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








Year range
1.
Article in Chinese | WPRIM | ID: wpr-863682

ABSTRACT

The international TCM clinical knowledge database is demand-oriented, fully integrated TM resources of the Institute of Information on Traditional Chinese Medicine of China Academy of Chinese Medical Sciences that has accumulated for decades, with increased new resources. The resources are structured by subject indexing, classification and knowledge extraction, and are hierarchically translated by machine translation and manned proofreading. In addition, the research group also designs and develops service platform using ontology, semantic web, association relationship and other information technology. The knowledge database will provide knowledge service to TCM practitioners and the general public worldwide, and promote the internationalization of TCM.

2.
Article in Chinese | WPRIM | ID: wpr-868072

ABSTRACT

Objective:To review the imaging characteristics and evaluate the diagnostic value of Doppler echocardiography for congenital pseudoaneurysm of the mitral-aortic intervalvular fibrosa (PMAIVF).Methods:Between June 2008 and January 2020, 4 patients with PMAIVF were diagnosed by CTA, MRI and operative findings in Shanghai Children′s Medical Center and Children′s Hospital of Soochow University. The echocardiographic characteristics were analyzed retrospectively in these children.Results:PMAIVF was characterized by a pulsatile echo-free sac that expanded in systole and collapsed in diastole with to-and-fro blood flow on color and pulsed-wave Doppler echocardiography between the mitral leaflet and the aortic annulus. Three cases were diagnosed correctly, and 1 case was misdiagnosed as left atrial mass.Conclusions:PMAIVF can be diagnosed accurately by Doppler echocardiography, but it is prone to be misdiagnosed and must be distinguished from aortic root abscess, atrial mass and coronary artery fistula.

3.
Article in Chinese | WPRIM | ID: wpr-868037

ABSTRACT

Objective:To review the imaging characteristics and evaluate the diagnostic value of Doppler echocardiography for congenitally malposition of septum primum(MSP).Methods:Images of Doppler echocardiography were retrospectirely rewiewed and compared with CTA, operative and necropsy findings in 8 cases with MSP in Xinhua Hospital, and Shanghai Children′s Medical Center, Shanghai Jiaotong University School of Medicine from January 2009 to October 2019.Results:MSP was characterized by the absent of superior limbic band of septum secundum and different degrees of the leftward deviation of septum primum, and the pulmonary veins which connected with the posterior wall of the anatomical left atrium incorporated intothe right atrium. The associated malformations included totally anomalous (7 cases) and partially anomalous (1 case) pulmonary venous drainage directly to the right atrium. Six of 8 cases were diagnosed correctly. In the remaining 2 cases, 1 case misdiagnosed as single atrium, and the other case misdiagnosed as cor triatriatum.Conclusions:MSP could be diagnosed accurately by Doppler echocardiography. This malformation should be distinguished from single atrium and cor triatriatum.

4.
Article in Chinese | WPRIM | ID: wpr-867949

ABSTRACT

Objective:To observe the short-term efficacy of 3D-printed custom-made hemipelvic prosthesis in the treatment of primary malignant bone tumors of the pubis.Methods:From June 2017 to May 2019, a total of 5 patients with pubic primary malignant tumor received type Ⅲ hemipelvectomy and reconstruction with a 3D-printed custom-made hemipelvic prosthesis at Department of Orthopedics, West China Hospital. They were 3 males and 2 females with an average age of 36.3 years (range, from 26 to 46 years). Of them, 3 underwent resection of the upper pubic ramus and 2 resection of both pubic rami. All their tumors were chondrosarcomas, with one case of Enneking stage Ⅱa and 4 cases of Enneking stage Ⅱb. Preoperative CT/MRI image fusion was used to determine the tumor-free resection margin, design guide templates for osteotomy and prosthesis, and simulate surgical procedures. A total of 5 3D-printed custom-made hemipelvic prostheses were designed, including 3 ones with an intramedullary stem to preserve partial pubis and 2 ones with a non-intramedullary stem not to preserve the pubis. The functional recovery was assessed by Musculoskeletal Tumor Society (MSTS) scores. The prosthetic position and osseointegration were evaluated by imaging examination. Oncological outcomes and complications were recorded.Results:R0 resection and precise reconstruction were accomplished in all patients. Their intraoperative blood loss ranged from 300 to 3, 700 mL (mean, 1, 680 mL), operation time from 180 to 430 min (mean, 294 min), and follow-up time from 13 to 29 months (mean, 20.6 months). All the 5 patients were alive with no evidence of disease or tumor recurrence. The functional MSTS scores at the final follow-up ranged from 29 to 31 (mean, 29.8). One male patient complained of erectile dysfunction. Fretting wear around the prosthetic stem was found in 3 patients while bone wear on the normal pubic side in 2. Osseointegration was observed in all patients with no complications like deep infection, prosthesis dislocation, prosthetic or screw breakage.Conclusion:Since 3D-printed custom-made hemipelvic prostheses can result in fine short-term efficacy for pubic primary malignant bone tumors, they may be a reliable method to reconstruct pelvic malignant tumors.

