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Copyright of Journal of Prevention & Treatment For Stomatological Diseases is the property of Journal of Prevention & Treatment For Stomatological Diseases Editorial Office and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This article summarized clinical data and nursing management of a patient with drug-induced hypersensitivity syndrome characterized by toxic epidermal necrolysis and dermatitis combined with multiple organ failure treated with continuous renal replacement therapy (CRRT). Given the complex illness condition of the patient, a comprehensive evaluation on nursing risks was carried out before CRRT. In addition to enhance the nursing cooperation in CRRT, nurses had improved the nursing interventions on symptoms of multiple organ failure, catheter maintanence, skin care, diet guildance and health education during the hospitalizaiton. After effective treatment and meticulous care, the patient's skin condition and psychological state were improved. (本文总结1例以中毒性表皮坏死松解症为表现特征的药物超敏反应综合征样皮炎合并多脏器衰竭患者行连续性肾脏替代治疗(CRRT)的护理经验。患者病情复杂, 入院后积极完善评估和检查, 采取CRRT治疗, 同时加强脏器衰竭护理、CRRT护理、管路护理、皮肤护理, 做好饮食指导和健康宣教, 积极预防并发症, 患者的皮损明显减轻, 生命体征相对恢复稳定。)

Objective To investigate the efficacy of transjugular intrahepatic portosystemic shunt (TIPS) in preventing rebleeding in patients with hepatocellular carcinoma (HCC) comorbid with esophagogastric variceal bleeding and the influencing factors for prognosis. Methods A retrospective analysis was performed for the clinical data of 35 HCC patients comorbid with esophagogastric variceal bleeding who were admitted to Zengcheng Branch of Nanfang Hospital, Southern Medical University, and were treated with TIPS from July 2019 to April 2023. The Kaplan-Meier curve was used to assess rebleeding rate and survival rate after TIPS, and the Cox regression model was used to investigate the influencing factors for postoperative rebleeding and survival. Results The TIPS procedure was technically successful in all patients, with a median follow-up time of 16.4 months. During follow-up, 11 patients (31.4%) experienced esophagogastric variceal rebleeding, with the 1-month, 3-month, and 1-year rebleeding rates of 5.7%, 17.1%, and 28.6%, respectively. White blood cell count (WBC) (risk ratio [HR]=1.31, 95% confidence interval [CI]: 1.04 — 1.64, P=0.021), number of tumors ≥3 (HR=35.68, 95%CI: 1.74—733.79, P=0.021), and portal pressure gradient before TIPS (HR=0.85, 95%CI: 0.73 — 0.99, P=0.032) were independent predictive factors for rebleeding after TIPS. Shunt dysfunction was observed in 5 patients after surgery. A total of 19 patients died during follow-up, with a median survival time of 9.6 months. Portal vein tumor thrombosis (PVTT) (HR=7.04, 95%CI: 1.31—37.78, P=0.023), total bilirubin (TBil) (HR=1.02, 95%CI: 1.00—1.03, P=0.042), and serum albumin (HR=0.82, 95%CI: 0.72 — 0.94, P=0.004) were independent predictive factors for survival after TIPS. Conclusion TIPS procedure can be used as a therapeutic option to prevent esophagogastric variceal rebleeding in patients with HCC. Patients with a relatively high level of WBC or TBil or those with PVTT tend to have a poorer prognosis, and the application of TIPS treatment in such patients should be determined with caution. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To construct the automatic surveillance module for coagulation dysfunction complicated with bleeding events based on adverse drug events active surveillance and assessment system (ADE-ASAS-II), and to explore an automated method for monitoring adverse drug reactions (ADR) under complex diagnostic conditions. METHODS: Taking tigecycline as a case study, a quantitative-text composite monitoring module was constructed through the combination of trigger technology and natural language processing technology based on decision tree algorithm, and the coagulation dysfunction-associated bleeding events were mined based on the hospital information system (HIS) data of a large grade III, level A hospital. The module settings were optimized iteratively, and the manual evaluation results were used as the "gold standard" to compare the monitoring performance of modules under different optimization schemes to determine the optimal settings. The incidence of positive events and their basic characteristics were calculated. RESULTS: A total of 2 345 patients using tigecycline were monitored from 2019 to 2022 were monitored, and 83 positive cases were identified after manual evaluation. Under the initial module setting, 985 cases were alarmed, with a precision rate of 7. 72%, a recall rate of 91. 57% and F1 value of 14. 23%. After iterative optimization, 475 cases were alarmed, the recall rate was stable, the precision rate was increased to 16. 00% and the F1 value was increased to 27. 24%; 1 870 cases were marked as negative cases by ADE-ASAS-II, which had reduced approximately 80% of the manual evaluation workload. Of the 1 359 patients who met the inclusion and exclusion criteria (1 276 negative cases and 83 positive cases), the incidence of coagulation dysfunction complicated with bleeding events was 6. 11%. CONCLUSIONS: The development of the module of coagulation dysfunction complicated with bleeding events has improved the detection efficiency of ADE-ASAS-II for ADR under complex diagnostic conditions, and has expanded the monitoring method for identifying ADR by combining structured and unstructured HIS data. Subsequent expansion of the sample is needed to verify the stability of the module and to continuously improve the system algorithm, so as to further enhance the monitoring efficiency. [ABSTRACT FROM AUTHOR]

Objective To compare the efficacy and safety of large volume ligation device and tissue glue injection in the treatment of GOV gastric varicose veins, and to provide reference for the treatment of GOV gastric varicose veins. Methods A total of 150 patients with GOV type gastric varicose veins were prospectively included. Patients were divided into the endoscopic varicose vein ligation (EBL) group (78 cases) and the endoscopic varicose vein embolization (EVO) group (72 cases) according to their condition and willingness. In EBL group, GOV type gastric varices were treated by endoscopic ligation with a large volume ligation device. The EVO group was treated with tissue glue combined with cinnamyl alcohol injection. All patients were re-examined with gastroscopy 2-3 weeks after the first operation to observe whether varicose veins were residual and bleeding (if so, treatment should be repeated at this follow-up visit). Gastroscopy was performed at 1, 3 and 6 months after surgery to evaluate the main outcome measures after endoscopic treatment, including success rate of varicose vein hemostasis, technical success rate, eradication rate, recurrence rate and related complications (secondary indicators): endoscopy-related bleeding, fever, sepsis and distant embolization. Results There were no significant differences in technical success rate, hemostasis success rate, average treatment times and 6-month eradication rate of gastric varices between the EBL group and the EVO group. The recurrence rate was higher in the EVO group than that of EBL group (P＜0.05). The endoscopy-related bleeding rate and fever rate were lower in the EBL group than those in the EVO group (P＜0.05). In the EVO group, 1 patient developed pulmonary embolism after injection and 3 patients developed septicemia. Conclusion The short-term efficacy of high volume ligation device is similar to that of endoscopic injection of tissue glue in eradicating GOV gastric varices, but the former is safer than the latter. [ABSTRACT FROM AUTHOR]

Copyright of Chinese Journal of Clinical Healthcare is the property of Chinese Journal of Clinical Healthcare and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Very severe aplastic anemia is a very rare and serious disease of hematopoietic system, which is characterized by continuous impairment of hematopoietic function of bone marrow, resulting in insufficient number of three types of cells (red blood cells, white blood cells and platelets) in whole blood cells. This paper summarized the nursing management of a patient with severe aplastic anemia complicated with multiple infections. According to the patient's existing symptoms, key issues of nursing were clarified including infection prevention and control, illness condition monitoring, risk assessment and prevention of falls and bleeding. In addition to routine personalized care psychological care was carried out to improve the patients’ treatment adherence. (极重型再生障碍性贫血(VSAA)是一种非常罕见的、严重的造血系统疾病, 表现为骨髓造血功能持续受损, 导致全血细胞中的三大类细胞(红细胞、白细胞和血小板)数量不足。本文总结1例极重型再生障碍性贫血合并多重感染的患者的护理体会。根据患者临床症状, 明确护理重点, 积极控制感染, 加强病情观察, 做好跌倒及出血风险评估和防控, 针对性开展心理护理, 疏导患者情绪, 提高患者治疗依从性, 促进早期康复。)

