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1.
JOURNAL OF RARE DISEASES ; (4): 195-201, 2024.
Article in Chinese | WPRIM | ID: wpr-1032040

ABSTRACT

Objective This study aims to sort out the rare disease drugs in the China′s Second List of Rare Diseases, to provide reference for the management of rare disease drug treatment. Methods Up to December 31, 2023, based on the China′s Second List of Rare Diseases, we sorted out the drugs approved in China with the drug label, or approved by the U.S. Food and Drug Administration(FDA) and the European Medicines Agency (EMA) for the treatment of the above diseases, and developed the second batch of rare disease drug catalog in China. The accessibility, localization and coverage of the national medical insurance were also analyzed. Results From the point of view of diseases, a total of 37 diseases in the China′s Second List of Rare Diseases have drug indications approved in China, and 10 diseases have drugs listed by the U.S. FDA/EMA and approved in China, but for off-label use. From the point of view of drugs, there are 55 drug indications approved for the treatment of the China′s Second List of Rare Diseases, and 22 drugs listed in the U.S. FDA/EMA and approved in the China, but for off-label use. Among the above-mentioned drugs with domestic approved rare disease indications or approved numbers, 39 drugs have at least one domestic approval number for a dosage form, covering 30 rare diseases; 37 drugs used for at least one rare disease are included in the national medical insurance catalog and are covered by reimbursement, covering 29 rare diseases. Conclusions The list of rare disease drugs in the China′s Second List of Rare Diseases was established. The number of rare disease drugs and covered diseases approved by China and the U.S. FDA/EMA has increased, and the number of rare disease drugs and covered diseases that are localized and included in the medical insurance catalog has also continued to increase.

2.
JOURNAL OF RARE DISEASES ; (4): 202-213, 2024.
Article in Chinese | WPRIM | ID: wpr-1032041

ABSTRACT

Objective To summarize and analyze what the listing in market of orphan drugs in China, the United States, the European Union, and Japan in 2023, and to provide empirical reference to Chinese pharmaceutical enterprises, pharmaceutical management, and new drug research and development departments. Methods Collect the 2023 drug market data released by official drug regulatory agencies in four countries and international organization-China, the United States, the European Union, and Japan categorize the market of rare disease drugs and and their indications, approval dates, R&D status in China, component therapeutic areas, and special review and approval pathways were analyzed. Results Findings in 2023, 28 orphan drugs were listed in the United States, mostly anti-tumor related, accounting for 32.1% (9 out of 28); 17 orphan drugs were listed in the European Union, anti-tumor related accounting for 47.0% (8 of 17); 22 listed in Japan; and 45 listed in China. In 2023, over 70% orphan drugs listed in the European Union and Japan entered the phase of clinical trials/marketing and applications/approved clinical applications in China (86.4% from Japan and 70.6% from European Union). Conclusions Currently, there is no qualification accreditation mechanism for orphan drugs in China. However, in 2023, the number of rare disease drugs listed in China was the greatest among the four countries/international organization. It reflects that China′s Catalog for Rare Diseases played a guiding role in drug research and development. Meanwhile, the reform of drug approval and review in China and the issue of rare disease catalogs took place in a short period of time, so the review and approval, as well as research and development of rare disease drugs are still in the catching up stage.

3.
JOURNAL OF RARE DISEASES ; (4): 214-220, 2024.
Article in Chinese | WPRIM | ID: wpr-1032042

ABSTRACT

Objective To analyze the effectiveness and safety of bisphosphonates in the treatment of patients with calcification defense. Methods PubMed, Embase databases, CNKI and Wanfang were searched to collect the case reports and clinical studies of bisphosphonates for calcification defense. Then, the relevant information of patients was extracted for statistical analysis. Results A total of 18 case reports were selected involving 20 patients. Thirteen patients (65.0%) were treated with pamidronate, four (20.0%) were treated with etidronate, two (10.0%) were treated with alendronate, and one (5.0%) was treated with zoledronic acid. Thirteen patients (65.0%) recovered completely, the recovery time of whom ranged from half month to nine months. The tolerance of bisphosphonates in most patients(90.0%)was good, while one patient who did not tolerate pamidronate recovered after the frequency of administration was adjusted and one patient with high dosage of etidronate returned to normal after the discontinuation of the usage. Conclusions Bisphosphonates, an inhibitor of bone resorption, is effective and safe in the treatment of patients with calcification defense.

