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1.
Journal of Biomedical Engineering ; (6): 1219-1228, 2021.
Article in Chinese | WPRIM | ID: wpr-921864

ABSTRACT

With the rapid development of artificial intelligence technology, researchers have applied it to the diagnosis of various tumors in the urinary system in recent years, and have obtained many valuable research results. The article sorted the research status of artificial intelligence technology in the fields of renal tumors, bladder tumors and prostate tumors from three aspects: the number of papers, image data, and clinical tasks. The purpose is to summarize and analyze the research status and find new valuable research ideas in the future. The results show that the artificial intelligence model based on medical data such as digital imaging and pathological images is effective in completing basic diagnosis of urinary system tumors, image segmentation of tumor infiltration areas or specific organs, gene mutation prediction and prognostic effect prediction, but most of the models for the requirement of clinical application still need to be improved. On the one hand, it is necessary to further improve the detection, classification, segmentation and other performance of the core algorithm. On the other hand, it is necessary to integrate more standardized medical databases to effectively improve the diagnostic accuracy of artificial intelligence models and make it play greater clinical value.


Subject(s)
Algorithms , Artificial Intelligence , Humans , Male , Prognosis , Prostatic Neoplasms/diagnosis , Technology
2.
Article in Chinese | WPRIM | ID: wpr-884568

ABSTRACT

Objective:The standard treatment for inoperable locally advanced esophageal cancer is concurrent chemoradiotherapy, but the survival was not satisfied. Nituzumab is a humanized IgG monoclonal antibody against EGFR. The purpose of this study is to investigate the toxicity and efficacy of concurrent chemoradiotherapy combined with nituzumab for locally advanced esophageal cancer.Methods:We retrospectively reviewed the clinical data of locally advanced esophageal cancer who were treated with concurrent chemoradiotherapy combined with nituzumab in Peking University Cancer Hospital from June 2015 to June 2020. Kaplan- Meier method was used for analysis. Results:Thirty Patients were enrolled this study.After a median follow-up of 22.5 months, The objective response rate was 93%. The 1-year, 2-year, 3-year overall survival rates were 83%, 57% and 41%, with the progression-free survival rates 75%, 47% and 32%, with the local-recurrence free survival rates 83%, 53% and 37%, with the metastasis-free survival rates 75%, 51% and 36%, respectively.The incidence of grade≥3 hematological toxicity was 32%. There were 16% patients experiencing grade≥3 esophagitis.Conclusion:The preliminary result of concurrent chemoradiotherapy combined with nituzumab is effective and safe for patients with locally advanced esophageal cancer.

3.
Article in Chinese | WPRIM | ID: wpr-884525

ABSTRACT

Objective:To evaluate the 5-year survival outcome of patients with unresectable locally advanced non-small cell lung cancer (NSCLC) treated with Endostar in combination with platinum-based concurrent chemoradiotherapy.Methods:From March 2009 to June 2015, 115 patients with the unresectable locally advanced NSCLC from two prospective studies[Clinical trials 2009-2012(ClinicalTrials.gov NCT01894) and 2012-2015(ClinicalTrials.gov, NCT01733589)] were treated with Endostar in combination with platinum-based concurrent chemoradiotherapy. A total dose of 60-66 Gy was delivered in 30-33 fractions. Endostar was given 1 week prior to the beginning of radiotherapy, and repeated fortnightly during the concurrent chemoradiotherapy. After long-term follow up, survival outcome was evaluated in 104 patients treated with radiation dose of ≥60 Gy. Kaplan-Meier method was used for survival analysis. Univariate survival analysis was performed using the log-rank test.Results:Of 104 eligible patients, 60.6% of them had squamous carcinoma and 65.4% were classified in stage Ⅲ B. All the patients received ≥2 cycles of Endostar and 93.3% of them received 4 cycles of Endostar. The median follow-up time was 68.3 months. The median overall survival (OS) and median progression-free survival (PFS) were 31.3 and 13.9 months, respectively. The 3-year and 5-year OS were 45.6% and 35.7%, respectively. The 3-year and 5-year PFS were 27.1% and 24.9%, respectively. Univariate analysis indicated that sex, ECOG, pathological type, clinical stage, radiotherapy technique, chemotherapy regimen, chemotherapy cycle and cycle of Endostar use were not associated with OS. Late radiation injury occurred in 14.4% of patients, and no grade 4-5 late injury was observed. Conclusion:Patients with unresectable locally advanced NSCLC treated with Endostar fortnightly in combination with platinum-based concurrent chemoradiotherapy achieve better OS than historical data with tolerable toxicities.

