中国综合临床最新文献

{"title":"Effects of exercise therapy on type 2 diabetes patients in the working mode of \" combination of physical and health\"","authors":"Jie Zhu, M. Hu, Min Qian, Yifeng Wang, Miaomiao Zhao, Ying-jiu Zhai, K. Mu","doi":"10.3760/CMA.J.ISSN.1008-6315.2019.05.006","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1008-6315.2019.05.006","url":null,"abstract":"Objective \u0000To evaluate the effect of aerobic exercise combined with resistance exercise on blood sugar and constitution in patients with type 2 diabetes mellitus. \u0000 \u0000 \u0000Methods \u0000Fifty eligible subjects in community type 2 diabetes database were randomly selected and a model intervention group of \" 1+ 2+ 1\" was established.The regular exercise intervention was conducted for six months by combining aerobic exercise with resistance exercise.The fasting blood sugar, blood pressure, heart rate, body mass and fat mass before and after intervention were compared by paired t test.Changes in related physical indicators. \u0000 \u0000 \u0000Results \u0000After 6 month of exercise therapy, fasting blood glucose of subjects reduced from (8.58±4.40) mmol/L to (6.29±1.72) mmol/L(P=0.032). Body weight also reduced from (62.44±7.35) Kg to (60.70±7.54) Kg(P=0.008). In physical quality related indexes, fat mass decreased significantly, while protein content increased significantly.There were no changes in muscle mass and fat free body weight.In addition, grip strength and flexion range of subjects significantly increased after exercise therapy.Comprehensive score of physical quality of subjects increased from (73.25±5.65) to (75.48±5.04)(P=0.010). \u0000 \u0000 \u0000Conclusion \u0000Exercise therapy of aerobic exercise combined with resistant exercise can effectively reduce blood glucose, body weight and fat mass, increase muscle strength, flexibility and physical quality.This also reflects that the community-led \" health and physical integration\" mode of work is an effective means to manage chronic diseases and enhance the physical fitness of residents. \u0000 \u0000 \u0000Key words: \u0000Combination of physical and health; Aerobic exercise; Resistant exercise; Type 2 diabetes","PeriodicalId":10365,"journal":{"name":"Clinical Medicine of China","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47166576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of XELOX regimens plus combination of endostar and thalidamide as first-line treatment for advanced colorectal cancer","authors":"Yuzhi Li, Y. Bao, F. Sun","doi":"10.3760/CMA.J.ISSN.1008-6315.2019.05.012","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1008-6315.2019.05.012","url":null,"abstract":"Objective \u0000To investigate the efficacy and safety of two antiangiogenic drugs (recombinant human endostatin endostar and thalidomide) combined with capecitabine and oxaliplatin(XELOX) regimens in the treatment of advanced colorectal cancer. \u0000 \u0000 \u0000Methods \u0000From January 2015 to May 2018, 40 patients of advanced metastatic colorectal cancer with organ metastasis and non-resectable were selected from the first people′s hospital of Hefei and Anhui Provincial Hospital, and they were randomly divided into treatment and control group, with 20 cases in each group.The treatment group received intravenous infusion (IV) of endostar for continuous 7 days (day 1~7) combined with oral administration of thalidomide for continuous 14 days (day 1~14) plus XELOX regimens after the fifth dose of endostar (day 6~19), and the control group was treated with XELOX regimen (day6~19). \u0000 \u0000 \u0000Results \u0000The objective response rate (ORR) was 50% (10/20) and 20% (4/20) respectively (χ2=3.956, P 0.05), and the median progression free survival (mPFS) was 6.8 in both groups.There was no significant difference in Karnofsky performance score (KPS) and incidence of adverse reactions between the two groups before and after treatment (P>0.05). \u0000 \u0000 \u0000Conclusion \u0000Combination of endostar and thalidamide plus XELOX regimen as first-line treatment have better antitumor activity and are well-tolerated in patients with advanced colorectal cancer. \u0000 \u0000 \u0000Key words: \u0000Recombinant human endostatin; Endostar; Thalidomide; Advanced colorectal cancer","PeriodicalId":10365,"journal":{"name":"Clinical Medicine of China","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46137380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Plastic bronchitis associated with bleeding in child: A case report and literature review","authors":"Yan-hua