Incidencia de infección de vías urinarias con catéter de nefrostomía percutánea posterior a la implementación de un programa estandarizado de cuidados / Incidence of urinary tract infections in patients with permanent percutaneous nephrostomy after implementation of a standardized care program

Resumen Antecedentes: Los catéteres de nefrostomía percutánea (CNP) que se utilizan en algunos hospitales oncológicos condicionan un incremento en las infecciones del tracto urinario (ITU). Objetivo: Determinar el impacto de un programa estandarizado de atención en la incidencia de ITU que requiere hospitalización (ITU-RH). Material y métodos: Estudio retrospectivo que incluyó pacientes con un primer CNP. Se comparó la incidencia, riesgo relativo (RR), costos y evolución de los pacientes con ITU-RH durante el período previo a la intervención (P0) versus posterior a ella (P1). Resultados: Se instalaron 113 CNP durante P0 y 74 durante P1. Durante P0, 61 pacientes (53.9 %) presentaron 64 episodios de ITU-RH, en 22 557 días de uso de CNP. Durante P1, cuatro pacientes (5.4%) cursaron con ITU-RH en el transcurso de 6548 días de uso del CNP (razón de tasa de incidencia de 0.21, IC 95 % = 0.05-0.57). El RR fue de 0.09 (IC 95 % = 0.03-0.25). El costo mensual por día-cama fue de 3823 USD en P0 y de 1076 USD en P1; el de los antibióticos, de 790 USD en P0 y 123.5 USD en P1. Conclusiones: Este estudio resalta la importancia de un programa estandarizado del cuidado de los dispositivos permanentes, el cual disminuye el uso de antibióticos, la hospitalización y el costo de la atención.

Abstract Background: Percutaneous nephrostomy tubes (PNT), which are used in some cancer hospitals, are associated with an increase in the incidence of urinary tract infections (UTI). Objective: To determine the impact of a standardized care program on the incidence of UTI requiring hospitalization (UTI-RH). Material and methods: Retrospective study that included patients with a first PNT inserted. The incidence, relative risk (RR), costs and outcomes of patients with UTI-RH were compared during the period before (P0) vs. after the intervention (P1). Results: 113 PNCs were inserted during P0, and 74 at P1. During P0, 61 patients (53.9%) experienced 64 UTI-RH events in 22,557 PNT days. At P1, four patients (5.4%) had a UTI-RH in 6,548 PNT days (IRR: 0.21, 95% CI: 0.05-0.57). The RR was 0.09 (95% CI: 0.03-0.25). Monthly cost per day/bed was USD 3,823 at P0 and USD 1,076 at P1, and for antibiotics, it was USD 790 at P0 and USD 123.5 at P1. Conclusions: This study highlights the importance of a standardized care program for permanent percutaneous devices, since this reduces antibiotic use, hospitalization, and the cost of care.

Application of 10-F pig tail drainage tube in single-port thoracoscopic lobectomy / 局解手术学杂志

Objective To explore the effect of 10-F pig tail drainage tube on postoperative incision pain and drainage effect in patients undergoing single-port thoracoscopic lobectomy.Methods A total of 120 patients with lung cancer who underwent single-port thoracoscopic lobectomy admitted to First Affiliated Hospital of Hebei University of Traditional Chinese Medicine were selected and divided into the control group and the observation group,with 60 cases in each group.Patients in the control group were placed a 28-F silicone drainage tube in the posterior mediastinum from the side that deviated from the surgical incision after surgery;and patients in the observation group were placed a 10-F pig tail drainage tube horizontally in the posterior mediastinum at the 7th intercostal space of the posterior axillary line(besides,a 10-F pig tail drainage tube should be placed in the 2nd intercostal space of the midclavicular line if the upper or middle lobes were resected).The pain scores 1,3 and 5 days after operation,healing of surgical incision,extubation time of drainage tube,total drainage volume after opera-tion of patients in the two groups were compared.The incidences of postoperative subcutaneous emphysema,atelectasis and re-intubation of patients in the two groups were recorded.Results There was no statistically significant difference in the total drainage volume,extubation time,incidences of subcutaneous emphysema,atelectasis or re-intubation after operation of patients between the two groups(P>0.05).The postoperative healing of surgical incision of patients in the observation group was better than that in the control group(P<0.05),and the score of postoperative incision pain was significantly lower than that in the control group(P<0.05).Conclusion The application of 10-F pig tail drainage tube after single-port thoracoscopic lobectomy can reduce postoperative incision pain,and ensure the drainage effect of postopera-tive hydrothorax and pneumatosis,without the increase of pulmonary complications.

