直肠黏膜环切术治疗直肠前突30例疗效观察

目的观察直肠黏膜环切术(PPH)治疗直肠前突的临床疗效。方法将60例直肠前突患者随机分为治疗组30例,采用PPH术;对照组30例,采用经直肠切开修补术(Sehapayah法)。观察两组患者治愈率及术后并发症。结果治疗组与对照组治愈率分别为70.0%和43.3%,差异有统计学意义(P0.05)。术后排空困难、会阴膨出感的发生率治疗组低于对照组(P0.05或0.01)。结论治疗直肠前突PPH术与传统经直肠切开前突修补术相比,具有手术操作简单、术后并发症少、恢复时间短、安全性高等优点。     

规范筛查流程下住院高血压患者的病因构成分析

目的分析在现代规范的高血压筛查流程下阜外医院高血压中心近两年住院高血压患者的病因构成。方法采用回顾性研究方法,分析在现代规范的继发性高血压筛查流程下阜外心血管病医院高血压病区2011年9月至2013年8月住院高血压患者的病因及构成情况。结果（1）共1440例住院高血压患者,其中继发性高血压677例,占47．O％,男性294例（43。4％）,平均年龄39,834-12．03岁。（2）本中心继发性高血压的首位病因为原发性醛固酮增多症198例,29。2％（198／677）,其次为多发性大动脉炎（累及降主动脉和肾动脉）160例。23．6％（160／677）,粥样硬化性肾动脉狭窄126例,18．6％（126／677）、睡眠呼吸暂停综合征58例,8,6％（58／677）,及其他135例,19．9％。结论我中心在现代规范的高血压筛查流程下,住院高血压患者的继发性高血压检出率明显提高,病因构成比发生了明显变化。     

Background rates of adverse events of special interest for COVID-19 vaccine safety monitoring in the United States, 2019–2020

BackgroundThe U.S. Food and Drug Administration (FDA) Biologics Effectiveness and Safety (BEST) Initiative conducts active surveillance of adverse events of special interest (AESI) after COVID-19 vaccination. Historical incidence rates (IRs) of AESI are comparators to evaluate safety.MethodsWe estimated IRs of 17 AESI in six administrative claims databases from January 1, 2019, to December 11, 2020: Medicare claims for adults ≥ 65 years and commercial claims (Blue Health Intelligence®, CVS Health, HealthCore Integrated Research Database, IBM® MarketScan® Commercial Database, Optum pre-adjudicated claims) for adults < 65 years. IRs were estimated by sex, age, race/ethnicity (Medicare), and nursing home residency (Medicare) in 2019 and for specific periods in 2020.ResultsThe study included >100 million enrollees annually. In 2019, rates of most AESI increased with age. However, compared with commercially insured adults, Medicare enrollees had lower IRs of anaphylaxis (11 vs 12–19 per 100,000 person-years), appendicitis (80 vs 117–155), and narcolepsy (38 vs 41–53). Rates were higher in males than females for most AESI across databases and varied by race/ethnicity and nursing home status (Medicare). Acute myocardial infarction (Medicare) and anaphylaxis (all databases) IRs varied by season. IRs of most AESI were lower during March–May 2020 compared with March–May 2019 but returned to pre-pandemic levels after May 2020. However, rates of Bell’s palsy, Guillain-Barré syndrome, narcolepsy, and hemorrhagic/non-hemorrhagic stroke remained lower in multiple databases after May 2020, whereas some AESI (e.g., disseminated intravascular coagulation) exhibited higher rates after May 2020 compared with 2019.ConclusionAESI background rates varied by database and demographics and fluctuated in March–December 2020, but most returned to pre-pandemic levels after May 2020. It is critical to standardize demographics and consider seasonal and other trends when comparing historical rates with post-vaccination AESI rates in the same database to evaluate COVID-19 vaccine safety.     

Expansion of the application domain of a macromolecular ocular irritation test (OptiSafe™)

The OptiSafe (OS) test is shelf-stable, macromolecular eye irritation test that does not include any animal ingredient or component (“vegan”). The purpose of this study was to evaluate the test's accuracy for an expanded application domain for both the original and recently updated OS method. This study involved the testing of additional ocular corrosives and previously excluded foaming agents (“surfactants”) using both the original and updated OS methods and then combining these data with prior validation data for a total of 147 chemicals. Predictivity was evaluated by a statistical comparison of the OptiSafe predictions with historical in vivo “Draize” rabbit eye data for the same chemicals (from public databases). We report that for the detection of chemicals not requiring classification for eye irritation [Globally Harmonized System of Classification and Labeling of Chemicals (GHS) No Category], the accuracy, specificity, and sensitivity were 92.8%, 79.6%, and 100.0%, respectively, for the updated method; for the detection of chemicals inducing extreme eye damage/corrosion (GHS Category 1), the accuracy, specificity, and sensitivity were 79.4%, 71.8%, and 91.7%, respectively, for the updated method. Results indicate that both the original and updated methods have a high accuracy for the expanded application domain that included ocular corrosives and surfactants.     

Database analysis of hypersensitivity pneumonitis in Japan

BackgroundThree epidemiological small-scale studies on hypersensitivity pneumonitis (HP) have been performed in Japan to date. Herein, we aimed to clarify the clinical characteristics of various types of HP diseases using a large nationwide database in Japan.MethodsWe used the Japanese Diagnostic Procedure Combination database that includes data from 1,031 participant hospitals. Patients with HP from 2011 to 2017 were identified using International Classification of Diseases 10th Revision codes. We analyzed patient characteristics, the yearly transition of the number of HP cases, rate per one million hospitalizations, geographical distribution, seasonality, and risk factors for in-hospital mortality.ResultsIn total, 3,634 patients with HP were identified, including summer-type HP (SHP) (n = 490), bird fancier's lung (BFL) (n = 199), ventilation pneumonitis (n = 106), farmer's lung (n = 48), and unspecified HP (n = 2761). The length of hospital stay was significantly longer in patients with BFL (19 days) than in patients with SHP (15 days). SHP was more prevalent in the southwestern region of Japan, and hospitalization occurred mainly in summer (37.8%) and fall (37.3%). Ventilation pneumonitis was predominant in winter (28.6%) and spring (38.7%). In-hospital mortality was significantly associated with old age (p < 0.001), low body mass index (p = 0.016), severe dyspnea (p < 0.001), and BFL diagnosis on admission (p = 0.031).ConclusionsThis study revealed the clinical characteristics of SHP and BFL, including the frequency of causative antigens, geographical distribution, seasonality, and risk factors for mortality, which may help in diagnosing HP and identifying causative antigens.     

超声三维斑点追踪技术评估左室型单心室Glenn术后心功能变化

目的 应用超声三维斑点追踪技术(three-dimensional speckle tracking imaging,3DSTI)观察左室型单心室患儿Glenn手术前、后左心功能的变化.方法 对17例左室型单心室患儿于Glenn术前及术后分别进行三维超声和心脏磁共振检查,估测左心功能;术前、术后分别与年龄、性别匹配的1...