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Outcomes of Coronary Artery Bypass Graft Surgery Versus Percutaneous Coronary Intervention in Patients Aged 18-45 Years with Diabetes Mellitus

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Chinese Medical Journal 2017年第24期130卷 2906-2915页

作者： Yang Li Ran Dong Kun Hua Tao-Shuai Liu Shao-You Zhou Ning Zhou Hong-Jia Zhang Department of Cardiac Surgery Beijing Anzhen Hospital Capital Medical University Beijing 100029 China

Background：Debate on treatment for young patients with coronary artery disease still *** study aimed to investigate the intermediate-and long-term outcomes between coronary artery bypass grafting （CABG） and percutaneous coronary intervention （PCI） in patients aged 18-45 years with diabetes mellitus （DM）.Methods：Between January 2006 and March 2016,a total of 2018 DM patients aged 18-45 years including 517 cases of CABG and 1501 cases of PCI were enrolled in the *** propensity score matching （PSM）,406 patients were matched from each *** intermediate-and long-term data were *** primary end point of this study was long-term *** secondary end points included long-term major adverse cardiovascular and cerebrovascular events （MACCEs）,stroke,angina,myocardial infarction （MI）,and repeat ***：Before PSM,the in-hospital mortality was 1.2% in the CABG group and 0.1% in the PCI group,with statistically significant difference （P 〈 0.0001）.The 10-year follow-up outcomes including long-term survival rate and freedom from MACCEs were better in the CABG group than those in the PCI group （97.3% vs.94.5%,P =0.0072;93.2% vs.86.3%,P 〈 0.0001）,but CABG group was associated with lower freedom from stoke compared to PCI group （94.2% vs.97.5%,P =0.0059）.After propensity score-matched analysis,these findings at 10-year follow-up were also *** from MACCEs was higher in CABG group compared to PCI group,but no significant difference was observed （93.1% vs.89.2%,P =0.0720）.The freedom from recurrent MI was significantly higher in CABG patients compared with PCI patients （95.6% vs.92.5%,P =0.0260）.Furthermore,CABG was associated with a higher rate of long-term survival rate than PCI （97.5% vs.94.6%,P =0.0403）.There was no significant difference in the freedom from stroke between CABG and PCI groups （95.3% vs.97.3%,P =0.9385）.The hospital cost was greater for CABG （13,936 ± 4480 US dollars vs.10,926 ± 7376 US dollars,P 〈 0.000

关键词： Coronary Artery Bypass Grafting: Coronary Artery Disease Diabetes Mellitus Percutaneous Coronary Intervention

Gastroenterology in developing countries:Issues and advances

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World Journal of Gastroenterology 2009年第23期15卷 2839-2854页

作者： Kate L mandeville Justus Krabshuis Nimzing Gwamzhi Ladep Chris JJ Mulder Eamonn MM Quigley Shahid A Khan Centre for Infectious Diseases Epidemiology Department of Primary Care and Population Sciences University College London Hampstead Campus Royal Free Hospital London NW3 2PF United Kingdom Highland Data Les Charleix 24390 Tourtoirac Dordogne France Department of Medicine University of Jos and Jos University Teaching Hospital Jos Plateau State P.M.B. 2076 Nigeria Department of Gastroenterology VU University Medical Center Amsterdam 1081 HV Holland World Gastroenterology Organisation and Department of Medicine National University of Ireland Cork University Hospital Clinical Sciences Building Wilton Cork Ireland Department of Hepatology and Gastro-enterology Faculty of Medicine Imperial College London St Mary's Campus London W2 1NY United Kingdom

Developing countries shoulder a considerable burden of gastroenterological disease. Infectious diseases in particular cause enormous morbidity and mortality. Diseases which afflict both western and developing countries are often seen in more florid forms in poorer countries. Innovative techniques continuously improve and update gastroenterological practice. However, advances in diagnosis and treatment which are commonplace in the West, have yet to reach many developing countries. Clinical guidelines, based on these advances and collated in resource-rich environments, lose their relevance outside these settings. In this two-part review, we first highlight the global burden of gastroenterological disease in three major areas： diarrhoeal diseases, hepatitis B, and Helicobacter pylori. Recent progress in their management is explored, with consideration of future solutions. The second part of the review focuses on the delivery of clinical services in developing countries. Inadequate numbers of healthcare workers hamper efforts to combat gastroenterological disease. Reasons for this shortage are examined, along with possibilities for increased specialist training. Endoscopy services, the mainstay of gastroenterology in the West, are in their infancy in many developing countries. The challenges faced by those se^ing up a service are illustrated by the example of a Nigerian endoscopy unit. Finally, we highlight the limited scope of many clinical guidelines produced in western countries. Guidelines which take account of resource limitations in the form of ＂cascades＂ are advocated in order to make these guidelines truly global. Recognition of the different working conditions facing practitioners worldwide is an important step towards narrowing the gap between gastroenterology in rich and poor countries.