This article summarized the nursing management for a patient with Salmonella enterica serovar Typhimurium infection complicated by vomiting. A nursing plan including isolation strategy for prevention of enteric infections, nursing intervention on relief of vomiting symptoms, psychological care, illness monitoring and dietary guidance were carried out during the treatment. The nursing plan was designed to reduce the incidence of complicaitons, relieve the clinical symptoms and improve the recovery of the patient. (本文总结1例感染鼠伤寒沙门菌伴呕吐患者的护理经验, 包括肠道传染病隔离措施、呕吐护理、心理护理、病情观察、饮食护理等护理措施, 通过积极有效的护理措施预防并发症, 改善患者症状, 促进患者早日康复。)

The liver plays an important regulatory role in maintaining the dynamic balance of coagulation and anticoagulation in the body. Such dynamic balance is fragile in patients with liver cirrhosis, and the risk of bleeding can be increased due to reductions in coagulation factors and platelet count and excessive fibrinolysis； meanwhile, thrombus can be formed due to the increases in von Willebrand factor and coagulation factor Ⅷ, the reductions in anticoagulant protein C and anticoagulant protein S, the increase in thrombin-generating potential, and alterations in antifibrinolytic components. This article reviews the mechanisms of coagulation disorder in liver cirrhosis, so as to help clinicians with the prevention and treatment of bleeding or thrombotic disorders in patients with liver cirrhosis. [ABSTRACT FROM AUTHOR]

Tubal ectopic pregnancy with hydatidiform mole is extremely rare in clinical practice, and preoperative diagnosis is often difficult. The diagnosis is mainly based on the postoperative histopathology results. This article reports a 38 -year -old woman whom underwent laparoscopic right fallopian tube resection in an emergency due to rupture of right fallopian tube pregnancy. The postoperative pathology revealed completeness hydatidiform mole. The patient recovered well after surgery, with a satisfactory decrease in serum human chorionic gonadotropin (hCG) during the follow-up period. There were no symptoms of vaginal bleeding, coughing, hemoptysis, or related lesion metastasis. Tubal pregnancy with hydatidiform mole often manifests as acute abdominal disease. Therefore, for patients with acute abdominal disease, the possibility of hydatidiform mole should be paid to. The treatment is mainly based on surgery, and chemotherapy should be performed if necessary. After surgery, close follow -up is required, and doctors should be noting the possibility of lesion erosion and malignancy too. [ABSTRACT FROM AUTHOR]

Objective　To investigate the efficacy of percutaneous transhepatic variceal embolization （PTVE） alone or in combination with partial splenic embolization （PSE） in the treatment of portal hypertensive hemorrhage in liver cirrhosis through a meta-analysis. Methods　This study was conducted according to PRISMA guideline， with a PROSPERO registration number of CRD42023396690. Wanfang Med Online， CNKI， CBM， VIP Databases， PubMed， Embase， the Cochrane Library， and Web of Science databases were searched for articles on PTVE alone or in combination with PSE in the treatment of portal hypertensive hemorrhage in liver cirrhosis published up to December 23， 2022. The articles were selected based on inclusion and exclusion criteria， and related data were extracted. The RevMan 5.4.1 statistical analysis software was used to perform the meta-analysis. Results　Eight articles were finally included， with a total sample size of 592 cases， among which there were 316 cases in the PTVE+PSE group and 276 cases in the PTVE group. The meta-analysis showed that compared with the PTVE group， the PTVE+PSE group had significantly lower postoperative portal vein pressure （standardized mean difference ［SMD］= − 1.75， 95% confidence interval ［CI］： −2.33 to −1.16， P<0.05）， postoperative diameter of the portal vein （SMD=−0.87， 95%CI： −1.64 to −0.10， P<0.05）， postoperative rebleeding rate （odds ratio ［OR］=0.17， 95%CI： 0.11 — 0.28， P<0.05）， mortality rate （OR=0.13， 95%CI： 0.04 — 0.37， P<0.05）， and incidence rate of postoperative portal hypertensive gastrointestinal disease （OR=0.17， 95%CI： 0.07 — 0.45， P<0.05］， as well as a significantly higher postoperative platelet level（ SMD=0.79， 95%CI： 0.52 — 1.06， P<0.05）， while there were no significant differences between the two groups in the incidence rates of postoperative ascites. Conclusion　Compared with PTVE alone， PTVE combined with PSE can effectively reduce the rebleeding rate and mortality rate of portal hypertensive hemorrhage in liver cirrhosis， the incidence rate of portal hypertensive gastrointestinal disease， and portal vein pressure， and it can also shorten the diameter of the portal vein and increase platelet level. Therefore， it is an effective interventional method for the treatment of portal hypertension hemorrhage in liver cirrhosis. [ABSTRACT FROM AUTHOR]

Portal vein thrombosis is one of the common complications of liver cirrhosis. The incidence of portal vein thrombosis is increased with the progression of diseases. The incidence and progression of portal vein thrombosis are associated with multiple factors. The indications of anticoagulant therapy remain to be investigated. At present, portal vein thrombosis is no longer considered as a contraindication for liver transplantation. Nevertheless, complicated portal vein thrombosis will increase perioperative risk of liver transplantation. How to restore the blood flow of portal vein system is a challenge for surgical decision-making in clinical practice. Rational preoperative typing, surgical planning and portal vein reconstruction are the keys to ensure favorable long-term prognosis of liver transplant recipients. In this article, epidemiological status, risk factors, typing and identification of portal vein thrombosis, preoperative and intraoperative management of portal vein thrombosis in liver transplantation, and the impact of portal vein thrombosis on the outcomes of liver transplantation were reviewed, aiming to provide reference for perioperative management of portal vein thrombosis throughout liver transplantation. [ABSTRACT FROM AUTHOR]

