OBJECTIVE:To observe therapeutic efficacy and safety of carboprost tromethamine in the treatment of postpartum hemorrhage with two routes of administration. METHODS:285 patients with postpartum hemorrhage were randomly divided into control group(143 cases)and trial group(142 cases). Control group was given Carboprost tromethamine injection 250 μg on del-toid of arm;trial group was given same dose of Carboprost tromethamine injection via cervix uteri. Both groups received medicine after third stage of labor. The therapuetic efficacy,the amount of endometrorrhagia and colporrhagia within 2 h,the incidence of ADR after labor were observed in 2 groups. RESULTS:After treatment,the amount of postpartum hemorrhage was smaller than 400 ml in 2 groups and didn't exceed the standard,without statistical significance(P>0.05). The amount of endometrorrhagia in trial group was significantly higher than in control group,with statistical significance(P<0.05);the amount of colporrhagia in tri-al group was significantly lower than in control group,with statistical significance(P<0.05). There was no statistical significance in the incidence of ADR between trial group(4.90%)and control group(6.31%)(P>0.05). CONCLUSIONS:The intramuscular injection is selected for the prevention of postpartum hemorrhage caused by uterine inertia;the cervical injection is selected for the prevention of postpartum hemorrhage caused for the other patients.

Objective To evaluate the effects of goal-directed fluid therapy on the tissue perfusion of elderly patients undergoing Laparoscopic Radical Cystectomy.Methods Thirty patients aged 60-82 years with ASA physical status Ⅰ or Ⅱ who were presenting for elective laparoscopic radical cystectomy were randomly divided into routine fluid replacement group (group C,n=15) and GDFT group (group G,n=15).Patients in group C received routine fluid replacement.Patients in group G were treated under goal-directed fluid infusion strategy with a target of SVV≤13%,CI≥2.5 L·min-1·m-2 and ScvO2≥73% under the monitoring of PiCCO.The indexes of hemodynamics and tissue perfusion were collected and recorded at 7 time points: before induction of anesthesia (T1),5 minutes after intubation (T2),5 minutes after pneumoperitoneum and change positions (T3),1 hour after pneumoperitoneum (T4),5 minutes after the abdomen was opened (T5),1 hour after the abdomen was opened (T6) and the end of surgery (T7).Results Compared with group C,group G received less fluid.MAP and SVV between two groups were no statistical significance.The CI in group G in time point T4,T6 and T7 was significantly higher than that in group C (P<0.05).The HR in group G in time point T5 and T6 was significantly higher than that in group C (P<0.05).The aLac in group G in time point T4 and T5 was significantly lower than that in group C (P<0.05).Pcv-aCO2,DO2I and O2ERe between the two groups were not statistically different.Postoperative rehabilitation indexes between the two groups were not statistically significant.Conclusion The GDFT guided under SVV,CI and ScvO2 can keep the effective circulatory volume and pressure to ensure the whole body perfusion,reduce aLac and improve microcirculation without affecting the balance of oxygen supply and demand and the postoperative complication.

Objective To evaluate the value of dual energy computed tomography (DECT) for the diagnosis of gout.Methods Twenty-fivc consccutive patients with gout were selected as the experimental group and 20 patients with rheumatoid arthritis (RA) were selected as the control group.DECT scans were performed for every patient (all peripheral joints for the experimental group and affected joints for the control group).And every patient with gout had X-ray examination of the involved joints.x2 test and t-test were used for statistical analysis.Results All 25 patients with gout showed urate deposits on their DECT scans,whereas none of 20 controls showed urate deposits (P＜0.01).DECT scans revealed a total of 184 areas of urate deposition in 25 patients,in which 107 (58.2％) were at feet and ankle,72 (39.1％) were at knees,4 (2.2％) were at hands and wrists,1 (0.5％) was at elbows,whereas physical examination only showed 64 areas of urate deposition,in which 38(59.4％) were at feet and ankle,24(37.5％) were at knees,2(3.1％) at hands and wrists,0 was at elbows(P＜0.01 ).Only 6 patients with gout showed nonspecific manifestations on X-ray.Conclusion DECT scans may have potential value for the diagnosis of gout since it could produce evident colour displays for urate deposits and help to identify subclinical tophus deposits.

