ObjectiveTo analyze the clinical and epidemiological characteristics of hospitalized avian influenza A (H7N9) virus infections in Hunan province from 2013 to 2017, and provide evidences for control, diagnosis and treatment of this disease.MethodsNinety-one hospitalized patients were confirmed with H7N9 infection in Hunan. Excluding 2 patients less than 18 years old and 10 with missing data, 79 patients with H7N9 infection were analyzed.ResultsMost confirmed cases were affected in the second and fifth epidemic wave and number of patients in the fifth wave was more than the sum in prior 4 waves. Epidemiological characteristics, clinical symptoms and case fatality did not change significantly. Administration of antiviral drugs was more active in the fifth wave [from illness onset to antiviral drug: (6.3±2.4)d vs. (7.6±2.4)d, P=0.047]. Multiple logistic regression analysis showed that shock (OR=4.683, 95%CI 1.136–19.301, P=0.033) was the independent risk factor of H7N9 infections. There were no significant differences in case fatality among group oseltamivir, group oseltamivir+peramivir, and group peramivir.ConclusionsPatients with avian influenza A (H7N9) increased in the fifth wave but clinical characteristics changed little. Antiviral treatment should be more active. Shock is an independent risk factor of H7N9 infections. Oseltamivir-peramivir biotherapy can not reduce case fatality compared with oseltamivir or peramivir monotherapy.
ObjectivesTo investigate the prevalence of mycoplasma pneumonia (MP) in the pediatric outpatient department of Shanghai Pudong New District Zhoupu Hospital and its relationship with the concentration of fine particulate matter (PM 2.5) in the air.MethodsPatients with respiratory tract infection, from one month to 15 years old, diagnosed in the pediatric department of Shanghai Pudong New District Zhoupu Hospital from May 2016 to April 2017 were enrolled. Mycoplasma pneumonia antibody was detected by colloidal gold assay, and mycoplasma antibody was detected after 1 week of negative test. PM 2.5 index of the same period was also collected. SAS 9.1.3 software was used for statistical analysis.ResultsA total of 3 862 children were enrolled, of which 947 were positive for MP, with a positive rate of 24.52%. The positive rates of each age group were 10.02% for the one month to one year old group, 23.51% for the 1 to 4 years old group, 31.70% for the 4 to 7 years old group, and 22.81% for the 7 to 15 years old group. The positive rate of each age group had statistically significant difference (χ2=86.120 0, P<0.000 1). The positive rates of spring, summer, autumn, and winter were 25.06%, 20.43%, 19.52 and 33.61%, respectively. The difference was statistically significant (χ2=67.1446, P<0.000 1). Combining the PM 2.5 index in Shanghai Pudong area from May 2016 to April 2017, the positive correlation between PM 2.5 and positive rate of MP was found (r=0.9007, P<0.001).ConclusionsThe positive rate of MP in Shanghai Pudong area is 24.52%, and reach its highest level in the preschool children and in winter. It is positively correlated with the PM 2.5 index as well.
ObjectiveTo summarizes the clinical characteristics of chronic appendicitis in children and discusses the diagnostic methods and the clinical application value of laparoscopic surgery.MethodsThe clinical data and treatment process of 68 children with chronic appendicitis admitted to the First Affiliated Hospital of Anhui Medical University from January 2015 to January 2020 were retrospectively analyzed, and their clinical characteristics and treatment experience were summarized and analyzed.ResultsAccording to different medical histories and symptoms, 68 cases were divided into 3 groups, with 15 patients in the typical symptom group, 28 patients in the appendix abscess group, and 25 patients in the asymptomatic group. All the 25 children in the asymptomatic group underwent barium enema examination, among which 68.0% (17/25) had filling defect in the appendix cavity, 16.0% (4/25) had no obvious appendix visualization, and 68.0% (17/25) had residual barium in the appendix cavity after 72 hours. The incidence of children in the 3 groups was concentrated at school age, but there was no significant difference in the proportion of children in different age groups between the three groups (P>0.05). All cases underwent laparoscopic exploration, 66 cases successfully completed laparoscopic appendectomy, 2 cases transferred to laparotomy, and all recovered satisfactorily. There was no statistically significant difference in the incidence of postoperative complications between the 3 groups (P>0.05).ConclusionsThe clinical manifestations of chronic appendicitis in children are diverse and difficult to diagnose. Barium enema examination (including re-examination after 72 hours) in children with atypical symptoms can help confirm the diagnosis. Chronic appendicitis in children is more common in school-age children, and laparoscopic exploration+appendectomy are the preferred treatment.