Objective To explore the effects of nasal irrigation with adrenalin-saline in functional endoscopic sinus surgery (FESS) on the surgical field and blood loss. Methods This was a prospective randomized controlled study. Eighty patients who had undergone FESS were collected and randomly assigned to the saline group (nasal irrigation with 0.9% sodium chloride, control group) or the adrenalin-saline group (nasal irrigation with 1∶100 000 adrenalin-saline, observation group) with each including 40 patients. For both groups, the Boezaart grading scale and visual analogue scale (VAS) were used to score the surgical field quality and operator satisfaction with the surgical field, respectively, and the blood loss and the relevant perioperative hemodynamic variables were compared. Results There were no statistically significant differences between the two groups in any study variables (P>0.05). All surgeries were completed successfully without intraoperative cardiovascular events or surgical complications, while among the patients with LM score >12, blood loss was smaller in the treatment group [(97.00±31.00)mL] than that in the control group[(129.00±42.00) mL], with a statistically significant difference (P<0.05). Conclusion Intraoperative nasal irrigation with 1∶100 000 adrenalin-saline in FESS was safe, with small hemodynamic effects and no surgical complications, which reduced blood loss in patients with LM score >12, while there was no significant advantages whether in the surgical field quality or in the operator satisfaction with the surgical field. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To probe into the efficacy and safety of rivaroxaban combined with clopidogrel bisulfate for dual antithrombotic therapy ( DAT) in the treatment of senile patients with acute coronary syndrome ( ACS) complicated with nonvalvular atrial fibrillation (NVAF) after percutaneous coronary intervention (PCI). METHODS: A total of 120 elderly patients with ACS complicated with NVAF underwent PCI admitted into Hai’ an People’ s Hospital from Jan. 2019 to Jun. 2021 were selected to be randomly divided into observation group and control group, with 60 cases in each group. After quality control to exclude therapeutic regimen change and follow-up lost, 57 cases in the observation group and 53 cases in the control group were finally enrolled. The observation group was given DAT regimen, while the control group was given triple antithrombotic therapy (TAT) of warfarin, aspirin and clopidogrel bisulfate, the course of treatment were 12 months for both groups. The scores of risk degree of atrial fibrillation thrombus (CHA2DS2-VASc) and risk of atrial fibrillation anticoagulant bleeding (HAS-BLED) were evaluated before treatment and after 6 and 12 months of treatment, respectively; at the end of the research, the incidences of thromboembolic events and bleeding events, as well as the classification proportions of bleeding events severity were observed. RESULTS: After 6 and 12 months of treatment, the CHA2DS2-VASc and HAS-BLED scores of both groups were slightly higher than those before treatment, the difference was not statistically significant (P>0. 05). At the end of the research, the differences of the incidences of compound thromboembolic events ( stent thrombosis, recurrent acute myocardial infarction, ischemic stroke, pulmonary embolism or peripheral arterial embolism, recurrent revascularization and all-cause mortality ) between two groups were not statistically significant ( P > 0. 05 ); the differences of the incidences of drug cumulative bleeding events (hemorrhagic stroke, gingival bleeding, subcutaneous bleeding, respiratory tract bleeding, digestive tract bleeding, urethremorrhage and anemia ) and the severity of bleeding events (mild, moderate and severe bleeding) were not statistically significant (P>0. 05). CONCLUSIONS: The DAT regimen has equivalently antithrombotic treatment effect as TAT regimen in senile patients with ACS complicated with NVAF after PCI, and do not increase the risk of bleeding in patients. [ABSTRACT FROM AUTHOR]

Extracorporeal membrane oxygenation (ECMO) is an advanced life support modality for patients with respiratory or cardiac failure. During ECMO, various factors impair coagulation function, resulting in an imbalance between procoagulation and anticoagulation, thus increasing the incidence of bleeding and posing a significant challenge to the development of clinical work. In this article, the epidemiology, causes, anticoagulation and monitoring of high-risk bleeding during ECMO were reviewed, aiming to provide reference for clinical practice. [ABSTRACT FROM AUTHOR]

Venous thromboembolism (VTE) is a significant complication and a risk factor for mortality in patients with lung tumors. Anticoagulation therapy plays a crucial role in the prevention of VTE. However, its safety and effectiveness, specifically in lung cancer patients, have not been systematically evaluated. This study aimed to conduct a meta-analysis to assess the efficacy and safety of prophylactic anticoagulation in patients with lung cancer. We systematically searched for relevant literature published in Pubmed, Embase, CNKI, and Wanfang databases until September 2020 and screened the literature according to predefined inclusion and exclusion criteria. The included studies were evaluated for quality using the modified Jadad scale, and Review Manager 5.4 software was used for data analysis. Four randomized controlled trials (n = 2272 participants) were included in the meta-analysis. The quality evaluation revealed that two articles were of high quality (≥ 4 points), while the remaining articles were of low quality (≤ 3 points). The average Jadad score for all references was 3.5. The meta-analyses demonstrated that anticoagulant therapy significantly reduced the incidence of VTE in lung cancer patients [RR = 0.55, 95% CI (0.43, 0.70), P < 0.00001]. However, there were no statistically significant differences in the incidence of total bleeding [RR = 1.74, 95% CI (0.87, 3.50), P = 0.12], minor bleeding [RR = 1.64, 95% CI (0.66, 4.05), P = 0.29], and major bleeding [RR = 1.70, 95% CI (0.91, 3.16), P = 0.10]. In conclusion, anticoagulant therapy effectively reduced the incidence of VTE in lung cancer patients without a statistically significant increase in bleeding complications. [ABSTRACT FROM AUTHOR]

to summarize a case of acute myocardial infarction (Ami) who was treated with emergency PCI after intravenous thrombolytic therapy. During the treatment, nursing intervention was carried out for the patients with severe pain due to myocardial ischemia, to enhance the patient’s own comfort. And the implementation of patients with cardiac rehabilitation care, so as to ease the patients during the treatment of excessive reaction to improve the treatment effect. This article reviews the first aid measures and nursing measures of 1 patient with acute myocardial infarction, and summarizes the relevant nursing experience (本文总结1例急性心肌梗死(AMI)静脉溶栓患者的护理经验, 包括饮食干预、健康宣教等常规护理以及疼痛干预、溶栓治疗不同阶段的护理措施, 通过快速正确诊断、密切观察病情变化、及时治疗和精心护理, 提高AMI患者生存率和生命质量。)

卵巢成熟畸胎瘤是卵巢肿瘤中最常见的生殖细胞肿瘤, 好发于育龄期妇女, 但儿童时期发病, 很容易造成漏诊、误诊, 从而造成严重后果。贵州中医药大学第二附属医院普外科于2022年10月收治1例儿 童卵巢成熟畸胎瘤伴出血及坏死患者, 经手术治疗后恢复良好, 现结合相关文献进行复习。 [ABSTRACT FROM AUTHOR]

Copyright of China Journal of Oral & Maxillofacial Surgery is the property of Shanghai Jiao Tong University, College of Stomatology and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Severe infections due to sepsis often result in multi-organ insufficiency, such as cardiac insufficiency, renal insufficiency, hypohepatia, septic encephalopathy, coagulation dysfunction etc. Severe infections not only cause inflammatory storm, but also induce spleen abscess, and even combined with spontaneous splenic rupture hemorrhage. Spontaneous splenic rupture has an insidious onset, usually without a history of trauma, and is easily missed diagnosis. In this case, the patient with sepsis had sudden onset of abdominal pain and progressive decrease in hematocrit, thus the abdominal CT was immediately performed. The perisplenic mixed high-density shadow indicated splenic hemorrhage. After consultation with the department of hepatobiliary surgery, emergency dissection was performed. Splenic hematoma and laceration were found during the operation, thus total splenectomy was conducted. Pathological indicated chronic inflammatory cell infiltration of spleen, spleen abscess with bleeding. After operation, the patient’s hematocrit was stable, abdominal pain improved significantly, and he was discharged from hospital after systematic therapy. [ABSTRACT FROM AUTHOR]

Transjugular intrahepatic portosystemic shunt (TIPS) is a procedure to establish a portosystemic shunt between the hepatic vein and the portal vein via the jugular approach, so as to reduce portal venous pressure and control acute esophagogastric variceal bleeding (EGVB). The prognosis of EGVB has been improved significantly over the past few decades, and endoscopic variceal ligation combined with drug therapy is now recommended as the first-line treatment regimen for this disease. The latest research advances in the management of EGVB over the past decade have focused on the relatively new concept of "early" or "pre-emptive" TIPS, that is to say, early TIPS (within 72 hours after admission, ideally within 24 hours) is recommended for patients with EGVB who are at a relatively high risk of failure in standard treatment. This article briefly introduces the effect of early TIPS on controlling bleeding, mortality rate, and hepatic encephalopathy, the high-risk population for early TIPS, timing of intervention, cost effectiveness, the applications of early TIPS in a real-world setting, and recommendations for early TIPS in international guidelines and consensus statements [ABSTRACT FROM AUTHOR]

Esophagogastric variceal bleeding (EGVB) is one of the main complications of decompensated portal hypertension, especially in patients with liver cirrhosis, and it often has a high mortality rate. Medication combined with endoscopy is the main prevention and treatment method for EGVB, while transjugular intrahepatic portosystemic shunt (TIPS) combined with variceal embolization can also be selected for some high-risk patients, and individualized diagnosis and treatment of portal hypertension based on hepatic venous pressure gradient should become the latest consensus and the main strategy. This article mainly reviews endoscopic therapy and TIPS for the prevention and treatment of EGVB patients with decompensated portal hypertension in terms of selection of indications, incidence rate of complications, and respective advantages and disadvantages. [ABSTRACT FROM AUTHOR]

