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30 July 2021, Volume 16 Issue 04 Previous Issue    Next Issue

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Study the effect of infliximab on physical and mental health in Crohn’s disease patients with active anal fistula ZHOU Jie, HONG Liwen, WANG Lei, ZHANG Chen, WANG Zhengting, ZHANG Tianyu, FAN Rong 2021, 16 (04):  225-229.  DOI: 10.16138/j.1673-6087.2021.04.001 Abstract ( 274 )   HTML ( 5 )   PDF (522KB) ( 164 )   Objective To understand whether the remission of active anal fistula (AAF) directly affects the quality of life, self-esteem and body image in the patients with Crohn’s disease (CD), and whether infliximab (IFX) treatment can improve their psychosocial disorders. Methods The data including baseline information of CD patients with AAF in the inflammatory bowel disease(IBD) database of our hospital, CD-related clinical features, anal fistula types, perianal CD activity index, IBD simplified questionnaire, body image scale, Rosenberg self-esteem scale, and 6-12 months follow-up information were collected and analyzed retrospectively. To evaluate the effect of IFX treatment on improving psychosocial state. Results Among the 297 CD patients, 103 patients (34.7%) had AAF. The remission rate of IFX treatment was 64.0% in CD patients with perianal fistula, which was significantly higher than that in the patients who did not receive IFX treatment (38.5%, P=0.010). In addition, compared with CD patients who did not receive IFX treatment for AAF, IFX treatment improved the quality of life, body image satisfaction and self-esteem in CD patients with AAF significantly(all P<0.05). Conclusions Anal fistula remission can improve the inferiority complex, body image satisfaction and quality of life in CD patients with AAF. IFX treatment promotes the physical and mental health of patients, and improves the quality of life through significantly alleviating the condition of anal fistula in the patients with CD. Figures and Tables | References | Related Articles | Metrics

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Clinical effect of subintimal stent implantation in the patients with chronic total occlusion in coronary artery HU Jian, YANG Zhenkun, YAN Xiaoxiang, NI Jun, DING Fenghua 2021, 16 (04):  230-233.  DOI: 10.16138/j.1673-6087.2021.04.002 Abstract ( 158 )   HTML ( 4 )   PDF (380KB) ( 60 )   Objective To evaluate clinical effect of subintimal stent implantation in the patients with chronic total occlusion(CTO) in coronary artery. Methods From January 2016 to January 2019, 73 patients with CTO in coronary artery who underwent coronary stent implantation successfully in our hospital were selected as the research objects. Intravascular ultrasound(IVUS) confirmed that a segment of the stent was in the false lumen (subintimal), but the proximal and distal parts of the stent were in the true lumen. The clinical and biochemical indexes of all patients were recorded in details. The clinical characteristics, major adverse cardiac events (MACE) (including death, angina recurrence, in-stent restenosis, and revascularization due to myocardial ischemia) during hospitalization and one-year follow-up were carefully noted. Results During one-year follow-up period, there were no death cases, 2 cases of myocardial infarction, 9 cases of angina recurrence, and the incidence of MACE was 15%. In addition, 13(18%) patients had in-stent restenosis, and 11 (15%) patients underwent revascularization due to myocardial ischemia again. Conclusions The subintimal stent implantation is feasible and effective approach for chronic coronary artery occlusion. Figures and Tables | References | Related Articles | Metrics

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Atrioesophageal fistula: a case report and literature review DONG Yanbin, LI Hua, MAO Lina 2021, 16 (04):  234-239.  DOI: 10.16138/j.1673-6087.2021.04.003 Abstract ( 218 )   HTML ( 6 )   PDF (640KB) ( 74 )   Objective To analyze the clinical feature, diagnosis, treatment and prognosis of the patients with atrioesophageal fistula(AEF). Methods A patient with AEF admitted to our hospital was reported and the related literatures were reviewed. “Atrioesophageal fistula” was used as the keyword to retrieve the literature from Pubmed database and Wanfang database until June 2020. Results Eighty-three English and 3 Chinese documents related to AEF were retrieved. A total of 43 patients were reported. Forty-one cases were finally enrolled, combined with this case, 42 cases were reviewed. Thirty-three were male and 9 were female in 42 cases, and age range was 27-78 years [mean age (58.02±13.47) years]. The onset of symptoms after the procedure of radiofrequency ablation was 1-50 d, and the average time was(23.74±11.44) d. The common clinical manifestations of patients were fever, nervous system symptoms, chest tightness/chest pain, gastrointestinal bleeding and hemoptysis. The patients were divided into survival group and death group. Compared with survival group, the age in the death group were higher [(62.25±12.29) years vs. (52.38±13.19) years, P<0.05]. The proportion of patients treated with surgery in the survival group was higher than that in the death group (16/18 vs 8/24, P<0.05). Logistic regression analysis showed that surgical treatment was an independent protective factor for patients. Conclusions AEF is a serious complication of radiofrequency ablation. The mortality rate of patients is high, and surgical treatment can improve the survival rate of patients. Figures and Tables | References | Related Articles | Metrics

