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Objective: To investigate how plasma exchange (PE) and double plasma molecular adsorption combined with half-volume plasma exchange (DPMAS + half-volume PE) affect the curative effect and short-term survival rate in liver failure. Methods: Data from 181 cases of liver failure caused by different etiologies from January 1, 2017 to September 31, 2020, were selected. Patients were divided into a PE treatment alone group and a DPMAS + half-dose PE treatment group. The laboratory indicators with different models of artificial liver before and after treatment and the survival rates of 7, 14, 28, and 90 days after discharge were observed in the two groups. Measurement data were analyzed by t-tests and rank sum tests. Categorical data were analyzed by χ (2) test. Results: Non-biological artificial liver therapy with different models improved the liver and coagulation function in the two groups of patients with liver failure (P < 0.05 in PTA% intra-group). The coagulation function was significantly improved in the PE treatment alone group compared with that in the DPMAS + half-dose PE group [PT after treatment: (20.15 ± 0.88) s in the PE treatment alone group, (23.43 ± 1.02) s, t = -2.44, P = 0.016 in the DPMAS+half-dose PE group; PTA: 44.72% ± 1.75% in the PE treatment alone group, 35.62% ± 2.25%, t = 3.215 P = 0.002 in the DPMAS + half-dose PE group]. Bilirubin levels were significantly decreased in the DPMAS+half-dose PE group compared to the PE treatment alone group [total bilirubin after treatment: (255.30 ± 15.64) μmol/L in the PE treatment alone group, (205.46 ± 9.03) μmol/L, t = 2.74, P = 0.07 in the DPMAS + half-dose PE group; direct bilirubin after treatment: (114.74 ± 7.11) μmol/L in the PE treatment alone group, (55.33 ± 3.18) μmol/L, t = 7.54, P < 0.001) in the DPMAS + half-dose PE group]. However, there was no significant effect on leukocytes and neutrophils after treatment with different models of artificial liver (P > 0.05) in the two groups, and platelets decreased after treatment, with no statistically significant difference between the groups (t = -0.15, P = 0.882). The inflammatory indexes of the two groups improved after treatment with different models of artificial liver (P < 0.05], and the 28 and 90 d survival rates were higher in the DPMAS+half-dose PE group than those of the PE treatment alone group (28 d: 60.3% vs. 75.0%, χ (2) = 4.315, P = 0.038; 90 d: 56.2% vs. 72.5%. χ (2) = 10.355 P < 0.001). DPMAS + half-dose PE group plasma saving was 1385 ml compared with PE treatment alone group (Z = -7.608, P < 0.05). Conclusion: Both DPMAS+half-dose PE and PE treatment alone have a certain curative effect on patients with liver failure. In DPMAS+half-dose PE, the 28-day survival rate is superior to PE treatment alone, and it saves plasma consumption and minimizes blood use in clinic.
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Relevant research in recent years has demonstrated that the atrial fibrillation occurrence rate is significantly higher in patients with cirrhosis. The most common indication for long-term anticoagulant therapy is chronic atrial fibrillation. The use of anticoagulant therapy greatly reduces the incidence rate of ischemic stroke. Patients with cirrhosis combined with atrial fibrillation have an elevated risk of bleeding and embolism during anticoagulant therapy due to cirrhotic coagulopathy. At the same time, the liver of such patients will go through varying levels of metabolism and elimination while consuming currently approved anticoagulant drugs, thereby increasing the complexity of anticoagulant therapy. This article summarizes the clinical studies on the risks and benefits of anticoagulant therapy in order to provide a reference for patients with cirrhosis combined with atrial fibrillation.