关键词： Helicobacter pylori Developing countries Gastrointestinal diseases Health care delivery Practice guidelines

Clinical observation on row needling at the Governor Vessel on the head for poststroke insomnia

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Journal of Acupuncture and Tuina Science 2022年第1期20卷 32-39页

作者： XIA Jixing LI Yanhua CHEN Yunping ZHANG Kaiwei Department of Neurology Xianning First People’s HospitalHubei ProvinceXianning 437100China Department of Pain Rehabilitation Xianning First People’s HospitalHubei ProvinceXianning 437100China Department of Neurology Union HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430022China 不详

Objective:To observe the clinical efficacy of row needling at the Governor Vessel on the head for poststroke insomnia,analyze the changes of sleep structure,serum amino acid neurotransmitters,vascular endothelial cell function and cognitive function,in order to explore the mechanism of this ***:A total of 41 patients with poststroke insomnia were included in an observation group and treated with row needing at the Governor Vessel on the head;33 patients with poststroke insomnia were included in a control group and given routine acupuncture *** patients in both groups were treated consecutively for one *** efficacy was observed and the changes of related indicators were ***:After treatment,the efficacy of the observation group was better than that of the control group(P<0.05).The sleep latency in the observation group was shorter than that in the control group(P<0.05);the total sleep duration,deep sleep duration,light sleep duration and rapid eye movement sleep duration in the observation group were significantly longer than those in the control group(P<0.05);the total waking duration and the waking times over 5 min were significantly less than those in the control group(P<0.05).The serum glutamic acid,γ-aminobutyric acid,calcitonin gene-related peptide,brain-derived neurotrophic factor,nerve growth factor and nitric oxide levels were significantly higher than those in the control group(P<0.01).The tumor necrosis factor-α,interleukin-6,bradykinin,and endothelin-1 levels were lower than those in the control group(P<0.01).The Pittsburgh sleep quality index score in the observation group was lower than that in the control group(P<0.01),and the mini-mental state examination score was higher than that in the control group(P<0.05).Conclusion:Row needling at the Governor Vessel on the head can effectively improve the sleep structure,cognitive function,and sleep quality of patients with poststroke *** possible mechanisms are

关键词： Acupuncture Therapy Governor Vessel Neurotransmitter Endothelial Cells stoke Insomnia

Impact of Acupuncture Therapy in Postoperative Aortic Dissection Patients with Cerebral Infarction:A Case Study

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Chinese Journal of Integrative Medicine 2017年第1期23卷 76-79页

作者： HSUEH Tun-Pin HUNG Yu-Chiang HU Wen-Long Department of Chinese Medicine Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of MedicineKaohsiungTaiwan 000800China Kaohsiung Medical University College of Medicine KaohsiungTaiwan 000800China Fooyin University College of Nursing Kaohsiunch Taiwan 000800China

Aortic dissection is a life-threatening disease that can produce a variety of symptoms and complications. Patients at high risk for mortality, such as individuals with aortic regurgitation, cardiac tamponade, or myocardial infarction, should be treated by surgery as soon as possible, especially in cases with acute ascending aortic dissections （Stanford type A）. However, patients with aortic dissection may suffer adverse outcomes that lead to mortality and morbidity, such as stoke, re-dissection, myocardial infarction, and heart failure. Patients with surgically treated acute type A aortic dissection show an 18.2% likelihood of stroke in early morbidity.

