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简介：ObjectivesToevaluatetheeffectsofn-3fattyacidsonthecoronaryheartdiseasepatients.MethodsFromSeptember2007toMarch2008,60patientswithcoronaryheartdiseasewererandomlyassignedton-3fattyacidsgroup(groupN)andcontrolgroup(groupC).BothgroupsreceivedstandardcoronaryarterydiseasesecondarypreventiontreatmentandgroupNalsoreceivedeicosapentaenoicacid(EPA)1.8gplusdocosahexaenoicacid(DHA)1.2gperdayfor12weeks.Plasmatriacylglycerols,totalcholesterol,low-densitylipoproteincholesterol(LDL-C),high-densitylipoproteincholesterol(HDL-C)andbloodpressureweremeasuredbeforeandafterthestudy.ResultsPlasmatriacylglycerols,bloodpressureandLDL-ClevelwereloweringroupNaftern-3fattyacidstreatmentwhilenochangewasfoundingroupC(P<0.05).HDL-Clevelslightlyincreasedandtotalcholesterollevelslightlydecreasedaftern-3fattyacidsbutbothchangewerenotsignificant(P>0.05).ConclusionsN-3fattyacidshavebeneficialeffectsonthecoronaryarterydiseasepatients.

简介：AIM:Toestablishtheefficacyandsafetyofbimatoprost0.03%monotherapyinglaucomaandocularhypertension(OHT)patientswithinadequateintraocularpressure(IOP)oncurrenttherapy.METHODS:Pre-andpost-switchIOPswereanalyzedfor59consecutivepatientswhowereswitchedfromcurrenttherapytobimatoprostmonotherapybetween2011-2015.Demographicinformation,diagnosis,andanyadverseeventswererecorded.ChangeinIOPpost-preswitchwasanalyzedusinga2-sidedStudent'spairedt-testatthe5%significancelevel.RESULTS:TherewasastatisticallysignificantmeanreductioninIOPatthefirstfollowupvisit,whichwasmaintainedatsubsequentfollowupvisitsforpatientsregardlessofdiagnosis,orpre-switchtreatment(P<0.001).SubgroupanalysisalsodemonstratedastatisticallysignificantmeanreductioninIOPwhenlookingatOHTpatientsonly,aswellaspatientswithanydiagnosisswitchedfromlatanoprostmonotherapytobimatoprostmonotherapy(P<0.001).CONCLUSION:Thisisthelargestindependentdatasetwhichsupportsswitchingglaucomapatientswithpoorresponsetocurrenttreatmentontobimatoprostmonotherapybeforeconsideringotheradjuvantmedicalormoreinvasivetherapy.

简介：Highlevelsoflowmolecularweight(LMW)IgMincertaindiseasesareassociatedwithclinicalandlaboratoryindiceswhichreflecttheseverityofthedisease.TheseassociationssuggestthatLMWIgMmayplayanimportantroleintheimmunopathogenesisofthesediseases.TofurtherapproachthequestionconcerningthefunctionalactivityofLMWIgMindisease,apanelofLMWIgMandhighmolecularweight(HMW)IgMpreparationswithorwithoutrheumatoidfactor(RF)activitywereusedtoinvestigatetheirantibodybindingactivityandtheireffectorfunction.ItwasfoundthatLMWIgM-RFandHMWIgM-RFhadasimilarbindingcapacitytoFcfragmentastherewasnosignificantdifferenceintheaffinityindexbetweenthem.ItfurthershowedthattherateofactivationandtotalamountofutilizationofcomplementbyLMWIgMandHMWIgMwassimilar,althoughthemeanfluorescenceofC3depositionbyIgM-RFandHMWIgM-RFwasslightlyhigherthanthatofLMWIgM-RFandothercontrolRFantibodies.However,thecurrentstudydemonstratedthatLMWIgMhadstrongneutrophilactivatingpropertieswhencomparedwithHMWIgM.ThesefindingssuggestthatonemechanismofLMWIgMcontributingtotheimmunopathogenesisofRAmaybeduetotheformationofcirculatingimmunecomplex(CIC)byLMWIgMwithsubsequentactivationofneutrophils.WhetherLMWIgMhasotherfunctionalactivityindiseaseisunclearandneedsfurtherinvestigation.

