Advanced Emergency Medicine (E-Journal)
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The Application of Intracardiac Ultrasound in Atrial Septal Puncture
Get PDFObjectives: To investigate the safety and effectiveness of atrial septal puncture assisted by intracardiac ultrasound, and to evaluate the value of intracardiac ultrasound in atrial septal puncture. Methods: Sixty patients who underwent radiofrequency ablation for the first time were randomly divided into two groups. Patients in experimental group underwent intraventricular ultrasound-assisted atrial septal puncture, while those in control group underwent X-ray guided atrial septal puncture. The success rate, puncture time and complications of the two groups were compared. Results: All atrial septal puncture was successful in the experimental group, while one-time puncture was successful in 21 cases and unsuccessful in 9 cases in the control group with a success rate of 83.33%. There was significant difference in puncture success rate between the two groups. Moreover, the puncture time of the experimental group (5.00±1.5 min) was significantly shorter than that of the control group (6.90±1.32 min). Furthermore, the complication rates of the experimental group and the control group were 10% and 13.33%, respectively, with no significant difference. Conclusion: Ultrasound-assisted atrial septal puncture was significantly superior to X-ray guided atrial septal puncture, with high puncture success rate, short puncture time and fewer complications
The Application of Echocardiography in the Diagnosis of Heart Disease
Get PDFObjective: To explore the application value of echocardiography in the diagnosis of hypertension-related heart disease. Methods: 88 suspected hypertension-related heart disease patients admitted to our hospital from January 2022 to February 2023 were randomly divided into a control group (n=44) and a study group (n=44) using a random number table. The control group underwent routine electrocardiogram examination, while the study group underwent echocardiography examination. The diagnostic detection rates, sensitivity, specificity, missed diagnosis rate, and misdiagnosis rate of the two examination methods were compared. Results: The detection rates of left ventricular hypertrophy, left atrial enlargement, myocardial ischemia, aortic dilation, and diffuse interventricular septal thickening in the study group were 81.82%, 88.64%, 47.73%, 79.55%, and 90.91%, respectively. In the control group, the detection rates of left ventricular hypertrophy, left atrial enlargement, myocardial ischemia, aortic dilation, and diffuse interventricular septal thickening were 61.36%, 40.91%, 29.55%, 31.82%, and 63.64%, respectively. The detection rates in the study group were significantly higher than those in the control group, and the differences were statistically significant (P<0.05). The sensitivity and specificity of echocardiography in diagnosing hypertension-related heart disease were higher than those of routine electrocardiography, and the missed diagnosis rate and misdiagnosis rate were lower than those of routine electrocardiography (P<0.05). Conclusion: The application of echocardiography in the diagnosis of hypertension-related heart disease can effectively improve the accuracy, sensitivity, and specificity of diagnosis, reduce the missed diagnosis rate and misdiagnosis rate, and provide a reliable reference for the formulation of clinical treatment plans. It has a high application value
Progress of Autophagy Related Research in the Treatment of Ophthalmic Diseases
Get PDFAutophagy is a process in which some organelles and proteins are wrapped by cells into specific membranes and then transported to lysosomes to degrade these membranes, ultimately degrading small molecules and energy. Autophagy can make cells have a certain tolerance to starvation, and remove damaged organelles and protein structure dislocation caused by cell aging, so as to balance the intracellular environment. Autophagy includes autophagy molecules, microactive autophagy and macrophage autophagy. The mechanism characteristics of autophagy itself have aroused the upsurge of relevant application research, and more and more diseases are related to it. This paper reviews the research progress of autophagy in novel clinical application of autophagy
A Perplexing Case of a DUOX2 Mutation and Graves’ Disease