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Humans , Atrial Fibrillation/epidemiology , Stroke/epidemiology , Anticoagulants/therapeutic use , Hemorrhage , Liver Cirrhosis/drug therapy , Risk FactorsABSTRACT
Objective@#To evaluate the diagnostic value of 18F-fluorodeoxyglucose (FDG) PET/CT imaging in non-traumatic unilateral vocal cord paralysis (UVCP) and compare the radioactive uptake in different lesions.@*Methods@#Clinical data of 62 patients (49 males, 13 females; age: (61.7±12.8) years) with non-traumatic UVCP (43 cases of left vocal cord paralysis and 19 cases of right) admitted to Ji′an Hospital from January 2016 to December 2018 were analyzed retrospectively. Pathological results, imaging or follow-up results were considered as the standard of final diagnosis. The diagnostic efficacy of PET/CT imaging for the primary cause was analyzed. The maximum standardized uptake values (SUVmax) of vocal cord in patients with different etiology were compared by independent-sample t test.@*Results@#According to the final diagnosis, the primary causes of UVCP were as follows: malignant tumors (n=44), inflammation (n=16), glomus jugulare tumor (n=1) and idiopathic UVCP (n=1). The diagnostic accuracy of PET/CT imaging for the primary cause was 90.32%(56/62): 44 cases were correctly diagnosed as malignant tumors, while 11 cases as inflammation, and 1 case as glomus jugulare tumor. Among 62 patients, 29 patients had increased SUVmax in the affected side (direct invasion group; further divided into tumor group (n=12) and non-tumor group (n=17)), and other 33 patients had increased SUVmax in the healthy side (indirect invasion group). SUVmax of the affected vocal cord in direct invasion group was higher than that in the healthy side (9.97±5.21 vs 2.43±0.62; t=8.14, P<0.01). The differences between affected side and healthy side in the tumor group (14.92±3.91 vs 2.84±0.54) and the non-tumor group (6.48±2.48 vs 2.14±0.50) were statistically significant (t values: 9.94, 7.93, both P<0.01). In the indirect invasion group, SUVmax in the affected side of vocal cord was significantly lower than the healthy side (1.89±0.35 vs 6.97±2.63; t=11.44, P<0.01). There were significant differences in radioactive uptake between affected side of direct invasion group and healthy side of indirect invasion group (t=2.86, P<0.01), affected sides of tumor group and non-tumor group (t=7.46, P<0.01), affected side of tumor group and healthy side of indirect invasion group (t=6.07, P<0.01). But the radioactive uptake difference between affected side of non-tumor group and healthy side of indirect invasion group was not statistically significant (t=0.51, P>0.05).@*Conclusions@#18F-FDG PET/CT imaging has high diagnostic value in pathogenic diagnosis of non-traumatic UVCP. The different radioactive uptake of vocal cords in the affected side and the healthy side provides more accurate etiological information for clinical analysis.
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Objective To evaluate the diagnostic value of 18F-fluorodeoxyglucose (FDG) PET/CT imaging in non-traumatic unilateral vocal cord paralysis (UVCP) and compare the radioactive uptake in different lesions.Methods Clinical data of 62 patients (49 males,13 females;age:(61.7±12.8) years)with non-traumatic UVCP (43 cases of left vocal cord paralysis and 19 cases of right) admitted to Ji'an Hospital from January 2016 to December 2018 were analyzed retrospectively.Pathological results,imaging or follow-up results were considered as the standard of final diagnosis.The diagnostic efficacy of PET/CT imaging for the primary cause was analyzed.The maximum standardized uptake values (SUVmax) of vocal cord in patients with different etiology were compared by independent-sample t test.Results According to the final diagnosis,the primary causes of UVCP were as follows:malignant tumors (n=44),inflammation (n=16),glomus jugulare tumor (n =1) and idiopathic UVCP (n =1).The diagnostic accuracy of PET/CT imaging for the primary cause was 90.32％ (56/62):44 cases were correctly diagnosed as malignant tumors,while 11 cases as inflammation,and 1 case as glomus jugulare tumor.Among 62 patients,29 patients had increased SUVmax in the affected side (direct invasion group;further divided into tumor group (n =12) and non-tumor group (n =17)),and other 33 patients had increased SUVmax in the healthy side (indirect invasion group).SUVmax of the affected vocal cord in direct invasion group was higher than that in the healthy side (9.97±5.21 vs 2.43±0.62;t=8.14,P＜0.01).The differences between affected side and healthy side in the tumor group (14.92±3.91 vs 2.84±0.54) and the non-tumor group (6.48±2.48 vs 2.14±0.50) were statistically significant (t values:9.94,7.93,both P＜0.01).In the indirect invasion group,SUVmax in the affected side of vocal cord was significantly lower than the healthy side (1.89±0.35 vs 6.97±2.63;t =11.44,P＜0.01).There were significant differences in radioactive uptake between affected side of direct invasion group and healthy side of indirect invasion group (t =2.86,P＜0.01),affected sides of tumor group and non-tumor group (t=7.46,P＜0.01),affected side of tumor group and healthy side of indirect invasion group (t=6.07,P＜0.01).But the radioactive uptake difference between affected side of non-tumor group and healthy side of indirect invasion group was not statistically significant (t =0.51,P＞0.05).Conclusions 18F-FDG PET/CT imaging has high diagnostic value in pathogenic diagnosis of non-traumatic UVCP.The different radioactive uptake of vocal cords in the affected side and the healthy side provides more accurate etiological information for clinical analysis.