Objective To explore the clinical and inflammatory characteristics and risk factors of severe asthma to improve clinicians' awareness of the disease. Methods The general information of patients with asthma who visited the Department of Respiratory Medicine, the First Hospital of Shanxi Medical University from May 2018 to May 2021, as well as the diagnosis and treatment of asthma, personal history, comorbidities, auxiliary examination, asthma control test (ACT) score were collected. A total of 127 patients were included, including 40 in the severe asthma group and 87 in the mild-to-moderate asthma group. Chi-square test, independent sample t test and logistic regression were used to analyze the clinical characteristics, inflammatory markers and risk factors of severe asthma. Results Compared with the patients with mild to moderate asthma, the patients with severe asthma were more older (51.0±12.0 years vs 40.7±12.8 years, P<0.05), had more smokers (32.5% vs. 14.9%, P<0.05), and more males (67.5% vs. 40.2%, P<0.05). The patients with severe asthma got poor FEV1%pred [(56.1±23.8)% vs. (93.2±18.0)%, P<0.05] and FEV1/FVC [(56.7±13.2)% vs. (75.8±9.0)%, P<0.05)], and more exacerbations in the previous year (2.7±3.1 vs. 0.1±0.4, P<0.05), lower ACT score (14.4±3.7 vs. 18.0±5.0, P<0.05), and higher blood and induced sputum eosinophil counts [(0.54±0.44)×109/L vs. (0.27±0.32)×109/L, P<0.05; (25.9±24.2)% vs. (9.8±17.5)%, P<0.05]. There was no significant difference in the proportion of neutrophils in the induced sputum or FeNO between the two groups (P>0.05). Analysis of related risk factors showed that smoking (OR=2.740, 95%CI 1.053 - 7.130), combined with allergic rhinitis (OR=14.388, 95%CI 1.486 - 139.296) and gastroesophageal reflux (OR=2.514, 95%CI 1.105 - 5.724) were risk factors for severe asthma. Conclusions Compared with patients with mild to moderate asthma, patients with severe asthma are characterized by poor lung function, more exacerbations, and a dominant eosinophil inflammatory phenotype, which is still poorly controlled even with higher level of treatment. Risk factors include smoking, allergic rhinitis, and gastroesophageal reflux, etc.
ObjectiveTo investigate the clinical characteristics of epileptics with pregnancy and then provide reference for standardized management of epileptics with pregnancy. MethodsFrom June 2012 to June 2021, epileptics with pregnancy who delivered in Jinan Central Hospital were selected as the research subjects. The clinical data such as the application of Antiseizure medications (ASMs) during pregnancy, seizure frequency, pregnancy outcomes, delivery ways, offspring feeding ways and the incidence of complications were investigated and analyzed. ResultsAmong 36 epileptics with pregnancy, 20 cases (55.56%) were treated with ASMs alone, 5 cases (13.88%) were treated with combined medication, and 11 cases (30.56%) were treated without ASMs during pregnancy. 15 cases (41.67%) adhered to systematic application of ASMs, 17 cases (47.22%) did not adhere to systematic application of ASMs, and 4 cases (11.11%) had unknown medication history. The frequency of seizures increased in 5 cases, decreased in 7 cases and unchanged in 24 cases during pregnancy. Pregnancy outcomes: full-term delivery in 33 cases (91.67%), preterm delivery in 1 case (2.78%) and abortion in 2 cases (5.56%). Delivery mode: cesarean section in 31 cases (91.18%), vaginal delivery in 3 cases (8.82%). After delivery, 4 cases (11.76%) were fed with milk powder and 30 cases (88.24%) were breast-fed. Complications: There were 6 cases complicated with anemia (16.67%), 5 cases complicated with gestational hypertension (13.89%), 3 cases complicated with gestational diabetes (8.33%), 4 cases complicated with premature rupture of membranes (11.11%), 2 cases complicated with fetal growth restriction (5.56%), 2 cases complicated with oligohydramnios (5.56%), 3 cases complicated with fetal distress (8.33%) and 3 cases complicated with neonatal asphyxia (8.33%). ConclusionsThe proportion of epileptics with pregnancy who were systematically treated with ASMs was low and the seizures were poorly controlled. There is a lack of standardized management for such patients in clinical practice.