Objective To investigate the clinical features,the radiological characteristics,and the pathological changes of cerebral sparganosis.Methods We retrospectively collectted and summarized the clinical data of 42 patients with cerebral sparganosis from the Iinstitute of Anti-parasitic Diseases of Jiangxi Province and the First Affiliated Hospital of Nanchang University during January 2000 to January 2014.The follow-up period of the 42 patients ranged from 4 to 96 months.Results Forty-two cases (30 males and 12 females) with cerebral sparganosis were enrolled in the study.Among the 42 patients,34 cases suffered from seizures,16 cases experienced headaches,and 14 cases had limb weakness.The brain CT scan showed the small and punctuate calcifications scattering around the lesions in 18 cases.The features of enhanced MRI included aggregating ring-like enhancement in 38 cases,tunnel lesions in 14 cases,and lesion migration in 13 cases.Twenty-four of the 42 patients were performed surgery.The brain tissues revealed multiple inflammatory tunnels,in which live or degenerated larvae were identified in 20 cases,but only eosinophilia tunnels were observed in the other 4 cases.The serum and cerebro-spiral fluid specimens from 18 patients without surgery were positive to spirometra mansoni antigen.Their cerebral lesions disappeared and got a favorable prognosis after administration of praziquantel in long term follow-ups.Conclusions There is a high incidence of cerebral sparganosis in Poyang lake basin.The clinical features of cerebral sparganosis mainly include seizure,headache and hemiparesis.The enhanced lesions show knot or tunnel signs on multi-planar MRI which are associated with the multiple inflammatory tunnels of larvae migration.A longterm administration of high dose opraziquantel can also get a good treatment prognosis without the classical surgical therapy for cerebral sparganosis.

Objective:To investigate the effect of power PICC with two different external lengths in patients with hematologic diseases.Methods:From August 2020 to August 2021, a retrospective analysis was conducted on 233 cases of hematologic diseases who received power PICC catheterization in Department of Hematology, the Nanfang Hospital of Southern Medical University, the patients were divided into 0-1 cm group (132 cases) and 2-4 cm group (101 cases) according to the external lengths after catheter insertion. The incidence of related complications and patient comfort at 24 hours, 72 hours, 7 days and 14 days after catheterization were compared between the two groups.Results:At 24 hours and 72 hours after catheterization, the incidence of bleeding at puncture point in 0-1 cm group was 14.39%(19/132) and 9.85%(13/132), in 2-4 cm group was 30.69%(31/101) and 32.67%(33/101), the difference was statistically significant ( χ2=9.02, 14.16, both P<0.05). The rate of redness and swelling of punture point at 7 days after catheterization was 9.09%(12/132) and 40.59%(41/101) in the two groups, with statistical significance ( χ2=32.32, P<0.05). The rates of slightly prolapse at 7 and 14 days after catheterization were 18.18% (24/132) and 18.94%(25/132) in 0-1 cm group, 59.41% (60/101) and 67.33%(68/101) in 2-4 cm group, the difference between the two groups was statistically significant ( χ2=42.18, 55.86, both P<0.05). In the observation of comfort at 14 days after catheterization, the comfort score of patients in the 0-1 cm group was significantly higher than that in the 2-4 cm group, and the difference between the two groups was statistically significant ( χ2=7.34, P<0.05). Conclusions:Patients with hematologic diseases can reduce the risk of bleeding and slightly prolapse, and improve the comfort of patients when the external lengths is 0-1 cm of power PICC, which is worthy of clinical application and promotion. The catheterizer should adopt accurate in appropriate measurement method to determine the best lengths of the catheters.

