2.Predictive value of trauma index on the prognosis in patients with traumatic spinal cord injury
Journal of Clinical Surgery 2017;25(1):65-66,67
Objective To investigate the predictive value of trauma index on the prognosis in pa-tients with traumatic spinal cord injury.Methods Enrolled 168 cases of patients with traumatic spinal cord injury,the traumatic index score and the American Spinal Injury Association (ASIA)grade were as-sessed on admission,then followed up for 6 months,the Spearman correlation analysis was performed to a-nalysis the relationship between trauma index and ASIA grade,and Receiver operating curve (ROC)anal-ysis was used to evaluate the relationship between trauma index and prognosis.Results There was a sig-nificant negative correlation between trauma index score and ASIA grade(r =-0.68,P <0.01).A total of 157 cases (93.5%)completed follow-up,the trauma index score had a good predictive value on the traumatic death in these patients,it's sensitivity was 71.4%,specificity was 76.1%,the best cut-off point was 25 points(P <0.01 );Compared with the low score group (<25 points),the high group (≥25 points)showed a lower ASIA grade and higher mortality,the differences were statistically significant (P <0.01).Conclusion The trauma index score was related with the spinal cord injury,and it is a predictive factor of poor prognosis in patients with traumatic spinal cord injury.
3.Discussion of hospitals' reform of the property right system
Wei FAN ; Huixian HU ; Tuqiang LI
Chinese Journal of Hospital Administration 1996;0(09):-
By analyzing the crisis of survival in 2 hospitals, the authors argue that reform of the hospital property right system may be a way out. However, in the process of the reform, hospitals may face some problems. One problem is how to ensure the steady transition and sustained development of a hospital if the whole of it is sold out to an enterprise run by the local people. Another problem is how to safeguard the status, salary and welfare of the staff. To ensure the success of the reform, the following measures need to be taken: ①strengthening leadership, seeking unity of thinking, and clarifying the guiding ideology; ②formulating rigorous and detailed plans so as to guarantee a steady transition; ③making proper arrangements for the placement of the staff after the change of the property right system so as to ensure the ideological stability of the staff.
4.Influence of age on prevalence rates of chronic complications of hospitalized aged patients with hypertension——analysis of 17,682 cases
Hua CUI ; Yixin HU ; Li FAN ; Guoliang HU ; Wei DAI
Journal of Geriatric Cardiology 2009;6(2):91-94
Objective To understand the relationship between age and chronic complications in hospitalized aged patients with hypertension, to provide evidence for hypertension prevention and control. Methods To retrospectively analyze the clinical and laboratory data on 17,682 patients with essential hypertension during Jan 1st,1993-Dee 12th, 2008 in PLA general hospital. Results 1)Among all of the inrolled cases, those aged 60-64 account for 27.87%, 65-69 years group account for 26.55%, 70-74 years group accounted for 23.96%, 75-79 years group accounted for 14.14%, 80-84 years group accounted for 5.26%, 85-89 years group accounted for 1.69%, > 90 years accounted for 0.41%. 2) The prevalence rate of chronic complications in 60-69 years group were 31.3-31.2% for diabetes and,22.6-27.0% for cerebrovascular disease, 9.5-11.1% for myocardial infarction, 6.7-9.1% for heart failure, 5.8-6.0% for renal dysfanction 4.9-6.8% for atrial fibrillation, 0.1-0.3% for multiple organ dysfunction syndrome (MODS) in the elderly(P <0.05 ). 3) The first four complications of hypertension were diabetes(33.5%), cerebrovascular disease (31.9%), myocardial infarction(13.2%) and heart failure(12.3%) in 70-74 years group (P<0.05), cerebrovascular disease (42.8%), diabetes (32.8%), heart failure (16.5%) and myocardial infarction(15.9%) in 75-79 years group (P<0.05), cerebrovascular disease (45.4%), diabetes (35.0%), heart failure (21.1%) and myocardial infarction(15.9%) in 80-84 years group (P<0.05), cerebrovascular disease(42.5%), diabetes (35.8%), heart failure (23.1%) and renal dysfanction (17.7%) in 85-89 years group(P<0.05 ),and cerebrovascular disease (45. 2%), heart failure(31.5%), diabetes (26.0%) and renal dysfanction (20.5%) in patients more than 90 years group (P<0.05). Conclusions The prevalence rate and kinds of chronic complications in hospitalized aged patients with hypertension were changed with the increasing age, and the first kind of complication is cerebrovascular disease. It is of more importance to prevent the occurrence of renal dysfanction and heart failure in those hypertension patients who were more than 80 years old.