This paper summarized the nursing management for a long-term bedridden elderly patient with nasal feeding diet complicated with various diseases. During the daily oral care, the patient swallowed the mouth care straw tip (silicone foreign body) accidentally. Given the old age and poor gastrointestinal function of the patient, targeted intervention was implemented followed by precisely locating foreign body. Comprehensive nursing measures including biochemical index monitoring, medication care and prevention of complications were carried out to ensure the successful removal of the foreign body (本文总结1例高龄、合并多种疾病且长期卧床的鼻饲饮食患者发生异物吞食事件的护理体会。老年人群胃肠功能减弱, 通过检查定位异物位置, 针对性采取消化道异物处理方式, 同时注意生化指标监测、用药以及并发症预防等细节护理, 以促进异物顺利排出体外。)

目的 旨在统计SWI相位图病灶本身信号强度（直接征象）鉴别单纯出血或钙化发生错判的概率，并通过logistic回归分析确定错判的独立影像学危险因素，为影像及临床医师鉴别诊断提供依据。 方法 回顾性分析2016-2019年首都医科大学附属北京天坛医院单纯出血或钙化病例，连续性入组。将SWI图像进行标准化，即将左手图变成右手图。含有多个病灶者，所有病变逐个评估。两名观察者直观定性评估SWI相位图数据：低、高信号或无法判断（混杂或等信号），预测病变为出血或钙化。与CT诊断“金标准”进行对比，预判结果与CT结果不一致者认定为失败组，一致者为成功组。评估的临床及影像学影响因素包括年龄、性别、病灶直径、平均CT值、T1WI和T2WI信号、SWI相位图病灶本身信号强度（直接征象）、左右手图、病灶位置、侧别、单多发及病灶性质。采用logistic回归分析SWI相位图病灶本身信号强度法鉴别失败的影响因素。 结果 共纳入受试者41例，病灶339个，钙化及出血病灶分别为157个及182个。失败组105个病灶，成功组234个病灶。通过SWI相位图病灶本身信号强度（直接征象）错判率为30.97%。多因素logistic回归分析显示，SWI相位图等或混杂信号（OR 97.263，95%CI 28.746～329.096，P4 mm（OR 2.437，95%CI 1.168～5.084，P=0.018）是导致SWI相位图病灶本身信号强度（直接征象）错判的独立危险因素。 结论 SWI相位图病灶高或混杂信号者、T2WI低或混杂信号者、CT值91～300 Hu者及病灶直径>4 mm者采用SWI相位图病灶本身信号强度（直接征象）方法鉴别单纯出血及钙化错误风险高，对临床及影像学诊断有一定指导作用。 Objective To investigate the influencing factors for false differentiating simple hemorrhage from calcification by cerebral lesion signal intensity on SWI phase image. Methods This retrospective analysis enrolled the consecutive patients with simple calcifications and/or microhemorrhage on head SWI phase image at Beijing Tiantan Hospital, Capital Medical University between 2016 and 2019. Follow-up CT scan was taken as the gold standard. The evaluation standard on right handed SWI phase image: low and high intensity signal sign for hemorrhage and calcification, respectively. The clinical and imaging parameters included gender, age, lesion side, location, diameter, single or multiple lesions, lesion nature, CT value, T1WI and T2WI signal, lesion signal intensity on SWI phase image, left- or right-handed MR image. Multivariate logistic regression analysis was used to analyze the influencing factors for false differentiating the lesions. Results A total of 339 lesions from 41 cases were analyzed, including 157 hemorrhage lesions and 182 calcification lesions. 234 lesions were correctly diagnosed and 105 lesions were incorrectly diagnosed, and the false diagnosis rate was 30.97% by the signal intensity on SWI phase image. Multivariate logistic regression analysis showed that equal or mixed signal intensity (OR 97.263, 95%CI 28.746-329.096, P

This paper summarizes the nursing experience of a patient who received endoscopic variceal ligation in the treatment of esophageal varices, including preoperative psychological care, instrument preparation, patient preparation, intraoperative care, postoperative general care, complication care and other targeted nursing measures. Through the comprehensive nursing mode, full preoperative preparation, close surgical cooperation, and meticulous postoperative care, the success of esophageal variceal ligation was guaranteed, the pain of patients was reduced, the patient's symptoms were improved. (本文总结1例内镜下食管静脉曲张套扎术治疗食管静脉曲张患者的护理体会, 包括术前的心理护理、器械准备、患者准备、术中护理、术后一般护理、并发症护理等针对性护理措施。充分的术前准备、密切的手术配合和细致的术后护理是保障食管静脉曲张套扎术成功的关键, 有助于减轻患者疼痛, 改善患者病症, 促进其康复。)

Objective Idiopathic venous thromboembolism (VTE) has high prevalence, risk and recurrence. The purpose of this study was to investigate whether prolonged anticoagulation can reduce the incidence of VTE outcome events. Methods We selected 306 patients diagnosed with idiopathic VTE in Kailuan General Hospital, from January 1, 2013 to December 31, 2016. All the patients (aged 24 to 85 years) with anticoagulation for 3 months were randomly divided into conventional anticoagulant group and prolonged anticoagulant group with a follow⁃ up of36 months. The primary outcome event was the recurrence of VTE and secondary outcome events were bleeding, including major bleeding and clinically related non - major bleeding. Results A total of 306 VTE patients were included in the analysis, with a mean age of (61.54 ± 11.54) years and 184 males (60.13%). In the conventional anticoagulation group (n = 155), there were 45 VTE recurrence, 3 major bleeding, and 21 clinically relevant non-major bleeding; in the prolonged anticoagulation group (n = 151), there were 8 VTE recurrence, 5 major bleeding and 30 clinically relevant non-major bleeding. Prolonged anticoagulation therapy significantly reduced the incidence of VTE recurrence when compared with conventional anticoagulation therapy (log-rank test, P < 0.000 1), and no significant increase of major bleeding and clinically relevant non-major bleeding (log - rank test, all P = 0.458 8) were observed. Prolonged anticoagulation therapy significantly reduced the risk of VTE recurrence compared to conventional anticoagulation therapy (HR = 0.44, 95%CI: 0.19 ~ 0.99). Moreover, prolonged anticoagulation therapy didn′t increase the risk of major bleeding and clinically relevant non-major bleeding in VTE, with HR (95%CI) of 1.00 (0.24, 4.19), 1.71 (0.83, 3.51), respectively. Conclusion The recurrence rate of VTE patients in the prolonged anticoagulant group is lower than that in the conventional anticoagulant group, and the incidence of major hemorrhage and clinically related non-major hemorrhage do not increase. The prolonged anticoagulant therapy has high application value for preventing the recurrence in patients with idiopathic VTE. [ABSTRACT FROM AUTHOR]

Spontaneous hemoperitoneum in pregnancy (SHiP) is a very rare and serious complication of pregnancy. Closely associated with endometriosis, and lack of specificity in clinic, it will increase the morbidity of the fetus and the mother. A SHiP case was reported that both mother and fetus were safe after operation. A 30-year-old primigravida was hospitalized with persistent lower abdominal pain lasting for half an hour at 39+2 weeks. She suffered from endometriosis and received laparoscopic surgery for rupture of ovarian endometrioma four months prior to the current pregnancy. An emergency cesarean section due to suspected fetal distress and possible placental abruption was performed and a healthy female neonatal was delivered with Apgar score of 10 at 1 min, and no placental signs of abruption. During the operation, 1 200 mL of intraperitoneal hemorrhage was seen. A new active bleeding venous vessel was seen in the middle and lower segment of the right posterior wall of the uterus. The bleeding was treated and healed by suturing. SHiP requires early detection, rapid diagnosis and appropriate intervention to improve maternal and fetal outcomes in clinical practice. [ABSTRACT FROM AUTHOR]