简介：摘要BACKGROUNDDifferent degrees of disorders are reported in respiratory function, physical function and psychological function in patients with corona virus disease 2019 (COVID-19), especially in elderly patients. With the experience of improved and discharged COVID-19 patients, timely respiratory rehabilitation intervention may improve prognosis, maximize functional preservation and improve quality of life (QoL), but there lacks of studies worldwide exploring the outcome of this intervention.OBJECTIVETo investigate the effects of 6-week respiratory rehabilitation training on respiratory function, QoL, mobility and psychological function in elderly patients with COVID-19.METHODSThis paper reported the findings of an observational, prospective, quasi-experimental study, which totally recruited 72 participants, of which 36 patients underwent respiratory rehabilitation and the rest without any rehabilitation intervention. The following outcomes were measured: pulmonary function tests including plethysmography and diffusing lung capacity for carbon monoxide (DLCO), functional tests (6-min walk distance test), Quality of life (QoL) assessments (SF-36 scores), activities of daily living (Functional Independence Measure, FIM scores), and mental status tests (SAS anxiety and SDS depression scores)．RESULTSAfter 6 weeks of respiratory rehabilitation in the intervention group, there disclosed significant differences in FEV1(L), FVC(L), FEV1/FVC%, DLCO% and 6-min walk test. The SF-36 scores, in 8 dimensions, were statistically significant within the intervention group and between the two groups. SAS and SDS scores in the intervention group decreased after the intervention, but only anxiety had significant statistical significance within and between the two groups.CONCLUSIONSSix-week respiratory rehabilitation can improve respiratory function, QoL and anxiety of elderly patients with COVID-19, but it has little significant improvement on depression in the elderly.

简介：AbstractBackground:Hasner valve incision has been recently introduced as a new treatment for ophthalmic patients with epiphora symptoms. The aim of this study was to examine whether surgical outcomes of Hasner valve incision for inferior nasolacrimal duct obstruction were different between pediatric and adult patients.Methods:A total of 53 eyes of 52 patients who underwent Hasner valve incision in the Beijing Tongren Hospital from October 2016 to November 2019 were retrospectively observed. Patients were divided into two groups, including pediatric group (23 eyes of 22 patients, <18 years old) and adult group (30 eyes of 30 patients, ≥18 years old). Success rate of surgery was determined by both subjective measure (complete resolution of epiphora) and objective measure (lacrimal passage irrigation and tear meniscus height). Fisher exact test was conducted.Results:By conducting Fisher exact test and comparing complete resolution of epiphora (P = 0.627), lacrimal passage irrigation (P = 0.663), measurement of Tear Meniscus Height (P = 0.561), and appearance of complication (P = 0.339), there was no statistically significant difference of surgical outcomes between pediatric and adult patients (P > 0.05).Conclusion:Hasner valve incision was effective for both adult and children with inferior nasolacrimal duct obstruction, with no difference in surgical outcomes between the two groups.

简介：ObjectivesTocomparetheshortandmid-termoutcomesincasesofpercutaneoustransluminalcoronaryangioplasty(PTCA)inpatientswithunstablevstableangina.MethodsPatientsselectedforPTCA/stentingweredividedintotwogroups,onewithstableanginapectoris(SAgroup,n=92)andonewithunstableanginapectoris(UAgroup,n=112).Theoutcomesofcoronaryangiographies(CAG),initial(30-d)successoftheprocedure,andfollow-upstatusinthetwogroupswerecompared.ResultsBaselinecharacteristicsweresimilar,althoughthepatientswithunstablesymptomsmorefemales(P<0.05),andhadahigheraverageCCSclass(P<0.05)andahigherincidenceofpostinfarctionangina(P<0.01).Thefrequencyof’complexstenosisinpatientswithunstableanginawashigherthanthatofpatientswithstableangina,33%v20%(P<0.01).Atotalof309vesselsacceptedtheprocedure;including210stentsweresuecessfullydeliveredto156patients.143and67stentswereimplantedinthe

简介：AbstractBackground:Although the single-stage posterior realignment craniovertebral junction (CVJ) surgery could treat most of the basilar invagination (BI) and atlantoaxial dislocation (AAD), there are still some cases with incomplete decompression of the spinal cord, which remains a technique challenging situation.Methods:Eleven patients were included with remained myelopathic symptoms after posterior correction due to incomplete decompression of the spinal cord. Transoral odontoidectomy assisted by image-guided navigation and intraoperative CT was performed. Clinical assessment and image measurements were performed preoperatively and at the most recent follow-up.Results:Eleven patients were followed up for an average of 47 months. Symptoms were alleviated in 10 of 11 patients (90.9%). One patient died of an unknown reason 1 week after the transoral approach. The clinical and radiological parameters pre- and postoperatively were reported.Conclusion:Transoral odontoidectomy as a salvage surgery is safe and effective for properly selected BI and AAD patients after inadequate indirect decompression from posterior distraction and fixation. Image-guided navigation and intraoperative CT can provide precise information and accurate localization during operation, thus enabling complete resection of the odontoid process and decompression of the spinal cord.