关键词： Impact of Acupuncture Therapy in Postoperative Aortic Dissection Patients with Cerebral Infarction GCS MCA than

<i>In Vivo</i>Emulsification Analysis of 1000 cs and 5000 cs Silicone Oil after Rhegmatogenous Retinal Detachment Vitrectomy Surgery

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Open Journal of Ophthalmology 2017年第4期7卷 231-239页

作者： Arief Kartasasmita Widi Kusdiono Rova Virgana Shanti Boesorie Department of Ophthalmology Faculty of Medicine Universitas Padjadjaran/Cicendo National Eye Hospital Bandung Indonesia

Purpose: To compare in vivo emulsification of silicone oil 1000 and 5000 centistokes (cs) after retinal detachment surgery. Design: Comparative non-interventional Retrospective study. Methods: Silicone oils from patients who underwent retinal detachment surgery were investigated using Spectrophotometer UV-Vis. Spectroscopically changes determine emulsification with the time of tamponade, inflammation, patients age and severity of retinal detachment. Results: We found significant difference on absorbance (p = 0.004) between used 1000 Centi stoke (cs) silicon oil (average wave length 2.51 nm;SD: 1.575 nm) and used 5000 cs silicon oil (average wave length 0.910 nm;SD: 0.564 nm). Conclusions: In vivo emulsification was higher in silicone oil 1000 compared to 5000 cs silicone oil after vitreoretinal tamponade 8 - 12 weeks due to retinal detachment surgery. Emulsification related to higher absorbance and lower transmittance in 1000 cs silicone oil. Inflammation may become a factor affecting this condition.

关键词： Silicone Oil Spectrophotometry Emulsification

G-CSF alleviated cellular damage induced by cerebral ischemia/reperfusion by modulating apoptosis and autophagy through MAPK/JNK and PI3K/Akt pathway in a spatial-depend manner

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G-CSF alleviated cellular damage induced by cerebral ischemi...

The standardization therapeutics of ischemic stroke the clinical analysis of 312 patients with stoke

2015年老年医学学术年会

作者： Liu Ming Guan Zhufei Guo Qilin Liu Xiaoyan Ji Gang Zhang Xiaoming Wang Yanmei Zhang Yu Huang Yanyan Zhou Houguang Guo Jingchun Houguang Zhou Department of Geriatrics Neurology Huashan HospitalFudan University 1University

Backgrounds: The function of G-CSF in treating cerebral ischemia is still unclear. Mechanism underling may associate with the intricacy cellular apoptosis and autophagy which were impaired by ischemia stoke. Aims: Here we intend to reevaluate the neuroprotection effect and discuss the underlying mechanism by applying G-CSF in a transient MCAO(t-MCAO) mice model. Methods: Mice were divided into 3 groups: G-CSF treated group;NS treated group;Sham groupafter yieldingto t-MCAO surgery at 20-week old. Drugs were treated every day for 2 consecutive weeks. Brain tissues were collected at 24 hours, 48 hours and 28 days after drug treatment. Behaviors were tested at day 1, 4, 7, 14, 21, and 28 respectively after surgery. Results: Neurological outcomes were promoted dramatically by G-CSF in a long run, accompanied by the restricted atrophy of hippocampal volume insulted by t-MCAO. No obvious decline of vascular density and significant neogenesis can be observed within the hippocampus region 28 days after G-CSFinterventionin thetMCAO mice model. Successively, we found that the expression levels of Beclin-1 and PIK3C3 that participated in the autophagysome formation decreased 24 hours later after G-CSFintervention,while no change of apoptosis was observed, which indicated that only autophagy process were confined in hippocampus. Intriguingly, P53 level and the ratio of Bax/Bcl-2 were declined with an increase of PIK3C3 24 hours after G-CSF injection, which indicated that apoptosis was inhibited while autophagy was enhanced in striatum region synchronously. Our further studies revealed that p-Akt level had a synergetic change with Beclin-1 and PIK3C3 instead of P53 and Bax/Bcl-2. Nevertheless, the decreasing of p-JNK might associate with the inhibition of ***:These findings imply that G-CSF has a strong propensity to modulate the apoptosis and autophagy condition simultaneously through the MAPK/JNK and PI3K/Akt pathway respectively in a spatial-dependent mannera

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中国临床神经科学 2000年第Z1期8卷 67-页

作者： Dong Qiang Fang Xin Hun Xiang Hua Shah hospital 200040 Hua Shah Hospital 200040 Hua Shah Hospital 200040