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Incidence and risk factors for leukoaraiosis in hospitalized patients with acute ischemic stroke LI Qianqian, XIN Xiaoyu, TANG Huidong, WU Fang 2021, 16 (04):  240-245.  DOI: 10.16138/j.1673-6087.2021.04.004 Abstract ( 186 )   HTML ( 3 )   PDF (620KB) ( 132 )   Objective To investigate the incidence and risk factors of leukoaraiosis (LA) in hospitalized patients with acute ischemic stroke（AIS）. Methods Five hundred and ninety-three hospitalized patients with AIS were divided into the non-LA group（n=61）, mild LA group（n=324）and moderate-severe LA group（n=208） according to the severity of paraventricular LA. Five hundred and ninety-three patients were also divided into non-LA group（n=183）, mild LA group（n=257） and moderate-severe LA group（n=153） according to the severity of deep LA. The differences in clinical characteristics between the paraventricular and deep groups were compared. The risk factors for LA in the patients with AIS were analyzed by multivariate Logistic regression. Results In the enrolled cases, the incidence of paraventricular LA was 89.7% and that of deep LA was 69.1%.In the paraventricular LA group, age, blood urea nitrogen(BUN), total cholesterol(TC), low-density lipoprotein cholesterol (LDL-C）, apolipoprotein AⅠ/apolipoprotein B (apoAⅠ/apoB）, homocysteine (Hcy）, fibrinogen (Fg), hypertension (Hcy), and previous stroke history of the 3 groups were compared, and the differences were statistically significant (all P<0.05). Age, hypertension, and previous stroke history were independent risk factors for moderate-severe paraventricular LA [odds ratio(OR)=4.41, 1.94, 6.84, all P<0.05]. In the deep LA group, age, BUN, TC, apoAⅠ/apoB, Hcy, hypertension, and previous stroke history of the 3 groups were compared and showed statistically significant differences (P<0.05). Age, serum Hcy level, hypertension, and past stroke history were independent risk factors for moderate to severe deep LA (OR=3.82, OR=1.04, OR=1.96, OR=2.85, all P<0.05). Conclusions Age, hypertension, and previous stroke history are independent risk factors for moderate-severe paraventricular and deep LA in hospitalized patients with AIS. Increased serum Hcy level is an independent risk factor for moderate-severe deep LA in the patients. Figures and Tables | References | Related Articles | Metrics

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Correlation analysis of vitamin D and nocturnal blood pressure in the patients with chronic kidney disease XUAN Yingli, CHEN Feihong, QIN Li, HE Ruibin, PANG Shiqing, YUAN Jiangzi 2021, 16 (04):  246-250.  DOI: 10.16138/j.1673-6087.2021.04.005 Abstract ( 240 )   HTML ( 3 )   PDF (499KB) ( 258 )   Objective To observe whether vitamin D level is related to changes of blood pressure in the patients with chronic kidney disease. Methods A total of 120 patients (62 male and 58 female) with chronic kidney disease [age, 18-80(55.22±14.33) years] were enrolled. The patients were divided into 3 groups based on their vitamin D concentration, including very low vitamin D group (≤20 mg/L), low vitamin D group (21-29 mg/L) and vitamin D sufficient group (≥30 mg/L). The clinical data and blood pressure of 3 groups were compared, and the correlation between vitamin D concentration and each variable was analyzed. Results The levels of 24-h systolic blood pressure, 24-h diastolic blood pressure, daytime systolic blood pressure, daytime systolic blood pressure, nocturnal systolic blood pressure, and nocturnal diastolic blood pressure in very low vitamin D group (n=40) and low group (n=45) were higher than those in vitamin D sufficient group(n=35)（all P<0.05）, but the dropping rate of blood pressure at night in two groups were lower than the vitamin D sufficient group. It showed that vitamin D level had negative linear correlation with calcium concentration（r=-0.259, P=0.026）, 24-h systolic blood pressure（r=-0.657, P=0.036）, 24-h diastolic blood pressure, nocturnal diastolic blood pressure（r=-0.203, P=0.000）, nocturnal systolic blood pressure（r=-0.198, P=0.000）.However, vitamin D level was positively correlated with the dropping rate of blood pressure at night. Multivariate Logistic regression analysis showed that vitamin D was a risk factor for the development of nocturnal hypertension in the patients with chronic kidney disease(P=0.037). As serum vitamin D levels decreased, the dropping rate of nocturnal hypertension decreased. Conclusions In the patients with chronic kidney disease,vitamin D level was negatively correlated with 24-h systolic blood pressure, 24-h diastolic blood pressure, nocturnal systolic blood pressure, and nocturnal diastolic blood pressure, but it was positively correlated with the dropping rate of blood pressure at night. Figures and Tables | References | Related Articles | Metrics

