Objective To investigate the safety and effectiveness of percutaneous nephrostomy in the treatment of obstructive urinogenic sepsis complicated with thrombocytopenia.Methods Clinical data of 116 patients with urogenic sepsis complicated with thrombocytopenia admitted to Xiaogan Hospital of Wuhan University of Science and Technology from October 2017 to May 2021 were collected.There were 23 patients with abnormal renal function indexes(serum creatinine＞500 mmol/L).Preoperative urinary tract CT or ultrasound were performed to confirm hydronephrosis.According to the number of platelets in preoperative blood routine,they were divided into study group(platelet＜50 × 109/L)and control group(platelet ≥ 50 × 109/L).Percutaneous nephrostomy was performed under ultrasound guidance in both groups.The outcome indexes included the success rate of operation,body temperature,routine white blood cell count,the time to return to normal of procalcitonin,postoperative bleeding,shock,and side injury.Results In the study group,preoperative fever time was(6.9±2.2)days,platelet count was(35± 10.2)x 109/L,preoperative procalcitonin(PCT)was(36±6.2)ng/ml,and serum creatinine increased by 30％.While,the data in control group were(4.2+2.0)days,(115±58.9)x 109/L,(20±2.6)ng/ml and 12％,respectively.The difference between the two groups was statistically significant(P＜0.05).The recovery time of PCT in study group and control group was(6.9±2.8)days and(4.8±1.5)days,respectively.The normal recovery time of body temperature was(36.2±3.5)hours and(28.5±2.3)hours,respectively.The recovery time of white blood cell count was(5.3± 1.2)days and(3.2±2.5)days,respectively.The recovery time of platelet was(6.0±2.3)days and(3.5±2.0)days,respectively.The difference between the two groups was statistically significant(P＜0.05).There was no significant difference in surgical success rate,postoperative collateral injury,massive hemorrhage,shock and other complications between the two groups(P＞0.05).Conclusion Percutaneous nephrostomy(PCN)is effective and safe in the treatment of urogenic sepsis with thrombocytopenia,and it is worth popularizing.

Visual hallucination(VH)is a common symptom of schizophrenia,the underlying mechanism has not been fully elucidated.It has been found that the dysfunction of dopamine(DA)system,the overactivation of α-amino-3-hydroxy-5-methyl-4-isoxazole-propionate(AMPA)receptor in glutamate system and the dysfunction of γ-aminobutyric acid(GABA)ergic neurons can induce VH in patients with schizophrenia.In addition,abnormalities in brain structural and functional networks and visual networks are also closely related to the occurrence of VH.The purpose of this paper is to review the neurochemistry and nerve injury mechanism of VH in schizophrenic patients to deeply understand the characteristics of VH,and make more accurate judgment in the early diagnosis,condition evaluation and treatment plan of schizophrenic patients.

INTRODUCTION: There is limited literature on clinical outcomes following percutaneous coronary intervention (PCI) in Asian dialysis patients. We evaluated the angiographic characteristics and clinical outcomes of dialysis patients treated with PCI in an Asian society. METHODS: A retrospective analysis was performed of 274 dialysis patients who underwent PCI in a tertiary care institution from January 2007 to December 2012. Data on clinical and angiographic characteristics was collected. The primary endpoint was major adverse cardiac events (MACE), defined as a composite of cardiac death, acute myocardial infarction (AMI) and stroke at two years. RESULTS: 274 patients (65.0% male, median age 62.0 years) with 336 lesions (81.8% Type B2) were treated. 431 stents (35.0% drug-eluting stents) with a mean diameter of 2.96 mm and mean length of 21.30 mm were implanted. The MACE rate was 55.8% (n = 153) at two years, from death (36.5%) and AMI (35.0%). In multivariable analysis, age and diabetes mellitus were significant predictors of both mortality (odds ratio [OR] 1.09, 95% confidence interval [CI] 1.05-1.12, p < 0.001; OR 2.65, 95% CI 1.46-4.82, p = 0.001, respectively) and MACE (OR 1.06, 95% CI 1.03-1.08, p < 0.001; OR 1.84, 95% CI 1.07-3.15, p = 0.027, respectively). Left ventricular ejection fraction (LVEF) (OR 0.97, 95% CI 0.95-0.99, p = 0.006) was a significant predictor of mortality but not MACE. CONCLUSION Asian dialysis patients who underwent PCI had a two-year MACE rate of 55.8% due to death and AMI. Age, LVEF and diabetes mellitus were significant predictors of mortality at two years.