Objective: To study the outcome after the standardization therapeutics of ischemic stroke and the relatively factors which can influence the outcome of patients with stroke. Methods: Using data collected from 312 patients enrolled in the clinical standardization therapeutics trial, and neurological impairment at the hospitalization and the discharge was quantified using the China Stroke Scale (CSS), the outcome at the discharge using the percentage of CSS decreasing. The outcome was rated as cure if the percentage of CSS decreasing was over 89% and dead. Analyses were adjusted for age, history of previous disorders, and the form of onset, blood pressure at onset, complication. Results: The percentage of cure after the thrombolysis was 12.5%, after anticoagulant was 8.23%, after decreasing fibrinogen was 8.57% and after the convention treatment was only 5.66%. And at the same time, the percentage of dead after the thrombolysis was 12.5%, after anticoagulant was 8.23%, after decreasing fibrinogen was 8.57% and after the convention treatment was 10.1%. The other factors had no differently between the variability treatments. The complication could influence the outcome of stroke patients, especially the infect of respiratory, disturbance of kidney and electrolyte. Conclusions: The standardization therapeutics should be contributing the outcome of patients with ischemic stroke.

关键词： clinical analysis ischemic stroke form of

The Effect of Torsion Deformity and Medial Knee Osteoarthritis on Lower Limb Extensor Moments during Gait

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Open Journal of Rheumatology and Autoimmune Diseases 2013年第2期3卷 119-124页

作者： David S. mandeville Kenneth A. Krackow Sridhar R. Rachala Mary Bayers-Thering Department of Orthopaedic Surgery Kaleida Health/Buffalo General Hospital Buffalo USA Department of Orthopaedics State University of New York at Buffalo Buffalo USA Kinesiology and Health Science Department California State University Sacramento USA

The aim of this study was to quantify the effect of torsion deformity on the lower limb kinetics during the loading response phase of gait. A total of 24 subjects: 6 end-staged medial knee OA with torsion deformity (TKO), 8 without torsion deformity (KOA), and 10 controls (CON) were imaged using computed tomography (CT). Internal moment of support and sagittal hip, knee and ankle joint moments were assessed using gait analysis. TKO showed greater external rotations of the proximal tibia and the distal femur compared to subjects with medial knee OA without torsion deformity and controls. TKO showed greater moment of support and a greater knee extensor moment when compared to controls when supporting the weight of the body during gait. The TKO intorsion deformity occurred as a result of a proximal malrotation of the tibia. In the presence of torsion deformity, the kinetic synergy of the lower limb showed increased total moment of support for subjects with medial knee OA. The greater extensor output from TKO may be the result of an increased muscular response to overcome an interrupted inter-segmental exchange of accelerations during the loading response phase of gait.

关键词： Knee Osteoarthritis Tibial Torsion Computed Tomography Gait Analysis Total Moment of Support

Report of moderate or severe sodium and chloride disturbance on 82 cases with acute cerebral stroke

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中国临床神经科学 2000年第Z1期8卷 54-页

作者： Ma shun-tian YiWu People′ s hospital YiWu Zhejiang322000

Abtract Objective: To decrease the fatality rate and prevalence rotc of acute cerebral stroke complicated with morderate or servere serum sodium and chioride disturbance by explonng the relation between the pathogency and prognosis Methods: Medical records were surveyed and clinical presentation, laboratory test, complicated。 Actiology pathogency and prognosis were analyzed m 82 cases with moderate or severe serum sodium and chloride disturbance among 736 cases with acute cerebral stroke collected, Results: The prevalence rate and fatality rate of acutc cerebral stroke complicated with moderate or severe serum sodium and chlorede disturbance were 11.3% (82/ 736) and 60.8% (49/52) which were different significantly form that complicated with normal or minimal sedium sodium and chloride disturbame (p (0.001) 。 The 82 cases occured at 3-13 days after hospitalization (mean 6 days) 。 The actiology and pathogency were mainly ralated with some endogenic and iatrogenic factors such as hypothalamic-pituitary system were destroyed resultly from acute cerbral stroke which led to SIADH。 Conclusion: The fatality rate of acute cerebral stroke complicatee with moderate or seyere serum sodium and chloride disturbance is mcreased significantly, Put prophylaxis first to decrease the prevalence rate and fatalty rate。 Pay attlention to comprehensive therapy of acute cerebral stoke to prevent endogenic sodium and chloride disturbance and especially place importance on iatrogenic disturbance。

关键词： acute cerebral stroke serum sodium prevalence rate comprehensive therapy clinical presentation