Get PDFIt is commonly accepted that DUOX2 mutations may cause congenital hypothyroidism and thyrotropin resistance, thus its combination with Graves' disease would be unusual. In this case, our patient's serum thyroid function tests suggested a high probability of thyroid hormone resistance syndrome, but genetic testing did not suggest gene mutations of THRα or THRβ. This is a rare case report of thyroid hormone resistance
Effect of FTY720 on the Tissue Microenvironments of Acute Spinal Cord Injury
Get PDFObjectives: To observe the effect of FTY720 on the changes of tissue microenvironment after acute spinal cord injury (ASCI) in rats. Methods: A total of 168 female SD rats were randomly divided into A, B and C groups, with 56 rats in each group. In group A (Sham-operation group), only T9 laminectomy was performed without spinal cord injury, and 0.3 ml normal saline was given by gavage immediately after suture. Group B (control group) was given 0.3 ml normal saline by gavage, group C (treatment group) was given 0.3 ml FTY720 diluted in 3mg/kg normal saline by gavage. The rats were sacrificed at 6h, 12h, 24h, 72h, 7d and 21d after operation. The injured spinal cord (the corresponding part of group A) was taken for ultrathin section, and HE staining was used to observe the necrosis of the spinal cord, inflammatory cell infiltration, glial scar formation, and the size of the syringomyelia in each group. The ratio of syringomyelia area to spinal cord area was calculated 21 days after injury. SPSS 13.0 software was used for statistical analysis. Results: HE staining showed that the morphology of the spinal cord in group A was normal at each time point: At 12h to 48h after operation, progressive edema of the spinal cord and liquefaction necrosis of the injured central area were observed, accompanied by inflammatory cell infiltration, mainly neutrophils, lymphocytes and monocytes. At 12h and 72h after operation, the degree of inflammatory cell infiltration in group B was significantly higher than that in group C (P<0.05). The degree of lymphocyte infiltration in group C was significantly lower than that in group B 12 hours after operation (P< 0.05). At 72 hours after operation, the central area of the injury had formed an unorganized structure cavity, and a large number of inflammatory cells infiltrated around the cavity, mainly microglia/monocytes. The number of glial scar cells in group B was significantly higher than that in group C (P < 0.05). The syringomyelia formed 21 days after operation. The syringomyelia ratio in group B was significantly higher than that in group C (P<0.05). Conclusions: FTY720 can significantly improve neurological function in rats after ASCI possibly by inhibiting the inflammatory response after spinal cord injury, thereby reducing the secondary injury of the spinal cord
Head-to-Head Comparison of TB-LAMP, Mycobacterial Culture and Adenosine Deaminase for Diagnosis of Pleural Tuberculosis in China
Get PDFObjectives: The objective of the prospective single-center study was to investigate the diagnostic performance of Loop-Mediated Amplification test (TB-LAMP), mycobacterial culture and adenosine deaminase (ADA) for diagnosing pleural tuberculosis (TB) from the pleural effusions in a TB-endemic setting. Methods: We retrospectively analyzed patients suspected of having pleural TB in Weifang between March 2018 and October 2019. The PE samples were evaluated by smear microscopy, mycobacterial culture, TB-LAMP and ADA assay. Results: Overall, 170 patients with suggestive of pleural TB were retrospectively reviewed in this study, of which 125 were diagnosed as pleural TB. Among 125 pleural TB cases, 52 cases were identified by TB-LAMP, resulting in a sensitivity of 41.6%. When combing MGIT and TB-LAMP, 13 additional positive cases were detected compared to MGIT culture alone, demonstrating a sensitivity of 56.8%. The mean ADA levels were corelated with age, and the mean ADA value of <35 years group was significantly higher than that of ≥70 years group (p=0.0214). Conclusion: In conclusion, our data demonstrate the promising effectiveness of TB-LAMP in detection of MTB in concentrated PE specimens. The ADA levels are decreased with advanced age, highlighting the urgent need for confirmation of different cut-off values for various age group
Analysis of the application of methylprednisolone injection combined with ambroxol injection in the treatment of asthma
