Umbilical appearance and patient/parent satisfaction over 5 years of follow-up after umbilical hernia repair in children

Background/purpose

We evaluated the long-term umbilical appearance and patient/parent satisfaction at follow-up after umbilical hernia repair (UHR).

维生素E对鼠海马神经元细胞的抗氧化损伤作用

目的观察维生素E对老年痴呆(Alzheimer'sdisease)的治疗作用,研究氧化损伤对鼠海马神经元细胞的损伤作用及维生素E对其氧化损伤的保护作用。方法用氧化(H2O2)、维生素E处理后氧化的方法对鼠海马神经细胞(HT-22)进行分组处理。用二维电泳法、蛋白银染法及特殊氧化蛋白免疫染色法探测被氧化的蛋白。结果氧化处理12h后出现细胞生存率明显下降31.19%;经维生素E处理后再氧化处理的细胞生存率几乎达到正常组水平。经H2O2氧化处理的鼠海马神经元细胞的氧化蛋白数目增加了,而维生素E提前处理过的那组没有增加。结论维生素E对鼠神经元细胞的氧化损伤起保护作用,是有效的抗氧化治疗剂。     

肾上腺素递增剂量方程与氨茶碱及生脉注射液联合在心肺复苏中的应用

目的 探讨肾上腺素递增剂量方程G=(K+2n-1)mg/3min(K=1、2,n=1、2、3……,G≤0.2 mg/kg)与氨茶碱7mg/kg及生脉注射液快速同步联合在心肺复苏(CPR)中的应用效果及临床价值.方法 将328例心脏骤停患者分成3组,即标准剂量肾上腺素组(SDE组)112例、方程G=(K+2n-1)mg/3min(K=1、2,n=1、2、3……,G≤0.2 mg/kg)中首次剂量K=1mg(方程1)组106例及K=2mg(方程2)组110例.同时进行心电、平均动脉压(MAP)、心率(HR)、自主循环恢复时间等监测,并评价复苏效果.结果 方程2组和方程1组自主循环恢复率、24h存活率、出院存活率、出院存活Glasgow昏迷评分与SDE组比较均显著升高(P＜0.01),方程2组和方程1组CPR始用药至自主循环恢复时间与SDE组比较显著缩短(P＜0.01).方程2组、方程1组和SDE组CPR始用药至自主循环恢复中肾上腺素用量明显减少(P＜0.05),但方程2组和方程1组达到自主循环恢复所需静脉推注肾上腺素的周期数与SDE组比较显著减少(P＜0.01).结论 采用肾上腺素递增剂量方程G=(K+2n-1)mg/3nmin(K=1、2,n=1、2、3……,G≤O.2mg/kg)和氨茶碱7mg/kg及生脉注射液快速同步联合应用,在CPR流程中能显著提高心脏复苏率、提高存活率,并且显著缩短自主循环恢复时间,改善神经系统及脑功能,提高复苏时效效应,是提高心、肺、脑复苏成功率的又一新方法和途径.     

Use of organs from increased infectious risk deceased donors in pediatric kidney transplantation

Living donors are the main source of transplanted kidneys for children and young people in many countries, but there still remains a significant need for deceased donor kidney transplantation. Given the waiting times associated with deceased donor kidney transplantation and the morbidity or mortality that can occur in those on the waiting list, it is essential that the utilization of kidneys from deceased donors is optimized. The use of organs from deceased donors at increased risk of transmitting human immunodeficiency virus, hepatitis B virus, or hepatitis C virus is relatively common in adults, but far less so in children. The risks and benefits of the use of kidneys from increased infectious risk donors (IIRD) are discussed. The variation of definitions of IIRD between countries is explored as is the need for pediatric nephrologists and transplant surgeons to have an understanding of the prevalence of viral diseases within the country in which they work. The role of screening tests such as nucleic acid tests is examined, along with the concept of residual risk. Finally, considerations in acquiring informed consent in the use of kidneys from IIRDs in children and young people are discussed.     

Is a Higher Number of Total Hip and Knee Arthroplasty Revisions Associated With Increased Mortality?

BackgroundIt remains uncertain whether patients who undergo numerous total hip arthroplasty (THA) and/or knee arthroplasty (TKA) revisions exhibit decreased survival. Therefore, we sought to determine if the number of revisions per patient was a mortality predictor.MethodsWe retrospectively reviewed 978 consecutive THA and TKA revision patients from a single institution (from January 5, 2015-November 10, 2020). Dates of first-revision or single revision during study period and of latest follow-up or death were collected, and mortality was assessed. Number of revisions per patient and demographics corresponding to first revision or single revision were determined. Kaplan-Meier, univariate, and multivariate Cox-regressions were utilized to determine mortality predictors. The mean follow-up was 893 days (range, 3-2,658).ResultsMortality rates were 5.5% for the entire series, 5.0% among patients who only underwent TKA revision(s), 5.4% for only THA revision(s), and 17.2% for patients who underwent TKA and THA revisions (P = .019). In univariate Cox-regression, number of revisions per patient was not predictive of mortality in any of the groups analyzed. Age, body mass index (BMI), and American Society of Anesthesiologists (ASA) were significant mortality predictors in the entire series. Every 1 year of age increase significantly elevated expected death by 5.6% while per unit increase in BMI decreased the expected death by 6.7%, ASA-3 or ASA-4 patients had a 3.1 -fold increased expected death compared to ASA-1 or ASA-2 patients.ConclusionThe number of revisions a patient underwent did not significantly impact mortality. Increased age and ASA were positively associated with mortality but higher BMI was negatively associated. If health status is appropriate, patients can undergo multiple revisions without risk of decreased survival.     

