Objective To explore the risk factors related to periprosthetic infection after breast augmentation, and to provide a basis for reducing the risk of postoperative infection. Methods A total of 1 056 female patients who underwent breast augmentation between January 2010 and January 2018 were analyzed retrospectively. The patients were 20 to 44 years old (mean, 31.6 years). The body mass index (BMI) was 19.0-31.1 kg/m2, with an average of 24.47 kg/m2. According to the periprosthetic infection standard of the United States Centers for Disease Control and Prevention (CDC), the patients were divided into infection group and non-infection group. Age, BMI, diabetes, previous history of immunosuppression, history of smoking, previous history of breast surgery, previous history of mastitis, combined with active dermatitis, surgical approach, the type and shape of breast prosthesis, implant in the different layers, combined with mastopexy, operation time, postoperative antibiotic time, postoperative breast crash, and postoperative potential infection surgery were analyzed by univariate analysis. The influencing factors of prosthetic infection were screened by logistic regression. Results Periprosthetic infection occurred in 60 cases after operation, and the infection rate was 5.68%. Among them, 11 cases were acute infection, 33 cases were subacute infection, 16 cases were delayed infection, and 20 cases were positive in bacterial culture. Postoperative breast crash occurred in 114 cases. Univariate analysis showed that diabetes, previous history of immunosuppression, history of smoking, previous history of mastitis, postoperative breast crash, postoperative potential infection surgery, and combined with breast suspension were the influencing factors of postoperative periprosthetic infection (P<0.05). Multivariate analysis showed that diabetes, history of smoking, and postoperative breast crash were the risk factors of periprosthetic infection (P<0.05). Conclusion Diabetes, smoking, and postoperative breast crash are the risk factors of periprosthetic infection after breast augmentation.
Objective To explore whether the polymorphism of transforming growth factor β1 (TGF β1) gene at 869T/C and 915G/C loci contributes to the genetic susceptibility to hypertension. Methods Assessed under the same criteria, all case control studies on relationship between the polymorphism of TGF β1 gene and hypertension were searched in both English and Chinese databases. All articles retrieved were screened and evaluated, and meta-analyses were conducted with RevMan 5.1 software. Results A total of 14 case control studies were included. The results of meta-analyses showed TGF β1 gene C allele was related to hypertension (OR=1.37, 95%CI 1.21 to 1.54). It was noted that individuals with CC genotype and TT genotype had a significant increased risk of hypertension (OR=1.43, 95%CI 1.27 to 1.60; OR=0.64, 95%CI 0.53 to 0.78, respectively). And there was no b evidence showing that TGF β1 915G/C genetic polymorphism was related to hypertension. The results from meta-analyses of the studies based on Chinese population on the two loci were in consistent with the outcomes of overall meta-analyses. Sensitivity analyses indicated the results were stable. And publication bias was not present, reflected by P values from Egger’s regression asymmetry test and Begg’s adjusted rank correction test. Conclusions 869T/C polymorphism of TGF β1 gene is associated with hypertension. C allele is potentially one of the genetic risk factors for hypertension. Present studies do not support a direct relationship between 915G/C polymorphism TGF β1 gene and hypertension.
Objective To review the latest development in the research on the application of the electrostatic spinning technology in preparation of the nanometer high polymer scaffold. Methods The related articles published at home and abroad during the recent years were extensively reviewed and comprehensively analyzed. Results Micro/nano-structure and space topology on the surfaces of the scaffold materials, especially the weaving structure, were considered to have an important effect on the cell adhesion, proliferation, directional growth, and biological activation. The electrospun scaffold was reported to have a resemblance to the structure of the extracellular matrix and could be used as a promising scaffold for the tissue engineeringapplication. The electrospun scaffolds were applied to the cartilage, bone, blood vessel, heart, and nerve tissue engineering fields. Conclusion The nanostructured polymer scaffold can support the cell adhesion, proliferation, location, and differentiation，and this kind of scaffold has a considerable value in the tissue engineering field.
