Objective To explore and summarize the locations,clinical manifestations,and treatment strategies of foreign bodies in the oral and maxillofacial region(FBOMR)among patients treated in our hospital,providing clinical insights and references for the pre-vention and management of FBOMR.Methods A retrospective analysis was conducted on the clinical data of 17 FBOMR patients hos-pitalized in our hospital from May 2022 to May 2024.The demographic information,etiology of injury,characteristics of foreign bodies,extraction methods,surgical duration,complications,and follow-up outcomes were analyzed.Differences in treatment strategies among patients with varying injury patterns were compared.Results The average age of the 17 FBOMR patients was(45.71±18.19)years old,with a male to female ratio of 1∶0.7.Etiological analysis revealed:iatrogenic causes(58.82%,10/17),occupational exposure(23.53%,4/17),and accidental injuries(17.65%,3/17).Secondary infections occurred in 64.71%(11/17)of cases during foreign body retention.All cases underwent successful surgical removal,with the following approaches:conventional surgery(64.71%,11/17),computer navigation-assisted surgery(29.41%,5/17),and endoscope-assisted surgery(5.88%,1/17).Compared to the conventional group,computer navigation-assisted surgery significantly reduced intraoperative trauma(P＜0.05).Conclusion Retained FBOMR poses serious risks to patients'physical and mental health.Surgical intervention remains the gold standard for clinical manage-ment.Precise three-dimensional localization and minimally invasive techniques,such as computer-assisted navigation and endoscopy,are recommended to minimize tissue damage and improve outcomes.

Objective To explore and summarize the locations,clinical manifestations,and treatment strategies of foreign bodies in the oral and maxillofacial region(FBOMR)among patients treated in our hospital,providing clinical insights and references for the pre-vention and management of FBOMR.Methods A retrospective analysis was conducted on the clinical data of 17 FBOMR patients hos-pitalized in our hospital from May 2022 to May 2024.The demographic information,etiology of injury,characteristics of foreign bodies,extraction methods,surgical duration,complications,and follow-up outcomes were analyzed.Differences in treatment strategies among patients with varying injury patterns were compared.Results The average age of the 17 FBOMR patients was(45.71±18.19)years old,with a male to female ratio of 1∶0.7.Etiological analysis revealed:iatrogenic causes(58.82%,10/17),occupational exposure(23.53%,4/17),and accidental injuries(17.65%,3/17).Secondary infections occurred in 64.71%(11/17)of cases during foreign body retention.All cases underwent successful surgical removal,with the following approaches:conventional surgery(64.71%,11/17),computer navigation-assisted surgery(29.41%,5/17),and endoscope-assisted surgery(5.88%,1/17).Compared to the conventional group,computer navigation-assisted surgery significantly reduced intraoperative trauma(P＜0.05).Conclusion Retained FBOMR poses serious risks to patients'physical and mental health.Surgical intervention remains the gold standard for clinical manage-ment.Precise three-dimensional localization and minimally invasive techniques,such as computer-assisted navigation and endoscopy,are recommended to minimize tissue damage and improve outcomes.