Emergency single drainage tube and dual target thalamic hematoma ventricular drainage surgery based on body surface marker localization for the treatment of thalamic hemorrhage breaking into the ventricle with hydrocephalus / 中国神经精神疾病杂志

Objective To explore the application value of emergency temporal body surface positioning for single drain dual-target thalamic hematoma ventricular drainage in the treatment of thalamic hemorrhage breaking into ventricle with hydrocephalus.Methods A retrospective analysis was conducted on 223 patients with thalamic hemorrhage breaking into the ventricles with hydrocephalus,including a study group of 115 cases who underwent emergency single drain dual-target thalamic hematoma ventricular drainage surgery with temporal body surface positioning,and a control group of 108 cases who underwent emergency ventricular drainage first and then underwent stereotactic thalamic hematoma drainage surgery after the condition stabilized.Compare the differences in postoperative complications and treatment outcomes between two groups of patients,and evaluate the application value of temporal surface positioning for single drain dual-target thalamic hematoma ventricular drainage surgery in the treatment of thalamic hemorrhage breaking into the ventricle with hydrocephalus.Results The postoperative rebleeding rates,hematoma clearance and death were 5.2％,87.5％±7.3％and 13.9％in the study group and 4.7％,90.2％±8.5％and 15.7％in control group,respectively.There was no significant difference between the two groups(P＞0.05).The tube time,postoperative intracranial infection,Shunt dependent hydrocephalus,effective treatment and favorable prognosis of and the control group were(75.5±18.4)h,3.5％,19.1％,53.9％and 51.3％in the study group and(130.8±22.9)h,13.9％,35.1％,38.7％and 38.0％,respectively.The difference between the two groups was statistically significant(P＜0.05).Conclusion Body surface landmark-guided emergency single drain dual-target thalamic hematoma ventricular drainage surgery for the treatment of thalamic hemorrhage breaking into the ventricle with hydrocephalus is safe and reliable,and can improve the patient's prognosis.

Design and application of a drainage tube dredging umbrella and anti-retrograde infection kit / 中华危重病急救医学

The consensus has been reached on the benefits of surgical drainage. However, catheter-related blockage and retrograde infection remain bottleneck problems in the treatment process. To this end, with Huashan Hospital, Fudan University, as the main inventors, a drainage tube dredging umbrella and anti-retrograde infection kit have been designed and applied for the national utility model patent (patent number: ZL 2023 2 1300036.2). The main body of the kit consists of a catheter dredging umbrella, drainage tube, and drainage bag. Several isolation layers are installed in the drainage bag to form a maze structure and a reflux valve is added, thereby increasing the distance and resistance of liquid reflux, greatly reducing the possibility of liquid reflux entering the drainage tube, so as to reduce the risk of retrograde infection through physical means. When the drainage tube is blocked, the drainage tube and joint tube of the drainage bag can be separated, the unblocking umbrella can be inserted into the blockage through the guide wire, the cannula can be inserted along the guide wire, the guide wire is pulled to release the dredging umbrella in the contraction state, and the dredging umbrella can be pulled back in the expansion state until the blockage is removed from the drainage tube. The operating procedure is standardized and simple. While preventing retrograde infection (anti-retrograde infection kit), the catheter dredging umbrella could effectively address the issue of catheter blockage. It has certain clinical promotion and application value.

Design and clinical application of a blue cap anticoagulant blood volume measurement card / 中国医学装备

To develop a blue cap anticoagulant tube blood volume measuring card of to solve the problem of insufficient or excessive blood collection in clinical coagulation specimens.The device was composed of a measuring card,a transparent housing with a base and a tube holder.The measuring card was divided into qualified and unqualified areas,the housing was used to insert the card,the tube holder was used to place blood collection tubes.The device was used by clinical nurses to judge the adequacy of blood collection volume in blue cap anticoagulant tube.After the use of the device,the failure rate of clinical blue cap anticoagulation tube specimens submission was reduced from 6.71‰ to 2.73‰,shortened the time limit for specimen submission.At the same time,the device made the rejection judgment of department specimens more standardized and avoided the acceptance of unqualified specimens caused by subjective judgment errors.The device has simple structure,convenient operation and strong practicability,and has promotion value.

Analysis of influencing factors of tube bleeding and its correlation with perioperative complications after coronary artery bypass grafting / 中华胸心血管外科杂志

