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Objective:To explore the risk factors for early mortality in heart transplant(HT)recipients and construct a nomogram prediction model.Methods:From 2018 to 2022, preoperative clinical data were retrospectively reviewed for 163 consecutive HT recipients.Risk factor variables were shortlisted by univariate correlation analysis based upon early(90-day)postoperative patient survival.Lasso regression was then employed for screening all variables and common variables were combined.A nomogram was constructed for predicting the probability of early mortality after considering actual circumstance.Receiver operating characteristic(ROC)curve, area under the ROC curve(AUC), Harrell's C-index and calibration curves were employed for evaluating and internally validate the performance of the model.Decision curve analysis was performed for assessing clinical utility of the model.Results:In survival and mortality groups, mechanical ventilation, nervous system lesions, use of extracorporeal membrane oxygenation, red blood cell count ≤3.52×10 12/L, mean pulmonary arterial pressure>27 mmHg, pulmonary vascular resistance>4.01 Wood Unit, albumin≤33 g/L, aspartate aminotransferase >50 U/L, hemoglobin ≤108 g/L, platelet count ≤109×10 9/L and total bilirubin>57 μmol/L demonstrated statistically significant differences( P<0.05). At the same time, according to actual situations and different variables, hemoglobin ≤108 g/L, albumin ≤33 g/L, platelet count ≤109×10 9/L, total bilirubin>57μmol/L, aspartate aminotransferase>50 U/L, nervous system lesions and average pulmonary arterial pressure >27 mmHg were seven variables.And a nomogram with relatively high reliability was constructed for predicting the probability of early mortality post-HT(nomogram model evaluation, AUC 0.917, C index 0.910 and good calibration curve). Decision curve analysis indicated that the nomogram could benefit HT recipients. Conclusions:Risk factors have been identified for early mortality in HT recipients.And the nomogram prediction model offers a simple and reliable tool for predicting early mortality post-HT.It has important implications for individualized treatment of HT candidates.
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Objective:To evaluate the clinical value of microprobe endoscopic ultrasonography in the diagnosis and treatment of children with protuberant lesions in the upper gastrointestinal tract.Methods:A retrospective study was performed to analyze the clinical data of children who underwent microprobe endoscopic ultrasonography for treating protuberant lesions in the upper gastrointestinal tract in the Department of Gastroenterology, Jinan Children′s Hospital from January 2018 to June 2021.The endoscopic ultrasound characteristics of children with protuberant lesions in the upper gastrointestinal tract were summarized and compared with the pathological results.Results:Microprobe endoscopic ultrasonography was performed in 29 children.Ectopic pancreas was found in 12 cases (41.4%), Brunner gland hyperplasia in 4 cases (13.8%), cysts in 3 cases (10.3%), duodenum accessory nipple in 3 cases (10.3%), extragastric compression in 2 cases (6.9%), lymphoma in 2 cases (6.9%), gastric duplication malformation in 1 case (3.4%), stromal tumor in 1 case (3.4%) and leiomyoma in 1 case (3.4%). According to the results of microprobe endoscopic ultrasonography, 15 cases with protuberant lesions were treated by deep biopsy and handled under endoscope.The tissue was checked by pathological examination.The microprobe endoscopic ultrasonography diagnosis of 14 cases were in accordance with their pathological diagnosis[93.3% (14/15)].Conclusions:Microprobe endoscopic ultrasonography can effectively diagnose and differentiate protuberant lesions in the upper gastroi-ntestinal tract of children, so it can be used to guide the clinical treatment under endoscope.Microprobe endoscopic ultrasonography is a safe and reliable treatment for children.
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Staphylococcus utilizes vancomycin-resistance associated sensor/regulator ( VraSR) , a two-component signal transduction system ( TCS) , to sense and respond to cell wall damage and to adapt to environmental changes through regulating transcriptions of downstream genes. It has been indicated that VraSR can regulate the transcription of a series of genes involved in the synthesis of peptidoglycan, drug re-sistance, and virulence in Staphylococcus aureus ( S. aureus) . A similar two-component system, VraSR, is also present in Staphylococcus epidermidis ( S. epidermidis ) , sharing a high homology with the VraSR of S. aureus. Little is known about the functions of VraSR in S. epidermidis and it is not yet clear what the simi-larities and differences in resistance and pathogenicity are. Based on the previous work of our group, a brief review on the regulation mechanism of staphylococcal VraSR was performed.
