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AIM: To explore the predictive value of red blood cell distribution width (RDW) in early poor neurologic improvement after intravenous thrombolysis in acute ischemic stroke (AIS). METHODS: A total of 102 patients with acute ischemic stroke who received intravenous thromblysis with alteplase within 4.5 hours of onset were analyzed retrospectively. RDW level was measured before thrombolysis. According to the percentage change in NIHSS at 24 hours, the patients were divided into two groups: good neurological improvement (≥ 30%) group (n=53) and poor neurological improvement (<30%) group (n=49). The univariate and multivariate Logistic regression analysis were used to investigate whether RDW level is an independent factor affecting patients' neurological improvement. The receiver operating characteristic (ROC) curve was used to analyze the cut-off value of RDW to predict poor early neurological improvement after thrombolysis. RESULTS: Compared with the good neurological improvement group, higher proportion of atrial fibrillation (24.5% vs. 9.4%, P= 0.042), diabetes mellitus (57.1% vs. 30.2%, P= 0.006), hemorrhagic transformation (10.2% vs. 0%, P=0.023) in the poor neurological improvement group. The level of RDW in poor neurological improvement group was significantly higher than that in good neurological improved group(14.09±0.77) vs. (13.31±0.63), P=0.000. Logistic regression analysis showed that elevated RDW (OR=4.614, 95%CI: 2.263-9.408, P=0.000) and history of diabetes mellitus (OR=2.606, 95%CI: 1.034-6.573, P=0.042) were independently associated with early poor neurological improvement. The ROC curve analysis showed that the optimal cut-off value of RDW to predict poor early neurological improvement after thrombolysis was 13.56% (AUC=0.782, 95%CI: 0.690-0.874; sensitivity 76%; specificity 74%). CONCLUSION: Elevated RDW is of a certain value in predicting the poor early neurological improvement of AIS patients after thrombolysis.
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Objective:To investigate the effectiveness and feasibility of 3D printing-assisted extracorporeal fenestration techniques in thoracic aortic endoluminal repair.Methods:Retrospectively analyzed the clinical data of patients who underwent endovenous repair of the thoracic aorta with the application of 3D printing technology-assisted extracorporeal windowing in the Department of Cardiovascular Surgery, Wuhan University Hospital from January 2019 to May 2021, and analyzed the surgical results as well as the occurrence of perioperative complications.Results:A total of 10 patients with a mean age of(53.3±15.7) years were included, including 4 cases of complex B aortic coarctation, 5 cases of thoracic aortic aneurysm and 1 case of abdominal aortic aneurysm. All patients in this group underwent endoluminal repair of the thoracic aorta with 3D printing assisted extracorporeal fenestration, including 1 case of PCI performed at the same time. There were no postoperative complications and no perioperative deaths.Conclusion:3D printing technology assisted extracorporeal fenestration and endoluminal aortic repair can accurately position aortic stents for fenestration, optimise endoluminal treatment options and improve patient prognosis.
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Objective:To explore the associations of urinary retinol binding protein (RBP) and β 2-microglobulin (β 2-MG) with urinary albumin to creatinine ratio (UACR) and renal function in hospitalized patients with type 2 diabetes mellitus (T2DM). Methods:A total of 1 030 Chinese patients with T2DM were included in this study. The subjects were divided into the UACR normal group (<30 mg/g), microalbuminuria group (30-300 mg/g) and macroalbuminuria group (>300 mg/g). Patients with normal UACR were further divided into two groups according to the estimated glomerular filtration rate (eGFR): the eGFR low group (<90 ml·min -1·1.73m -2) and the normal eGFR group (≥90 ml·min -1·1.73m -2). Urine RBP and β 2-MG levels among the groups were compared. Multiple linear regression analyses were applied to evaluate risk factors of urine RBP and β 2-MG. Results:In all patients ( n=1 030), urine RBP and β 2-MG increased gradually with the increase of UACR across the three groups, the proportions of abnormal urine RBP (>0.7 mg/L) and β 2-MG (>370 μg/L) in these groups were 3.8%, 8.5%, 39.0% ( P<0.001), and 12.9%, 26.7%, 46.8% ( P<0.001), respectively. In the UACR normal group ( n=788), 12.2% of the patients were with eGFR<90 ml·min -1·1.73m -2. The proportion of abnormal β 2-MG (>370 μg/L) was higher in the eGFR low group than that in the eGFR normal group (29.2% vs. 10.7%, P<0.001). Multivariate linear stepwise regression analyses were performed using natural logarithm of urine RBP or β 2-MG as dependent variable, and showed that urine RBP was independently associated with UACR ( β=0.0005, P<0.001), serum creatinine ( β=0.006, P<0.001) and glycosylated hemoglobin A1c ( β=0.050, P=0.001), and β 2-MG was independently correlated with UACR ( β=0.000 4, P<0.001), serum creatinine ( β=0.011, P<0.001), systolic blood pressure ( β=0.005, P=0.031) and fasting blood-glucose ( β=0.027, P=0.046). Conclusions:Urine RBP and β 2-MG are positively associated with high UACR and impaired renal function in T2DM patients, and these changes could occur before UACR and eGFR turned out to be abnormal. It is recommended that urine RBP and β 2-MG be detected as early as possible to identify diabetic kidney disease in patients with normal UACR and eGFR.