Objective:To investigate the influencing factors of increased tube bleeding within 24 h after coronary artery bypass grafting(CABG) and its correlation with perioperative complications.Methods:This study was a prospective observational study. The patients with CABG surgery were enrolled in Beijing Anzhen Hospital affiliated to Capital Medical University from May 2018 to December 2021. The age, sex, complications, blood tests and other clinical data of outpatients were collected. Left ventricular ejection fraction(EF) and left ventricular enddiastolic diameter(LVED) were detected by echocardiography. MGF and PI of grafts were recorded during CABG. Perioperative troponin Ⅰ, blood clotting pentathlon, all-cause death, perioperative myocardial fraction, atrial fibrillation and stroke were collected. According to the tube bleeding within 24 h after operation, the patients were divided into increased group(tube bleeding>1 000 ml) and normal group(tube bleeding≤1 000 ml). The preoperative baseline data, intraoperative indexes and perioperative complications were compared between the two groups. Logistic regression, Spearman and linear regression models were used to analyze the correlation between tube bleeding within 24 h and clinical data.Results:304 patients underwent CABG were enrolled. There were 185 cases(60.9%) in the increased group and 119 cases(39.1%) in the normal group. After adjusting for age, sex and BMI, multivariate logistic regression analysis showed that male( OR=2.40, 95% CI: 1.38-4.18, P=0.002), history of stroke( OR=2.37, 95% CI: 1.07-5.26, P=0.034), and history of myocardial infarction( OR=1.81, 95% CI: 1.13-2.91, P=0.014) could significantly increase the risk of tube bleeding within 24 h after surgery. The average blood flow of the anterior descending branch( OR=0.99, 95% CI: 0.99-1.00, P=0.022) and the circumflex branch( OR=0.99, 95% CI: 0.98-1.00, P=0.003) during the operation was significantly negatively correlated with the increase of tube bleeding within 24 h after surgery, while the PI of anterior descending branch( OR=1.81, 95% CI: 1.26-2.61, P=0.001), circumflex branch( OR=1.45, 95% CI: 1.07-1.97, P=0.017), right coronary artery( OR=1.84, 95% CI: 1.29-2.62, P=0.001) were positively correlated with the increase of tube bleeding within 24 h after operation. In addition, prothrombin time significantly increased the risk of increased tube bleeding within 24 h after surgery( OR=1.16, 95% CI: 1.03-1.30, P=0.018). Linear regression analysis showed that there was a significant positive linear correlation between ICU time and tube bleeding within 24 h after surgery( OR=0.17, 95% CI: 0.96-4.58, P=0.003), and a significant negative linear correlation between postoperative ejection fraction and tube bleeding within 24 h( OR=-0.25, 95% CI: -33.18--13.07, P<0.001). Conclusion:Increased tube bleeding within 24 h after CABG is most common in males and patients with a history of cardiovascular and cerebrovascular infarction. Better graft hemodynamic parameters can reduce the tube bleeding within 24 h after the operation, further improve cardiac function and reduce ICU time.

Effect of metal-supported multi-sided foramen ultrafine drainage tube on the formation of thoracic residual cavity after uniportal video-assisted thoracoscopic upper lobectomy: A retrospective study in a single center / 中国胸心血管外科临床杂志

@#Objective To investigate the effect of multi-sided foramen ultrafine drainage tube with metal support on the formation of thoracic residual cavity after uniportal video-assisted thoracoscopic (VATS) upper lobectomy. Methods The clinical data of the patients who underwent uniportal VATS upper lobectomy for lung cancer in the Department of Thoracic Surgery of the First Hospital of Lanzhou University from January 2021 to April 2022 were retrospectively analyzed. According to the type of ultrafine drainage tube used in the surgery, the patients were divided into a test group (using metal-supported multi-sided foramen ultrafine drainage tube) and a control group (using ordinary 12F ultrafine drainage tube). The incidence of postoperative thoracic residual cavity and operation-related data were compared between the two groups. Results A total of 200 patients were enrolled, including 126 males and 74 females, with a mean age of 57.52 years. There were 90 patients in the test group, and 110 patients in the control group. The incidence of postoperative thoracic residual cavity in the test group was lower than that in the control group (P=0.045). The differences in the postoperative bedtime, postoperative visual analogue scale, postoperative analgesic pump using time, postoperative hospitalization time, times of postoperative thoracentration and drainage, postoperative drainage time and hospitalization cost between the two groups were statistically significant (P<0.05). The incidences of postoperative lung infection, pleural effusion and atelectasis complications were lower in the test group than those in the control group (P<0.05). The differences in the preoperative anesthesia time, operation time, intraoperative bleeding and postoperative lung leakage were not statistically significant (P>0.05). Conclusion The use of multi-sided foramen ultrafine drainage tube with metal support can reduce the incidence of thoracic residual cavity after uniportal VATS upper lobectomy, and can reduce pain and economical burdens and the incidence of operation-related complications, accelerating the recovery of patients after surgery. The application of multi-sided foramen ultrafine drainage tube with metal support in uniportal VATS upper lobectomy can be widely used in the clinic.

