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Objective To investigate the CT characteristics of hepatitis B cirrhosis, and to predict the risk of bleeding by establishing a predictive model for upper gastrointestinal bleeding in liver cirrhosis. Methods A retrospective analysis was performed for the clinical data of 101 patients with hepatitis B cirrhosis who were admitted to Tianjin First Central Hospital from January 2015 to June 2021, and these patients were divided into upper gastrointestinal bleeding group and non- bleeding group. The two groups were compared in terms of laboratory findings and CT values in plain scan, arterial phase, portal vein phase, and venous phase measured by contrast-enhanced CT, and the changes in CT values (ΔCT) across different phases were calculated. The t -test or the Mann-Whitney U rank sum test was used for comparison of continuous data between two groups, and the chi-square test was used for comparison of categorical data between two groups. Logistic regression analysis was used to predict the related risk factors; The discrimination of the model was evaluated by calculating the area under the working characteristic curve of the subjects, and the model calibration criteria were determined by Hosmer-lemeshow. Based on the results of multivariate logistic regression analysis, Rstudio4.1.2 R package was used to establish a predictive model, and draws the corresponding ROC curve, calibration curve and clinical decision curve. Results There were significant differences in serum TBil, WBC and PLT levels between the non-bleeding group and the bleeding group (all P < 0.05). There were significant differences in liver-plain, spleen-P-plain and spleen-P-A ΔCT(all P < 0.05). The univariate logistic analysis showed that there were significant differences in leukocytes (odds ratio [ OR ]=0.770, 95% confidence interval [ CI ]: 0.624-0.952, P =0.016), platelets ( OR =0.979, 95% CI : 0.965-0.994, P =0.006), liver plain scan ( OR =1.142, 95% CI : 1.058-1.233, P =0.001), ΔCT value of the spleen from portal vein phase to plain scan ( OR =0.979, 95% CI : 0.959-1.000, P =0.050), and ΔCT value of the spleen from portal vein phase to arterial phase ( OR =0.979, 95% CI : 0.944-0.994, P =0.015) between the hepatitis B cirrhosis patients with upper gastrointestinal bleeding and those without bleeding. The multivariate logistic analysis showed that platelets ( OR =0.968, 95% CI : 0.944-0.993, P =0.011), liver plain phase ( OR =1.148, 95% CI : 1.047-1.259, P =0.003), and ΔCT value of the spleen from portal vein phase to arterial phase ( OR =0.951, 95% CI : 0.908-0.995, P =0.030) were independent risk factors for upper gastrointestinal bleeding. A predictive model for upper gastrointestinal bleeding in hepatitis B cirrhosis was established based on the results of the multivariate logistic analysis, and a calibration curve was plotted. This model had an area under the receiver operating characteristic curve of 0.801 at the cut-off value of 0.433, with a sensitivity of 81.4% and a specificity of 77.6%. The calibration curve of the model fitted well with the ideal curve. Conclusion There are special ΔCT changes in hepatitis B cirrhosis, and the predictive model based on ΔCT has a good predictive ability for upper gastrointestinal bleeding in patients with hepatitis B cirrhosis.
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OBJECTIVE:To establish a method for the determination of related substances in Cabazitaxel injection. METHODS:HPLC method was used. The determination was performed on Agilent Eclipse XDB-C18column with mobile phase consisted of water-acetonitrile-ethanol(gradient elution)at the flow rate of 1.0 mL/min. The column temperature was 35 ℃,and the detection wavelength was set at 230 nm. The sample size was 20 μ L. Established method was used to determine related substances in 3 batches of Cabazitaxel injection. RESULTS:The linear relationship of cabazitaxel were 0.039-11.60 μ g/mL(r=0.999 8,n=7). The detection limit was 2×10-4μg,and quantitation limit was 8×10-4μg. RSD of precision and reproducibility tests were all lower than 10.0%(n=6). The amount of single impurity in 3 batches of samples ranged 0.07%-0.08%,and total amount of impurities were 0.26%-0.29%. CONCLUSIONS:Established method is simple,accurate and reliable,can be used for the determination of related substances in Cabazitaxel injection.
