Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 3 de 3
Filter
Add filters








Language
Year range
1.
Chinese Journal of Trauma ; (12): 646-652, 2021.
Article in Chinese | WPRIM | ID: wpr-909916

ABSTRACT

Objective:To investigate the related factors that affect the timing and prognosis of early tracheostomy in patients with multiple rib fractures.Methods:A retrospective case series study was conducted on medical data of 222 patients with multiple rib fractures who underwent tracheostomy in Affiliated Hospital of Yangzhou University from February 2013 to October 2019,including 160 males and 66 females,with the age of 18 to 85 years [(49.5 ± 16.3)years]. According to the practice management guidelines for tracheostomy timing and the use of propensity score matching technology,there were 118 patients with tracheostomy within 7 days of tracheal intubation (early group) and 104 patients with tracheostomy after 7 days of tracheal intubation (late group) before matching,and there were 87 patients in early group and 87 patients in late group after matching. Data were compared between groups including the gender,age,underlying disease,injury severity score (ISS),Glasgow coma score (GCS),number of fractured ribs,total number of rib fractures (NTRF),first rib fracture,flail chest,traumatic brain injury,combined injuries (spine,maxillofacial,sternum),acute respiratory distress syndrome (ARDS),volume fraction of pulmonary contusion(VPC),blood lactic acid (within 24 hours of admission),hemothorax,pneumothorax,mechanical ventilation time,duration of tracheostomy,time from tracheal intubation to incision,length of hospital stay,length of stay in ICU,closed thoracic drainage,number of fiberoptic bronchoscopy,multi-drug resistant bacteria infection,ventilator-associated pneumonia,antibiotic use time,duration of sedative and analgesic drugs used and 28-day mortality. The multivariate Logistic regression analysis was used to predict independent risk factors for early tracheostomy. The Pearson method was used to compare the relationship between multiple factors. The receiver operating characteristic (ROC) curve was used to predict indicators that affect the prognosis of patients with early tracheostomy,and calculate the best cut-off value. The Kaplan-Meier single factor and COX multivariate survival were used to analyze the relevant factors affecting the 28-day mortality of patients.Results:(1) In early group,the NTRF,ARDS and VPC were higher than those in late group,and the time from tracheal intubation to incision and 28-day mortality rate were lower than those in late group ( P < 0.05),while the two groups showed no significant differences in the gender,age,underlying diseases and ISS ( P > 0.05). (2) The multivariate Logistic regression analysis showed that there was statistical significance in NTRF ( OR = 1.775,95% CI 1.439-2.188),ARDS( OR = 3.740,95% CI 1.441-9.711),VPC ( OR = 1.087,95% CI 1.052-1.124) ( P < 0.05); the Pearson method analysis showed a significant correlation between VPC and NTRF ( r = 0.369, P < 0.05) and a low degree of correlation between ARDS and VPC ( r = 0.179, P < 0.05),but there was no significant correlation between ARDS and NTRF ( r = 0.132, P > 0.05). (3) The ROC curve analysis showed that the area under the curve (AUC) of the VPC and NTRF [AUC = 0.832 (95% CI 0.770-0.893),AUC = 0.804 (95% CI 0.740-0.868)] were significantly higher than those of the number of rib fractures [AUC = 0.437(95% CI 0.352-0.523),GCS [AUC = 0.519 (95% CI 0.432-0.605)] and ISS [AUC = 0.484 (95% CI 0.398-0.571)] ( P < 0.05). After calculating the Yorden index,the best cut-off value for VPC was 23.9,and the best cut-off value for NTRF was 8.5. (4) The Kaplan-Meier single factor and multivariate COX model survival analysis showed that the 28-day survival ratio of patients with early tracheostomy was significantly better than that of late tracheostomy ( P < 0.05). Conclusions:The NTRF,ADRS and VPC are independent risk factors for the timing and prognosis of early tracheostomy. There is a significant correlation between VPC and NTRF. The VPC ≥ 23.9% and or NTRF ≥ 8.5 can be used to predict early tracheostomy in patients with multiple rib fractures. Early tracheostomy may benefit the 28-day survival of patients with multiple rib fractures.

2.
Chinese Journal of Medical Genetics ; (6): 468-471, 2019.
Article in Chinese | WPRIM | ID: wpr-771988

ABSTRACT

OBJECTIVE@#To explore the genetic basis of a child affected with refractory leukocytopenia and thrombocytopenia.@*METHODS@#Clinical manifestation and auxiliary examination of the child were discussed. Whole exome next generation sequencing (NGS) and multiplex ligation-dependent probe amplification (MLPA) were used to detected potential mutations of the FANCA gene.@*RESULTS@#Repeated blood tests indicated that the child had abnormal WBC count at (2.7-3.98)×10


Subject(s)
Child , Female , Humans , Exons , Fanconi Anemia Complementation Group A Protein , Genetics , Heterozygote , Leukopenia , Genetics , Mutation , Thrombocytopenia , Genetics
3.
Chinese Journal of Virology ; (6): 632-637, 2013.
Article in Chinese | WPRIM | ID: wpr-356655

ABSTRACT

Bats are considered as important animal reservoirs for many pathogenic viruses to humans. The viral metagenomic analysis was performed to study gut and lung tissues of 30 insectivorous bats collected in Yunnan Province and 26 reads were noted to group A rotavirus (RVA). Further RT-PCR screening on bat samples and in vitro viral isolation on cell cultures confirmed the presence of a novel RVA, named as RVA/Bat-tc/MYAS33/2013/G3P[10], in one of 30 Stoliczka's trident bats. The VP7 gene of this strain MYAS33 was closely related to that of an equine RVA strain from Argentina and the nucleotide sequence similarity was 93%, while its VP4 gene was a rare P[10] type and obtained the maximum sequence identity (94.8%) with that of a human strain from Thailand. The present study highlights the potential role of bats as reservoirs for RVAs.


Subject(s)
Animals , Humans , China , Chiroptera , Virology , Molecular Sequence Data , Phylogeny , Rotavirus , Classification , Genetics , Rotavirus Infections , Virology , Viral Proteins , Genetics
SELECTION OF CITATIONS
SEARCH DETAIL