4.
International Journal of Surgery ; (12): 390-393, 2023.
Article in Chinese | WPRIM | ID: wpr-989468

ABSTRACT

Objective:To investigate the classification of main pancreatic duct and treatment strategy after linear stapler closure of pancreatic neck in laparoscopic pancreaticoduodenectomy (LPD).Methods:The records of 51 consecutive patients with LPD who were treated by linear staple closure technique of pancreatic neck from February to December 2022 from Binzhou Second People′s Hospital, Shijingshan Campus, Beijing Chaoyang Hospital, Capital Medical University, Rizhao Hepatobiliary-Pancreatic-Splenic Surgery Research Institute, Chaoyang Central Hospital, Shandong Juxian People′s Hospital, Weihai Municipal Hospital, Binzhou Central Hospital, and Affiliated Hospital of Chifeng University were retrospectively reviewed. According to the visibility, position and diameter of the main pancreatic duct at the stump of the pancreas, the type of main pancreatic duct was divided into type I, type Ⅱ, type Ⅲa and type Ⅲb. The number of cases in each main pancreatic duct classification and the corresponding treatment strategies were examined.Results:A total of 51 cases of LPD were successfully completed. Of these patients, the males comprised 56.9%(29/51), and females comprised 43.1%(22/51), with age ranging from 31 to 88 years old. The type of the main pancreatic duct at the stump of the pancreas included 7 cases (13.7%) of type Ⅰ, 39 cases (76.5%) of type Ⅱ, 2 cases (3.9%) of type Ⅲa, and 3 cases (5.9%) of type Ⅲb. Corresponding treatment strategies were adopted according to different main pancreatic duct types, the main pancreatic duct was successfully found, and a support drainage tube was inserted.Conclusion:After linear stapler closure of pancreatic neck, corresponding treatment strategies should be adopted according to the classification of the main pancreatic duct, which would help to improve the success rate of finding the main pancreatic duct and placing a support drainage tube.

5.
Article in Chinese | WPRIM | ID: wpr-989523

ABSTRACT

Objective:To study the value of cell paraffin block immunohistochemistry and pleural fluid Crk like protein (CRKL) and macrophage inhibitory cytokine-1 (MIC-1) in the diagnosis of malignant pleural effusion.Methods:A total of 98 patients with pleural effusion treated in Shantou Central Hospital from February 2020 to February 2021 were retrospectively selected as the research objects, including 58 benign cases and 40 malignant cases. The levels of CRKL and MIC-1 in pleural effusion were detected by enzyme-linked immunosorbent assay. The pleural effusion was analyzed by cell paraffin block immunohistochemistry. The levels of various indexes in benign group and malignant group were compared. The diagnostic value of cell paraffin block immunohistochemistry and pleural effusion CRKL and MIC-1 for benign and malignant pleural effusion was analyzed by receiver operating characteristic (ROC) curve.Results:With pathological results as the gold standard, 54 cases of benign and 44 cases of malignant were diagnosed by cell paraffin block immunohistochemistry. The diagnostic accuracy was 75.5% (74/98) , and the sensitivity and specificity were 75.0% (30/40) and 75.9% (44/58) respectively. The levels of pleural effusion CRKL [2.84 (2.17, 3.98) ng/ml vs. 1.88 (0.94, 2.62) ng/ml], MIC-1 [2.28 (1.67, 2.98) ng/ml vs. 1.76 (1.22, 2.32) ] ng/ml] in the malignant group were higher than those in the benign group, with statistically significant differences ( Z=-4.57, P<0.001; Z=-3.09, P<0.001) . The optimal critical value of CRKL in pleural effusion for the diagnosis of malignant pleural effusion was 2.33 ng/ml, the area under the curve (AUC) was 0.76 (95% CI: 0.66-0.85) , and the sensitivity and specificity were 67.5% (27 /40) , 74.1% (43/58) . The optimal critical value of MIC-1 in pleural effusion for the diagnosis of malignant pleural effusion was 2.10 ng/ml, the AUC was 0.74 (95% CI: 0.64-0.85) , and the sensitivity and specificity were 60.0% (24/40) , 82.8% (48/58) . The AUC of MIC-1 and CRKL in pleural effusion combined with cell paraffin block immunohistochemistry for the diagnosis of malignant pleural effusion was 0.83 (95% CI: 0.75-0.91) , and the sensitivity and specificity were 85.0% (34/40) and 70.7% (41/58) . The sensitivity and AUC of combined diagnosis were significantly higher than those of CRKL and MIC-1 alone (sensitivity: χ2=4.26, P=0.046; χ2=6.27, P=0.012; AUC: Z=3.53, P<0.001; Z=4.14, P<0.001) . Conclusion:CRKL and MIC-1 in pleural effusion of patients with malignant pleural effusion are highly expressed, which can be used as indicators for the diagnosis of malignant pleural effusion. Detection combined with cell paraffin block immunohistochemistry can improve the diagnostic value of malignant pleural effusion.

