目的 探讨改道置管肛外引流术治疗直肠黏膜下脓肿的临床疗效。 方法 2007年5月－2012年5月，将76例直肠黏膜下脓肿患者分为改道置管肛外引流术（治疗组）和传统切开引流术（对照组）治疗，每组各38例，两组患者在年龄、性别比、病程等方面具有可比性。观察两组患者治愈时间、治愈率、随访3个月的复发情况以及肛门直肠压力测定，评价两组患者临床疗效及肛门功能保护情况。 结果 治疗组患者治愈时间为（21.3 ± 6.37）d，对照组为（29.5 ± 4.52）d，治疗组时间明显缩短（t=5.79，P＜0.01）；治疗组治愈率97.3%，对照组为73.6%，差异有统计学差异（χ2=6.81，P＜0. 01）；两组患者随访3个月的肛门功能比较，RRP治疗组为3.48 ± 0.61，对照组3.22 ± 0.79，差异无统计学意义（t=−1.61，P＞0.05）；ARP治疗组为19.05 ± 3.76，对照组为17.55 ± 3.31，差异无统计学意义（t=−1.85，P＞0.05）；ALCT治疗组为36.74 ± 4.70，对照组为37.13 ± 3.90，差异无统计学意义（t=−0.39，P＞0.05）；AMCP治疗组为24.03 ± 5.80，对照组为21.8 ± 4.91，差异无统计学意义（t=−1.61，P＞0.05）。 结论 改道置管肛外引流术治疗直肠黏膜下脓肿可缩短疗程，提高治愈率。
With the development of photothermal nanomaterials, photothermal therapy based on near-infrared light excitation shows great potential for the bacterial infected wound treatment. At the same time, in order to improve the photothermal antibacterial effect of wound infection and reduce the damage of high temperature and heat to healthy tissue, the targeted bacteria strategy has been gradually applied in wound photothermal therapy. In this paper, several commonly used photothermal nanomaterials as well as their targeted bacterial strategies were introduced, and then their applications in photothermal antibacterial therapy, especially in bacterial infected wounds were described. Besides, the challenges of targeted photothermal antibacterial therapy in the wound healing application were analyzed, and the development of photothermal materials with targeted antibacterial property has prospected in order to provide a new idea for wound photothermal therapy.
Post-stroke cognitive impairment (PSCI) is the most common dysfunction after stroke, which seriously affects patients’ quality of life and survival time. To strengthen the management and prevention of PSCI, the European Stroke Organization and the European Academy of Neurology jointly developed the guidelines for PSCI in 2021. This paper introduces the background, compilation method and structure, management suggestions and expert consensus of PSCI, the next research direction, etc. Compared with the current prevention and treatment measures of PSCI in China, it aims to provide methodological reference for Chinese scholars to develope PSCI guidelines and reference evidence for clinical prevention and treatment of PSCI.
ObjectiveTo investigate the epidemiological characteristics of the first cluster of patients with coronavirus diseases 2019 (COVID-19) in Gansu.MethodsAll 6 COVID-19 patients from a non-familial cluster in Gansu, were extracted from Gansu Provincial Health Information System until Feb 20, 2020. The patients were confirmed by nucleic acid detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The analyses were included via retrospective method: patient clinical characteristics, the summary of epidemiology, and CT image characteristics.ResultsThis clustered outbreak was the first non-family clustered outbreak in Gansu after traveled to Thailand. All 6 COVID-19 confirmed patients were a kindergarten staff in Gansu, aged from 26 to 51 years, and were female. They traveled to Thailand in the same period, and had the same epidemiological exposure history. They were diagnosed as COVID-19 by transnasopharyngeal swab real-time fluorescent reverse transcription-PCR for SARS-CoV-2 nucleic acid examination at different time points after return to Gansu. The first patient was ill on January 21, 2020, with fever as first symptom. She was diagnosed at the Xigu District People’s Hospital in Lanzhou and was transferred to Lanzhou Pulmonary Hospital after being diagnosed. She was cured with one week’s antiviral treatment. The remaining 5 patients were treated in Longxi People’s Hospital. The common clinical symptoms were fever, throat discomfort, headache, and fatigue. Through 7 to 10 days’ antiviral treatment, they all were cured. All patients belonged to common type and had good prognosis.ConclusionThe COVID-19 patients in a non-familial cluster have the same epidemiological history. Early medical observation, SARS-CoV-2 nucleic acid examination and comprehensive chest CT should be arranged promptly to make diagnosis and give responsive treatment, so that the prognosis is often good.