Objective To analyze the predictive efficacy of serum growth differentiation factor 15 (GDF-15) in combination with the bleeding score on bleeding after percutaneous coronary intervention (PCI) in patients with coronary artery disease (CAD). Methods Totally 225 CAD patients were divided into the bleeding group (31 patients) and non-bleeding group (194 patients) according to whether they bled after PCI treatment, and the serum GDF-15 levels and bleeding scores (HAS-BLED bleeding score and CRUSADE bleeding score) of the two groups were compared. Multi-factor Logistic regression analysis was used to analyze the influencing factors and risk factors for bleeding after PCI treatment in CAD patients. Receiver operating characteristic (ROC) curves were plotted to examine the predictive efficacy of serum GDF-15, HAS-BLED bleeding score, and CRUSADE bleeding score alone and in combination on bleeding after PCI treatment in CAD patients. Results Significant differences were found in the proportion of women, serum GDF-15 levels, HASBBLED bleeding score, and CRUSADE bleeding score between the bleeding and non-bleeding groups (all P<0. 05). Multifactorial Logistic regression analysis showed that serum GDF-15 level [OR (95%CI) =13. 408 (3. 130 to 57. 442), P= 0. 000], HAS-BLED bleeding score [OR (95%CI) =2. 394 (1. 313 to 4. 364), P=0. 004], and CRUSADE bleeding score [OR (95%CI) =1. 065 (1. 010 to 1. 123), P=0. 019)] were associated with bleeding events. When the critical value of serum GDF-15 was 2 467. 61 pg/mL, its predictive sensitivity for bleeding after PCI treatment in CAD patients was 51. 6%, specificity was 86. 1%, and area under ROC was 0. 720 (95%CI: 0. 623 to 0. 817, P<0. 05); when the critical value of HAS-BLED bleeding score was 2, its predictive sensitivity for bleeding after PCI treatment in patients was 74. 2%, specificity was 68. 8%, and area under ROC was 0. 730, (95%CI: 0. 635 to 0. 825, P<0. 05); when the critical value of CRUSADE bleeding score was 30, its predictive sensitivity for bleeding events was 77. 4%, specificity was 55. 2%, and area under ROC was 0. 689 (95%CI: 0. 596 to 0. 781, P<0. 05); the predictive sensitivity of serum GDF-15 combined with HAS-BLED bleeding score for bleeding after PCI treatment in CAD patients was 74. 2%, specificity was 78. 9%, and area under ROC was 0. 794 (95%CI: 0. 711 to 0. 876); serum GDF-15 combined with CRUSADE bleeding score had a predictive sensitivity of 87. 1%, specificity of 61. 3%, and area under ROC of 0. 788, 95%CI of 0. 711 to 0. 865 for bleeding after PCI treatment in patients with CAD; significant difference was found in the bleeding between the GDF-15 and GDF-15 combined with HAS-BLED bleeding score (P<0. 05). Conclusion Serum GDF-15, HAS-BLED bleeding score, and CRUSADE bleeding score were all effective predictors of bleeding risk after PCI in patients with CAD. The combined predictive efficacy of the two indicators was higher than that of the single indicator. [ABSTRACT FROM AUTHOR]

目的 比较SWI相位图病灶本身信号强度（传统直观）法与病灶周围征象即极晕（间接）法对单纯出血或单纯钙化的诊断效能。 方法 本研究纳入以随访CT为“金标准”（单次病灶CT或复查CT值变化）的单纯钙化灶和单纯出血灶。针对每个病灶分别采用SWI相位图病灶本身信号强度（传统直观）法和病灶周围极晕（间接）法评估。SWI相位图全部转换为右手图后再进行评估。SWI相位图病灶本身信号强度（传统直观）法评估标准：病灶本身呈低、高信号分别代表出血及钙化。病灶周围极晕（间接）法评估标准：低信号两极征或高信号反晕征，认定病变为出血；高信号两极征或低信号反晕征，认定病变为钙化。用科恩Kappa值评估两名观察者评判相位图病灶本身信号强度、病灶周围极晕结果的一致性。采用阴性预测值、阳性预测值、敏感度及特异度评估上述两种方法鉴别钙化的诊断效能。 结果 共纳入224个病灶（共36例患者）。其中出血灶123个病灶（8例患者），钙化灶101个病灶（28例患者）。两名观察者病灶本身信号强度法（K=0.768）及病灶周围极晕法（K=0.876）分析SWI相位图的结果一致性较好。SWI相位图病灶本身信号强度法鉴别钙化的阳性预测值、阴性预测值、敏感度及特异度分别为66.7%、70.2%、61.4%、74.8%。病灶周围极晕法鉴别钙化的阳性预测值、阴性预测值、敏感度及特异度分别为99.0%、97.6%、97.0%、99.2%。 结论 SWI相位图病灶周围极晕法具有潜在的临床实用价值，有可能成为一种简便易行的MR鉴别单纯出血或钙化的方法。 Abstract: Objective To compare the diagnostic value of traditional method of signal intensity of foci and indirect signs (reversed halo sign and bipolar sign) on SWI phase image in differentiating simple calcification from hemorrhage. Methods The included simple calcification and simple hemorrhage were confirmed by follow-up CT scan. All the lesions were evaluated by traditional method and indirect polar-halo method. The evaluation standard of traditional method as follows: low and high intensity sign representing hemorrhage and calcification, respectively. The evaluation standard of indirect method as follows: low signal intensity bipolar sign or high signal intensity reversed halo sign representing hemorrhage, and high signal intensity bipolar sign or low signal intensity reversed halo sign representing calcification. The Kappa value was calculated to evaluate the consistency of lesion signal intensity and peri-lesion polar-halo sign results between the two observers. Positive predictive value (PPV), negative predictive value (NPV), sensitivity and specificity were calculated to evaluate the diagnosis value of SWI direct and indirect characteristics in differentiating simple calcification and hemorrhage. Results A total of 224 lesions (36 patients) were included, with 101 simple calcifications (28 patients) and 123 simple hemorrhagic lesions (8 cases). The consistency coefficient of the two observers on traditional method and indirect polar-halo method was 0.768 and 0.876, respectively. The PPV, NPV, sensitivity and specificity of traditional method in identifying calcification were 66.7%, 70.2%, 61.4% and 74.8%, respectively. The PPV, NPV, sensitivity and specificity of polar-halo method in identifying calcification were 99.0%, 97.6%, 97.0% and 99.2%, respectively. Conclusions The indirect polar-halo sign on SWI phase image has a higher diagnostic accuracy, which may be a more reliable way to differentiate simple hemorrhage from simple calcification.

