Objective: To investigate the clinical effect of comprehensive management of vascular access in chronic renal failure.Methods: A total of 206 patients with chronic renal failure who received the first dialysis treatment in our hospital from March 2015 to December 2021 were selected and divided into group A (patients were dialysis with autologous arteriovenous fistula, n=100), group B (patients were converted to autologous arteriovenous fistula from temporary or long-term hemodialysis catheter, n=76 and group C (patients receiving temporary or long-term hemodialysis catheter dialysis, n=30) according to the different vascular access of the patients during dialysis treatment. The dialysis adequacy, renal function, inflammation, anemia indexes and the incidence of complications were compared among the three groups.Results: The decrease rate of urea nitrogen, blood flow in vascular access and urea clearance fraction in groups A and B were significantly higher than those in group C (P<0.05). After treatment, the levels of BUN and Cr in group A were strikingly lower than those before treatment and those in group C; the levels of BUN and Cr in group B were markedly lower than those before treatment and those in group C (P<0.05); the levels of BUN and Cr in group C were obviously lower than those before treatment (P<0.05). After treatment, the levels of IL-6, CRP and TNF-alpha in group A were remarkably lower than those before treatment and those in groups B and C, and the levels of IL-6, CRP and TNF-alpha in group B were dramatically lower than those before treatment and those in group C (P<0.05). After treatment, the level of EPO in group A was significantly lower than that before treatment and that in group C, and the level of Hb was markedly higher than that before treatment, and that in group B and group C (P<0.05); the level of EPO in group B was obviously lower than that before treatment and that in group C, and the level of Hb was significantly higher than that before treatment and that in group C (P<0.05). The total incidence of complications in group A was significantly lower than that in groups B and C (P<0.05).Conclusion: The use of autologous arteriovenous fistula as the vascular access for hemodialysis in patients with chronic renal failure has a good dialysis effect, and is beneficial to reduce the micro-inflammatory state of the body, improve the anemia state, and reduce the incidence of complications. Clinically, patients with chronic renal failure should be encouraged to avoid the use of central venous catheters and establish autologous arteriovenous fistulas as early as possible.
Introduction: To summarize the clinical characteristics of patients with ankylosing spondylitis (AS) combined with fibromyalgia (FM), in order to provide clues and a basis for early diagnosis and standard treatment. Materials and methods: A total of 26 patients with AS complicated with FM who were treated in Jiangsu Province Hospital of Traditional Chinese Medicine from January 1, 2017 to December 31, 2021, were collected. The clinical data of the patients were retrospectively analyzed, including epidemiological characteristics, clinical manifestations, diagnostic characteristics, drug conditionsResults: The onset age of AS combined with FM was concentrated between 19 and 40 years old (73%), and the ratio of male to female was close to 1:1 (54% vs 46%). When FM was diagnosed, all patients did not show typical inflammatory low back pain, and most of the patients could not relieve the pain after activity (88%), but no patient (0%) recorded waking up with pain at night. All patients (100%) had dorsoaxial pain, most patients also had shoulder girdle pain (69%) and buttock pain (54%). A small number of patients had chest pain (31%), upper limb pain (46%), and lower limb pain (35%). Most patients had sleep disorders (62%), fatigue (69%), neuropsychiatric symptoms (54%), and self-reported paresthesia (81%). Prior to diagnosis, most patients had used 1-2 NSAIDs (81%) and most had used biologics (74%). After the diagnosis of FM, the symptoms of most patients (77%) were improved after adding the indicated drugs (pregabalin and duloxetine).Conclusion: In patients with AS who present with diffuse pain, especially diffuse pain that does not show a clear tendency to improve with rest after activity, nor does it show a tendency to wake up with pain and difficulty turning over at night (especially 3-5 am). In cases where there is no improvement with multiple NSAIDs, biologics, the possibility of comorbid FM needs to be considered with emphasis. In patients with AS combined with FM, anti-FM drugs are required to improve the patient's symptoms.