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Objective:To compare the clinical efficacy and safety of percutaneous transluminal septal branch anhydrous alcohol ablation (PTSAAA) and percutaneous transluminal septal branch microsphere embolization (PTSBME) in the treatment of patients with symptomatic hypertrophic obstructive cardiomyopathy.Methods:The clinical data of 55 patients with symptomatic hypertrophic obstructive cardiomyopathy treated by PTSAAA and PTSBME were retrospectively analyzed, among whom 27 were treated with PTSAAA and 28 with PTSBME. The changes of postoperative indicators of the two groups of patients were compared, including the improvement degree of symptoms [shortness of breath after activity (cardiac function NYHA classification), chest tightness, chest pain (angina CCS classification) and amaurosis, the decrease of left ventricular outflow tract pressure gradient (LVOTPG)], the ventricular septum thickness shown by color Doppler echocardiography, the incidences of complications at postoperative month 6 and 12, and the incidences of cardiovascular events at follow-up month 12. LSD- t, χ 2 or Fisher exact probability methods were used to compare the differences of indicators between the two groups. Results:Compared to the relative indicators before operation, there were significant differences in shortness of breath after activity, chest pain and amaurosis, LVOTPG, ventricular septum thickness, the incidences of complications at postoperative month 6 and 12 and the incidences of cardiovascular events at follow-up month 12 in both the PTSAAA group and PTSBME group ( P<0.05). The PTSBME group was not inferior to the PTSAAA group in the improvement degree of amaurosis, cardiac function NYHA classification and angina CCS classification and left ventricular ejection fraction (LVEF) at postoperative month 6 and 12 ( P>0.05) as well as in the LVOTPG decrease and the ventricular septum thickness at postoperative month 6 [(16.8±7.5) mmHg vs (15.8±7.3) mmHg, (19.8±4.9) mm vs (17.4±4.1) mm, P>0.05], but was superior to the PTSAAA group in the LVOTPG decrease and the ventricular septum thickness at postoperative month 12 [(15.2±6.7) mmHg vs (9.8±5.4) mmHg, (18.4±5.1) mm vs (12.2±3.2) mm, P<0.05]. There were statistical significances in the incidences of cardiovascular events and third degree atrio-ventricular block and nosocomial mortality between the two groups (6 vs 1; 5 vs 0, P<0.05), and the PTSBME group was superior to the PTSAAA group in safety. Conclusion:PTSBME may be a safe and effective method for the management of patients with symptomatic hypertrophic obstructive cardiomyopathy.
