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简介：疼痛追随者仓库肌内(IM)油的注射基于车辆的药是学习的很少。这研究试图有希望地在4-mL海狸油车辆在1000mg睾丸激素undecanoate(TU)的IM注射以后在这个星期期间决定流行，决定因素，严厉和疼痛的功能的后果。在一个学术andrology诊所收到常规T代替治疗的雄激素缺乏的人被招募在深IM臀的注射以后在第一天和日报在七次用有色的视觉线性类似物规模报导疼痛分数一个星期。时间功课和covariables影响疼痛分数被变化(ANOVA)的混合模型分析分析。在125个人，的追随者168注射疼痛被80%人报导，在注射以后立即达到顶点，到达仅仅中等的严厉，持续1鈥？天并且在白天回到基线4。疼痛几乎没要求很少止痛使用并且在每日的活动生产了最小的干扰。疼痛分数的时间功课在经历了二连续注射的43个人是可再现的。疼痛在有更早痛苦的注射，而是在严重的更少的人是更严重的更旧并且更多的肥胖的人。根据在管理注射的富有经验的护士之间的注射以后的疼痛经验有可以忽略的差别。在4-mL海狸油的仓库TU的深IM臀的注射很好被容忍，注射以后的疼痛被更早痛苦的注射经验，以及年龄和肥胖影响。

简介：AIM:TostudytheevolutionoftherefractivestatusandexaminetheaffectedfactorsininfantsduringthefirstyearoflifeinalargesamplesizeinChina.METHODS:Atotalof1258babies(2516eyes)aged32wkgestationalageto1yparticipatedinthestudy,including766prematureand492full-terminfants.First,eachbabyreceivedanorthopticexamination,slit-lampcheckingandfundusimaging.Patientswithdiseaseswhichmightaffectrefractivestatuswereexcludedfromthecohort.Thecycloplegiaretinoscopywasperformed.Theirneonatalhistorieswerereviewed.Eachmeasurementcontainedtherefractivestatusandcalculationofthesphericalequivalent(SE).RESULTS:Refractivestateshowedanaveragehyperopiaof+0.94±1.63Datearlyages,followedbyatrendtowardmorehyperopia.Therefractivestatereachedthetop(+2.43±1.46D)attheageofonetotwomonths.Thenglidingtilloneyearoldwhentherefractivestatereached+0.59±1.41D.Theprevalenceofastigmatismwas42.17%inthestudy,being2.82%myopicastigmatismand39.35%hyperopicastigmatism.The94.1%ofhyperopicastigmatismwaswith-the-ruleastigmatismand71.83%ofmyopicastigmatismwaswith-the-ruleastigmatism.Refractivestatebetweenboysandgirlswasdifferent.ThemeanSEofboyswas+1.97±1.57D,whilethatofgirlswas+1.79±1.46D,andthedifferencewassignificant.CONCLUSION:Beforeoneyearold,thechangeofrefractivestatusisassociatedwithcheckingageandsex.Attheageofonetotwomonths,thedegreeofhyperopiareachesthetop.Boyshavemorehyperopicdegreethangirls,andwiththe-ruleastigmatismispredominant.Excludingprematureinfantswithadvancedretinopathyofprematurity,prematureandfull-termchildrenhavesamerefractionstatus.

