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1.
Article in Chinese | WPRIM | ID: wpr-1024352

ABSTRACT

Objective To investigate the clinical efficacy of percutaneous closure of foramen ovale guided by transthoracic echocardio-graphy with simply delivery sheath.Methods The clinical data of patients with patent foramen ovale underwent interventional closure and percutaneous closure guided by transthoracic echocardiography with simply delivery sheath in our hospital from January 2020 to December 2022 were analyzed retrospectively,the patients were divided into interventional closure group(40 cases)and simply delivery sheath group(39 cases).The operation time,incidence of surgical complications,and surgical success rates of patients in the two groups were compared.The closure effect were evaluated by ultrasound immediately after surgery.All the patients were followed up for 6 months after surgery to evaluate remission of the symptoms.Results The surgical success rate of simply delivery sheath group(100%)was higher than that of interventional closure group(90.0%),with statistically significant difference(P<0.05).The operation time of simply delivery sheath group was longer than that of interventional closure group,with statistically significant difference(P<0.05).One patient in the interventional closure group had small amount of pericardial effusion during the operation.Two patients had decreased blood pressure and slowed heart rate in simply delivery sheath group,and symptoms disappeared after treatment.There was no significant difference in the incidence of complications between the two groups(P>0.05).After 6-month follow-up,all occluders were in good position and no residual leakage was found.The symptoms of headache or dizziness disappeared in 28 patients in interventional closure group,significantly relieved in 8 patients;the symptoms of headache or dizziness disappeared in 30 patients in simply delivery sheath group,and significantly relieved in 9 patients.Conclusion Percutaneous closure for patent foramen ovale under the guidence of transthoracic echocardiography with simply delivery sheath is safe and feasible with satisfactory efficacy and higher successful rate without radiation hazard.It is worthy of clinical promotion.

2.
Zhonghua xinxueguanbing zazhi ; (12): 42-48, 2024.
Article in Chinese | WPRIM | ID: wpr-1045787

ABSTRACT

Objective: To assess the association between body mass index (BMI) and major adverse cardiovascular and cerebrovascular events (MACCE) among patients with acute coronary syndrome (ACS). Methods: This was a multicenter prospective cohort study, which was based on the Improving Care for Cardiovascular Disease in China (CCC) project. The hospitalized patients with ACS aged between 18 and 80 years, registered in CCC project from November 1, 2014 to December 31, 2019 were included. The included patients were categorized into four groups based on their BMI at the time of admission: underweight (BMI<18.5 kg/m2), normal weight (BMI between 18.5 and 24.9 kg/m2), overweight (BMI between 25.0 and 29.9 kg/m2), and obese (BMI≥30.0 kg/m2). Multivariate logistic regression models was used to analyze the relationship between BMI and the risk of in-hospital MACCE. Results: A total of 71 681 ACS inpatients were included in the study. The age was (63.4±14.7) years, and 26.5% (18 979/71 681) were female. And the incidence of MACCE for the underweight, normal weight, overweight, and obese groups were 14.9% (322/2 154), 9.5% (3 997/41 960), 7.9% (1 908/24 140) and 7.0% (240/3 427), respectively (P<0.001). Multivariate logistic regression analysis showed a higher incidence of MACCE in the underweight group compared to the normal weight group (OR=1.30, 95%CI 1.13-1.49, P<0.001), while the overweight and obese groups exhibited no statistically significant difference in the incidence of MACCE compared to the normal weight group (both P>0.05). Conclusion: ACS patients with BMI below normal have a higher risk of in-hospital MACCE, suggesting that BMI may be an indicator for evaluating short-term prognosis in ACS patients.


Subject(s)
Humans , Female , Adolescent , Young Adult , Adult , Middle Aged , Aged , Aged, 80 and over , Male , Body Mass Index , Overweight/complications , Acute Coronary Syndrome , Thinness/epidemiology , Prospective Studies , Risk Factors , Obesity/complications , Hospitals
3.
Article in Chinese | WPRIM | ID: wpr-1009221

ABSTRACT

OBJECTIVE@#To investigate the efficacy and clinical results of total internal protection technique in anterior cruciate ligament reconstruction.@*METHODS@#A total of 56 patients undergoing anterior cruciate ligament reconstruction treated from January 2018 to December 2019 were selected. According to the different surgical methods, they were divided into total internal reconstruction group and standard bone tunnel group. There were 21 patients in the total internal reconstruction group, including 15 males and 6 females, aged from 20 to 48 with an average of (35.6±6.7) years old, and 35 patients in the standard tibial tunnel group, including 26 males and 9 females, aged 22 to 51 years old with an average of (33.7±9.6) years old. Preoperative examination of Lachman test was positive, magnetic resonance indicated anterior cruciate ligament rupture. There were no significant differences between the two groups in age, sex, body mass index, time from injury to ACL reconstruction, combined meniscus injury and operation method, operation time, ligament diameter, ligament length and other general information. Postoperative evaluation included operation duration, length and diameter of transplanted tendon after braid. International Knee Documentation Committee (IKDC) score, Lysholm score, Tegner score and perioperative complications 2 years after surgery.@*RESULTS@#Both groups were followed up, ranging from 24 to 30 months with an average of (26.9±3.4) months. Postoperative incision healing was good, and no failure or joint infection occurred at the last follow-up. There was no statistically significant difference between the two groups in IKDC score, Lysholm score and Tegner score before, 1 year and 2 years after surgery. However, IKDC score, Lysholm score and Tegner score at 1 year and 2 years after surgery.@*CONCLUSION@#The same postoperative function and stability of knee joint can be obtained by both the residual whole technique and the standardized reconstruction technique. In the residual whole group, only the semitendinosus muscle is taken, and the femoral thin muscle is retained, with greater tibial bone mass preserved, which is safe and effective in clinical practice.