4.
International Journal of Surgery ; (12): 226-232,F3, 2021.
Article in Chinese | WPRIM | ID: wpr-882474

ABSTRACT

Objective:To compare the safety and efficacy of continuous transversus abdominis plane (CTAP) block and patient-controlled intravenous analgesia (PCIA) in abdominal surgery postoperatively.Methods:PubMed, Embase, Web of Science, CNKI and other English and Chinese databases were searched since their establishment to February 2021 with "continuous/modified, transversus/transverse abdominis plane block, TAP block, patient controlled analgesia, patient-controlled analgesia, patient controlled intravenous analgesia, patient-controlled intravenous analgesia, PCA/PCIA/IV-PCA" as the search keywords. According to the analgesia treatment methods, patients were divided into continuous transversus abdominis plane block group (CTAP group) and patient-controlled intravenous analgesia group (PCIA group). Review Manager 5.4 software was used to conduct a Meta-analysis on outcome indicators such as postoperative nausea and (or) vomiting (PONV), dizziness, pain score and recovery status after abdominal surgery. Risk ratio ( RR) was calculated for counting data, Mean ± SD was calculated for measurement data. Heterogeneity was measured by I2, and related data were analyzed by using either a fixed effects model or a random effects model. Results:(1) The results of literature search: A total of 6 randomized controlled trials, including 2 published in English and 4 published in Chinese were analyzed, involving 479 patients. The results of the Meta-analysis: Compared with PCIA, CTAP block had lower incidence of PONV ( RR=0.22, 95% CI: 0.08-0.62, P<0.01), lower incidence of dizziness ( RR=0.27, 95% CI: 0.09-0.79, P=0.02), lower pain scores on movement at 24 h ( MD=-0.75, 95% CI: -1.42--0.08, P=0.03) and 48 h ( MD=-0.68, 95% CI: -1.05--0.31, P<0.001) postoperatively, and earlier time of first mobilization ( MD=-0.49, 95% CI: -0.69--0.30, P<0.001) and first exhaust ( MD=-10.47, 95% CI: -13.53--7.41, P<0.001), with statistically significant differences. However, there were no statistically significant differences in pain scores at rest at 24 h ( MD=-0.25, 95% CI: -0.57-0.08, P=0.14) and 48 h ( MD=-0.15, 95% CI: -0.39-0.09, P=0.22) postoperatively and postoperative length of hospital stay ( MD=-1.01, 95% CI: -2.28-0.26, P=0.12). Conclusion:CTAP block is a relatively safe and effective analgesic method, and it′s more consistent with the concept of enhanced recovery after surgery (ERAS) and can be recommended as an alternative method of PCIA.

5.
Article in Chinese | WPRIM | ID: wpr-800298

ABSTRACT

Surgical minimally invasive techniques such as image intervention, laparoscopy, endoscopy, and assisted medical robotics have become the mainstream of minimally invasive surgery (MIS). However, the vague concept, diverse misunderstanding, and the lack of standards have led to a lot of malpractice in current MIS. Based on the analysis of the clinical situation and the domestic and foreign literatures, the authors have put forward the theory of comprehensive minimally invasive surgery (CMIS), and established the concepts of minimally invasive prevention, minimally invasive diagnosis and minimally invasive follow-up in the view of hepatobiliary surgery. The authors have proposed "three-All" principles of all personnel, all aspects and all processes, and established a comprehensive four-level criteria of outcomes, complications, time and costs for CMIS, in an attempt to provide feasible and practical concepts and standards for MIS from a clinical practice and theoretical level, with a view to standardizing minimally invasive procedures and solving the problem of MIS.