Hu","doi":"10.3760/CMA.J.ISSN.1008-6315.2019.05.020","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1008-6315.2019.05.020","url":null,"abstract":"Objective \u0000To analyze the clinical diagnosis and treatment of a child with hemorrhagic plastic bronchitis, and to explore the etiology of hemorrhagic plastic bronchitis with review of relevant literature, so as to improve the clinicians′understanding of plastic bronchitis. \u0000 \u0000 \u0000Methods \u0000Clinical data of a female children with hemorrhagic plastic bronchitis was retrospectively reviewed.The patient had congenital heart disease, with repeated cough and hemoptysis as the first symptom.Chest CT scan showed cylindrical bronchiectasis of the right lower lobe and the bloodly bronchial cast was removed by bronchoscopy.The related literatures were review. \u0000 \u0000 \u0000Results \u0000After treatment, the symptoms of cough and cough were improved significantly. \u0000 \u0000 \u0000Conclusion \u0000When patients with recurrent hemoptysis and conventional treatment has no effective, it should be alert to the possibility of plastic bronchitis.The bronchoscopy can identify the causes and remove the casts, also need to pay attention to rebleeding. \u0000 \u0000 \u0000Key words: \u0000Plastic bronchitics; Bleeding; Children","PeriodicalId":10365,"journal":{"name":"Clinical Medicine of China","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44770091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A case of myocardial injury caused by allergy","authors":"Dongmei Zhang","doi":"10.3760/CMA.J.ISSN.1008-6315.2019.05.021","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1008-6315.2019.05.021","url":null,"abstract":"Objective \u0000Urticaria, itchy skin, chest tightness, abdominal pain and anaphylactic shock are the common clinical manifestations of allergic reactions.In addition, the relevant literature indicates that allergies can cause coronary vasospasm or rupture of atherosclerotic plaque, leading to acute coronary syndrome, which is named Kounis syndrome.Here we report a case of a child admitted to the emergency departments with myocardial injury and ST depression on electrocardiography while a severe allergic reaction.The patient was discharged from the hospital after receiving anti-allergic and nutritional myocardial medication.I hope that we can learn more about Kounis syndrome through this case. \u0000 \u0000 \u0000Key words: \u0000Allergic reaction; Myocardial injury; Allergic angina; Kounis syndrome","PeriodicalId":10365,"journal":{"name":"Clinical Medicine of China","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46348875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical analysis of 33 cases on laparoscopic resection of presacral cysts","authors":"B. Niu, Jiaolin Zhou, Bin Wu","doi":"10.3760/CMA.J.ISSN.1008-6315.2019.05.016","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1008-6315.2019.05.016","url":null,"abstract":"Objective \u0000To summarize and analyze our experiences uponperforming laparoscopic resection ofpresacral cysts, at the aim of generalizing the minimally invasive surgery in the treatment of this disease. \u0000 \u0000 \u0000Methods \u0000The clinical data of 33 patients with presacral cysts treated by laparoscopy in Peking Union Medical College Hospital of Chinese Academy of Medical Sciences from November 2012 to June 2017 were retrospectively analyzed.The operation time, the incidence of intraoperative and postoperative complications and the length of hospital stay were counted. \u0000 \u0000 \u0000Results \u0000Tumor excision was completed according to the plan without conversion to open surgery.The average operation time was (124.4±63.0) minutes.There were 1 case of rectal injury and 1 case of presacral venous plexus hemorrhage.The complications were 6%.Postoperative rectal leakage occurred in 2 cases (6%). The average hospitalization time after operation was (6.7±4.3) days.Of 33 cases, 2 cases were lost.One case had recurrence of presacral cyst one year after operation. \u0000 \u0000 \u0000Conclusion \u0000Laparoscopic resection of presacral cysts is technically feasible, and helps to improve intraoperative exposure, increase operating space and improve the resection rate of tumors. \u0000 \u0000 \u0000Key words: \u0000Laparoscopy; Presacral space; Retrorectal cyst","PeriodicalId":10365,"journal":{"name":"Clinical Medicine of China","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41309187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors of mortality in