Subject(s)
Male , Female , Humans , Adult , Young Adult , Middle Aged , Anterior Cruciate Ligament/surgery , Retrospective Studies , Treatment Outcome , Arthroscopy/methods , Knee Joint/surgery , Anterior Cruciate Ligament Injuries/surgery
4.
Zhonghua xinxueguanbing zazhi ; (12): 42-48, 2024.
Article in Chinese | WPRIM | ID: wpr-1046110

ABSTRACT

Objective: To assess the association between body mass index (BMI) and major adverse cardiovascular and cerebrovascular events (MACCE) among patients with acute coronary syndrome (ACS). Methods: This was a multicenter prospective cohort study, which was based on the Improving Care for Cardiovascular Disease in China (CCC) project. The hospitalized patients with ACS aged between 18 and 80 years, registered in CCC project from November 1, 2014 to December 31, 2019 were included. The included patients were categorized into four groups based on their BMI at the time of admission: underweight (BMI<18.5 kg/m2), normal weight (BMI between 18.5 and 24.9 kg/m2), overweight (BMI between 25.0 and 29.9 kg/m2), and obese (BMI≥30.0 kg/m2). Multivariate logistic regression models was used to analyze the relationship between BMI and the risk of in-hospital MACCE. Results: A total of 71 681 ACS inpatients were included in the study. The age was (63.4±14.7) years, and 26.5% (18 979/71 681) were female. And the incidence of MACCE for the underweight, normal weight, overweight, and obese groups were 14.9% (322/2 154), 9.5% (3 997/41 960), 7.9% (1 908/24 140) and 7.0% (240/3 427), respectively (P<0.001). Multivariate logistic regression analysis showed a higher incidence of MACCE in the underweight group compared to the normal weight group (OR=1.30, 95%CI 1.13-1.49, P<0.001), while the overweight and obese groups exhibited no statistically significant difference in the incidence of MACCE compared to the normal weight group (both P>0.05). Conclusion: ACS patients with BMI below normal have a higher risk of in-hospital MACCE, suggesting that BMI may be an indicator for evaluating short-term prognosis in ACS patients.


Subject(s)
Humans , Female , Adolescent , Young Adult , Adult , Middle Aged , Aged , Aged, 80 and over , Male , Body Mass Index , Overweight/complications , Acute Coronary Syndrome , Thinness/epidemiology , Prospective Studies , Risk Factors , Obesity/complications , Hospitals
5.
Article in Chinese | WPRIM | ID: wpr-1007206

ABSTRACT

Objective@#To explore the relationship between lifestyle and myopia and construct Nomogram model to predict myopia risk among primary school students in Tianjin, so as to provide a scientific basis for precision myopia prevention and control.@*Methods@#From April to July of 2022, a census method was used to conduct vision testing and lifestyle related questionnaires among 373 180 primary school students in 15 districts of Tianjin. The relationship between lifestyle and myopia was analyzed by the multivariate Logistic regression, and a nomogram prediction model was constructed to predict myopia risk.@*Results@#The detection rate of myopia among primary school students in Tianjin was 37.6%. The results of the multivariate Logistic regression showed that daily outdoor activity time of 1-2 h ( OR =0.94) and >2 h ( OR =0.84), time of using daily electronic devices of >2 h ( OR =1.03), daily paper materials reading and writing time of 1-2 h ( OR =1.02) and >2 h ( OR =1.09), weekly fresh vegetable intake of 2-6 times ( OR =0.93) and ≥7 times ( OR =0.88) were statistically correlated with myopia ( P <0.01). The Nomogram prediction model showed that the factors associated with myopia were grade, family history of myopia, gender, daily outdoor activity time, weekly frequency of fresh vegetable intake, daily paper materials reading and writing time, and time of using daily electronic devices time.@*Conclusions@#The lifestyle of primary school students in Tianjin is associated with myopia. The constructed nomogram model could provide a scientific basis for identifying key intervention populations for myopia prevention and taking targeted prevention and control measures.