BACKGROUND: AND PURPOSE: Previous studies have explored the association between retinal vascular changes and cognitive impairment. The retinal vasculature shares some characteristics with the cerebral vasculature, and quantitative changes in it could indicate cognitive impairment. Hence, a comprehensive meta-analysis was performed to clarify the potential relationship between retinal vascular geometric changes and cognitive impairment. METHODS: Relevant databases were scrupulously and systematically searched for retinal vascular geometric changes including caliber, tortuosity, and fractal dimension (FD), and for cognitive impairment. The Newcastle-Ottawa Scale was used to evaluate the methodological quality of included studies. RevMan was used to perform the meta-analysis and detect publication bias. Sensitivity analyses were also performed. RESULTS: Five studies that involved 2,343 subjects were finally included in the meta-analysis. The results showed that there was no significant association between central retinal artery equivalents (Z=1.17) or central retinal venular equivalents (Z=1.74) and cognitive impairment (both p>0.05). Similarly, no significant difference was detected in retinal arteriolar tortuosity (Z=0.91) and venular tortuosity (Z=1.31) (both p>0.05). However, the retinal arteriolar FD (mean difference: −0.03, 95% CI: −0.05, −0.01) and venular FD (mean difference: −0.03, 95% CI: −0.05, −0.02) were associated with cognitive impairment. CONCLUSIONS A smaller retinal microvascular FD might be associated with cognitive impairment. Further large-sample and well-controlled original studies are required to confirm the present findings.

China still has more than 30,000 patients of advanced schistosomiasis while new cases being reported consistently. D-dimer is a fibrin degradation product. As ascites being the dominating symptom in advanced schistosomiasis, the present study aimed to explore a prediction model of ascites with D-dimer and other clinical easy-achievable indicators. A case-control study nested in a prospective cohort was conducted in schistosomiasis-endemic area of southern China. A total of 291 patients of advanced schistosomiasis were first investigated in 2013 and further followed in 2014. Information on clinical history, physical examination, and abdominal ultrasonography, including the symptom of ascites was repeatedly collected. Result showed 44 patients having ascites. Most of the patients' ascites were confined in the kidney area with median area of 20 mm². The level of plasma D-dimer and pertinent liver function indicators were measured at the initial investigation in 2013. Compared with those without ascites, cases with ascites had significantly higher levels of D-dimer (0.71±2.44 μg/L vs 0.48±2.12 μg/L, P=0.005), as well ALB (44.5 vs 46.2, g/L) and Type IV collagen (50.04 vs 44.50 μg/L). Receiver operating characteristic curve analyses indicated a moderate predictive value of D-dimer by its own area under curve (AUC) of 0.64 (95% CI: 0.54–0.73) and the cutoff value as 0.81 μg/L. Dichotomized by the cutoff level, D-dimer along with other categorical variables generated a prediction model with AUC of 0.76 (95% CI: 0.68–0.89). Risks of patients with specific characteristics in the prediction model were summarized. Our study suggests that the plasma D-dimer level is a reliable predictor for incident ascites in advanced schistosomiasis japonica patients.
Area Under Curve ; Ascites* ; Case-Control Studies ; China ; Cohort Studies ; Collagen Type IV ; Fibrin ; Humans ; Kidney ; Liver ; Physical Examination ; Plasma* ; Prospective Studies* ; ROC Curve ; Schistosoma japonicum ; Schistosomiasis japonica* ; Schistosomiasis* ; Ultrasonography

Objective The evaluation index system of quality of assisted fertility treatment care was constructed to provide the basis for scientific evaluation of quality of care in reproductive center. Methods Based on the structure-process-outcome (SPO) quality model, evaluation index system for fertility treatment care in the reproductive center was constructed by literature query, field process tracking, Delphi expert consultation and analytic hierarchy process (AHP). Results The effective recovery rate ( RR ) of the two rounds of the questionnaire was 100% . The expert authority coefficient Cr values were 0.813, 0.845 respectively. The W value of the coordination coefficient was 0.331, 0.372, both of which were statistically significant (P<0.01). Finally, an evaluation index system of quality of assisted fertility treatment care with three dimensions, 14 secondary indicators and 47 items was formed. Yaaph software was used to determine the weight coefficients of primary and secondary indicators, and the consistency test ( Cr<0.1) was performed, and the variation coefficients of all tertiary items were <0.20. Conclusions The weight of the quality index system of assisted reproductive treatment care in reproductive center is reasonable, the indicators were clear, systematic and objective, and worthy of clinical promotion.