XEN drainage tube implantation combined with mitomycin C for open angle glaucoma / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To investigate the clinical efficacy and safety of XEN drainage tube implantation combined with mitomycin C(MMC)for open angle glaucoma(OAG).METHODS:A total of 37 OAG patients(37 eyes)were retrospectively included, grouped by anti-glaucoma surgical treatment as the first choice or not, with 17 patients(17 eyes)in the group with primary surgical treatment, and 20 patients(20 eyes)in the group with the numerous surgeries. The intraocular pressure(IOP), kinds of IOP-lowering drugs, and complications were collected and analyzed in 1 a follow-up postoperatively.RESULTS:Upon the one-year follow-up, IOP had decreased from 27.56±9.94, 28.43±14.18 mmHg to 15.16±3.65, 17.18±5.83 mmHg in both groups, respectively, representing a reduction of 55.01% and 60.43%, respectively(t=4.863, P&#x003C;0.001; t=3.255, P=0.004). The IOP at various follow up points were lower than preoperative points in both groups(Ftime=6.876, Ptime&#x003C;0.001; Fintergroup=0.242, Pintergroup=0.626; Ftime×intergroup=0.959, Ptime×intergroup=0.458). The complete success rate was 47% and 45%, the qualified success rate was 76% and 75%(Z=-0.115, P=0.909), respectively, and there was no significant difference in the cumulative survival rate between two groups(χ2=0.042, P=0.838; χ2=0.004, P=0.949). At the last follow up, IOP-lowering drugs were reduced from 3(2, 3)to 1(0, 2)in both groups(Z=-3.289, -3.796, all P&#x003C;0.001), and no significant difference between groups(Z=-0.581, P=0.561). Hypotony is the most common short-term complications, anterior chamber haemorrhage followed, while, filtering bleb encapsulation is the most frequent long-term complication, no serious complications occurred, but with XEN drainage tube exposure in 1 eye and drop in 1 eye.CONCLUSION:Initial XEN drainage tube implantation combined with MMC and numerous glaucoma surgeries are both safe and effective treatment for OAG patients, while the incidence of filtering bleb encapsulation is high in those with numerous glaucoma surgeries.

Treating Chronic Urticaria with the Method of Dredging Sanjiao （三焦） / 中医杂志

The membranous tube of sanjiao （三焦） is not only the path of the transport of fluid and qi， but the way of the invasion of pathogenic factors， therefore， it cooperates with the skin mucous membrane physically and influence on each other pathologically. It is believed that the core pathogenesis of chronic urticaria is pathogens intruding sanjiao， membrane collaterals acute spasm， and fluid and qi disturbance， of which defense qi insufficiency and pathogens intruding sanjiao initiates the disease， while struggle between healthy and pathogenic qi and membrane collaterals acute spasm is the intermediate stage， and disturbed fluid， qi and blood movement is the terminal stage. Following the core treatment principle of dredging sanjiao， the internal treatment is to open striae and interstices and dispel pathogens out using self-made Guben Shufeng Decoction（固本疏风汤）modifications， and the external treatment is to dredge and regulate membrane collaterals， move qi and fluid， and treat sanjiao simultaneously， commonly using cutting therapy on Danzhong （RN 17） to move qi and fluid， seal umbilical therapy on Shenque （RN 8） to supplement and nourish ying-wei （营卫）， and natural moxibustion on Xuehai （SP 10） to move blood and unblock collaterals.

Safety and cost-benefit analysis of patients without gastric tube after thoracolaparoscopic esophagectomy: A prospective cohort study / 中国胸心血管外科临床杂志

@#Objective To compare the safety and comfort of patients with or without postoperative gastric tube placement after esophageal cancer surgery, and analyze the cost and nursing time of gastric tube placement. Methods The patients with esophageal cancer undergoing minimally invasive surgery in West China Hospital of Sichuan University in 2021 were enrolled. The patients were divided into a gastric tube indwelling group and a non gastric tube indwelling group according to whether the gastric tube was indwelled after the operation. The safety and comfort indicators of the two groups were compared. Results A total of 130 patients were enrolled. There were 66 patients in the gastric tube indwelling group, including 53 males and 13 females, aged 61.80±9.05 years and 64 patients in the non gastric tube indwelling group, including 55 males and 9 females, aged 64.47±8.00 years. Six patients in the non gastric tube indwelling group needed to place gastric tube 1 to 3 days after the operation due to their condition. There was no statistical difference in the incidence of postoperative complications between the two groups (P>0.05). The subjective comfort of patients in the gastric tube indwelling group was significantly lower than that in the non gastric tube indwelling group (P<0.001), and the incidence of foreign body sensation in the throat of patients in the gastric tube indwelling group was higher than that in the non gastric tube indwelling group (P<0.001). The average nursing time in the gastric tube indwelling group was about 59.58 minutes, and the average cost of gastric tube materials and nursing was 378.24 yuan per patient. Conclusion No gastric tube used after operation for appropriate esophageal cancer patients will not increase the incidence of postoperative complications (pulmonary infection, anastomotic leakage, chylothorax), but can increase the comfort of patients, save cost and reduce nursing workload, which is safe, feasible and economical.