6.
Article in Chinese | WPRIM | ID: wpr-1022446

ABSTRACT

Objective:To investigate the short-term efficacy and safety of Donafenib as postoperative adjuvant therapy for patients with high risk of recurrence after radical resection of hepatocellular carcinoma (HCC).Methods:The propensity score matching (PSM) and retrospective cohort study was conducted. The clinicopathological data of 157 HCC patients with high risk of recurrence after radical resection who were admitted to 6 medical centers, including The First Affiliated Hospital of Nanjing Medical University et al, from June 2021 to February 2023 were collected. There were 128 males and 29 females, aged (59±10)years. Of 157 patients, 101 cases undergoing Donafenib as postoperative adjuvant therapy were divided into the the Donafenib group, and 56 cases under-going no systemic postoperative adjuvant therapy were divided into the control group. Observation indicators: (1) PSM and comparison of general data of patients between the two groups after matching; (2) postoperative treatment; (3) follow-up and survival of patients; (4) analysis of risk factors affecting recurrence-free survival of patients. PSM was done based on the principle of optimal perfect matching, with the clamp value of 0.5, and the Donafenib group and the control group were matched at a ratio of 1.25∶1. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was conducted using the t test. Measurement data with skewed distribution were represented as M(range). Count data were described as absolute numbers and/or percentages, and comparison between groups was conducted using the chi-square test. Comparison of ordinal data between groups was conducted using the Kruskal-Wallis H test. The Kaplan-Meier method was used to calculate survival rates and draw survival curves, and the Log-Rank test was used for survival analysis. The COX proportional hazard model was used for univariate and multivariate analyses. Results:(1) PSM and comparison of general data of patients between the two groups after matching. Of 157 patients, 126 cases were successfully matched, including 70 cases in the Donafenib group and 56 cases in the control group, respectively. The elimination of tumor number confounding bias ensured comparability between the two groups after PSM. (2) Postoperative treatment. After PSM, of 70 patients in the Donafenib group, there were 23 cases receiving Donafenib monotherapy, 26 cases combined with transcatheter arterial chemoembolization (TACE), 14 cases combined with immunotherapy, and 7 cases combined with TACE+immunotherapy. Of 56 patients in the control group, there were 37 cases receiving postoperative follow-up alone and 19 cases combined with TACE. (3) Follow-up and survival of patients. All 157 patients were followed up, and the follow-up time of the 101 patients in Donafenib group and the 56 patients in control group were 10.1(range, 6.3-14.6)months and 22.2(range, 15.1-25.5)months, respectively. During the follow-up period, 70 patients in the Donafenib group experienced treatment-related adverse reactions, inclu-ding 8 cases of grade 3 adverse reactions, 23 cases of grade 2 and 39 cases of grade 1 adverse reactions, respectively. After PSM, the postoperative 12-, 18-month recurrence-free survival rates were 83.7%, 83.7% in the 70 patients of Donafenib group and 67.8%, 58.9% in the 56 patients of control group, respectively, showing a significant difference in the postoperative recurrence-free survival time between the two groups ( hazard ratio=0.395, 95% confidence interval as 0.176-0.888, P<0.05). (4) Analysis of risk factors affecting recurrence free survival of patients. Results of multivariate ana-lysis showed that microvascular invasion, vascular thrombus, clinical stage as ⅢA were independent risk factors affecting recurrence-free survival in patients with high risk of recurrence after radical resection of HCC ( hazard ratio=2.181, 2.612, 2.612, 95% confidence interval as 1.028-4.629, 1.128-6.047, 1.128-6.047, P<0.05), Donafenib as postoperative adjuvant therapy was an independent protective factor affecting recurrence-free survival in patients with high risk of recurrence after radical resection of HCC ( hazard ratio=0.457, 95% confidence interval as 0.227-0.920, P<0.05). Results of further analysis showed that after PSM, there were significant differences in the postoperative recurrence-free survival time in patients with different clinical factors, including male, age ≥60 years, tumor diameter >5 cm, positive microvascular invasion, positive hepatitis B virus infection, alpha fetoprotein <200 μg/L, between the Donafenib group and the control group ( hazard ratio=0.283, 0.202, 0.174, 0.345, 0.273, 0.180, 95% confidence interval as 0.114-0.707, 0.044-0.937, 0.038-0.794, 0.128-0.929, 0.091-0.819, 0.052-0.620, P<0.05). Conclusion:Donafenib as postoperative adjuvant therapy can effectively reduce the short-term recurrence rate in patients with high risk of recurrence after radical resection of HCC, with good safety and tolerance.

7.
Article in Chinese | WPRIM | ID: wpr-1026252

ABSTRACT

Objective To investigate the value of dual-energy CT quantitative parameters combined with CT features for predicting perineural invasion(PNI)of colorectal adenocarcinoma.Methods Preoperative whole-abdominal CT data of 79 patients with colorectal adenocarcinoma confirmed by postoperative pathology were retrospectively analyzed.The patients were divided into PNI group(n=31)or no PNI group(n=48).Univariate analysis was used to compare CT features and dual-energy CT quantitative parameters between groups,and the variables with significant differences were included in binary logistic regression analysis to construct a combined model.Receiver operating characteristic(ROC)curves were drawn and area under the curve(AUC)were calculated,the efficacy of single CT parameters and combined model for predicting PNI of colorectal adenocarcinoma were evaluated.Results There were significant differences of the location of the primary lesion,the maximum thickness of the diseased intestinal wall,the presence or absence of peritumoral lymph node metastases,peritumoral mesenteric streak shadow and tumor deposits shown on CT between groups(all P<0.05).Significant differences of the arterial phase slope of energy spectrum curve(λHU),iodine concentration(IC),normalized IC(NIC),dual energy index and the venous phase NIC of dual energy index were found between groups(all P<0.05).AUC of the above single parameters for predicting PNI of colorectal adenocarcinoma ranged from 0.615 to 0.698,while of the combined model was 0.864.Conclusion Dual-energy CT quantitative parameters combined with CT features could be used to effectively predict PNI of colorectal adenocarcinoma.

8.
Article in Chinese | WPRIM | ID: wpr-1027133

ABSTRACT

Objective:To investigate the value of ultrasound in the diagnosis of secondary loss of response in children with Crohn′s disease at maintenance stage treated with Infliximab.Methods:From January 2017 to December 2021, 51 children with Crohn′s disease who received Infliximab treatment and clinical response in the Beijing Children′s Hospital Affiliated to Capital Medical University were retrospectively analyzed, and whether there was secondary loss of response during the maintenance period was observed. The ultrasound examination results at the 14th week of treatment were collected to understand the correlation between ultrasound examination of intestinal wall and peri-intestinal healing and secondary loss of response.Results:A total of 15 out of 51 patients (29.4%) experienced secondary loss of response during treatment follow-up up to 54 weeks. Compared to children with continuous response, children with secondary loss of response had a thicker intestinal wall at week 14 of treatment [5.0 (3.8, 6.0)mm compared to 3.0 (2.0, 4.0)mm, P<0.001], and a higher proportion of intestinal wall stratified structure disappearance [8/15 (53.33%) compared to 3/36 (8.33%), P<0.001]. When intestinal wall thickness>3.0 mm, the sensitivity was 0.955, and the specificity was 0.483. The sensitivity and specificity of clear diagnosis of secondary loss of response in intestinal wall stratification were 0.727 and 0.825, respectively. The sensitivity and specificity of combined diagnosis for secondary loss of response were 0.933 and 0.611, respectively. Conclusions:At the 14th week of treatment with Infliximab in children with Crohn′s disease, the thickness of intestinal wall measured by ultrasound being more than 3.0 mm and the disappearance of intestinal wall statified structure provide important information for the diagnosis of secondary loss of response.