Objective: To explore the differences of clinical efficacy and safety between transjugular intrahepatic portosystemic shunt (TIPS) assisted by gastric coronary embolization and TIPS alone in the treatment of upper gastrointestinal bleeding secondary to portal hypertension in liver cirrhosis.Methods: 78 patients with upper gastrointestinal bleeding secondary to portal hypertension in liver cirrhosis admitted to our hospital from January 2019 to June 2021 were retrospectively included. Among them, 35 cases were treated with TIPS alone (control group) and 43 cases were treated with TIPS assisted by gastric coronary embolization (observation group). The incidence of postoperative rebleeding, preoperative and postoperative portal hemodynmic indexes, liver function indexes, coagulation function indexes and the incidence of complications were compared between two groups.Results: The incidence of rebleeding in the observation group 6 and 12 months after surgery was significantly lower than that in the control group (P<0.05). The levels of albumin, total bilirubin and prothrombin time in the observation group 12 months after surgery were significantly better than those in the control group and before surgery (P<0.05). There was no significant difference between two groups in the incidence of fever and abdominal pain (P>0.05). The incidence of hepatic encephalopathy in the observation group was significantly lower than that in the control group (P<0.05).Conclusion: Compared with TIPS surgery alone, TIPS assisted by gastric coronary embolization can effectively reduce the risk of rebleeding, improve liver function and blood coagulation, without affecting portal haemodynamics, and help prevent the occurrence of hepatic encephalopathy in the treatment of upper gastrointestinal bleeding secondary to portal hypertension in liver cirrhosis.
Objective: To investigate the clinical efficacy and safety of dose-escalation of icotinib hydrochloride in targeted therapy of epidermal growth factor receptor (EGFR)-mutated lung adenocarcinoma patients after progression. Methods: A total of 80 patients with EGFR-mutated lung adenocarcinoma who were diagnosed and treated in our hospital from January 2018 to January 2021 were selected and divided into the control group and the observation group according to the random number table method, with 40 cases in each group. The control group was given docetaxel combined with a conventional dose of icotinib hydrochloride targeted therapy, and the observation group was given an additional dose of icotinib hydrochloride after treatment resistance on the basis of the control group. The clinical efficacy, health status, cancer-related fatigue status, serological indicators, and toxic and side effects were compared between the two groups. Results: The disease control rate (DCR) in the observation group was significantly higher than that in the control group (P<0.05). After treatment, the levels of CD4+, CD4+/CD8+ in the two groups were significantly lower than those before treatment, and the levels of CD4+/CD8+ and CD4+ were significantly higher than those before treatment (P<0.05). The difference was not statistically significant (P>0.05). After treatment, the Piper fatigue scale (RPFS) score in the observation group was significantly lower than that before treatment and the control group, and the KPS score was significantly higher than that before treatment and the control group (P<0.05). The survival of the observation group was better than that of the control group (chi 2=4.240, Lon RankP=0.039). There was no significant difference in the total incidence of toxic and side effects between the two groups (P>0.05). After treatment, the levels of cytokeratin 19 fragment (CYFRA21-1), carcinoembryonic antigen (CEA) and carbohydrate antigen 125 (CA125) in observation group were significantly lower than those before treatment and control group (P<0.05). Conclusions: EGFR-mutated lung adenocarcinoma patients who are resistant to icotinib hydrochloride targeted therapy and then given icotinib hydrochloride plus dose therapy have good clinical efficacy. It is not only beneficial to inhibit the proliferation of tumor cells, reduce the tumor volume, improve the prognosis of patients, but also has no obvious malignant effect on the immune function of the body, the treatment effect is relatively safe and effective.
