ObjectiveTo analyze the asymmetry of posterior-anterior radiograph of patients with facial asymmetry after orthodontic and surgical treatment. MethodsWe retrospectively analyzed the clinical data of 50 patients with varying degrees of facial asymmetry treated with orthodontic and surgical methods between June 2013 and June 2014. The asymmetric rate of posterior-anterior radiograph of the patients before and after treatment were compared with that of another 50 healthy subjects. ResultsMaxillary indexes including L2, L3, L4, L5, L6, L7, L8, L9, and L10 asymmetric rates of the patients were significantly different from those of the normal subjects (P < 0.05); L3, L6, L7 and L10 asymmetric rates were significantly different before and after treatment (P < 0.05). Mandibular indexes including L1, L3, L4, L5, L6, L7, L8, L9, and L10 asymmetric rates were significantly different from normal indicators (P < 0.05); L1, L3, L4, L5, L6, L7, L8, L9, and L10 asymmetric rates changed significantly after treatment (P < 0.05). ConclusionClinical facial asymmetry mainly manifests on the bottom 1/3 part of the face, and facial mandibular asymmetry is the most obvious.
ObjectiveTo investigate the clinical nursing path of health education in patients with gout. MethodsA total of 220 patients with gout treated in People's Hospital of Jiangyou from September 2010 to November 2011 were randomly divided into observation group and control group with 110 patients in each.After routine health education for the control group and clinical nursing path health education for the observation group,we compared patients'compliance with doctors,gout-related indicators and health education satisfaction degree between the two groups of patients. ResultsThere was no statistically significant difference in compliance with doctors between the two groups before health education (P>0.05).After health education,the score of five single items on compliance with doctors and the total score for patients in the observation group were all significantly improved (P<0.05).For patients in the control group,the scores of each item and the total score were also significantly improved (P<0.05) except the item of regular drug-taking and regular health examination (P>0.05).After health education,all scores and the total score of the observation group were higher than those of the control group (P<0.05). ConclusionFor health education for gout patients,clinical nursing path is better than routine health education in scores of compliance with doctors,improvements of symptoms,and health education satisfaction degree of the patients.
Objective To systematically evaluate correlation between exon-1 (locus 49, A/G) and promoter (locus -318, C/T) polymorphisms of Chinese population cytotoxic T lymphocytes associated antigen-4 (CTLA-4) gene and Graves’ Disease (GD). Methods Relevant studies were electronically searched in CNKI, VIP, CBM, PubMed, EMbase and The Cochrane Library from 1980.1 to 2011.12. According to the inclusion and exclusion criteria, we selected and screened all case-control studies on the correlation between CTLA-4 exon -1 (locus 49, A/G) and promoter (locus -318, C/T) polymorphisms of Chinese population and GD. Then we extracted the data and assessed the methodological quality of the included studies. Meta-analysis was performed using RevMan 5.0 and STATA 12.0 software. Results (1) Ten studies on exon-1 were included. Results of meta-analyses showed that Chinese population with genotype G/G had a higher GD risk than those with genotype A/A (OR=3.38, 95%CI 2.07 to 5.51) and A/G (OR=1.72, 95%CI 1.31 to 2.25). Also, the allele G showed significant association with increased GD risk compared to the allele A (OR=1.87, 95%CI 1.44 to 2.41). (2) Five studies on promoter-318 were included. Results of meta-analyses showed that Chinese population with genotype T/T presented no increased relative risk compared to those with genotype C/C (OR=0.75, 95%CI 0.26 to 2.12) or C/T (OR=0.92, 95%CI 0.31 to 2.73). Meanwhile, the allele T showed no increased relative risk compared to the allele C (OR=0.83, 95%CI 0.61 to 1.12). Conclusion The allele G at the locus 49 of exon -1 of Chinese population is significantly associated with increased GD risks, yet the correlation between promoter –318 C/T polymorphism and GD hasn’t been demonstrated. Due to the limited quality and quantity of the included studies, more high-quality studies are needed to test the above conclusion.
