Objective:To analyze the risk factors of pulmonary thromboembolism (PTE) in patients with pulmonary tuberculosis (PTB), to improve the awareness of clinicians.Methods:A total of 120 PTB patients complicated with PTE (PTE group) and 120 PTB patients without PTB (control group) admitted to the Affiliated Hospital of Zunyi Medical University from January 2018 to December 2022 were included. Clinical data from both groups were collected and compared. Statistical analyses were performed using the chi-square tests and Mann-Whitney U test, and binary logistic regression analysis was performed to identify the risk factors for PTE in PTB patients. Results:The age of the PTE group was 69.00(63.00, 76.75) years. The rates of comorbid chronic pulmonary diseases, respiratory failure, and diabetes in PTE group were 40.00%(48/120), 24.17%(29/120), and 12.50%(15/120), respectively.The incidence rates of dyspnea, chest distress, chest pain, and palpitations in PTE group were 80.83%(97/120), 21.67%(26/120), 23.33%(28/120), and 10.00%(12/120), respectively. The D-dimer level in PTE group was 3.34 (2.05, 6.60) mg/L. These results were all higher than those in the control group (10.00%(12/120), 7.50%(9/120), 3.33%(4/120), 36.67%(44/120), 6.67%(8/120), 13.33%(16/120), 3.33%(4/120), and 0.97(0.41, 2.11) mg/L, respectively). The differences were all statistically significant ( χ2=28.80, 12.51, 6.92, 48.30, 11.10, 4.01 and 4.29, respectively, Z=-8.76; all P<0.05). Binary logistic regression analysis revealed that older age (odds ratio( OR)=1.057), comorbid chronic pulmonary diseases ( OR=2.998), diabetes ( OR=8.703), presence of dyspnea ( OR=5.132), and elevated D-dimer levels ( OR=1.672) were independent risk factors for PTE in PTB patients (all P<0.05). Conclusions:Older age, comorbid chronic pulmonary diseases, diabetes, dyspnea and elevated D-dimer levels are risk factors for PTE in PTB patients. Clinicians should remain vigilant to these factors to reduce the risk of missing PTE in this population.

Objective:To analyze the risk factors of pulmonary thromboembolism (PTE) in patients with pulmonary tuberculosis (PTB), to improve the awareness of clinicians.Methods:A total of 120 PTB patients complicated with PTE (PTE group) and 120 PTB patients without PTB (control group) admitted to the Affiliated Hospital of Zunyi Medical University from January 2018 to December 2022 were included. Clinical data from both groups were collected and compared. Statistical analyses were performed using the chi-square tests and Mann-Whitney U test, and binary logistic regression analysis was performed to identify the risk factors for PTE in PTB patients. Results:The age of the PTE group was 69.00(63.00, 76.75) years. The rates of comorbid chronic pulmonary diseases, respiratory failure, and diabetes in PTE group were 40.00%(48/120), 24.17%(29/120), and 12.50%(15/120), respectively.The incidence rates of dyspnea, chest distress, chest pain, and palpitations in PTE group were 80.83%(97/120), 21.67%(26/120), 23.33%(28/120), and 10.00%(12/120), respectively. The D-dimer level in PTE group was 3.34 (2.05, 6.60) mg/L. These results were all higher than those in the control group (10.00%(12/120), 7.50%(9/120), 3.33%(4/120), 36.67%(44/120), 6.67%(8/120), 13.33%(16/120), 3.33%(4/120), and 0.97(0.41, 2.11) mg/L, respectively). The differences were all statistically significant ( χ2=28.80, 12.51, 6.92, 48.30, 11.10, 4.01 and 4.29, respectively, Z=-8.76; all P<0.05). Binary logistic regression analysis revealed that older age (odds ratio( OR)=1.057), comorbid chronic pulmonary diseases ( OR=2.998), diabetes ( OR=8.703), presence of dyspnea ( OR=5.132), and elevated D-dimer levels ( OR=1.672) were independent risk factors for PTE in PTB patients (all P<0.05). Conclusions:Older age, comorbid chronic pulmonary diseases, diabetes, dyspnea and elevated D-dimer levels are risk factors for PTE in PTB patients. Clinicians should remain vigilant to these factors to reduce the risk of missing PTE in this population.

Objective: This is a study to evaluate complication rate, satisfaction and quality of life after breast reconstruction under different classifications. The classification criteria are the timing of operation, surgical procedures, and patients′age. Methods: By reviewing the surgical cases from August 2004 to June 2018, the authors summarized the data of 102 patients with breast reconstruction of the same surgeon in Peking University People′s Hospital and Plastic Surgery Hospital (Institute) CAMS PUMC. Fifty-four patients who met the inclusion criteria and completed the BREAST-Q breast reconstruction module scale, were divided into immediate group or delayed group, according to the timing of operation; divided into abdomen group or other procedures group, according to the surgical procedure; and divided into the young patients′group or senior patients′group according to age. The index were (1) postoperative complication rate, (2)satisfaction with breasts, psychosocial well-being, physical well-being of chest and abdomen, sexual well-being, satisfaction with outcome, satisfaction with information, satisfaction with care (based on the BREAST-Q scale). Results: Complication rate was 9.1%(1/11) in the immediate group, 16.3%(7/43) in the delayed group, 14.7%(5/34) in the abdomen group, 15.0%(3/20) in other procedures group, 13.6%(3/22) in the young patients′group, and 15.6%(5/32) in the senior patients′group. There was no significant difference in the incidence of complications (P>0.05). The postoperative scores of satisfaction with breasts, psychological well-being and sexual well-being were significantly higher in the immediate group than in the delayed group(P=0.026, P<0.001 and P=0.001, respectively). The score of postoperative physical well-being of chest was significantly higher in the abdomen group than other procedures group(P=0.020). The score physical well-being of abdomen was lower compared with the preoperative in the abdomen group (P<0.001). The score of physical well-being of abdomen was lower in the senior patients′group than that of the young patients′group (P=0.010). Conclusions The complication incidence of breast reconstruction patients was similar among different groups. The breast reconstruction surgery can significantly improve satisfaction and quality of life of patients. To some extent, immediate breast reconstruction can reduce the psychological and physiological effects of breast loss on patients, leading to higher postoperative satisfaction. Breast reconstruction with abdominal flaps can provide patients with better chest health but poor abdomen health. Although elderly patients undergoing breast reconstruction will have poor physical well-being of abdomen, they can still achieve higher satisfaction of operation.