Objective: To explore the correlation between the levels of interleukin-6 (IL-6), soluble P-selectin (sP-selectin), D-dimer (D-D) and platelet (PLT) and the severity of severe pneumonia with sepsis pneumonia.Methods: A total of 125 patients with severe pneumonia complicated with sepsis who were treated in our hospital from January 2018 to May 2019 were randomly selected as the study group. According to the PCIS score, the patients were divided into non-critical group (65 cases), critical group (53 cases) and extremely critical group (7 cases). The basic clinical data such as gender, central venous pressure (CVP), respiratory rate, heart rate and PCIS score were compared. The levels of IL-6 and sP-selectin were measured by enzyme-linked immunosorbent assay. The PLT level of each group was determined by automatic hematology analyzer. The levels of D-D in each group were measured by latex immunoturbidimetry assay. The correlation between IL-6, sP-selectin, D-D and PLT levels and PCIS score was analyzed by multiple linear stepwise regression analysis.Results: There was no significant difference in age, gender, CVP, respiratory rate, memory, heart rate and other basic clinical data among the three groups (P>0.05), but with the increase of the severity of the disease, the PCIS score was significantly decreased (P<0.05). Compared with the non-critical group, the levels of serum IL-6, sP-selectin and D-D in the critical and extremely critical groups were dramatically increased, and the level of PLT was remarkably decreased (P < 0.05). Moreover, the serum IL-6, sP-selectin and D-D levels in the extremely critical group were notedly higher than those in the critical group, and the PLT level was markedly lower than that in the critical group (P<0.05). Multiple linear stepwise regression analysis showed that IL-6, sP-selectin and D-D levels were positively correlated with PCIS score, while PLT level was negatively correlated with PCIS score (P<0.01).Conclusion: The serum levels of IL-6, sP-selectin and D-D in patients with severe pneumonia complicated with sepsis were significantly increased, and the PLT level was enormously reduced, which were significantly correlated with the PCIS score, and could be used as important indicators to evaluate the severity of severe pneumonia complicated with sepsis pneumonia.
Introduction: Dentists are potential candidates for burnout due to the specifities in clinical practice and additional external factors initiated by the current pandemic. The aim of this study was to investigate dentists' intentions and attitudes toward COVID-19 vaccination and to examine how the latter were associated with the levels of their occupational burnout.Materials and methods: An anonymous validated 43-question survey, including demographic and pandemic questions and the Maslach Burnout Inventory (MBI), was administered to a random sample of 1405 dentists from 73 settlements in Bulgaria. The data was analyzed with IBM SPSS Statistics 25.0 using standard descriptive statistics, one way ANOVA, Kolmogrov-Smirnov, and Shapiro-Wilk tests, Kruskal-Wallis H test and Mann-Whitney U test.Results: Overall, 387 dentists responded to the survey (response rate 27.5%). All three dimensions of burnout corresponded to moderate level of burnout (EE -21.29 +/- 12.49, DP -10.17 +/- 6.20 and PA -34.76 +/- 7.87). A large proportion of respondents (n=151; 39.0%) reported they did not intend to get vaccinated and almost 1/4 of dentists (n = 95; 24.5%) believed that COVID-19 vaccines would have many side effects. COVID-19 vaccine unwillingness was significantly linked to the elevated levels of emotional exhaustion and depersonalization (p<0.05). There was also a significant relationship between vaccine side effects beliefs and burnout dimensions(p<0.05).Conclusion: Dentists' occupational burnout and intentions for vaccination were significantly associated. Developing programs to reduce vaccination hesitancy, increase trust and build favorable attitudes is vital for controlling the COVID-19 pandemic and can play a role in protection of psychological well-being of dentists.
Introduction: Rheumatoid arthritis (RA) has been associated with an increased risk of respiratory infections, and the Covid-19 pandemic represents a serious threat for RA patients. Considering the controversy in the scientific literature, the present study aims to investigate the prevalence and severity of Covid-19 in regard to disease-modifying anti-rheumatic drugs (DMARD) treatment in a large Methods: A total of 156 patients with RA on biologic or targeted synthetic DMARD (b/tsDMARD) as well as 102 patients on conventional synthetic DMARD (csDMARD) answered a standardized questionnaire focused on the development, symptoms, and Results: The prevalence of confirmed or suspected Covid-19 infection did not differ between the two investigated therapeutic groups and the prevalence of hospitalization for moderate or severe Covid-19 infection was low (about 5%). No one of the investigated antirheumatic drugs was specifically associated with the Covid-19 development, symptoms or complications. In the group of female RA patients, the prevalence of confirmed (13.6% vs. 22.4%) and suspected (10.6% vs. 17.6%) Covid-19 infection was significantly lower Conclusion: The therapy with b/tsDMARD in RA patients has not been associated with increased Covid-19 incidence, distinct clinical symptoms, or worse outcomes when compared to csDMARD therapy. Moreover, it might decrease Covid-19 incidence or increase the asymptomatic cases in women with RA. Gender and sex-specific differences in RA and Covid-19 interrelations need further evaluation.
