ObjectiveTo investigate the effect of 24-week intradialytic progressive resistance exercise on hemoglobin and iron metabolism in maintenance hemodialysis (MHD) patients.MethodsFrom April to May 2019, 62 MHD patients were enrolled and randomly assigned into exercise group (n=31) and control group (n=31). Both groups of patients received regular routine hemodialysis, on that basis, patients in the exercise group completed intradialytic resistance exercise three times per week for 24 weeks. Each exercise included 8-10 muscle groups (grasping the grip ring with both hands, flexion and extension of the elbows and shoulders on the non-vascular side and lower limbs with sandbag), 3 sets of 15 repetitions with a rest of 1-2 min between 2 sets. Exercise began with a low load, the sandbag weight was gradually increased, and the Borg score was aimed to be 11-13 points after exercise. Hemoglobin, serum ferritin, transferrin saturation, serum creatinine, high-sensitivity C-reactive protein, urea clearance index, recombinant human erythropoietin (rHuEPO) dosage at baseline and after 24 weeks, as well as the cumulative iron supplement dose and hemoglobin variation of the two groups during the study period were evaluated.ResultsThere were 20 patients in the exercise group and 30 ones in the control group who completed the study. After 24 weeks of progressive resistance exercise, the medium (lower quartile, upper quartile) of the amount of rHuEPO in the exercise group decreased from 6 000 (6 000, 9 000) U/week to 6 000 (4 500, 7 125) U/week (Z=?2.599, P=0.009), while that in the control group had no statistically significant difference (Z=?1.340, P=0.180); there was no statistically difference in hemoglobin, hemoglobin coefficient of variation, serum ferritin, transferrin saturation, or 24-week cumulative iron supplementation between the two groups.ConclusionIntradialytic progressive resistance exercise can reduce the amount of rHuEPO in MHD patients, which is benefitial to optimizing the management of hemoglobin.
Total hip arthroplasty is an end-stage treatment for hip diseases such as hip osteoarthritis and osteonecrosis of the femoral head. Traditional surgery models are still mostly used in China, and related day surgery models abroad have shown that day surgery for total hip arthroplasty is as safe and feasible as traditional pattern without increase in complications and readmission. It can also shorten the length of hospitalization for patients, reduce hospitalization costs, thereby speeding up bed turnover and increasing the utilization of medical resources. This article reviews the patient admission, perioperative management, anesthesia and surgical techniques, post-discharge rehabilitation and nursing care of patients undergoing day surgery for total hip arthroplasty, and aims to providea reference for the development of day surgery for total hip arthroplasty in China.
Objective To review the basic research and cl inical progress of elbow heterotopic ossification after injury. Methods The recent l iterature concerning heterotopic ossification of the elbow was reviewed. Results Heterotopic ossification was caused by variety of stimul i and conditions. The current methods of prevention and treatment were to improve surgical techniques, to reduce trauma and bleeding, to rinse the area with bone fragments with plenty of salt water, and to use non-steroidal anti-inflammatory drugs. Conclusion Once heterotopic ossification occurred, surgical treatment is unique treatment method, so emphasis is to prevent heterotopic ossification.
ObjectiveTo summarize the clinical progress on living related liver transplantation (LRLT). MethodsThe latest progress were reviewed based on recent documents and the experience on LRLT in our department. ResultsLRLT made much progress on evaluation of donor, harvesting the graft liver, donor health assessment and outcomes after living donor liver transplantation, and main factors affecting the survival of liver graft and so on. Conclusion Living related liver transplantation has many unsurpassable advantages, which suits the situation of China and has capacious clinical application.