6.
Article in Chinese | WPRIM | ID: wpr-957025

ABSTRACT

Objective:To study the use of primary continuous single-layer pancreaticojejunostomy after linear stapler closure of pancreatic neck in pancreaticoduodenectomy (PD).Methods:The clinical data of 21 patients who were treated with primary continuous single-layer pancreaticojejunostomy after linear stapler closure of pancreatic neck in PD at Beijing Chaoyang Hospital Affiliated, West Campus, Capital Medical University, Rizhao Hepatobiliary-pancreatic-splenic Surgery Research Institute, Binzhou Second People’s Hospital, Chaoyang Central Hospital from February 2022 to May 2022 were retrospectively analyzed. There were 12 males and 9 females, with ages ranging from 31.0 to 82.0 years (median age 63.0 years). The success rates of linear stapling at pancreatic neck, time of pancreaticojejunostomy, postoperative complications, pancreatic fistula risk score, and length of hospital stay were studied.Results:Among the 21 patients, there were 3 patients who underwent open PD and 18 patients who underwent laparoscopic PD. Primary continuous single-layer pancreaticojejunostomy after linear stapler closure of pancreatic neck was successfully carried out in all these patients. The success rate was 100.0%. The success rate of finding pancreatic ducts at the pancreatic stumps and inserting an drainage tube was 100.0%(21/21). In the 3 patients who underwent open PD, the operation time were 230.0, 245.0 and 250.0 minutes respectively. The time for completing pancreaticojejunostomy were 12.0, 13.0 and 12.0 minutes respectively. The estimated blood loss were 300.0, 450.0 and 600.0 ml respectively. The length of hospital stay were 14.0, 15.0 and 21.0 days. In the 18 patients who underwent laparoscopic PD, the operation time was (295.9±14.5) min, the time for constructing pancreaticojejunostomy was (22.3±1.5) min, the blood loss was (180.0±40.0) ml, the length of hospital stay ranging from 8.0 to 16.0 days (median 10.5 days). Among all the 21 patients, the pancreatic fistula risk score was (4.7±1.5). Postoperative acute pancreatitis occurred in 3 patients (14.3%), delayed gastric emptying occurred in 4 patients (19.0%), and all of them recovered after conservative treatment. There was no postoperative bleeding, nosocomial infection, grade B and C postoperative pancreatic fistula or perioperative death.Conclusion:The continuous single-layer pancreaticojejunostomy after linear stapler closure of the pancreatic neck was safe, reliable, simple and technically easy. It has the potential to prevent clinical postoperative pancreatic fistula and pancreaticojejunostomy bleeding. It is worth to popularize this surgical procedure.