Objective To investigate the effect of autologous tissue breast reconstruction with microsurgical lymph node transfers and lymphatic-venous anastomoses for the treatment of mastectomy related axillary cavitydeformation and upper extremity lymphedema .Methods The donor sites of lymph node transfers were mainly chosen according to the donor site of breast reconstruction .Themicrosurgical lymph nodes were transferred to the axillary cavity .When the superficial lymph vessels could be detected in lymphangiography with indocyanine green , thelymphatic-venous anastomoses were done to improve the lymphatic drainage .The treatment effect was assessed by the perimeter changes of different parts of upper extremity, the isotope lymphangiography and associated symptoms . Results 20 cases involved in autologous tissue breast reconstruction with microsurgical lymph node transfers , 18 cases from ingruinallymph nodes and 2 cases from lateral thoracic lymph nodes .2 cases receivedlymphatic-venous anastomoses on their upper extremity .The perimeters of palm and wrist were found significantly decreased in 6 months postoperation , while the perimeters of midpoint forearm and upper arm also decreased .The cellulitis, pain and swell happened less during the follow-up from 6 months up to 4 years. The postoperation isotope lymphangiography showed functional transferred lymph nodes inaxillary cavity , better lymphatic drainage and less volume of upper extremity .The subcutaneous superficial lymphatic drainage signs could be observed by the isotope lymphangiography in cases who had lymphatic -venous anastomoseson upper extremity .Conclusions Autologous tissue breast reconstruction with microsurgical lymph node transfers and lymphatic-venous anastomoses is a promising option for the treatment of mastectomy related axillary cavitydeformation and upper extremity lymphedema .The long term results need longer follow-up and more research .

Objective To investigate the effect of autologous tissue breast reconstruction with microsurgical lymph node transfers and lymphatic-venous anastomoses for the treatment of mastectomy related axillary cavitydeformation and upper extremity lymphedema .Methods The donor sites of lymph node transfers were mainly chosen according to the donor site of breast reconstruction .Themicrosurgical lymph nodes were transferred to the axillary cavity .When the superficial lymph vessels could be detected in lymphangiography with indocyanine green , thelymphatic-venous anastomoses were done to improve the lymphatic drainage .The treatment effect was assessed by the perimeter changes of different parts of upper extremity, the isotope lymphangiography and associated symptoms . Results 20 cases involved in autologous tissue breast reconstruction with microsurgical lymph node transfers , 18 cases from ingruinallymph nodes and 2 cases from lateral thoracic lymph nodes .2 cases receivedlymphatic-venous anastomoses on their upper extremity .The perimeters of palm and wrist were found significantly decreased in 6 months postoperation , while the perimeters of midpoint forearm and upper arm also decreased .The cellulitis, pain and swell happened less during the follow-up from 6 months up to 4 years. The postoperation isotope lymphangiography showed functional transferred lymph nodes inaxillary cavity , better lymphatic drainage and less volume of upper extremity .The subcutaneous superficial lymphatic drainage signs could be observed by the isotope lymphangiography in cases who had lymphatic -venous anastomoseson upper extremity .Conclusions Autologous tissue breast reconstruction with microsurgical lymph node transfers and lymphatic-venous anastomoses is a promising option for the treatment of mastectomy related axillary cavitydeformation and upper extremity lymphedema .The long term results need longer follow-up and more research .

Objective To compare the changes in optic disc parameters after intraocular pressure (lOP) reduction between primary angle-closure glaucoma (PACG) and primary open angle glaucoma (POAG) eyes, and to determine if there is a difference of lamina eribrosa compliance between POAG and PACG. Design Prospective comparative study. Participants 36 PACG (49 eyes) and 35 POAG (49 eyes). Methods Patients underwent Heidelberg Retina Tomography (HRT Ⅱ) and Humphrey visual field test before IOP reduction. HRT and Humphrey visual field test were repeated one month after the IOP was reduced by laser, anti-glaucomatous medications or surgery treatment. Factors that affected the change in IOP were assessed including age, pretreatment IOP, IOP reduction, initial cup: disc ratio and diagnosis (POAG/PACG). Main outcome measures Changes of HRT parameters including cup area, mean cup depth, cup volume, and rim area after IOP reduction. Results The cup area, mean cup depth and cup volume decreased, and rim area in-creased significantly when the IOP was reduced (P<0.05), but there were no significant differences in the changes between PACG and POAG patients (P>0.05). Changes of these four HRT parameters were related to the amount of IOP reduction and the baseline ratio of cup to disc(P>0.05), but not related to age and pre-treatment IOP (P<0.05). Conclusions The cup became smaller and the rim area in-creased after IOP lowering with treatment in both POAG and PACG, and the magnitude of the change was similar in both groups. The lamina cribrosa compliance may not be different between POAG and PACG. (Ophthalmol CHN, 2009, 18: 264-269)