Objective To explore the diagnosis value of CT-guide percutaneous biopsy in the pulmonary nodules.Methods A total of 101 cases of the pulmonary nodules with unknown causes who underwent Germany-made auto-spring-gun spiral CT-guide percutaneous pulmonary biopsy were studied.Results The accuracy of centesis was 100%.97 cases were succeeded in getting diagnosis,the diagnosis rate was 96.0%.Among them,there were 61 cases of lung cancer,4 cases of malignant pleural mesothelioma,10 cases of metastatic carcinoma,16 cases of tuberculosis,6 cases of inflammatory pseudotumor.Pneumothorax occurred in 8 cases,hemoptysis occurred in 3 cases.The rate of complication was 10.9%.Conclusion CT-guide percutaneous biopsy to the pulmonary nodules is a safe and effective diagnostic means,which has a high diagnosis raze with few complication.

Objective To analyze MSCT characteristics of septic pulmonary embolism (SPE) caused by intravenous drug and to improve diagnosis. Methods The MSCT findings of 16 patients of SPE induced by intravenous drug were analyzed retrospectively from March, 2001 to September, 2008. Results Peripheral or sub-pleural zones were commonly affected mainly within upper lung. Patchy, nodular and cavity shadows were detected respectively in 9 (56.25%), 12 (75.00%) and 8 patients (50.00%), while pulmonary cysts in 14 patients (87.50%). Six patients underwent CTPA, and pulmonary arteries filling defect was found in 2 patients. Pleural effusion and pneumothorax were also found in 10 and 3 patients, respectively, whereas miscellaneously shaped lesions were deteced in all 16 patients. Conclusion MSCT is an important method for diagnosing SPE caused by intravenous drug abuse. Pulmonary arteries filling defect is the direct sign and the cysts and nodular shadow with or without cavity in peripheral or sub-pleural pulmonary zones are characteristic findings.

Sepsis-induced cardiomyopathy is a reversible myocardial dysfunction due to sepsis, which may be severe enough to complicate cardiogenic shock, and without effective drug and with high mortality during the acute phase. A case of sepsis-induced cardiomyopathy complicated with cardiogenic shock was treated in the intensive care unit (ICU) of Shunde Hospital Southern Medical University. A 37 years old female patient was admitted because she had suffered repeated fever for 5 days, chest tightness and abdominal pain for 3 days. At the same time, there were severe cardiac depression and abdominal infection, which could be explained by the monismtheory of sepsis cardiomyopathy. The cardiogenic shock patient was not improved after antibiotic therapy and hemodynamic support, extracorporeal membrane oxygenation (ECMO) support was prescribed. The circulation failure was smoothly got through with ECMO and was transfer from ICU to ordinary ward. Computed tomographic angiography (CTA) of abdominal aorta and colonoscopy indicated lesions of small intestine. The diagnosis of infection and bleeding in ileum diverticulum was confirmed during the operation and the lesions was removed. She recovered and was discharged 1 week after operation. Through the case review, we aim to improve the awareness of sepsis-induced cardiomyopathy and the value of ECMO support in cardiogenic shock.

Objective To investigate the risk factors of in-hospital mortality and establish a risk prediction model for patients receiving venoarterial extracorporeal membrane oxygenation(VA-ECMO).Methods We retrospectively collected the data of 302 patients receiving VA-ECMO in ICU of 3 hospitals in Guangdong Province between January,2015 and January,2022 using a convenience sampling method.The patients were divided into a derivation cohort(201 cases)and a validation cohort(101 cases).Univariate and multivariate logistic regression analyses were used to analyze the risk factors for in-hospital death of these patients,based on which a risk prediction model was established in the form of a nomogram.The receiver operator characteristic(ROC)curve,calibration curve and clinical decision curve were used to evaluate the discrimination ability,calibration and clinical validity of this model.Results The in-hospital mortality risk prediction model was established based the risk factors including hypertension(OR=3.694,95%CI:1.582-8.621),continuous renal replacement therapy(OR=9.661,95%CI:4.103-22.745),elevated Na2+ level(OR=1.048,95%CI:1.003-1.095)and increased hemoglobin level(OR=0.987,95%CI:0.977-0.998).In the derivation cohort,the area under the ROC curve(AUC)of this model was 0.829(95%CI:0.770-0.889),greater than those of the 4 single factors(all AUC<0.800),APACHE Ⅱ Score(AUC=0.777,95%CI:0.714-0.840)and the SOFA Score(AUC=0.721,95%CI:0.647-0.796).The results of internal validation showed that the AUC of the model was 0.774(95%CI:0.679-0.869),and the goodness of fit test showed a good fitting of this model(χ2=4.629,P>0.05).Conclusion The risk prediction model for in-hospital mortality of patients on VA-ECMO has good differentiation,calibration and clinical effectiveness and outperforms the commonly used disease severity scoring system,and thus can be used for assessing disease severity and prognostic risk level in critically ill patients.

Objective To investigate the risk factors of in-hospital mortality and establish a risk prediction model for patients receiving venoarterial extracorporeal membrane oxygenation(VA-ECMO).Methods We retrospectively collected the data of 302 patients receiving VA-ECMO in ICU of 3 hospitals in Guangdong Province between January,2015 and January,2022 using a convenience sampling method.The patients were divided into a derivation cohort(201 cases)and a validation cohort(101 cases).Univariate and multivariate logistic regression analyses were used to analyze the risk factors for in-hospital death of these patients,based on which a risk prediction model was established in the form of a nomogram.The receiver operator characteristic(ROC)curve,calibration curve and clinical decision curve were used to evaluate the discrimination ability,calibration and clinical validity of this model.Results The in-hospital mortality risk prediction model was established based the risk factors including hypertension(OR=3.694,95%CI:1.582-8.621),continuous renal replacement therapy(OR=9.661,95%CI:4.103-22.745),elevated Na2+ level(OR=1.048,95%CI:1.003-1.095)and increased hemoglobin level(OR=0.987,95%CI:0.977-0.998).In the derivation cohort,the area under the ROC curve(AUC)of this model was 0.829(95%CI:0.770-0.889),greater than those of the 4 single factors(all AUC<0.800),APACHE Ⅱ Score(AUC=0.777,95%CI:0.714-0.840)and the SOFA Score(AUC=0.721,95%CI:0.647-0.796).The results of internal validation showed that the AUC of the model was 0.774(95%CI:0.679-0.869),and the goodness of fit test showed a good fitting of this model(χ2=4.629,P>0.05).Conclusion The risk prediction model for in-hospital mortality of patients on VA-ECMO has good differentiation,calibration and clinical effectiveness and outperforms the commonly used disease severity scoring system,and thus can be used for assessing disease severity and prognostic risk level in critically ill patients.