9.
Article in Chinese | WPRIM | ID: wpr-1029301

ABSTRACT

Objective:To summarize the arrhythmic characteristics, clinical course, and prognosis of chaotic atrial tachycardia (CAT) in neonates.Methods:The researchers retrospectively analyzed and described the clinical data obtained from 30 neonates diagnosed with CAT and treated at the Maternal and Child Health Hospital of Hubei Province from January 2019 to August 2022. Prenatal and postnatal data were collected to analyze the electrocardiogram characteristics, clinical manifestations, treatment, and prognosis of CAT. Statistical analysis was performed using Mann-Whitney U and Chi-square (or Fisher's exact) tests. Results:(1) Among the 30 newborns with CAT, 19 were male infants (63%). The diagnosis age [ M(min-max)] was 11 days (1-28 days). Among them, 20 (67%) were born with full term, six (20%) had low birth weight, and 15 (50%) had abnormal cardiac structures. (2) The incidence of postnatal complex arrhythmias (coexisting with atrial fibrillation, flutter, supraventricular tachycardia, etc.) in fetuses with abnormalities, including fetal arrhythmias and fetal distress, was higher than those without abnormalities (9/14 vs 3/16, Fisher's exact, P=0.024). The median maximum atrial rate in incessant-type CAT patients (8 cases) was higher than that of paroxysmal-type CAT patients (22 cases) [400 bpm (300-700 bpm) vs 300 bpm (200-460 bpm), Z=-2.41, P=0.02]. There was no statistically significant difference in the maximum ventricular rate between the two groups [250 bpm (190-350 bpm) vs 270 bpm (180-350 bpm), Z=-0.26, P=0.800]. There were 19 cases (63%) complicated with diseases that seriously affected the respiratory or circulatory system, or infectious diseases. (3) Antiarrhythmic drugs were used in 23 cases (77%), including six cases treated with one drug, 12 cases with two drugs, and five cases with more than two drugs, mainly propafenone (20 cases, 67%). Seven cases (23%) with no complex arrhythmia turned to normal rhythm spontaneously without using antiarrhythmic drugs. Among all cases, 16 (53%) achieved clinical cures after complete cardioversion during hospitalization, while 14 cases (47%) were not cured. (4) The children who were cured during hospitalization were followed up for 1.5 months (2 weeks to 8 months) after discharge, and no recurrence was observed, indicating good growth and development. Untreated patients were followed up for 1.9 years (3.5 months to 4.4 years), of which seven cases completely recovered within six months, and the other seven cases continued to recur. However, no adverse outcomes, such as death, occurred. Conclusions:The overall prognosis of neonatal CAT is favorable. A history of fetal arrhythmia and intrauterine distress may increase the risk of CAT. Active drug treatment should be considered for children of CAT with complex arrhythmia.

10.
Zhonghua xinxueguanbing zazhi ; (12): 825-831, 2023.
Article in Chinese | WPRIM | ID: wpr-1045702

ABSTRACT

Objectives: To evaluate the feasibility and preliminary clinical results of transcatheter pulmonary valve replacement (TPVR) with the domestically-produced balloon-expandable Prizvalve system. Methods: This is a prospective single-center observational study. Patients with postoperative right ventricular outflow tract (RVOT) dysfunction, who were admitted to West China Hospital of Sichuan University from September 2021 to March 2023 and deemed anatomically suitable for TPVR with balloon-expandable valve, were included. Clinical, imaging, procedural and follow-up data were analyzed. The immediate procedural results were evaluated by clinical implant success rate, which is defined as successful valve implantation with echocardiography-assessed pulmonary regurgitation<moderate and peak trans-pulmonary pressure gradient<40 mmHg (1 mmHg=0.133 kPa). Results: A total of 5 patients were included, with 4 males, aged 14 to 37 years. The initial diagnosis included Tetralogy of Fallot (2 cases), truncus arteriosus (1 case), pulmonary atresia (1 case) and subaortic stenosis (1 case, prior Ross procedure). Four patients underwent RVOT reconstruction with homograft or artificial conduit, and one patient was treated with trans-annular patch technique. The indications of TPVR included RVOT obstruction and regurgitation (3 cases), isolated obstruction (1 case), and isolated regurgitation (1 case). Of the 4 patients with varying severity of ROVT obstruction, the average preprocedural peak jet velocity of RVOT was 3.5 m/s, and the average peak pressure gradient was 50.0 mmHg. Except for one patient, who had previously been implanted with a covered Cheatham-Platinum (CP) stent due to severe stenosis of the main pulmonary artery, other patients underwent pre-stenting with a covered CP stent before TPVR. Clinical implant success was achieved in all of the 5 patients, and there was no serious periprocedural complications. The average trans-pulmonary peak jet velocity and peak pressure gradient derived from postprocedural echocardiography was 2.3 m/s and 21.2 mmHg, respectively. All patients experienced significant symptom relief after the procedure. All patients completed 3-month follow-up, and 4 completed 6-month follow-up. There was no case of infectious endocarditis during follow-up. All patients were graded as NYHA functional class one at the latest follow-up. Conclusions: TPVR using the domestically-produced balloon-expandable Prizvalve system is safe and feasible for the treatment of patients with post-surgical RVOT dysfunction and suitable landing-zone anatomy. The safety, effectiveness, and long-term valve durability of the Prizvalve system deserve further research.


Subject(s)
Male , Humans , Pulmonary Valve/surgery , Heart Valve Prosthesis/adverse effects , Heart Valve Prosthesis Implantation , Constriction, Pathologic/surgery , Prospective Studies , Ventricular Outflow Obstruction/surgery , Treatment Outcome , Cardiac Catheterization/methods , Transcatheter Aortic Valve Replacement
11.
Beijing Da Xue Xue Bao ; (6): 857-864, 2023.
Article in Chinese | WPRIM | ID: wpr-1010141