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Objective To evaluate the efficacy and safety of endoscopic submucosal excavation (ESE) and submucosal tunneling endoscopic resection (STER) for gastroesophageal junction (GEJ)submucosal tumors (SMTs) originating from the muscularis propria(MP) layer.Methods Clinical data of sixty-one patients with GEJ SMTs originating from the MP layer who were treated with ESE(ESE group,n=39) or STER(STER group,n=22) between January 2013 and December 2015 in Changhai Hospital were retrospectively analyzed.Outcomes and complications in the two groups were compared.Results Single lesion in 61 patients were all resected by therapeutic endoscopy successfully.Operation time in the STER group was shorter than that of the ESE group(47.27±20.89 min VS 66.56±40.07 min,P＜0.05).There was no significant difference in number of hemostatic clips between the two groups[7.10±5.57 VS 8.00± 1.88,P＞0.05].Hospitalization time of STER group was shorter than that of the ESE group [3.0(1.25) d VS 4.0 (1.00) d,P＜0.05].One patient developed delayed hemorrhage in ESE group,while no other complications occurred in either group.The wound healed in both groups under gastroscopy,and no residual or recurrent tumors were detected during the follow-up period.Conclusion Both STER and ESE can be used for GEJ SMTs originating from the MP layer,but STER is more safe and efficient.
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Objective To explore the characteristics and laws of burned children,and to find the coping strategies on preventing and reducing the incidence of pediatric burns.Methods The age distribution,burn causes, degree of burn,easy -happening months and on -site treatment of 978 children under 12 years old were retrospective-ly analyzed.Results 978 pediatric burns patients made up 55.4% of all burned patients among which there were 601 male patients and 377 female patients.Most of them were 1 -3 years old.The main reason of burn was hot liquid. Most of them were minor and moderate burned.The easy -happing months were from May to September.Only 11.0%of these children were correctly treated.Most burn children were from countryside.Conclusion The main reasons of children being burned are poor management of hot liquid,carelessness and the indifference of safety consciousness. The cases of burned children are regular.It is important to strengthen the publicity and education of precaution and the consciousness of safety protection of custodian.The publicity of knowledge about burning safety and correct on -site treatment are important for prevention and cure of burned children.
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Objective To evaluate the necessity and feasibility of low-dose dual-source CT coronary angiography imaging in the evaluation of high body mass index (BMI) patients. Methods Sixty patients with BMI≥28 kg/m2 and heart rate 65-90 beats/min were selected, and they were divided into prospective electrocardiography gated scanning group and retrospective electrocardiography gated scanning group by random digits table method with 30 cases each. The image quality, CT dose weighing index (CTDI) and dose length product (DLP) were compared between 2 groups. Results There was no statistical difference in the score of coronary image quality between retrospective electrocardiography gated scanning group and prospective electrocardiography gated scanning group:(3.47±0.61) scores vs. (3.18±0.94) scores, P>0.05. The CTDI and DLP in prospective electrocardiography gated scanning were significantly lower than those that in retrospective electrocardiography gated scanning: (32.44 ±10.18) mGy vs. (45.86 ±15.34) mGy and (458.00±95.27) mGy/cm vs. (532.15±154.43) mGy/cm, and there were statistical differences (P<0.05). Conclusion For high BMI patients, different low-dose dual-source CT scanning, especially prospective electrocardiography gated scanning, can guarantee image quality and reduce the radiation dose and the radiation damage at the same time.
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〔Abstract〕 In the paper , a case study of Tongji Hospital of Tongji University is conducted and the construction method and the imple -mentation plan for the wireless network based on 802.11 ac standard are introduced .The implementation effect of WLAN based on 802.11 ac standard is summarized and analyzed .By comparing the old and the new standard , the construction plan and the future development of WLAN in hospitals are discussed .
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Objective To investigate the prevalence of nutritional risk and malnutrition,and the application of nutrition support in hospitalized patients with surgically treated gynecologic malignant tumors.Methods 237 hospitalized patients with malignant tumors receiving surgery in Department of Gynecology of Beijing Hospital from January 1 to December 31,2013 were continuously sampled.Nutritional Risk Screening 2002 (NRS 2002) was performed in the morning the day after admission.NRS 2002 score ≥ 3 was considered indicating nutritional risk.Malnutrition was judged in accordance with NRS 2002.The application of postoperative nutrition support was recorded.Results The nutritional risk screening was applicable in all the patients (100％).The prevalence of malnutrition was 5.1％ (12/237) in the whole study population,9.2％ in the elderly (≥65 years),significantly higher than that in the patients ＜ 65 years (2.7％) (P =0.034).The nutritional risk rate was 21.1％ (50/237),which was 29.9％ in the patients ≥ 65 years and significantly lower in the patients ＜ 65 years (16.0％) (P =0.014).The nutritional risk rate in the patients with ovarian and endometrial cancers was higher the rate in those patients with vaginal and vulvar cancer was lower.47 patients (19.8％)received postoperative nutrition support,all being parenteral nutrition,including total parenteral nutrition in 13 patients (5.5％) and single transfusion (providing two or more than two amongs glucose,fat emulsion,andi amino acids) in 34 (14.3％).Tube feeding was not applied in all the patients.33 cases (66％) in the 50 patients with nutritional risk were supported by parenteral nutrition,while 14 cases (7.5％) in the 187 patients without nutritional risk were supported by parenteral nutrition.Conclusions There is nutritional risk in the patients with gynecology malignant tumors,the rate of which is higher in elderly patents (≥ 65 years) than in the patients of other age groups.Therefore,attention must be paid to ensure adequate postoperative nutrition support in the elderly patients.
