Effect of artificial liver support therapy on the short-term prognosis of patients with liver failure in the plateau stage: A stratified analysis based on Model for End-Stage Liver Disease score / 临床肝胆病杂志

ObjectiveTo investigate the effect of artificial liver support therapy on the short-term (28- and 90-day) mortality rate of patients with liver failure in the plateau stage through a stratified analysis based on Model for End-Stage Liver Disease (MELD) score. MethodsA retrospective analysis was performed for 187 patients with liver failure who were admitted to Nanfang Hospital, Southern Medical University, from January 2015 to April 2019, with 73 patients in the artificial liver group and 114 in the non-artificial liver group. The stratified analysis based on MELD score in the plateau stage was performed to investigate the differences in 28- and 90-day mortality rates, hospital costs and length of hospital stay of surviving patients, and incidence rate of adverse reactions of artificial liver support therapy between the two groups. The t-test was used for comparison of continuous data between the two groups, and the chi-square test or the Fisher’s exact test was used for comparison of categorical data between the two groups. ResultsCompared with the non-artificial liver group, the artificial liver group had a significant reduction in the 28-day mortality rate of the patients with an MELD score of 30-39 (5.9% vs 39.6%, P＜0.001) or those with an MELD score of 40 (25.0% vs 72.7%, P＜0.05). Compared with the non-artificial liver group, the artificial liver group had a significant reduction in the 90-day mortality rate of the patients with an MELD score of 30-39 (23.5% vs 623%, P＜0.001). Artificial liver support therapy did not significantly shorten the mean hospital stay of the surviving patients (P＞0.05) and had no significant influence on the total hospital costs of the surviving patients within 90 days (P＞0.05). The incidence rate of adverse reactions related to artificial liver support therapy was 29.1%, but the symptoms were mild and were relieved after symptomatic treatment. ConclusionPatients with an MELD score of ＜30 in the plateau stage tend to have low 28- and 90-day mortality rates, and artificial liver support therapy can be reasonably selected according to the patient’s economic conditions and willingness. Artificial liver support therapy is recommended for patients with an MELD score of 30-39 in the plateau stage if there is no obvious contraindication. For patients with an MELD score of 40 in the plateau stage, artificial liver support therapy is recommended within 28 days if there is no obvious contraindication, and liver transplantation is recommended as soon as possible. Artificial liver support therapy has no significant influence on the total hospital costs and mean hospital stay of the surviving patients within 90 days and does not increase the economic burden of patients.

CT-guided iodine-125 implantation in the treatment of malignant tumor / 中国组织工程研究

BACKGROUND: As a new radiotherapy for malignant tumor, brachytherapy of radioactive seed implantation enables the inter-tissue implantation of radioactive seeds to be applied further with the appearance of seed implantation treatment planning system (TPS), and the gradual consummation of ultrasound and CT-guided precise positioning system.OBJECTIVE: To evaluate the methods, feasibility, safety and efficacy of CT-guided iodine-125 (125I) implantation for malignant tumors.DESIGN: A controlled observation before and after implantation.SETTING: The First People's Hospital of Hefei City.PARTICIPANTS: Twenty-one patients with malignant tumors, who were not suitable for surgical treatments of operation,were selected from the First People's Hospital of Hefei City from January 2004 to March 2005. There were 26 lesions, including 9 lesions of primary unresectable carcinoma and 17 lesions of metastasis tumors.METHODS: Under CT guidance, 125I seeds were implanted into malignant tumor according to TPS, the radioactivity quantum were 22, 26, 30 and 33 MBq per granule. Larger radiation 125I wes suitable for the implantation in the center of a lesion and smaller ones were for the margin of the lesion and the peripheral region of some important organisms such as vessels and nerves. The interval between larger seeds was about 1.5 cm whereas the interval between smaller ones was about 1.0 cm.MAIN OUTCOME MEASURES: The seed distribution, existence of complication and changes of the size of lesion after implantation were observed.RESULTS: ① The seeds were implanted successfully in all the 21 cases. No complication was observed. The practical distribution of the implanted seeds was basically the same as the scheduled scheme before implantation. All the 21 patients were involved in the analysis of results. ② The number of seeds implanted in one lesion was 5 to 40 (mean 14).Pain relief was obtained in all 10 cases of malignant tumors of bone after implantation. Follow-up CT reexamination demonstrated that 18 lesions were obviously diminished, necrosis was found in 4 lesions and remaining 4 lesions had no significant changes in size. ③ The average sizes of 14 lesions in 11 patients at 5-7 months after implantation were obviously smaller than those before implantation (1.84 cm vs 3.41 cm, t =5.7237, P ＜ 0.001). The average sizes of 12 lesions in 10 patients at 8-10 months after implantation were also obviously smaller than those before implantation (1.96 cm vs 3.43 cm, t =5.577 8, P ＜ 0.002).CONCLUSION: CT-guided 125I implantation is a safe, effective and feasible method for the treatment of malignant tumor.

Application of PBL method in the teaching of pedodontics / 中华医学教育探索杂志

Objective To utilize the PBL method for the teaching reform of pedodontics lesson in Zhengzhou University. Methods Dental students of 2004 grade of Zhengzhou University were divided into 2 groups randomly,one group of which were taught with PBL method while the other group with traditional teaching method. The teaching effect was measured with questionnaire survey and examination. Result The PBL method was welcomed by undergraduate students and there was statistical significant difference between the examination scores of the two groups (P

Design and Implementation of Mobile Nursing Station / 医疗卫生装备

Objective To solve the problem that traditional electronic medical records(EMR) system could not be extended to patients' bedside because of the wired network connection restrictions.Methods Based on wireless transmission and data synchronization technologies in PDA,a mobile nursing station was developed.Results Such functions were realized as patient identity verification,implementation of doctor's orders and vital signs collection beside patients' bed.Conclusion Technical support is provided for closing EMR information chain and improving medical quality.[Chinese Medical Equipment Journal,2008,29(2):53-54]

Construction of friendly outpatient service with information technology / 医疗卫生装备

Because the medical treatment mode is being transformed into 'patients as orientation',our hospital introduces queuing system,transformsand redesigns programs of registration system,outpatient doctor workstation system,outpatient charge system and outpatient dosage system.By using liquid crystal display and automatic phonetic call,the outpatient procedure is optimized with a friendly service environment so as to improve the work efficiency and enhance the overall administration and service quality.