7.
Article in Chinese | WPRIM | ID: wpr-928204

ABSTRACT

Aiming at the problems of individual differences in the asynchrony process of human lower limbs and random changes in stride during walking, this paper proposes a method for gait recognition and prediction using motion posture signals. The research adopts an optimized gated recurrent unit (GRU) network algorithm based on immune particle swarm optimization (IPSO) to establish a network model that takes human body posture change data as the input, and the posture change data and accuracy of the next stage as the output, to realize the prediction of human body posture changes. This paper first clearly outlines the process of IPSO's optimization of the GRU algorithm. It collects human body posture change data of multiple subjects performing flat-land walking, squatting, and sitting leg flexion and extension movements. Then, through comparative analysis of IPSO optimized recurrent neural network (RNN), long short-term memory (LSTM) network, GRU network classification and prediction, the effectiveness of the built model is verified. The test results show that the optimized algorithm can better predict the changes in human posture. Among them, the root mean square error (RMSE) of flat-land walking and squatting can reach the accuracy of 10 -3, and the RMSE of sitting leg flexion and extension can reach the accuracy of 10 -2. The R 2 value of various actions can reach above 0.966. The above research results show that the optimized algorithm can be applied to realize human gait movement evaluation and gait trend prediction in rehabilitation treatment, as well as in the design of artificial limbs and lower limb rehabilitation equipment, which provide a reference for future research to improve patients' limb function, activity level, and life independence ability.


Subject(s)
Humans , Algorithms , Gait , Machine Learning , Neural Networks, Computer , Walking
8.
Article in Chinese | WPRIM | ID: wpr-884672

ABSTRACT

Objective:To explore the perivenous blocking management strategy for portal vein-superior mesenteric vein (PSMV) resection and reconstruction and its effect on postoperative complications in patients undergoing pancreaticoduodenectomy (PD).Methods:The data of 137 patients with pancreatic cancer treated with PD in Beijing Chaoyang Hospital Affiliated to Capital Medical University, Chaoyang Central Hospital, the Second Hospital of Chaoyang, Rizhao Central Hospital, the Second People's Hospital of Binzhou from January 2010 to December 2020 were collected. There were 83 males and 54 females with an average age of 61.8 years. There were 42 patients in the reconstruction group and 95 patients in the control group. The main intraoperative indexes and postoperative complications were compared between the two groups with the aim to review our experience in PSMV resection and reconstruction by using the perivenous blocking management strategy.Results:PD was successfully completed in 137 patients in the reconstruction group, the PSMV blocking time was 15-120 min, with a median of 30 min. The operation time 380 (330, 465) min, intraoperative blood loss 725 (500, 1000) ml, and postoperative hospital stay 21.0 (16.0, 28.0) d in the reconstruction group were significantly higher than those of control group [305 (280, 340) min, 400 (300, 500) ml and 18.0 (14.0, 24.5) d] (all P<0.05). The reoperation rate and perioperative mortality were 4.8% (2/42) and 2.4% (1/42) in the reconstruction group, while 2.1% (2/95) and 1.0% (1/95) in the control group, respectively. There was no significant difference between the two groups (both P>0.05). The incidence of pancreatic fistula, peritoneal effusion and infection, pulmonary infection of the reconstruction group was significantly higher than those of the control group ( P<0.05). There was no significant difference in the incidence of postoperative bleeding, delayed gastric emptying, biliary fistula, incision infection, reoperation between the two groups ( P>0.05). Conclusions:PSMV resection and reconstruction significantly increased the incidences of complication after PD, including pancreatic fistula, peritoneal effusion/infection and pulmonary infection. The perivenous blocking management strategy significantly promoted smooth postoperative recovery and effectively reduced morbidity rates of postoperative bleeding and mortality after PSMV resection and reconstruction in PD.