Background: Major adverse cardiovascular events (MACE, including stroke and cardiovascular mortality) in patients with carotid arterial disease (CAD) are still a significant global issue.Aims: Our goal was to analyze the prognostic role of risk factors (RF), comorbidities and levels of specific biomarkers: asymmetric dimethylarginine (ADMA), homocysteine (HCY) and vitamin B12 (VB12) for MACE in Bulgarian patients with significant CAD.Materials and methods: We studied 98 patients with significant CAD, mean age 67.46 years, hospitalized in Cardiology Clinic of UMHAT "Alexandrovska" during the period between 2014 and 2020 years. They were divided into two groups, depending on whether they underwent carotid arterial stenting (CAS) (84 in total) or not (14 in total). The differences in RF, comorbidities and ADMA, HCY and VB12 between the two studied groups were assessed, as well as their prognostic value for MACE appearance, using parametric methods (Chi-square test) and ROC analysis.Results: Patients with stroke had a significantly higher incidence of arterial hypertension (AH) (87.1 %, p < 0.009), diabetes mellitus (DM) type 2 (29,0 % p < 0.028) and smoking (38.7 %, p < 0.028) compared to those without stroke. The rates of dyslipidemia and obesity did not show statistically significant differences between the two studied groups. Regression analysis showed that AH was the most significant RF for the occurrence of stroke (OR 3.99, p <0.04). Moreover, the incidence of AH was significantly higher in patients with previous myocardial infarction (p <0.031). No statistical significance was found for dyslipidemia, DM type 2, obesity and smoking in both groups (with/without MI). In the studied patients with CAD, potential factors for MACE were: previous stroke (p < 0.017) and MI ( p < 0.047), and the presence of stroke increased almost 4 times the risk of death /OR=3.765/. Importantly in all patients with known significant CAD, whether or not they underwent stenting, ADMA and HCY values were significantly elevated (p <0.001), compared to the control group (healthy volunteers without known carotid pathology were assessed as a control group), and cut-off values related to an increased risk for MACE were > 0.91 for ADMA and > 12.25 for HCY, respectively.Conclusion: Based on these data we could recommend: patients with known carotid artery disease with or without interventional treatment, aged over 69.5 years, with the presence of AH, DM type 2 and smoking, and ADMA / HCY values above 0.91/12.25 Mmol/l respectively, are associated with elevated risk of MACE. The risk is significantly increased if these patients have previous stroke and/ or myocardial infarction.
Lung cancer is associated with high mortality, which is predominately comprised of non-small cell lung cancer (NSCLC) cases. Epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors comprise one of the most common targeted therapies for NSCLC. To understand the anti-proliferative activities of the combination of osimertinib and anlotinib in NSCLC, human NSCLC mutant cells (EGFR T790M NSCLC) were treated with osimertinib and/or anlotinib in our study. The significant decline in cell viability, an increase in cell cycle arrest in the G0/G1 phase, and an increase in apoptosis confirmed the anti-proliferative activities of anlotinib and osimertinib against EGFR T790M NSCLC cells. The anti-proliferative activities of a concomitant combination of anlotinib and osimertinib was better than that of sequential combinations, as well as that with anlotinib or osimertinib treatment alone. Moreover, a decrease in the phosphorylation of EGFR, PI3K, AKT, and ERK indicated that anlotinib and osimertinib inhibited activation of the PI3K/AKT and MAPK/ERK signaling pathways. The inhibitory effect of the concomitant combination of anlotinib and osimertinib on EGFR signaling was more effective than that with sequential combinations, as well as that with anlotinib or osimertinib alone. Our findings suggest that the concomitant combination of anlotinib and osimertinib enhances their anti-proliferative activities against EGFR T790M NSCLC.
