Purpose To investigate the clinical value of three-dimensional hysterosalpingo-contrast-sonography (3D-HyCoSy) in the assessment of fallopian tubal patency.Materials and Methods Fallopian tubal patency of 33 infertile women was assessed using transvaginal 3D-HyCoSy, and the results were compared with laparoscopically salpingoraphy, the sensitivity, specificity, positive likelihood ratio and negative likelihood ratio of 3D-HyCoSy were evaluated.Results 3D-HyCoSy showed 20 passable fallopian tubes, 10 partially passable fallopian tubes and 36 obstructed tubes, while lapascopically salpingoraphy showed 23 passable fallopian tubes, 7 partially passable fallopian tubes and 36 obstructed tubes. The total coincidence rate of 3D-HyCoSy to assess the fallopian tubal patency was 86.4% (57/66), with the sensitivity of 93.0% (40/43), specificityof 73.9% (17/23), positive likelihood ratio of 7.15, and negative likelihood ratio of 0.20.Conclusion Tubal patency can be efficiently and accurately assessed using 3D-HyCoSy, but patients with obstructed or partially passable fallopian tubes should undergo laparoscopy to clarify.

Objective To study characteristics and current situation of physically restrains (PR) patients in ICU in third-level hospitals.Methods The physical restrains of ICU patients from January to June 2017 in a third-level hospital in Jiangsu Province was prospectively analyzed.Results The usage rate of physical restraint was 69.4％,and the usage number of restraint was 19 ～ 37.5,with median number of 19 times.The proportion of total restraints to total hospitalized restraint was 79.4％.The PR tools and restraint locations were single.The restraint complication occurred 78 times,with the complication rate of 45.7％ (59/129).Conclusion ICU patients have higher body constraint usage,longer constraint time,higher incidence of complications.So the nurses need to strengthen PR-related education and training to reduce the PR usage and complications.

Objective To study characteristics and current situation of physically restrains (PR) patients in ICU in third-level hospitals.Methods The physical restrains of ICU patients from January to June 2017 in a third-level hospital in Jiangsu Province was prospectively analyzed.Results The usage rate of physical restraint was 69.4％,and the usage number of restraint was 19 ～ 37.5,with median number of 19 times.The proportion of total restraints to total hospitalized restraint was 79.4％.The PR tools and restraint locations were single.The restraint complication occurred 78 times,with the complication rate of 45.7％ (59/129).Conclusion ICU patients have higher body constraint usage,longer constraint time,higher incidence of complications.So the nurses need to strengthen PR-related education and training to reduce the PR usage and complications.

OBJECTIVETo investigate the distribution of HBV genotypes in Changzhou area and to clarify the genotype-related difference in the liver function, the level of HBV DNA and the long-term effect of lamivudine in the pathogenicity of HBV.

METHODSNested PCR and sequence analysis were conducted in 14 acute hepatitis (AH), 104 chronic hepatitis (CH), and 28 liver cirrhosis or hepatocellular carcinoma (LC/HCC) patients.

RESULTSOne hundred and forty six samples were positive for HBV DNA, and 51 samples were classified as genotype B (34.9%), 95 samples were classified as genotype C, serum ALT value was 383.8 +/- 335.7 IU in patients with HBV genotypes B, and 364.3 +/- 333.7 IU in genotypes C, HBV DNA value was 10(7.795 +/- 1.22) copies/ml in genotypes B and 10(7.69 +/0- 1.19) copies/ml in genotypes C, and there were 36 and 64 HBeAg positive cases in patients with genotypes B and C; there were no significant difference on the level of ALT, HBV DNA and the expression of HBeAg (P>0.05), but genotype C in LC/HCC was higher than CH (P<0.01). Twenty three genotype B and forty five genotype C patients received lamivudine treatment, after 48 weeks, 18 genotype B and 14 genotype C patients had higher ALT or HBV DNA positive.

CONCLUSIONSThese results indicate that genotype B and C existing Changzhou area; genotype C is associated with the development of severe liver disease and better therapeutic effect could be obtained in the patients with genotype C.

Adult ; Antiviral Agents ; therapeutic use ; DNA, Viral ; genetics ; Female ; Genotype ; Hepatitis B ; complications ; drug therapy ; Hepatitis B virus ; genetics ; Humans ; Lamivudine ; therapeutic use ; Liver Cirrhosis ; etiology ; virology ; Liver Neoplasms ; etiology ; virology ; Male ; Middle Aged ; Polymerase Chain Reaction ; Treatment Outcome

Objective This study compares a dual-freeze protocol with a triple freeze protocol for hepatic cryoablation in the Tibetan pig model.Method Cryoablation with a dual-(10-5-10-5 min)and triple-freeze (5-5-5-5-10-5 min) protocol for the normal livers of 9 Tibet pigs was performed under exposed operation.Temperature changes of cryoprobes and diameter changes of iceballs were measured during the ablation,and seven days later the pathological changes of cryozones were reviewed and the surface and depth cryolesions were measured.Results Compared with cryoablation with two freeze-thaw cycles,there was a greater iceball diameter for cryoablation by three freeze-thaw cycles.Also,seven days after cryosurgery,there were similar surface and deep cryolesions in dual-and triple-freeze protocols.Pathologically,the triple freezing protocol was associated with a longer zone of complete necrosis.Conclusions With the same freezing time (20 min),the triple-freeze protocol may become a more powerful liver-ablation method in cryosurgical application.