Objective:To evaluate the prognostic values of parameters from hypothermic machine perfusion (HMP) after static cold storage (SCS) on short-term outcomes of kidney transplantation.Method:From February 2023 to October 2023, the authors retrospectively reviewed the clinical and HMP data of recipients undergoing adult deceased donor kidney transplantation at Xuanwu Hospital, Capital Medical University. HMP resistance and renal arterial anatomical variants were utilized for subgroup analysis. The primary endpoints were delayed graft function (DGF) and whether or not creatine level normalized. The secondary endpoints were the lowest creatine level within 1 month post-kidney transplantation, reduction extent of creatinine level, duration for creatine level to decline to the lowest and duration for creatinine normalization. Single and multiple variable analyses were utilized for examining the correlation between HMP parameters and short-term postoperative outcomes.Result:A total of 157 recipients were included for analysis. Mean serum creatinine level was (870.0±283.9) μmol/L and mean trough creatinine level within 1 month postoperatively (118.5±63.5) μmol/L. Sixteen recipients (10.2%) had delayed graft function (DGF) and creatinine failed to normalize in 10 receipients (6.4%). Average time for creatinine to decline to the lowest level within 1 month was (14.5±7.6) d (3~30 d) and average time for creatinine to normalize (6.4±5.8) d (1~30 d). Multiple variable regression analysis revealed that terminal resistant index was independently correlated with multiple events, including DGF ( P<0.01), whether or not creatinine level normalized within 1 month ( P=0.001), reduction extent of creatinine level ( P<0.01) and duration for creatinine normalization ( P=0.024) . Conclusion:Parameters of HMP after SCS are capable of predicting the short-term outcomes of kidney transplantation. Terminal resistant index is an independent risk factor for several prognostic events.

Objective:To evaluate the right atrial volume and function abnormalities in patients with pulmonary hypertension (PH) by four-dimensional automatic quantitation technique, and to explore the application value of this technique in evaluating the risk stratification and World Health Organization functional class(WHO-FC) of PH patients.Methods:Eighty-four adult patients with PH diagnosed by right heart catheterization from April to October 2022 in Fuwai Central China Cardiovascular Hospital were consecutively enrolled as the PH group. All cases were divided into 3 groups according to the mean pulmonary arterial pressure (mPAP): mild PH group ( n=28), moderate PH group ( n=28), severe PH group ( n=28). Twenty-eight healthy volunteers matched by gender and age were included in the same period as the control group. The volume and strain parameters of the right atrium were obtained by analyzing the four-dimensional image of the right atrium using four-dimensional automatic quantitation technique, including right atrial minimum volume index (RAVImin), right atrial maximum volume index (RAVImax), right atrial presystolic volume index (RAVIpreA), right atrial ejection fraction (RAEF), right atrial passive ejection fraction (RAPEF), right atrial active ejection fraction, RAAEF, longitudinal strains of right atrial reserve, conduit and systolic period (RASr, RAScd, RASct), circumferential strains of right atrial reserve, conduit and systolic period (RASr-c, RAScd-c, RASct-c). The differences in right atrial parameters among four groups were compared.ROC curve was used to analyze the diagnostic efficiency of right atrial four-dimensional strain parameters for PH patients with WHO-FC≥Ⅲ. Pearson linear correlation analysis was used to investigate the relationships between RASr and right atrial area (RAA), NT-proBNP and tricuspid annular plane systolic excursion to pulmonary arterial systolic pressure ratio (TAPSE/sPAP). Results:①Compared with the control group, RAEF, RAPEF, RASr, RAScd, RASr-c, RAScd-c were significantly decreased in mild, moderate and severe PH groups; while RAAEF, RASct, RASct-c were significantly increased in mild PH group and significantly decreased in moderate and severe PH groups, and the differences were statistically significant (all P<0.05). RAVImin, RAVImax, RAVIpreA gradually increased among the control, mild PH, moderate PH and severe PH groups, and the differences were statistically significant (all P<0.05). RAEF, RAPEF, RAAEF, RASr, RAScd, RASct, RASr-c, RAScd-c, RASct-c were decreased successively among mild, moderate and severe PH groups, and the differences were statistically significant (all P<0.05). ②ROC curve showed that RASr had the highest diagnostic efficiency in PH patients with WHO-FC ≥Ⅲ, and the cut-off value was 20.5% (AUC=0.914, P<0.001). ③Correlation analysis showed that RASr was correlated with RAA, NT-proBNP and TAPSE/sPAP ( r=-0.803, -0.621, 0.739; all P<0.001). Conclusions:The degree of right atrial function impairment increased in patients with mild, moderate and severe PH in turn. RASr is the best predictor of WHO-FC ≥Ⅲ in patients with pulmonary hypertension and is a potential parameter for risk stratification in patients with PH.