5.
Article in Chinese | WPRIM | ID: wpr-754853

ABSTRACT

To review the imaging characteristics and evaluate the diagnostic value of echocardiography for congenital double‐chambered left ventricle ( DCLV ) in children , and improve the diagnostic accuracy of initial echocardiography . Methods Doppler echocardiography was performed and these images were compared retrospectively with operative and computed tomography angiography findings in 8 children with DCLV . Results DCLV was characterized by the presence of a main left ventricular chamber and an auxiliary chamber seperated by abnormally hypertrophic muscle and/or fiber bundles . Six cases were diagnosed with type A ,and 2 cases with type B by Li Jun′s classification . T he associated malformations included ventricular septal defect ( 3 cases ) ,mitral regurgitation ( 2 cases ) ,mitral valve stenosis ( 1 case) . Six of 8 cases( 75 .0% ) were diagnosed correctly using Doppler echocardiography ,in the remaining 2 cases ( 25 .0% ) ,1 case was missed ,1 case misdiagnosed as left ventricular diverticulum . Conclusions DCLV could be correctedly diagnosed by Doppler echocardiography . This malformation should be differentiated from left ventricular diverticulum , left ventricular aneurysm , left ventricular non‐compaction ,and ventricular septal defect .

6.
Chinese Journal of Pediatrics ; (12): 614-619, 2019.
Article in Chinese | WPRIM | ID: wpr-810798

ABSTRACT

Objective@#To explore the clinical manifestations, diagnosis, treatment and prognosis of anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) .@*Methods@#A retrospective study identified 91 patients diagnosed with ALCAPA at Shanghai Children′s Medical Center from March 2010 to August 2017. According to the left ventricular ejection fraction (LVEF) at the time of consultation, patients were divided into the cardiac insufficiency group (n=54) and the normal cardiac function group (n=37). Clinical features (age of onset, clinical performance, etc) and auxiliary examinations (electrocardiogram, echocardiography, etc) between the two groups were compared using a t-test and a Chi-square test. Prognostic factors were analyzed by an ordered logistic regression and a Pearson correlation coefficient.@*Results@#(1) The age of diagnosis of patients in the cardiac insufficiency group who were usually misdiagnosed as cardiomyopathy was (10.0±2.6) months (20/54) , whereas the age of diagnosis of patients in the normal cardiac function group who were usually misdiagnosed as valvular diseases was (40.0±7.8) months (4/37). According to the pathophysiological mechanism, forty of the 54 (74%) patients in the cardiac insufficiency group were infantile type, and 78% patients (29/37) in the normal cardiac function group were adult type. (2) Preoperative electrocardiogram showed the deep Q wave in lead I occurred more frequently in the cardiac insufficiency group than in the normal cardiac function group (28/54 vs. 11/37, χ2=4.388, P=0.036). (3) Twenty patients died in the cardiac insufficiency group including 12 patients who died from postoperative cardiac pump failure and 8 children who did not undergo surgery due to poor prognosis and died from other reasons. There was no death in the normal cardiac function group. (4) Preoperative LVEF was the unique risk factor affecting prognosis (F=16.872, P=0.005). The preoperative LVEF was significantly lower than the postoperative LVEF ((37±11)% vs. (45±14)%, t=3.614, P=0.001) in the cardiac insufficiency group. During the follow-up period, 6 patients in the cardiac insufficiency group still presented with postoperative cardiac dysfunction, and the patients in the normal cardiac function group still had normal cardiac function.@*Conclusions@#Preoperative LVEF was the unique risk factor affecting prognosis of ALCAPA. Patients with infantile type ALCAPA and preoperative cardiac insufficiency should receive long-term follow-up treatment.