简介：AIM:Toexaminetheassociationofgeneticpolymorphisms(-308)G/ATNFα,(+250)A/GLtα,(+36)A/GTNFR1,(+1663)A/GTNFR2withthedevelopmentofprimaryopenangleglaucoma(POAG)amongpeopleinCentralRussia.METHODS:Thestudysampleincluded443individuals,ofwhich252patientswithPOAGand191individualsinthecontrolgroup.Genotypingof(-308)G/ATNFα,(+250)A/GLtα,(+36)A/GTNFR1,(+1663)A/GTNFR2wasperformedusingpolymerasechainreaction.ThedistributionofallelesandgenotypesofthestudiedDNAmarkersinthegroupswasexaminedby2×2contingencytablesandχ2withtheYates'scorrectionforcontinuityandoddsratios(OR)with95%confidenceintervals(CI).RESULTS:Allele(-308)GTNFα(Р=0.01,OR=1.78,95%CI1.12-2.85)wasidentifiedasariskfactorforPOAG.Homozygotes(-308)AATNFαareatalowestriskfordevelopmentofthedisease(Р=0.01,OR=0.0005).ThefollowingcombinationofgeneticvariantsofcytokineswereassociatedwithareducedriskofPOAG:(+1663)ATNFR2and(+250)GLtα(OR=0.34)CONCLUSION:Geneticpolymorphisms(-308)G/ATNFα,(+250)A/GLtα,(+1663)A/GTNFR2associatedwiththedevelopmentofPOAGinthepopulationofCentralRussia.

简介：AIMTo调查在植入与的病人与光斩的现象联系的独立因素折射，旋转地不对称，multifocalintraocular透镜(MIOL).METHODSThirty--经历了单方的奔流外科的34个病人的四只眼睛，由旋转地不对称的MIOL的培植列在后面被包括。距离和近视觉的尖酸结果，intraocular错误，比较喜欢的读物距离，外科手术前、手术后的折射错误，mesopic和photopic学生直径，和mesopic和photopickappa角度被估计。病人们也被管理满足调查。光斩的现象被问询表分级。独立人士相关的因素被关联和bivariate识别到mesopic学生中心(学生中心移动)的从photopic的逻辑回归analyses.RESULTSThe距离显著地与瞪视/光圈症状被联系[机会比率(或)=2.065，95%信心间隔(CI)=0.916-4.679，P=0.006]并且夜里视觉问题(OR=1.832，95%CI=0.721-2.158，P=0.007)。外科手术前的photopic角度kappa显著地与瞪视/光圈症状被联系(OR=2.155，95%CI=1.065-4.362，P=0.041)。photopic角度kappa显著地也与瞪视/光圈症状被联系(OR=2.155，95%CI=1.065-4.362，P=0.041)并且与夜里视觉问题(OR=1.832，95%CI=0.721-2.158，P=0.007)在与旋转地不对称的MIOLs.CONCLUSIONA植入的病人，在视觉、学生的轴(角度kappa)之间的大学生中心移动和错误排列可以在旋转地不对称的MIOL的培植以后在光斩的现象的出现起一个作用。

简介：AbstractPurpose:Boarding is a common problem in the emergency department (ED) and is associated with poor health care and outcome. Imam Khomeini Hospital is the main healthcare center in Urmia, a metropolis in the northwest of Iran. Due to the overcrowding and high patient load, we aim to characterize the rate, cause and consequence of boarding in the ED of this center.Methods:All medical records of patients who presented to the ED of Imam Khomeini Hospital from August 1, 2017 to August 1, 2018 were retrospectively analyzed. Patients with uncompleted records were excluded. Boarding was defined as the inability to transfer the admitted ED patients to a downstream ward in ≥2 h after the admission order. Demographic data, boarding rate, mortality and triage levels (1-5) assessed by emergency severity index were collected and analyzed. The first present time of patients was classified into 4 ranges as 0:00-5:59, 6:00-11:59, 12:00-17:59 and 18:00-23:59. Descriptive, parametric and non-parametric statistical tests were performed and the risk of boarding was determined by Pearson Chi-square test.Results:Demographic data analysis showed that 941 (58.5%) male and 667 (41.5%) female, altogether 1608 patients were included in this study. Five patients (0.3%) died. The distribution of patients with the triage levels 1-5 was respectively 79 (4.9%), 1150 (71.5%), 374 (23.3%), 4 (0.2%) and 0 (0%). Most patients were of level 2. Only 75 (4.7%) patients required intensive care. The majority of patients (84.2%) were presented at weekdays. The maximum patient load was observed between 12:00-17:59. Of the 1608 patients, 340 (21.1%) experienced boarding within a mean admission time of 13.70 h. Among the 340-boarded patients, 20.1% belonged to surgery, 12.1% to orthopedics, 10.9% to neurosurgery and 10.3% to neurology. The boarding rate was higher in females, patients requiring intensive care and those with low triage levels. Compared with the non-boarded, the boarded patients had a higher mean age.Conclusion:The boarding rate is higher in the older and female patients. Moreover, boarding is dependent on the downstream ward sections: patients requiring surgical management experience the maximum boarding rate.

