Objective To study demographic features,clinical characteristics and in-hospital cost of patients due to different causes in one center in 2007-2011 and discuss their correlation.Methods A retrospective analysis was conducted on all patients who were treated with amputation from 2007 to the first half of 2011 in the Second Affiliated Hospital of Zhejiang University to carefully record their data,such as demographic characteristics,entity,medical history,clinical information,amputation location,amputation level,hospital day and medical cost.Results A total of 805 patients at age of (42.1 ± 18.1)years underwent amputation from 2007 to the first half of2011.Among them,the male patients accounted for 72.3％.The patients engaged in farm,industry and transportation accounted for 69.7％.Traumatic amputation occupied 66.1％,followed by 15.3％ of tumor amputation and diabetic amputation proportioned 4.5％,occupying 13.2％ of non-traumatic amputation.Ratios of lower limb amputations and amputations above levels of joints of palmar digitals and toes were 64.9％ and 61.7％.Mean hospital day was 20 days (range,14-34 days) and mean medical cost was 15 000 RMB (range,8 881-31 975 RMB).Conclusions Amputation largely occurs in the male adults and mainly results from trauma.High amputation,long hospital stay and high medical cost are the main characteristics.

Objective To analyze the causes,treatment and prevention of operation-related complications in liver malignancy patients after CT-guided percutaneous microwave coagulation therapy (PMCT).Methods A total of 68 patients with liver malignancy underwent CT-guided PMCT and their complications were analyzed retrospectively.Results The tumor diameter was 2.0-13.8 cm,mean 6.2 cm.Transcatheter arterial chemoembolization (TACE) was performed before PMCT in 64 patients,and 68 patients received 120 times of PMCT (1-8 times per patient).The main untoward reaction of PMCT was vagus nerve accentuation.Seven patients (7/120,5.83%) had complications including needle-tract implantation (n=2),liver abscess (n=2),pneumatothorax (n=1),cardiovascular accident (n=l) and enormous biloma with infection (n=l),6 were treated finally,and implanted tumor advanced in 1 patient.Conclusion CT-guided PMCT in liver malignancies is a safe therapeutic option with low rate of operation-related complications,which can be prevented and treated.Complications of PMCT are associated with the needle tract,frequency,coagulation range and perioperative management.

Objective To investigate the safety and clinical efficacy of uterime artery chemoembolization in postpartum hemorrhage (PPH) caused by abnormal placental implantation.Methods Between December 2006 and September 2009, there were 23 cases of abnormal placental implantation with PPH in our hospital, among which 9 presented with continuous small amount of vaginal bleeding and 14 with acute excessive bleeding.The average bleeding time was (8±6) d and the mean blood loss was (980±660) ml.Abnormal placental implantation was confirmed by color Doppler ultrasound (CD-US) in all cases, the internal lilac artery angiography was performed to identify the uterine artery and bilateral uterine artery chemoembolization (UACE) with methotrexate (MTX) and gelfoam particles to the distal end of uterine artery was conducted after.CD-US rechecked all patients within 48 h after UACE and those patients with blurred margins between placenta and uterus and abnormal blood flow (> 1 cm×1 cm) received ultrasonic-guided per vagina MTX multipoint injections.All cases were followed up for 3-26 months (average 12 months) to observe vaginal bleeding, placenta tissue discharge, serum human chorionic gonadotropin (hCG), uterine involution, menses, and side-effects or complications.Results (1) Curative effect: These 23 cases underwent 24 procedures of UACE successfully and vaginal bleeding ceased at an average of (3.5±1.3) min after UACE.Reduced blood flow in the placental implantation area was detected under CD-US after UACE.Among the 23 patients, wterine curettage was required in 16 cases due to retained placenta tissues with the mean blood loss of (40 ± 28) ml during the operation, 2 underwent subtotal hysterectomy and confirmed to be placenta percreta by pathology examination, and placenta tissues were spontaneously discharged completely in 5 cases.Totally, 91% of the patients (21/23) reserved their uterus.(2) Follow-up: the serum hCG reduced to normal within 1-13 d after the placenta tissue were evacuated.Regular menstruation returned within 2-3 months in those patients who reserved uterus and normal size uterus was found under sonography at 3 months.No severe complication was reported except for some post embolization syndrome, such as pelvic pain or fever.Conclusions UACE, combined with ultrasonic-guided transvaginal MTX injection, is a safe, minimal invasive and quick hemostatic procedure in treatment of abnormal placental implantation with PPH, and allows the preservation of uterus possible.CD-US is helpful in evaluation of the blood flow changes before and after UACE in abnormal placental implantation patients.