6.
Article in Chinese | WPRIM | ID: wpr-823828

ABSTRACT

Surgical minimally invasive techniques such as image intervention,laparoscopy,endoscopy,and assisted medical robotics have become the mainstream of minimally invasive surgery (MIS).However,the vague concept,diverse misunderstanding,and the lack of standards have led to a lot of malpractice in current MIS.Based on the analysis of the clinical situation and the domestic and foreign literatures,the authors have put forward the theory of comprehensive minimally invasive surgery (CMIS),and established the concepts of minimally invasive prevention,minimally invasive diagnosis and minimally invasive follow-up in the view of hepatobiliary surgery.The authors have proposed "three-All" principles of all personnel,all aspects and all processes,and established a comprehensive four-level criteria of outcomes,complications,time and costs for CMIS,in an attempt to provide feasible and practical concepts and standards for MIS from a clinical practice and theoretical level,with a view to standardizing minimally invasive procedures and solving the problem of MIS.

7.
Article in Chinese | WPRIM | ID: wpr-821269

ABSTRACT

Objective@#To investigate the consistency of plasma prothrombin time (PT) results detected by the STAGO STA-R Evolution and Mindray Precil C3510 automatic coagulation analyzers. @*Methods@#The PTs from 69 plasma samples were detected by the STA-R Evolution and Precil C3510 coagulation analyzers, respectively, and the obtained results were compared. Based on the CLSI EP9-A3 protocol, the ESD test was used to detect outliers, the scatter plot, difference plot, and frequency distribution plot were drawn, and the method comparison and bias evaluation were performed using the Passing-Bablok regression and Bland-Altman plot. @*Results@#The PTs (median \[P 25, P 75\]) detected by the STA-R Evolution and Precil C3510 analyzers were 19.00 (13.85, 25.65) s and 20.50 (13.83, 26.30) s, respectively, and there was no significant difference between them (P>0.05). No outliers were detected by the ESD test, and the variation of PTs (CV) was constant. There were no systematic, random and proportional differences in PT results from two coagulation analyzers. The bias between two coagulation analyzers was within the acceptable range (1/2 CLIA′88 TEa). The predicted bias of PT at each medical decision point was also within the acceptable range. @*Conclusion@#The results of PT detected by the Precil C3510 and STA-R Evolution coagulation analyzers are comparable, and the bias is within the acceptable range, which can meet the needs of clinical diagnosis and treatment.

8.
Chinese Journal of Lung Cancer ; (12): 696-701, 2019.
Article in Chinese | WPRIM | ID: wpr-775569

ABSTRACT

BACKGROUND@#The standard treatment for locally advanced non-small cell lung cancer (NSCLC) is radiotherapy concurrent with chemotherapy, but the survival was not satisfied. With the development of intensity modulated radiotherapy, simultaneous integrated boost technique (SIB) becomes the research direction of locally advanced NSCLC. The aim of this study is to investigate the efficacy and safety of SIB intensity modulated radiotherapy technique for locally advanced NSCLC.@*METHODS@#We retrospectively reviewed the clinical data of locally advanced NSCLC who were treated with radiotherapy by SIB technique in Peking University Cancer Hospital from June 2015 to December 2018. Kaplan-Meier method was used for analysis.@*RESULTS@#Ninty-three patients were included in the analysis. After a median follow-up of 34.23 months, 3-year overall survival (OS), progression-free survival (PFS), local-recurrence free survival (LRFS) and metastasis free survival (MFS) rates were 53.0%, 37.0%, 50.5% and 50.5%, respectively. The incidence of grade ≥3 esophagitis was 5.4%. There were 2 (2.2%) patients experiencing grade ≥3 radiation-related pneumonia.@*CONCLUSIONS@#Radiation with SIB intensity modulated radiotherapy technique is effective and safe for patients with locally advanced NSCLC.