简介：瞄准：评估影响多囊肝疾病的非侵略、侵略的治疗的结果的因素。方法：有到2006年6月的从1986年7月的完全的后续的病人的临床的文件的分析。结果：41个病人(男性，7；女性，34)，11.9年变老的47.8+/-，和5.7+/-6.7年后续，被学习。硷性磷酸酯酶(AP)举起(15%病人)与侵略治疗的要求被联系(信息技术，P=0.005)。信息技术率是更高的在比非征兆的病人征兆(65.4%对14.3%，P=0.002)，并且在拿神经质的代替治疗(HRT)的女人(P=0.001)。包囊复杂并发症(CC)是更经常的(22%)在征兆的病人组织(P=0.023)。有身体质量的病人索引(BMI)>(59%)25在它以后有一个趋势到复杂并发症(P=0.075)。腹的疼痛为信息技术(78%)是最普通的症状(56%)和指示。十九个病人(46%)要求了第一种信息技术：12开的开窗术()，4laparoscopic开窗术(LF)和有肝的切除术(FHR)的3开窗术。三要求了第二种信息技术，并且一个人要求了第三个过程。复杂并发症在32%由于第一种信息技术被发现(16.7%，LF25%，FHR66.7%)，并且在在66.7%的第二种信息技术(100%)。后续死亡率是0。结论：症状，提高的AP，和CC的存在与信息技术要求被联系。HRT与症状和信息技术要求的存在被联系。有BMI>的病人25有一个趋势产生信息技术复杂并发症。复杂并发症的比例在FHR和秒信息技术组是更高的。RS是更经常的在以后。

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简介：AbstractObjective:To investigate the risk factors for lateral lymph node metastasis (LLNM) in papillary thyroid carcinoma (PTC).Methods:A retrospective analysis of 209 patients with PTC who underwent primary surgery at the Beijing Friendship Hospital affiliated with Capital Medical University from November 2014 to November 2018 was performed. The patients were divided into the LLNM group and the non-LLNM group. The clinical and pathological characteristics of the patients were analysed. The risk factors for LLNM were analysed by univariate and multivariate analyses.Results:The incidence of LLNM was 13.4% in PTC patients. Univariate analysis showed that the maximum diameter of the primary tumour > 2 cm (P < 0.001), bilateral primary tumour (P= 0.020), extrathyroidal extension (ETE) (P < 0.001), central lymph node metastasis (CLNM) (P < 0.001), and CLNM number ≥ 5 (P < 0.001) were significantly associated with LLNM. Multivariate logistic regression analysis showed that the maximum diameter of the primary tumour > 2 cm, ETE, and CLNM were independent risk factors for LLNM (OR values were 3.880, 5.202, and 4.474, respectively). There were 6 patients with skip lateral cervical lymph node metastasis, accounting for 21% of all LLNM patients.Conclusion:This study revealed several independent risk factors for predicting LLNM in PTC patients, such as the maximum diameter of the primary tumour > 2 cm, ETE and CLNM. Lateral neck dissection may be recommended in PTC patients with those risk factors. Paying attention to the occurrence of skip lateral cervical lymph node metastasis during the clinical diagnosis and treatment processes is necessary.

