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Objective To study the clinical efficacy of transjugular intrahepatic portosystemic shunt (TIPS) combined with agitation thrombolysis in treatment of acute portal vein thrombosis (PVT) in patients with liver cirrhosis.Methods The clinical data of 37 cirrhotic patients with acute PVT treated from January 2014 to December 2017 at the First Affiliated Hospital of Henan University of Science and Technology was analyzed.There were 20 males and 17 females with age ranging from 29 to 71 years.The patients were divided into the combined group (n =15) and the anticoagulation group (n =22).The combined group was treated with TIPS combined with agitation thrombolysis anticoagulation.The anticoagulation group was treated with anticoagulation.The changes in liver function and hemodynamics of portal vein of the two group were compared.Follow-up studies included postoperative portal vein patency,bleeding and survival rates of patients.Results The postoperative portal vein pressure and maximum burden of PVT in the combined group were significantly lower than those before operation,and the portal vein maximum blood volume and flow velocity of portal vein were significantly higher than those before operation (all P ＜ 0.05).At 2 weeks,6 months and 12 months after operation,the maximum burden of PVT of the combined group was (13.9 ±5.4)％,(16.1 ±5.5)％ and (13.8 ±6.2)％,respectively,which was significantly lower than that of the anticoagulant group (84.1±31.3)％,(85.9±27.6)％ and (88.2±39.5)％ (all P＜0.05).At 2 weeks,6 months and 12 months after operation,the flow velocity of portal vein of the combined group was (21.6 ± 5.7) cm/s,(16.1 ± 6.3) crn/s and (17.6 ± 4.9) cm/s,respectively,which was significantly higher than that of the anticoagulation group (9.7 ± 4.6) cm/s,(8.1 ± 4.3) cm/s and (8.2 ± 3.5) cm/s (all P ＜ 0.05).After operation,3 patients in the combined group developed recurrence of portal vein thrombosis,while the remaining patients had smooth blood flow in the portal vein and shunt.In the anticoagulation group,only 3 patients had unobstructed portal vein blood flow.The cumulative rate of no gastrointes tinal bleeding in the combined group was significantly better than the anticoagulant group.The cumulative survival rate of the combined group was also significantly better than the anticoagulation group (P ＜ 0.05).Conclusion TIPS combined with agitation thrombolysis was more effective than the traditional anticoagulant therapy in treatment of acute portal vein thrombosis in cirrhotic patients.
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Objective@#To investigate and summarize the effect of narrative nursing on anxiety and depression in patients undergoing coronary artery bypass grafting, and to provide reference for the formulation of clinical nursing plan.@*Methods@#A total of 61 patients underwent coronary artery bypass grafting were selected. 31 cases of narrative nursing were taken as the research group, and routine nursing was used in the other 30 cases as control group. Depression and anxiety were assessed by Self-rating Depression Scale (SDS) and Self-rating Anxiety Scale (SAS) before, 7 days after and 14 days after surgery.@*Results@#Totally 61 patients were successfully operated and no case died during hospitalization. There was no significant difference in SAS and SDS scores between the 2 groups before surgery. The SAS scores in the study group were 57.9±4.2, 50.8±4.9, 47.1±5.0 on the day of admission,7 days after operation and 14 days after operation, respectively, while those in the control group were 58.4±3.7, 57.9±5.2, 55.7±6.2. There were significant differences between the two groups after intervention (t=5.490, 5.973, P<0.01). The SAS score of the study group decreased 7 days after operation and 14 days after operation compared with that of the admission day (t= 6.125, 9.209, P < 0.01). The SDS scores in the study group were 54.3±4.6, 49.4±4.7, 42.7±4.8 on the day of admission,7days after operation and 14 days after operation, respectively, while those in the control group were 54.1±5.1, 52.3±5.6, 51.6±5.2. There were significant differences between the two groups after intervention (t=2.194, 6.949, P<0.01). SDS scores in the study group decreased 7 days after operation and 14 days after operation compared with the day of admission in this group, with significant differences (t=4.148, 9.715, P < 0.01).@*Conclusions@#Narrative nursing is helpful to relieve anxiety and depression in patients undergoing coronary artery bypass grafting.