9.
Article in Chinese | WPRIM | ID: wpr-614372

ABSTRACT

BACKGROUND: Ischiofemoral impingement (IFI) syndrome has attracted more and more attention, but there is little report on IFI because of its low incidence. Moreover, its imaging characters have not yet been fully understood.OBJECTIVE: To discuss the MRI diagnostic criteria for IFI, thus understanding the imaging characters of IFI revealed on MRI.METHODS: Sixteen cases (21 hips) of suspected IFI were selected as experimental group, and 25 healthy volunteers as control group. The bilateral ischiofemoral space (IFS, the shortest distance between the ischial tuberosity and lesser trochanter of femur) and quadratus femoris space (QFS, distance between the lesser trochanter of femur and hamstring tendon insertion) were measured on MRI axial image. The signal and morphology of the quadratus femoris were observed. The differences in QFS and IFS were compared between two groups.RESULTS AND CONCLUSION: (1) Among 16 patients, there were 13 females, and 3 males, and 5 female cases of bilateral IFI. (2) In the experimental group, the IFS ((13.65±3.87) mm versus (22.17±5.75) mm) and QFS ((7.15±3.50) mm versus (12.89±3.13) mm) showed significant differences between affected and opposite sides (P 0.05). (4) Compared with the control group, there were significant differences in IFS and QFS of the affected side in the experimental group, and no significant differences in IFS and QFS of the opposite side. (5) In the experimental group, quadratus femoris appeared with deformation, edema and atrophy. (6) To conclude, the incidence of IFI in females is significantly higher than that in males, and bilateral hips are usually affected. MRI diagnostic criteria for IFI are IFS ≤ 11.46 mm, QFS ≤ 5.53 mm of the affected side, and quadratus femoris present edema and deformation, which are more sensitive on axial fat-suppressed MRI imaging.

10.
Article in Chinese | WPRIM | ID: wpr-608411

ABSTRACT

Objective To evaluate the efficacy and safety of recombinant adenovirus-p53(rAdp53) injection combined with radiotherapy and hyperthermia in the treatment of unresectable advanced soft tissue sarcoma.Methods In this retrospective study, we evaluated 76 patients with unresectable advanced primary or recurrent soft tissue sarcoma treated in our hospital from November 2005 to November 2012.These patients received radiotherapy and hyperthermia with rAdp53(p53 group, n=41) or without rAdp53(control group, n=35).rAdp53((1-2)×1012viral particles each time, once a week, 8 times on average) was injected into the tumor or infused into the pelvic cavity.Radiotherapy (2 Gy each time, 5 times a week) was performed for the planning target volume at 56.3±5.3 Gy in the p53 group and 58.1±4.2 Gy in the control group, with no significant difference between the two groups (P>0.05).Superficial or deep thermotherapy was employed 8 times on average (twice a week).Clinical features, response rate, time to progression (TTP), overall survival (OS), and adverse events were compared between the two groups (P>0.05).The Kaplan-Meier method was used to calculate OS;the log-rank test was used for survival difference analysis and univariate prognostic analysis;the chi-square test was used for comparison of categorical data.Results At 2 months after treatment, the p53 group had significantly increased response rate (partial response+ complete response+ stable disease)(85% vs.54%, P=0.003) and local control rate (49% vs.23%, P=0.020) as well as prolonged TTP (12 months vs.5 months, P=0.010) and OS (48 months vs.31 months, P=0.049), as compared with the control group.No adverse events caused by radiotherapy and hyperthermia except transient fever were seen in the two groups.Conclusions Concurrent radiotherapy and hyperthermia combined with rAdp53 injection is effective and safe for patients with advanced soft tissue sarcoma.

11.
Article in Chinese | WPRIM | ID: wpr-619453

ABSTRACT

Objective To investigate the respiratory pathogen distribution characteristics in children with acute respiratory disease(ARD).Methods Distribution of respiratory pathogen in 28 600 children with ARD,treated from January 2011 to December 2014 in this hospital,were analyzed.Results Among the 28 600 children,12 162 cases were pathogen positive,including 7 704 cases(63.34%) with single pathogen infection and 4 458 cases(36.66%) with more than two kinds of pathogens infection.Time,season,sex and age distribution of pathogen infection were with statistical difference(P<0.05).There was significant difference in infection rate of pathogens between different time(P<0.05).Infection rate of Mycoplasmal pneumonia(MP) was the highest,and the infection rate of MP and influenza B virus(IFB) increased year by year.Except Legionella pneumophila(LP),the season distribution of infection rate of MP,Coxiella burneti(COX),Chlamydia pneumoniae(CP),adenovirus(ADV),respiratory syncytial virus(RSV),influenza A virus(IFA),IFB and parainfluenza virus(PIVs) were with statistical difference(P<0.05).The infection rate of MP and IFB were higher in the whole year.Conclusion Distribution of respiratory pathogen in children with ARD might be related with the changes of gender,age and season.Detection of respiratory infection pathogen could be with guiding value for clinical diagnosis and drug selection.

