Objective To study the changes in parameters of blood flow and frequency-spectrum appearance in superior mesenteric artery (SMA)and inferior mesenteric artery(IMA) in the patients with ulcerative colitis(UC). Methods The parameters of blood flow and frequency-spectrum of SMA and IMA in 16 cases of patients with UC were observed before and after treatment, and 10 healthy volunteers served as control. Results The parameters of blood flow of IMA in patients with left half colon UC (9 cases) and all colon UC (7 cases) significantly changed after treatment(P

Objective To evaluate the efficacy and safety of radiotherapy combined with concurrent and then adjuvant temozolomide in the patient with glioblastoma.Methods The databases of PubMed,Cochrane library,Medline and OVID were retrieved according to the Cochrane systematical assessment method.The included literatures were performed the quality evaluation and the meta analysis was performed after extracting the data.Results The summary of comparison between temozolomide group and radiotherapy group in the included studies showed that the 12-month overall survival rate[RR 1.22,95 ％ CI(1.01,1.47),P=0.04]and 24-month overall survival rate[RR 2.65,95 ％ CI(1.53,4.40),P＜0.01]had statistically significant differences;the 12-month pregrossion free survival rate[RR 2.59,95 ％CI(1.53,4.40),P=0.000 4] and 24-month pregrossion free survival rate[RR 6.77,95 ％ CI (2.82,16.26),P＜ 0.01] also showed statistically significant difference.The results of adverse reaction events revealed that the hematological toxic reactions in the temozolomide group had statistical difference between the concurrent therapy period and radiotherapy period [RR 3.21,95％CI(1.89,5.46),P＜0.01];which in the temozolomide group had statistical difference between the concurrent period and adjuvant period [RR 0.48,95 ％ CI(0.36,0.65),P＜0.01);but the non-hematological toxic reaction had no statistical difference[RR 1.11,95％CI(0.72,1.70),P=0.64].Conclusion Radiotherapy combined with concurrent and then adjuvant temozolomide therapy improves the overall and progression free survival period in the patient with glioblastoma,the higher occurrence rate of hematologic toxic reactions is correlated with temozolomide treatment drugs.

Objective Mild hypothermia provides protection for the brain and improves prognosis in the treatment of severe traumatic brain injury, which is widely acknowledged.The article aimed to analysis the prognosis and complications of long-term and short-term mild hypothermia on patients with severe traumatic brain injury. Methods According to the cochrane systematic review methods, thorough search was carried out in databases including Cochrane, Pubmed, Embase, CBM, CNKI, Wanfang and VIP.Eval-uation was made on the quality of selected documents, and Revman5.2 software was applied for meta analysis after data extraction. Results Long-term mild hypothermia achieved improved prognosis compared to short-term mild hypothermia ( GOS score 4 ~5 ) [RR=1.37, 95%CI (1.14, 1.64), P=0.0006].No significant difference was found between these two therapies in pneumonia in-cidence (P=0.94), arrhythmia incidence ( P=0.54) and stress ulcer incidence (P=0.99). Conclusion In comparison to short-term hypothermia therapy, long-term mild hypothermia therapy improved the prognosis of patients with severe traumatic brain inju-ry without obvious increase in the incidence of pneumonia, arrhythmia and stress ulcer.

Objective To investigate the efficacy and strategy of percutaneous laser disc decompression (PLDD) for patients with multisegmental lumbar disc herniation. Methods Between December 2005 and December 2008,a total of 56 patients with multisegmental lumbar disc herniation underwent PLDD. Under local anesthesia, the operation was performed using Nd:YAG laser. A digital subtraction angiography (DSA) system was employed to guide the surgery,insert burning, each 1 s, pulse intermission gasification 1 s, single segment laser total 400-800 J. In preoperative and postoperative 3 months visual analogue scale(VAS) and Oswestry disability index (ODI) scores of times during followed up,Macnab standard to assess the clinical curative effect. Results The patients were followed up for 6 - 36 months (mean 18 months). The ODI improved from (31.10 ±2.92) scores to (11.80 ±2.62) scores (t=3.067,P ＜0.01 ). The VAS also showed postoperative improvement of pain compared with preoperative findings (7.00 ± 1.41 ) scores vs (3.00 ± 0.81 ) scores (t= 2.802,P ＜0.01 ). According to the Macnab standard, 36 patients achieved excellent outcomes, 10 were good, 8 were fair, and 2 were poor. The rate of excellent and good outoomes was 82. 1% (46/56). No patient had postoperative complications. Conclusions PLDD is effective and safe for patients with multisegmental lumbar disc berniation. The cases recover quickly after the operation, because the procedure is minimally invasive.