目的總結外科治療膽心綜合征的經驗。方法回顧性分析我科治療35例膽心綜合征之方法及療效。結果35例中26例為急診手術，9例為擇期手術，治愈率為93.4%。術后1周觀察，原有心前區癥狀消失28例，心電圖恢復正常27例。隨訪1年無1例因心臟病再就診。結論膽道手術是治療膽心綜合征之有效方法； 良好的麻醉，充分的顯露及術中對迷走神經的阻滯是手術成功之關鍵。
ObjectiveTo analyze the choice of initial antibiotic treatment for health care-associated pneumonia (HCAP). MethodA retrospective study was conducted in patients with HCAP hospitalized in the Emergency Department of West China Hospital from January 1st to December 31st, 2014. A total of 156 HCAP patients were divided into anti-multidrug-resistant treatment group (group A, n=72) and quinolone monotherapy group (group B, n=84). The baseline characteristics, comorbidities, severity, pathogen distribution, antibiotics and clinical outcomes were compared between the two groups. ResultsIn group B, there were 46 males and 38 females with the age of (59.9±10.9) years, and the pneumonia severity index (PSI) score was 89.5±22.7; in group A, there were 44 males and 28 females with the age of (62.2±12.2) years, and the PSI score was 94.4±23.6. The differeces between the two groups were not significant (P>0.05). The duration of using antibiotics in group B was (14.5±3.7) days, which was longer than that in group A[(12.8±3.8) days, P=0.005]. The detection rate of multidrug-resistant bacteria, the proportion of changing antibiotics, the average length of hospitalization, the proportion of using mechanical ventilation, the proportion of patients transferred into Intensive Care Unit and 30 days mortality in group B was 17.9%, 34.5%, (16.9±3.6) days, 11.9%, 9.5%, and 4.8%, respectively; which were similar to those in group A[15.3%, 22.2%, (17.3±3.9) days, 16.8%, 12.5%, and 4.2%, respectively] (P>0.05). ConclusionsIt is unnecessary for all HCAP patients to receive anti-multidrug-resistant treatment. We should regard the risk factors and the popular local features of microbiology to determine the choice of antibiotic treatment.
ObjectiveTo explore the current status of treatment adherence in patients with chronic kidney disease without dialysis and to analyze its influencing factors.MethodsThe patients who visited the Outpatient Department of Nephrology of West China Hospital of Sichuan University from September to December 2020 were taken as the research objects. Self-designed general information questionnaire, treatment adherence questionnaire, physician-patient communication satisfaction, health information seeking behavior questionnaire, and physician-patient concordance questionnaire were used to investigate, and path analysis was used to explore the influencing factors of treatment adherence.ResultsA total of 203 valid questionnaires were obtained. Treatment adherence score was (21.69±2.42) points, self-reported health status was (2.48±0.91) points, physician-patient concordance was (20.39±2.70) points, physician-patient communication satisfaction was (67.73±5.52) points, and health information seeking behavior was (13.17±2.65) points. Health information seeking behavior (r=0.214, P=0.002), physicians-patient concordance (r=0.494, P<0.001), physician-patient communication satisfaction (r=0.229, P=0.001) were positively correlated with treatment adherence. Self-reported health status was negatively correlated with treatment adherence (r=?0.225, P=0.001). Path analysis showed that physicians-patient concordance was the most influencing factor of treatment adherence (total effect=0.474).ConclusionHealth information-seeking behavior and physicians-patient concordance are important factors affecting treatment adherence in chronic kidney disease patients without dialysis. In order to improve treatment adherence of chronic kidney disease patients, healthcare providers can provide various ways to provide information, which can help make more disease-related health knowledge available to patients. Moreover, healthcare workers should also further explore ways to improve the concordance related to reaching agreement between doctors and patients on medical and treatment options.
Anti-seizure medications (ASMs) are the most important and basic treatment for epilepsy, and are also the first choice for epilepsy treatment, but about one-third of patients have drug resistance. Perampanel (PER), as a novel third generation ASMs, inhibits the α-amino-3-hydroxy-5-methyl-4-isoxazole-propionic acid receptor (AMPAR) through non-competitive inhibition. AMPA plays an anti-seizure role. Since its approval in China in 2021, it has been mainly used in the treatment of focal epilepsy (with or without general seizure) as a single drug or addition, and has good safety, effectiveness and tolerability. Self-limited epilepsy with centrotemporal spikes (SeLECTS) is a common childhood focal epilepsy syndrome, accounting for 15% ~ 25% of various childhood epilepsies, PER has important advantages in clinical studies and has shown certain curative effect. At the same time, the overall effect of PER on cognition was neutral, with no systemic cognitive deterioration or improvement. In view of the relatively short application time of PER, which is still a new drug, this article will review the mechanism of action, dose, add-on (single drug) treatment, adverse events and, in order to provide clinicians with more drug choices and facilitate the individualized diagnosis and treatment of epilepsy.
目的 探討可調壓胸腔閉式引流瓶持續負壓吸引治療自發性氣胸持續漏氣的療效觀察及護理。 方法 將2008年3月－2012年10月收治的自發性氣胸行胸腔閉式引流術后接傳統閉式引流瓶，引流達3 d胸腔仍有漏氣患者55例分為A組（治療組）、B組（對比組）。Ａ組30例更換為可調壓胸腔閉式引流瓶、Ｂ組25例繼續使用傳統閉式引流瓶。 結果 Ａ組患者平均帶管時間縮短，管腔堵塞、引流液逆流、低蛋白血癥等并發癥發生比Ｂ組減少。 結論 可調壓胸腔閉式引流瓶持續胸腔負壓吸引治療自發性氣胸持續漏氣患者治療效果優于傳統閉式引流好，患者帶管時間及平均住院時間縮短，住院費用降低，安全性高，并發癥少。