7.
Article in Chinese | WPRIM | ID: wpr-806979

ABSTRACT

Objective@#To review the imaging characteristics and evaluate the diagnostic value of echocardiography for levoatriocardinal vein(LACV) in children.@*Methods@#Doppler echocardiography was performed and these images were compared retrospectively in 9 children with LACV, which were diagnosed through the operation of cardial surgery and computed tomography angiography findings.@*Results@#LACV was characterized by an anomalous vein connected the left atrium to the left innominate vein. There was a normal connection of the pulmonary vein with the left atrium. The associated malformations included mitral valve stenosis and mitral atresia (8 cases), single ventricle(3 cases), double outlet right ventricle (2 cases), hypoplastic left heart syndrome (2 cases), atrial septal defect with restrictive shunt (1 case), and patent foramen ovale (1 case). Six of 9 cases(66.7%) were diagnosed correctly using Doppler echocardiography, in the remaining 3 cases (33.3%), 1 case was miss diagnosed, 1 case misdiagnosed as persistent left superior vena cava, and 1 case misdiagnosed as partial anomalous pulmonary venous connection.@*Conclusions@#LACV can be diagnosed by Doppler echocardiography. This malformation should be differentiated from persistent left superior vena cava, and anomalous pulmonary venous connection.

8.
Chinese Pharmacological Bulletin ; (12): 934-941, 2017.
Article in Chinese | WPRIM | ID: wpr-620131

ABSTRACT

Aim To observe the effect of antibody NCX-3F10 on the main ion current of rat ventricular myocytes and its effect on arrhythmias induced by ischemia/reperfusion(I/R).Methods ① The whole-cell patch clamp technique was employed to record the Na+/Ca2+ exchange current(INa/Ca) and other major ion currents in rat ventricular myocytes.② The rat models of arrhythmia induced by ischemia/reperfusion were established by ligating the left coronary artery to in vivo and in vitro.Then the effects of antibody on the arrhythmia were observed.③ The IonOptix ion imaging system was used to observe the effect of antibody on calcium transients in single ventricular myocytes.Results ① The antibody NCX-3F10 dose-dependently inhibited INa/Ca from 5 to 40 mg·L-1.The IC50 for outward and inward currents was 11.15 and 11.69 mg·L-1, and the maximum inhibitory rates were 61% and 62%, respectively.The antibody also had an inhibitory effect on calcium current(ICa-L), and had no significant effect on inward rectifier potassium current(IK1), transient outward potassium current(Ito) and sodium current(INa).② In the isolated rat heart group I/R, 100% rats showed ventricular tachycardia, and 88.89% rats had ventricular fibrillation.After administration of antibody NCX-3F10(10 mg·L-1) 5 min before reperfusion, the incidence of ventricular tachycardia decreased to 44.43%(P<0.05), and the duration of ventricular tachycardia and ventricular fibrillation was also shortened remarkably(P<0.05).③ In the anesthetized rats after administration of antibody NCX-3F10(50 μg·kg-1) 5 min before reperfusion, the incidence and duration of ventricular tachycardia,the incidence and duration of ventricular fibrillation, and total number of ventricular premature beats were significantly decreased(P<0.05).④ From 5 to 40 mg·L-1, NCX-3F10 antibody decreased calcium transient amplitude in rat single ventricular myocytes dose-dependently(P<0.05).Conclusions The NCX-3F10 antibody shows significant arrhythmic effects on ischemia-reperfusion induced arrhythmia in rats both in vitro and in vivo, the underlying mechanism of which is related to NCX and L-type calcium current inhibition and calcium overload reduction by the NCX antibody.

9.
Chinese Journal of Nursing ; (12): 564-567, 2017.
Article in Chinese | WPRIM | ID: wpr-618683

ABSTRACT

This paper summarized the nursing experience of one infant with right lower limb ischemia caused by amniotic band syndrome. The nursing key points included:careful observation of the infant condition,exposing the wound,raising the affected limb,wound disinfection,and removing necrotic tissues at the surface skin,applying topical drugs for promoting tissue growth and antibiotics,selecting appropriate dressing to provide suitable environment for tissue regeneration;debridement of inguinal skin,dressing change,assessing pain and providing corresponding care during debridement;infection prevention. After 29 days of treatment and careful nursing care,the skin damage was repaired on the right lower limb,swelling subsided,the necrotic tissues at right inguinal region were completely cleared,granulation tissue was formed,and the infant was discharged smoothly.