简介：BackgroundVocalcordmovementdisorder(VCMD)isalaryngealdisordercharacterizedbyparadoxicaladductionofthevocalcordsduringininspiration,expirationorboth.ThenursingexperienceofpatientswithVCMDafteraorticdissectionsurgeryislimited.MethodsWeretrospectivelyanalyzedtheclinicaldataandnursingrecordsof269patientsafteraorticdissectionsurgeryinGuangdongGeneralHospitalbetweenMay2010andMay2012.Weobservedthepatients’pronunciation,andjudgediftherewasdysphagiaundergoingwaterdrinkingtesttwohoursafterextubation,toconfirmwhetherpatientshadVCMD.ResultsSeventeenpatientshadVCMDafteraorticdissectionsurgery,ofwhom2sufferedhoarseness,3haddysphasiaand12hadbothhoarsenessanddysphasia.Aftertimelytreatmentandcarefullynursing,allthepatientsrecoveredwell.ConclusionsWiththeenhancedcareofpatientswithaorticdissection,observinghoarsenessappearanceanddrinkingexperimentimmediatelyafterextubationcandetectVCMDassoonaspossible.Furtherrehabilitationtrainingandpsychologycarecanpreventbuckingandaspirationeffectively,andpromotingrecoveryandimprovingpatient’slifequality.

简介：AbstractBackground:A patient’s infectivity is determined by the presence of the virus in different body fluids, secretions, and excreta. The persistence and clearance of viral RNA from different specimens of patients with 2019 novel coronavirus disease (COVID-19) remain unclear. This study analyzed the clearance time and factors influencing 2019 novel coronavirus (2019-nCoV) RNA in different samples from patients with COVID-19, providing further evidence to improve the management of patients during convalescence.Methods:The clinical data and laboratory test results of convalescent patients with COVID-19 who were admitted to from January 20, 2020 to February 10, 2020 were collected retrospectively. The reverse transcription polymerase chain reaction (RT-PCR) results for patients’ oropharyngeal swab, stool, urine, and serum samples were collected and analyzed. Convalescent patients refer to recovered non-febrile patients without respiratory symptoms who had two successive (minimum 24 h sampling interval) negative RT-PCR results for viral RNA from oropharyngeal swabs. The effects of cluster of differentiation 4 (CD4)+ T lymphocytes, inflammatory indicators, and glucocorticoid treatment on viral nucleic acid clearance were analyzed.Results:In the 292 confirmed cases, 66 patients recovered after treatment and were included in our study. In total, 28 (42.4%) women and 38 men (57.6%) with a median age of 44.0 (34.0-62.0) years were analyzed. After in-hospital treatment, patients’ inflammatory indicators decreased with improved clinical condition. The median time from the onset of symptoms to first negative RT-PCR results for oropharyngeal swabs in convalescent patients was 9.5 (6.0-11.0) days. By February 10, 2020, 11 convalescent patients (16.7%) still tested positive for viral RNA from stool specimens and the other 55 patients’ stool specimens were negative for 2019-nCoV following a median duration of 11.0 (9.0-16.0) days after symptom onset. Among these 55 patients, 43 had a longer duration until stool specimens were negative for viral RNA than for throat swabs, with a median delay of 2.0 (1.0-4.0) days. Results for only four (6.9%) urine samples were positive for viral nucleic acid out of 58 cases; viral RNA was still present in three patients’ urine specimens after throat swabs were negative. Using a multiple linear regression model (F = 2.669, P = 0.044, and adjusted R2 = 0.122), the analysis showed that the CD4+ T lymphocyte count may help predict the duration of viral RNA detection in patients’ stools (t = -2.699, P = 0.010). The duration of viral RNA detection from oropharyngeal swabs and fecal samples in the glucocorticoid treatment group was longer than that in the non-glucocorticoid treatment group (15 days vs. 8.0 days, respectively; t= 2.550, P = 0.013) and the duration of viral RNA detection in fecal samples in the glucocorticoid treatment group was longer than that in the non-glucocorticoid treatment group (20 days vs. 11 days, respectively; t = 4.631, P < 0.001). There was no statistically significant difference in inflammatory indicators between patients with positive fecal viral RNA test results and those with negative results (P > 0.05).Conclusions:In brief, as the clearance of viral RNA in patients’ stools was delayed compared to that in oropharyngeal swabs, it is important to identify viral RNA in feces during convalescence. Because of the delayed clearance of viral RNA in the glucocorticoid treatment group, glucocorticoids are not recommended in the treatment of COVID-19, especially for mild disease. The duration of RNA detection may relate to host cell immunity.

