conclusion Cyanosis, younger age (infant), anemia, decreased MCV, decreased MCH, decreased MCHC and increased RDW are high risk factors of ID in CHD children.
【摘要】 目的 探討重組人凝血因子Ⅷ制劑小劑量短程預防性輸注能否有效減少中重度血友病A患兒關節出血問題。 方法 對2008年11月-2009年4月期間就診的13例年齡3~11歲的中重度血友病A患兒，均在為期2個月內接受重組人凝血因子Ⅷ 2次/周、間隔3 d、每次7.5~10.0 U/kg的靜脈預防性輸注，記錄治療前2個月與治療2個月時關節出血次數，以及同一關節反復發生出血的情況。 結果 治療前關節出血的發生次數為（3.77±2.13）次，治療后關節出血的發生次數為（0.46±0.87）次，治療前后比較，差異有統計學意義（Plt;0.01）；治療前靶關節出血的發生率為35.7％，治療后靶關節出血的發生率為0.0%，治療前后比較，差異有統計學意義（Plt;0.01）。患兒治療成本約510~680元/（kg?2個月）。 結論 重組人凝血因子Ⅷ制劑小劑量短療程預防性輸注能有效減少中重度血友病A患兒關節出血次數，同時可有效減少靶關節出血的發生率，從而在一定程度上保護關節的功能。治療費用相對可接受。【Abstract】 Objective To evaluate the efficacy of low-dose short-course infusion of recombinant human factor Ⅷ concentration in treating joint bleeding in children with severe and moderate hemophilia A. Methods Thirteen children aged 3 to 11 years old with severe or moderate hemophilia A were included in the present study from November 2008 to April 2009. For children in the treatment group, they were treated with low-dose short-course infusion of recombinant human factor Ⅷ concentration with a dose of 7.5-10.0 U/kg twice weekly as secondary prophylaxis for two months. The incidence of joint bleeding 2 months before treatment (control group) and during the 2 months of treatment (treatment group) was observed. Moreover, the incidence of their target joint bleeding was measured in both groups. Results Children in the control group had (3.77±2.13) joint bleedings while children in the treatment group had (0.46±0.87) joint bleedings, which was obviously lower than those in the control group (Plt;0.01). Meanwhile, the incidence of target joint bleeding in the treatment group was 0%, which was obviously lower than that in the control group (35.7%) (Plt;0.01). In the treatment group, the costs of treatment were about RMB 510-680 yuan/kg every 2 months. Conclusions Treatment with low-dose short-course infusion of recombinant human factor Ⅷ concentration can effectively decrease joint bleeding in children with severe and moderate hemophilia A, and can effectively decrease the incidence of target joint bleeding. Therefore, this method may play an important role in protection of the joint function in those patients at an acceptable cost.
目的 總結1例噬血細胞綜合征的臨床表現及治療方案。 方法 2009年12月收治1例以皮疹為突出表現的噬血細胞綜合征患兒的臨床表現及治療效果。 結果 患兒的皮疹表現突出，臨床較少見；采用HLH-2004方案治療后臨床癥狀、體征及實驗室指標短時間內恢復正常。近期隨訪，一般情況良好，血液學指標基本正常。 結論 患兒采用HLH-2004方案治療后預后良好。
Objective To assess the effectiveness and safety of trazodone versus alprazolam on adults’ generalized anxiety disorder (GAD). Methods Such databases as PubMed (1980 to May 2012), CBM (1990 to May 2012), VIP (1989 to May 2012), CNKI (1990 to May 2012) and WanFang Data (1990 to May 2012) were searched to collect the randomized controlled trials (RCTs) about trazodone vs. alprazolam for adults’ GAD. According to the inclusion and exclusion criteria, two reivewers screened literature, extracted data and assessed the quality of the included studies, then meta-analysis was conducted using RevMan 5.0 software. Results A total of 5 RCTs involving 403 patients were included. The results of meta-analysis showed that: a) After four-week treatment, there were no significant differences between the two groups in the HAMA scores (RR=1.04, 95%CI 0.95 to 1.13, P=0.38) and cure rate (RR=1.05, 95%CI 0.75 to 1.48, P=0.76); and b) The somnolence rate of the trazodone group was lower than that of the alprazolam group (RR=0.42, 95%CI 0.25 to 0.72, P=0.001). But there were no significant differences between the two groups in dizziness (RR=0.52, 95%CI 0.27 to 1.01, P=0.05), fatigue (RR=0.10, 95%CI 0.01 to 1.41, P=0.09), and poor appetite (RR=2.82, 95%CI 0.28 to 28.23, P=0.38). Conclusion There is no significant difference between razodone and alprazolam in the effectiveness when treating GAD, but razodone has lower side effects while alprazolam tends easily to cause somnolence. For the quantity limitation and low methodological quality of the included studies, this conclusion still needs to be further proved by more high quality RCTs.