peritoneal dialysis patients","authors":"Lihong Wang","doi":"10.3760/CMA.J.ISSN.1008-6315.2019.05.014","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1008-6315.2019.05.014","url":null,"abstract":"Objective \u0000To explore the risk factors affecting the death of peritoneal dialysis patients. \u0000 \u0000 \u0000Methods \u0000The clinical data of 275 patients with peritoneal dialysis who place a peritoneal catheter in the Department of Nephrology, First Affiliated Hospital of Guangxi Medical University and had regular peritoneal dialysis for more than 3 months from January 1, 2005 to December 31, 2015 were retrospectively analyzed.Sixty patients died in the observation group, and 215 patients who continued regular peritoneal dialysis were in the control group.Univariate analysis and two-class logistic regression analysis were used to analyze risk factors for death. \u0000 \u0000 \u0000Results \u0000The composition ratio of the primary disease to diabetic nephropathy in the death group and the control group was 15.0% (9/60) and 5.6% (12/215), respectively, the average age of patients entering peritoneal dialysis was (50.6±14.3) years old and (45.7±13.2) years old, respectively(t=-2.518), glomerular filtration rates were 6.0(4.5, 9.4) and 5.1(4.2, 6.6), respectively, blood potassium is (4.2±0.7) mmol/L and (4.5±0.7) mmol/L, respectively, serum creatinine was 721.0 (585.0, 891.3) μmol/L and 847 (723.3, 1 033.3) μmol/L, respectively, there were significant differences between the two groups (t=2.14, all P<0.05). Logistic regression analysis indicated that the primary disease was diabetic nephropathy, and the age of admission to peritoneal dialysis, glomerular filtration rate, blood uric acid are risk factors for death in peritoneal dialysis patients. \u0000 \u0000 \u0000Conclusion \u0000Diabetic nephropathy, age, glomerular filtration rate, and blood uric acid level are independent risk factors for death in peritoneal dialysis patients. \u0000 \u0000 \u0000Key words: \u0000Peritoneal dialysis; Glomerular filtration rate; Risk factors","PeriodicalId":10365,"journal":{"name":"Clinical Medicine of China","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46458199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical follow-up study of paclitaxel-coated balloon in the treatment of symptomatic lower extremity arteriosclerosis obliterans","authors":"Feifei Li, Wenhua Li, Jingmin Ou","doi":"10.3760/CMA.J.ISSN.1008-6315.2019.05.019","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1008-6315.2019.05.019","url":null,"abstract":"Objective \u0000To investigate the clinical effect of paclitaxel coated balloon in the treatment of symptomatic lower extremity arteriosclerosis obliterans. \u0000 \u0000 \u0000Methods \u0000From January 2016 to April 2017, 64 patients with symptomatic lower limb arteriosclerosis obliterans (ASO) of femoral and popliteal artery stenosis admitted to Chongming Branch Xinhua Hospital affiliated to Shanghai Jiaotong University School of Medicine were selected as the research subjects.According to the principle of randomization, they were divided into two groups, 32 cases in each group.In the drug-coated group, ordinary balloon was pre-expanded, and then paclitaxel drug-coated balloon was used to expand.If there were still retraction and stenosis of diseased vessels, which affected the blood flow of lower limbs, remedial stents were implanted.Bare stent group used a slightly smaller balloon to pre-expand superficial femoral artery and then release the stent.After one year follow-up, the changes of ankle-brachial index (ABI), restenosis rate of target lesion vessels, Rutherford grading changes, clinical drive target vessel revascularization rate, perioperative period, death rate of patients during follow-up period, amputation rate and complication rate were observed. \u0000 \u0000 \u0000Results \u0000There were no amputations or deaths in the whole group during the perioperative period and follow-up.The incidence of complications in the drug-coated group was 3.1% (1/32), significantly lower than that in the bare stent group 18.8% (6/32) (χ2=4.010, P=0.045). Before treatment, the ABI of patients in drug-coated group and bare stent group at 6 months and 12 months after treatment were significantly different (Finter-group=7.028, Pinter-group=0.024, Fintra-group=219.028, Pintra-group=0.000, Finteraction=350.028, Pinteraction=0.000), and ABI of the two groups at 12 months after treatment were (0.73±0.11) and (0.68±0.09), respectively, the difference was statistically significant (t=1.990, P=0.025). Six months after operation, the restenosis rates of target lesions in the two groups were 9.4%(3/32) and 15.6%(5/32), respectively, with no significant difference (χ2=0.571, P=0.450); The restenosis rate of bare stent group was 37.5%(12/32) 12 months after operation, which was significantly higher than that of drug-coated group by 15.6%(5/32) (χ2=3.925, P=0.048). Clinical observation results showed that 12 months after operation, the target-lesion revascularization (TLR) of the drug-coated group was 3.1% (1/32) and that of the bare stent group was 9.4% (3/32), with no significant difference.Rutherford grading was improved in both groups(χ2=1.067, P>0.05). \u0000 \u0000 \u0000Conclusion \u0000Paclitaxel drug-coated balloon is safe and effective in the treatment of symptomatic lower limb arteriosclerosis obliterans, which is worthy of clinical application. \u0000 \u0000 \u0000Key words: \u0000Arterial occlusion of the lower limb; Drug-coated balloon; Paclitaxel; Restenosis; Ankle brachial index","PeriodicalId":10365,"journal":{"name":"Clinical Medicine of China","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48175132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship between preoperative programmed death receptor 1, programmed death ligand 1 and clinical pathological parameters, early postoperative recurrence and metastasis in Patients with Esophageal Squamous Cell Carcinoma","authors":"Gen-jie Wang, Liang-yun Ma, Yu-zhou Shen","doi":"10.3760/CMA.J.ISSN.1008-6315.2019.05.007","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1008-6315.2019.05.007","url":null,"abstract":"Objective \u0000To investigate the relationship between programmed death 1 (PD-1), programmed death receptor-1 ligand (PD-L1) and clinical pathological parameters, early postoperative recurrence and metastasis in patients with esophageal squamous cell carcinoma. \u0000 \u0000 \u0000Methods \u0000The retrospectively analyze of Paraffin tissue specimens and clinical pathology data in 58 Patients undergoing radical esophageal squamous cell carcinoma surgery from January 2015 to January 2017 in the 910 hospital of PLA Joint Service Support force were performed.Expression of PD-1 and PD-L1 in esophageal squamous cell carcinoma and normal esophageal mucosa were detected by SP immunohistochemical staining.The positive expression rates of PD-1 and PD-L1 in normal esophageal mucosa and esophageal squamous cell carcinoma were compared.the relationship between PD-1 and PD-L1 and gender, age, family history, depth of tumor invasion, degree of differentiation, lymph node metastasis, and TNM staging were analyzed.Follow-up was performed by outpatient consultation and telephone consultation.The recurrence and metastasis of early postoperative (≤1 year) was analyzed.The PD-1 and PD-L1 in esophageal squamous cell carcinoma were analyzed in patients with recurrent metastasis and non-relapsing and metastasis. \u0000 \u0000 \u0000Results \u0000The positive expression rate of PD-1 in esophageal squamous cell carcinoma was 37.93%(22/58), which was significantly higher than that in normal esophageal mucosa 15.52%(9/58). The difference was statistically significant (χ2=7.440, P=0.006). The positive expression rate of PD-L1 in esophageal squamous cell carcinoma was 43.10%(25/58), which was significantly higher than that of normal esophageal mucosa 18.97%(11/58). The difference was statistically significant (χ2=7.894, P=0.005). There was a difference in the positive expression rate of PD-L1 between different infiltration depth and TNM stage, P 0.05). The positive expression rate of PD-L1 in the recurrence group was 71.43% (10/14), and that in the non-recurrent group was 34.09% (15/44). The difference was statistically significant, (χ2=6.037, P<0.05). \u0000 \u0000 \u0000Conclusion \u0000The expression of PD-1 and PD-L1 in cancer tissues of patients with esophageal squamous cell carcinoma is highly expressed.PD-L1 is closely related to the occurrence and progression of esophageal squamous cell carcinoma, and it is also an important index affecting early recurrence and metastasis.Which can be selected as a new target for early diagnosis and treatment. \u0000 \u0000 \u0000Key words: \u0000Esophageal squamous cell carcinoma; Programmed death 1; Programmed death receptor-1 ligand; Clinicopathological features; Recurrence and metastasis; Correlation","PeriodicalId":10365,"journal":{"name":"Clinical Medicine of China","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49290321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}