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Objective:To build a three-dimensional evaluation model of single bed efficiency in an obstetrics and gynecology hospital and provide reference for bed management in hospital.Methods:The sample ward and key indicators were determined through interviews. A two-level database was built according to patients′ data from hospital information system. K-means cluster analysis was used to get the beds classified by annual average vacancy(x), annual average turnover(y) and annual average case-mix index per capita(z). The authors built the three-dimensional bed efficiency model with x, y, z as boundaries and analyzed the bed efficiency by comparing the within group average point A k( x k, y k, z k) with the overall average point A0( x, y, z). Whereafter the bed efficiency of each medical work team was analyzed. Results:Thirty-six beds were classified into 4 categories according to utilization efficiency. 50% of the beds(18 beds) were well used, 28%(10 beds) had room for improvement, and 19%(7 beds) may have resource waste. Significant differences existed in bed efficiency among medical work teams.Conclusions:The model in our study can realize in-depth exploration by evaluating bed efficiency from two aspects of the whole ward and each medical work team. This model, which is mainly applicable to the situation where beds are under the charge of fixed medical work groups or doctors, can be adjusted and extended to meet different strategic needs of hospitals.
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Objective:To retrospectively analyze the experience of our center in the use of marginal donor heart, and to explore the principle of use and risk control of marginal donor heart.Methods:A total of 31 patients with end-stage heart disease underwent orthotopic heart transplantation in our center from January 2018 to December 2018, including 28 cases of pure heart transplantation, 2 cases of combined heart-lung transplantation, and 1 case of combined heart-kidney transplantation. 26 of the 31 cases were marginal donor hearts. These patients were all anastomosed by a double lumen method.Results:The rates of postoperative use of ECMO, IABP and acute rejection were zero in this study. The time of cardiopulmonary bypass in the marginal donor group was significantly longer compared with the conventional donor group( P<0.05), but there was no significant difference between the two groups in terms of hospitalization time, mechanical ventilation time, ICU stay time, abnormal rate of ECG, LVEF and blood biochemical indexes(all P>0.05). The postoperative follow-up rate was 100% in the two groups. One case of combined heart-lung transplantation in the marginal donor group died of multiple organ failure in the first month after surgery. During the postoperative follow-up period, the incidence of moderate to severe tricuspid regurgitation and the incidence of recurrent heart failure were zero in the two groups. There was no significant difference in the incidence of arrhythmia, LVEF, infection and blood biochemical parameters. Conclusion:The application of marginal donor heart has no significant effect on the short-term survival rate and recovery of patients after heart transplantation, but the long-term effect needs further follow-up.
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Objective:To investigate the effects of estrogen receptor beta agonist diarylpropionitrile (DPN) on mesenteric artery (MA) responsiveness and on Rho-kinase signaling pathway in cirrhotic portal hypertension rats, and to elucidate the mechanism of ER beta agonist in visceral hyperdynamic circulation in cirrhotic portal hypertension rats.Methods:Female rats were treated with bilateral ovariectomy, and CCl 4 was injected to establish cirrhotic portal hypertension model. After intervention, hemodynamic parameters and vascular reactivity of MA in each group were measured, and the levelof ER beta, Rho-kinase signaling pathway-related proteins and receptor desensitization-related proteins in MA in each group were detected. Results:DPN could significantly improve the hemodynamic parameters of ovariectomized cirrhosis rats and the response of MA to norepinephrine. DPN could increase the level of inhibited ROCK protein and decrease the expression of beta-arrestin-2 and the phosphorylation of ERK1/2.Conclusions:DPN could improve the responsiveness of MA to vasoconstrictor substances, and significantly improve the hyperdynamic circulation in ovariectomized cirrhosis rats. This effect may be related to DPN improving the desensitization of MA to vasoconstrictor receptors and the Rho-kinase pathway activation.
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Objective To summarize the clinical experience and efficacy of surgical treatment for Stanford type A aortic dissection leading to acute lower limb ischemia.Methods From January 2014 to January 2018,12 patients with severe lower limb ischemia caused by acute type A aortic dissection were treated with Suns surgery.Among them,11 patients were treated with restoration of lower limb blood supply preferentially,including 10 cases of femoral artery bypass and 1 case of abdominal aorta-iliac artery stent graft implantation.Another case was treated with ascending aorta-femoral artery bypass after Sung surgery.Results 3 cases died of ischemia and necrosis of the lower extremities.Two of them died of multiple organ failure due to amputation and one died of low cardiac output due to refractory acidosis.Acute renal failure performed bedside CRRT in 5 patients and ECMO in 1 patient.The remaining 9 patients were discharged from the hospital and the symptoms of lower limb ischemia disappeared.After an average follow-up of 23 months,the re-examination of the aorta CTA showed that the bypass artery was unobstructed and the distal femoral artery was well developed.One patient infecting vascular prosthesis was cured by taking out the unit.Conclusion For acute lower limb ischemia caused by type A aortic dissection,blood flow of lower extremities should be restored as soon as possible to reduce mortality and complications.Femoral artery bypass and abdominal aorta-iliac arterial repair are simple and effective in reconstructing lower limb blood supply.