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Objective To integrate the self-developed Web-based early warning management system into EMR system to decrease average medical fee as well as the occurrences of cost overrun,arrearage for self-paid fee and etc.Methods The method mapped into image for users' browse based on using the user-defined URL extension characteristic of EMR system,combining the advantages of Web platform in handling Http request,applying Java as well as SQL technology to obtain source data,integrating statistical analysis for multi-dimensional comparative analysis as well as visualization technology.Results This system changed the behavior pattern of early warning and supervision in course,relieved work burden of medical staffs,and helped hospital achieve high economic management benefit.Conclusion The application of crossplatform system realizes high effect and provides approaches for expanding other functions.
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Objective To explore the related factors of contrast agent leakage in CT enhanced scanning and to find out its preventive measures.Methods The clinical data of 46 patients with iodine leakage in the CT enhanced scanning during 2015 were retrospectively analyzed.Results The leakage rate had statistically significant difference between different patient's genders(P＜0.05).The leakage rate was related to the age of the patients(P＜0.01).The leakage rate showed the increasing trend with the increase of injection rate(P＜0.05).The leakage rate was related to the concentration of the contrast agent(P＜0.05).The leakage rate had no increasing trend with the increase of injection dose(P=0.675).The leakage rate was related to the years of injection nurses engaging this working(P＜0.01).Conclusion The leakage rate of female patients was higher than that of male.The older the patients,the greater the contrast agent concentration,the faster the injection rate and the lower the working years of injection nurses,the greater the leakage rate.
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Objective To explore the related factors of contrast agent leakage in CT enhanced scanning and to find out its preventive measures.Methods The clinical data of 46 patients with iodine leakage in the CT enhanced scanning during 2015 were retrospectively analyzed.Results The leakage rate had statistically significant difference between different patient's genders(P＜0.05).The leakage rate was related to the age of the patients(P＜0.01).The leakage rate showed the increasing trend with the increase of injection rate(P＜0.05).The leakage rate was related to the concentration of the contrast agent(P＜0.05).The leakage rate had no increasing trend with the increase of injection dose(P=0.675).The leakage rate was related to the years of injection nurses engaging this working(P＜0.01).Conclusion The leakage rate of female patients was higher than that of male.The older the patients,the greater the contrast agent concentration,the faster the injection rate and the lower the working years of injection nurses,the greater the leakage rate.
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Objective To study the correlation between the drug-resistance variation and the genotypes of hepatitis B virus (HBV)detected by the PCR-reverse dot blot and the relation between the HBV variation loci with the liver function indexes and HBV DNA viral loading.Methods The serum samples from 462 patients with chronic hepatitis B treated by oral nucleoside drugs were screened.The PCR-reverse dot blot was adopted to detect the drug-resistance gene mutation loci and genotypes.The correla-tion between the HBV drug-resistance mutant with the genotypes,liver function indexes and HBV DNA viral loads was performed. Results Among 462 patients taking nucleoside drugs for treating chronic hepatitis B,45 drug-resistance mutants were detected with the mutation rate of 9.74%;in which,16 cases (35.5%)were 180M and 204I/V mutant,6 cases(13.3%)were 204V,13 ca-ses(28.9%)were 204I mutant,3 cases (6.7%)were 180V mutant and 3 cases(6.7%)were 236T mutant.The HBV genotyping showed 105 cases of genotype B,337 cases of genotype C,0 case of genotype D and 2 cases of other genotypes.Conclusion (1)The HBVgenotypes in Maoming area may be different from the genotypes in other southern regions and is dominated by HBV-C geno-type.(2)The PCR-reverse dot blot method is a detection method for fastly and accurately finding the drug-resistance loci after nu-cleosides therapy.(3)The clinical analysis demonstrates that the drug-resistance mutation loci has no correlation with the liver func-tion index ALT(P >0.05),but there was certain correlation between the drug-resistance mutation loci in hepatitis B and HBV DNA viral load(P <0.05).
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Objective To investigate the influence of humanistic care on patients in the operation room.Methods 80 cases of surgery patients from November 2010 to October 2011 were given humanistic care,another 80 patients before implementation of humanistic care were chosen,and the satisfaction degree of doctors and patients and recovery of patients before and after the implementation of humanistic care were compared.Results After the implementation of humanistic care,the recovery of patients improved.The total satisfaction degree of patients and doctors reached 93.2％ and 98.1％,significantly higher than those before the impIementation,which were 82.1％ and 90.2％.Conclusions Implementation of humanistic care can improve the psychological and physical state of surgery patients,and help them gain better recovery.