Objective To evaluate the curative effect and safety of mild hypothermia on patients with traumatic brain injury. Methods According to the cochrane systematic review methods , the data bases such as Cochrane, Pubmed, Embase, CBM, CNKI, Wanfang and VIP database were searched. The quality of included documents were assessed to extract meta analysis data. Results Compared to the control group, there was no statistically significant difference in patients treated by hypothermia for 3 days or less in mortality , but the difference was statistically significant after the summary [RR=0.74, 95%CI 0.64~0.85,P<0.000 1]; And there was no statistically significant difference in improving neural function of patients treated by hypothermia for < 3 days , but hypothermia improves the prognosis after the summary [RR=1.40,95%CI 1.24~1.59,P<0.000 01]. The difference was statistically significant in the incidence of pneumonia (P=0.007), there was no statistically significant difference in the incidence of arrhythmia (P=0.06), but the difference was statistically significant after sensitivity analysis. Conclusions Patients treated by hypothermia for < 3 days is not valid for clinical outcomes , the duration of the treament up to 3 days may not reduce mortality rates, but can improve the prognosis, lasts longer than 3 days or until the pressure back to normal, reducing the mortality rate, improve the neurological prognosis;but increased incidence of pneumonia, whether to increase the rate of cardiac arrhythmias have yet to be determined.

Objective To explore safety evaluation of the approaches of the percutaneous eilational tracheostomy(PDT)ane traeitional tracheotomy in the treatment of neurological patients. Methods The stuey eesign was a multicenter,prospective,raneomizee clinical trial. One huneree ane seventy-six cases with acute nerve trachea incision from Feb. 2010 to Feb. 2013 of 3 hospitals were selectee as our subject. They were raneomly eivieee into the traeitional group ane PDT group. The information inclueing operation time,the incieence of pneumothorax,subcutaneous emphysema,tracheal fistula,esophageal,trachea ane lung injury from complications such as infection were recoreee. Results The complication rate in traeitional group was 19. 51%(16 / 82),higher than that of PDT group(8. 51%(8 / 94),P = 0. 021). The surgery perioe in PDT group was(7. 5 ± 2. 3)min,shortee than that in traeitional group((41. 6 ± 5. 8)min,P = 0. 000). Conclusion The approach of percutaneous tracheostomy can quickly buile airway of neurological patients with character of simple, safe,ane it also can reeuce the incieence of respiratory complications.

Objective To analyze the intervention effect of the dose-dense schemes of temozolomide on the newly diagnosed glioblastoma compared with the standard schemes. Methods The Pubmed,Cochrane,Em-base,CNKI,CBM,Wanfang,VIP databases were used for the retrievals on the intervention effect.The quality of included papers was assessed to extract network meta-analysis data with using the statistical software Stata 13.0. Results The treatment plans were ranked according to the intervention effect from the best to the worst as follows:the dose-dense,the early,the metronomic,the standard,the RT and post-RT adjuvant temozolomide. The most common adverse effects in hematotoxicity were neutropenia,leucopenia,lymphopenia,thrombocytopenia and ane-mia. Between the different temozolomide therapeutic regimens,there was no significant difference. Conclusion The intervention effect of the dose-dense schemes with temozolomide is better than the standard therapy. It also revealed that,the hematoxicity in the different temozolomide schemes is not significantly different.