Objective:To explore the influencing factors of uterine myometrial and parauterine venous plexus reflux during transvaginal four-dimensional contrast-enhanced hysterosalpingography, which will help reduce and avoid the occurrence of reflux and improve the accuracy of diagnosis.Methods:A total of 306 infertile patients who underwent transvaginal four-dimensional contrast-enhanced hysterosalpingograph from June 2016 to June 2017 in the Third Affiliated Hospital of Guangzhou Medical University were retrospectively enrolled. The ultrasonographic characteristics were reviewed and the correlations between reflux and endometrial thickness, days after menstruation, intrauterine operation history and patency of fallopian tube were analyzed.Results:The incidence of countercurrent during four-dimensional contrast-enhanced hysterosalpingography was 14.71%. The chi-square test showed that the endometrial thickness and the days after menstruation had statistically significant effects on the incidence of reflux ( P=0.031 and <0.001, respectively). There were no statistically significant effects of intrauterine operation history and patency of the fallopian tube on the incidence of reflux ( P=0.610, 0.137). Logistic regression analysis showed that the incidence of reflux was associated with endometrial thickness ( B=-1.171, P<0.001) and the days after menstruation ( B=0.439, P=0.015). Conclusions:Transvaginal ultrasound measurement of endometrial thickness before angiography and selection of appropriate examination time according to the menstrual cycle can effectively reduce the incidence of reflux, and adverse reactions, and improve the accuracy of four-dimensional contrast-enhanced hysterosalpingography.

Objective To explore the application effect of throughout nursing management mode in the free treatment of acquired immune deficiency syndrome (AIDS) in outpatient.Methods Follow the principle of voluntary participation,seventy-two infected person or patients with AIDS were chosen and were divided into the intervention group (n =34) and the control group (n =38).The control group received the routine nursing management mode,and the intervention group received the throughout nursing management mode.The seven compliance indicators were observed and analyzed one year after the intervention.Results The average interval time from confirming HIV to detecting CD4 cell count firstly was 20 d,and the average interval time from finding CD4 less than 350/μl firstly to antivirus treatment was 30 d in the intervention group,and were lower than 30 d,60 d in the control group,and the differences were statistically significant (Z =3.42,3.13,respectively; P ＜ 0.01).The proportions of full compliance,partial compliance in the intervention group were respectively 82.4％,14.7％,and were better than those in the control group(52.6％,34.2％),and the difference was statistically significant (Z =-2.693,P ＜ 0.01).The proportions of the standard of follow-up in the intervention group were respectively 82.4％,and were better than 55.3％ in the control group,and the difference was statistically significant (x2 =6.057,P ＜ 0.05).The proportions of detecting CD4 cell count every three months,the increased CD4 more than 100/μl 6-12 months after the antivirus treatment,the viral suppression 6-12 months after the treatment in the intervention group were respectively 97.1％,79.4％,82.4％,and were better than 81.6％,44.7％,60.5％ in the control group,and the differences were statistically significant (x2 =4.354,5.678,4.138,respectively; P ＜ 0.05).Conclusions The throughout nursing management mode can urge the patients to detect CD4 cell count and standardize the follow-up,and can promote the patients to treat as soon as possible,and increase the medication compliance,and improve the treatment effect,and reduce the incidence and mortality of AIDS-related diseases.

BackgroundThe incidence of delirium in critically ill psychiatric patients is high， and there are many factors affecting delirium occurrence. At present， epidemiological studies on delirium among critically ill patients in psychiatric hospitals are limited. ObjectiveTo explore the risk factors for delirium in critically ill patients in a psychiatric hospital， so as to guide the clinical management of delirium in psychiatric hospitals. MethodsThis retrospective study included 427 critically ill patients who were admitted to Shenzhen Kangning Hospital from January 1， 2019 to May 31， 2021. The delirium situation， gender， age， pre-admission course of illness （duration from the onset of acute mental state changes to in-patient registration at a psychiatric hospital）， history of mental illness， history of cognitive dysfunction， history of using psychoactive substances， history of using sedative and hypnotic drugs， number of combined chronic diseases， number of combined drugs and type of disease were examined as potential risk factors for delirium. Single Logistic regression was used to analyze the potential risk factors for delirium， and the potential risk factors were incorporated into the multi-factor Logistic regression analysis model so as to gradually screen out the risk factors for delirium in critically ill psychiatric patients. ResultsDelirium was present in 33.49% （143/427） of critically ill patients. Multi-factor Logistic regression analysis demonstrated that the presence of delirium was associated with mental and behavioral disorders caused by psychoactive substances （OR=8.949， P<0.01）， absent history of mental illness （OR=4.202， P<0.01）， number of combined chronic diseases （OR=1.249， P<0.01）， age （OR=1.031， P<0.01） and pre-admission course of illness （OR=0.942， P<0.01） . ConclusionDelirium was present in nearly 1/3 critically ill patients in the psychiatric hospital. The risk factors for delirium included short course of illness before admission， age， more combined chronic diseases， absent history of mental illness， mental and behavioral disorders caused by psychoactive substances. ［Funded by Shenzhen Fund for Guangdong Provincial High-level Clinical Key Specialties （number， SZGSP013）］

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.