Get PDFObjective: To observe the effectiveness of different medication regimens in the treatment of asthma diseases. Methods: Sixty-four patients with asthma who attended the medical records department from 2020.6 to 2022.8 were analyzed. 32 patients in group A were treated with methylprednisolone alone, while group B was treated with intravenous amiloride injection in addition to the medication regimen in group A. The improvement time of symptoms in each group was observed, the total effective rate was calculated and the differences between groups were analyzed. Results: In Group B, the improvement time of wheeze, cough, croup and wet rales was earlier than that in Group A (P＜0.05). In terms of total effective rate, the difference was 65.63% vs. 93.75% in group A vs. group B (P < 0.05). Conclusion: The combination of methylprednisolone and ambroxol injection in the treatment of asthma can provide more rapid relief of symptoms and improve the efficacy, which is worth promoting
Analysis of Ophthalmic Examination Results of 7364 Cases in Kunming Regional Health Management Center
Get PDFObjective To understand the distribution of eye diseases in the tested population, and to provide a reference basis for the prevention, diagnosis and treatment of eye diseases. Methods A total of 7, 364 patients in the Health Management Center from June 2022 to September 2022 underwent eye examination, and the statistical analysis of their eye examination results was conducted by retrospective analysis. Results Of the 7, 364 patients, 6, 202 cases(84. 22%) had a history of eye disease or eye surgery, and the top five eye diseases were refractive error(75. 35%), cataract(18. 06%), pterygium(4. 09%), pinguecula(3. 57%), fundus tigre(2. 70%). Conclusion In the tested population, the prevalence of refractive error was the highest, followed by cataract, pterygium and so on in men Blebral spot, ptosis. More cataracts and fundus arteriosclerosis, and more women suffer from corneal diseases and trichiasis. There is no obvious difference between men and women, and middle-aged and elderly people have a higher probability of cataract and fundus diseases
The Value of Folic Acid Combined with Low Molecular Weight Heparin in the Treatment of Recurrent Abortion
Get PDFObjective: To retrospectively analyze the effect of folic acid combined with low molecular weight heparin regimen on recurrent abortion in hospital. Methods:Â The inclusion period was from February 2022 to February 2023. During this period, patients with recurrent abortion in the hospital were studied and discussed, including 70 patients. They were randomly assigned to a control group (35 patients were treated with low molecular weight heparin calcium and aspirin) and an observation group (35 patients were treated with folic acid on the basis of the control group). Relevant data were collected and sorted out, and finally processed using statistics. Results: The data of treatment results were processed by the statistical system, and the results (P<0.05) showed that the observation group had better information on various data such as hormone indicators, pregnancy outcome, and immune function indicators after treatment. Conclusion:Â The application of folic acid combined with low molecular weight heparin regimen is conducive to the smooth development of the treatment of recurrent abortion, can help patients control hormone indicators within a reasonable range, improve immune function and pregnancy outcomes, and has important significance in improving treatment effectiveness
Comparative Study on the Costs of Treating Diabetic Foot, Necrotizing Fasciitis, and Stage IV Pressure Ulcers
Get PDFObjective: To compare the total treatment costs for patients with diabetic foot with osteomyelitis, necrotizing fasciitis, and stage IV pressure ulcers in Dalian city, to explore the economic burden of diferent types of chronic wounds. Methods: Aretrospective analysis design was used, collecting data from 18 patients (6 of each wound type) from the electronic medical record system of a large hospital in Dalian. One-way ANOVAand Tukey’s HSD post-hoc tests were applied to compare the treatment costs of diferent wound types. Results: The treat-ment costs for the necrotizing fasciitis group were signifcantly higher than those for the stage IV pressure ulcer group, while the costs for the diabetic foot group did not show signifcant diferences from the other two groups. This fnding highlights the impact of chronic wound types on treatment costs and the importance of early intervention. Conclusion: The results provide data support for the optimized allocation of med-ical resources, especially in a context of limited resources. They emphasize the necessity of early identifcation and management of chronic wounds and provide a basis for establishing cost-efective treatment strategies