ABSTRACT

OBJECTIVE@#To explore the impacts of delayed ureteral stent removal on the quality of life (QoL) and mental health of urinary calculi postoperative patients due to the corona virus disease 2019(COVID-19) pandemic.@*METHODS@#The demographic and clinical data of patients with ureteral stent placement after urinary endoscopic lithotripsy and returned to Peking University People's Hospital for stent removal from December 2019 to June 2020 were collected. Ureteral stent symptoms questionnaire (USSQ) score and the outcome 20-item self-rating anxiety scale (SAS) and self-rating depression scale (SDS) were collected to estimate the QoL and mental status. The USSQ consisted of 44 questions in 6 domains (including urinary symptom, physical pain, general health, work performance, sexual function, and ureteral stent related infection). For most questions in each domain, its score was a five-point Likert-type scale from 1 to 5, and a small proportion of questions was quantified by 1 to 4 or 1 to 7 scale. SAS and SDS both contained 20 questions used to assess a patient's level of anxiety and depression. Its scoring for each item was on a four-point Likert-type scale from 1 to 4. A total score (ranging from 20 to 80) was the main statistical indicator. The level of clinical anxiety and depression was quantified by using standard scores (total score multiplied by 1.25 to produce integers). And the multi-group structural equation model was constructed by analysis of moment structure (AMOS) analysis.@*RESULTS@#Overall, 71 patients were enrolled for analysis. It was found that the median duration of ureteral stent time differed significantly between the control and delayed groups for 32 (30, 33) d and 94.5 (88, 103) d, respectively. The delayed group resulted in higher scores in the USSQ multidimensional, which included urinary symptoms, general health, work performance and ureteral stent related infections. Anxiety and depression were also significantly serious in the delayed group than in the control group. A longer indwelling time of a ureteral stent could exacerbate the effects of urinary symptoms and physical pain on work performance (P=0.029 < 0.05). Among them, the patients with severe urinary symptoms leading to poor work performance were most significantly affected by prolonged ureteral stent duration time (CR=2.619>1.96).@*CONCLUSION@#Patients with delayed ureteral stent removal due to the COVID-19 had resulted in worse QoL and mental status. Stents related symptoms are more severe in patients with higher anxiety and depression degree during COVID-19. To improve the QoL and mental health of patients after urinary calculi surgery during COVID-19, it is still not recommended to prolong the stent duration time or corresponding intervention measures should be taken.


Subject(s)
Humans , Quality of Life , Pandemics , COVID-19/epidemiology , Ureter/surgery , Urinary Calculi , Pain , Ureteral Diseases , Stents , Surveys and Questionnaires , Ureteral Calculi
12.
Beijing Da Xue Xue Bao ; (6): 871-875, 2023.
Article in Chinese | WPRIM | ID: wpr-1010143

ABSTRACT

OBJECTIVE@#To investigate the status quo of recognition and management of renal colic among urological surgeons in China.@*METHODS@#From November 2021 to March 2022, 725 urological surgeons in China were surveyed in the form of a questionnaire, including their province, hospital grade, professional title, the number of patients with renal colic treated per week, the preferred drugs and the cognition of the disease. This study was approved by the Medical Ethics Committee of Peking University People's Hospital, and all respondents completed informed consent online.@*RESULTS@#During November 2021 and March 2022, urological surgeons across China were surveyed in the form of a questionnaire, and the reliability and validity of the questionnaire were verified before the study was carried out. In the study, 720 valid questionnaires were collected (accounting for 99.31% of the total number), in which 42.4% of the doctors' preferred drugs were non-steroidal anti-inflammatory drugs (NSAIDs), and 40.0% of the doctors' preferred antispasmodic drugs. Opioids were the first choice of 11.0% of the physicians and other treatments were preferred by 6.6% of physicians. In addition, 61.1% of the doctors thought that the mechanism of renal colic was elevated prostaglandin, 32.2% thought it was ureteral spasm, 5.0% thought it was calculi irritation, and 1.7% thought the mechanism was unclear. The doctor of the cognition of the generation mechanism of renal colic pain had a significant influence on the preferred treatment option (χ2=54.399, P < 0.001) that the "elevated prostaglandins" doctor more often preferred NSAIDs than the doctor who thought cramps and ureter stones caused renal colic (51.6% vs. 28.0%, χ2=34.356, P < 0.001;51.6% vs. 19.4%, χ2=13.759, P < 0.001). In addition, hospital class, physician title, and the number of weekly consultations by physicians influenced the choice of medications for renal colic (P < 0.05), tertiary hospitals, middle and senior professional titles and weekly patients with renal colic > 8 cases generally preferred NSAIDs.@*CONCLUSION@#There are deficiencies in the cognition and drug treatment of renal colic among urological surgeons in China. The choice of the preferred drug was related to the doctor's cognition of the disease, the grade of the hospital, the doctor's professional title and the weekly treatment volume.


Subject(s)
Humans , Renal Colic/drug therapy , Urologists , East Asian People , Reproducibility of Results , Anti-Inflammatory Agents, Non-Steroidal , Surveys and Questionnaires
13.
Journal of Experimental Hematology ; (6): 1556-1562, 2023.
Article in Chinese | WPRIM | ID: wpr-1010005

ABSTRACT

OBJECTIVE@#To analyze the pathogenic bacterial spectrum, drug resistance, and risk factors associated with multidrug-resistant bacterial infection and mortality in patients with hematologic diseases complicated by bloodstream infections, so as to provide reference for rational drug use and improving prognosis.@*METHODS@#Positive blood culture specimens of patients with hematologic diseases in two Class A tertiary hospitals of Shanxi province from January 2019 to December 2021 were retrospectively analyzed. Pathogen distribution, drug resistance and outcomes of patients with bloodstream infection were investigated, then the multivariate logistic analysis was performed to analyze the risk factors of multidrug-resistant bacterial infection and factors affecting prognosis.@*RESULTS@#203 strains of pathogens were identified, mainly Gram-negative bacteria (GNB) (69.46%, 141/203), of which Escherichia coli (E.coli) had the highest incidence (41.13%, 58/141), followed by Klebsiella pneumoniae (20.57%, 29/141) and Pseudomonas aeruginosa (12.77%, 18/141). Extended-spectrum beta-lactamase (ESBL)-producing E.coli and Klebsiella pneumoniae were 46.55% (27/58) and 37.93% (11/29), respectively. Carbapenem-resistant Gram-negative bacteria accounted for 10.64% (15/141). And Gram-positive bacteria accounted for 27.59% (56/203), Staphylococcus epidermidis, Streptococcus pneumoniae, and Staphylococcus aureus were the most frequently isolated pathogen among Gram-positive bacteria (14.29%, 12.50% and 10.71%, respectively), of which methicillin-resistant Staphylococcus aureus accounted for 33.33% (2/6), coagulase-negative staphylococci accounted for 87.50% (7/8), without vancomycin- or linezolid-resistant strain. Additionally, fungi accounted for 2.95% (6/203), all of which were Candida. Multidrug-resistant Gram-negative bacteria (MDR-GNB) accounted for 53.90% (76/141). Duration of neutropenia >14 days was a risk factor for developing MDR-GNB infection. The 30-day all-cause mortality was 10.84%. Multivariate logistic regression analysis showed that the significant independent risk factors for mortality were age≥60 years (P <0.01, OR =5.85, 95% CI: 1.80-19.07) and use of vasopressor drugs (P <0.01, OR =5.89, 95% CI: 1.83-18.94).@*CONCLUSION@#The pathogenic bacteria of bloodstream infection in patients with hematological diseases are widely distributed, and the detection rate of multidrug-resistant bacteria is high. The clinicians should choose suitable antibiotics according to the results of bacterial culture and antibiotic susceptibility test.