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Objective: To forecast the visceral leishmaniasis cases using autoregress integrated moving average (ARIMA) and hybrid ARIMA-EGARCH model, which offers a scientific basis to control visceral leishmaniasis spread in Kashgar Prefecture of Xinjiang, China. Methods: The data used in this paper are monthly visceral leishmaniasis cases in the Kashgar Prefecture of Xinjiang from 2004 to 2016. The sample data between 2004 and 2015 were used for the estimation to choose the best model and the sample data in 2016 were used for the forecast. Time series of visceral leishmaniasis started on 1 January 2004 and ended on 31 December 2016, consisting of 1 790 observations reported in Kashgar Prefecture. Results: For Xinjiang, the total number of reported cases were 2 187, the male-to-female ratio of cases was 1:1.42. Patients aged between 0 and 10 years accounted for 82.72% of all reported cases and the largest percentage of visceral leishmaniasis cases was detected among scattered children who accounted for 68.82%. The monthly incidences fitted by ARIMA (2, 1, 2) (1, 1, 1)
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To determine appropriate surgical methods and flaps to apply plastic surgery of facial defects. Several plastic methods were introduced progressively to eight cases. From simple to complex, we discussed the direct suture, relaxation suture, Z-flap, flap-footed, combined or multiple flaps, and free flap method to decrease the tension in wounds. The skin and flaps were successful in all eight cases and healed the wounds. It is important to choose appropriate surgical techniques and flaps to repair facial injuries.
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Humans , Face , General Surgery , Facial Injuries , General Surgery , Free Tissue Flaps , Plastic Surgery Procedures , Skin , Wound HealingABSTRACT
Objective To investigate compliance of breast cancer patients with postoperative peripherally inserted central catheter (PICC) in terms of upper limb motion, to formulate practical plan of upper limb motion, and to improve the compliance in the patients with PICC catheter.Methods A total of 75 patients after breast cancer operation with PICC for chemotherapy were selected from Department of Thyroid and Breast Surgery for upper limb activity instructions.Plan-Do-Check-Act method was used to evaluate the feasibility and effectiveness.Two cycles were performed in two weeks.Patients' compliance was assessed by the inquiry method.Results After practicing and refining nursing process, perfecting the risk assessment table, adjusting the education time, etc., the cognition and acceptance of the significance of upper limb motion were improved in the patients.The compliance of the patients to the upper limb motion instructions was satisfactory.Conclusions The upper limb motion scheme in this study was modified and perfected through application, research, and practice.This scheme could enhance the compliance of patients in terms of upper limb motion.
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Malignant lymphoma of the maxillary sinus is very rare. A case of diffuse large B-cell lymphoma (DLBCL) of the left maxillary sinus is presented here. A 59-year-old man came to our hospital complaining of swelling under the left lower eyelid without any other symptoms. Imaging examination including CT and MRI detected a tumor in the left maxillary sinus. The tumor was invasive into left orbit. The biopsy revealed a diffuse large B-cell lymphoma. The tumor cells were positive to CD20, CD79a, CD45. In conclusion, a very rare case of DLBCL of the maxillary sinus was reported.
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Humans , Male , Middle Aged , Lymphoma, Large B-Cell, Diffuse , Maxillary Sinus , Paranasal Sinus NeoplasmsABSTRACT
Objective To analyze the results in neonatal hearing screening,and then to make diagnosis and intervention for neonates with hearing problems as soon as possible.Methods From January 2004 to December 2008,7 064 newborns at Shanghai East Hospital received hearing screening by distortion product oto-acoustic emissions (DPOAE) 2～4 days after birth.Re-screening tests were performed for infants who failed the initial screening 42 days after birth.Those newborns who failed again received further audiologic diagnostic evaluations 3 months afterwards.Results Among 7 064 cases screened,out of 6 412 normal newborns,579 (9.03%)failed the initial screening,and 38 (7.41%)failed re-screening.129 cases of the other 652 (19.79%) newborns in NICU failed the initial screening,and 20 cases (18.69%) failed re-screening.There were statistical differences between the passing rates of the two groups (P