睡眠過程中反復出現呼吸暫停造成的間歇低氧是阻塞性睡眠呼吸暫停低通氣綜合征( OSAHS) 的主要病理生理學特點, 它能夠導致自主神經, 特別是交感神經興奮性異常增高[1] , 后者可能是OSAHS合并心血管疾病包括高血壓、充血性心力衰竭、心肌梗死以及心律失常的主要危險因素之一[2,3] 。現將慢性間歇低氧( chronic intermittent hypoxia,CIH) 所致交感神經異常興奮的相關研究作一綜述。
目的 采用低場MRI非增強掃描探討強直性脊柱炎（AS）累及脊柱的MRI表現。 方法 從2010年3月－2013年3月間就診的76例AS患者的MRI圖像中選取19例脊柱受累者資料，對病變部位MRI圖像進行分析，評價AS累及脊柱在低場MRI非增強掃描狀態下的MRI表現特點。 結果 19例患者中頸椎病變3例，胸椎病變9例，腰椎病變7例；MRI表現為椎體終板炎17例、椎間盤炎13例、脊柱滑膜關節炎15例、椎旁韌帶炎11例、韌帶骨化和骨性強直9例。 結論 低場MRI非增強掃描能直觀顯示AS脊柱病變，主要表現為椎體終板炎、椎間盤炎、脊柱滑膜關節炎、椎旁韌帶炎、韌帶骨化和骨性強直，壓脂T2WI序列對活動性炎性病變顯示良好，T1WI、T2WI序列能較好顯示結構性病變。
Objective To improve the knowledge of inflammatory bowel disease complicated with venous thromboembolism for better diagnosis and treatment. Methods One case of patient with ulcerative colitis complicated with a multiple vessel thromboembolism ( pulmonary arterial, deep vein of lower limb, and superior mesenteric vein) was analyzed, and related literatures were reviewed. Results The patient resulted in pulmonary thromboembolism ( PTE) recurrence because of irregular treatment. In addition to deep vein thrombosis of the lower extremity, a new discovery of the superior mesenteric vein embolism ( MVT) was diagnosed. The bleeding risk of heparin or lowmolecular weight heparin ( LMWH) for treatment is low, while that of warfarin is high. Conclusions Venous thromboembolism ( VTE) has a close relationship with inflammatory bowel disease ( IBD) such as ulcerative colitis. The symptomis not so typical that it is easy to misdiagnosis and missed diagnosis. It is noted that mesenteric venous thrombosis ( MVT) should be excluded in IBD patients suffering from VTE, if the source of embolus is not clear. Suitable treatment should be considered according to the risk stratification of VTE and risk-benefit ratio because of a high bleeding risk.
Objective To investigate the effectiveness of laparoscopic Y-shaped polypropylene mesh in the treatment of uterine and vaginal vault prolapse. Methods Between June 2010 and December 2012, 24 patients with uterine and vaginal vault prolapse were treated by laparoscopic pelvic reconstruction (vagina and uterus-sacral fixation) with Y-shaped polypropylene mesh. The age of patients was 35-60 years (mean, 48.6 years). The disease duration was 2-8 years (mean, 5 years). According to the pelvic organ prolapse quatitative (POP-Q) classification by International Continence Society (ICS), 16 cases were classified as uterine prolapsed degree II and 8 cases as degree III; 15 cases were classified as vaginal prolapse degree I, 7 cases as degree II, and 2 cases as degree III. All patients received postoperative follow-up regularly. Subjective evaluation was done based on prolapse quality of life questionnaire (P-QOL), and objective evaluation based on POP-Q classification. Results All the patients were operated successfully. The operation time was 22-68 minutes (mean, 33 minutes); the blood loss was 30-80 mL (mean, 51 mL); the indwelling urethral catheter remain was 3-7 days (mean, 4 days); and the hospitalization days were 4-9 days (mean, 6.8 days). Twenty-four patients were followed up 3-12 months (mean, 9 months), of whom, 2 were followed up less than 6 months. All patients had normal urination after withdrawal of urethral catheter, and the residual urine volume was in normal range. No patients had mesh erosion and discomfort during sex, vaginal and anal bearing down. The P-QOL scores at 3, 6, and 12 months after operation were significantly improved when compared with the preoperative value (P lt; 0.05); but there was no significant difference among 3, 6, and 12 months after operation (P gt; 0.05). The postoperative POP-Q classification was degree 0 in 19 cases and degree I in 3 cases, and the objective cure rate was 91.7%. No recurrence was found during follow-up. Conclusion Laparoscopic Y-shaped polypropylene mesh for treatment of uterine and vaginal vault prolapse is a safe and effective method, especially applicable to preserve the uterus, and higher requirements of sexual life of patients.
