China ; epidemiology ; Cross Infection ; epidemiology ; Drug Resistance, Fungal ; Female ; Hospitalization ; Humans ; Male ; Microbial Sensitivity Tests ; Mycoses ; epidemiology ; Prevalence ; Respiratory Tract Infections ; microbiology ; Sentinel Surveillance

China ; epidemiology ; Cross-Sectional Studies ; Female ; Hospitalization ; Humans ; Infusions, Intravenous ; statistics & numerical data ; Male

Objective To determine the timing for therapy and efficacy for different types of hepatic artery stenosis (HAS) after orthotopic liver transplantation(OLT). Methods From October 2003 to May 2007, a total of 21 patients had hepatic artery stenosis after OLT in this hospital. Of the 21 patients, 19 underwent stent placement in their narrowed hepatic arteries and 2 were regularly followed up. Liver function, clinical outcomes, and the hepatic artery potency were reviewed. Results The occurring rate of HAS was 3.43% (21/613) and its median time of diagnosis was 146 days (range, 2-515 days). Six patients with early HAS were treated with interventions and 2 of them died.For the 4 surviving patients, 2 received retransplantation. For the 15 patients with late HAS, 13 were treated with interventions and 4 of them died. Two patients received retransplantation. Seven surviving patients had abnormality in liver function. Another 2 patients had normal liver function because of hepatic portal form compensatory circulation. Conclusion The presence of ischemic bile duct lesion and whether or not favourable compensatory circulation exists or not should be considered before individualized therapeutic regimens adopted according to postoperative HAS types.

OBJECTIVETo explore the effect of leukoaraiosis on conscious disturbance in patients with acute cerebral infarction.

METHODSA follow-up study including 138 patients with acute cerebral infarction matched with the diagnostic criteria of the Forth Cerebrovascular Disease Conference, were carried out. Patients were divided into two groups, using MRI to estimate the white substance process around cerebral ventricle, including 78 of them with leukoaraiosis and 60 without leukoaraiosis were followed up using Glasgow coma scale scores and England OCSP classification in 1 month, 3 month and 6 month after onset.

RESULTSThe independent factors of conscious disturbance included leukoaraiosis (OR = 5.294, 95% CI: 1.451-19.318), and OCSP classification (TACI and POCI especially) (OR = 14.489, 95% CI: 4.121-50.934). At the initial, the first month and the third month of the stroke episodes, significant difference (P < 0.05) was noticed when using Glasgow coma scales, and the scales in leukoaraiosis group was lower than the control.

CONCLUSIONTACI and POCI in OCSP classification were independent risk factors of conscious disturbance, and leukoaraiosis was also the independent factor. The incidence of conscious disturbance after stroke in patients with leukoaraiosis were lower than in that without leukoaraiosis. On the other hand, the degree of conscious disturbance was more serious and slower than those without leukoaraiosis, suggesting that the effect of leukoaraiosis was duplicate for conscious disturbance. Because patients with leukoraiosis had tolerance of chronic cerebral ischemia. The number of patients with conscious disturbance after stroke was fewer relatively. Leukoaraiosis had inactive effect for amelioration of conscious disturbance after three months of the episode. The grouping of OCSP played a primary while leukoaraiosis playing a secondary role, despite the patients with or without conscious disturbance after stroke.

Aged ; Brain ; pathology ; Brain Ischemia ; complications ; Consciousness Disorders ; etiology ; physiopathology ; Female ; Follow-Up Studies ; Glasgow Coma Scale ; Humans ; Incidence ; Leukoaraiosis ; etiology ; pathology ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Risk Factors ; Stroke ; complications

AIM:To rapidly evaluate the effective-ness,safety and economy of dienogest in the treat-ment of endometriosis so as to provide evidence-based reference for clinical drug selection and deci-sion.METHODS:Retrieved from PubMed,Embase,Cochrane Library,CNKI,SinoMed,Wanfang and health technology assessment(HTA)organization websites,HTA report,systematic review/Meta-anal-ysis and pharmacoeconomic study were included during the inception to Sep 2023.Data extraction and quality evaluation were carried out for the lit-erature that met the inclusion and exclusion crite-ria,and the research results were summarized and analyzed qualitatively.RESULTS:Nine systematic re-view/Meta-analyses,and 2 pharmacoeconomic studies were included.The quality of Meta-analysis literatures was low,and the quality of economic re-search was good.In terms of effectiveness,com-pared with no treatment,dienogest can significant-ly reduce postoperative recurrence rate,VAS score,and improve pregnancy rate and effective rate;Di-enogest has similar therapeutic effects in terms of recurrence rate as GnRHa and COC;With regard to recurrence rate and pregnancy rate,dienogest is superior to danazol,gestrinone,and mifepristone.In terms of safety,compared with placebo,the inci-dence of vaginal bleeding and headache was signifi-cantly increased with dienogest,and there was no difference in bone loss;The incidence of vaginal bleeding caused by dienogest was significantly high-er than that of GnRHa,but the incidence of hot flashes and bone loss was lower.In terms of econo-my,dienogest has a more cost-effective advantage comparing with GnRHa,but does not have econom-ic benefits comparing with COC.CONCLUSION:Di-enogest has good effectiveness and safety in the treatment of endometriosis,and economically su-perior to GnRHa,but inferior to COC.