简介：Depression/anxietyiscommonlypresentinpacedpatientsandisassociatedwithincreasedcardiovascularmorbidityandmortality.Thehighprevalenceofdepression/anxietyinpacedpatientssupportsastrategyofincreasedawarenessandtreatmentfordepression/anxietyinpacedpatients.Health-relatedqualityoflife(HRQoL)isbeingincreasinglyconsideredasanexpectedout-comeoftherapeuticinterventionsandrehabilitationprogramsinclinicalcardiologyincludingpatientsbeforeandafterpacemaker(PM)implantation.Thismultispecialtyconsensusdocumentreviewstheevidencelinkingdepression/anxietywitharrhythmiaandcardiacpacing;HRQoLandcardiacpacing,atthesametime,providesrecommendationsforhealthcareprovidersforthetreatmentofdepression/anxiety.

简介：AIM:Todeterminethelong-termeffectsofselectivelasertrabeculoplasty(SLT)onintraocularpressure(IOP)andthenumberofmedicationsusedupto5yfollowingtreatmentinglaucomapatientsreceivingmaximallytoleratedmedicaltherapy(MTMT).·METHODS:TheWillsEyeHospitalGlaucomaResearchCenterretrospectivelyreviewedthechartsofglaucomapatientswhounderwentSLTafterreceivingMTMT.Eyesthatdidnotachievetheirtargetpressurewithin3mofollowingSLTwereexcludedfromthestudy.ChangesinmeanIOPandnumberofglaucomamedicationsusedwereanalyzedat1,3,and5yfollowingSLT.·RESULTS:Seventy-fiveeyesof67patientswereincludedinthestudy.FifteeneyesthatreceivedSLTfailedtoachievetheirtargetpressurewithin3moandwereexcludedfromthestudy.Theaveragefollow-uptimewas37.4mo(±14.4).MeanIOPwassignificantlyreduced1yaftertreatment(P=0.005).Itwasalsoreduced3,5yaftertreatmentwithoutreachingstatisticalsignificance(P=0.20andP=0.072,respectively).Therewasasignificantdecreaseinmeannumberofmedicationsused1,3,5yaftertreatment(P<0.001,P<0.001,andP=0.039,respectively).Inthespanof5y,2eyes(2.7%)underwentrepeatSLT,7eyes(9.3%)underwentglaucomasurgeryandanadditional3eyes(4.0%)underwentboth.·CONCLUSION:SLTsignificantlyreducedthenumberofglaucomamedicationsused5yfollowingtreatmentinglaucomapatientsreceivingMTMT.SLTmaydelayoperating-roomsurgery.

简介：摘要The present global pandemic of COVID-19 has brought the whole world to a standstill, causing morbidity, death, and changes in personal roles. The more common causes of morbidity and death in these patients include pneumonia and respiratory failure, which cause the patients to require artificial ventilation and other techniques that can improve respiratory function. One of these techniques is chest physiotherapy, and this has been shown to improve gas exchange, reverse pathological progression, and reduce or avoid the need for artificial ventilation when it is provided very early in other respiratory conditions. For patients with COVID-19, there is limited evidence on its effect, especially in the acute stage and in patients on ventilators. In contrast, in patients after discharge, chest physiotherapy in the form of respiratory muscle training, cough exercise, diaphragmatic training, stretching exercise, and home exercise have resulted in improved FEV1 (L), FVC (L), FEV1/FVC%, diffusing lung capacity for carbon monoxide (DLCO%), endurance, and quality of life, and a reduction in anxiety and depression symptoms. However, there are still controversies on whether chest physiotherapy can disperse aerosols and accelerate the rate of spread of the infection, especially since COVID-19 is highly contagious. While some authors believe it is possible, others believe the aerosol generated by chest physiotherapy is not within respirable range. Therefore, measures such as the use of surgical masks, tele-rehabilitation, and self-management tools can be used to limit cross-infection.