Objective To investigate the effect of predictive nursing strategies on preventing side effects of azacitidine in patients with high-risk myelodysplastic syndrome. Methods Totally 40 patients undergoing subcutaneous injection therapy with azacitidine for high-risk myelodysplastic syndrome were randomly divided into the observation group and control group, with 20 cases in each group. Routing nursing management including posture nursing, oral care, psychological care and nursing of adverse reactions was carried out in the control group. In the observation group, a special nursing team was set up to enhance the predictive nursing interventions such as nutrition support, prevention of infection and hemorrhage, and so on. The side effects of azacitidine therapy were observed analyzed. Results The incidence of adverse reactions in the observation group was significantly lower than that in the control group (10. 00% vs. 45. 00%, P＜0. 05). Conclusion For those patients undergoing subcutaneous injection therapy with azacitidine for high-risk myelodysplastic syndrome, the predictive nursing is potentially effective to reduce the incidence of adverse drug reactions. (目的 探讨预见性护理干预预防较高危骨髓增生异常综合征患者阿扎胞苷治疗所致不良反应的效果。方法 40例较高危骨髓增生异常综合征患者随机分为观察组(n=20)和对照组(n=20)。两组患者均给予阿扎胞苷皮下注射治疗。对照组实施常规护理, 包括体位护理、口腔护理、心理护理和不良反应护理; 观察组实施预见性护理干预, 成立预见性护理小组, 强化营养干预、感染预防、出血预防等护理措施。比较两组不良反应发生情况。结果 观察组不良反应发生率10. 00%(2/20), 低于对照组的45. 00%(9/20), 差异有统计学意义(P＜0. 05)。结论 对较高危骨髓增生异常综合征患者, 应用阿扎胞苷治疗的同时配合预见性护理, 可以有效降低不良反应的发生风险。)

This paper summarized the perioperative nursing experience of a child with hemophilia B and adenoid hypertrophy undergoing surgery. The treatment and nursing plan was formed based on the multidisciplinary consultation and discussion. Health education about usage and precautions of prothrombin complex concentrate in replacement therapy was carried out before treatment. Based on the theory of enhance recovery after surgery, a comprehensive perioperative nursing interventions were carried out, including diet care, pain management, body temperature management, preoperative adaptive training. An effort was also made to enhance the psychological care, pre-discharge readiness assessment, discharge planning and guidance and continuous care after discharge. (本文总结1例血友病B患儿腺样体肥大围手术期的护理经验。经多学科会诊讨论并制定治疗护理方案, 告知替代治疗中凝血酶原复合物的使用方法及注意事项, 实施基于加速康复外科理念的围术期护理(饮食护理、疼痛管理、体温管理、术前适应性锻炼), 加强心理干预、出院前的出院准备度评估、出院计划与指导、出院后延续护理等。)

Objective The purpose of this study was to to determine the dignostic accuracy of flat-panel CT scans in predicting hemorrhagic transformation (HT) for patients with acute ischemic stroke (AIS) after thrombectomy. Methods From January 2019 to December 2021, consecutive AIS patients who received an immediate flat-panel CT scan after thrombectomy were enrolled in this study.The time window for the observation of HT was 5-7 days after the thrombectomy, which was determined according to the brain un-enhanced CT scan. The receiver operating characteristic (ROC) curve was adopted to assess the predictive accuracy of characteristics of flat-panel CT for HT. Results Totals of 108 patients were enrolled in this study, 58 (53.7%) patients presented with hyperdense lesions on flat-panel CT. Patients with hyperdense lesions experienced a higher proportion of HT than those patients without (58.7% vs. 10.0%, P＜0.001) .The hyperdensity on flat-panel CT predict HT yielded a sensitivity of 87.2% and a negative predictive value of 90.0%. Among all patients with hyperdensity on flat-panel CT, patients who developed HT had higher CT values (125 HU vs. 93 HU, P=0.001) and a higher proportion of mass effect (67.6 vs. 12.5, P＜0.001) . The area under the ROC curve of CT values, mass effect, and combination of above for prediction of HT were 0.74, 0.78, and 0.83, respectively. Conclusion The hyperdensity on post-thrombectomy flat-panel CT could detect HT with an excellent negative predictive value. The ability of flat-panel CT in predicting the transformation of hyperdensity into HT was improved when combined with CT values and mass effect. [ABSTRACT FROM AUTHOR]

Objective To explore the effect of oral-palatal plate on the recovery of the palatal donor site after connective tissue transplantation. Methods A total of 40 patients who underwent connective tissue transplantation in the Department of Implantology, Stomatological Hospital of Chongqing Medical University from January 2020 to June 2022 were selected and divided into the control group(20 cases) and the observation group(20 cases) according to whether the oral-palatal plate was placed in the palatal donor site after operation. After operation, the wounds in the donor area of the hard palate were closed by covering the wounds with platelet derivative concentrated growth factor(CGF). The oral-palatal plate was also used in the observation group. The postoperative bleeding, pain, and comfort of the donor area of the two groups were evaluated. Results The bleeding score and visual analogue scale in the observation group were significantly improved on the first and third day after operation compared with those in the the control group, and the differences were statistically significant(P<0. 05). The comfort scores of diet, sleep, language communication, emotion, and social activities in the observation group were significantly lower than those in the control group after using the oral-palatal plate, and the differences were statistically significant(P<0. 05). Conclusion Compared with CGF alone, the use of oral-palatal plate after surgery can significantly improve patients′ early bleeding and pain, and improve patients′ postoperative comfort. [ABSTRACT FROM AUTHOR]

Liver cirrhosis is a common chronic liver disease in clinical practice, and the main causes of this disease include virus, alcohol, and immunity. Patients may experience a variety of complications in the late stage of liver cirrhosis, including upper gastrointestinal bleeding, hepatic encephalopathy, hepatorenal syndrome, and liver cancer, among which upper gastrointestinal bleeding is the main cause of death, and therefore, the control and prevention of upper gastrointestinal bleeding caused by liver cirrhosis is the key to reducing mortality rate and prolonging survival time. This article summarizes the commonly used minimally invasive methods for the treatment of upper gastrointestinal bleeding in liver cirrhosis and analyzes the indications for different treatment methods and related advances, so as to provide a reference for clinicians to choose the most suitable treatment regimen for the patient, thereby improving the survival rate of patients. [ABSTRACT FROM AUTHOR]

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This paper summarized the nursing management of bleeding after transurethral resection of the prostate in a patient with maintenance hemodialysis. Key issues including monitoring the patient’s vital signs; accurately recording and controling the patient’s flow of water in and out; paying attention to the color, quality and quantity of the urine; monitoring the patient’s blood routine test, renal function and electrolytes; strengthening the nutrition support; strengthening early rehabilitation treatment; carrying out the early psychological intervention; relieving patient’s anxiety and other adverse emotions. (本文总结1例维持性血液透析患者行经尿道前列腺电切术(TURP)术后出血的护理经验。护理要点包括: 监测患者生命体征, 准确记录并控制患者的出入水量; 关注患者尿液的色、质、量; 监测患者的血常规、肾功能及电解质; 加强营养; 加强早期康复治疗; 贯彻落实早期心理干预, 缓解患者焦虑等不良情绪。)

Objective　To investigate the efficacy of lauromacrogol foam sclerosant and lauromacrogol injection in patients with internal hemorrhoids. Methods　A total of 94 patients with internal hemorrhoids treated in Kunming Second People’s Hospital from February 2020 to August 2021 were randomly selected and divided into study group and control group by number table method. The control group （n = 47）was treated with lauromacrogol injection，and the study group （ n = 47） was treated with lauromacrogol foam sclerosant. The total effective rate， clinical indicators （total course of treatment，operation cost，dosage of lauromacrogol ），intraoperative bleeding， postoperative pain and complications. Results　The total effective rate of the study group was higher than that of the control group，and the difference was statistically significant （P < 0.05）. The total duration of treatment，operation cost and dosage of lauromacrogol in the study group were lower than those in the control group，and the differences were statistically significant （P < 0.05）. The intraoperative local blood loss and postoperative pain in the study group were lower than those in the control group， and the differences were statistically significant （ P < 0.05） . The incidence of complications in the study group was lower than that in the control group， and the difference was statistically significant （ P < 0.05） . Conclusion　Lauromacrogol foam sclerosant is better than lauromacrogol injection in the treatment of patients with internal hemorrhoids，and can shorten the length of hospital stay，reduce the dosage of lauromacrogol，hospitalization costs，complications，and is worthy of promotion and application. [ABSTRACT FROM AUTHOR]