9.
Article in Chinese | WPRIM | ID: wpr-910563

ABSTRACT

Early postoperative hemorrhage (EPOH) is a common complication of pancreaticoduodenectomy (PD) and a main cause of death. The cause of EPOH is related to inappropriate vascular treatment during the operation, which may be recognized as a technical failure and avoided theoretically. PD is characterized by varieties of tissues that need to be separated and resected, large wound surface, many operations such as vascular separation, dissection, resection and reconstruction, and complex anastomoses. Therefore, the causes of EPOH are complex and varied. The most effective measure to prevent EPOH is to handle the vessels carefully and properly during the operation. In this paper, we systematically summarized the blood vessels involved in PD procedure, and the treatment strategies of these potential bleeding sites, and the clinical thinking and treatment principles of EPOH, so as to improve the quality of vascular treatment in PD procedure and to prevent EPOH.

10.
Article in Chinese | WPRIM | ID: wpr-910566

ABSTRACT

Objective:To study the impact of Roux-en-Y reconstruction with isolated pancreatic drainage (RYR) on delayed gastric emptying (DGE) after pancreaticoduodenectomy (PD).Methods:The data of 203 patients who underwent PD at 5 clinical centers from January 2014 to June 2020 were collected. According to the method of reconstruction of the digestive tract, the patients were divided into the RYR group ( n=88) and the conventional loop reconstruction (CLR) group ( n=115). The incidence and severity of DGE were compared between groups. The risk factors of clinically relevant DGE (CR-DGE) after PD were analysed by univariate and multivariate analyses. Results:Of 203 patients, there were 124 males and 79 females, aged (61.6±10.2) years. The overall incidence of DEG was 27.6% (56/203). The incidence of CR-DGE in the RYR group was significantly lower than that in the CLR group [13.6%(12/88) vs 26.1%(30/115), P=0.030]. Patient age of more than 65 years ( OR=2.966, 95% CI: 1.162-8.842, P=0.024), clinically relevant pancreatic fistula ( OR=3.041, 95% CI: 1.122-8.238, P=0.029), ascites and abdominal infection ( OR=10.000, 95% CI: 2.552-39.184, P=0.001), and CLR ( OR=3.206, 95% CI: 1.162-8.842, P=0.024) were identified as independent risk factors for CR-DGE. The duration of hospitalization and hospital expenditure of patients were significantly increased in the CR-DGE group ( P<0.05). Conclusions:Patients over 65 years with clinically relevant pancreatic fistula, with ascites or abdominal infection after operation, had a higher evidence of CR-DGE. Roux-en-Y reconstruction with isolated pancreatic could helped to decrease the incidence of CR-DGE after PD.

11.
Article in Chinese | WPRIM | ID: wpr-910585

ABSTRACT

Objective:To study the results of using a sequential menagement of conservative treatment, percutaneous transhepatic cholangial drainage(PTCD), laparoscopic cholecystectomy(LC) combined with laparoscopic common bile duct exploration(LCBDE) and primary duce closure(PDC) in patients with cholecystolithiasis and common bile duct stone(CBDS) who presented with acute cholangitis.Methods:The clinical data of 397 patients with CBDS and cholecystolithiasis who presented with acute cholangitis from January 2015 to August 2020 were retrospectively analyzed, including 230 patients from the West Campus, Beijing Chaoyang Hospital, Capital Medical University, 95 patients from the Second People's Hospital of Binzhou and 72 patients from Rizhao Central Hospital. Conservative treatment, PTCD and LC+ LCBDE+ PDC were used sequentially. The interval between PTCD and LCBDE, the decrease of serum total bilirubin and alanine aminotransferase after PTCD, the operative time of LC+ LCBDE+ PDC, and the intraoperative blood loss were analyzed. Postoperative indwelling time of abdominal drainage tube and PTCD tube time, postoperative hospital stay, postoperative complications, etc.Results:These were 15 males and 18 femals with the mean age of 57.5 years old. The mean serum total bilirubin and alanine aminotransferase levels decreased from (148.3±36.8) μmol/L and (172.6±26.9) U/L before PTCD to (32.6±5.9) μmol/L and (45.7±7.2) U/L after PTCD, respectively. The interval between PTCD and LCBDE was (25.3±2.6) d. The operation time of LC+ LCBDE+ PDC was (95.4±14.2) min. The intraoperative blood loss was (35.2±9.5 )ml and the mean postoperative hospital stay was (12.4±3.5) d. The postoperative indwelling time of abdominal drainage tubes and PTCD tubes were (10.6±2.3) d and (25.8±4.7) d, respectively. After surgery, bile leakage occurred in 3 patients (9.1%), abdominal hemorrhage in 1 patient (3.0%), biliary bleeding in 1 patient (3.0%), navel incision infection in 1 patient (3.0%), lower common bile duct stenosis in 2 patients (6.1%). All complications responded well to conservation treatment.Conclusions:Sequential treatment using conservative treatment, PTCD combined with LC+ LCBDE+ PDC in patients with cholecystolithiasis and CBDS who presented with acute cholangitis was safe, and efficacious using the minimally invasive approach. This approach is worth promoting to other centers.