OBJECTIVETo investigate the antibiotics use in inpatients with hospitals under different scales.

METHODSOn the day of August 7, 2003, antibiotics use among inpatients were investigated, medical order to each inpatient was checked and forms were filled.

RESULTSData showed that 54.86% of the 89,539 inpatients from 151 hospitals were using antibiotics, out of which 48.98% were used for therapeutic purposes while 35.44% for prophylaxis, and 15.58% for both therapy and prophylaxis. Among those who had received antibiotics, 61.43% received one, 33.65% received two and 4.92% received 3 or more agents. In patients who were on antibiotics for therapy, only 23.92% of the samples were sent for pathogens detection. The prevalence of antibiotics use was different among different hospitals, with teaching hospitals having the lowest and hospitals with less than 300 beds were higher than those with more than 300 beds. Departments of respiratory diseases, intensive care unit, and pediatrics had the higher use of antibiotics.

CONCLUSIONInpatients in 151 hospitals had high prevalence of antibiotics use, especially for prophylaxis use but pathogen detection was seldomly done. It is necessary to strengthen the rational use and management of antibiotics use in the hospitals.

Anti-Bacterial Agents ; therapeutic use ; Antibiotic Prophylaxis ; statistics & numerical data ; China ; Costs and Cost Analysis ; Data Collection ; Drug Utilization Review ; Female ; Humans ; Inpatients ; statistics & numerical data ; Male ; Surveys and Questionnaires

OBJECTIVETo study cardiopulmonary physiology during exercise in patients after extracardiac total cavopulmonary connection (ECTCPC).

METHODSTwenty-six patients were studied after ECTCPC by exercise testing with bicycle treadmill protocol. Heart rate (HR), blood pressure (BP), respiratory frequency (RF) and pulse oxygen saturation (SpO(2)) were measured continuously; twenty-six patients suffered from Fallot 4 underwent biventricular repair were also studied as control group.

RESULTSIn ECTCPC group, HR, BP, SpO(2) and RF all increased with exercise below 3 grade; when exceed 4 grade, BP, SpO(2) decreased and RF kept increasing. Compared with control group, HR, RF were higher (t = 2.13, P < 0.05; t = 2.31, P < 0.05), SpO(2) was lower (t = 2.46, P < 0.05) under the quiescent condition; When exceed 3 grade, HR, BP, SpO(2) decreased more significantly, but RF increased continuously. In fenestration group after ECTCPC, HR reached the top at 5 grades, but in group without fenestration it reached the top at 3 grades; In the whole process of exercising, RF kept higher and SpO(2) kept lower in fenestration group.

CONCLUSIONSThe ECTCPC patients showed obviously exercise limitation. Totally bypass of sinoatrial node in this operation may have some adverse effects on the integer regulation of HR.

Adolescent ; Adult ; Child ; Child, Preschool ; Exercise Test ; Female ; Follow-Up Studies ; Fontan Procedure ; methods ; Heart Defects, Congenital ; physiopathology ; surgery ; Humans ; Male ; Physical Endurance ; physiology ; Postoperative Period

OBJECTIVETo explore the pathogenic characteristics and management of brain injury in patients injured by high voltage electricity.

METHODSOne hundred and thirty eight patients injured by electricity were enrolled in this study. Postburn brain injury was diagnosed by clinical sighs and imaging analysis. The brain injury was graded as mild, moderate, severe and most severe. The relationships among the inlet of the electric current and the electric voltage and the degree of brain injury were analyzed, and the causes and pathogenesis of the brain injury were suggested. Treatment modality was optimized for the patients according to the diagnostic data.

RESULTSIn this group of patients, brain injury was identified in 106 cases, mostly rated as mild and moderate. Only 4 cases were ranked as severe degree with positive imaging findings. The electric voltage seemed to be not correlated with the incidence of postburn brain injury. But the intensity of electric current and the locations of electrical current inlet and outlet were closely related to the degree of brain injury. Among all the patients in this group, 131 survived and 7 died after treatment. But there was no death due directly to brain injury.