Outcomes of tube thoracostomies in COVID-19 patients: A retrospective cohort study in the University of the Philippines - Philippine General Hospital COVID-19 Referral Center

Objective@#To describe the treatment outcomes of patients who underwent tube thoracostomy for pleural complications in patients with COVID-19 and determine the association between patient profile and treatment outcomes.@*Methods@#A single-institution retrospective review of patients who underwent tube thoracostomy for complications of COVID-19 infection in the University of the Philippines - Philippine General Hospital (UP-PGH) from March 30, 2020, to March 31, 2021, was performed. These patients' demographic and clinical profiles were evaluated using median, frequencies, and percentages. The association between patient profile, and mortality and reintervention rates was assessed using univariable Cox proportional hazards regression analysis.@*Results@#Thirty-four (34) of 3,397 patients (1.00%) admitted for COVID-19 pneumonia underwent tube thoracostomy. Of these, 34, 47.06% were male, 52.94% were female, the median age was 51.5 years old, 85.29% had comorbid conditions, and 29.41% had a previous or ongoing tuberculous infection. The most common indication for tube thoracostomy was pleural effusion (61.76%), followed by pneumothorax (29.41%), and pneumo-hydrothorax (8.82%). The mortality rate was 38.24%, and the reintervention rate was 14.71%. Intubated patients had 14.84 times higher mortality hazards than those on room air. For every unit increase in procalcitonin levels, the mortality hazards were increased by 1.06 times.@*Conclusion@#An increasing level of oxygen support on admission and a level of procalcitonin were directly related to mortality risk in COVID-19 patients who underwent tube thoracostomy for pleural complications. There is insufficient evidence to conclude that patient-related, COVID-19 pneumonia-related, and procedure-related factors included in this study were significantly associated with reintervention risk.

Mechanism of neural tube defects caused by ethionine in mice / 中国生物制品学杂志

@#Objective To prepare a neural tube defects(NTDs)model in mice with the structural analogue of methionineethionine,and investigate the effects of NTDs on the proliferation,apoptosis and migration of nerve cells.Methods Mouse NTDs embryo model was established.The C57BL/6J mice were injected intraperitoneally with 500 mg/kg ethionine after gestation to 7.5 d(E7.5),while the mice in control group were injected with the same dose of normal saline.Mouse embryos were taken at E11.5 and observed under stereomicroscope;The levels of S-adenosylhomocysteine(SAH)and Sadenosylmethionine(SAM)in plasma of pregnant mice were detected by ELISA;Western blot and RT-PCR were used to detect the expression of migration proteins E-cadherin and N-cadherin and the mRNA transcription in embryonic brain tissue.The expression of proliferation protein PCNA and apoptosis protein cleaved-Caspase3,and Wnt/β-catenin signaling pathway marker proteins β-catenin,TCF4 and C-myc were detected by Western blot.Results After the intervention of ethionine,the SAM content in pregnant mice decreased,the SAH content increased,and the SAM/SAH ratio decreased.Compared with the control group,the E-cadherin and cleaved-Caspase 3 were highly expressed and the apoptosis increased in NTDs group;The expression of N-cadherin and PCNA decreased,and the cell proliferation and migration decreased;The low expression of Wnt/β-catenin signaling pathway marker proteins β-catenin,TCF4 and C-myc indicated that the pathway was inhibited.Conclusion Ethionine may cause NTDs by promoting cell apoptosis via inhibiting Wnt/β-catenin signaling pathway and the proliferation and migration of nerve cells.

Effect of α-Klotho on macrophage-vascular endothelial cell crosstalk in diabetic oxidative stress environment / 国际眼科杂志(Guoji Yanke Zazhi)

AIM:To investigate the effects of overexpressing α-Klotho(KL)in RAW264.7 cells stimulated by oxidative stress on the proliferation, migration, tube-formation and tight junction of human umbilical vein endothelial cells(HUVECs).METHODS:RAW264.7 cells were categorized into control, 4-hydroxynonenal(4HNE), and 4HNE+KL groups, with F4/80 expression assessed via immunofluorescence staining. Three groups of conditional media were prepared for HUVECs and culture divided into M&#x0026;#xF8;-NC, M&#x0026;#xF8;-4HNE, and M&#x0026;#xF8;-4HNE+KL groups. Cell proliferation was evaluated using CCK8 assay, while scratch test and Transwell assays were employed to measure cell migration. Additionally, tube-formation assay was conducted to assess cell tubule formation, and Western blot assay was utilized to detect the protein expression levels of Claudin 5, Occludin and ZO 1.RESULTS:The results of immunofluorescence staining showed that the fluorescence intensity of F4/80 of RAW264.7 cells in the 4HNE group was significantly enhanced compared with the control group, while that of F4/80 in the 4HNE+KL group was significantly decreased compared with the 4HNE group(all P&#x003C;0.05). The CCK8 assay results revealed a significant increase in the proliferation of HUVECs in the M&#x0026;#xF8;-4HNE group compared with the M&#x0026;#xF8;-NC group. Conversely, the proliferation of the M&#x0026;#xF8;-4HNE+KL group exhibited a significant decrease compared with that in the M&#x0026;#xF8;-4HNE group(all P&#x003C;0.01). The results of scratch test and Transwell assays demonstrated a significant increase in the migration of HUVECs in the M&#x0026;#xF8;-4HNE group compared with the M&#x0026;#xF8;-NC group, while the migration of the M&#x0026;#xF8;-4HNE+KL group exhibited a significant decrease compared with the M&#x0026;#xF8;-4HNE group(all P&#x003C;0.01). In the tube-formation assay, it was observed that the number of tubes formed by HUVECs in the M&#x0026;#xF8;-4HNE group was significantly increased compared with the M&#x0026;#xF8;-NC group, while that of tubes formed in the M&#x0026;#xF8;-4HNE+KL group was significantly decreased compared with the M&#x0026;#xF8;-4HNE group(all P&#x003C;0.01). Additionally, the Western blot results revealed a significant decrease in the relative expression levels of Claudin 5, Occludin, and ZO 1 in the M&#x0026;#xF8;-4HNE group compared with the M&#x0026;#xF8;-NC group. Conversely, in the M&#x0026;#xF8;-4HNE+KL group, there was a significant increase in the relative expression levels of Claudin 5, Occludin, and ZO 1 compared to the M&#x0026;#xF8;-4HNE group(all P&#x003C;0.01).CONCLUSIONS: KL inhibits the proliferation, migration, and tube-formation of HUVECs while enhancing the tight junction by changing the activation state of macrophages in the diabetic oxidative stress environment.