10.
Article in Chinese | WPRIM | ID: wpr-617431

ABSTRACT

Objective To investigate the role of different parenting styles plays in conduct problems of 3-years-old preschool children.Methods Participants were from 148 preschools in Longhua Shenzhen,China.A structured questionnaire covering family demographic characteristics,Conners' Parent Symptom Questionnaire and Egna Minnen Betraffande Uppfostran-Parents (EMBU-P) were conducted among primary caregivers of each child.There were 9289 valid participants in the analysis and logistic regression was used to assess the relationship between three dimensions of parenting (rejection,emotional warmth and control/overprotection) and conduct problems.Results After allowing for certain confounders,parental rejection (OR =1.17,P<0.01) and control/overprotection (OR =1.03,P<0.01) was positively associated with conduct problems and emotional warmth was negatively related to conduct problems (OR=0.98,P<0.01).Stratified analysis showed a significant relationship between conduct problems and both parents' rejection (OR father=1.16,P<0.01;OR motber=1.17,P<0.01),father's emotional warmth (OR=0.96,P<0.01) and mother's control/overprotection (OR=1.04,P<0.01).This relationship did not vary between boys and girls and between single and not single children.Conclusion Influence of parenting should be taken into consideration in the prevention and intervention of conduct problems.

11.
Chinese Journal of Medical Imaging ; (12): 516-519,524, 2017.
Article in Chinese | WPRIM | ID: wpr-615285

ABSTRACT

Purpose To evaluate features of the left ventricular twist in patients with atrial septal defect (ASD) using speckle tracking imaging (STI) in order to guide clinical application.Materials and Methods Fifty-eight patients with ASD confirmed by ardiac ultrasound in Shanghai Children's Medical Center from October 2015 to January 2016 were enrolled in this study as case group,which were further divided into group ASD-A with 30 cases and group ASD-B with 28 cases according to the volume of right ventricular.The volume of right ventricular was significantly increased in the group ASD-A,but the volume of right ventricular was not significantly increased in the group ASD-B.At the same time,30 normal children with matched age and sex were chosen as control group.The parameters of left ventricular twist motion in each group were measured and compared by using STI.Results In group ASD-A,The basal and apical part of 6 children rotated counterclockwise.Compared with those in the control group,the basal rotation angle and apical rotation angle of left ventricular in group ASD-A were significantly higher (P<0.01),and the peak twist and torison of left ventricular in group ASD-A were also higher (P<0.05).Compared with those in the control group,only the apical rotation angle in group ASD-B was higher (P<0.05),but the rest parameters of the left ventricular twist motion in group ASD-B were not statistically significantly higher (P>0.05).Conclusion The significant increase in the volume of right heart load in ASD impacts on the basal and apical rotation of left ventricular.

12.
Article in Chinese | WPRIM | ID: wpr-615284

ABSTRACT

Purpose To investigate the diagnostic value of fetal echocardiography in total anomalous pulmonary venous connection (TAPVC),and to analyze the reasons ofmisdiagnosis so as to improve accuracy of prenatal diagnosis.Materials and Methods The prenatal echocardiographic data of 24 cases of TAPVC confirmed by postnatal echocardiography and prenatal MRI from October 2001 to December 2015 in Children's Hospital Affiliated to Nanjing Medical University and Shanghai Children's Medical Center Affiliated to Shanghai Jiaotong University School of Medicine were retrospectively analyzed.Results In 24 cases,there were 14 fetuses of supracardiac type,7 cases of intracardiac type,2 cases of infracardiac type,and 1 case of mixed type.15 fetuses had TAPVC only,whereas 9 cases were associated with other cardiovascular anomalies,most commonly including bilateral right atria,single atrium,single ventricle,common atrioventricular valve and pulmonary stenosis.On 4-chamber views,the common sonographic sign was absent of pulmonary venous return to the left atrium in 24 cases (100.0%),and the presence of venous confluence between left atrium and descending aorta was observed in 22 cases (91.7%).In all 24 cases,1 case was missed diagnosis,and 3 cases were misdiagnosed as persistent left superior vena cava,common pulmonary vein atresia and patent left atrial cardinal vein.Conclusion TAPVC can be accurately diagnosed by fetal echocardiography,but it is prone to be misdiagnosed.