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Objective@#To investigate the association between the whole blood riboflavin level and the occurrence, development and prognosis of esophageal squamous cell carcinoma (ESCC) in China. @*Methods@#From March 2014 to September 2018, ESCC patients from three hospitals (the Affiliated Hospital of Medical College of Shantou University, Shantou Central Hospital in Southern Chaoshan area and First Affiliated Hospital of Zhengzhou University in Northern Taihang Mountain) were selected as a case group; non-esophageal patients who had a physical examination were selected as a control group. The case and control group were paired by age (±5 years) and a 1:1 ration. A total of 1 528 subjects were enrolled including 764 patients in the case group and 764 patients in the control group. About 3-5 ml venous blood samples were collected, and the erythrocyte glutathione reductase activity coefficient (GRAC) was measured to assess the whole blood riboflavin level. A multivariate conditional logistic regression model was used to analyze the association between the GRAC and the risk of ESCC. The association between the GRAC and the prognosis of ESCC was analyzed by using Cox proportional risk regression model based on 288 patients with complete survival data. They were divided into two groups, the high GRAC group (GRAC≥7.87) group and the low GRAC group (GRAC<7.87) according to the strongest correlation between the total survival time, survival outcome and GRAC (GRAC=7.87). @*Results@#Among the 1 528 patients, 958 patients were from Southern Chaoshan area, including 479 patients in the case group with an average age about (59.90±9.34) years and 479 patients in the control group with an average age about (59.55±8.77) years. Other 570 patients were from Northern Taihang Mountain area, including 285 patients in the case group with an average age (58.39±5.19) years and 285 patients in the control group with an average age about (58.74±4.57) years. The multivariate conditional logistic regression showed that the OR (95%CI) of the GRAC and the risk of ESCC was 1.009 (0.998-1.019). The Cox proportional hazard regression model analysis showed that the HR (95%CI) of the high GRAC group was 1.712 (1.034-2.824) compared with the low GRAC group in the 50-70 years group. @*Conclusion@#The whole blood riboflavin level might not be associated with the occurrence of ESCC. The high whole blood riboflavin level would be more beneficial to the prognosis of ESCC patients aged 50-70 years.
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To follow up and analyze patients with ventricular septal rupture( VSR) after acute myocardial infarction ( AM I) w ho underwent VSR occlusion ,screen the main risk factors of survival in perioperative patients with VSR after AM I ,and observe the postoperative cardiac function and hemodynamic changes by echocardiography . Methods Seventeen VSR patients were divided into the survival group ( 11 cases) and the death group ( 6 cases) within 30 days according to the survival time . T he changes of cardiac ultrasound parameters before and after the operation of VSR survivors were compared , and the hemodynamic recovery characteristics of VSR survivors were analyzed . Results Age ,the time to VSR occlusion ,preoperative left ventricular ejection fraction ,cardiogenic shock ,and the size of VSR were all the factors that were closely related to the 30‐day mortality of VSR with odds ratio of 0 .90 ( 95% CI 0 .73 to 1 .14 , P ＝0 .045) ,1 .89( 95% CI 1 .35 to 2 .23 , P ＝0 .003) ,0 .89( 95% CI 0 .57 to 1 .24 , P ＝0 .039) ,1 .45 ( 95% CI 1 .12 to 1 .78 , P ＝0 .027) and 11 .45( 95% CI 7 .89 to 15 .56 , P ＝0 .012) ,respectively ( all P＜0 .05 ) . Compared with the preoperative measurements , the left ventricular end‐diastolic volume and pulmonary artery systolic pressure were significantly reduced in the VSR survival group ( P ＜ 0 .05 ) . Conclusions The decrease of left ventricular end diastolic volume and pulmonary artery systolic pressure after operation indicates a better prognosis in the short period . Echocardiography is a vital tool in preoperative screening ,intraoperative monitoring and postoperative follow‐up in VSR occlusion .