Effects of plasma treatment time on modification of acrylic denture material

Objective：To study the relationship between plasma treatment time acrylic resin denture material in the size of 2 mm × 10 mm × 10 mm. and efficacy. Methods：Test specimens were prepared from an Plasma treatment was carried out on the surface of Polymethyl methacrylate（PMMA） at different time. XPS studies, IR spectra studies and measurement of wetting angle were performed. Results： XPS showed the peak corresponding to C-O getting higher as the treatment proceeded, however at 120 seconds, the peak did not increase any longer and partly crossed with the peak at the duration of 60 seconds. IR spectra showed the wave corresponding to C-H was reduced as O2-plasma treatment proceeded, and then changed little, Wetting angle initially decreased dramatically, however, as the reaction proceeded, wetting angle increased slightly. Conclusion：Equilibrium was reached for introducing oxygen-containing groups and changing of C-H. As the treatment proceeded, wetting angle increased slightly.     

脊髓型颈椎病术前脊髓MRI T2高信号的临床意义

目的探讨术前脊髓MRI T2高信号与行颈前路减压术的脊髓型颈椎病（CSM）临床特征的关系。方法将48例行颈前路减压术及MRI检查的CSM患者,按术前MRI T2信号分为3组：等T1/等T2信号为A组（21例）,等T1/长T2信号为B组（22例）,长T1/长T2信号为C组（5例）。记录患者年龄、病程、术前JOA、随访术后JOA评分及改善率。结果术前JOA、术后JOA评分及改善率的比较：A组与B组差异无统计学意义（P〉0.05）,A组与C组、B组与C组差异有统计学意义（P〈0.05）。结论 CSM伴有长T1/长T2信号者术前JOA、术后JOA及恢复率较差,伴有等T1/等T2、等T1/长T2信号的术前JOA、术后JOA评分及恢复率较好。长T1/长T2信号改变可以作为CSM术后恢复较差的预后指标。     

Increased serum IgE in alcohol abusers

Background: It has been reported that total serum IgE is increased in patients with alcoholic cirrhosis, but it is not clear if this fact is related to alcoholic liver disease or to alcohol intake. Objective: To measure serum IgE in a group of chronic alcoholics with different stages of liver injury in order to elucidate if IgE increase is related to alcoholic liver damage. Patients and methods: Total serum IgE was determined by enzyme immunoassay in 186 chronic alcoholic patients (137 male/49 female) and 101 healthy controls. Patients and controls with known reasons for IgE elevation were excluded. Among alcoholic patients, 24 had fatty liver, 28 hepatic fibrosis, 29 alcoholic hepatitis, and 67 liver cirrhosis (38 patients were not evaluable concerning liver injury). Results: Total serum IgE was found to be increased in alcoholics (median 154.5IU/mL, range 1–7329IU/mL) with respect to healthy controls (median 20IU/mL, range < 1–1417 IU/mL) (P < 0.001). IgE increase was moderate (180–1000 IU/mL) in 60 alcoholics (32.3%) and marked (> 1000 IU/mL) in 27 (14.5%). Male alcoholics had higher IgE levels than females (median 191 IU/mL and range 1–7329 IU/mL vs 105IU/mL and range 2–2189IU/mL) (P= 0.009). On logistic regression analysis, alcoholism, male sex and younger age (but not smoking) were independently associated with higher IgE levels. No clear relationship was noted between serum IgE and severity of alcoholic liver disease. Thus, no correlation was observed between IgE and parameters of liver function (serum bilirubin, albumin or prothrombin index). Likewise, IgE concentrations were not significantly different in patients with liver cirrhosis with respect to patients with less severe liver disease. Serum IgE was increased (> 180 IU/mL) in 47.8 % of cirrhotics and in 44% of patients without liver cirrhosis. In contrast, other immunoglobulins (IgG, IgA and IgM) were significantly correlated with liver dysfunction. Conclusion: Chronic alcoholism should be considered as a cause of increased total serum IgE, regardless of the severity of the underlying liver disease.     

放化疗对乳腺癌妇女性身份和性功能影响的多因素研究

目的:乳腺癌所造成的心理影响和冲击,受疾病的诊断和治疗方式、病程与分期、症状和功能反应的不同而各异;尤其是术后的放化疗对患者精神心理障碍和躯体的损害、性身份和性功能及其生活质量的影响。方法:对术后续贯进入肿瘤科继续接受放化疗和中医等辅助治疗的208例乳腺癌妇女,年龄24～83岁,平均47岁;其中88.9%为已婚妇女;受教育程度各水平均衡;接受乳房保留术占10.6%(22例),根除术占89.4%(186例);182例(87.5%)接受化疗,176例(84.6%)接受放疗。15.4%(33例)患者不知道自己所患疾病真相;患病时间为术后1～17年。乳腺癌患者的精神心理状态与人格的评定采用临床晤谈、明尼苏达多项人格问卷(MMPI)和生活事件量表以及基本情况问卷的方法,以SPSS10.0软件为工具进行统计学处理。结果:①MMPI测量结果为40.9%(85例)的患者Hs高于70分,72.6%(151例)的患者D分高于70,38.5%(80例)的妇女Hy分高于70,而Pd高于70占17.8%(37例),Mf高于60占50.0%(104例),但都低于70分;Pa有42.8%(89例)高于70,Pt有54.8%(114例)的人高于70,Sc有76.9%(160例)高于70,17.8%(37例)的患者Ma高于70;201例Si分低于70分,其中58.6%(118例)高于60分。②多元Logistic分析显示,放疗使对Mf(OR=2.01,P=0.03)和Pt(OR=2.81,P=0.01)量表得分增高。结论:放疗是Mf