Objective: To explore the correlation between the levels of serum cystatin C (CysC), inflammatory factors, folic acid and vitamin B12. Methods: From January 2018 to June 2019, 125 patients with ischemic cerebrovascular disease and the degree of carotid artery stenosis. ischemic cerebrovascular disease in our hospital were collected and divided into mild stenosis group (<30%), moderate stenosis group (30%-69%) and Meanwhile, 25 healthy adults in the outpatient department of our hospital at the same stage were collected as the normal stenosis group (<30%), moderate stenosis group (30%-69%) and severe stenosis group (70%-99%). Meanwhile, 25 healthy adults in the outpatient department of our hospital at the same stage were collected as the normal control group, and the serum Cys levels of each group were compared C. The levels of cathepsin S (cat s), folic The levels of cathepsin S (cat s), folic acid, vitamin B12, high sensitivity C-reactive protein (hs CRP), tumor necrosis factor -alpha (TNF -alpha) and interleukin-6 (IL-6) were analyzed. Results: Levels of serum Cys C and cat s in different degree stenosis groups were significantly lower than those in the normal control group (P<0.05). The level of serum Cys C in severe stenosis group and moderate stenosis group was significantly lower than that in mild stenosis group, and the level of cat s in severe stenosis group was significantly lower than that in moderate stenosis group (P<0.05), and the level of cat s in severe stenosis group was significantly lower than that in moderate stenosis group. The levels of folic acid and vitamin S in severe stenosis group was significantly lower than that in moderate stenosis group (P<0.05), and the level of cat s in severe stenosis group was significantly lower than that in moderate stenosis group (P<0.05). The levels of folic acid and vitamin B12 in different stenosis groups were significantly lower than those in normal control group (P<0.05). The levels of folic acid and vitamin B12 in severe stenosis group were significantly lower than those in mild stenosis group (P<0.05), and there was no The levels of folic acid and vitamin B12 in severe stenosis group were significantly lower than those in mild stenosis group (P<0.05), and there was no significant difference between mild stenosis group and moderate stenosis group (P>0.05). The levels of hs CRP, TNF -alpha and IL-6 in different stenosis groups were significantly higher than those in the normal control group (P<0.05). The levels of hs CRP, TNF -alpha and IL-6 in moderate stenosis group and severe stenosis group were significantly higher than those in mild stenosis group (P< 0.05). The levels of hs CRP, TNF -alpha and IL-6 in severe stenosis group were significantly higher than those in moderate stenosis group (P<0.05). The degree of carotid stenosis was negatively correlated with serum Cys C, folic acid and vitamin B12 levels (r=-0.190,-0.083,-0.290, P<0.05), and positively correlated with the levels of cat s, hs CRP, TNF -alpha and IL-6 (r=0.168, 0.255, 0.223, 0.159, P<0.05). Conclusion: The serum levels of Cys C, folic acid and vitamin B12 in patients with ischemic cerebrovascular disease were significantly decreased, and The levels of cat s and inflammatory factors were significantly increased; the levels of Cys C, folic acid and vitamin B12 were negatively correlated with The levels of Cys C, folic acid and vitamin B12 were negatively correlated with the degree of carotid artery stenosis, and the levels of cat s and inflammatory factors were positively correlated with the degree of stenosis.
Objective: To explore the value of peripheral blood NLRP3, pngal and PPENK in evaluating the prognosis of sepsis patients with acute renal injury, and to provide reference for clinical diagnosis and treatment.Methods: 168 sepsis patients admitted to our hospital from July 2020 to June 2022 were collected. According to whether the patients were complicated with AKI, the subjects were divided into AKI group (n=92) and non AKI group (n=76). The AKI group was further divided into survival group (n=52) and death group (n=35) according to the prognosis of the patients. Peripheral blood NLRP3 was detected by ELISA method; Double antibody sandwich enzyme-linked immunosorbent assay was used to detect the levels of PENK and pNGAl, and to compare the differences of the above indexes among the groups. Multivariate logistic regression was used to analyze the independent risk factors for the prognosis of sepsis with acute renal injury. ROC curve was used to analyze the prognostic value of NLRP3, pNGAL and PPENK in peripheral blood in patients with sepsis and acute renal injury.Results: the levels of NLRP3, pNGAL and PPENK in peripheral blood of AKI group were significantly higher than those of non AKI group (P<0.05). The levels of NLRP3, pNGAL and PPENK in the peripheral blood of patients in the death group were significantly higher than those in the survival group (P<0.05). Multivariate logistic regression analysis showed that NLRP3, pNGAL and PPENK in peripheral blood were independent risk factors for poor prognosis in patients with sepsis and AKI. ROC curve analysis showed that the AUC of NLRP3, pNGAL, PPENK and combined evaluation of prognosis of sepsis patients with AKI were 0.768, 0.728, 0.675 and 0.916, respectively. Conclusion: the detection of NLRP3, pNGAL and PPENK in peripheral blood alone or in combination has clinical value in evaluating the prognosis of sepsis patients with acute renal injury, and can be used for clinical promotion.