12.
Article in Chinese | WPRIM | ID: wpr-868820

ABSTRACT

The right hepatic artery (RHA) is the terminal artery supplying the right hepatic lobe. There are many anatomic variations of RHA, including low RHA and left hepatic artery bifurcation, aberrant course, tortuosity, abnormal branches of cystic artery and origin variation. The origin variation of RHA is divided into replaced RHA and accessory RHA. The replaced artery origins include superior mesenteric artery, celiac trunk, aorta, common hepatic artery, gastroduodenal artery, left gastric artery, splenic artery and right renal artery. The variations of RHA are important causes of intraoperative adverse events and postoperative complications in hepatobiliary-pancreatic-splenic surgery. It is an important guarantee for the safety of operation to know and master these RHA variations well before operation, to separate it carefully and to protect it properly during operation.

13.
Article in Chinese | WPRIM | ID: wpr-868835

ABSTRACT

Objective:To explore the influencing factors of long-term survival for hepatocellular carcinoma (HCC) treated by radiofrequency ablation (RFA).Methods:A retrospective analysis of 255 patients who underwent RFA as the main treatment modality for HCC from May 1, 2004 to Feb 28, 2015 was performed. All patients were divided into two groups according to the postoperative survival time: the 5-year or more survival group and the less than 5-year survival group. Clinical indicators such as age, maximum tumor size and number, and frequency of radiofrequency ablation were compared between the two groups. Cox single factor and multiple factors were used to analyze the influencing factors of long-term survival.Results:The median overall survival of all the 255 patients was 4.3 years (range 0.5-15.5 years). There were 115 patients (45.1%) who survived for 5 years or more and 140 patients (54.9%) who survived for less than 5 years. The 1-, 3-, 5-, and 10-year survival rates of all the patients were 86.7%, 61.2%, 44.8% and 34.8%, respectively. There were no significant differences in gender, age, accompanying symptoms, aetiology of liver disease, level of alpha fetoprotein and treatment ( P>0.05), but there were significant differences in Child-Pugh class, liver cirrhosis, maximum diameter of tumor, tumor number, tumor stage, and frequency of RFA ( P<0.05) between the 2 groups of patients. Multivariate analysis showed that age ≥70 years old, Child-Pugh class B, maximum diameter of tumor >5.0 cm, multiple tumor were independent risk factors of long-term survival, but the number of sessions of RFA was a protective factor. Conclusions:For medium sized HCC and solitary large HCC, RFA combined with other therapeutic modalities could achieve satisfactory therapeutic results. Age, Child-Pugh class, maximum diameter of tumor, tumor number and RFA frequency were influencing factors for long-term survival of HCC patients.