At present, interventional therapy for structural heart disease is in a period of vigorous development. Among them, transcatheter aortic valve replacement, as a representative of the interventional treatment of heart valve disease, has made rapid progress, which is a bright spot in the field of cardiovascular disease. The future development of transcatheter tricuspid valve repair/replacement is also promising. With the availability of important clinical evidence, the indications of transcatheter aortic valve replacement have been extended to the full risk range of severe aortic stenosis. More and more data showed that transcatheter mitral and tricuspid valve interventions could effectively alleviate patients’ symptoms and improve their prognosis. Transcatheter valve interventions have developed rapidly and have made tremendous progress in China. This article will review and interpret the important progress in the field of transcatheter valve interventions.
Objective To review the appl ication of and the research progress on acellular matrix (ACM) in cartilage tissue engineering. Methods Related l iteratures both at home and abroad were retrospected and analyzed. Results Manyresearchers improved the properties of cartilage ACM scaffold through co-appl ication of solution diosmosis method, freezedrying method and physical and chemical cross-l inking method etc., and the experimental results of applying cartilage ACM scaffold for the construction of tissue engineered cartilage were closely related to the properties of ACM. Conclusion ACM has a wide appl ication prospect for the construction of tissue engineered cartilage, and further in-depth studies are needed to improve its property.
ObjectiveTo study the clinical characteristics of patients onset epilepsy Dentatorubral-pallidoluysian atropy (DRPLA) in Epilepsy Center of Guangdong 999 Brain Hospital and improve understanding of the disease.
MethodsCollected five patients from August 2014 to August 2016 in Guangdong 999 Brain Hospital, whom diagnosed through genetic testing of DRPLA, analysed their disease course, family history, video-EEG, brain MRI and treatment data.
ResultsDRPLA performed as neurodegenerative diseases, and epilepsy population mainly performed as progressive myoclonic epilepsy (Progressive myoclonus epilepsy, PME).
ConclusionDRPLA is autosomal dominant neurodegenerative disease. In patients with cerebellar atrophy, neurological regression, ataxia, drug refractory epilepsy, it is recommended routinely to detect ATN1 gene, so that timely diagnosis and genetic counseling.
Objective To give a review and commentary on the treatment of acute foot and ankle injuries. Methods Based on the treatment experience and recent l iterature, a commentary on acute foot and ankle injuries were given, included the basic and cl inical research results, evaluation before operation, and treatment methods of the soft tissue and bone injuries. Results The treatment of acute foot and ankle injuries is still a hot point in orthopaedic surgery. Operative and non-operative treatment of fresh Achilles tendon rupture can achieve satisfactory results, and early weight-bearing do not increase the re-rupture rate. The time delay between first debridement and injury within 24 hours does not increase the infection rate. For the treatment of severe ankle fractures, attentions should be paid to the cartilage injury, and anatomic reduction, good real ignment, and the congruity recovery are very important. The treatment determination of calcaneal fractures depends on the fully understanding injury mechanisms, classifications, and treatment method. Talus fractures should try to be treated by experienced surgeons. Operation and fixation methods of Lisfranc injury depends on different injury types. Conclusion Acute foot and ankle injuries are common in cl inical, to achieve a satisfactory result in evaluation and treatment, it is important to have a fully evaluation of the injury type, and choose the best operation time and suitable treatment methods, as well as to fully understand the biomechanical characteristics of different regions.
Fleming proposed the concept of evidence-based pathology (EBP) in 1996. In recent years, there have been a lot of evidence-based studies on the diagnosis and prognosis of diseases. However, there are still limitations and challenges in the development, and the growth in application of evidence-based medicine in the pathology is still slow. This study introduced the history of evidence-based pathology, summarized the primary application areas and the latest research progress, analyzed current opportunities and challenges of evidence-based pathology, and provided some suggestions.
To review the literature about the development of the periodontal tissue engineering. Methods Based on an extensive review of the latest literature concerned, we analyzed and evaluated themethod of the periodontal tissue engineering. Results The development of the periodontal tissue engineering in the fields of the seed cells, modifier genes, cell factors, and scaffold materials provided a brand-new thinking and method for complete regeneration of the eriodontal tissues. Conclusion The periodontal tissue engineering has an excellent future butmany problems still require a further study and a satisfactory solution.