A real-world study on the influence of Qishi Tongguan Prescription on the pregnancy outcome of patients with tubal factor infertility after interventional recanalization / 国际中医中药杂志

Objective:To evaluate the effect of Qishi Tongguan Prescription on pregnancy outcomes after interventional recanalisation in patients with tubal infertility (TFI).Methods:This was a retrospective study based on real-world and propensity score matching. Totally 260 patients with TFI from January 2020 to October 2021 in Shuguang Hospital of Shanghai University of Traditional Chinese Medicine and Maternal and Child Health Hospital of Pudong New Area were selected as observation subjects, and were divided into 123 cases in the TCM combination group and 137 cases in the control group based on whether they were treated with Qishi Tongguan Prescription in combination with interventional revascularization. Propensity score matching (PSM) was used as a covariate to obtain a new sample of inter group covariate equilibrium, and confounding factors that may affect the pregnancy outcome of TFI patients undergoing interventional recanalization surgery were used as covariates. The intrauterine pregnancy rate, ectopic pregnancy rate, biochemical pregnancy rate, early abortion rate and adverse reactions of the two groups of patients within 12 months of follow-up were compared, and the influence of TFI intervention and recanalization combined with Qishi Tongguan Prescription on intrauterine pregnancy rate was evaluated.Results:Age, years of infertility, type of infertility, history of miscarriage, history of ectopic pregnancy, history of biochemical pregnancy, history of uterine surgery, history of pelvic laparotomy, and degree of tubal patency had an effect on whether intrauterine pregnancy was achieved after interventional reversal in patients with TFI ( P<0.05), with age [ OR (95% CI) was 0.843 (0.769, 0.926)], history of pelvic laparotomy [ OR (95% CI) was 0.477 (0.248, 0.920)] and the degree of tubal obstruction [ OR (95% CI) was 0.152 (0.046, 0.500)] were independent factors ( P<0.01 or P<0.05). 81 patients were seen in each of the 2 groups after PSM, of whom the intrauterine pregnancy rates in the combined herbal group at 9 and 12 months after recanalisation were 48.1% (39/81) and 58.0% (47/81) respectively, compared with 32.1% (26/81) and 35.8% (29/81) in the control group, with statistical significance between the 2 groups ( χ2 values of 4.34 and 8.03, respectively, P<0.01); there was no statistical significance in the ectopic pregnancy rate, biochemical pregnancy rate and early abortion rate between the 2 groups ( P>0.05). There were no significant adverse reactions during the treatment. Conclusion:Qishi Tongguan Prescription combined with interventional recanalization can effectively improve the intrauterine pregnancy rate and shorten the waiting time for pregnancy in patients with TFI with higher safety.

A Comparative Study of Three Methods of Preventing Intrauterine Adhesions after HEOS / 昆明医科大学学报