Subject(s)
Humans , Middle Aged , Bacteremia/mortality , Bacteria/isolation & purification , Drug Resistance , Drug Resistance, Bacterial , Gram-Negative Bacteria , Hematologic Diseases/complications , Methicillin-Resistant Staphylococcus aureus , Retrospective Studies , Risk Factors , Sepsis/mortality
14.
Chin. med. j ; Chin. med. j;(24): 1349-1357, 2023.
Article in English | WPRIM | ID: wpr-980848

ABSTRACT

BACKGROUND@#Dysfunction of the gap junction channel protein connexin 43 (Cx43) contributes to myocardial ischemia/reperfusion (I/R)-induced ventricular arrhythmias. Cx43 can be regulated by small ubiquitin-like modifier (SUMO) modification. Protein inhibitor of activated STAT Y (PIASy) is an E3 SUMO ligase for its target proteins. However, whether Cx43 is a target protein of PIASy and whether Cx43 SUMOylation plays a role in I/R-induced arrhythmias are largely unknown.@*METHODS@#Male Sprague-Dawley rats were infected with PIASy short hairpin ribonucleic acid (shRNA) using recombinant adeno-associated virus subtype 9 (rAAV9). Two weeks later, the rats were subjected to 45 min of left coronary artery occlusion followed by 2 h reperfusion. Electrocardiogram was recorded to assess arrhythmias. Rat ventricular tissues were collected for molecular biological measurements.@*RESULTS@#Following 45 min of ischemia, QRS duration and QTc intervals statistically significantly increased, but these values decreased after transfecting PIASy shRNA. PIASy downregulation ameliorated ventricular arrhythmias induced by myocardial I/R, as evidenced by the decreased incidence of ventricular tachycardia and ventricular fibrillation, and reduced arrythmia score. In addition, myocardial I/R statistically significantly induced PIASy expression and Cx43 SUMOylation, accompanied by reduced Cx43 phosphorylation and plakophilin 2 (PKP2) expression. Moreover, PIASy downregulation remarkably reduced Cx43 SUMOylation, accompanied by increased Cx43 phosphorylation and PKP2 expression after I/R.@*CONCLUSION@#PIASy downregulation inhibited Cx43 SUMOylation and increased PKP2 expression, thereby improving ventricular arrhythmias in ischemic/reperfused rats heart.


Subject(s)
Rats , Male , Animals , Myocardial Reperfusion Injury/metabolism , Connexin 43/genetics , Sumoylation , Down-Regulation , Rats, Sprague-Dawley , Arrhythmias, Cardiac/drug therapy , Myocardial Ischemia/metabolism , RNA, Small Interfering/metabolism
15.
Article in Chinese | WPRIM | ID: wpr-981714

ABSTRACT

OBJECTIVE@#To determine whether C7 angles (C7 slope, C7S) could replace T1 angles (T1 slope, T1S) by correlation analysis of T1S and C7S.@*METHODS@#A total of 442 patients from July 2015 to July 2020 in outpatient and inpatient department were enrolled retrospectively, and 259 patients who could identify the upper endplate of T1 were screened out . Of them, there were 145 males and 114 females, aged from 20 to 83 years old with an average of (58.6±11.2) years, including 163 patients with cervical spine surgery and 96 non-surgical patients. Patients were stratified by sex, age, cervical kyphosis, cervical alignment imbalance, and cervical spine surgery. These 259 patients included 145 cases in the male group, 114 cases in the female group;76 cases in the youth group (<40 years old), 109 cases in the middle-aged group (40 to 60 years old), and 74 cases in the elderly group(>60 years old); 92 cases in the cervical kyphosis group, 167 cases in the non-kyphosis group;51 cases in the cervical sequence imbalance group, 208 cases in the non-imbalance group;163 cases in the cervical surgery group, 96 cases in the non-operation group. The correlations of C7S and T1S in various modalities groups were analyzed.@*RESULTS@#Of 442 patients, the recognition rate of upper endplate of T1 was 58.6%(259/442), and that of C7 was 90.7%. The mean T1S and C7S of the 259 patients were (24.5±8.0)° [(25.9±7.7)° in the male group and (23.7±6.9)° in the female group] and (20.8±7.3)° [(22.5±7.5)° in the male group and(19.7±5.8)° in the female group], respectively. The total correlation coefficient between C7S and T1S was r=0.89, R2=0.79, and the linear regression equation was T1S=0.91×C7S+4.35. In the above general information and the grouping of deformity factors, T1S was highly correlated with C7S(r value 0.85 to 0.92, P<0.05).@*CONCLUSION@#There is a high correlation between T1S and C7S in different factor groups. For cases where T1S cannot be measured, C7S can be used to provide guidance and reference for evaluating the sagittal balance of the spine, analyzing the condition, and formulating surgical plans.


