1.The application of RoSCo score in the laparoscopic partial nephrectomy
Yongjiang ZHUANG ; Chao CAI ; Huijian ZHANG ; Peidan PENG ; Shaobin ZHENG
The Journal of Practical Medicine 2017;33(7):1109-1112
Objective To investigate the association between the RoSCo scoring system and the postopera tive complications of laparoscopic partial nephrectomy.Methods The clinical data of 127 patients with laparoscopic partial nephrectomy in our hospital from 2010 to 2015 were retrospectively analyzed.By studying all patients' preoperative clinical data,we give all the patients the RoSCo score,then divided all the patients into the RoSCo low group (3-4),RoSCo moderate group (5-6),RoSCo high group (7-8).Respectively study the association between the RoSCo score and Clavein score,operative time,intraoperative blood loss,warm ischemia time and length of hospital stay after laparoscopic partial nephrectomy.Results The RoSCo score was associated with postoperative complications of laparoscopic partial nephrectomy (P < 0.05) and was more accurate than the RENAL score alone.There were significant differences in bleeding,warm ischemia time,hospital stay and operation time between the low,middle and high groups of RoSCo (P < 0.05).Conclusion The RoSCo scoring system can be used to assess the complications of laparoscopic partial nephrectomy.
2.Effect of high-titer plasma in pediatric patients with severe adenovirus pneumonia
Hongyan PENG ; Feiyan CHEN ; Run DANG ; Yunlong ZUO ; Peidan HU ; Yiyu YANG ; Rong ZHOU ; Xia RONG ; Dehui CHEN
Chinese Journal of Pediatrics 2020;58(5):392-397
Objective:To explore the efficacy and safety of high-titer plasma in the treatment of pediatric patients with severe adenovirus pneumonia.Methods:The clinical data of 92 pediatric patients with severe adenovirus pneumonia admitted to pediatric intensive care unit (PICU) in Guangzhou Women and Children′s Medical Center from January 2016 to October 2019 were retrospectively collected. According to the treatment with or without high-titer plasma, the patients were divided into plasma treatment group ( n=41) and non-plasma treatment group ( n=51). The 51 patients with chest radiograph showing more than half the lungs involved were divided into plasma treatment group ( n=29) and non-plasma treatment group ( n=22). According to fever duration before plasma treatment, patients were divided into early group (≤5 days, n=5), middle group (>5-10 days, n=14), and late group (>10 days, n=22). Baseline data, therapeutic effects, and prognosis of patients in each group were analyzed with t test, non-parametric rank sum test, one-way ANOVA and chi-square test. Results:Ninety-two patients were included. There were no significant differences in age, gender, body weight, fever duration, sequential organ failure assessment, and Murray lung injury score between plasma treatment group and non-plasma treatment group before admission (all P>0.05). The proportion of patients whose temperature drop to normal within 5 days was higher in plasma treatment group than that in non-plasma treatment group (88% (36/41) vs. 69% (35/51), χ 2=4.745, P=0.029). However, there were no significant differences between the two groups in the proportions of invasive ventilator weaning within 14 days (63% (26/41) vs. 76% (39/51), χ 2=1.868, P=0.172), transfer out from PICU within 14 days (49% (20/41) vs. 69% (35/51), χ 2=3.724, P=0.054), discharge within 28 days (51% (21/41) vs. 61%(31/51), χ 2=0.846, P=0.358) and survived patients (85% (35/41) vs. 76%(39/51), χ 2=1.143, P=0.285). Among patients with severe chest radiograph, the proportions of patients whose temperature drop to normal within 5 days and survived patients were higher in plasma treatment group than those in non-plasma treatment group (86% (25/29) vs. 59% (13/22), χ 2=4.843, P=0.028; 83% (24/29) vs. 55%(12/22), χ 2=4.796, P=0.029, respectively). However, there were no significant differences between the two groups in the proportions of invasive ventilator weaning within 14 days (52% (15/29) vs. 59% (13/22), χ 2=0.274, P=0.601), transfer out from PICU within 14 days (34% (10/29) vs. 45% (10/22), χ 2=0.632, P=0.427), and discharge within 28 days (45% (13/29) vs. 45% (10/22), χ 2=0.002, P=0.964). Among early, middle and late group, the proportions of invasive ventilator weaning within 14 days were 2/5, 13/14 and 50% (11/22), respectively, with statistically significant difference (χ 2=8.119, P=0.017). There were no significant differences in the proportions of patients whose temperature drop to normal within 5 days (4/5, 14/14, 82% (18/22), χ 2=2.965, P=0.227), transfer out from PICU within 14 days (2/5, 10/14, 36%(8/22), χ 2=4.386, P=0.112), discharge within 28 days (2/5, 8/14, 50% (11/22), χ 2=0.462, P=0.794) and survived patients (4/5, 13/14, 82% (18/22), χ 2=0.966, P=0.617) in the three groups. Only one case with high-titer plasma therapy had rash in the course of infusing plasma and no other adverse reactions were observed. Conclusions:High-titer plasma can shorten the fever time and improve the proportion of survival patients in pediatric severe adenovirus pneumonia. The clinical effect of high-titer plasma is better in 5-10 days of fever course. High-titer plasma is an effective and safe treatment.