6.Deep venous thrombosis in preterm infants:3 cases report
Qi HU ; Wenting FAN ; Rui DENG ; Wei LIAO
Journal of Clinical Pediatrics 2016;34(6):453-456
Objective To enhance the awareness of diagnose and treatment of venous thrombus in premature infants. MethodsThe clinical features, treatment and prognosis of lower limb vein thrombus in three case of premature infants were retrospectively analyzed.ResultsThree premature infants of gestational age 29-36 weeks were found thrombosis in 1-57 days after birth. One case received peripherally inserted central cathete (PICC). All of three cases had infection signs and trauma. One case received thrombolytic and anticoagulant therapy, one case received high dose thrombolytic therapy, and both of them were treated successfully without bleeding complication. However, another case was deteriorated after giving up treatment.ConclusionsCritically ill premature infants are at high risk of thrombosis. Infection, indwelling tube, thrombophilia constitution, and maternal risk factors were the high risk factors of thrombosis. Early detection, early diagnosis, and effective individualized treatment can improve the prognosis.
7.Predictors of femoral head avascular necrosis after internal fixation of femoral neck fractures
Fan LIANG ; Hao PENG ; Wei HU ; Ming DENG
Chinese Journal of Trauma 2016;32(9):813-817
Objective To identify the independent prognostic factors for femoral head avascular necrosis after internal fixation of femoral neck fractures.Methods A retrospective analysis was made on 246 patients (246 hips) with femoral neck fractures treated by internal fixation between January 2002 and January 2010.There were 111 male and 135 female patients aged 19-59 years.A total of 101 patients were injured in traffic accidents,79 patients in falls from the height and 66 patients in ground-level falls.Eight parameters were identified as the prognostic factors of femoral head avascular necrosis,including gender,fracture type,preoperative traction,interval from injury to surgery,reduction methods,quality of fracture reduction,time of weight bearing,and fixation removal.Multivariate Logistic regression analysis was used to explore the risk factors of postoperative femoral head avascular necrosis.Results Period of follow-up was 1-13 years (mean,7.5 years).There were 38 patients (15.4%) with avascular necrosis of the femoral head.Multivariate analysis identified fracture type (95% CI-3.41--2.43,P < 0.01),preoperative traction (95% CI-3.77--0.6,P < 0.05) and quality of fracture reduction (95% CI -3.33--0.94,P < 0.01) as the independent predictors of avascular necrosis of the femoral head.Conclusion Fracture type,preoperative traction and quality of fracture reduction are the independent risk factors for avascular necrosis of the femoral head after internal fixation of femoral neck fractures.
8.The lateral epicondylitisnamed rationality:a systematic review
Ke XIONG ; Wei FAN ; Hong AN ; Xiao CAI ; Tingyi HU
Chinese Journal of Medical Education Research 2015;(1):78-83
Objective By analysis oflateralepicondylitis patients MRI features to explore the lateralepicondylitis namedrationality and authorized its opinions for the ninth edition surgery textbook. Methods Cochrane's systematic review methods were used to retrieve the literature about lateralepi-condylitis patients MRI features fromCochrane Library, Medline, OVID, EMBASE, Chinese biomedical literature database (CBM), VIP, CNKI, Wan fang digital journals, and totally 31 articles were reviewed. 13 articles met the inclusion criteria for the lateral epicondyle of humerus elbow in patients with MRI findings. In accordance with the case-control data RevMan 5.0 software was used for Meta analysis withodds ratio (OR) as count data statistics. Interval estimation wasmade of 95% confidence interval (CI). When the datacannot be performed Meta analysis, only qualitative analysis was made. Results 13 studies met the inclusion criteria, including 315 ipsilateralelbows (5 patients with bilateral disease, 305 patients with unilateral disease) and 169 asymptomatic side of the elbow (98 cases of patients with the contralateral elbow, 71 cases of healthy volunteers). The results of Meta analysis suggested that pa-tients and healthy volunteers of elbow MRI showed statistically significance [OR=88.55, 95%CI=(29.20, 268.57)]. Between ipsilateral elbow and contra lateral of elbow MRI showed statistically significance [OR=80.17, 95%CI=(21.53, 298.59)]. MRI analysis showed that in addition to signs of extensor tendon injury, the elbow was also widely associated with other changes, such as radial collateral ligament in-jury, bone marrow edema, joint effusion, tendon tear, and elbows muscle edema. Conclusion Through MRI findings,the maln pathological changes of the so-called lateralepicondyliti-saremalnly for total ex-tensor tendon and adjacent tissue of chronic injury, Naming the current external humeral epicondylitis is unreasonable. Therefore, periarthritis of lateral epicondyle of humerus seems to be the best appropri-ate term to be usedwhenthe ninth edition surgery textbooksisauthorized.