12.
Chongqing Medicine ; (36): 3198-3200,3203, 2015.
Article in Chinese | WPRIM | ID: wpr-602313

ABSTRACT

Objective To study the expression level and clinical significance of Galectin-3 and miRNA-21 in non-small-cell lung carcinoma(NSCLC).Methods One hundred and fifty patients with NSCLC were chosen as cancer group,and 1 50 patients with benign pulmonary diseases were chosen as control group.The expression level of Galectin-3 and that of miRNA-21 between two groups were compared,and the relevance between expression level of Galectin-3 and that of miRNA-21 and clinical feature were analysed.Results In cancer group,the expression level of Galectin-3 was 6.75±2.38,and that of control group was 1.12 ±0.29;the expression level of miRNA-21 was 5.91 ± 1.59,and that of control group was 0.97 ± 0.1 7,and the difference between two groups had statistical significance(P 0.05 ).Conclusion The expression level of Galectin-3 and that of miRNA-21 can be applied in the diagnosis and prognosis of non-small-cell lung carcinoma.

13.
Article in Chinese | WPRIM | ID: wpr-478276

ABSTRACT

Objective:To study changes of ECG and cardiac enzyme levels in patients with arrhythmia after in‐hospital infection .Methods :A total of 71 patients with arrhythmia complicated in‐hospital infection ,who were treated in our hospital ,were selected .ECG and cardiac enzyme levels were measured in all patients at hospitalization and after in‐hospital infection .ECG and cardiac enzyme levels were observed and compared between before and after infec‐tion .Results:Compared with before infection ,after infection ,there were significant rise in percentages of sinus tachycardia (29.58% vs .50.70% ) ,bundle branch block (22.54% vs .40.85% ) ,premature ventricular contraction (57.75% vs .78.87% ) and premature atrial contraction (70.42% vs .95.77% ) , P<0.05 or <0.01 ;significant in‐crease in percentages of ST‐T changes (19.72% vs .94.37% ) ,abnormal ST segment (35.21% vs .69.01% ) and ab‐normal PR interval (71.83% vs .94.37% ) , P<0.01 all;and significant rise in levels of creatine kinase isoenzyme [ (29.66 ± 7.54) U/L vs .(44.68 ± 8.93) U/L] and creatine kinase [ (283.65 ± 36.84) U/L vs .(329.47 ± 35.56) U/L] , P<0.01 both .Conclusion:After in‐hospital infection ,the percentages of arrhythmias and abnormal change of ECG wave and cardiac enzyme levels significantly rise in patients with arrhythmia ,physicians should strive to pre‐vent in‐hospital infection ,the patient's condition aggravation .

14.
Chinese Journal of Zoonoses ; (12): 806-811, 2014.
Article in Chinese | WPRIM | ID: wpr-455108

ABSTRACT

At present ,the mechanism of highly pathogenic avian influenza H5N1 virus causing human infection or death is still not fully clear .In order to better understand the pathogenesis of the disease ,the rhesus macaques were infected with H5N1 virus (AF148678/ACGoose/Guangdong/11961H5N1) .We analyzed the clinical symptoms ,characteristics of the virus invades body ,pathological changes ,and immune response to discuss the pathogenesis of viral pneumonia induced by H 5N1 virus infection from the early time to the recovery time .The rhesus macaques were infected with H5N1 virus through nasal .Clinical signs were assessed daily ,and major organs and blood were collected for detection of blood routine analysis ,viruses were isola-ted and titrated from organs ,and pathologic and immunohistochemical were also conducted .As a result ,the rhesus macaques in-fected with H5N1 virus experienced fever ,dyspnea ,and anorexia .The respiratory tract was the major target of the virus and the virus could not replicate in organs outside the respiratory tract .Positive staining cells by immunohistochemistry were bronchial epithelial cells and alveolar macrophages .Rhesus macaques experienced temporary severe pneumonia after 1-3 days ,mainly be-cause of neutrophils infiltration ;gradual recovery 6 days later ,mainly with macrophage infiltration ;lung tissue presented recov-ery state after 14 days ,mainly with T lymphocytes infiltration .Finally ,we concluded that the predilection of the H 5N1 virus to infect the lower airway suggests that it may be a limiting factor in human-to-human transmissibility of the H5N1 virus .The pathogenesis may include virus invasion ,replication and immune injury .