Objective To observe the effect and safety of the treatment of urethral stricture with guide wires leading a balloon dilatation catheter.Methods The clinical date of 25 cases of male patients suffering traumatic posterior urethral stricture were analyzed retrospectively,was treated with a balloon dilation catheter led by guide wires.Results All our patients were cured successfully with a guide-wire-leading balloon dilatation catheter expanding only once and there were no complications such as urethral perforation,rectal injury etc.Although 2 cases had not been ohviously improved risht after dilatation,but improved furtherly six months later.The follow-up was six to twelve months.23 cases were cured.2 osses were improved.The recovery rate was 92%.The effective rate was 100%.Conclusion It was safe and effective to treat urethral stricture with balloon dilation catheter led by guide wires.

The fibronectin was purified from human plasma by Gelatin-Sepharose 4B affinity chromatography. The rabbits were immunized with the fibronectin. the raw anti-fibronectin sera were absorbed bythe solid phase of the fibronectin free human serum. Then the specific anti-fibronectin sera were obtained. The fibronectins deposited on human bullet wounds, incised wounds as well as on blunt forceinJuries were demonst.ated by PAP immunohistochemical study using diluted anti-fibronectin serum.The results were quite sati factory.

Objective:To investigate the influential factors for poor prognosis in patients with acute myocardial infarction and construct a risk prediction nomograph model.Methods:A total of 173 patients with acute myocardial infarction who received treatment in The First People's Hospital of Huzhou from June 2018 to June 2021 were included in this study. They were divided into a good prognosis group ( n = 130) and a poor prognosis group ( n = 43) according to the follow-up results at 6 months after developing acute myocardial infarction. The clinical data of the two groups were compared using retrospective analysis methods. The potential influential factors were preliminarily screened using LASSO regression analysis. The influential factors of poor prognosis for acute myocardial infarction were investigated using logistic regression analysis. The risk prediction nomograph model was constructed using the "rms" package of R 4.2.6 language. The discriminability, calibration, and effectiveness of the model were evaluated by drawing the receiver operating characteristic curve, calibration curve, and decision curve. Model validation was conducted internally using the Bootstrap method (repeated sampling 1 000 times). Results:There were significant differences in the culprit vessel, Killip classification, vessel opening time, cardiac troponin I (cTnI), hypertension history, N-terminal pro-brain natriuretic peptide (NT-proBNP), diabetes history, creatinine, hyperlipidemia history, left ventricular ejection fraction, smoking history and creatine kinase isoenzymes-MB between the two groups (all P < 0.05). Seven potential influential factors were screened using LASSO regression model, including diabetes history, infarcted vessel anterior descending branch, Killip IV, vascular opening time, cTnI, NT-proBNP, and left ventricular ejection fraction. Logistic regression analysis showed that vascular opening time ( OR = 0.171, 95% CI: 0.053-0.548, P = 0.003), cTnI ( OR = 0.201, 95% CI: 0.079-0.510, P = 0.001), left ventricular ejection fraction ( OR = 1.469, 95% CI: 1.167-1.847, P = 0.001), NT-proBNP ( OR = 0.996, 95% CI: 0.993-1.00, P = 0.025) were independent influential factors of poor prognosis in patients with acute myocardial infarction (all P < 0.05). Linear regression analysis results indicate that the regression model did not exhibit significant multicollinearity (variance inflation factor < 10). Based on the four influential factors identified by logistic regression analysis, a nomogram model for predicting the poor prognosis of patients with acute myocardial infarction was developed. The area under the receiver operating characteristic curve was 0.979 [95% CI (0.959, 0.999)], and the consistency index was 0.934. The calibration curve of the model was close to the ideal curve. Decision curve analysis revealed that when the probability threshold predicted by the model ranged from 0.61 to 0.99, the predictive value of the model was superior. Conclusion:Factors influencing the poor prognosis of acute myocardial infarction include the time of vessel opening, cTnI, NT-proBNP, and left ventricular ejection fraction. The constructed nomogram model demonstrates good efficacy in predicting the poor prognosis of patients with acute myocardial infarction and can provide some reference for clinical doctors and nurses to identify patients with poor prognosis as soon as possible.