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Objective To evaluate the feasibility and accuracy of mitral valve prolapse( M VP) model made by three‐dimensional( 3D) printing based on three‐dimensional transesophageal echocardiography ( 3D‐T EE) data and the application value for mitral valvuloplasty . Methods 3D‐T EE volumetric data of 28 patients with M VP were acquired and postprocessed ,13 patients underwent mitral valve replacement and 15 patients underwent mitral valvuloplasty . A flexible material was used to made the valve 3D model by molding . T he areas of M VP identified by models were compared with surgical findings ,the circumference and the length and thickness of anterior and posterior mitral leaflets obtained from the valve specimens and the models were compared in the mitral valve replacement group . T he diameter between anterior and posterior ,the diameter between anterolaterior and posteromedial ,annulus area ,height of prolapsed leaflet and area of prolapsed leaflet were measured from 3D models and 3D‐T EE images in mitral valvuloplasty group . Surgical simulations were performed on the 3D models of the mitral valvuloplasty group ,and the water injection test was used to evaluate the surgical results and compared with the surgical results . Results 3D‐T EE volumetric data were successfully postprocessed and made as 3D M VP models in all patients . T he consistency of M VP location based on 3D models and surgical findings was 0 .92 . T he differences between the mitral valve replacement group and mitral valvuloplasty group were not significant ( P＞ 0 .05 ) . A simulation valvuloplasty was successfully performed on the 3D model in mitral valvuloplasty group ,2 patients underwent mitral valve replacement after water injection test . T he remaining 3D models successfully simulated the operation . Conclusions The M VP model made by 3D‐T EE and 3D printing technique has high feasibility and accuracy ,w hich may be promising for the mitral valvuloplasty of M VP .
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Objective To establish a medical quality evaluation system for gynecology wards in specialized gynecology hospitals by means of DRGs. Methods DRGs method was used to adjust risks of the information of gynecology inpatients discharged in 2016. On such basis, the medical quality evaluation system was built on the three dimensions of medical ability, medical efficiency and medical safety, while a general scoring was obtained by multiplying the scoring of the dimension with its respective weighting coefficients. Results The general scoring of the 10 wards ranged between 0. 89-1. 08, averaging 0. 99. That of Ward B ranked the highest, and Ward I the lowest of the ten. The medical ability scoring ranged between 0. 87-1. 12, averaging 1. 00;That of Ward B ranked the highest,and Ward I the lowest of the ten. Medical efficiency scoring ranged between 0. 93 -1. 23, averaging 1. 00;That of Ward J ranked the highest,and Ward E the lowest of the ten. Safety scoring ranged between 0. 89-0. 99, averaging 0. 94; That of Ward F ranked the highest, and Ward A the lowest of the ten. Conclusions The medical quality evaluation system based on DRGs can effectively evaluate wards of a gynecology department, supporting their fine management.
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Objective To establish a medical quality evaluation system for gynecology wards in specialized gynecology hospitals by means of DRGs. Methods DRGs method was used to adjust risks of the information of gynecology inpatients discharged in 2016. On such basis, the medical quality evaluation system was built on the three dimensions of medical ability, medical efficiency and medical safety, while a general scoring was obtained by multiplying the scoring of the dimension with its respective weighting coefficients. Results The general scoring of the 10 wards ranged between 0. 89-1. 08, averaging 0. 99. That of Ward B ranked the highest, and Ward I the lowest of the ten. The medical ability scoring ranged between 0. 87-1. 12, averaging 1. 00;That of Ward B ranked the highest,and Ward I the lowest of the ten. Medical efficiency scoring ranged between 0. 93 -1. 23, averaging 1. 00;That of Ward J ranked the highest,and Ward E the lowest of the ten. Safety scoring ranged between 0. 89-0. 99, averaging 0. 94; That of Ward F ranked the highest, and Ward A the lowest of the ten. Conclusions The medical quality evaluation system based on DRGs can effectively evaluate wards of a gynecology department, supporting their fine management.