Objective: To investigate long-term prognostic factors of root canal therapy in patients with chronic pulpitis secondary to cracked teeth, so as to provide more reference for the development of individualized intervention plans.Methods: 134 teeth from 134 patients with chronic pulpitis secondary to cracked teeth admitted to our hospital from January 2015 to January 2017 were included retrospectively, all of whom received root canal therapy. After 5 years of follow-up, the retention rate of affected teeth was recorded, and the independent influence factors of the 5-year retention rate of affected teeth after root canal therapy were evaluated by means of univariate and multivariate analysis. Results: After 5 years of follow-up, the final evaluation was completed, which indicated that the retention rate of 124 affected teeth from 124 patients was 91.13%. Univariate analysis showed that whether patients received crown restoration, crack distribution, crack depth and periodontal condition of affected teeth were all related to the 5-year retention rate of affected teeth after root canal therapy (P<0.05). Multivariate analysis of logistic regression model showed that crown restoration was an independent protective factor for 5-year retention rate of affected teeth after root canal therapy (P<0.05). Cracks reaching the floor of the pulp chamber and periodontal probing depth >5mm were independent risk factors for 5-year retention rate of affected teeth after root canal therapy (P<0.05). Conclusion: The long-term prognosis of patients with chronic pulpitis secondary to cracked teeth is closely related to whether they receive crown restoration, crack depth and periodontal lesions of the affected teeth.
Objective: To explore the effect of minimally invasive percutaneous screw placement and open pedicle screw internal fixation on the treatment of thoracolumbar fractures. Methods: From October 2018 to April 2019, 64 patients with thoracolumbar fractures were randomly divided into an observation group and a control group. The observation group was treated with minimally invasive percutaneous screw placement, while the control group was treated with open pedicle screw internal fixation. Results: There was no significant difference in the length of operation between the two groups (P>0.05), but the amount of bleeding in the observation group was significantly less than that in the control group (P<0.05). After periods of 2 weeks, 5 months and at the last follow-up, the scores given in VAS pain ratings by the observation group were significantly different from those given by the control group (P<0.05). In addition, the vertebral compression rate and Cobb angle of the two groups significantly recovered before and after operation, and the two indexes were significantly improved compared to those before operation, but there was no significant difference between the two groups (P>0.05). Conclusion: Minimally invasive percutaneous screw placement surgery had the same treatment effect as traditional open surgery pedicle screw internal fixation, which reduced the compression rate of the patient's vertebral body and quickly recovered the Cobb angle. However, minimally invasive surgery caused less bleeding, reduced postoperative pain and improved the prognoses of patients.
Objective: The purpose of this paper is to solve certain problems with the treatment of early glottic and laryngeal carcinoma with cryoablation under a laryngoscope.Methods: A total of 88 patients with early glottic laryngeal cancer T0-T1 treated in our hospital from January 2016 to October 2020 were taken as the research object. Among them, 86 were male and 2 were female, aged from 35 to 99 years old. None of the patients needed radiotherapy or chemotherapy after the operation. They all underwent CO2 laser surgical resection with a supporting laryngoscope microscope. All patients were followed up regularly for five years after discharge and the treatment results were analysed and studied.Results: The results of the study show that the use of supporting laryngoscope microscope CO2 laser surgery for early (T0-T1) portal larynx cancer resection can improve the treatment effect by 75%, raise the patient recovery rate to 100%, the tumour removal rate to 95.8%, the patient survival rate to 98.8% (only one person died) and lower the recurrence rate to only 7.9%.Conclusion: These data prove the feasibility and superiority of supporting laryngoscope microscope CO2 laser surgical resection in the treatment of early-stage laryngeal carcinoma.