Objective:To investigate the influence of hypomagnesemia on the prognosis of patients with severe sepsis.Methods:A retrospective study was conducted. The clinical data of 207 septic patients admitted to the department of critical care medicine of the First Affiliated Hospital of University of Science and Technology of China from January 1, 2016 to December 21, 2020 were analyzed, including gender, age and laboratory indicators within 24 hours after sepsis diagnosis [procalcitonin (PCT), C-reactive protein (CRP), blood lactic acid (Lac), pH value and blood magnesium, calcium, chlorine and phosphorus levels]. The acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score, sequential organ failure assessment (SOFA) score and 28-day prognosis were collected. The patients were divided into survival group and non-survival group according to the prognosis, and the clinical data and laboratory indexes were compared between the two groups. Pearson correlation test was used to analyze the correlation between clinical indicators. Multivariate Logistic regression analysis was used to screen the risk factors affecting the prognosis. The receiver operator characteristic curve (ROC curve) was drawn, and the area under ROC curve (AUC) was calculated to evaluate the potential prognostic indicators.Results:Among the 207 septic patients, 102 survived and 105 died on the 28th day, and the 28-day mortality was 50.72%. There were no significant differences in gender, age, CRP, pH value, blood chlorine or blood phosphorus levels between the two groups. The blood magnesium and blood calcium levels in the non-survival group were significantly lower than those in the survival group [blood magnesium (mmol/L): 0.68±0.14 vs. 0.80±0.12, blood calcium (mmol/L): 1.93±0.21 vs. 2.01±0.20, both P < 0.01], and PCT, Lac, APACHE Ⅱ score and SOFA score were significantly higher than those in the survival group [PCT (mg/L): 8.32 (1.64, 55.01) vs. 3.55 (0.97, 12.31), Lac (mmol/L): 2.90 (1.70, 4.30) vs. 2.10 (1.03, 3.89), APACHE Ⅱ score: 21.24±6.40 vs. 17.42±7.02, SOFA score: 9.14±3.55 vs. 6.91±3.31, all P < 0.01]. Among the 207 patients, 96 patients had normal blood magnesium level (0.75-1.25 mmol/L) and 111 patients had hypomagnesemia (< 0.75 mmol/L). The 28-day mortality of septic patients in the hypomagnesemia group was significantly higher than that in the normal magnesium group [61.26% (68/111) vs. 38.54% (37/96), P < 0.01]. Pearson correlation analysis showed that the blood magnesium level of sepsis patients was negatively correlated with PCT ( r = -0.173, P < 0.05), and it was positively correlated with APACHE Ⅱ score ( r = 0.159, P < 0.05), but it had no correlation with CRP or SOFA score ( r values were -0.029 and 0.091, both P > 0.05). Logistic regression analysis showed that serum magnesium, APACHE Ⅱ score and SOFA score were independent risk factors for 28-day death in patients with sepsis [serum magnesium: odds ratio ( OR) < 0.001, 95% confidence interval (95% CI) was 0.000-0.002, P < 0.001; APACHE Ⅱ score: OR = 1.092, 95% CI was 1.022-1.168, P = 0.010; SOFA score: OR = 1.168, 95% CI was 1.026-1.330, P = 0.019]. ROC curve analysis showed that blood magnesium and APACHE Ⅱ score had a certain predictive value for 28-day mortality in patients with severe sepsis [AUC (95% CI) was 0.723 (0.655-0.791) and 0.680 (0.607-0.754), respectively]. When the blood magnesium threshold was 0.64 mmol/L, the sensitivity was 41.0% and the specificity was 93.1%. When APACHE Ⅱ score threshold was 16.50, the sensitivity was 78.1% and the specificity was 55.9% indicating that the specificity of serum magnesium was higher than that of APACHE Ⅱ score. Conclusions:Severe septic patients complicated with hypomagnesemia have a poor prognosis. Serum magnesium level can be used as a prognostic indicator for severe septic patients.