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Objective To investigate the correlations of serum cystatin C level with severity of stroke and short-term outcome in patients with acute ischemic stroke.Methods Patients with first-ever acute ischemic stroke aged ≥50 years who did not receive thrombolysis and took a visit within 3 d after onset were selected prospectively.The serum cystatin C level was detected within 24 h after admission and various clinical data were collected.The National Institutes of Health Stroke Scale (NIHSS) was used to assess the neurological deficits on the day of admission.The NIHSS score ＜8 was defined as mild stroke and ≥8 was defined as moderate to severe stroke.The modified Rankin Scale (mRS) was used to evaluate the short-term outcome at discharge or 14 d after onset,0-2 was defined as good outcome and ＞2 was defined as poor outcome.Results A total of 188 patients were enrolled,including 93 (49.5％) females and 95 (50.5％) males,their mean age was 65.4 ±9.2 years old (range 50-87).There were 120 patients with mild stroke (63.8％),68 with moderate to severe stroke (36.2％);106 patients (56.4％) had good outcome and 82 (43.6％) had poor outcome.Univariate analysis showed that serum cystatin C level in the moderate to severe stroke group was significantly higher than that in the mild stroke group (1.36 ± 0.29 mg/L vs.1.21 ±0.23 mg/L;t =3.902,P ＜ 0.001),the serum cystatin C level in the poor outcome group was significantly higher than that in the good outcome group (1.38 ± 0.25 mg/L vs.1.22 ± 0.25 mg/L;t =4.101,P =0.001).Multivariate logistic regression analysis showed that the serum cystatin C level was an independent risk factor for stroke severity (odds ratio 12.182,95％ confidence interval 11.163-13.202;P ＜ 0.001) and short-term poor outcome (odds ratio 9.025,95 ％ confidence interval 8.202-9.848;P ＜ 0.001).Conclusion The serum cystatin C level is significantly correlated with the severity of stroke and the short-term outcome in patients with acute ischemic stroke.
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Objective To investigate the clinical value of neutrophil-lymphocyte ratio (NLR) in postmenopausal patients with type 2 diabetes mellitus (T2DM). Methods A total of 128 newly diagnosed T2DM female patients were randomly recruited from the Zhujiang Hospital of Southern Medical University from March to September 2015. According to the physiological state, the patients were divided into menopausal group (n=66) and non-menopausal group (n=62). Fifty-six healthy females were chosen as the control group. The values of blood pressure, blood lipid, fasting plasma glucose (FPG), fasting insulin (FINS) and white blood count (WBC), neutrophil count, percentage of neutrophils,lymphocytes count, and percentage of lymphocytes were detected and compared between three groups. The NLR and the HOMA insulin resistance index (HOMA-IR) were calculated. Results Age, systolic blood pressure (SBP), triglyceride (TG), FINS, percentage of neutrophil, NLR, HOMA-IR were significantly higher in menopause group than those of control group and non-menopause group (P0.05). There was no linear correlation between NLR and HOMA-IR (rs=0.015, P > 0.05), HbA1c (r=0.030, P > 0.05). Conclusion NLR is of a certain significance in the assessment of inflammatory status and IR levels in postmenopausal women with T2DM, which may be related to the changes of autonomic nervous system.
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The research findings published by National Surgical Adjuvant Breast and Bowel Project have continued to change the clinical practice of early-stage breast cancer over the past decade.Sentinel lymph node biopsy has become the new surgical operation standard.The aromatase inhibitor adjuvant endocrine therapy cycle has been extended from 5 years to 10 years, which benefits the patients with high risk and reactivity.Chemotherapy combined with trastuzumab has become the standard adjuvant therapy strategy of human epidermal growth factor receptor-2-positive invasive breast cancer.In addition, the research progress is also related to the optimization of the fields including the postoperative adjuvant chemotherapy and neoadjuvant chemotherapy.
