目的:探讨成人麻疹的流行病学与临床特征。方法:回顾性分析196例成人麻疹的临床资料。结果:患者以外来流动人员及本地农村人口多见,平均年龄26.78岁,多数患者未接种麻疹疫苗或麻疹疫苗史不详。成人麻疹患者临床症状重,皮疹典型,为充血性斑丘疹,麻疹黏膜斑(Koplik’s spots)明显,且持续时间长,可合并肝脏和心肌损伤,但并发症以肺炎和支气管炎为主。结论:有必要加强成人的免疫接种,尤其是外来的务工人员,强化医务人员对麻疹的认识,避免麻疹的流行。
ObjectiveTo summarize the recent development of diagnosis and treatment for congenital biliary dilation in adult patients. MethodThe literatures at home and abroad during recent years were reviewed, and the progress of diagnosis and treatment for congenital biliary dilation in adult patients were summarized. ResultsThere were no specific clinical manifestations in adult patients of congenital biliary dilation. The diagnosis mainly depended on imaging examinations. Complete excision and Roux-en-Y hepatojejunostomy was the main the treatment method. ConclusionsEarly diagnosis and proper surgical approach are important for good therapeutic efficacy and lower postoperative complication rate.
Objective To explore the feasibility and safety of laparoscopic cyst resection and Roux-en-Y hepatojejunostomy in treatment for adult congenital cholangiectasis and to compare the therapeutic effects of laparoscopic procedure with conventional open procedure. Methods The clinical data of 33 adult patients with congenital cholangiectasis from May 2008 to September 2011 in the department of general surgery of Shengjing Hospital of China Medical University were retrospectively analyzed. Fourteen patients received laparoscopic procedure （laparoscopic group），whereas the other 19 patients received conventional open procedure （conventional group）. Results All the operations were carried out successfully through laparoscopic procedure. The mean time of operation in the laparoscopic group was significantly longer than that in the conventional group （195min versus 130min，P＜0.01）. The average intraoperative blood loss in the laparoscopic group was significantly less than that in the conventional group （80ml versus 270ml，P＜0.01）. In contrast，the mean time of bowel peristalsis recovery and postoperative hospital stay in the laparoscopic group were significantly shorter than those in the conventional group （time of bowel motion recovery：76h versus 104 h，P＜0.01；hospital stay：6.1 d versus 9.6 d，P＜0.01）. There were no differences in the early complications between two groups （P＞0.05）. Conclusions Totally laparoscopic treatment for congenital cholangiectasis in adult is feasible and safe. It is worth to be generally applied because of its minimal invasion and fast postoperative recovery.
ObjectiveTo sum up the diagnosis and treatment of adult ileal duplication with clinical cases from Peking Union Medical College Hospital (PUMCH). MethodsSix cases of adult ileal duplication admitted in our hospital from February 1996 to December 2010 were analyzed. Different assistant investigations were supposed to different patients due to the chief complaints including gastroscope, colonoscopy, abdominal CT scan, arteriography, 99Tcm radionuclide imaging, and double-balloon intestinal endoscope. None was made a definite diagnosis before operation with only one uncertain case. All cases received operation and pathological examination. Results All cases admitted were male. The chief complaints included intestinal bleeding, abdominalgia, intestinal obstruction, and abdominal mass. Five out of six patients received gastroscope, colonoscopy, and abdominal CT scan while three received mesenteric arteriography, but none was found any suggestion for ileal duplication. Even 99Tcm radionuclide imaging pointed out only two with abnormal abdominal bleeding. Three received doubleballoon intestinal endoscope, paying attention that only one discovered with ileal duplication. In a concluding, none was made a definite diagnosis before operation with only one uncertain case. All the cases received operation. The duplications of ileum in the length of 6-25 cm were found at the site of 11-100 cm proximal to ileocecum during the operation. Pathological report confirmed the clinical diagnosis of all cases with adult ileal duplications． Two cases were found with ectopic gastric mucosa, another two with diverticulum, and one with ectopic pancreas， in addition the remaining with inflammatory fibrous pseudotumor. Prognosis were good for all after operation. ConclusionsIleal duplications are rarely seen in adults, gender prefer male． Without specific clinical symptoms and inspections, definite diagnosis before operation is hard to make. But maybe doubleballoon intestinal endoscope and 99Tcm radionuclide imaging can give out positive result. Surgeons should be aware of this condition when performing abdominal exploration. Once discovered, resection is necessary.