14.
Article in Chinese | WPRIM | ID: wpr-868845

ABSTRACT

Objective:To study the timing of radiofrequency ablation (RFA) in treatment of complicated pyogenic liver abscesses (PLA).Methods:A retrospective analysis was performed on 49 patients with complicated PLA who were treated with the RFA-based treatment modality from August 2010 to January 2020 at Beijing Chaoyang Hospital, West Campus, Capital Medical University, Institute of Hepatobiliary, Pancreas and Spleen Surgery and the Second Hospital, Binzhou. The patients were divided into the early RFA group (≤ 72 h, n=27) and the delayed RFA group (>72 h, n=22) according to the timing of RFA. RFA was guided by laparoscopy combined with Ultrasound or CT. The safety and effective rates of RFA, and the total expenses were evaluated. Results:All patients in both the early and the delayed RFA groups were successfully cured (100%). No serious complications, including biliary leakage and massive hemorrhage, happened in the 2 groups. Significantly longer operating time and hospital stays [(8.1±1.6)d vs. (9.5±1.5)d], and higher hospital costs [(3.4±0.2) ten thousand yuan vs. (3.8±0.4) ten thousand yuan] were found in the delayed RFA group when compared with the early RFA group ( P<0.05). Conclusion:RFA treatment of complicated PLA should be completed within 72 hours of onset of PLA.

15.
Chinese Critical Care Medicine ; (12): 477-480, 2018.
Article in Chinese | WPRIM | ID: wpr-703675

ABSTRACT

Human infection with avian influenza A (H7N9) is an acute contagious respiratory disease. Acute respiratory distress syndrome (ARDS) is a common complication in patients with severe avian influenza A (H7N9), for whom mechanical ventilation (MV) is an important supportive method. A patient, suffered from severe avian influenza A (H7N9) and complicated with ARDS, was admitted to the Second Affiliated Hospital of Guizhou Medical University in January 2017. With very intensive care for oxygenation, respiration and consciousness, and monitoring, she was successfully cured by comprehensive managements, among which noninvasive mechanical ventilation (NIV) was the major respiratory support method. The result demonstrate that, in patients with conscious state, satisfied expectoration ability and relatively good cooperation, and with close observation of oxygenation and respiratory rate, NIV may be accepted as an effective method for patient with ARDS caused by severe avian influenza A (H7N9).

16.
Article in Chinese | WPRIM | ID: wpr-708401

ABSTRACT

Benign occupations of the liver (BOL) are a heterogeneous group of benign hepatic lesions,a minority of which may need active management.It's reported that radiofrequency ablation (RFA) can be used to treat BOL,such as hepatic haemangioma,focal nodular hyperplasia (FNH),hepatocellular adenoma,simple hepatic cyst,liver abscess and hepatic echinococcosis.RFA has exhibited a potentiality to replace resection as the first-line treatment option for hepatic haemangioma.For multiloculated intractable simple hepatic cyst or liver abscess,when patients are not suitable for or refuse surgical resection,RFA may be an alternative option for the resection;and it also has many advantages over resection,including effectiveness,safety,minimal invasiveness and repeatability in the treatment of FNH,hepatocellular adenoma,and hepatic echinococcosis.A review will be presented on the current situation and latest progression of RFA therapy for BOL in this article.

17.
Article in Chinese | WPRIM | ID: wpr-708449

ABSTRACT

Objective To evaluate the efficacy of radiofrequency ablation (RFA) in treatment of complicated pyogenic liver abscess (PLA).Methods A retrospective analysis was conducted on 20 patients with complicated PLA treated from August 2010 to January 2018 in the West Campus of Beijing Chao-yang Hospital which is Affiliated to the Capital Medical University and Rizhao Central Hospital of Shandong Province.These patients were treated with RFA based treatment modalities using CT-guided or laparoscopy combined with Ultrasound-guided RFA.The successful rate,efficacious rate and safety of RFA were respectively analyzed.Routine follow-up was carried out after treatment.Results The successful rate of RFA was 100%.The median operation time was 45 minutes.All the 20 patients were cured by one session of RFA.The multilocular lesion in one patient was converted to a unilocular lesion after one session of RFA.The patient was then cured by percutaneous hepatic abscess drainage.No serious complications were observed.Conclusions RFA was safe and efficacious.It should be considered as an alternative treatment for patients with complicated PLA who were not responsive to,or not applicable to antibiotics treatment and radiological intervention.