15.
Article in English | WPRIM | ID: wpr-14502

ABSTRACT

Subolesin (4D8), the ortholog of insect akirins, is a highly conserved protective antigen and thus has the potential for development of a broad-spectrum vaccine against ticks and mosquitoes. To date, no protective antigens have been characterized nor tested as candidate vaccines against Dermacentor silvarum bites and transmission of associated pathogens. In this study, we cloned the open reading frame (ORF) of D. silvarum 4D8 cDNA (Ds4D8), which consisted of 498 bp encoding 165 amino acid residues. The results of sequence alignments and phylogenetic analysis demonstrated that D. silvarum 4D8 (Ds4D8) is highly conserved showing more than 81% identity of amino acid sequences with those of other hard ticks. Additionally, Ds4D8 containing restriction sites was ligated into the pET-32(a+) expression vector and the recombinant plasmid was transformed into Escherichia coli rosetta. The recombinant Ds4D8 (rDs4D8) was induced by isopropyl beta-D-thiogalactopyranoside (IPTG) and purified using Ni affinity chromatography. The SDS-PAGE results showed that the molecular weight of rDs4D8 was 40 kDa, which was consistent with the expected molecular mass considering 22 kDa histidine-tagged thioredoxin (TRX) protein from the expression vector. Western blot results showed that rabbit anti-D. silvarum serum recognized the expressed rDs4D8, suggesting an immune response against rDs4D8. These results provided the basis for developing a candidate vaccine against D. silvarum ticks and transmission of associated pathogens.


Subject(s)
Animals , Antigens/chemistry , Arthropod Proteins/chemistry , Chromatography, Affinity , Cloning, Molecular , Cluster Analysis , Conserved Sequence , Dermacentor/genetics , Electrophoresis, Polyacrylamide Gel , Escherichia coli/genetics , Gene Expression , Humans , Molecular Sequence Data , Molecular Weight , Phylogeny , Recombinant Proteins/chemistry , Sequence Analysis, DNA , Sequence Homology, Amino Acid
16.
Article in Chinese | WPRIM | ID: wpr-427131

ABSTRACT

Objective To investigate the complications and the risk factors of pancreatic fistula after pancreaticoduodenectomy.Methods The clinical data of 339 patients who underwent pancreaticoduodenectomy at the First Affiliated Hospital of Sun Yat-Sen University from January 2000 to Decembcr 2009 were retrospectively analyzed.The risk factors of pancreatic fistula were analyzed.The incidences of complications accured from 2000 to 2004 and from 2005 to 2009 were compared.All data were analyzed by the t test,chi-square test,Fisher exact probability or Logistic regression model.Results The incidence of complications of all patients was 33.0% ( 112/339),and the incidence of pancreatic fistula was 8.6% (29/339).Of the 29 patients complicated with pancreatic fistula,6 patients were in grade A,8 in grade B and 15 in grade C.Soft texture of remnant pancreas and the diameter of pancreatic duct smaller than 3 mm were the independent risk factors of pancreatic fistula( OR =1.75,3.75,P < 0.05 ).The number of hospital death was 12,including 1 patient died during the first period (2000-2004) and 11 patients died during the second period (2005-2009).Three patients died of pancreatic fistula and abdominal hemorrhage,3 died of postoperative upper gastrointesitnal bleeding,2 died of cardiac insufficiency,1 died of respiratory failure,1 died of pancreatic fistula,abdominal infection and necrotic pancreatitis,1 died of abdominal hemorrhage and hepatic and renal failure,1 died of bililary fistula,abdominal infection and multiple organ dysfunction syndrome.Conclusions Soft texture of remnant pancreas and the diameter of the pancreatic duct smaller than 3 mm are important risk factors of postoperative pancreatic fistula.Pancreatic fistula is the main factor causing death after pancreaticoduodenectomy.