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Objective To study the value of dual energy cerebral arteries computed tomographic angiography (CTA) in diagnosis of cerebral aneurysm.Methods As a gold standard of digital subtraction angiography (DSA) findings,the dual energy cerebral arteries CTA imaging features of 30 cases confirmed by DSA for cerebral aneurysm were retrospectively analyzed.The diagnosis accuracy of cerebral aneurysm between dual energy cerebral arteries and DSA was compared.Results Dual energy cerebral arteries CTA could display the direct signs of cerebral aneurysms,it played better in the signs of aneurysm of the siphon segment of internal carotid artery than that by conventional cerebral arteries CTA.The measurement of the size and neck by dual energy cerebral arteries CTA had good agreement to DSA,there was no statistical difference (P ＞ 0.05).The radiation dose of dual energy cerebral arteries CTA was 19.1-25.4(21.7 ± 0.5)mSv.Conclusion The dual energy cerebral arteries CTA can show the size and neck of cerebral aneurysm clearly,has high value in clinical application of the diagnosis of cerebral aneurysm.
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Objective To compare the clinical efficacy of three different methods in treatment of tuberculous pleural effusion.Methods 108 patients with tuberculous pleural effusion were divided into three groups by randomized single blind methods,and each group had 36 cases.Group A was given Chinese medicine formulations and central venous catheter pleural drainage for injection,group B was given minimally invasive thoracic closed drainage,while group C was given conventional pleural puncture.The clinical efficacy,complications and hospitalization corresponding cost were compared in three groups.Results The clinical effective rates of the three groups were 97.2％,83.3％,61.1％ (x2 =12.90,14.17,15.28,all P ＜ 0.05).In group A,the tuberculous pleural effusion disappearedfastest,hospitalization corresponding cost was lowest and less complications,followed by group B,and group C was the worst,there were statistically significant differences (all P ＜ 0.05).Conclusion Chinese medicine formulations combined with central venous catheter drainage in the treatment of tuberculous pleural effusion has good clinical effecacy,and it is an effective treatment method,which is worth to be further promoted in clinical.
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Objective To evaluate the efficacy and safety of cutting ballon angioplasty (CBA) in small vessel diffuse lesion Methods 44 patients with 48 lesions underwent successful coronary angioplasty with cutting ballon angioplasty Results All of the lesions were treated successfully by 4 6?2 4 times dilation of cutting ballon The total duration of ballon inflation was (227 4?102 3) s The lesions were dilated at a pressure up to (901 8?222 9) kPa The severity of vascular stenosis lessened obviously [(88 6?7 9)% vs (16 8?15 4)%, P =0 001] without severe complications Conclusion Cutting ballon angioplasty (CBA) on small vessel diffuse lesion is safty and effective
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Objective To analyze the double contrast(DC) imaging of anterior gastric wall cancer,in order to raise the knowledge of the imaging feature.Methods DC examination was confirmed by clinical data check and pathology before the operation in 35 cases of anterior gastric wall cancer.Results Occurence rates of hanging droplets,white foggy phonomen,overhanging white line and linear signs were 78%,94%,66% and 88%,respectively.Multiple mural lines would appear if the stomach greater or lesser curvature was involved with cancer.When one or two signs of them was defined,it has important significance to diagnose.Conclusions DC imaging has characteristic manifestation in diagnosis of the anterior gastric wall cancer.In combination of cautiously observation,fully recognization on all sings,changes of peripheral tissues structure imaging in cancer lesion situs and along with comprehensive clinical analysis could raise the accuracy in diagnosis of the anterior gastric wall cancer,before the stomach cancer operation.