18.
International Journal of Surgery ; (12): 811-815,封3, 2018.
Article in Chinese | WPRIM | ID: wpr-732767

ABSTRACT

Objective To evaluate the efficacy and clinical outcomes of early laparoscopic radiofrequency ablation(RFA) forspontaneously ruptured hepatocellular carcinoma (HCC).Methods A retrospective analysis was conducted on 12 patients with spontaneously ruptured HCC treated by laparoscopic RFA from April 2005 to June 2018 in the West Campus of Beijing Chao-yang Hospital,Capital Medical University.The successful rate,safety,peritoneal recurrence rate,complete ablation rate and survival rate of RFA were respectively analyzed.Results The median size of the 12 HCC cases was 5.85 cm (4.0-10.1 cm) in the maximal dimension.Procedures of laparoscopic RFA ablation were performed successfully for all patients.Complete ablation was achieved in 58.3%patients (7/12).Five patients with incompletely ablated tumors received repeated RF ablation to achieve completeablation.Four patients (33.3%) developed minor complications(Dindo-Clavien grade Ⅰ).The mean follow-up of 36.8 months,4 patients (33.3%) were alive and 8 (66.7%) died.Of the 12 patients,the 1-and 3-year survival rates were 90.0% and 60.0%,respectively.No patient had peritoneal recurrence.Conclusion Early laparoscopic RFA therapy is an minimally invasive,safety and effective treatment measure for spontaneouslyruptured HCC in selected patients,which presents an advantage of achieving simultaneous hemostasis,tumorelimination,and rinsing of peritoneal cavity to minimize the risk of peritoneal metastasis.

19.
Chinese Critical Care Medicine ; (12): 473-476, 2017.
Article in Chinese | WPRIM | ID: wpr-616014

ABSTRACT

One confirmed diagnosiscase of severe human infection by avian influenza H7N9 admitted to intensive care unit (ICU) of the Second Affiliated Hospital of Guizhou Medical University on January 12th, 2017 was reported. The patient was treated with the sepsis bundle, and recovered finally, including a series of comprehensive treatments, such as respiratory support, circulation support, antiviral, anti-inflammation, immunization enhancement, critical nursing, fluid management, nutritional support and treatment of complications. The critical patient was admitted on January 27th, and the treatment was successful. It has important significance to rescue the severe human infection from avian influenza H7N9 by the sepsis bundle.

20.
Chinese Journal of Immunology ; (12): 220-225, 2017.
Article in Chinese | WPRIM | ID: wpr-508286

ABSTRACT

Objective:Immunoregulation study of umbilical mesenchymal stem cell (UCMSCs) on allogeneic umbilical cord blood(UCB) CD4+T lymphocytes,which proliferation,apoptosis and the differentiation to CD4+CD25+ regulatory T cell (Treg) in vitro. Methods:Establishing on direct contact or transwell co-culture system,adopt in different proportion of UCMCs with phytohaemag-glutinin (PHA)-activated UCB CD4+T lymphocytes were co-cultured. The proliferation of lymphocyte,percent of CD4+CD25+/CD4+and Foxp3 expression, regulatory T cell marker gene were measured. Apoptosis of CD4+T lymphocytes were observed in the direct contact or transwell coculture system of UCMSCs with desamethason( DXM)-stimulated UCB CD4+T lymphocytes. Results: The UCB CD4+T lymphocytes cocultured with UCMSCs with PHA-activating for 3 days,compared with the UCMSCs free control group,the amount of cells was reduced noticeably(P<0. 05) and the percent of CD4+CD25+in CD4+T lymphocytes and Foxp3 expression significantly in-creased(P<0. 01) in a dose dependent way(P<0. 05). The UCB CD4+T lymphocytes cocultured with UCMSCs with DXM-inducing for 7 days,the apoptosis rate was significantly lower than that of the control group without UCMSCs (P<0. 01). These effects were partially attenuated in transwell coculture but could not be eliminated. Conclusion: UCMSCs are negative effect on UCB CD4+T lymphocytes-mediated immunity effects,and mainly manifested in the regulation on cell proliferate ability and differentiation rather than promoting apoptosis.

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