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简介：AbstractBackground:Endoscopic resection bleeding (ERB) classification was proposed by the authors’ team to evaluate the severity of intraoperative bleeding (IB) during endoscopic submucosal dissection (ESD). This study aimed to evaluate the application of ERB classification and to analyze the risk factors of major IB (MIB) and postoperative bleeding (PB) associated with ESD for gastric neoplastic lesions.Methods:We retrospectively enrolled a total of 1334 patients who underwent ESD between November 2006 and September 2019 at The First Medical Center of Chinese People’s Liberation Army General Hospital. All patients were divided into the non-MIB group (including ERB-0, ERB-controlled 1 [ERB-c1], and ERB-c2) and the MIB group (including ERB-c3 and ERB-uncontrolled [ERB-unc]) according to the ERB classification. Risk factors of major MIB and risk factors of PB were analyzed using a logistic regression model.Results:Among the 1334 patients, 773 (57.95%) had ERB-0, 477 (35.76%) had ERB-c1, 77 (5.77%) had ERB-c2, 7 (0.52%) had ERB-c3, and no patients had ERB-unc. The rate of PB in patients with IB classifications of ERB-0, ERB-c1, ERB-c2, and ERB-c3 were 2.20% (17/773), 3.35% (16/477), 9.09% (7/77), and 2/7, respectively. In multivariate analysis, proximal location (odds ratio [OR]: 1.488; 95% confidence interval [CI]: 1.045-3.645; P = 0.047) was the only significant risk factor of MIB. Chronic kidney disease (CKD) (OR: 7.844; 95% CI: 1.637-37.583; P = 0.010) and MIB (ERB-c3) (OR: 13.932; 95% CI: 2.585-74.794; P = 0.002) were independent risk factors of PB.Conclusions:Proximal location of lesions was a significant risk factor of MIB. Additionally, CKD and MIB (ERB-c3) were independent risk factors of PB. More attention should be paid to these high-risk patients for MIB and PB.

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简介：IntroductionHIVserostatusdisclosurehasbecomeanentrycriterionforpreventionofsexualpartnersspread,soweaimedtoexaminetheprevalenceofdisclosureandassociatedfactorsamongpeoplelivingwithHIV/AIDS(PLWHA)inLiuzhouCity,GuangxiZhuangAutonomousRegion,southernChina.MethodsThePLWHAwithmaritalorregularsexualrelationshipwereeligibleforourstudy,andaself-designedquestionnairewasassignedtoalltheconvenientlysampledparticipants.Determinantsofdisclosurewereanalyzedusingchi-squaretestandbinaryLogisticregression.ResultsAtotalof425PLWHAwereincludedinthepresentstudy.Twohundredandforty-five(57.6%)disclosedtheirHIV-positivestatustotheirspouses/regularsexualpartners,while180(42.4%)didnot.Amongthe245informedspouses/regularsexualpartners,236(96.3%)hadreceivedtheHIVtestingandthepositiveratewas50.4%.Whileamongthenon-in-formedspouses/regularsexualpartners,63(35.0%)hadreceivedtheHIVtestingandthepositiveratewas3.2%.BinaryLogisticregressionanalysisindicatedthatage,area,monthlyincome,HIV/AIDSrelatedknowledgeandantiretroviraltherapy(ART)wereindependentlyassociatedwithHIVserostatusdisclosure.ConclusionsThedisclosureratewaslowinthisstudy.Astoitsinfluencingfactors,itisnecessarytoprovidecomprehensivedisclosureconsultingamongPLWHAlivinginurban,theelderlyorhighmonthlyincomeandemphasizethepropagandaonHIV/AIDSrelatedknowledge,expandcoverageforantiretroviraltherapy,soastoprovidescientificreferenceforpromotingHIVdisclosureandreducingtheHIVincidenceofspouses/regularsexualpartnersamongPLWHA.