9.The protective effects of edaravone combined with ulinastatin on the treatment of brain injury in rats with severe acute pancreatitis
Xiaohong WANG ; Ronglong WEI ; Hui FAN ; Jianghong HU
Chinese Journal of Hepatobiliary Surgery 2013;19(7):544-549
Objective To investigate the protective effects of edaravone combined with ulinastatin on the treatment of brain injury in rats with severe acute pancreatitis.Methods A total of 100 male Sprague-Dawley rats were randomly divided into 10 groups that consisted of a normal control 6 and 48 hour group,a SAP 6 and 48 hour group,an edaravone treated 6 and 48 hour group,a ulinastatin treated 6 and 48 hour group,and finally a combination of edaravone and ulinastatin treated 6 and 48 hour group.Each group included 10 rats.Neurobehavioral scores were observed and a series of blood,pancreatic tissue,and brain tissue samples were obtained at 6 and 48 hours after operation.Serum amylase,brain tissue Evans Blue content,brain tissue water content,and the histopathological change of the pancreas and brain tissues were observed.Serum TNF-α was detected by RIA.The TNF-α mRNA and nuclear factor kappa B(NF-κB) p65 activity in brain tissues were measured with RT-PCR and immunohistochemistry,respectively.Results In contrast to the 48 hour SAP,edaravone treated,and ulinastatin treated groups,the serum amylase,brain tissue Evans Blue content,brain tissue water content,histopathological score of the rat pancreas and brain tissue,serum TNF-a,TNF-a mRNA,and NF-κB p65 activity in brain tissues significantly decreased while neurobehavioral scores significantly increased in the 48 hour combined edaravone and ulinastatin treatment group (P<0.01).Conclusion Edaravone combined with ulinastatin can play a protective role on brain injury in rats with severe acute pancreatitis.
10.Efifcacy of the consolidation chemotherapy after autologous stem cell transplantation in refractory/relapse lymphoma
Yang YU ; Xing FAN ; Ling WANG ; Wei TANG ; Jiong HU
China Oncology 2014;(10):761-764
Background and purpose: High-dose chemotherapy followed by autologous stem cell transplantation (auto-HSCT) is considered as the ifrst line treatment for patients with relapse/refractory lymphoma after conventional chemotherapy. However, most of these patients still relapse the second time. The purpose of this study was to analyze the efifcacy of the consolidation chemotherapy after autologous stem cell transplantation (HSCT) refractory/relapse lymphoma in high risk. Methods:A total of 38 patients with relapsed/refractory lymphoma including Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL) were included, who were underwent auto-HSCT in our transplan-tation department from Jan. 2010 to Dec. 2013. In treatment group, 19 patients received 2 courses of consolidation che-motherapy after auto-HSCT every 2 to 3 months, with the regimen of mini-BEAM or modiifed mini-CBV. Another 19 patients had no chemotherapy after auto-HSCT as control group. Results:The median follow-up duration was 17.2 and 7.5 months in the treatment and control group respectively. The follow-up data demonstrated prolonged progression-free survival (PFS) in the treatment group than the control group [24.7 months vs 7.8 months, P=0.029 under intend-to-treat analysis ITT;24.7 months vs 5.2 months, P=0.01 under per protocol analysis(pp)]. There is also a trend of improved overall survival (OS) in the treatment group (P=0.055, ITT). Conclusion:Consolidation chemotherapy after auto-HSCT for refractory/relapsed lymphoma patients delay the relapse and tend to improve the overall relapse rate.