格林模式在小耳畸形患者体重管理中的应用

目的探索格林模式在小耳畸形患者体重管理中的应用效果。方法便利抽样法选取2017年8月至2018年7月我院收治的小耳畸形一期手术患儿共59例,采用随机数字表法分为干预组和对照组。对照组由责任护士进行常规健康教育,干预组接受为期6个月的基于格林模式设计的体重管理干预。结果干预组的体重、体脂含量、BMI、饮食及运动依从性、再造耳形态的满意度等,与对照组比较均有显著性差异(P0. 05)。结论格林模式体重管理干预能有效控制体重,提高健康饮食和运动的依从性,提高手术满意度,值得临床推广应用。     

以家庭为中心的护理干预在先天性小耳畸形患儿围手术期的应用

目的:探讨以家庭为中心的护理模式对缓解先天性小耳畸形患儿及父母焦虑的效果。方法:将110例小耳畸形患儿及父母随机分成对照组及干预组,每组各55例,对照组沿用常规护理模式,干预组实施"以家庭为中心的护理"措施,比较两组患儿及其父母的焦虑情况。结果:进入手术室及麻醉诱导时(T2)、术后1d(T3)、术后7d(T4)干预组患儿耶鲁围手术期焦虑量表(modified Yale preoperative anxiety scale,m YPAS)评分明显低于对照组,差异有统计学意义(P0.05)。干预组患儿父母症状自评量表(symptom checklist,SCL-90)评分明显低于对照组,差异有统计学意义(P0.05)。结论:对先天性小耳畸形患儿行"以家庭为中心的护理"干预可以缓解患儿及父母围手术期的焦虑,提高围手术期依从性,提高护理质量及满意度。     

不同年龄段先天性小耳畸形患者临床特征分析

目的:收集先天性小耳畸形患者临床资料对不同年龄段小耳畸形患者临床特征进行分析。方法:通过收集2009.03～2010.03于中国医学科学院整形外科医院外耳整形中心就诊的小耳畸形患者临床资料,建立数据库并进行分析。结果:按出生年代分为3组,不同年龄段之间患侧分布、性别分布及病情分度均无明显差异。结论:不同年龄段先天性小耳畸形患者临床特征相似,提示不同因素导致的先天性小耳畸形可能存在相同的致病机制。     

罕见的先天性第4、5掌骨融合畸形1例

<正>1病例资料患儿男,8岁,出生后即发现右手第4、5掌骨呈分叉畸形,环指外展位、小指内收位畸形。家族史：患儿母亲妊娠期未发现病毒感染表现,未服用过化学药物,未接触毒物、射线,无吸烟饮酒史。父亲在母亲怀孕前和怀孕中戒烟、戒酒。父母非近亲婚配,双方家族中无相同病史。患儿无营养和智力障碍。患儿各生长发育的主要阶段如站、立、行等与同龄儿童相似。查体：一般情况良好,智力发育正常,心肺肝脾未见异常。右手第4、5掌骨呈分叉畸形,环指外展位、小指内收位畸形。指蹼异常宽大,     

耳模型无创矫治小儿先天性耳廓畸形的临床疗效、并发症分析

探究小儿先天性耳廓畸形治疗中应用耳模型无创矫治的临床价值。方法 选取2021年 1月-2022年12月我院收治的先天性耳廓畸形患儿60例，依据随机数字表法分为对照组和研究组，每组 30例。对照组应用佩戴牵引钩治疗，研究组应用耳模型无创矫治，比较两组临床疗效、并发症发生率、 耳廓形态评分、疼痛评分、颅耳间垂直距离、颅耳角及患儿家属满意度。结果 研究组临床总有效率为 96.67%，与对照组的86.67%比较，差异无统计学意义（P ＞0.05）；研究组并发症发生率为3.33%，低于对 照组的20.00%（P ＜0.05）；研究组治疗后耳廓形态评分及疼痛评分均低于对照组（P ＜0.05）；研究组治 疗后颅耳间垂直距离短于对照组，颅耳角小于对照组（P ＜0.05）；研究组患儿家属满意度为93.33%，高于 对照组的73.33%（P ＜0.05）。结论 耳模型无创矫治小儿先天性耳廓畸形的疗效良好，可改善耳廓形态， 缩短颅耳间垂直距离，改善颅耳角，且并发症发生率低、疼痛程度轻、患儿家属满意度高。     