Objective To develop an artificial neural network model to predict the risk of rebleeding within one year in cirrhotic patients with esophagogastric variceal bleeding. Methods We retrospectively collected 441 cirrhotic patients with esophagogastric variceal bleeding hospitalized at Beijing Ditan Hospital, Capital Medical University, from August 2008 to October 2017. The enrolled patients were followed up for one year. According to the primary endpoint which was rebleeding within one year, patients were divided into rebleeding(249 cases) and non-rebleeding(192 cases) groups. Fisher exact test or chi-square test were used for comparison of categorical data. Comparison of continuous data with normal distribution between groups was performed using t test, while comparison of non-normally distributed data was performed by Mann-Whitney U test. Cox univariate and multivariate regression were used to identify independent factors affecting rebleeding within one year in cirrhotic patients with esophagogastric variceal bleeding, and then an artificial neural network prediction model was constructed using identified factors. The predictive performance of the model was evaluated using the area under the receiver operating characteristic curve(AUC). Results In total, 249(56.5%) patients developed esophagogastric variceal rebleeding within one year. Cox multivariate regression showed INR(AHR=1.566, 95%CI: 1.023～2.398, P=0.039) and NLR(AHR=1.033, 95%CI: 1.009～1.058, P=0.006) were risk factors for 1-year rebleeding, while CHB(AHR=0.769, 95%CI: 0.597～0.991, P=0.042), Na(AHR=0.967, 95%CI: 0.936～0.999, P=0.044), endoscopic(AHR=0.829, 95%CI: 0.743～0.926, P=0.001) and surgical treatment(AHR=0.246, 95%CI: 0.120～0.504, P<0.001) were protective factors. Using the above six independent influence factors, we successfully constructed an artificial neural network model(https://lixuan.me/annmodel/myg-v3/). The model’s ability to predict 1-year rebleeding had an AUC of 0.782(95%CI: 0.740-0.825), which was higher than 0.672(95%CI: 0.622-0.722, P<0.001) of Cox regression model, 0.557(95%CI: 0.504-0.610, P<0.001) of Child-Pugh and 0.562(95%CI: 0.509-0.616, P<0.001) of MELD scores. Conclusion The artificial neural network model has good individualized prediction performance and can be used as a risk assessment tool for esophagogastric variceal rebleeding. [ABSTRACT FROM AUTHOR]

Objective To analyze the rebleeding rate in hepatocellular carcinoma (HCC) patients with portal vein tumor thrombus (PVTT) after endoscopic treatment of esophagogastric variceal bleeding and then assessed the risk factors of the rebleeding in the patients. Methods This study retrospectively recruited 169 hepatitis B - associated HCC patients complicated with PVTT and esophagogastric variceal bleeding treated by endoscopy in Department of Gastroenterology, Beijing Di tan Hospital from September 2008 to December 2016. Among them, 47 patients had PVTTlI, 67 patients had PVTTIII, and 55 patients had PVTTIV. Their clinicopathological and follow - up data were retrieved from the medical records and statistically analyzed. Continuous data were compared among groups using ANOVA or Kruskal - Wallis H test. Categorial data were compared among groups using Chi - square test or corrected Fisher test. The Kaplan - Meier curves and Log - rank test were performed to analyze the rebleeding rate and cumulative survival rates after treatment. The univariate multivariate Cox regression analyses were used to identify the risk factors affecting the rebleeding of patients. Results Compared with PVTT II and III, PVTTIV patients had a higher serum level of the direct bilirubin (Z = 6. 153, P = 0. 046). The endoscopy treatment successfully blocked esophagogastric variceal bleeding in all patients. There was no significant difference in the rebleeding rates within six months and a year after the treatment (all P > 0. 05 ). It was also no statistically significant difference in cumulative survival rates in six months and 1 -, 2 -, and 3 - year after the treatment in PVTT lI, III, and N patients (all P > 0 . 05). Cox multivariate regression analysis showed that hepatic encephalopathy (HR = 3. 643, 95 % CI: 2. 099 - 6. 325, P < 0. 001), γ - glutamyltransferase (HR = 1. 002, 95 % CI: 1. 000 - 1. 005, P = 0 029), AFP (HR= 1. 000, 95% CI: 1. 000 -1. 000, P = 0. 002) and numbers of tumor lesions (HR= 1. 647, 95% CI: 1. 011 -2. 684, P = 0. 045) were all independent risk factors for 1 - year rebleeding in these PVTT patients with esophagogastric variceal bleeding after endoscopic treatment. Conclusion Endoscopic hemostasis is a feasible treatment option for HCC patients with PVTT and esophagogastric variceal bleeding. However, there was no significant difference in the rebleeding and cumulative survival rates in these patients. Furthermore, hepatic encephalopathy, γ - glutamyltransferase, AFP and numbers of tumor lesions were all independent risk factors for 1 - year rebleeding in these patients. [ABSTRACT FROM AUTHOR]

Reconstructed rebalanced hemostasis exists in patients with liver cirrhosis, while such balance is unstable and can be easily broken by stress factors, which may lead to bleeding or thrombosis. There is a lack of effective strategies to prevent and solve the disrupted balance in clinic due to the complex pathogenesis of rebalanced hemostasis, limited testing methods, and insufficient awareness among clinicians. With reference to the articles in recent years, this article summarizes the mechanism of rebalanced hemostasis in liver cirrhosis and the causes of bleeding and thrombosis and discuss the association between blood transfusion and rebalanced hemostasis and the selection of anticoagulant drugs during thrombosis, in order to provide a theoretical basis and new ideas for solving related issues in clinical practice. [ABSTRACT FROM AUTHOR]

To explore the risk factors of hemorrhage induced by argatroban in patients with progressive cerebral infarction and to establish a risk prediction model. Methods Totally 216 inpatients treated with argatroban due to progressive cerebral infarction were divided into the bleeding group and non-bleeding group according to whether hemor⁃ rhage occurred or not. Univariate analysis was used to identify risk factors for bleeding，and then we established a risk pre⁃ diction model of bleeding by multivariate Logistic regression analysis. Results Among 216 patients，bleeding occurred in 39 cases（18. 06%）after treatment，including massive bleeding（10. 3%）and minor bleeding（89. 7%）. The results of multivariate Logistic regression analysis demonstrated that BMI，whether the anticoagulants were used within 48 h，wheth⁃ er cerebrovascular intervention therapy was received，and the admission blood glucose were independent influence factors for bleeding after argatroban treatment. Further，the combined predictor Y was obtained（Y=-0. 206-2. 042XBMI（1）- 2. 459XBMI（2）-1. 677XBMI（3） + 2. 775X whether anticoagulants were used-2. 673X whether cerebrovascular intervention therapy was received + 0. 102X admission glucose），and the area under the receiver operating characteristic（ROC）curve（AUC）was 0. 738. Conclusions The progressive cere⁃ bral infarction patients with low BMI，high blood glucose at admission，combined use of anticoagulants，and no cerebral vascular intervention have a higher bleeding probability after applying argatroban. The model constructed in this study has a good predictive ability，which can effectively identify the patients at high risk of bleeding induced by argatroban treat⁃ ment from patients with progressive cerebral infarction [ABSTRACT FROM AUTHOR]