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Objective To explore the application of self-made guided wire operating-tray,which is designed for percutaneous tranluminal coronary angioplasty (PTCA),in performing coronary intervention (PCI).Methods A total of 40 patients who were planned to receive PCI were randomly divided into the study group (n=20,using guided wire operating-tray) and the control group (n=20,using traditional method to operate guide wire).Under local anesthesia PCI was carried out in all patients of both groups.The frequency of guide wire winding,the degree of surgical sheet contamination within the operation area,and the comfort and convenience of operating guide wire were assessed,the results were compared between the two groups.Results The frequency of guide wire winding and the degree of surgical sheet contamination within operation area in the study group were remarkably lower than those in the control group (P＜0.05).The comfort and convenience of operating guide wire in the study group was better than that in the control group (P＜0.05).Conclusion In performing PCI,the use of self-made guided wire operating-tray can effectively avoid guide wire winding and reduce the degree of surgical sheet contamination within the operation area.
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Objective:To analyze influence factors in patients with acute myocardial infarction (AMI) undergoing e‐mergency percutaneous coronary intervention (PCI ) .Methods:Clinical data of 656 patients ,who received emer‐gency PCI because of AMI in our hospital from Jan 2005 to Jan 2015 ,were retrospectively analyzed .Short -term prognosis ,including incidence rates of heart failure (HF) ,cardiogenic shock (CS) ,arrhythmias and mortality , were compared and analyzed among these patients from onset related factors ,coronary disease and vascular reope‐ning time etc .Results:Mean onset age of men was significantly younger than that of women (P0.05 all) .Incidence rate of arrhythmia in RCA group was significantly higher than those of LAD group , LCX group and multi -vessel group (56.36% vs .31.55% ,37.50% ,34.38% ) ,mortality of LM group was signifi‐cantly higher than those of LAD group ,RCA group and LCX group (25.00% vs .1.79% ,0.91% ,0% ) , P<0.05 or <0.01. Incidence rate of HF in 10~12h group was significantly higher than those of 0~3h ,4~6h and 7~9h group (79.46% vs .61.70% ,66.81% ,64.78% ) ,incidence rate of arrhythmia was significantly lower than those of 0~3h ,4~6h and 7~9h group (32.14% vs .55.32% ,43.81% ,44.65% ) ,and incidence rate of CS was significant‐ly higher than that of 0~3h group (35.27% vs .21.28% ) , P<0.05 or <0.01. Conclusion:Onset age ,season and DM ,coronary disease extent ,vascular reopening time are risk factors influencing short‐term prognosis of AMI .
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Objective:To examine the clinical value of combining indocyanine green (ICG) fluorescence navigation with blue dye in sen-tinel lymph node biopsy (SLNB) for patients with breast cancer. Methods:A total of 89 patients with early-stage breast cancer who met the inclusion criteria were admitted at Shantou Central Hospital, Guangdong from May 2013 to April 2014. In phase one, ICG and blue dye were applied in all 53 patients, and then SLNB and axillary lymph node dissection (ALND) were performed based on fluores-cence signal or visual sense of the lymph nodes. In phase two, 36 patients with early-stage breast cancer were included. ALND was omitted when sentinel lymph nodes were frozen showing negative result. Rates of detection, accuracy, and false-negative were calcu-lated. Results:A total of 89 patients were monitored, of which the total rate of SLNB detection was 96.6%(86/89). In the validation pe-riod, the rates of detection, accuracy, and false-negative were 94.3%(50/53) 98.0%(49/50), and 2.6%(1/38), respectively. In the alter-ative period, the rates of detection reached 100%. Of the 196 sentinel lymph nodes, 179 showed fluorescence signal, 142 exhibited blue dying, 54 only demonstrated fluorescence signals, and 45 demonstrated metastasis with five signaling fluorescence. About 24.7%of patients were diagnosed with SLN metastasis (22/89), where SLNB in two patients showed fluorescence signal but without blue dye. No ipsilateral lymph node relapsed were observed during a median follow up of 25 months. Conclusion:Combination of ICG fluores-cence navigation with blue dye in SLNB is safe for patients with breast cancer.
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It is related to the treatment effect of the disease and the quality of life of the patient that perioperative management of ruptured esophagogastric varices bleeding with portal hypertension.According to the individual characteristics of the patient combined with the experience of the surgeons,the key points of individualized treatment consist of accurate and comprehensive preoperative preparation,fine post-operative treatment,and the changes of pre-and post-operative hemodynamics of portal vein system to choose a reasonable procedure,meanwhile,the delicate postoperative managements can improve the surgical effect of portal hypertension.