Objective: The purpose of this article is to study the diagnostic value of the ultra-high-power microscopy of pharyngeal swabs of patients with respiratory mycoplasma infections and its role in promoting the treatment of respiratory diseases in patients.Methods: The mycoplasma culture medium test and mycoplasma IgM test were compared in terms of their positive rates and their advantages and disadvantages.Results: The results of the study showed that the positive rate for the mycoplasma IgM test was 48.78%. The ultra-high magnification microscope was obviously superior and has the advantage of being fast and low cost while producing accurate results. Its positive rate is as high as 88.09%.Conclusion: Using ultra-high-power microscopy to examine pharyngeal swabs from patients with respiratory mycoplasma infection is of great significance.
To explore the adoption value of ultrasonic image features based on deep residual network (ResNet) in breast imaging reporting and data system (BI-RADS) classification and prognosis of breast cancer, 60 patients with breast cancer were selected and classified into control group (traditional manual feature extraction) and experimental group (image feature extraction based on deep ResNet) averagely. The results showed that the region of interest (ROI) extracted by deep ResNet model was more accurate than traditional manual extraction. In grades 3, 4, 5, and 6 of BI-RADS, the experimental group's accuracy (0.75, 0.79, 0.82, and 0.89, respectively), recall (0.81, 0.78, 0.93, and 0.77, respectively), and F1 scores (0.76, 0.78, 0.88, and 0.84, respectively) were better than those of control group (0.57, 0.67, 0.74, and 0.68; 0.65, 0.65, 0.69, and 0.68; 0.59, 0.61, 0.73, and 0.65, respectively). Besides, in grades 4a, 4b, and 4c, observation group's accuracy (0.73, 0.78, and 0.82, respectively), recall (0.78, 0.78, and 0.80, respectively), and F1 scores (0.71, 0.74, and 0.73, respectively) were also better than those of control group (0.58, 0.64, and 0.69; 0.67, 0.7, and 0.66; 0.65, 0.63, and 0.66, respectively) (P<0.05). The size of breast tumor was closely related to lymph node metastasis and patient's prognosis. To sum up, breast cancer ultrasonic image features based on deep learning had vital adoption value in BI-RADS classification and prognosis.
Background: In this study, it was aimed to compare the intraoperative and postoperative results of the use of conventional blood cardioplegia and del nido cardioplegia solution in terms of myocardial protection and the formation of arrhythmias. Materials and methods: The study was planned as a retrospective case-control study. The study population consisted of all patients who underwent isolated coronary artery bypass graft surgery (CABG) performed by a single team at a private hospital in Osmaniye between March 2016 and May 2020. Power analysis was performed to determine the adequacy of sample size. Results: The groups had similar sociodemographic and clinical characteristics The DNC group had significantly lower cross -clamp time, pump time, amount of cardioplegia, use of inotropic agents, and need for defibrillation than the BC group during CABG The DNC group had significantly lower rates of hospitalization, right ventricular dysfunction, atrial fibrillation, ventricular arrhythmia, and mortality rates than the BC group. Conclusion: These results indicate that the DNC is an easy-to-use procedure for CABG patients because it provides short ischemic and cardioplegia time and less oxidative stress and hyperkalemic arrest.