In the Spring Festival of 2020, China waged an unexpected battle against coronavirus disease 2019. Within the scope of constructing smart hospitals, it has become a brand-new subject concerning how the construction can facilitate the scientific prevention and control of the epidemic. According to the development direction, basing on the concept of “patient-centered” medical services, and combining with the construction ideas of traditional medical information products and emerging technologies, Guangdong Provincial People’s Hospital, as the first government-leading “demonstration hospital for 5G application”, was fully dedicated to promoting the mode of contactless diagnosis and treatment and providing smart medical information service, thereby setting up a “scientific and technological firewall against the epidemic”.
ObjectiveTo explore the feasibility of establishment of a artificial joint aseptic loosening mouse model by cobalt-chromium particles stimulation.MethodsTwenty-four 8-week-old male severe combined immunodeficient (SCID) mice were divided into experimental group (n=12) and control group (n=12). The titanium nail was inserted into the tibial medullary cavity of mouse in the two groups to simulate artificial joint prosthesis replacement. And the cobalt-chromium particles were injected into the tibial medullary cavity of mouse in experimental group. The survival of the mouse was observed after operation; the position of the titanium nail and the bone mineral density of proximal femur were observed by X-ray film, CT, and Micro-CT bone scanning; and the degree of dissolution of the bone tissue around the tibia was detected by biomechanical test and histological staining.ResultsTwo mice in experimental group died, and the rest of the mice survived until the experiment was completed. Postoperative imaging examination showed that there was no obvious displacement of titanium nails in control group, and there were new callus around the titanium nails. In experimental group, there was obvious osteolysis around the titanium nails. The bone mineral density of the proximal tibia was 91.25%±0.67%, and the maximum shear force at the tibial nail-bone interface was (5.93±0.85) N in experimental group, which were significantly lower than those in control group [102.07%±1.87% and (16.76±3.09) N] (t=5.462, P=0.041; t=3.760, P=0.046). Histological observation showed that a large number of inflammatory cells could be seen around the titanium nails in experimental group, while there was no inflammatory cells, and obvious bone tissue formation was observed in control group.ConclusionThe artificial joint aseptic loosening mouse model can be successfully established by cobalt-chromium particles stimulation.
ObjectiveTo determine the prevalence of aspirin (ASA) resistance in pediatric patients with congenital heart disease and evaluate whether postoperative thrombosis is associated with aspirin resistance.MethodsA total of 52 patients undergoing high-risk congenital cardiac surgery were recruited in a prospective cohort study at Fuwai Hospital from August 2016 to December 2017. There were 29 males and 23 females with a median age of 8 months (6 d to 13 years). The response to aspirin was determined using the thromboelastography with platelet mapping (TEG-PM) system several days after administration. According to the arachidonic acid (AA) inhibition< 50% or not, they were divided into an ASA resistance group (n=14) and an ASA sensitivity group (n=38). Risk factors of ASA resistance were identified using univariate and multivariate analysis. Patients were monitored prospectively for three months for the development of a thrombosis event. ResultsOf 52 children analyzed, 14 (26.9%) were ASA resistance. The prevalence of thrombosis after ASA antiplatelet therapy was 5.9%. Dose escalation based on aspirin testing was performed in 3 of 14 patients, and the ASA sensitivity was observed in 1 patient. No correlation was found between ASA resistance and postoperative thrombosis (r=0.04, P=0.80).ConclusionPostoperative thrombosis is not associated with aspirin resistance in these patients. Our findings also suggest that resistance may be due to lack of aspirin doses, monitoring of aspirin therapy and consideration of dose adjustment or alternative agents for unresponsive patients.