【Objective】 To investigate the effect of leukocyte-depleted suspended red blood cells (lds-RBCs) storaged for different time on blood transfusion effect of patients with hematologic diseases and malignant tumors, as well as to evaluate the storage quality of lds-RBCs in blood stations. 【Methods】 Seven hospitals (4 tertiary-A hospitals and 3 secondary-A hospitals), applying for blood from our blood center, were selected. Blood transfusion cases (medical record) and related data (indicators) of patients with blood diseases and malignant tumors in those hospitals from December 2018 to May 2019 were collected, including disease diagnosis (type) before transfusion, demographic characteristics, date of solo transfusion of lds-RBCs, units of lds-RBCs [(1~2)U/bag, 1 U=200 mL whole blood], different storage duration (1~5 weeks) (bar code), and hemoglobin (Hb) 48 h before and after transfusion. The efficacy of lds-RBCs (storaged for different time) transfusion in patients with hematologic diseases and malignant tumors was evaluated by statistical analysis. 【Results】 A total of 3 557 patients with hematologic diseases and malignant tumors were enrolled in this study. No significant changes were noticed in transfusion efficacy by blood transfusion unit, gender and previous transfusion history (P > 0.05). The effective rate of lds-RBCs in patients with blood diseases and malignant tumors, stratified by storage duration, i. e. storaged for >1~2 weeks, >2~3 weeks, >3~4 weeks and more than >4~5 weeks, was 78.77% vs 77.68% vs 75.06% vs 70.37%, and 79.32% vs 76.73% vs 72.79% vs 67.65%, respectively(P<0.05), with lds-RBCs of 4-5 storage weeks presenting the lowest transfusion efficacy in both groups of patients. 【Conclusion】 The storage time of most lds-RBCs supplied by our center is moren than 3 weeks, and the transfusion effect of lds-RBCs stored for 5 weeks needs further observation. In order to ensure and improve the efficacy of blood transfusion, evidence-based medicine and information management are needed to help the clinical gasp the advantageous time of blood products and shorten the storage-to-transfusion time of red blood cells.

PURPOSE: Details of patients hospitalized for asthma exacerbation in mainland China are lacking. To improve disease control and reduce economic burden, a large sample survey among this patient population is indispensable. This study aimed to investigate the clinical characteristics and outcomes of such patients.METHODS: A retrospective study was conducted on patients hospitalized for asthma exacerbation in 29 hospitals of 29 regions in mainland China during the period 2013 to 2014. Demographic features, pre-admission conditions, exacerbation details, and outcomes were summarized. Risk factors for exacerbation severity were analyzed.RESULTS: There were 3,240 asthmatic patients included in this study (57.7% females, 42.3% males). Only 28.0% used daily controller medications; 1,287 (39.7%) patients were not currently on inhaled corticosteroids. Acute upper airway infection was the most common trigger of exacerbation (42.3%). Patients with severe to life-threatening exacerbation tended to have a longer disease course, a smoking history, and had comorbidities such as hypertension, chronic obstructive pulmonary disease (COPD), and food allergy. The multivariate analysis showed that smoking history, comorbidities of hypertension, COPD, and food allergy were independent risk factors for more severe exacerbation. The number of patients hospitalized for asthma exacerbation varied with seasons, peaking in March and September. Eight patients died during the study period (mortality 0.25%).CONCLUSIONS: Despite enhanced education on asthma self-management in China during recent years, few patients were using daily controller medications before the onset of their exacerbation, indicating that more educational efforts and considerations are needed. The findings of this study may improve our understanding of hospital admission for asthma exacerbation in mainland China and provide evidence for decision-making.
Adrenal Cortex Hormones ; Asthma ; China ; Comorbidity ; Disease Progression ; Education ; Female ; Food Hypersensitivity ; Hospitalization ; Humans ; Hypertension ; Inpatients ; Medication Adherence ; Mortality ; Multivariate Analysis ; Pulmonary Disease, Chronic Obstructive ; Retrospective Studies ; Risk Factors ; Seasons ; Self Care ; Smoke ; Smoking