Objectives Through a systematic review, to summarize and describe various health security mechanisms of protecting financial risk from illness in low and middle income countries (LMICs), and to analyze causes that lead to different effects in financial risk protecting. Methods Search words were chosen by both health policy experts and search coordinators after discussion and pilot. Twenty-four electronic databases, websites of 11 health institutions, and the search engine Google were searched. Any original study to evaluate the role of financial protection of health security mechanism in LMICs was included. Pre-designed data extraction form was used for collecting strategies and study method of included studies, and extracted information was analyzed and described. Results Fifty-two studies were included, and 56 specific health security mechanisms were categorized into 6: community-based health insurance, social health insurance, health sector reform, subsidy, user fee, and new rural cooperative medical scheme (NRCMS) in China. Forty-two mechanisms had positive effect in financial protection, 6 were negative, 5 had no effect and the effect of the other 2 was unclear. Conclusion Mechanisms that produced positive effect can be summarized as: setting up of co-payment rate, design of benefit packages, providing free care for vulnerable population, delivering primary health care directly in remote area, and Chinese NRCMS. Mechanisms to protect the poor from financial risk of illness include: government provides health insurance, providing free care and setting up different co-payment rate according to income. The failure of health security mechanisms can be ascribed the deviation from its original goal of health security mechanism design, due to various inner or external causes.
Objective To detective KRAS and BRAF mutations in gastrointestinal stromal tumors (GISTs) and explore its significance in resistance of imatinib treatment. Methods Three hundred and eighty-one c-kit/PDGFRA mutation samples, 119 c-kit/PDGFRA wild type samples, and 19 pairs of samples before and after imatinib resistance from 519 patients with GIST were enrolled in this study. Polymerase chain reaction was used to detect KRAS exon 2 and BRAF exon 15 mutations. The survival data were evaluated in patients with KRAS or BRAF mutation. Results KRAS mutation was found in 2 cases (1.7%) of c-kit /PDGFRA wild type GISTs, the type of KRAS mutation was G12D and G12C, respectively. BRAFV600E mutation was found in 2 cases (1.7%) of wild type GISTs. No KRAS and BRAF mutations were found in the patients with the c-kit/PDGFRA mutation GISTs and pairs of GISTs before and after imatinib resistance. Two patients with KRAS mutation showed shorter progression free survivals for imatinib treatment. Two patients with BRAF mutation had longer recurrence free survivals. Conclusions Low frequency of KRAS or BRAF mutation only happens in wild type GISTs. KRAS mutation might be related to imatinib primary resistance, but not to secondary resistance.
ObjectivesTo systematically review the prevalence of senile pruritus (SP) in Chinese population.MethodsPubMed, EMbase, CENTRAL, CINAHL, CBM, CNKI, WanFang Data and VIP databases were electronically searched to collect cross-sectional studies on the prevalence of SP in Chinese population from inception to May 2019. Two reviewers independently screened literature, extracted data and assessed risk of bias of included studies, then, meta-analysis was performed by Stata 12.0 software.ResultsA total of 11 studies involving 13 398 patients were included. The results of meta-analysis showed that, the overall prevalence of SP was 31.0% (95%CI 18.0% to 44.0%). Subgroup analysis showed that the prevalence rate of male was 34.9% (95%CI 18.6% to 88.5%). The prevalence rates of SP among 60, 70, 80 and 90 age groups were 20.0% (95%CI 14.2% to 25.7%), 48.4% (95%CI 21.5% to 75.3%), 53% (95%CI 12.4% to 93.5%), and 58.5% (95%CI 22.4% to 94.6%), respectively. The prevalence rates of SP in community, hospital and cadre relaxation club were 33.4% (95%CI 31.3% to 35.6%), 40.4% (95%CI 22% to 58.7%), and 14.4% (95%CI 1.1% to 27.7%), respectively. The prevalence rates of SP in southern China and northern China were 26.7% (95%CI 18.7% to 34.7%) and 36.8% (95%CI 21.8% to 51.7%), respectively.ConclusionsThe overall prevalence rate of SP in the Chinese population is high. The prevalence rates of SP among ages, regions and research sites are different.