Subject(s)
Middle Aged , Adolescent , Humans , Male , Female , Aged , Young Adult , Adult , Aged, 80 and over , Lordosis/surgery , Retrospective Studies , Cervical Vertebrae/surgery , Kyphosis/surgery , Neck
16.
Zhonghua xinxueguanbing zazhi ; (12): 619-625, 2023.
Article in Chinese | WPRIM | ID: wpr-984694

ABSTRACT

Objective: To explore the value of cardiac magnetic resonance imaging (CMR) in the risk stratification of hypertrophic cardiomyopathy (HCM). Methods: HCM patients who underwent CMR examination in Fuwai Hospital between March 2012 and May 2013 were retrospectively enrolled. Baseline clinical and CMR data were collected and patient follow-up was performed using telephone contact and medical record. The primary composite endpoint was sudden cardiac death (SCD) or and equivalent event. The secondary composite endpoint was all-cause death and heart transplant. Patients were divided into SCD and non-SCD groups. Cox regression was used to explore risk factors of adverse events. Receiver operating characteristic (ROC) curve analysis was used to assess the performance and the optimal cut-off of late gadolinium enhancement percentage (LGE%) for the prediction of endpoints. Kaplan-Meier and log-rank tests were used to compare survival differences between groups. Results: A total of 442 patients were enrolled. Mean age was (48.5±12.4) years and 143(32.4%) were female. At (7.6±2.5) years of follow-up, 30 (6.8%) patients met the primary endpoint including 23 SCD and 7 SCD equivalent events, and 36 (8.1%) patients met the secondary endpoint including 33 all-cause death and 3 heart transplant. In multivariate Cox regression, syncope(HR=4.531, 95%CI 2.033-10.099, P<0.001), LGE% (HR=1.075, 95%CI 1.032-1.120, P=0.001) and left ventricular ejection fraction (LVEF) (HR=0.956, 95%CI 0.923-0.991, P=0.013) were independent risk factors for primary endpoint; Age (HR=1.032, 95%CI 1.001-1.064, P=0.046), atrial fibrillation (HR=2.977, 95%CI 1.446-6.131, P=0.003),LGE% (HR=1.075, 95%CI 1.035-1.116, P<0.001) and LVEF (HR=0.968, 95%CI 0.937-1.000, P=0.047) were independent risk factors for secondary endpoint. ROC curve showed the optimal LGE% cut-offs were 5.1% and 5.8% for the prediction of primary and secondary endpoint, respectively. Patients were further divided into LGE%=0, 0<LGE%<5%, 5%≤LGE%<15% and LGE%≥15% groups. There were significant survival differences between these 4 groups whether for primary endpoint or secondary endpoint (all P<0.001) and the accumulated incidence of primary endpoint was 1.2% (2/161), 2.2% (2/89), 10.5% (16/152) and 25.0% (10/40), respectively. Conclusion: LGE is an independent risk factor for SCD events as well as all-cause death and heart transplant. LGE is of important value in the risk stratification in patients with HCM.


Subject(s)
Humans , Female , Adult , Middle Aged , Male , Contrast Media , Retrospective Studies , Stroke Volume , Gadolinium , Ventricular Function, Left , Magnetic Resonance Imaging , Cardiomyopathy, Hypertrophic/diagnostic imaging , Death, Sudden, Cardiac , Risk Assessment
17.
Zhonghua Yu Fang Yi Xue Za Zhi ; (12): 626-633, 2023.
Article in Chinese | WPRIM | ID: wpr-985454

ABSTRACT

Objective: To investigate the association of the levels of high sensitivity C-reactive protein (hs-CRP) with frailty and its components among the elderly over 65 years old in 9 longevity areas of China. Methods: Cross-sectional data from the Health Ageing and Biomarkers Cohort Study (HABCS, 2017-2018) were used and the elderly over 65 years old were included in this study. Through questionnaire interview and physical examination, the information including demographic characteristics, behavior, diet, daily activity, cognitive function, and health status was collected. The association between hs-CRP and frailty and its components in the participants was analyzed by multivariate logistic regression model and restrictive cubic spline. Results: A total of 2 453 participants were finally included, the age was (84.8±19.8) years old. The median hs-CRP level was 1.13 mg/L and the prevalence of frailty was 24.4%. Compared with the low-level group (hs-CRP<1.0 mg/L), the OR (95%CI) value of the high-level group (hs-CRP>3.0 mg/L) was 1.79 (1.35-2.36) mg/L. As for the components, the hs-CRP level was also positively associated with ADL disability, IADL disability, functional limitation and multimorbidity. After adjusting for confounding factors, compared with the low-level group, the OR (95%CI) values of the high-level group for the four components were 1.68 (1.25-2.27), 1.88 (1.42-2.50), 1.68 (1.31-2.14) and 1.39 (1.12-1.72), respectively. Conclusion: There is a positive association between the levels of hs-CRP and the risk of frailty among the elderly over 65 years old in 9 longevity areas of China. The higher hs-CRP level may increase the risk of frailty by elevating the risk of four physical functional disabilities, namely ADL disability, IADL disability, functional limitation and multimorbidity.


Subject(s)
Humans , Aged , Aged, 80 and over , C-Reactive Protein/analysis , Frailty/epidemiology , Cohort Studies , Cross-Sectional Studies , China/epidemiology
18.
Chinese Critical Care Medicine ; (12): 438-441, 2023.
Article in Chinese | WPRIM | ID: wpr-982609

ABSTRACT

Sepsis-associated coagulopathy refers to extensive coagulation activation accompanied by a high risk of bleeding and organ failure. In severe cases, it is manifested as disseminated intravascular coagulation (DIC) and leads to multiple organ dysfunction syndrome (MODS). Complement is an important component of the innate immune system and plays an important role in defending against invasion of pathogenic microorganisms. The early pathological process of sepsis involves excessive activation of the complement system, which forms an extremely complex network through interactions with the coagulation, kinin and fibrinolytic system, amplifying and exacerbating the systemic inflammatory response. In recent years, it has been suggested that uncontrolled complement activation system can exacerbate sepsis-associated coagulation dysfunction or even DIC, indicating the potential value of intervening in the complement system in the treatment of septic DIC, and related research progress is reviewed in this article in order to provide new ideas for the discovery of sepsis-associated coagulopathy therapy drugs.