皮肤再生不良1例

皮肤再生不良,又名先天性皮肤缺陷,临床上很少见.现将笔者诊治的1例报告如下. 患儿男,1d.因出生后头皮、双上肢皮肤缺损于2010年8月30日我院产科请我科会诊.患儿出生后即发现头皮、双上肢皮肤缺损,手足关节活动正常.患儿系第二胎第二产,足月顺产,娩出时无外伤史,出生时体重2.8kg,Apgar评分10分,患儿母亲孕早期因感冒又不知自己怀孕曾服用过感冒冲剂和三黄片,孕期无外伤史及放射线史、有毒物质接触史,父母非近亲结婚,家族中无类似患者,无遗传病史.患儿母亲曾于1年半前产下一类似胎儿,自述头皮3/4面积缺损,手足、腹部大面积皮肤缺损,未予治疗,患儿于2小时后死亡.患儿母亲在孕早期同样服用过三黄片.患儿父母亲长期从事家禽养殖业.2次怀孕期间均未进行任何健康检查.     

过敏性紫癜患儿饮食控制及效果观察

目的了解饮食护理对过敏性紫癜患儿疾病恢复和复发的影响。方法将 78例患儿随机分为两组 ,均予抗过敏治疗 ,观察组 (4 0例 )进行系统饮食控制 ;对照组 (38例 )禁食鱼、虾、蟹 ,其它按常规进食。结果患儿紫癜及腹痛消失时间、住院时间 ,观察组明显短于对照组 (均P <0 .0 1) ;复发率观察组明显低于对照组 (P <0 .0 1)。结论加强对过敏性紫癜患儿合理的饮食控制 ,能促进疾病的康复 ,缩短住院时间 ,减少复发率。     

精神分裂症患儿父母心理健康状况调查

目的探讨精神分裂症患儿父母心理健康状况。方法采用SCL 90对 36例精神分裂症患儿父母进行调查。结果患儿父母整体心理健康状况较常模差 ,其中人际关系、抑郁、焦虑及偏执 4项因子分与常模比较 ,差异有极显著性意义 (均P <0 0 1) ;躯体化、敌对和恐怖 3项因子分与常模比较 ,差异有显著性意义 (均P <0 0 5 )。患儿母亲躯体化、抑郁、焦虑 3项因子分均明显高于父亲 ,两者比较 ,差异有显著性意义 (均P <0 0 5 ) ;而人际关系因子分明显低于父亲。结论临床医护人员应重视精神分裂症患儿父母的心理健康状况 ,并给予相应的心理干预措施。     

维甲酸致胎鼠骨骼畸形模型的建立

目的利用维甲酸胎鼠模型,观察其骨骼畸形出现的情况,探讨骨骼畸形的发生机制。方法于孕期第10天经胃管给SD母鼠注入125 mg/kg体重全反式维甲酸,对照组仅予载体溶液。分娩前24 h剖腹取出胎鼠,实验组和对照组分别随机各取20只和10只胎鼠去除软组织,行骨软骨双重染色法,显微镜观察骨骼情况。结果实验组胎鼠体重(4．294±0．670)g与对照组(4．743±0．542)g比较,差异有统计学意义(P＜0．05)。对照组未见骨骼畸形。维甲酸组有18只(90%)胎鼠可见明显的全身骨骼畸形,最常见的畸形分别是长骨畸形(80%)、腕掌跗跖骨缺如(80%)、胸廓外形异常(80%)、椎体畸形(75%)、骨盆畸形(70)和脊椎裂(65%)。结论维甲酸有较强的胎鼠骨骼致畸作用,这种作用是多部位的。维甲酸大鼠是研究骨骼先天性畸形的实用工具模型。     