Objective To study the inducing factors and clinical characteristics of patients hospitalized for asthma exacerbation in China. Methods Patients hospitalized for asthma exacerbation at 29 hospitals in China were retrospectively recruited during 2013-2014. Results Clinical data of 3 240 asthmatic patients were collected and analyzed including 1 369(42.3%) males and 1 871(57.7%)females. The patients hospitalized for asthma exacerbation counted for 2.95% (6 375/215 955) of all patients hospitalized during the same period. The leading six inducing factors, in sequence, were acute upper respiratory tract infection[42.3%(1 370/3 240)],changes of weather[22.8%(738/3 240)],noxious gas[(4.3% (140/3 240), allergy challenges [3.5%(115/3 240)], strenuous exercise [1.8%(57/3 240)], and air pollution [1.5%(49/3 240)].In older patients,more exacerbations were induced by weather changes,yet less sensitive to allergy challenges. As to middle-aged patients, they were less sensitive to upper respiratory tract infections,however the difference was not statistically significant(P>0.05).In winter more asthma patients were induced by upper respiratory tract infections,while in autumn more patients were induced by weather changes,strenuous exercise and air pollution.In spring and summer more patients were induced by allergy challenges, but the differences failed to achieve statistical significance (P>0.05). In northern cities more patients were induced by upper respiratory infections, whereas in southern cities more by noxious gases. Allergy challenges and air pollution tended to affect more patients in northern cities,but the difference was of no significance (P>0.05). The differences of inducing factors among patients of different gender, with or without a smoking history, and with different exacerbation severity didn't show any statistical significance. The patients with severe and life-threatening exacerbations counted for 20.1%(652/3 240).The percentage of patients older than 60 years was higher in patients with severe or life-threatening exacerbations than in whose with mild or moderate exacerbations,so did the percentage of male patients,of patients with disease duration longer than 10 years, with smoking history, and with a history of hospitalization or emergency department visits due to asthma exacerbation during the last year.Conclusion The acute upper respiratory tract infection ranks top among all the inducing factors. Senility, male gender, long duration of disease, smoking history, and a history of frequent hospital visits might be the risk factors for severe or life-threatening asthma exacerbations.

Objective:To evaluate the clinical efficiency and prognostic factors of autologous peripheral blood stem cell trans-plantation (APBSCT) in 30 cases of multiple myeloma (MM). Methods:Two of the 30 patients received the second treatment of APB-SCT because of relapse after the first treatment. Thus, a total of 32 case-times of APBSCT were studied. Combination chemotherapy was inducted regularly before APBSCT (11 patients used bortezomib as an induction drug), and chemotherapy combined with the G-CSF regimen was used to mobilize peripheral blood stem cells. Preconditioning was based on melphalan. Results:Mononuclear cells in harvest were 6.41 × 108/kg, and CD34+cells in harvest were 4.75 × 106/kg. The median times of neutrophil and platelet engraftment were 9.5 and 11 d, respectively. The complete remission (CR) and very good partial remission (VGPR) rates were 37.5%and 34.4%af-ter APBSCT, respectively. The median overall survival (OS) was 67.27 months in all patients, and the median progression-free survival (PFS) was 29.77 months. The median PFS rates were 29 and 20 months in the patients who achieved CR and PR, respectively, and the median PFS was not observed in the patients who achieved VGPR. Statistical differences in PFS were detected between the CR+VGPR and PR groups (P=0.025). The CR rates were 63.6%and 23.8%in the bortezomib (bortezomib-based chemotherapy) and non-bortezo-mib groups (P=0.034), respectively. The median OS and PFS were not obtained in the bortezomib group, whereas the median PFS was 22 months in the non-bortezomib group (P=0.045). Conclusion: MM patients treated with bortezomib-based chemotherapy followed by APBSCT had prolonged PFS. APBSCT can improve the response and survival of MM patients.