Objective To compare the efficacy of three different methods in the prevention of adhesion after the HEOS system for different degrees of intrauterine adhesions.Methods 284 patients with mild,moderate and severe intrauterine adhesions,who were treated with the HEOS system,were divided into three groups,the intrauterine device with sodium hyaluronate gel was placed in Group A,Foley water capsule tube with sodium hyaluronate gel was placed in Group B,and sodium hyaluronate gel was placed in Group C only.The recovery of uterine adhesion,improvement of menstruation,endometrial thickness,and adverse reactions were compared among the three groups.Results The mild intrauterine adhesions group showed statistical differences among the three groups(P<0.05).Group A had a higher menstrual improvement rate than Group C(P<0.017),and there was no significant difference in other therapeutic indicators(P>0.017).However,the adverse reaction rate in Group A was also higher than that in Group C(P<0.017).In the moderate intrauterine group,there was a significant difference in the improvement rate of intrauterine adhesions between Group B and the other two groups(P<0.017).Group A and B were higher than Group C in terms of menstrual status,endometrial thickness,and adverse reactions(P<0.017).In severe intrauterine adhesions,Group A had higher efficacy indicators than other groups(P<0.017).Conclusions The curative effect index and adverse reaction rate were analyzed,after operation.For the light,moderate,and severe intrauterine adhesions,sodium hyaluronate gel,Foley water capsule tube with sodium hyaluronate gel,and intrauterine device with sodium hyaluronate gel were the best choice for adhesion.Individual and hierarchical management can achieve good clinical effects,which is worth popularizing.

Feasibility study on automatic segmentation of pelvic intestinal tube for radiotherapy images based on deep learning / 复旦学报（医学版）

Objective To study the feasibility on automatic contouring of pelvic intestinal tube based on deep learning for radiotherapy images.Methods A total of 100 patients with diagnosis of rectal cancer,received radiotherapy in Zhongshan Hospital,Fudan University from 2019 to 2021,were randomly selected.Sixty cases were randomly enrolled to train the models,and the other 40 cases were applied to test.Based on the original small intestine model in automatic segmentation software AccuContour,60,40 and 20(2 groups)cases in the model cases were used to train the models Rec60,Rec40,Rec20A and Rec20B with manual contouring as ground truth.Other 40 cases for test were applied to evaluate the Dice similarity coefficient(DSC),95%Hausdorff distance(HD95)and average symmetric surface distance(ASSD)between the manual contouring and original model along with model Rec60.The DSC of the 5 groups of auto-segmentations were compared as well.The paired t tests were performed for each pair of the original model and 4 trained models.Results The small bowel contoured by trained models were more similar to the manual contouring.They could distinguish the boundary of the intestinal tube better and distinguish the small bowel from the colon.The average DSC,HD95 and ASSD of Rec60 were 0.16 higher(P＜0.001),12.4 lower(P＜0.001)and 5.14 lower(P＜0.001)than the original model respectively.According to the paired t tests,there were no statistical differences in DSC between the 4 training models and the original model.No statistical difference was observed between Rec60 and Rec40,while they were both significantly different from the two Rec20 models.There was no statistical difference between Rec20B and Rec20B.Conclusion For radiotherapy images,model training can effectively improve the accuracy of intestinal tube delineation.Forty cases were enough for training an optimal model of automatic segmentation for pelvic intestinal tube in AccuContour software.

Application values of fixed tube current based on head circumference in children's head CT examinations / 实用放射学杂志

Objective To explore the application values of fixed tube current based on head circumference(HC)in children's head CT examinations.Methods A total of 573 children's head CT imaging data were collected retrospectively,the tube current and HC were recorded.Pearson's correlation analysis was used to determine the relationship of tube current with HC,counted the median tube current values of each group based on HC and used them as the prefixed tube current.Seventy-two children were prospectively collected.According to the random number table method,the children were divided into the control group and the experimental group,with 35 cases in the control group and 37 cases in the experimental group.The control group used automatic exposure control(AEC)technology for tube current,while the experimental group used the median value of tube current corresponding to HC group-ing.The difference in radiation doses and image qualities between the two groups was compared.Results Pearson analysis of 573 retrospec-tive cases showed that the correlation between HC and tube current was considerably strong(r=0.95,P＜0.001).The median tube current values of each group based on HC were 70-130 mAs.There were statistically significant differences in CTDIvol.16 and SSDEDW based on water equivalent diameter(DW)between the two groups(t=-11.27,2.81,P＜0.05).Compared with the control group,CTDIvol.16 and SSDEDW in the experimental group decreased by 10.83％and 12.59％respectively.There were no statistically signifi-cant differences in signal-to-noise ratio(SNR)between the two groups(t=-1.26,P＞0.05)and there were also no statistically significant differences in the subjective evaluation of images(Z=-0.45,P＞0.05).Conclusion Measuring children's HC before examination and setting the fixed tube current corresponding to HC grouping can reduce radiation doses while maintaining image qualities.