耳矫治器无创矫正先天性耳廓形态畸形疗效观察

目的:探讨耳矫治器无创矫正先天性耳廓形态畸形的疗效。方法:选取2019年5月-2020年6月笔者医院收治的先天性耳廓形态畸形患儿204例(204耳)作为研究对象。根据患儿矫正初始年龄将其分为以下两组:小龄组(≤42d)132例,大龄组(42d)72例,所有患儿均给予耳矫治器治疗。治疗后随访3个月,根据患儿耳廓形态进行疗效评价,并记录其矫正时间和并发症情况。结果:小龄组有效率(93.94%)高于大龄组(83.33%),矫正时间低于大龄组,差异有统计学意义(P0.05)。随访期间,小龄组出现4例皮损,1例皮疹,1例感染;大龄组出现5例皮损,2例皮疹,3例感染;小龄组并发症总发生率(4.55%)低于大龄组(13.89%),差异有统计学意义(P0.05)。耳矫治器治疗垂耳、招风耳、耳轮畸形、杯状耳、Stahl's耳、隐耳的有效率分别为95.65%、84.62%、96.67%、86.11%、86.36%、94.44%,以垂耳、耳轮畸形、隐耳有效率最高。结论:耳矫治器无创矫正先天性耳廓形态畸形疗效好,且患儿越早接受治疗,效果越好,矫正时间越短,并发症越少。其中以垂耳、耳轮畸形、隐耳的患儿矫正效果更佳。     

Retinoic acid suppresses intimal hyperplasia and prevents vessel remodeling following arterial injury.

Vitamin A and its derivatives (retinoids) are capable of inhibiting vascular smooth muscle cell proliferation in vitro. The present study examines the effect of two retinoids, all-trans retinoic acid and 13-cis retinoic acid, on intimal hyperplasia following arterial injury. After receiving varying doses of all-trans retinoic acid or 13-cis retinoic acid, 78 male Sprague-Dawley rats underwent standard balloon catheter denudation of the left common carotid artery. Morphometric analysis and immunohistochemistry for proliferating cell nuclear antigen was performed at early and late time points. Intimal/medial ratios were reduced in a dose-dependent fashion for animals treated with all-trans retinoic acid (P = 0.001) and 13-cis retinoic acid (P = 0.004). Proliferating cell nuclear antigen labeling indices were reduced after treatment with all-trans retinoic acid and 13-cis retinoic acid at early time points post-injury. At a dose of 10 mg/kg, both all-trans retinoic acid and 13-cis retinoic acid inhibited vessel remodeling as measured by increases in luminal diameter (P < 0.05) and external elastic lamina (P < 0.05). Retinoids are an attractive clinical option for the treatment of restenosis following angioplasty and arterial surgery.     

Clinical and genetic analysis of microtia in Japan

Abstract

Microtia is thought to have a multifactorial inheritance, but several investigators disagree. Here we report our survey of the hereditary factors and possible causes. We conducted a questionnaire survey of 428 patients with microtia who were being treated at two hospitals from September 2006 to September 2008. We recorded their age, sex, affected side, duration of gestation, birth weight, age of parents at patients' birth, accompanying malformations, number of siblings, familial occurrence, smoking habit of parents, and medication/disorders of mother during pregnancy, and analysed the results. There were preponderances of male (61%), unilateral (90%) and right-sided disease (59%). Other than the first and second branchial arch syndrome, microtia is often accompanied by other congenital deformities, in particular congenital heart disease; cleft lip, or palate, or both; vertebral defects; and anomalies of extremities. The occurrence in first-degree relatives was 2%. Most maternal disorders and medication taken during pregnancy were common and there was no clear link. Statistically, there was a tendency to low birth weight and high maternal age, but it is not possible to identify these as a specific cause of microtia. Multifactorial inheritance is unlikely to be the cause of microtia as there was only one finding in agreement with its widely accepted characteristics. However, we cannot completely discount it as there were too few cases in some groups to make a judgement.     