OBJECTIVETo explore the clinical characteristics and prognostic value of monosomal karyotype (MK) patients in adult acute myeloid leukemia (AML).

METHODSWe retrospectively studied 45 patients of MK⁺ in newly-diagnosed adult AML in our center from Oct 2000 to Dec 2012. Clinical characteristics, cytogenetic data and prognostic features were analyzed in the cohort of MK⁺ patients.

RESULTSMK was found in 45 patients (19.0%) of 237 newly-diagnosed adult AML with cytogenetic data available at diagnoses. Among these 45 cases, there were 28 male (62.2%) and 17 female (37.8%). Median age of MK⁺ patients at diagnose was 58(18-91) years old. The presence of -5(31.1%) and -7(17.8%) were the most common chromatid among MK⁺ AML patients. MK was much more prevalent among elderly patients. Among AML patients, the proportions of MK⁺ patients younger than 30, 30 to 59 and older than 60 years old groups were 11.5%, 17.7% and 22.4%, respectively. There was no difference between MK⁺ and MK⁻ patients in gender distribution (P=0.545). There was also no difference between MK⁺ and MK⁻ patients in the distribution of FAB castigation (P=0.239). Median survival of MK⁺ AML patients was 6.5 months. Cumulative 5-year overall survival (OS) of was 5.2%. Forty-three MK⁺ patients (43/45, 95.6%) also had a complex karyotype (CK). Two cases that did not meet the CK had not achieved complete remission (CR), and died within 6 months. There were 12 patients who were CK⁺ in 192 MK⁻ patients. The differences of OS and CR rates between MK⁺CK⁺ patients and MK⁻CK⁺ were statistically significant (P<0.05).

CONCLUSIONThe increased detection rate of MK with age was associated with lower CR and OS in AML patients.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Chromosome Aberrations ; Female ; Humans ; Karyotyping ; Leukemia, Myeloid, Acute ; diagnosis ; genetics ; Male ; Middle Aged ; Monosomy ; Prognosis ; Remission Induction ; Retrospective Studies ; Young Adult

Objective To evaluate the effect of a modified culture method on the karyotype anomalies detection rate in elderly patients with multiple myeloma (MM),and to explore the relationship between clinical characteristics and chromosome anomalies in multiple myeloma.Methods Two culture methods were applied on the bone marrow samples which obtained from 28 MM patients.One method was used to culture cells for 24 hours with interleukin 6 (IL-6) 10 μg/L and granulocyte-macrophage colony-stimulating factor (GM-CSF) 40 μg/L,and the other for 6 days.Karyotype was analyzed by G-banding technique.Results In the 24-hour culture group,no metaphases cell was found in 4 cases (14.3 ％),karyotype anomalies were found in 6 cases in the other 24 cases,and the detection rate was 25.0％ (6/24).In the 6-day culture group,no metaphases cell was found in 1 patient (3.6％),karyotype anomalies were found in 15 cases in the other 27 patients,and the detection rate was 55.6％ (15/27).There was a significant difference in the detection rate of karyotype anomalies between the two groups (x2 =4.89,P ＜ 0.05).In 27 cases with enough metaphases in the 6-day culture group,20 cases were newly diagnosed or in progression,among whom karyotype anomalies were found in 14 cases (70.0％,14/20),and 7 cases were in stable phase,among whom karyotype anomalies were found in 1 case (14.3％,1/7).The detection rate of abnormal karyotype was higher in newly diagnosed or in progressive patients than in stable patients (P ＜0.05).Conclusions 6-day culture method can improve the detection rate of karyotype anomalies in elderly patients with multiple myeloma,which is better than 24-hour culture method.The detection rate of karyotype anomalies is higher in newly diagnosed or in progressive patients than in stable patients.