Application value of 100 kVp low tube voltage combined with ASIR-V in Adamkiewicz artery imaging of spinal cord / 实用放射学杂志

Objective To investigate the effect of 100 kVp low tube voltage combined with adaptive statistical iterative reconstruc-tion-Veo(ASIR-V)on the imaging display,image quality and radiation dose of Adamkiewicz artery(AKA).Methods Ninety patients with computed tomography angiography(CTA)of aorta were randomly divided into two groups.In group A,the tube voltage was 100 kVp,and ASIR-V was 80%reconstructed.The tube voltage in group B was 120 kVp,and adaptive statistical iterative recon-struction(ASIR)was 40%reconstructed.The CT value and the standard deviation(SD)value of descending aorta were measured at the 12th thoracic vertebra level,and the CT value and the SD value of the spinal cord were measured at the same level to calculate the signal-to-noise ratio(SNR)and contrast-to-noise ratio(CNR)of AKA.According to the continuity between AKA and intercostal artery or lumbar artery,the visualization of AKA was evaluated by two doctors with a double-blinded method and a five-point method,and the radiation doses of group A and group B were compared.Results Compared with group B,the CT value of aorta in group A was sig-nificantly increased by about 22.83%(P<0.001).The background noise of AKA in group A was significantly lower than that in group B(P<0.001),and the SNR and CNR were significantly higher than those in group B(P<0.001).The visualization score of AKA in group A was higher than that in group B(P<0.05).The effective dose(ED)in group A was significantly lower than that in group B by about 41.28%(P<0.001).Conclusion 100 kVp combined with ASIR-V technique for spinal cord AKA imaging can obtain better image quality,improve the sensitivity of AKA display and reduce the radiation dose.

Application of three artificial kidney hydronephrosis methods in percutaneous nephrolithotripsy / 中国现代医生

@#Objective To compare the effects of three kinds of artificial hydronephrosis in percutaneous nephrolithotomy.Methods A total of 120 patients who underwent single-tract percutaneous nephrolithotomy in the Eighth Hospital of Wuhan from May 2020 to April 2022 were selected and divided equally into three groups according to different methods of artificial hydronephrosis.Patients in group A were received preoperative indwelling ureteral catheter and injection of normal saline through ureteral catheter to dilate renal pelvis and form artificial hydronephrosis.Patients in Group B were placed with double J catheters before surgery,and the bladder was filled with physiological saline through the catheter.The renal pelvis was dilated through the double J catheters,resulting in artificial hydronephrosis.Patients in Group C were received intravenous injection of furosemide and stimulated diuretic method to actively dilate renal pelvis to form hydronephrosis.The one-time puncture success rate,channel establishment time,overall operation time,stone clearance rate and incidence of surgical complications of percutaneous nephrolithotomy after hydronephrosis were compared among the three groups.Results The operation was successfully completed in the three groups.There was no significant difference in the one-time puncture success rate and channel establishment time between group A and group B(P>0.05),which were all higher than group C(P<0.05).The overall operation time of group B was shorter than that of group A and group C(P<0.05).There were no significant differences in stone clearance rate and surgical complications among the three groups(P>0.05).Conclusion Preoperative indwelling of double J tubes to create artificial kidney hydronephrosis has advantages such as high success rate of one-time puncture,short channel establishment time,and surgical time.

Evaluation of the retention effect of nasointestinal canal indwelling in severe neurosurgical patients guided by miniature visualization system / 中国实用护理杂志

Objective:To investigate the feasibility, safety and reasonable operation of nasointestinal canal indwelling guided by miniature system in severe neurosurgery patients, and compare its advantages and disadvantages with traditional blind insertion.Methods:A prospective randomized controlled trial design was used to select 128 critically ill patients in need of enteral nutrition support at the Department of Neurosurgery, the First Affiliated Hospital of Nanjing Medical University from March 2022 to October 2023 by convenient sampling method. They were divided into blind insertion group and visualization group by random number table method, with 64 cases in each group. Nasointestinal canal indwelling was performed in the blind insertion group by traditional blind insertion method, and in the visualization group, nasointestinal canal indwelling was performed by indentations guided by the miniature visualization system. The success rate of initial catheterization, the time of catheterization, complications, changes of vital signs during catheterization and changes of nutritional indexes after catheterization were evaluated in 2 groups.Results:In the blind insertion group, there were 35 males and 29 females, aged (59.44 ± 13.84) years old. In the visualization group, there were 41 males and 23 females, aged (58.28 ± 12.08) years old. The success rate of the first catheter placement in the visual group was 96.8% (62/64), higher than that in the blind group 82.8% (53/64), and the difference was statistically significant ( χ2=6.94, P<0.05). The catheter placement time of the visualization group was (20.08 ± 2.69) min, which was shorter than that of the blind insertion group (38.19 ± 3.79) min, and the difference between the two groups was statistically significant ( t=29.99, P<0.05). There was no significant difference in the incidence of complications, changes of vital signs during catheterization and the changes of nutritional indexes after catheterization between two groups (all P>0.05). Conclusions:Compared with traditional blind nasointestinal canal indwelling, nasointestinal canal indwelling guided by the miniature visualization system can improve the success rate of the first catheterization and shorten the catheterization time. Although there is no difference in the complication rate, changes in vital signs during catheterization and changes in nutritional indexes after catheterization, it is believed that with the continuous development and upgrading of this technology, it will further reflect the advantages of this technology, which is worthy of further clinical trials and application.