Efficacy and safety of Chinese herbal medicine for benign prostatic hyperplasia: systematic review of randomized controlled trials

Chinese herbal medicine is commonly used as a treatment for benign prostatic hyperplasia (BPH), but its efficacy and safety remain to be examined. To compare the efficacy and adverse events of Chinese herbal medicine alone or used adjuvantly with Western medications for BPH. Two independent reviewers searched the major electronic databases for randomized controlled trials comparing Chinese herbal medicine, either in single or adjuvant use with Western medication, with placebo or Western medication. Relevant journals and grey literature were also hand-searched. The outcome measures included changes in urological symptoms, urodynamic measures, prostate volume and adverse events. The frequency of commonly used herbs was also identified. Out of 13 922 identified citations of publications, 31 studies were included. Eleven studies with a Jadad score ≥3 were selected for meta-analysis. Chinese herbal medicine was superior to Western medication in improving quality of life and reducing prostate volume. The frequency of adverse events in Chinese herbal medicine was similar to that of placebo and less than that of Western medication. The evidence is too weak to support the efficacy of Chinese herbal medicine for BPH due to the poor methodological quality and small number of trials included. The commonly used herbs identified here should provide insights for future clinical practice and research. Larger randomized controlled trials of better quality are needed to truly evaluate the efficacy of Chinese herbal medicine.     

Botanical drugs and stem cells

The potential to generate virtually any differentiated cell type from stem cells offers the possibility of creating new sources of cells for regenerative medicine. To realize this potential, it will be essential to control stem cell differentiation. Chinese herbal medicine is a major aspect of traditional Chinese medicine and is a rich source of unique chemicals. As such, individual herbs or extracts may play a role in the proliferation and differentiation of stem cells. In this review, we discuss some of the Chinese herbal medicines that are used to treat human diseases such as neuronal degenerative diseases, cardiovascular diseases, and osteoporosis. We also describe the relationship between Chinese herbal medicines and stem cell regulation.     

肝移植术后妊娠

目的探讨肝移植术后妊娠的指征，母体和胎儿／新生儿存在的风险及其处理措施。方法复习相关文献并进行综述。结果肝移植术后多数育龄妇女可以恢复正常月经周期。高血压、肾功能损害、先兆子痫、继发于免疫抑制的细菌和病毒感染以及剖宫产几率增加是母体的主要风险。胎儿／新生儿的风险主要是流产、早产、胎膜早破、肾上腺皮质功能不足、胎儿畸形、免疫缺陷和巨细胞病毒、乙肝病毒及细菌感染。结论在多数患者，肝移植术后妊娠可以获得良好效果，但在妊娠前应进行严格的评估，在妊娠期应多科联合进行严密的监测。当前应制定一个基于现有研究结果的肝移植术后妊娠指南。     

Pregnancy outcomes in solid organ transplant recipients with exposure to mycophenolate mofetil or sirolimus

BACKGROUND: Animal and limited human studies have raised concerns as to the safety of in utero exposure to mycophenolate mofetil (MMF) and sirolimus (SRL) in transplant recipients. This study examined the outcomes of pregnancies with exposure to MMF or SRL from 30 female transplant recipients (39 pregnancies) who have reported pregnancies to the National Transplantation Pregnancy Registry. METHODS: Data were collected via questionnaires, phone interviews and medical records. RESULTS: There were 18 kidney recipients reporting 26 pregnancies with exposure to MMF: 15 livebirths (LB), 11 spontaneous abortions (SA). Structural malformations were reported in four of the 15 children (26.7%) including: hypoplastic nails and shortened fifth fingers (one), microtia with cleft lip and palate (one), microtia alone (one), and neonatal death with multiple malformations (one). One kidney/pancreas (K/P) recipient reported one SA. Three liver recipients reported three pregnancies; two LB (no malformations), and one second trimester SA. Two heart recipients reported one LB (no malformations) and two SA. SRL exposures included seven recipients (four kidney, one K/P and two liver) reporting four LB (one infant whose mother was switched from MMF to SRL during late pregnancy had cleft lip and palate and microtia) and three SA. CONCLUSIONS: A higher incidence of structural malformations was seen with MMF exposures during pregnancy compared to the overall kidney transplant recipient offspring, while no structural defects have as yet been reported with early pregnancy sirolimus exposures. Centers are encouraged to report all pregnancy exposures in transplant recipients.     