CONCLUSIONThere was high incidence of postburn brain injury in patients injured by high voltage electricity. The injury might be related to the direct effect of electrical current on the brain tissue, to mechanical injury, to the cardio-pulmonary lesions caused by electrical current, or to massive skin burn. Early and accurate diagnosis of the injury was of key importance for lowering both mortality and disability.

Adolescent ; Adult ; Aged ; Brain Injuries ; diagnosis ; etiology ; therapy ; Burns, Electric ; complications ; diagnosis ; therapy ; Child ; Child, Preschool ; Female ; Humans ; Injury Severity Score ; Male ; Middle Aged ; Young Adult

OBJECTIVETo summarize our experience in adult-to-infant living donor liver transplantation (A-ILDLT) and to analyze the efficacy and complications of A-ILDLT.

METHODSThe clinical data, surgical strategies and complications of 28 adult donors and infantile recipients who underwent A-ILDLT from April 2006 to December 2009 were retrospectively analyzed. These 28 patients (14 boys and 14 girls) aged from 80 days to 11.5 months with body weights of 3.08 to 10.3 kg at the time of operation . They suffered from biliary atresia with decompensated cirrhosis. The living donors were 15 mothers, 9 fathers, 3 grandma and 1 elder brother with ABO compatible with the infantile recipients. 27 Donor organs were the left lateral lobe grafts (segment II, III) and 1 graft was segment II. All patients were followed up for 5 to 24 months.

RESULTSThese grafts were orthotopically transplanted into the infantile recipients. The average length of stay was 9.3 days for the donor group without any complications. Postoperative immunosuppression included prednisone, Cyclosporin and mycophenolate mofetil (MMF). A total of 24 postoperative complications occurred in 20 recipients, including 5 vascular complications, 4 bleeding, 7 pneumonia, 2 bowel obstruction, 4 intestinal perforation and 3 rejection. Three recipients died of hepatic arterial thrombosis (HAT). The perioperative mortality rate of recipients was 10.7% (3/28) and the survival rate was 89.3% in peroperative period. One died of stricture of hepatic vein and 1 of accidental asphyxia during follow-up term. At present, 23 cases are still alive.

CONCLUSIONA-ILDLT has become an effective method to infants with end-stage liver disease. The postoperative vascular complication is the predominant cause of death.

Female ; Humans ; Infant ; Liver Diseases ; surgery ; Liver Transplantation ; methods ; Living Donors ; Male ; Retrospective Studies ; Treatment Outcome

BACKGROUND AND OBJECTIVEIn Guangxi province, from 1970s to 1990s, the mortality of primary liver cancer (PLC) ranked the first among a variety of malignant tumors. Investigating the epidemiological characteristics of PLC is very important for developing reasonable and effective treatment strategy, allocating health resources rationally, and evaluating the quality of PLC prevention and control. This study was to analyze the mortality and epidemiological characteristics of PLC in Guangxi province between 2004 and 2005.

METHODSMulti stage stratified cluster random sampling method was used to select 9 counties (cities or urban areas) as sample points. The residents' death causes between 2004 and 2005 were analyzed, and the epidemiological characteristics of PLC were investigated.

RESULTSIn the period of 2004-2005, the crude mortality of PLC was 34.39/100,000 in Guangxi province population (55.30/100,000 in men and 13.21/100,000 in women). The national population standardized mortality in 1964 was 22.17/100,000. The man to woman ratio of mortality was 4.19:1. PLC ranked as the first death cause among a variety of malignant tumors, and PLC related death accounted for 30.70% of all tumor related death cases. Age specific mortality of PLC was increased with age, rising significantly from 30 year old (from 25 year old in men and from 40 year old in women), and reached a peak at 75 year old.

CONCLUSIONSThe mortality of PLC shows a decreasing trend in Guangxi province in the early 21st century, and the starting age of PLC death peak postpones about 10 years than that in 1990s. It shows that the comprehensive prevention and control measures of PLC implemented in Guangxi province are fruitful. However, the PLC mortality in Guangxi province is still significantly higher than the national average level, and it still ranks as the first death cause in a variety of malignant tumors in Guangxi province. PLC mainly occurs in middle aged and elderly people. The prevention and treatment research of PLC still has a long way to go.

Adolescent ; Adult ; Age Distribution ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; China ; epidemiology ; Female ; Humans ; Infant ; Liver Neoplasms ; epidemiology ; mortality ; Male ; Middle Aged ; Mortality ; trends ; Sex Distribution ; Young Adult