【摘要】 目的 研究降鈣素基因相關肽（calcitonin gene related peptide， CRGP）在肝硬化門靜脈高壓癥患者食管下段胃底靜脈曲張中的作用。 方法 以2005年1月－2010年8月46例肝硬化門靜脈高壓癥不同程度食管下段胃底靜脈曲張患者作為研究對象，并按食管下段胃底靜脈曲張嚴重程度分為輕度曲張組、中度曲張組、重度曲張組，以30例行胃腸疾病手術無肝病患者作為對照。術中水柱法測定門靜脈壓力；酶聯免疫吸附法測定門靜脈血中CGRP含量。 結果 對照組及輕、中、重度曲張組門靜脈壓力分別為（14.8±2.1）、（30.5±2.5）、（44.3±3.2）、（47.6±3.8） cm H2O（1 cm H2O=0.098 kPa）。門靜脈血中CGRP的含量分別為（45.4±5.4）、（69.2±7.2）、（93.6±8.7）、（98.2±9.4） pg/mL。對照組門靜脈壓力及CGRP含量明顯低于其他3組（Plt;0.05），在輕度曲張組明顯低于中度和重度曲張組（Plt;0.05），中度和重度曲張組之間差異無統計學意義（Pgt;0.05）。 結論 CRGP在肝硬化門靜脈高壓癥食管下段胃底靜脈曲張的發生和發展中起重要作用，CGRP可作為反映食管靜脈曲張程度的一種有用指標。【Abstract】 Objective To investigate the role of calcitonin gene related peptide (CRGP) in pathogenesis of esophageal varices in portal hypertension with cirrhosis. Methods from January 2005 to August 2010, 46 patients with portal hypertension and cirrhosis at different degrees of esophageal varices were divided into mild varicose group, moderate varicose group and severe varicose group according to the severity of esophageal varices. The patients who underwent gastrointestinal surgery without liver disease were as the control. Portal vein pressure was detected by mercury during the surgery. The expression of CGRP was assayed by enzyme-linked immunosorbent assay. Results The portal pressure was (14.8±2.1), (30.5±2.5), (44.3±3.2), and (47.6±3.8) cm H2O (1 cm H2O=0.098 kPa) in the control group and the mild, moderate and severe varicose group, respectively. Those CGRP content in the portal vein was (45.4±5.4), (69.2±7.2), (93.6±8.7), and (98.2±9.4) pg/mL, respectively. CGRP content and portal vein pressure were the lowest in control group, which were significantly lower than those in the other three groups (Plt;0.05); which were also significantly lower in mild varicose group than those in the moderate and severe esophageal varices group (Plt;0.05), while no statistic difference between moderate and severe esophageal varices group was found (Plt;0.05). Conclusion CGRP plays an important role in the occurrence and development of portal hypertension with cirrhosis concurrent esophageal varices, and it may serve as a useful indicator reflecting the degree of esophageal varices.
ObjectiveTo systematically review the prevalence of cognitive impairment in patients with sarcopenia. MethodsThe PubMed, EMbase, Web of Science, Cochrane Library, CBM, CNKI, VIP and WanFang Data databases were electronically searched to collect studies related to the objectives from inception to December 10, 2022. Two reviewers independently screened literature, extracted data and assessed the risk of bias of the included studies. Meta-analysis was then performed by using Stata 14.0 software. ResultsA total of 27 studies were included. The overall prevalence rate of cognitive impairment in sarcopenia was 36.1% (95%CI 29.4% to 42.8%). Subgroup analysis showed that the prevalence in Europe was higher than that in other areas. The prevalence of nursing home residents was highest. ConclusionCurrent evidence shows that the prevalence of cognitive impairment in patients with sarcopenia is high. Due to the limited quality and quantity of the included studies, more high quality studies are needed to verify the above conclusion.
【Abstract】Objective To analysis the clinical characteristics, pathogenesis, diagnosis and treatment of acute acalculous cholecystitis.Methods Seventy-nine cases of acute acalculous cholecystitis from January 1996 to January 2003 were retrospectively reviewed.Results Of those 79 cases, 13 cases were treated nonoperatively and 66 cases were treated operatively. Twentythree cases were suppurative, 43 cases were gangrenous with perforation in 18 cases，which were proved by postoperative pathology. Seventysix cases were cured and 3 cases were dead. Conclusion Keeping vigilant alert, observing dynamically as well as appropriate operative intervention are effective to improve the prognosis of acute acalculous cholecystitis.