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Relationship between secretory leukocyte protease inhibitor and acute coronary syndrome JIN Yao, HUANG Hui, WU Zhijun 2021, 16 (04):  251-254.  DOI: 10.16138/j.1673-6087.2021.04.006 Abstract ( 137 )   HTML ( 3 )   PDF (520KB) ( 51 )   Objective To explore the relationship between secretory leukocyte protease inhibitor (SLPI) and acute coronary syndrome (ACS). Methods A total of 243 patients with ACS and 242 age- and gender- matched individuals with normal coronary arteries undergoing coronary angiography from July 2018 to September 2020 in Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine were enrolled. The serum SLPI level was detected by enzyme-linked immunosorbent assay, and the correlation between serum SLPI level and ACS was evaluated. Immunofluorescence was used to detect the localization of SLPI in ventricular aneurysm. Results The serum SLPI level in ACS patients was significantly higher than that in healthy controls [(452.0±167.6) ng/L vs. (420.5±154.3) ng/L, P=0.032]. Multivariate Logistic regression analysis showed that the increased serum SLPI level was an independent risk factor for ACS [odds ratio(OR)=1.309, 95% confidence interval (CI):(1.040-1.648), P=0.022]. Immunofluorescence showed SLPI was co-expressed with alpha-smooth muscle actin (α-SMA) in the ventricular aneurysm. Conclusions Serum SLPI level is an independent risk factor for ACS, and SLPI is expressed in smooth muscle cell of ventricular aneurysm. Figures and Tables | References | Related Articles | Metrics

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Effects of three dimensional printing fingerboard on finger spasm in early stroke patients LU Chunhua, WANG Kai, ZENG Zhen, ZHANG Qin, HE Wen, ZHEN Chunhong, ZHANG Xiao, LI Guo 2021, 16 (04):  255-260.  DOI: 10.16138/j.1673-6087.2021.04.007 Abstract ( 199 )   HTML ( 2 )   PDF (682KB) ( 112 )   Objective To explore the early use of three dimensional (3D) printing fingerboard to prevent finger spasm in the stroke patients and its rehabilitation effect. Methods Totally 90 cases of the stroke patients with hand dysfunction were divided into 3 groups according to random single-blind method, which included 3D printing group, traditional group and control group. They were treated with personalized 3D printing finger splint, traditional finger splint from factory mass production and conventional good limb positioning. Before starting treatment and after 3 months treatment, the patients’ surface electromyography(sEMG), passive root-mean-square(RMS) value of flexor finger group, modified Ashworth scale (MAS), Fugl-Meyer assessment upper extremity (FMA-UE), range of motion (metacarpal, proximal interphalangeal, distal interphalangeal), and modified Barthel index (MBI) were assessed. Results A total of 86 patients completed the study, and the age range were 59-79 (70.92±4.75) years, including 29 cases in 3D printing group, 28 cases in traditional group, and 29 cases in control group. The passive RMS value of finger flexor group, hand MAS rating, FMA-UE and MBI of 3 group patients were significantly different from those before treatment(all P<0.001). The joint range of motion of 3 group patients (march finger, proximal finger, far finger) had no statistical difference before and after treatment (all P>0.05). After 3 months treatment, the passive RMS, MAS, FMA-UE and MBI indexes of the finger flexors of 3 groups were statistically different(all P<0.05). Comparison among groups, the 3D printing group was better than traditional group and control group(both P<0.05); but there was no statistical difference in the range of motion among 3 group patients (P>0.05). Conclusions Early use of 3D printed fingerboards can effectively prevent increasing of finger muscle tension and spasm in the stroke patients, promote recovery of upper limbs motor functions, and improve patients’ activities of daily living. Figures and Tables | References | Related Articles | Metrics

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Experimental study of the effect of compound combination of traditional Chinese medicine on atherosclerosis WANG Shun, ZHU Huafang, MAO Chengyu, LI Dongjiu, WANG Changqian 2021, 16 (04):  261-266.  DOI: 10.16138/j.1673-6087.2021.04.008 Abstract ( 249 )   HTML ( 3 )   PDF (701KB) ( 88 )   Objective To explore a combination of resveratrol, berberine, curcumin and artesunate with a reasonable dose ratio to obtain the most effective and safest compound combination to provide an alternative selection for the patients with atherosclerosis and statin intolerance. Methods The atherosclerotic model in apolipoprotein E-knockout (ApoE-/-) mice was established by high fat diet. Four compound of Chinese medicine including resveratrol, berberine, curcumin and artesunate were divided into 9 groups according to orthogonal test table L9(34). Through evaluating the degree of atherosclerosis and the level of low-density lipoprotein cholesterol（LDL-C） in each group, the most effective and safest combination of 4 compounds were obtained and verified. Results According to the therapeutic effect on blood LDL-C and aortic atherosclerotic plaque, the range analysis of orthogonal experiment suggested the best compound combination, which was: resveratrol 1.25 mg/(kg·d), berberine 0.625 mg/(kg·d), curcumin 12.5 mg/(kg·d), artesunate 6.25 mg/(kg·d). In verification phase, it was shown that the traditional Chinese medicine combination group had smaller atherosclerotic plaque areas, lower liver injury than the single drug group (all P<0.05). Conclusions Through orthogonal test, we obtained a best compound combination of traditional Chinese medicine in all combination groups, which could prevent atherosclerosis and was verified to be effective and safe. This study provided a reference method in clinical transformation for traditional Chinese medicine. Figures and Tables | References | Related Articles | Metrics