【摘要】 目的 探討康復宣教與訓練等干預手段對股骨干骨折患者圍手術期的影響。 方法 2010年6月－2011年3月收治股骨干骨折患者90例，其中男48例，女42例；年齡17~58歲，平均38歲。開放性骨折28例，閉合性骨折62例。股骨骨折部位:上1/3骨折33例，中1/3骨折35例，下1/3骨折20例，多段骨折2例。橫形骨折20例，斜形骨折30例，粉碎性骨折40例。將90例患者隨機分為康復組（46例）和對照組（44例）。對照組采用骨科術前常規處理，康復組采用骨科術前常規處理加康復宣教與訓練。 結果 康復組住院時間為（5.35±1.27） d，對照組為（7.67±1.85） d，兩組比較差異有統計學意義（Plt;0.05）。 康復組治療后發生并發癥7例，對照組16例，康復組并發癥發生率（15.2%）明顯低于對照組（36.4%），差異有統計學意義（Plt;0.05）。治療后5 d，康復組療效獲優35例，良6例，可3例，差2例，優良率89.1%；對照組獲優25例，良5例，可12例，差2例，優良率68.2%；兩組療效比較差異有統計學意義（Plt;0.05）。 結論 康復宣教與訓練能預防與改善股骨干骨折圍手術期臥床引起的并發癥，減輕患者腿部疼痛及腫脹，縮短圍手術期時間，使患者能盡早手術，加快住院床位周轉，提高患者生活質量。【Abstract】 Objective To explore the effects of rehabilitation education and training interventions on perioperative patients with femoral shaft fractures. Methods A total of 90 patients with femoral shaft fractures were selected from June 2010 to March 2011, including 48 males and 42 females aged from 17 to 58 years (mean 38 years). In these 90 patients, open fracture was in 28 and closed fracture was in 62. Fracture site: upper 1/3 fracture was in 33, middle 1/3 fracture was in 35, lower 1/3 fracture was in 20 and multiple fractures was in 2. There were transverse fractures in 20 patients, oblique fractures in 30 patients and comminuted fractures in 40 patients. All of the patients were randomly divided into experimental group (46 patients) and control group (44 patients). The patients in the control group underwent the routine treatment before the orthopedic surgery; besides the routine treatment, the patients in the experimental group were given the rehabilitation education and training before the orthopedic surgery. Results The hospital duration in the rehabilitation group was (5.35±1.27) days while in the control group was (7.67±1.85) days, the difference was statistically significant (Plt;0.05). There were 7 cases who had complications in rehabilitation group compared with 16 patients in the control group; the incidence of the complications in the rehabilitation group (15.2%) was significantly lower than that in the control group (36.4%) (Plt;0.05). After the treatment for 5 days, the therapeutic effect in rehabilitation group were excellent in 35 cases, good in 6 cases, middle in 3 cases and poor in 2 cases (with the good rate of 89.1%); while in the control group were excellent in 25 cases, good in 5 cases, middle in 12 cases and poor in 2 cases (with the good rate of 68.2%); the difference was significant between the two groups (Plt;0.05). Conclusion Rehabilitation education and training could prevent the perioperative complications in patients with femoral shaft fracture, decrease the pain and edema, speed up the turnover of hospital beds, and improve the patients’ quality of life.