13.
Chinese Journal of Pathophysiology ; (12): 1371-1378, 2017.
Article in Chinese | WPRIM | ID: wpr-608989

ABSTRACT

AIM: To investigate the effect of zacopride, an inward rectifier potassium channel agonist, on ouabain-induced arrhythmias in adult rats, and to explore the underlying electrophysiological mechanism.METHODS: Using ouabain to establish in vitro and in vivo arrhythmic rat models, the effects of zacopride on ouabain-induced arrhythmias were observed.The technique of whole-cell patch clamp was used to observe the effects of zacopride on inward rectifier potassium current (IK1), resting membrane potential (RMP) and delayed afterdepolarizations (DADs) in single rat ventricular myocyte.RESULTS: Zacopride at 1 μmol/L significantly reduced total number of premature ventricular beats, and the duration and incidence of ventricular tachycardia and ventricular fibrillation induced by ouabain in rat hearts in vitro (P<0.05).In anesthetized rats, zacopride at 15 μg/kg significantly reduced total number of premature ventricular beats, and the duration and incidence of ventricular tachycardia and ventricular fibrillation induced by ouabain (P<0.05).IK1 was significantly inhibited by ouabain (P<0.05), which was partially and even completely reversed by zacopride at 0.1~10 μmol/L.RMP value was significantly reduced by ouabain (P<0.05), and then increased to different levels after treatment with zacopride (0.1~10 μmol/L).Zacopride at 1 μmol/L showed its maximal effect and RMP was restored to normal level.Moreover, zacopride at 1 μmol/L markedly suppressed ouabain-induced DADs in single rat ventricular myocyte.The incidence of DADs decreased from 91.67% to 12.50% after zacopride was applied (P<0.05), and this effect was abolished by 1 μmol/L BaCl2.CONCLUSION: Inward rectifier potassium channel agonist zacopride significantly inhibits ouabain-induced ventricular arrhythmias in adult rats.The mechanism is related to increased RMP level and inhibition of DADs by activation of IK1 channel.

14.
Article in Chinese | WPRIM | ID: wpr-667069

ABSTRACT

Objective To review the imaging characteristics and evaluate the diagnostic value of echocardiography for congenital malformations of the right atrium(CMRA).Methods Doppler echocardiography was performed and these images were compared with operative findings in 1 1 children with CMRA.Results CMRA was characterized by idiopathic dilation of the right atrium and right heart appendage,congenital diverticulum of the right atrium and coronary sinus.CMRA consisted of idiopathic dilation of the right atrium(4 cases),congenital diverticulum of the right atrium(3 cases),idiopathic dilation of the right heart appendage(2 cases),and congenital diverticulum of the coronary sinus(2 cases).The associated malformations included patent foramen ovale(6 cases),atrial septal defect(3 cases),pulmonary hypertension(3 cases),and hypoplastic tricuspid valve(2 cases).Eight of 1 1 cases were diagnosed correctly,and other 3 cases were misdiagnosed,in which 1 case with idiopathic dilation of the right atrium misdiagnosed as Ebstein's anomaly,1 case with congenital diverticulum of the right atrium misdiagnosed as congenital enlargement of the right atrial appendage,and 1 case with congenital diverticulum of the coronary sinus misdiagnosed as coronary sinus stenosis.Conclusions CMRA could be diagnosed accurately by Doppler echocardiography,but it is prone to be misdiagnosed and must be distinguished from Ebstein's anomaly.

15.
Article in Chinese | WPRIM | ID: wpr-508730

ABSTRACT

The purpose of education is to cultivate talents who can master the ability of self-learning lifelong. With the rapid development of multimedia technology, the knowledge carrier represented by micro curriculum plays a very important role in improving students' self-learning ability. In traditional Chinese medicine college, due to the short of time, weak learning foundation, the ability of self-learning is hard to improve in the modern medical courses such as biochemistry. This is not conducive to the cultivation of modern talents of Chinese medicine. In this paper, we chose the biochemistry teaching in TCM college as an example, and discuss how we can make the application of micro courses reasonably in the teaching process. This study was regarded as a starting to improve the students' self-learning ability effectively.

