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Objective To evaluate the effect of body mass index (BMI) on early prognosis of the recipients after lung transplantation. Methods Clinical data of 307 lung transplant recipients were retrospectively analyzed. According to preoperative BMI, all recipients were divided into the low (BMI <18.5 kg/m2, n=114), normal (18.5 kg/m2≤BMI <24 kg/m2, n=145) and high (BMI≥24.0 kg/m2, n=48) BMI groups, respectively. Baseline data including age, sex, blood type, BMI, preoperative complications, preoperative pulmonary hypertension, and intraoperative use of extracorporeal membrane oxygenation (ECMO) of all recipients were compared among three groups. The survival rate of all recipients was estimated by Kaplan-Meier curve and the survival curve was delineated. The differences of survival rate were analyzed by log-rank test. The 30-, 90- and 180-d mortality risk of all recipients after lung transplantation in different BMI groups was compared by multivariate Cox regression analysis. Results There were significant differences in age and sex of recipients among three groups (both P<0.05). There was a significant difference regarding the 180-d survival rate after lung transplantation among different BMI groups (P<0.05). Multivariate Cox regression analysis showed that the 90-d mortality risk after lung transplantation in the high BMI group was 2.295 times higher than that in the normal BMI group [hazard ratio (HR) 2.295, 95% confidence interval (CI) 1.064-4.947, P=0.034]. In the high BMI group, the 180-d mortality risk after lung transplantation was 2.783 times higher compared with that in the normal BMI group (HR 2.783, 95%CI 1.333-5.810, P=0.006), and the 180-d mortality risk in the low BMI group was 2.181 times higher than that in the normal BMI group (HR 2.181, 95%CI 1.124-4.232, P=0.021). Conclusions Compared with the recipients with normal BMI, their counterparts with high and low preoperative BMI have higher mortality risk early after lung transplantation. Adjusting preoperative BMI to normal range contributes to improving early prognosis of lung transplant recipients.
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Objective Psychological intervention combined with carboprost ammonia butyl alcohol three for pregnancy clinical effect in the treatment of postpartum hemorrhage and its impact on quality of life. Methods According to the different nursing methods from January 2015 to December2016 in our hospital with high risk of postpartum hemorrhage patients were divided into 50 groups: control group with routine nursing care plus carboprost ammonia butyl alcohol three treatment, the observation group with psychological intervention plus carboprost ammonia butyl alcohol three treatment; comprehensive observation of the two groups of 2h and 24h in patients with postpartum hemorrhage, bleeding time, quality of life and other aspects, and the related data were analyzed. Results The psychological intervention plus carboprost ammonia Butyl alcohol three (observation group) carboprost ammonia butyl alcohol three with better effect than the treatment of postpartum hemorrhage pregnancy (control group) treatment, 2h and 24h in patients with postpartum bleeding was less than the control group, the bleeding time was shorter than the control group, the quality of life is better than the control group, the difference was statistically significant (P<0.05). Conclusion Postpartum hemorrhage: Patients with psychological intervention plus carboprost ammonia butyl alcohol three treatment effect of pregnancy, can decrease the 2h and 24h in patients with postpartum hemorrhage, bleeding time is short, the quality of life of patients, is worthy of clinical widely used to treat patients with postpartum hemorrhage pregnancy.
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Objective To evaluate the clinical efficacy of dendritic cells-cytokine induced killer cells combined with surgical treatment for primary liver cancer.Methods Totally 78 patients with primary liver cancer were randomly divided into experiment group (n =30) and control group (n =48).The patients in experiment group received hcpatectomy combined with dendritic cells-cytokine induced killer cell treatment while those in control group were given hepatectomy treatment.The median time to recurrence,progression-free survival,survival and quality of life were evaluated.Observed side effects of cell therapy in experiment group.Results Experiment group received a total of dendritic cells-cytokine induced killer cell treatment 78,an average of 2.6 times per person.Fever occured in 8 patients who received dendritic cells-cytokine induced killer cell treatment.After one cycle of immune therapy,the KPS score of 20 cases was improved,8 cases were stable and and 2 case was worsen in the experiment group.The KPS score of 10 cases were improved,32 cases were stable and and 6 cases were worsen in the control group,and the difference is statistically significant (P ＜ 0.05).The progression-free survival rates for 1,2 and 3 years in the experiment group were 73.3％,40.0％,23.3％ and 68.7％,27.0％,14.5％ in the control groups,respectively.The progression-free survival rates in the experiment group were improved compared to the control group and the difference is statistically significant (P ＜ 0.05).The median time of recurrence in the experiment group were (16.9 ± 2.6) months and (13.5 ± 2.9) months in the control group,respectively (P ＜ 0.05).The 1-2-3-years survival rates in the experiment group were 85.0％,50.0％,35.0％ and 85.0％,40.0％,23.3％ in the control group respectively.There was no statistically significant difference between these two groups (P ＞ 0.05).Conclusions Dendritic cellscytokine induced killer cells combined with surgical treatment on primary liver cancer is safe and effective,it can improve quality of life,and delay the recurrence time after surgery.But not improve long-term survival.
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Objective To Discuss the effect of surgical treatment from enteral and parenteral nutrition that in perioperative period of hepatolithiasis patients who taking hepatectom.Methods Retrospective analysis 55 cases who taking hepatectomy treatment in Fuling Central Hospital of Chongqing City from March 2011 to March 2015,all elective operations.According to the different nutrition support methods in perioperative period,randomly divided into enteral and parenteral group (n =25) and parenteral nutrition group (n =30).Results The postoperative complication rate and recovery time of bowel function in patients with enteral and parenteral nutrition,it was better than parenteral nutrition group (28 ％ vs 40％),[(4.50 ± 0.50) d vs (5.50 ± 1.00) d],the difference had statistical significance (P ＜ 0.05).Before and after operation in two groups of body mass index [(22.10 ± 1.80) vs (22.30 ± 1.70)],prealbumin impovement [(130.00 ± 45.00) mg/L vs (124.00 ± 55.00) mg/L],albumin impovement [(35.50 ± 2.72) g/L vs (36.50 ± 2.70) g/L],had no statistical significance (P ＞ 0.05).Conclusion Enteral and parenteral nutrition in perioperative can significantly improve the nutritional status of patients and the effect of surgical treatment.
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Objective To investigate the clinical effect and safety of spleen-preserving surgery by microwave tissue coagulation (MTC) therapy.Methods Retrospectively analyzed the clinical data of 45 cases undergoing spleen retaining surgery by MTC therapy (observation group) and comparative study was used on another 45 cases experiencing splenectomy (comparative group),clinical effect and complications were compared.All cases were patients from Jan.2010 to Jun.2013.Results All cases were cured.Hospitalization of observation group is obviously shorter than that of comparative group(P =0.007).The rate of complication in observation group(4.44％) is lower than that in comparative group (20.00％),but the time and amount of bleeding in operation of observation group is much more than that of comparative group.Conclusion MTC can effectively guarantee patients safety,shorten hospital stay,and be worthy of popularization.
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Advances in hepatic surgical technique,perioperative care and improvements in patient selection criteria have increased the number of patients who could undergo major or extended hepatectomy with curative intent.Posthepatectomy liver failure (PHLF) is one of the most serious complications after liver resection.Different risk factors are related to the occurrence of PHLF,among surgery-related factors,massive bleeding and remnant liver volume were related to higher frequency of PHLF.The presence of diabetes and liver disease such as cirrhosis,cholestasis,steatosis had been involved with the occurrence of PHLF.So far there is no good method for the treatment of PHLF,so prevention is very important.