Medicine
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In Traditional Korean Medicine (TKM), diseases on the left or right side of the human body have been treated differently according to the theory of Donguibogam, which is an encyclopedic source for TKM. In the Wind chapter of Donguibogam, left hemiparesis due to stroke is called Tan, a sort of Hyeol-Byeong, and right hemiparesis due to stroke is called Tan, a sort of Gi-Byeong. As neuroscience develops, it has been shown that the functions of the left and right hemispheres differ, as do the symptoms caused by differently located lesions in the brain. In light of these recent findings and the theory of Donguibogam, it may be useful when treating patients in clinical practice to consider the side of the human body on which symptoms appear. The aim here is to establish whether side-dependent treatments are more effective in treating patients with symptoms on different sides of the body. Specifically, this exploratory study investigates changes in gait pattern among stroke patients with hemiparesis or hemiplegia during gait recovery. ⋯ If the use of gait analysis systems (GAITRite, G-walk, and Treadmill) confirms differences in gait recovery pattern among stroke patients according to the paralyzed side, the findings will provide essential evidence for differential treatment of stroke patients on that basis.
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Observational Study
Association of gestational diabetes mellitus and abnormal vaginal flora with adverse pregnancy outcomes.
Gestational diabetes mellitus (GDM) is associated with adverse perinatal outcomes. This study aimed to examine the association between GDM and abnormal vaginal flora, and the association between abnormal vaginal flora and adverse pregnancy outcomes. This was a prospective study of pregnant women who visited Xuanwu Hospital of the Capital Medical University (Beijing, China) between February and October 2015. ⋯ The vaginal infection rate was higher in patients with GDM compared with healthy pregnant women. GDM and abnormal vaginal flora were both associated with adverse pregnancy outcomes. The vaginal Lactobacillus species were different between the 2 groups, which could contribute to the adverse outcomes.
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Case Reports
Senile Lemierre syndrome complicated with descending necrotizing mediastinitis: A case report.
Senile patients with LS complicated with DNM are rarely seen in clinical practice, and extensive cervical incision and drainage plus administration of effective antibiotics are the basis for treatment. Currently, the treatment controversy mainly has focused on whether mediastinal incision and drainage is necessary for patients with type I DNM, and whether anticoagulation therapy is required for jugular venous emboli and distant metastatic emboli induced by LS. ⋯ Concomitant use of anticoagulants on the basis of repeated cervical incision and drainage + administration of effective antibiotics can obtain excellent therapeutic efficacy in the treatment of patient with LS complicated with type I DNM.
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Preoperative left ventricular dysfunction is a risk factor for postoperative mortality and morbidity in cardiovascular surgeries with cardiopulmonary bypass, including thoracic aortic surgery. Using a retrospective study design, this study aimed to clarify the short- and mid-term outcomes of patients who underwent acute type A aortic dissection (ATAAD) repair with reduced left ventricular function. Between July 2007 and February 2018, a total of 510 adult patients underwent surgical repair of ATAAD in a single institution. ⋯ The serial echocardiograms revealed no postoperative deterioration of LVEF during the 3-year follow-up. Even with a more conservative aortic repair procedure, the patients with preoperative left ventricular dysfunction are at higher surgical risk for in-hospital mortality. However, once such patients are able to survive to discharge, the midterm outcome can still be promising.
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Comparative Study
Clinicopathological features of atypical membranous nephropathy with unknown etiology in adult Chinese patients.
Membranous nephropathy is typically classified as idiopathic and secondary, but nowadays the number of atypical membranous nephropathy (aMN) is increasing, many of which cannot determine its etiology in China. In this study, we compared the clinical and pathological characteristics of idiopathic membranous nephropathy (iMN) with aMN with unknown etiology from a single center in China. We retrospectively reviewed the clinical data of 577 patients with iMN and aMN at Peking University People's Hospital from January 2006 to December 2015 over a 10-year period, and analyzed their clinical and pathological characteristics. ⋯ The patients with positive PLA2R antibody had higher positive rate of microscopic hematuria and urinary protein, lower albumin. The aMN patients are younger, higher smoking rate, its main clinical manifestation is nephrotic syndrome, but more of them accompanied with nephritis syndrome than those in iMN patients. Serum PLA2R antibody could not distinguish aMN from iMN. aMN could be a special glomerular disease in China, and need a further research on a larger scale.