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简介：BACKGROUND:Exposuretolow-levelleadhasatoxiceffectonthedevelopmentofneonates,whichhasattractedwideattention.Colostrumleadlevelcanbeusedastheindicationofleadexposure.OBJECTIVE:Toobservetherelationshipofcolostrumleadlevelandtheneurobehavioraldevelopmentofinfants.DESIGN:Aprospectivecontrolobservation.SETTING:CenterforMaternalandChildHealth,ShanxiProvincialChildren'sHospital.PARTICIPANTS:Totally128neonatesoffull-termnormaldelivery,76maleand52female,fromShanxiProvincialMaternalandChildHealthCenterandJiexiuMaternalandChildHealthCenterwereinvolvedinthisstudy.Alltheinvolvedneonateshadnoperipartalischemic/hypoxichistoryorfetusintrauterinedevelopmentallag.Pregnantwomenhadnovariousacuteandchronicdiseasesinpregnancy,familyhistoryofneurologicaldiseaseoroccupationalleadexposure.128portionsofcolostrumsampleoffull-termnormaldeliverywerecollected.Informedconsentsofdetecteditemswereobtainedfromthepuerperantsandtheirrelatives.METHODS:①Experimentalgrouping:Leadlevelinthecolostrumwasdeterminedbyatomicabsorptionspectrometry.Accordingtoleadlevelinthecolostrum,theneonateswereclassifiedintotwoexposuregroupsofgreaterthanorequalto0.24μmol/Linahigh-levelleadgroupandlessthan0.24μmol/Linalow-levelleadgroup.②Experimentalevaluation:Mentaldevelopmentalindex(MDI)andpsychologicaldevelopmentalindex(PDI)of3-month-oldinfantswereevaluatedwithBayleyScalesofInfantDevelopment(BSID).TherelationshipsofMDI,PDIandcolostrumleadlevelwereperformedcorrelationregressionanalysis;Therelationshipofcolostrumleadlevelanddevelopmentwasperformedmulti-factoranalysiswithfamilyenvironmentandhealthquestionnaires.MAINOUTCOMEMEASURES:①EvaluationresultsofMDIandPDI.②Multi-factoranalysisresults.RESULTS:Totally128neonateswereinvolvedinthestudy.Tenandelevenneonateswerelostduetoemigra

简介：AbstractBackground:A surgical site infection (SSI) is a major post-operative complication from elective colorectal surgery; however, few studies have focused on evaluating the risk factors for SSI. This study aimed to analyze the relative correlation of medical and environmental factors as well as patient-related factors that contribute to the incidence of all types of SSI.Methods:A retrospective search for eligible patients was conducted using the patient database of the Gastrointestinal Surgery Center of the Third Affiliated Hospital of Sun Yat-sen University from January 2011 to August 2017. Pre-operative demographic and surgical data were extracted and recoded according to the study protocol. Univariate and multivariate analyses were performed to clarify factors affecting the incidence of SSI. Propensity analysis was conducted to minimize bias in the demographic characteristics to explore the prophylactic effect of pre-operative administration of oral antibiotics.Results:Univariate analysis of the baseline characteristics revealed that younger age (odds ratio [OR]: 0.378; 95% confidence interval [CI]: 0.218–0.657) and pre-operative oral antibiotic use (OR: 0.465; 95% CI: 0.255–0.850) were protective factors, while pre-operative anemia (OR: 4.591; 95% CI: 2.567–8.211), neoadjuvant chemotherapy history (OR: 2.398; 95% CI: 1.094–5.256), and longer surgical duration (OR: 2.393; 95% CI: 1.349–4.246; P = 0.002) were identified as risk factors for SSI. Multivariate analysis indicated that age (P = 0.003), surgical duration (P = 0.001), and pre-operative oral antibiotic use (P < 0.001) were independent factors that affect the incidence of SSI. Furthermore, a propensity-matched analysis confirmed the protective effect of oral antibiotic use, with a 1-day course of oral antibiotic producing a similar effect to a 3-day course.Conclusions:Age, surgical duration, and pre-operative oral antibiotic use were associated with the incidence of SSI. However, pre-operative oral antibiotic use was the only controllable factor. From the results of our study, pre-operative oral antibiotic use is recommended before elective colorectal surgery and a 1-day course is enough to provide the protective effect.