Subject(s)
Humans , Blood Coagulation Disorders , Complement Activation , Blood Coagulation , Multiple Organ Failure , Sepsis
19.
Article in Chinese | WPRIM | ID: wpr-982783

ABSTRACT

Objective:To investigate the efficacy of functional endoscopic sinus surgery(FESS) in the treatment of olfactory dysfunction in patients with chronic rhinosinusitis with nasal polyps (CRSwNP) , at the same time, it provides an evidence for the prognosis evaluation of olfaction and the clinical application of oERPs to evaluate the plasticity of olfaction cortex. Methods:From October 2021 to October 2022, 45 patients with CRSwNP who underwent FESS nine-step standardized treatment in our department were recruited as the research subjects, divided into 22 patients with eosinophilic CRSwNP(ECRS)and 23 patients with non-eosinophilic CRSwNP(nECRS). VAS-olfactory dysfunction (VAS-OD) score, SNOT-22 olfactory score, Sniffin' Sticks test and oERPs collection and processing were performed before the operation. All items were evaluated again 3 months after the operation. Results:VAS-OD and SNOT-22 olfactory score were significantly lower in all CRSwNP patients after the operation than those before the operation[F(1, 43) =357.429, P<0.001; F(1, 43) =185.657, P<0.001], the scores of T, D, I and TDI scores in Sniffin' Sticks test were significantly higher than those before the operation[F(1, 43) =126.302, P<0.001; F(1, 43) =311.301, P<0.001; F(1, 43) =131.401, P<0.001; F(1, 43) =295.885, P<0.001]; The decrease of VAS-OD and SNOT-22 olfactory score in the ECRS group was smaller than that in the nECRS group[F(1, 43) =4.825, P=0.033; F(1, 43) =9.916, P=0.003], T, D and TDI scores were significantly lower in nECRS group than those in nECRS group[F(1, 43) =6.719, P=0.013; F(1, 43) =4.890, P=0.032; F(1, 43) =4.469, P=0.040]; There was a positive correlation between preoperative eosinophil-to-lymphocyte ratio(ELR) and SNOT-22 olfactory score and how much it changes(r=0.455, P=0.002; r=-0.414, P=0.005), a negative correlation between T, TDI score and how much they change respectively(r=-0.431, P=0.003; r=-0.385, P=0.009; r=-0.383, P=0.010; r=-0.316, P=0.035). The latency of P3 was significantly shorter after operation than that before operation in all CRSwNP patients[F(1, 14) =24.840, P<0.001], however, the amplitude has no significant surgical effect. Conclusion:FESS could significantly improve the olfactory function of CRSwNP patients, while changes in plasticity may occur in the olfactory cortex. In addition, the preoperative peripheral blood eosinophil granulocyte level can predict the postoperative olfactory improvement.


Subject(s)
Humans , Prospective Studies , Nasal Polyps/surgery , Rhinitis/surgery , Sinusitis/surgery , Olfaction Disorders/etiology , Chronic Disease , Endoscopy/adverse effects
20.
Zhonghua Yu Fang Yi Xue Za Zhi ; (12): 1222-1230, 2023.
Article in Chinese | WPRIM | ID: wpr-1045859

ABSTRACT

Objective: The study investigated the clinical distribution, antimicrobial resistance and epidemiologic characteristics of hypervirulent Carbapenem-resistant Klebsiella pneumoniae (hv-CRKP) in a hospital in Henan Province to provide a scientific basis for antibiotic use and nosocomial infection prevention and control. Methods: A retrospective analysis of the clinical data from the cases was carried out in this study. Clinical data of patients infected with the CRKP strain isolated from the clinical microbiology laboratory of Henan Provincial Hospital of Traditional Chinese Medicine from January 2020 to December 2022 were retrospectively analyzed. A string test, virulence gene screening, serum killing, and a G. mellonella infection model were used to screen hv-CRKP isolates. The clinical characteristics of hv-CRKP and the drug resistance rate of hv-CRKP to twenty-five antibiotics were analyzed using WHONET 5.6. Carbapenemase phenotypic characterization of the hv-CRKP was performed by colloidal gold immunochromatographic assay, and Carbapenemase genotyping, multi-locus sequence typing (MLST) and capsular serotyping of hv-CRKP isolates were performed by PCR and Sanger sequencing. Results: A total of non-duplicate 264 CRKP clinical isolates were detected in the hospital from 2020 to 2022, and 23 hv-CRKP isolates were detected, so the corresponding detection rate of hv-CRKP was 8.71% (23/264). The hv-CRKP isolates in this study were mainly from the intensive care unit (10/23) and neurosurgery department (8/23), and the main sources of hv-CRKP isolates were sputum (10/23) and bronchoalveolar lavage fluid (6/23). The hv-CRKP isolates in this study were highly resistant to β-lactam antibiotics, fluoroquinolones and aminoglycosides, and were only susceptible to colistin, tigecycline and ceftazidime/avibactam. The detection rate of the blaKPC-2 among 23 hv-CRKP isolates was 91.30% (21/23) and none of the class B and class D carbapenemases were detected. Results of MLST and capsular serotypes showed that ST11 type hv-CRKP was the dominant strain in the hospital, accounting for 56.52% (13/23), and K64 (9/13) and KL47 (4/13) were the major capsular serotypes. Conclusion: The hv-CRKP isolates from the hospital are mainly from lower respiratory tract specimens from patients admitted to the intensive care department and the drug resistance is relatively severe. The predominant strains with certain polymorphisms are mainly composed of the KPC-2-producing ST11-K64 and ST11-KL47 hv-CRKP isolates in the hospital.


Subject(s)
Humans , Klebsiella pneumoniae/genetics , Multilocus Sequence Typing , Retrospective Studies , Klebsiella Infections/drug therapy , Anti-Bacterial Agents/therapeutic use , Hospitals , Carbapenem-Resistant Enterobacteriaceae/genetics , Microbial Sensitivity Tests , Carbapenems/pharmacology
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