The interfragmentary micromovement induced by mechanical vibration was measured in vitro in seven preserved adult cadaveric femurs by using accelerometers. Accuracy analysis of this method indicated that it can detect relative interfragmentary micromovement as small as 0.1 mm or below under certain range of frequency. Also, the results have shown that the mechanical vibration can induce interfragmentary micromovement under intramedullary nailing, but it can not do so under plate fixation.
In China, the epidemic pattern of acute hepatitis E virus (HEV) infection has changed from waterborne outbreaks to foodborne sporadic cases. However, the clinical course of sporadic acute hepatitis E (AHE) has not been well defined.Consecutive patients with AHE who were admitted to the Jinan Infectious Disease Hospital, Jinan, Shandong Province between January 2003 and December 2014 were evaluated and followed. Demographic data, clinical manifestations, results of laboratory tests, and outcomes were recorded. Risk factors for liver failure and death were analyzed.A total of 680 patients with AHE were identified during the study period. The incidence was highest in February, March, and April, accounting for about 41% of the cases. The male to female ratio was 5.1:1 (574/106). The average age was 50.9±12.8years. The prevalence rates of prodromal fever, fatigue, loss of appetite, and jaundice were 25.6%, 85.6%, 83.8%, and 92.8%, respectively. The median (range) serum alanine aminotransferase, aspartate aminotransferase, bilirubin, albumin, and platelet levels were 727 (8-6270) U/l, 300 (17-6226) U/l, 196.8 (8.0-1083) μmol/l, 33.0 (15.2-45.8) g/l, and 162 (10-589)×109/l, respectively. The prevalence of hepatitis B surface antigen (HBsAg) was 18.5% (126/680) and of liver cirrhosis was 9.4% (64/680). Thirteen percent (89/680) of the cases progressed to liver failure, including 4.1% (28/680) with acute liver failure (ALF) and 9.0% (61/680) with acute-on-chronic liver failure (ACLF). Among patients with HBsAg positivity or cirrhosis, 28.6% (36/126) and 36.0% (23/64), respectively, progressed to ACLF. Multiple logistic regression analysis indicated that age >53years, prodromal fever, HBsAg positivity, cirrhosis, and thrombocytopenia (platelet count <150×109/l) were independently associated with the development of liver failure, with an odds ratio (95% confidence interval) of 2.5 (1.5-4.3), 1.9 (1.1-3.2), 3.7 (2.0-6.7), 2.1 (1.1-4.2), and 5.9 (3.3-10.4), respectively. The overall mortality was 5.6% (38/680), and the mortality rates in patients with and without underlying liver disease were 9.3% (22/237) and 3.6% (16/443), respectively. Multiple logistic regression analysis indicated that hepatic encephalopathy, bilirubin >500μmol/l, international normalized ratio (INR)>2, and severe thrombocytopenia (platelet count <100×109/l) were independently associated with death, with an odds ratio (95% confidence interval) of 7.2 (2.4-21.8), 5.8 (1.9-17.2), 24.1 (7.9-73.3), and 10.8 (3.6-32.9), respectively.In areas that are dual endemic for hepatitis B virus and HEV, the HEV vaccine for patients with obvious liver diseases is of significance. Thrombocytopenia is an important predictor of liver failure and mortality in sporadic AHE.
ABSTRACT Renovascular hypertension (RVH) is a primary cause of secondary hypertension, primarily driven by the activation of the renin–angiotensin–aldosterone system activation. Recently, growing studies suggested accessory renal artery (ARA) might also contribute to RVH. However, the treatment of ARA‐related hypertension and whether to take interventional treatment lack consensus. Herein, we report two cases of ARA‐related hypertension in our hospital. Imaging studies of both patients showed ARA stenosis. One patient had ARA occlusion well‐compensated through tortuous collateral branches, achieving normal blood pressure by medical treatment alone. The other patient had ARA stenosis coexisted with main renal artery stenosis, and revascularization of both arteries led to a significant postoperative reduction in blood pressure. A literature review was conducted to summarize overall treatment strategies for ARA‐related hypertension and clarify the relationship between ARA and hypertension. Recent research supported an association between ARA and hypertension. While medical therapy remains the first‐line treatment for ARA‐related hypertension, interventional procedures should be considered for patients whose blood pressure remains uncontrolled despite conservative management.
The passing of the Tort Liability Act makes the possibility of passive euthanasia in our country.For this reason,it is necessary to clarify and improve relevant legislation of the passive euthanasia.Becouse the basis of the right to euthanasia is controversial in the legal science field,we should focus on the self-determination death which is less disputing.In addition,related laws and rules should be stipulated and modified in the areas of the for cement of object,conditions,subject and the main purposes of passive euthanasia.
AbstractBackground: Nursing literature suggested that patient mistreatment has significant effects on nurses’ personal emotions and job burnout. Yet, further research is needed to understand the mechanisms underlying these associations and the spillover effects on nurses' families. This study combined the cognitive appraisal of stress and goal progress theory to explore the association between patient mistreatment, work-family conflict, and emotional exhaustion in nurses, as well as the mediating role of social sharing and the moderating role of perceived organizational support (POS). Methods: From October 9 to November 1, 2022, a cross-sectional study was conducted with 1627 nurses from the Hematology Specialist Alliance of Chongqing during the COVID-19. Questionnaires were administered to collect demographic data, patient mistreatment, perceived organizational support, social sharing of negative work events, work-family conflict, and emotional exhaustion. Hierarchical linear regression and conditional processes were used to analyze the data. Results: Patient mistreatment was positively associated with work-family conflict (β=.314, p<.001) and emotional exhaustion (β=.354, p<.001). Social sharing of negative work events played a partial mediating role in the relationship between patient mistreatment, work-family conflict (effect=.077, SE=.014) and emotional exhaustion (effect=.067, SE=.013). Moderated mediation analysis found that the mediation effect was stronger when the perceived organizational support was high. Conclusion: Our findings reveal the amplifying effect of social sharing of negative events on nurses' work-family conflict and emotional exhaustion. Perceived organizational support strengthens the positive effects of patient mistreatment on the social sharing of negative work events, thus resulting in increased work-family conflict and emotional exhaustion. We also discuss practical implications, limitations, and directions for future research.
Objective: To investigate the effect of Zhuangyang capsule,a traditional Chinese medicine,on the serum prolactin of schizophrenic patients treated with risperidone.Methods: All 76 schizophrenic patients who met the DSM-Ⅳ criteria for schizophrenia were randomized for 8 weeks treatment with either Zhuangyang capsule(trial group,n=39) or placebo capsule(control group,n=37) added on risperidone.The serum level of prolactin was measured at baseline and 8 weeks.Positive and negative syndrome scale(PANSS) was used to evaluate the psychotic symptoms.Results: For the trial group,the serum level of prolactin decreased significantly after 8 weeks treatment(P0.01),while the serum level of prolactin increased significantly for the control group(P0.01).There was a significant difference in improvement of the serum level of prolactin in trial group compared with that of control group(decreased 26.51 ng/ml vs increased 15.56 ng/ml)(P0.01).The effect of Zhuangyang capsule on the serum prolactin of schizophrenic patients had no significant difference between male and female groups.Conclusion: Zhuangyang capsules can effectively decrease the higher serum level of prolactin induced by risperidone.
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