体外受精-胚胎移植术后宫内宫外同时妊娠15例临床分析

目的探讨体外受精-胚胎移植(IVF-ET)后宫内宫外同时妊娠的发病率、危险因素、早期诊断及最佳治疗方式。方法对2001年10月至2006年10月在我院生殖中心行IVF-ET后获宫内宫外同时妊娠(HP)15例进行回顾性分析。结果同期IVF-ET后临床妊娠1,230例,HP15例,发生率1.2%。15例均为输卵管因素不育,其中1例合并男性因素;7例有盆腔手术史,3例宫外孕史;14例为宫内合并输卵管妊娠,1例为双侧输卵管切除术后合并间质部妊娠。15例患者均于确诊后手术治疗,其中10例在异位妊娠破裂前确诊,5例于破裂后确诊。术后9例宫内妊娠继续至足月分娩,4例胚胎停止发育,2例继续妊娠。结论输卵管病变或(和)盆腔手术史是IVF-ET术后HP发生的主要危险因素。IVF术前术中适当处理、早期诊断、及时治疗异位妊娠,有助于挽救宫内妊娠。     

Risk factors of microtia: A systematic review and meta-analysis

Background

The pathogenesis of microtia is still unclear. Various risk factors have been studied but they remain inconclusive. We conducted the first ever systematic review and meta-analysis to look for the association between microtia and various environmental risk factors.

Methods

Relevant case-control studies published between January 2000 to October 2014 were identified through a systematic search in PubMed and EMBASE. Reference lists from relevant review articles were also searched. Studies were included if they meet our selection criteria. Out of 1706 potential articles, 12 were included in the systematic review and 8 in the meta-analysis.

Results

Risk factors which showed significant positive association with microtia were: cold-like syndrome during pregnancy (OR?=?2.15; 95 % CI?=?1.36, 3.41, P?=?0.001); multiple gestation (OR?=?1.55; 95 % CI?=?1.05, 2.29, P?=?0.03); and gestational diabetes (OR?=?1.48; 95 % CI?=?1.04, 2.10, P?=?0.03). Risk factors which showed positive association but statistically insignificant were: threatened abortion (OR?=?1.22; 95 % CI?=?0.69, 2.15, P?=?0.50); smoking during pregnancy (OR?=?1.05; 95 % CI?=?0.63, 1.77, P?=?0.84); alcohol during pregnancy (OR?=?1.08; 95 % CI?=?0.65,1.80 P?=?0.77); urinary tract infection (OR?=?1.04; 95 % CI?=?0.59, 1.84, P?=?0.89); essential hypertension (OR?=?1.04; 95 % CI?=?0.74, 1.47, P?=?0.82); maternal diabetes (OR?=?3.98; 95 % CI?=?0.72, 21.96, P?=?0.11); respiratory tract infection (OR?=?1.26,95 % CI?=?0.84,1.88, P?=?0.26); chronic disease during pregnancy (OR?=?1.29,95 % CI?=?0.99,1.69, P?=?0.06); severe nausea/vomiting (OR?=?1.16; 95 % CI?=?0.66, 2.04, P?=?0.61); NSAIDs during pregnancy (OR?=?1.17, 95 % CI?=?0.61,2.22, P?=?0.64); antihypertensives during pregnancy (OR?=?1.84,95 % CI?=?0.94,3.62, P?=?0.08); and illegal drugs during pregnancy (OR?=?1.69; 95 % CI?=?0.65, 4.39, P?=?0.28). Reduced risk for microtia was found with these factors: folic acid (OR?=?0.55; 95 % CI?=?0.33, 0.92, P?=?0.02); advanced maternal age (OR?=?0.94; 95 % CI?=?0.79, 1.11, P?=?0.45); ampicillin during pregnancy (OR?=?0.80,95 % CI?=?0.50, 1.28, P?=?0.35); and metronidazole during pregnancy (OR?=?0.77,95 % CI?=?0.40, 1.48 P?=?0.44).