简介：目的：观察艾灸预处理对急性胃黏膜损伤大鼠胃黏膜细胞凋亡相关因子的影响，探讨艾灸诱导HSP70与上述因子的关系，从细胞凋亡线粒体信号转导途径探讨艾灸预处理保护胃黏膜损伤的机制。方法：将32Wister大鼠随机分为4组，即捆绑组、模型组、艾灸穴位组、艾灸非穴组。艾灸穴位组和艾灸非穴组大鼠艾灸预处理8d，捆绑组和模型组大鼠只捆绑，不艾灸。除捆绑组外，其余各组制备大鼠急性胃黏膜损伤模型。采用Western—blot方法检测大鼠胃黏膜细胞色素C（Cyt—c）的表达，免疫组织化学方法检测胃黏膜HSP70，胃黏膜细胞凋亡，Apaf-1，Caspase-9，Caspase-3，Bcl-2和BaX的表达。结果：与捆绑组相比，模型组大鼠胃黏膜HSP70表达，胃黏膜细胞凋亡指数，胞浆Cyt—C，Apaf-1，Caspase-9，Caspase-3，Bcl-2和Bax含量明显增加（P〈0．05或P〈0．01）。与模型组相比，艾灸穴位组大鼠胃黏膜HSP70表达和Bcl-2明显增加（P〈0．01），而细胞凋亡指数，胞浆Cyt—C，Apaf-1，Caspase-9，Caspase-3，Bax均显著降低（P〈0．01）。与艾灸穴位组相比，艾灸非穴组大鼠胃黏膜HSP70表达和Bcl-2显著降低（P〈0．01），而凋亡指数，Cyt—c，Apaf-1，Caspase-9，Caspase-3，Bax显著升高（P〈0．05或P〈0．01）。结论：艾灸通过上调大鼠胃黏膜细胞HSP70表达，并影响细胞凋亡线粒体信号转导途径相关因子Cyt—C，Apaf-1，Caspase-9，Caspase-3，Bcl-2和Bax，由此抑制胃黏膜细胞凋亡，达到保护胃黏膜损伤的作用。

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简介：Objective:Anlotinibhydrochlorideisamultitargettyrosinekinaseinhibitorthattargetsvascularendothelialgrowthfactorreceptor,fibroblastgrowthfactorreceptor,platelet-derivedgrowthfactorreceptor,c-Kit,andc-MET;therefore,itexhibitsbothantitumorandanti-angiogeneticactivities.AphaseIIItrialhasshownthatanlotinibimprovedprogression-freesurvival(PFS)andoverallsurvival(OS)inpatientswithadvancednon-smallcelllungcancer(NSCLC),whopresentedwithprogressivediseaseorintoleranceafterstandardchemotherapy.Thisstudyaimedtoanalyzethecharacteristicsofpatientsreceivinganlotinibtreatmenttodeterminethedominantpopulationswhoarefitforthetreatment.Methods:DatawerecollectedfromMarch2015toJanuary2017fromarandomized,double-blind,placebo-controlled,multicenter,phaseIIItrialofanlotinib(ALTER0303).Atotalof437patientswereenrolledandrandomlyallocated(2:1)totheanlotinibandplacebogroups.Kaplan–Meieranalysisandlog-ranktestwereperformedtocomparePFSandOS.Coxproportionalhazardsmodelwasadoptedformultivariateprognosticanalysis.Results:Multivariateanalysisindicatedthathighpost-therapeuticperipheralbloodgranulocyte/lymphocyteratioandelevatedalkalinephosphataselevelswereindependentriskfactorsforPFS.Meanwhile,elevatedthyroid-stimulatinghormone,bloodglucose,andtriglyceridelevels;hypertension;andhand–footsyndromewereindependentprotectivefactorsofPFS.Highposttherapeuticperipheralbloodgranulocyte/lymphocyteratio,anEasternCooperativeOncologyGroup(ECOG)score≥2,andthesumofthemaximaltargetlesionlengthatbaselinewereindependentriskfactorsofOS,andhypertriglyceridemiawasanindependentprotectivefactorofOS.Conclusions:ThisstudypreliminarilyexploredthepossiblefactorsthataffectedPFSandOSafteranlotinibtreatmentinpatientswithadvancedrefractoryNSCLC,andthebaselinecharacteristicsofthetherapeuticallydominantpopulationswere