Objective:To investigate the clinical characteristics of gastrointestinal symptoms in patients with coronavirus disease 2019 (COVID-19) during the whole disease process, and provide reference for etiological diagnosis and treatment.Methods:The clinical data of patients with COVID-19 admitted in the Infectious Diseases Branch of the First Affiliated Hospital of University of Science and Technology of China from January 22nd, 2020 to March 8th, 2020 were analyzed retrospectively. According to whether there were gastrointestinal symptoms (poor appetite, nausea/vomiting and diarrhea), all patients were divided into gastrointestinal symptom group and asymptomatic group. The characteristics of gastrointestinal symptoms, such as poor appetite, nausea, vomiting and diarrhea were counted and analyzed, and the correlation between gastrointestinal symptoms and gender, age, basic diseases, disease severity, laboratory examination and drug treatment were analyzed.Results:A total of 80 COVID-19 patients were involved, 43 cases (53.8%) presented with poor appetite, 17 cases (21.3%) had nausea and vomiting, and 33 cases (41.3%) had diarrhea. Among them, 5 cases, 1 case and 4 cases respectively preformed poor appetite, nausea/vomiting and diarrhea before admission, while the others experienced gastrointestinal symptoms within 48 hours after admission. Duration of poor appetite, nausea/vomiting and diarrhea (days) of all patients were 5.3±2.1, 2.2±1.0 and 1.4±0.9, respectively. The patients with poor appetite were older than those without symptoms (years old: 48.2±17.6 vs. 39.3±15.1), albumin (Alb) level and the lymphocytes ratio were lower than those in asymptomatic group [Alb (g/L): 39.8 (35.7, 45.1) vs. 46.1 (42.6, 49.4), lymphocytes ratio: 0.19 (0.09, 0.28) vs. 0.28 (0.17, 0.35)], while the neutrophil ratio, the levels of C-reactive protein (CRP), D-dimer, and lactate dehydrogenase (LDH) were higher than those in asymptomatic group [the neutrophil ratio: 0.74 (0.61, 0.85) vs. 0.64 (0.52, 0.76), CRP (mg/L): 21.4 (3.9, 52.9) vs. 5.6 (2.4, 14.0), D-dimer (mg/L): 0.2 (0.2, 0.5) vs. 0.2 (0.1, 0.3), LDH (μmol·s -1·L -1): 4.49 (3.59, 5.19) vs. 3.12 (2.77, 4.90)]; at the same time, more traditional Chinese medicine was used in the patients with gastrointestinal symptoms [65.1% (28/43) vs. 40.5% (15/37), all P < 0.05]. In addition, 14 cases of 18 patients with cardiovascular diseases presented with poor appetite, 7 patients had nausea and vomiting symptoms. All of the 3 patients with chronic kidney disease presented with poor appetite, nausea and vomiting, and 2 of them had diarrhea. Conclusions:The gastrointestinal symptoms in patients with COVID-19 are common. Whether it is caused by the virus or related drugs, diet and mental conditions, clinicians should analyze the causes of these symptoms timely, and then provide a better treatment for patients with COVID-19.

Acute respiratory failure due to acute hypoxemia is the major manifestation in severe coronavirus disease 2019 (COVID-19). Rational and effective respiratory support is crucial in the management of COVID-19 patients. High-flow nasal cannula (HFNC) has been utilized widely due to its superiority over other non-invasive respiratory support techniques. To avoid HFNC failure and intubation delay, the key issues are proper patients, timely application and improving compliance. It should be noted that elder patients are vulnerable for failed HFNC. We applied HFNC for oxygen therapy in severe and critical ill COVID-19 patients and summarized the following experiences. Firstly, to select the proper size of nasal catheter, to locate it at suitable place, and to confirm the nose and the upper respiratory airway unobstructed. Secondly, an initial ow of 60 L/min and 37℃ should be given immediately for patients with obvious respiratory distress or weak cough ability; otherwise, low-level support should be given first and the level gradually increased. Thirdly, to avoid hypoxia or hypoxemia, the treatment goal of HFNC should be maintained the oxygen saturation (SpO) above 95% for patients without chronic pulmonary disease. Finally, patients should wear a surgical mask during HFNC treatment to reduce the risk of virus transmission through droplets or aerosols.
Aged ; Betacoronavirus ; isolation & purification ; Cannula ; Coronavirus Infections ; therapy ; Humans ; Oxygen ; administration & dosage ; Pandemics ; Pneumonia, Viral ; therapy