16.
Article in Chinese | WPRIM | ID: wpr-496755

ABSTRACT

To study the behavior and attention problems in children with obstructive sleep apnea and hypopnea syndrome (OSAHS),Total 451 children (300 boys and 151 girls) aged >5 years with sleep and breathing problems undergoing polysomnography (PSG) monitoring from September 2012 to March 2014 were enrolled in this study.The behavior part of Vanderbilt attention deficit hyperactivity disorders (ADHD) parent rating scale (VADPRS) and Conners index of hyperactivity (CIH) were completed by the parents.Children were divided into OSAHS group (n =347) and non-OSAHS (n =104) group according to the diagnostic criteria of OSAHS (AHI > 5).According to VADPRS scores the prevalence of attention defect tendency in OSAHS group was 6.63% (23/347),which was significantly higher than that in non-OSAHS group [1.00% (1/104),x2 =5.100,P < 0.05];the prevalence of hyperactivity in OSAHS and nonOSAHS groups was 6.92% (24/347) and 1.92% (2/104),respectively (x2 =3.672,P > 0.05).According to CIH scores,the prevalence of hyperactivity in OSAHS group was 11.24% (39/347),which was significantly higher than that in non-OSAHS group [1.92% (2/104),x2 =3.976,P <0.05].Children with OSAHS are prone to have problems of attention and hyperactivity,even likely to have attention deficit and hyperactivity disorders.

17.
Article in Chinese | WPRIM | ID: wpr-341514

ABSTRACT

<p><b>OBJECTIVE</b>To investigate the risk factors of intra-abdominal infection(IAI) after colorectal cancer surgery.</p><p><b>METHODS</b>Clinical and follow-up data of 773 colorectal cancer patients undergoing operation in our hospital from October 2011 to December 2014 were retrospectively analyzed. Patients were divided into intra-abdominal cavity infection group (110 cases, IAI group) and non intra-abdominal infection group(663 cases, non-IAI group). All the patients administered prophylactic antibiotics 30 minutes to 2 hours before operation. Univariate and multivariate analysis were performed to evaluate the risk factors of IAI.</p><p><b>RESULTS</b>Preoperative factors associated with postoperative IAI included hepatic cirrhosis, kidney diseases, diabetes or other basic diseases, prophylactic use of drugs, hypoalbuminemia, anemia, intestinal obstruction, and American Society of Anesthesiologists (ASA) anesthetic grading score (all P<0.05). Postoperative factors associated with postoperative IAI included use of laparoscopy or stapler, united exenteration, existence of anastomotic fistula, time of drainage tube placement, operation time and tumor staging (all P<0.05). Multivariate logistic regression analysis showed that preoperative diabetes(OR=2.36, 95% CI:1.45 to 4.76, P<0.01), combined exenteration (OR=2.02, 95% CI:1.02 to 4.00, P<0.01), anastomotic leak (OR=4.41, 95% CI:1.77 to 10.99, P=0.001), operation time≥140 minutes (OR=2.88, 95% CI:1.78 to 4.67, P<0.01) and period of postoperative drainage≥10 days(OR=4.57, 95% CI:2.78 to 7.52, P<0.01) were independent risk factors of postoperative IAI, while the use of stapler was protective factor (OR=0.37, 95% CI: 0.23 to 0.60, P<0.01). Compared with prophylactic use of cephamycins plus metronidazole, cefuroxime plus metronidazole had a higher rate of IAI(OR=2.10, 95% CI:1.23 to 3.58, P=0.007).</p><p><b>CONCLUSIONS</b>Prevention of postoperative IAI is required for colorectal cancer patients, particularly in those with preoperative diabetes, combined exenteration, anastomotic leak, operation time longer than 140 minutes and postoperative drainage period longer than 10 days. Preoperative use of cephamycins plus metronidazole has better efficacy in prevention of postoperative IAI.</p>


Subject(s)
Anastomotic Leak , Colorectal Neoplasms , General Surgery , Digestive System Surgical Procedures , Drainage , Humans , Intestinal Obstruction , Intraabdominal Infections , Epidemiology , Laparoscopy , Neoplasm Staging , Postoperative Complications , Epidemiology , Retrospective Studies , Risk Factors
18.
Article in Chinese | WPRIM | ID: wpr-493797