Objective To investigate the risk factors for rebleeding after emergency esophageal variceal ligation (EVL) in patients with liver cirrhosis. Methods A retrospective analysis was performed for the clinical and laboratory data of 290 patients with liver cirrhosis who underwent emergency EVL in The Fifth Medical Center of Chinese PLA General Hospital from January 2016 to December 2019, and according to the presence or absence of rebleeding within 1-year follow-up, they were divided into rebleeding group and non-rebleeding group. The t-test was used for comparison of normally distributed continuous data between two groups, and the Wilcoxon rank sum test was used for comparison of non-normally distributed continuous data between two groups; the chi-square test was used for comparison of categorical data between two groups. A multivariate logistic regression analysis was performed with the statistically significant factors as independent variables to screen out the independent risk factors for rebleeding after emergency EVL, and the receiver operating characteristic (ROC) curve was plotted to obtain the indices for predicting the probability of rebleeding and establish a predictive model. Results The univariate analysis showed that there were significant differences between the two groups in platelet count (t=-1.888, P=0.047), Child-Pugh score (χ²=5.975, P=0.049), albumin level (t=-2.229, P=0.029), and splenic vein diameter (t=3.808, P=0.001). The multivariate logistic regression analysis showed that Child-Pugh score (odds ratio [OR]=0.280, 95% confidence interval [CI]: 0.108-0.729, P=0.009), splenic vein diameter (OR=1.549, 95%CI: 1.197-2.005, P=0.001) and albumin level (OR=0.832, 95%CI: 0.729-0.949, P=0.006) were independent influencing factors for rebleeding after EVL. The predictive model based on these three factors had an area under the ROC curve of 0.796, with a sensitivity of 83.7% and a specificity of 74.5% at the cut-off value of -0.086. Conclusion Child-Pugh score, albumin level, and splenic vein diameter are independent risk factors for rebleeding after emergency EVL, and the combination of the three indices has the highest sensitivity and specificity in predicting rebleeding. [ABSTRACT FROM AUTHOR]

Based on the literature review, this paper summarized the Traditional Chinese Medicine nursing of peptic ulcer bleeding from perspectives of emergency care, routine nursing and comprehensive nursing management, and provided reference for the improvement of Traditional Chinese Medicine nursing protocol for peptic ulcer bleeding. (本文通过查阅文献, 从急救护理、常规护理、综合护理等各方面对消化性溃疡出血的中医护理进行了综述, 以期为进一步完善消化性溃疡并出血的中医护理方案提供参考。)

Objective To observe the application effect of " full management mode " in anticoagulantion therapy for patients after cardiac valve replacement. Methods Totally 208 patients after cardiac valve replacement were selected as the observation group，and then the " full management mode " covering "outpatient clinic + community" was adopted in the anticoagulation management by multidisciplinary collaboration "one-stop" anticoagulation clinic combined with informa‑ tion follow-up platform. In addition，208 patients after cardiac valve replacement，followed up in the general outpatient de‑ partment，were selected as the control group. During the follow-up period，modified Morisky score was applied to evalu‑ ate medication compliance of warfarin in the two groups，while the results and detection times of prothrombin time and in‑ ternational normalized ratio（INR）were compared. Time in therapeutic range（FTTR）was used to evaluate the anticoag‑ ulation therapy in the two groups and the anticoagulation related complications were observed. Results Morisky scores of patients in the observation group and control group were 6. 75（1. 50）and 5. 50（2. 00）points，INR test numbers were 9. 00（12. 75）and 5. 00（10. 00），INR test results were 1. 96（0. 65）and 1. 91（0. 76），and FTTR were 49. 64% and 41. 05%，respectively，with statistically significant differences between these two groups（all P< 0. 05）. There were 19 cases of anticoagulation related complications in the observation group and 27 cases in the control group. Conclusion "Full management mode "，which can improve INR detection frequency and warfarin medication compliance of patients af‑ ter cardiac valve replacements，has good effect on anticoagulation management and improves anticoagulation quality of pa‑ tients. [ABSTRACT FROM AUTHOR]

Objective·To evaluate the effects of inhaled nitric oxide on renal injury and hemorrhage after surgery. Methods·China National Knowledge Infrastructure (CNKI), Chinese Biomedical Literature Database (CBM), WanFang Data, PubMed, Embase, Web of Science and The Cochrane Library were searched systematically from the establishment of each database to March 26, 2021. "外科手术"and"一氧化氮"were used as Chinese keywords for retrieval. Correspondingly, the "nitric oxide" "surgical procedures, operative" "cardiac surgical procedures" "cardiac surgery" and "transplantation" were used as subject words and free words for searching. The literatures were screened according to the pre-established inclusion and exclusion criteria. Meta-analysis was performed by using RevMan 5.3. The study end points were the incidences of renal injury and hemorrhage. Results·Seven literatures were included for analysis, with a total of 689 surgical patients. Of them, 337 received nitric oxide treatment and 352 received placebo treatment. Compared with the control group, patients treated with nitric oxide demonstrated a statistically difference in reducing the incidence of postoperative renal injury (RR= 0.75, 95%CI 0.61‒0.92, P=0.005). There was no significant difference in the incidence of hemorrhage (RR=0.79, 95%CI 0.22‒2.83, P=0.710) between the two groups. Conclusion·Application of nitric oxide after surgery does not increase the risks of renal injury and hemorrhage. In contrast, the use of nitric oxide in cardiopulmonary bypass might protect renal function. [ABSTRACT FROM AUTHOR]

This paper reviewed the nursing management and complication observation after interventional therapy in five patients with acute superior mesenteric artery embolism. Postoperative complications included bowel necrosis, intra-abdominal hemorrhage and hemorrhage at wound site. A comprehensive nursing management, including illness observation, complication identification and predictive nursing, is required to reduce the risk of death and improve the rehabilitation. (本文回顾性分析了5例老年急性肠系膜上动脉栓塞患者介入治疗的术后护理经验及并发症观察结果。术后并发症包括发生肠坏死、腹腔出血、伤口出血等。密切观察病情变化, 及时、有效地识别并发症, 采取预见性护理, 对降低病死率及促进患者康复具有重要意义。)

Objective To analyze the effect of aspirin on gastric mucosal secretion function, bleeding, atrophy and cancer risk in patients with chronic atrophic gastritis (CAG). Methods A total of 97 patients with CAG confirmed by gastroscopy in this hospital from August 2019 to February 2020 were randomly divided into two groups. Helicobacter pylori(HP)antibody (+) was treated. The treatment group(48 cases) was treated with aspirin 100 mg/d for one year, while the control group(49 cases)had non NSAIDs. After 3,9 months of follow-up, the serum gastric function indexes including pepsinogen Ⅰ(PGⅠ), pepsinogen Ⅱ (PGⅡ), gastric secrete element - 17(G-17) and HP antibody were detected. The high-risk population were examined by endoscopy according to the new gastric cancer screening scoring system. SPSS20.0 was used to analyze the effect of aspirin on the above indicators, and to assess the risk of bleeding and cancer. Results Among the 97 CAG patients, there were 74 cases of closed type(type C), of which type C-1 accounted for 48.6%, type C-2 for 33.8%, and type C-3 for 17.6%;while open type(type O) had 23 cases, type O-1 accounted for 65.2%, type O-2 for 21.7%, type O-3 for 13.0%. There was no significant difference in the bleeding rate between the control and treatment group [6.12%(3/49) and 8.33%(4/48)](P >0.05). In the treatment group, the serum PGⅠ level and PGⅠ/PGⅡ (PGR)increased significantly, and the serum G-17 level decreased, the differences were statistically significant(P <0.05). After radical cure of HP, the new gastric cancer screening score in both groups decreased, especially in the treatment group, the differences were statistically significant(P < 0.05). Conclusion Aspirin reduces the risk of gastrointestinal cancer in patients with CAG. [ABSTRACT FROM AUTHOR]

The liver plays an important role in procoagulant and anticoagulant mechanisms in human body. There are complex changes in hemostasis in patients with liver cirrhosis, with the presence of interaction between the portal venous system and the peripheral system and differences in etiology, and such patients have a dual trend of hemorrhage and thrombosis. At present, there are certain limitations in coagulation function tests commonly used in clinical practice. The primary etiology and results of various coagulation tests should be considered before initiation of anticoagulant therapy for patients with liver cirrhosis, so as to make the best clinical decisions for patients. [ABSTRACT FROM AUTHOR]