Objective To analyze the relationship between the residence and oncological characteristics of colorectal patients served by Sichuan University West China Hospital as a regional center in the current version of the Database from Colorectal Cancer (DACCA). Methods The DACCA version selected for this data analysis was the updated version on January 5, 2022. The data items analyzed included: residence, precancerous lesions, family history of cancer, tumor location, tumor morphology, tumor orientation, tumor pathology, tumor differentiation and preoperative TNM staging. According to the regional distribution of colorectal cancer patients' residence in the database, they were divided into Sichuan group and non-Sichuan group, and the Sichuan group was further divided into Sichuan-Chengdu group and Sichuan-non-Chengdu group. Results The DACCA database was filtered by conditions to obtain 7 232 valid data. ① The composition ratio of precancerous lesions in different places of residence: The difference between the Sichuan group and the non-Sichuan group was statistically significant (χ2=14.462, P=0.003), and the difference between the Sichuan-Chengdu group and the Sichuan-non-Chengdu group was not statistically significant (χ2=7.591, P=0.101). ② Composition ratio of family history of cancer in different places of residence: In the family history of cancer in oneself, the difference between Sichuan group and non-Sichuan group as well as between Sichuan-Chengdu group and Sichuan-non-Chengdu group were not statistically significant (χ2=1.121, P=0.606; χ2=1.047, P=0.621). In the family history of cancer in relatives, the differences in the composition ratio of different tumor histories between the Sichuan group and the non-Sichuan group, and between the Sichuan-Chengdu group and the Sichuan-non-Chengdu group were not statistically significant (χ2=0.813, P=0.692; χ2=2.696, P=0.262). ③ Tumor site composition ratios in different places of residence: The difference between Sichuan group and non-Sichuan group was not statistically significant (χ2=0.476, P=0.490), and the difference between Sichuan-Chengdu group and Sichuan-non-Chengdu group was statistically significant (χ2=36.216, P<0.001). ④ Tumor morphology composition ratio in different places of residence: The difference between Sichuan group and non-Sichuan group was statistically significant (χ2=19.560, P<0.001), and the difference between Sichuan-Chengdu group and Sichuan-non-Chengdu group was not statistically significant (χ2=5.377, P=0.247). ⑤ Composition ratio of tumor orientation in different places of residence: The differences in composition ratio of tumor orientation between Sichuan group and non-Sichuan group and between Sichuan-Chengdu group and Sichuan-non-Chengdu group were statistically significant (χ2=17.484, P=0.005; χ2=26.820, P<0.001). ⑥ Composition ratio of tumor pathological properties under different residence: The differences in the comparison of pathological properties between Sichuan group and non-Sichuan group as well as between Sichuan-Chengdu group and Sichuan-non-Chengdu group of CRC patients were not statistically significant (χ2=8.136, P=0.408; χ2=7.278, P=0.506). ⑦ Composition ratio of tumor differentiation degree under different residence groupings: the differences in the composition ratio of tumors with different degrees of differentiation were not statistically significant between Sichuan group and non-Sichuan group, and between Sichuan-Chengdu group and Sichuan-non-Chengdu group (H=0.289, P=0.591; H=0.156, P=0.693). ⑧ The composition ratio of TNM staging of tumors before operation in different places of residence: between the Sichuan group and the non-Sichuan group, the difference in the composition ratio of preoperative TNM staging of CRC patients was statistically significant (H=8.023, P=0.005); between the Sichuan-Chengdu group and the Sichuan-non-Chengdu group, the difference in the composition ratio of preoperative TNM staging of CRC patients was not statistically significant (H=0.218, P=0.640). Conclusions Data analysis in DACCA reveal multiple associations between the place of residence and oncological characteristics of CRC patients. There are differences in the composition of the types of precancerous lesions among CRC patients in different places of residence. The proportion of CRC is higher in the family history of cancer. In terms of the site of tumor occurrence, the proportion of tumors located in the rectum is higher than that in the colon. In the composition of tumor morphology in all regions, the ulcerative type is the most frequent. The composition of tumor orientation is different in patients with CRC, and those who has involved a circle of the intestinal wall are the most frequent. Most CRC patients are already in middle or late stage when the tumor is discovered, and the proportion of middle or late stage patients in non-Sichuan provinces was even higher.