17.
Article in Chinese | WPRIM | ID: wpr-425078

ABSTRACT

Objective To investigate the complications and the risk factors for pancreatic leakage after pancreaticoduodenectomy.Methods One hundred and sixty-nine patients who received pancreaticoduodenectomy in our hospital between January 2000 and December 2009 were reviewed.Chisquare and logistic statistic analysis were performed to determine the risk factors for pancreatic leakage.The difference in complication rates between different periods were analyzed.Results The mortality was 2.4%.The morbidity was 34.9%,and the pancreatic leakage rate was 7.7%.Logistic analysis revealed significant risk factors for pancreatic leakage included intraoperative bleeding of more than 400 ml(OR=2.87; 95% confidence interval:1.17-8.19; P=0.048),soft texture of remnant pancreas(OR =1.95 ; 95 % confidence interval:0.87-6.19 ; P =0.032)and pancreatic duct diameter smaller than 3 mm(OR=3.78 ; 95 % confidence interval:1.01-10.63 ; P =0.019).There was no significant difference in mortality,morbidity,pancreatic leakage,and upper gastric bleeding between the periods 2000-2004 and 2005-2009.However,re-operation rate and postoperative hospital stay were significantly higher in the period of 2005-2009.Conclusions Intraoperative bleeding,soft texture of remnant pancreas and pancreatic duct diameter smaller than 3mm were significant risk factors for postoperative pancreatic leakage.A pancreaticojejunostomy anastomotic technique familiar to the surgeon might reduce postoperative pancreatic leakage.

18.
Article in Chinese | WPRIM | ID: wpr-748072

ABSTRACT

OBJECTIVE@#To discuss the clinical presentation, diagnostic criterion and treatment principle of chronic invasive sinusitis caused by dematiaceous fungi.@*METHOD@#One patient was diagnosed as chronic invasive sinusitis based on history, headache, especially eye symptoms without fever, sinus CT and MRI, endoscopic and cytological findings in the nasal cavity. Surgical debridement was performed, and the patient was administered with systemic anti-fungi treatment.@*RESULT@#Alternaria was identified on culture. The patient was proved of tissue invasion histopathologically through biopsy. The patient survived after treatment without recurrence.@*CONCLUSION@#Extensive and aggressive surgical debridement, prompt and adequate dosage of intravenous antifungal therapy , together with controlling of the underlying disease, all contribute to a complete resolution of the disease.


Subject(s)
Alternaria , Female , Humans , Middle Aged , Mycoses , Microbiology , Therapeutics , Sinusitis , Microbiology , Therapeutics
19.
Article in Chinese | WPRIM | ID: wpr-387872

ABSTRACT

Objective To evaluate the impact of early enteral nutrition (EEN) compared with parenteral nutrition (PN) on patients after hepatectomy. Methods Seventy-eight patients undergoing liver resection were randomized prospectively into two groups: EEN group receiving early enteral nutrition (n=35) and PN group receiving parenteral nutrition (n=43). The patients in both groups received isocaloric and isonitrogenous nutritional formulas 24 h after operation and the formulas were stopped on postoperative day 7. The general conditions, liver function tests, clinical complications,and clinical nutritional variables at three time points that included preoperative phase, postoperative day 1 (POD 1) and postoperative day 8 (POD 8) were observed. Results No significant differences were found in length of hospital stay, liver function and clinical nutritional variables between the 2 groups. In the EEN group, the serum prealbumin level almost returned to the preoperative level on POD 8. The nutritional complication rate of the EEN group was increased significantly but it was milder than that of the PN group. The time of gut function recovery in the EEN group was shorter than that of the PN group. The costs of nutritional drugs showed a significant decrease in the EEN group.Conclusion Early enteral nutrition is safe, rational and effective in patients who have undergone hepatectomy. Early enteral nutrition is better than parenteral nutrition in promoting liver function recovery, liver protein synthesis, postoperative recovery of gut function and decreasing costs of nutritional drugs.

20.
Article in Chinese | WPRIM | ID: wpr-230830

ABSTRACT

Brain atlas provides a spatial reference system on which other images can be interpreted in a consistent way, and it is essential for the brain imaging research. However, because of the differences in structure between occidental and oriental brains, the brain atlas based on Western populations, e. g., the International Consortium for Brain Mapping's 154 T1 Weighted Average Atlas, may not be appropriate for other ethnic groups. Therefore, in the present study, we produce an average brain atlas which is based on the data collected from 100 healthy Chinese volunteers. The differences in brains between the Chinese population and the Western population were also investigated. Comparatively,Chinese brains are wider and shorter in size, and smaller in volume.


Subject(s)
Asians , Brain , Physiology , Brain Mapping , Female , Humans , Imaging, Three-Dimensional , Magnetic Resonance Imaging , Male , Reference Values
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