The diagnosis and management of congenital heart disease (CHD), the most common inborn defect, has been a tremendous success of modern medicine. With the development of diagnostic techniques, surgical procedures and interventional techniques, more than 90% of CHD children can survive to adulthood. Consequently, the prevalence of patients with CHD has shifted away from infancy and childhood towards adulthood. Adult CHD cardiology is now encompassing not only young or middle-aged adults but also patients aged above 60 years. Standardized guidelines can provide good theoretical support for the comprehensive management of adult CHD. Ten years after the European Society of Cardiology guidelines for the management of grown-up CHD released in 2010, the new version was officially released in August 2020. The new version of guidelines updated the classification and stratification of diseases, comprehensive intervention methods and intervention timing, and put forward some new concepts, new intervention standards and methods. For adult CHD that has not been repaired or needs to be repaired again, the indication and mode of surgical intervention and perioperative management have a great impact on the prognosis. The new version of the guidelines provides a detailed description of the surgical and intervention indications and methods for different diseases, and clarifies the management methods for high-risk groups. This article attempts to interpret this newly updated guideline from the perspective of a surgeon, sort out several key diseases introduced by the guideline, and strives to provide a concise and actionable guideline for domestic counterparts.
ObjectivesTo systematically review the prevalence of asthma in adults (>14 years old) in China.MethodsPubMed, Web of Science, CENTRAL, CINAHL, WanFang Data, CBM, CNKI, and VIP databases were electronically searched to collect cross-sectional studies on the prevalence of asthma in Chinese adults from January 2000 to December 2019. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies, then, meta-analysis was performed by using Stata 15.0 software.ResultsA total of 67 cross-sectional studies, involving 1 381 673 subjects and 19 871 adult asthma patients were included. The results of meta-analysis showed that the prevalence rate of asthma in adults in China was 1.81% (95%CI 1.59% to 2.01%). The subgroup analysis showed that the prevalence rates of asthma in males and females were 1.87% and 1.76%, respectively. The prevalence rates were 2.16% in the northeast region, 1.34% in the central region, 1.63% in the eastern region and 2.23% in the western region. The prevalence rates were 0.73%, 1.53%, and 2.81% in 15-40 years old, 41-60 years old, and >60 years old, respectively. The prevalence rates were 3.07% in illiteracy population, 1.69% in primary school population, 1.46% in junior middle school population, 1.01% in senior high school population and 0.98% in college and above population. The prevalence rates were 2.23%, 2.10%, 1.17%, 1.45%, 1.09%, and 1.41% in agriculture, forestry and animal husbandry personnel, workers, public officials, business and service personnel, military personnel, and other occupations, respectively. The prevalence rates were 1.41% and 1.59% in Han and other ethnic populations, respectively. The prevalence rates were 2.03% in cities and 1.99% in rural areas. And the prevalence rates were 1.22% in 2000 to 2005, 2.07% in 2006 to 2010, 2.25% in 2011 to 2015, and 2.62% in 2016 to 2019.ConclusionsThe prevalence rate of asthma in Chinese adults is higher, which is different due to the influence of age, sex, region, education, and occupation.
目的 总结成人大肠套叠治疗经验。方法 回顾性分析我院1969～1998年收治的83例成人大肠套叠患者的临床资料。结果 经钡灌肠复位6例，手术治疗77例。肿瘤性大肠套叠60.2%，其中恶性肿瘤性套叠占64.0%。恶性肿瘤套叠手术切除5年生存率43.8%。结论 对成人大肠套叠治疗首选手术切除，慎用手术复位，不主张钡灌肠复位。
Objective To research the methods and techniques of SD rat bone marrow stromal cells （MSCs）culture in vitro and to provide a large number of MSCs for cell therapy. Methods Bone marrow from the femur and tibia of the early age SD rats was taken to culture to the passage 1-4 （P1-P4）, its growth was observed and P3 cells were evaluated by HE staining and immunohistochemisty. Results The growing speed of P1-P3 was faster than that of P0, cells fusion was 85%-90% after 3-4 d and the cells were arranged in groups liked whirlpool shape or parallel; （3.4-3.6）×104/cm2 cells were gained and the total cell number of P1-P3 was 4.08×106, 2.44×107 and 2.85×108 respectively, the rate of trypan blue rejecting stained was 95%-97%. P4’s growing speed was slower than before, 1.42×109 in 3.0×104/cm2 cells were gained, and the rate of rejecting stained was 95%. P4-cell output was amplified nearly 2 000-fold higher than P0-cell. P3 immunohistochemical analysis indicated CD105+ cells 61.9%， CD44+ 45.4%， CD29+ 16.8%， CD45+ 8.2%， CD31+ 13.7%， CD34+ 8.3% and CD11b+ 1.5%, respectively. Conclusion The culture of whole bone marrow is suitable for a large number of MSCs provision in vitro, and can meet the needs of the cell therapy research.