From April 2017 to June 2020, 46 patients with acute non-variceal upper gastrointestinal bleeding (ANVUGIB) underwent endoscopic vascular embolization (EVE) in the Department of Gastroenterology of the First Affiliated Hospital of University of Science and Technology of China for rebleeding after endoscopic hemostasis therapy (including local drug injection, electrocoagulation, hemostatic clamp and ligation, etc.). All 46 patients immediately stopped bleeding after EVE, and the effective rate of immediate hemostasis was 100.0%. Postoperative abdominal pain occurred in 13 cases (28.3%), abdominal distension in 3 cases (6.5%) and fever in 2 cases (4.3%). The mucosa healed gradually under gastroscopy 3 and 12 months after the operation. No gastrointestinal rebleeding occurred during the follow-up. Therefore, EVE is a safe and effective method for ANVUGIB patients with failure of initial endoscopic hemostasis, which is worthy of further clinical study and application.

Objective:To compare the efficacy and safety of endoscopic sclerotherapy with polycinnamol solution and foam in the treatment of grade II hemorrhagic internal hemorrhoids.Methods:From September 2020 to June 2021, 81 patients with grade II hemorrhagic internal hemorrhoids were collected from the Department of Gastroenterology, the First Affiliated Hospital of University of Science and Technology of China. They were randomly divided into an observation group and a control group. The observation group was injected with polycinnamol solution, and the control group was injected with polycinnamol foam. All of them were treated with endoscopic sclerotherapy. The clinical data of the two groups were compared and analyzed. The operation time, immediate hemostasis rate, incidence of postoperative complications (such as fever, pain, bleeding and Urinary retention), recurrence and rebleeding rate of the two groups were observed, and the efficacy and safety of the two groups in the treatment of grade II hemorrhagic internal hemorrhoids were compared.Results:There was no statistically significant difference in basic data between the two groups of patients (all P>0.05), indicating comparability. The surgical operation time of the observation group patients [(7.40±1.18)min] was shorter than that of the control group [(13.88±0.95)min] ( P<0.05); The injection dose of polycinnamol [(5.79±1.61)ml] in the observation group was higher than that in the control group [(4.38±1.92)ml] ( P<0.05). The immediate postoperative hemostasis rate in the observation group was the same as that in the control group (100%). The incidence of postoperative fever (7.32%), perianal pain (4.88%), bleeding (7.32%), and urinary retention (4.88%) complications in the observation group had no significant difference from that in the control group [postoperative fever (5.00%), anal pain (7.50%), bleeding (7.50%), and urinary retention (2.50%)] (all P>0.05). Two months after surgery, the rebleeding rate in the observation group (4.88%) was not significantly different from that in the control group (7.50%) ( P>0.05), but the rebleeding score in the observation group (1.21±0.63) was lower than that in the control group (2.62±0.71), with a statistically significant difference ( P<0.05). The rebleeding rate (2.44%) and the rebleeding score (2.33±1.51) in the observation group were lower than those in the control group [the rebleeding rate (12.50%) and the rebleeding score (5.54±2.42)] at 12 months after follow-up, and the differences were statistically significant ( P<0.05). Conclusions:Endoscopic sclerotherapy is effective in the treatment of grade II hemorrhagic internal hemorrhoids. There is no significant difference in the immediate and short-term hemostasis rate and the incidence of complications between two different dosage forms of sclerotherapy, namely, polycinnamol solution and foam, but the operation of the solution injection is more time-saving and the long-term recurrence rate is lower, which is worthy of clinical application.