ObjectiveThe purpose of the research is to study the distribution and early warning of electroencephalogram (EEG) in acute mountain sickness (AMS). MethodsA total of 280 healthy young men were recruited from September 2016 to October 2016. The basic data were collected by the centralized flow method, the general situation of the division of the investigators after the training, the Lewis Lake score, the computer self-rating anxiety scale and depression scale, and the collection of EEG. Follow up in three months. Results94 of the patients with AMS, morbidity is 33%, 21 (22.34%) of the patients are moderate to severe, 73 (77.66%) are mild, morbidity is 26.67%. The abnormal detection rate of electrogram was 7.9% (22/280), which were mild EEG, normal EEG abnormal rate was 8.6% (16/186), abnormal detection rate of mild AMS was 4.1% (3/73), and the abnormal detection rate was 14.3% (3/21) in the medium / heavy AMS. The latter was significantly different from the previous (P < 0.05). Three months follow-up of this group of patients with 0 case of high altitude disease. Conclusions The EEG in AMS is mainly a rhythm irregular, unstable, poor amplitude modulation; or two hemisphere volatility difference of more than 50% or slightly increased activity. The result is statistically significant, suggesting that EEG distributions has possible early warning of AMS.
Objective To analyze the clinical characteristics of the Guang’an Omicron epidemic and summarize the management experiences and practices in pandemic prevention and control of major infectious diseases.Methods Retrospective analysis was performed on patients infected with coronavirus disease (COVID-19), afterwards treated and observed in the isolation ward of Guang’an People’s Hospital and the shelter of Guang’an City from May 9 to June 26, 2022. The characteristics of patients at different age stages and the related factors affecting the severity, re-positive and negative conversion was analyzed. Results Finally 1 278 patients were collected, including 508 males and 770 females, with an average age of 41.3±22.6 years. Among them, 1 054 patients were asymptomatic carriers. The overall severe rate was 0.86%, the severe rate of the high-risk group was 3.06%. The median negative conversion time was 10.0 days and re-positive rate was 7.36%. Patients aged＞60 years were 2.589 times more likely to have a longer negative conversion time than those aged≤60 years (95%CI 1.921-3.489, P＜0.001). Conclusion The clinical characteristics of Guang’an COVID-19 epidemic are mainly that the elderly with high risk factors are more likely to develop severe cases, have longer clearance time, and re-positve is more likely to occur.
This paper systematically reviews the important events and their significance in different stages of the construction of the Chinese discipline system of wound repair, and puts forward the following suggestions for its future development: the disciplinary content should be more normalized, standardized and organized; it is necessary to break through policy restrictions, and establish multidisciplinary integrated management, seamlessly connected treatment model, and integrated combination of therapy and rehabilitation, basing on models and standards of research-oriented hospitals and departments; the application of information technology in the discipline should be strengthened; some other items and problems, such as medical management, medical supervision and medical insurance, need further in-depth research and specific solutions.
Objective To observe the effects of cryopreservation and resuscitation on the biological characteristics of mesenchymal stem cells (MSCs) derived f rom human umbilical cord blood. Methods MSCs were isolated and cultured f rom human umbilical cord blood in vitro. The cells were passaged , and the third generation of MSCs were cryopreserved in－196 ℃ liquid nitrogen for 4 weeks with cryopreservation medium , which contained 10 % dimethyl sulfoxide (DMSO) and 90 % fetal calf serum ( FCS) . The morphology , proliferation and differentiation of MSCs were investigated and compared with those of MSCs before cryopreservation. Results There was no significant difference of morphology between pre-cryopreserved MSCs and the ones af ter resuscitation. It was observed that all MSCs were spindle-shaped and showed adherence growth characteristic before and af ter cryopreservation. The cell growth curves of MSCs were also similar before and af ter cryopreservation. Even though the curve of resuscitated MSCs descended a little as compared with that of pre-cryopreserved MSCs , there was no significant difference ( Pgt; 0. 05) . After 2-week adipocytic differentiation induction , fat drops could be found in the kytoplasm of MSCs and they were red when stained with oil-red O staining , which suggested that MSCs could be induced and differentiated into adipocytes. Af ter 4-week osteoblastic differentiation induction , MSCs could be induced and differentiated into osteoblasts , and calcium node showed black when stained with Von Kossa staining. There were no significant changes of the differentiating ability of MSCs into adipocyte and osteoblast before and after cryopreservation. Conclusion MSCs derived from human umbilical cord blood maintains their biological characteristics af ter cryopreservation and resuscitation.