ABSTRACT

Objective:To see the influence of different antiplatelet therapies on stroke patients’ readmission by performing a deep data-mining into Beijing Healthcare Insuring Database,based on a large sample size.Methods:Aretrospective cohort study,was adopted to extract patients primarily diag-nosed as ischemic stroke from healthcare database.The first hospital records were considered as the pa-tient’s baseline in this study,who were divided into MAPT (aspirin)and DAPT (aspirin and clopi-dogrel)according to the patient’s baseline medications.A follow-up was conducted to see whether the patients would have rehospitalization record because of major result events after medication.The major re-sult events,included:(1 )recurrence of ischemic stroke;(2)hemorrhagic transformation of ischemic stroke;(3)myocardial infarction;(4)the digestive hemorrhage.The Kaplan-Meier figure was used to compare the survival situations between these two groups,the log-rank test was used to test the difference of the survival curve,and 1 ∶1 propensity score matching was calculated from the patients’baseline da-ta.Cox proportional hazards model was used to calculate the hazard ratio (HR).Results:A total of 27 695 patients From January 201 0 to September 201 3 were included,4 047 with DAPT,and 23 648 with MAPT.Because the baseline characteristics of the patients was disequilibrium,so we used 1 ∶1 pro-pensity score matching,after which,the number of the two groups was 4 046 each.Adjusted for the gen-eral demographic characteristics such as age,sex,nationality,complication and drug combination,no statistical significance was observed between the survival curves of the two groups (P =0.06).HR value of major result events between the groups was 0.91 (0.82 -1 .01 ,P =0.07),which was not statistically significant.The covariate gender HR =1 .36 (1 .20 -1 .55,P 1 .05)did not increase the risk of readmission.Conclusion:There was no difference in prevention of readmission between patients with DAPT and MAPT.Patients with complications should actively treat the complications at the same time as they prevent recurrence after first attack.

19.
Article in Chinese | WPRIM | ID: wpr-476407

ABSTRACT

Objective To investigate the incidence and risk factors of surgical site infection ( SSI ) in patients with colorectal cancer .Methods Clinical data of patients with colorectal cancer undergoing surgical treatment in Jiaxing First Municipal People’ s Hospital from October 2011 to December 2014 were retrospectively reviewed.The gender, age, underlying diseases, smoking history, preventive medication, abdominal surgery history , type of surgery , preoperative levels of hemoglobin and albumin , use of laparoscopy, use of stapler, combined organ resection, TNM staging, American Society of Anesthesiologists ( ASA) score was documented .Multivariate logistic regression analysis was performed to identify the risk factors of SSI .Results A total of 773 patients were enrolled in the study , and SSI was observed in 144 cases (18.63%).Multivariate logistic regression analysis showed that use of laparoscopy ( OR =0.35, 95%CI:0.15-0.79,P <0.05), use of stapler (OR =0.59, 95% CI: 0.39-0.88,P <0.05) were protective factors for SSI, while diabetes (OR=2.11, 95% CI: 1.25-3.58,P<0.01), liver cirrhosis (OR=2.12,95%CI:1.18-3.79,P<0.05), ASA score (3-4 points) (OR=2.01,95%CI:1.20-3.58, P<0.01), combined organ resection (OR=2.17,95% CI:1.20-3.92,P<0.05), and anastomotic leak (OR=6.85, 95%CI:3.01-15.63,P<0.01) were risk factors for SSI.Conclusions The incidence of SSI is high in patients with colorectal cancer undergoing surgery .Use of laparoscopy and stapler may reduce the incidence of SSI .

20.
Article in Chinese | WPRIM | ID: wpr-474470

ABSTRACT

Objective To study the effectiveness of laparoscopic radiofrequency ablation in the application of primary liver cancer.Methods 92 patients with primary liver cancer were randomly divided into the two groups,the control group(n=46)and the observation group(n=46).The control group was operated through hepatectomy,while the observation group was operated through laparoscopic radiofrequency ablation.The recurrence rate,survival time, quality of life in the two groups were observed.Results Separately on the recurrent tumor of different diameter were compared between the two groups,no significant difference in relapse rate(χ2 =2.14,1.92,all P>0.05).There was no significant difference between the two groups in 3,12,24 months about survival cases (χ2 =1.24,1.96,2.08,all P>0.05 ).To compute the expected survival rate with Kaplan Meier method,the control group survival time was 22.3 months,the observation group survival time was 21.1 months,no significant difference between the two groups (P>0.05 ).The two groups after operation in 3 months,the quality of life of patients all patients were increased,and the observation group improved significantly,compared with the control group (t=2.676,P<0.05 ).Conclusion Laparoscopic radiofrequency ablation had quite effect and liver resection operation curative,but can improve the quality of life.

SELECTION OF CITATIONS
SEARCH DETAIL