Conclusions

Our study indicates cold-like syndrome, multiple gestation, and gestational diabetes as significant risk factors for microtia; whereas folic acid consumption during pregnancy is shown to be a protective factor. Studies on risk factors for microtia are still very limited to establish the definitive risk factors. Further large-scale and multicentre studies are needed to clarify the role of key risk factors for the development of microtia.Level of Evidence: Level II, risk / prognostic study.

     

The outcomes of artificial insemination by cryopreserved donor semen and analysis of its affecting factors

Objective:To analyze the outcomes of artificial insemination by frozen-thawed donor's semen(AID)and its affecting factors.Methods:Retrospective analysis of the results of 412 AID cycles performed in 173 couples be-tween February 2002 and December 2003 was presented,to evaluate the influence of female age,methods of insemination,therapeutic regime,post-thaw semen motility and number of treatment cycles on the fecundity of women undergoing AID.Results.Overall pregnancy rate of 31.6%(130/412)and delivery rate of 27.2%(112/412)per cycle and cumulative pregnancy rate of 72.3%(125/173)were achieved,with abortion rate of 13.9%(18/130)and multiple pregnancy rate of 2.68%.In 125 pregnant women,inseminations were performed 1-5 cycles,and 89.2% pregnant women conceived within three treatment cycles with twice AID in each cycle.Some factors such as ovarian stimulation(OS),female age(under 38 years),methods of insemination and luteal phase support bear no significant relations to preg-nancy rate,but the motility of post-thaw semen was significantly related to pregnancy rate.A-mong 115 neonates with weight 2,750～5,000 g,one was found congenital ventricular septal de-fect.Conclusions:Insemination with frozen-thawed semen is safe and effective.In women less than 38 years with normal reproductive function,satisfactory pregnancy rate could be achieved when AID was performed twice per cycle before and after ovulation within 4 consecutive sponta-neous cycles.     

Herbal medicines for asthma: a systematic review

BACKGROUND: Asthma is one of the most common chronic diseases in modern society and there is increasing evidence to suggest that its incidence and severity are increasing. There is a high prevalence of usage of complementary medicine for asthma. Herbal preparations have been cited as the third most popular complementary treatment modality by British asthma sufferers. This study was undertaken to determine if there is any evidence for the clinical efficacy of herbal preparations for the treatment of asthma symptoms. METHODS: Four independent literature searches were performed on Medline, Pubmed, Cochrane Library, and Embase. Only randomised clinical trials were included. There were no restrictions on the language of publication. The data were extracted in a standardised, predefined manner and assessed critically. RESULTS: Seventeen randomised clinical trials were found, six of which concerned the use of traditional Chinese herbal medicine and eight described traditional Indian medicine, of which five investigated Tylophora indica. Three other randomised trials tested a Japanese Kampo medicine, marihuana, and dried ivy leaf extract. Nine of the 17 trials reported a clinically relevant improvement in lung function and/or symptom scores. CONCLUSIONS: No definitive evidence for any of the herbal preparations emerged. Considering the popularity of herbal medicine with asthma patients, there is urgent need for stringently designed clinically relevant randomised clinical trials for herbal preparations in the treatment of asthma.