简介：AIM:Todeterminewhetherretinalcirculatorychangesplayaroleinthepathogenesisofmaculardisordersinpatientswhoareotherwisehealthy.METHODS:Patientswithmaculardisordersthatrequiredangiographicimagingwereincludedinthisprospectivecaseseries.Afteracompleteocularexam,fluoresceinangiographywasperformedusingastandardizedtechniqueontheHRA-II(HeidelbergEngineering,Heidelberg,Germany)withspecialfocusontheposteriorpole.Onlypatientswithgoodqualityimageswereincludedintheanalysis.Circulatoryparametersrecordedincludedthearm-choroidtime,choroid-retinalartery,andfinallytheretinalartery-veintime.Zonalasymmetry(betweentheupperandlowerzonesdividedbyalinepassingthroughthecentreofthefovea)intransittimes,ifanywasalsonoted.Appropriatestatisticalanalysiswasdone.Circulationtimeswerecomparedwithagematchedhistoricalcontrols.Changesinretinaldyetransittimesrelativetohistoricalagematchedcontrols,ifany,werenotedandcomparedbetweenvariousdisorders.RESULTS:Atotalof156eyesof156patients(120males)wereincludedinthestudy.Meanage:49.14±14.93y.Maculardisordersstudiedwereagerelateddegeneration,polypoidalvasculopathy,centralserouschorioretinopathy(CSCR)andparafovealtelangiectasia.DelayedcirculationtimewasnotedinCSCRpatientsonly.CONCLUSION:CSCRpatientsappeartohavedelayedarterialfilling,retinalcirculatorydisturbancesdonotseemtocontributetothepathogenesisofothermaculardisorders.

简介：针刺华佗夹脊穴(T3-L5)，治疗30例肥胖症患者，治疗2个疗程，显效12例，有效15例，无效3例，总有效率90．0％。

简介：AbstractImportance:In low resource countries, there has been scarcity of research on the risk factors associated with neutropenic enterocolitis, a serious complication that commonly develops during treatment of cancer patients.Objective:To identify the pattern of intestinal complications in pediatric leukemia patients treated with intensive chemotherapy, including those with neutropenic enterocolitis; to assess the outcome; and to evaluate the risk factors associated with the mortality in these patients.Methods:During the period from June 2015 to December 2016, a prospective study was carried out on pediatric patients diagnosed with acute leukemia who received induction/or re-induction phases of chemotherapy at South Egypt Cancer Institute. Patients with documented episodes of intestinal complications were included in the study. Recovery or death from an episode of intestinal complication was utilized as the primary outcome measure for the study. Using univariable and multivariable methods, potential risk factors associated with mortality were delineated by logistic regression analysis, both for the entire intestinal complications episodes as a whole and for those episodes of neutropenic enterocolitis only.Results:Out of 88 documented episodes of intestinal complications from 77 patients; 58 episodes were identified as neutropenic enterocolitis from 47 patients. In those patients who were having episodes of neutropenic enterocolitis, the presence of abdominal tenderness (OR 4.529, 95%CI 1.062-19.317, P = 0.041); a longer duration of neutropenia (OR 1.215, 95%CI 1.030-1.434, P = 0.021); and hemodynamic instability (OR 17.023, 95%CI 4.095-70.772, P < 0.001), were found to be independently associated with worse outcome.Interpretation:In Upper Egypt, the use of intensive systemic chemotherapy during the induction phase of acute leukemia was found to be associated with potentially lethal intestinal complications. A high index of clinical suspicion is warranted.

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简介：AbstractElectronic health (medical) records, which are also considered as patients’ information that are routinely collected, provide a great chance for researchers to develop an epidemiological understanding of disease. Electronic health records systems cannot develop without the advance of computer industries. While conducting clinical trials that are always costly, feasible and reasonable analysis of routine patients’ information is more cost-effective and reflective of clinical practice, which is also called real world study. Real world studies can be well supported by big data in healthcare industry. Real world studies become more and more focused and important with the development of evidence-based medicine. These big data will definitely help in making decisions, making policies and guidelines, monitoring of effectiveness and safety on new drugs or technologies. Extracting, cleaning, and analyzing such big data will be a great challenge for clinical researchers. Successful applications and developments of electronic health record in western countries (eg, disease registries, health insurance claims, etc) have provided a clear direction for Chinese researchers. However, it is still at primary stages in China. This review tries to provide a full perspective on how to translate the electronic health records into scientific achievements, for example, among patients with diabetes. As a summary in the end, resource sharing and collaborations are highly recommended among hospitals and healthcare groups.

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