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Objective To investigate the nursing needs of patients with depression before coronary artery bypass surgery(CABG), so as to provide the basis for such patients for psychological nursing. Methods The phenomenological research methods of qualitative research were used. Fourteen patients were interviewed with semi structural interview. Colaizzi analytical method was used to process and analyze the data. Results The nursing needs of patients with depression before CABG included six themes: the needs of security; the needs of love and belonging; self-realization demand; the needs of disease related information; the needs of economic support ;the needs of psychological treatment. With different levels of depression and different features, patients`nursing needs were different. Conclusions The patients with depression before CABG have complicated requirements, the medical workers should transform nursing mode and give specific guidance in order to meet the needs of the patients.
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Objective To evaluate the influence of preoperative quitting time on coronary artery bypass grafting (CABG) patients with postoperative hypoxemia incidence.Methods 151 patients with coronary bypass surgery and preoperative history of smoking who preparation of CABG in hospital were recruited from September 2011 to September 2013.According to the preoperative smoking cessation time patients were divided into five groups:0 days,1-30 days,31-60 days,61-90 days,more than 90 days.Single factor regression and Logistic analysis were used to analyse the influence of preoperative quitting time on CABG patients with postoperative hypoxemia incidence.Results Age,weight,smoking habit,quitting time,hypertension,diabetes mellitus were risk factors of hypoxemia after coronary artery bypass grafting.Logistic regression analysis showed that age,body weight,smoking habit,smoking time were independent risk factors of hypoxemia after coronary artery bypass grafting.The incidences of hypoxemia of the five groups 0 days,1-30 days,31-60 days,61-90 days and more than 90 days were 55.56％ (15/27),59.26％ (16/27),27.58％ (8/29),22.73％ (5/22),15.63％ (5/32).The incidence of hypoxemia had significant difference (x2=19.212,P ＜ 0.05).Conclusions Age,weight,smoking habit,quitting time were independent risk factors of hypoxemia after CABG.With the quitting time increase,hypoxemia after CABG overall downward trend.Difference quitting time before the operation,the hypoxemia occurred difference rate influence,On the preoperative smoking CABG patients were smoking cessation intervention timely helps to reduce the occurrence of postoperative hypoxemia.
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HFE gene is a major histocompatibility complex class I-like gene, which was identified as a candidate gene for hemochromatosis in 1996. The proposed role for HFE is its part in the regulation of the interaction of the transferrin receptor with transferrin. Hemochromatosis, the common autosomal recessive disease of iron overload, affects at least 1 in 300 Caucasians. The identification of the C282Y mutation in the HFE gene has led to population screening studies. Much of this work has also included the analysis of a second mutation, H63D, which appears to have a low penetrability. HFE protein was recently found to coprecipitate with the transferrin receptor and to affect the reaction between transferrin and the transferrin receptor. Functional data suggest that the mutation C282Y abolishes the association of the HFE protein with beta 2-microglobulin (beta 2M), making the complex unable to reach the cell surface. Clearly, if the mutation protein is unable to reach the cell surface, this regulatory feature is missing. The role of a second mutation in the HFE gene, H63D, is less clear. Current data suggest that this mutation protein can associate with beta 2-microglobulin and does reach the cell surface and that the defect lies in a failure to modify the affinity of the transferrin receptor for transferrin. This does not explain the low degree of penetrability associated with this mutation.
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Humans , Gene Frequency , HLA Antigens , Genetics , Hemochromatosis , Genetics , Hemochromatosis Protein , Histocompatibility Antigens Class I , Genetics , Membrane Proteins , MutationABSTRACT
HLA-G is a non-classical major histocompatibility complex class I molecule that differs from the classical HLA I class molecules by (1) a limited polymorphism, (2) a tissue-restricted distribution and (3) a transcription of spliced messenger RNAs encoding for at least four membrane-bound and two soluble HLA-G isoforms. Extensive studies over the past few years have identified HLA-G as a molecule involved in immune tolerance. In this review, attempts were made to summarize the current state of knowledge of the polymorphisms, expression, function, the effects of HLA-G on immuno-associated disease, evolution of HLA-G and its utility in disease therapy.