Introduction: To investigate the clinical efficacy of lateral tibial osteotomy (LTO) combined with knee arthroscopic debridement (KAD)in the treatment of knee osteoarthritis (KOA). Material and method: A total of 80 patients with medial compartment osteoarthritis (MCOA) of the knee treated in our hospital were selected and divided into control group (CG) and observation group (OG) according to the differences in surgical methods. The CG (n=40) was treated with LTO alone, while the OG (n=40) was treated with LTO combined with KAD. Knee joint function, pain degree, lower limb force line and inflammatory factors were evaluated before operation and 12 weeks after operation. The complications of each group were recorded. Results: At 12 weeks after operation, the HSS and Lysholm score of each group were increased compared with those before operation (P<0.05), and those of the OG was strikingly raised than those of the CG (P<0.05). At 12 weeks after operation, the VAS score of each groups were obviously reduced compared with those before operation (P<0.05), and that of the OG were markedly lower than that of the CG (P<0.05). Moreover, at 12 weeks after operation, mMPTA and aFTA of each groups were dramatically reduced compared with those before operation, and those of the OG were reduced than those of the CG (P<0.05). Three days after operation, the levels of IL-1 beta, TNF-alpha and PGE2 in each groups were obviously reduced compared with those before operation (P<0.05), and those in the OG were remarkably reduced than those in the CG (P<0.05). A significant difference in the total incidence of complications between the CG (5.00%) and the OG (10.00%) was not observed (P>0.05). Conclusion: LTO combined with KAD in the treatment of KOA has better short-term efficacy than simple LTO, which can effectively improve knee function, relieve pain perception, adjust the lower limb line, reduce the level of inflammatory factors, and has high safety.
Purpose: To explore the effect of seed soup on reproductive endocrine and ovarian TGF-I3/SMADS pathways in infertile rats caused by ovulation disorder to clarify its mechanism on such infertility. Methods: Infertility was induced by testosterone propionate. Untreated rats were selected as the control group. The rats were randomly divided into the model and treatment groups. Serum levels of estradiol (E2), luteinizing hormone (LH), follicle-generating hormone (FSH), androgen (T), prolactin (PRL), progesterone (P), and gonadotropin-releasing hormone (GnRH) were detected by radioimmunoassay. The expressions of TGF-I31, Smad7, estrogen receptor alpha(Er alpha), follicle-stimulating hormone receptor (FSHR), and luteinizing hormone receptor (LHR) in ovaries were detected by Western blot. Results: The levels of serum P, PRL, E2, FSH, and LH in the model group were lower than in the control group. The levels of GnRH and T were higher than in the control group. These differences were statistically significant (P<0.05). The levels of serum P, PRL, E2, FSH, and LH in the treatment group were higher than in the model group. The levels of GnRH and T were lower than in the model group. These differences were statistically significant (P < 0.05). The expressions of ER alpha, LHR, and TGF-I31 in ovarian tissue in the model group were higher than in the control group. The expressions of FSHR and Smad7 were lower than in the control group. These differences were statistically significant (P < 0.05). The expressions of ER alpha, LHR, and TGF-I31 in ovarian tissues in the treatment group were lower than in the model group, and the expressions of FSHR and Smad7 were significantly higher than in the model group (P<0.05). Conclusion: Seed decoction improved reproductive endocrine regulation in infertile rats with ovulation disorder, which may be achieved through the TGF-I31/Smad7 signaling pathway in the granulosa cells of rat ovaries.
Introduction: The impact of de-escalation has not been studied in hospitalized patients with urinary tract infections (UTI). With the increasing use of empirical broad-spectrum antibiotics in patients with UTIs, there is a need to study the use of de-escalation in these patients. The aim of this study is to assess the frequency of de-escalation and outcomes in patients with urinary tract infections and to estimate the frequency of legitimate causes for the omission of de-escalation. Methods: A descriptive study was conducted over a period of six months at a tertiary care teaching hospital in South India. Patients with urinary tract infections who were treated with empiric broad-spectrum antibiotics were included in this study. A urine culture was performed and the patients were followed up for any change in antibiotic therapy. The final outcomes of all the patients were noted. Results: Of the 75 patients with UTIs who were treated empirically, de-escalation was done in only 31 (42%) patients. Legitimate causes for omission of de-escalation were observed in only 21.3% of patients with UTIs. In 37.3% of the patients with UTIs, de-escalation was omitted without any valid justifications. De-escalation was associated with a reduction in the mean duration of treatment and rate of re-infection. The mortality rate remained unaffected by de-escalation. Conclusion: De-escalation is a feasible and safe strategy that is associated with a reduction in the duration of treatment, and hospital stays with no excess mortality and therefore should be routinely practiced.
