Study on establishing management programs for hypothermia in trauma patients in emergency department / 中华护理杂志

Objective To establish management programs for hypothermia in trauma patients in emergency department,so as to guide clinical nursing practice and provide references for scientific management of post-traumatic hypothermia.Methods The first draft of management prograns was established by retrieval of trauma-related guidelines and original studies at home and abroad.Two rounds of expert consultation were conducted via Delphi method to finalize the management programs.Results The management programs consisted of 4 first-level items (hypothermia related assessment,prevention and graded intervention,evaluation,coordination with the team),15 second-level items and 36 third-level items.The expert authority scores of two rounds were 0.85 and 0.86.The expert coordination coefficients at all levels ranged between 0.257 and 0.347.Conclusion There were high levels of enthusiasm,authority and team coordination in experts.The management programs can be used as a basis for comprehensive evaluation and scientific management for hypothermia in trauma patients.

Research on the natural history of non-alcoholic fatty liver disease should be taken seriously / 中华肝脏病杂志

Nonalcoholic fatty liver disease (NAFLD) is a multi-system disease, and metabolic syndrome, type 2 diabetes, and NAFLD interact as both cause and effect. Deaths caused by cardiovascular diseases and malignant tumors are the adverse outcome of patients with NAFLD and nonalcoholic steatohepatitis (NASH), and increased deaths caused by liver disease is mainly seen in NASH patients. There is a causal relationship between NASH and hepatocellular carcinoma, and almost 50% of patients with NASH-associated hepatocellular carcinoma do not have liver cirrhosis. At present, cohort studies on the natural history of NAFLD in China should be enhanced in order to provide a basis for the development of health strategies and prevention and treatment measures. This editorial elaborates on the association of NAFLD with diabetes, cardiovascular disease, liver cirrhosis, and hepatocellular carcinoma from the perspective of clinical epidemiology, in order to emphasize the importance of the natural history of NAFLD.

The role of multi-slice CT in preoperative staging of colonic tumors / 中华放射学杂志

Objective To determine the accuracy of multi-slice CT pneumocolon in the staging of colonic carcinomas.Methods Thirty-six patients, who were strongly suspected to have colonic disorders, underwent CT pneumocolon before and after intravenous injection of iodinated contrast agent. CTVE, MPR, SSD, and Raysum images were then obtained by using 4 different softwares in workstation (ADW3.1). 33 positive cases were staged preoperatively according to TNM standard. All cases were proved by surgical or colonoscopic histology. Sensitivity and accuracy of MSCT were determined for the detection of cancers, lymph nodes, and metastases. Results MSCT pneumocolon examinations demonstrated 32 lesions, missing one case. Sensitivity and positive accuracy value for T staging were 96.97% (32/33) and 87.88% (29/33), respectively; Sensitivity and positive accuracy value for lymph node involvement were 73.91% (17/23) and 69.57% (16/23), respectively. The density of metastatic lymph node was higher than that of normal one. Five cases in M stage were all diagnosed correctly.Conclusion MSCT pneumocolon is a better method of depicting the colorectal carcinoma. It allows for accurate staging of the colorectal carcinoma, especially detecting the invasion of adjacent tissues and distant metastasis. However the value for early T staging in colorectal carcinoma and minute metastasis of lymph nodes is limited. It is helpful to combine all the findings of lymph nodes, including the size, density, and location, to make a correct diagnosis.

Assessment of colonic disease by multi slice CT pneumocolon after incomplete colonoscopy / 中华放射学杂志

Objective To evaluate the use of preoperative MSCT in patients with clinically suspected colorectal disease after incomplete colonoscopy Methods After incomplete colonoscopy, 31 patients underwent MSCT before and after intravenous injection of iodinated contrast agent CT virtual colonography (CTVC), multiplanar reformation (MPR), shaded surface display (SSD), and Raysum images were obtained by using 4 different software in workstation The results of MSCT were compared with the findings of colonoscopy, intraoperative colon palpation, and postoperative pathology Results After incomplete colonoscopy, MSCT was successfully performed in all 31 cases Postoperative pathology revealed 22 colorectal cancers (one synchronous cancers, two with polyps) and 9 benign disease 22 colonic carcinomas were all correctly diagnosed by MSCT (including synchronous disease), 2 benign diseases were misdiagnosed as malignancy, and one polyp was missed Conclusion MSCT is a feasible and useful method for evaluating the entire colon before surgery in patients with occlusive disease