Objective:To evaluate the effects of pulmonary embolism response team (PERT) on the quality of care and clinical outcomes in patients with acute pulmonary embolism.Methods:This was a single-center retrospective cohort study. Patients with acute pulmonary embolism treated in Beijing Anzhen Hospital Affiliated to Capital Medical University from July 5, 2016 to July 4, 2018 were enrolled. Patients with acute pulmonary embolism who had traditional care from July 5, 2016 to July 4, 2017 (before the implementation of PERT) were classified as PERT pre-intervention group. Patients with acute pulmonary embolism who started PERT care from July 5, 2017 to July 4, 2018 were divided into the PERT intervention group. The diagnosis and treatment information of patients was collected through the electronic medical record system, and the quality of care (time from visit to hospitalization, time from hospitalization to anticoagulation initiation, time from visit to definitive diagnosis, total hospital stay, time in intensive care unit (ICU), hospitalization cost) and clinical outcomes (in-hospital mortality and incidence of bleeding) were compared between the two groups.Results:A total of 210 patients with acute pulmonary embolism, aged (63.3±13.7) years old, with 102 (48.6%) female patients were included. There were 108 cases in PERT pre-intervention group and 102 cases in PERT intervention group. (1) Quality of diagnosis and treatment: there was a statistical significance between the two groups in the distribution of time from diagnosis to definitive diagnosis ( P=0.002). Among them, the rate of completion of diagnosis within 24 hours after PERT intervention was higher than that before PERT intervention (80.4% (45/56) vs. 50.0% (34/68), P<0.001). The time from treatment to hospitalization was shorter than that before PERT intervention (180.0 (60.0, 645.0) min vs. 900.0 (298.0, 1 806.5) min, P<0.001). The total length of hospital stay was less than that before PERT intervention (12 (10, 14) d vs. 14 (11, 16) d, P=0.001). There was no statistical significance in the time from hospitalization to anticoagulant therapy, the length of ICU stay and hospitalization cost between the two groups (all P>0.05). (2) Clinical outcomes during hospitalization: There was no statistical significance in the incidence of hemorrhage and mortality between the two groups during hospitalization (both P>0.05). Conclusion:PERT has improved the efficiency of diagnosis and treatment of patients with acute pulmonary embolism and significantly shortened the total hospital stay, but its impact on clinical outcomes still needs further study.

Objective:To detect the expression of angiogenic factor (AGGF1) with G-patch and FHA domain 1 in hepatocellular carcinoma (HCC), and to investigate its relationship with HCC angiogenesis, invasion and metastasis and its clinical significance.Methods:A total of 90 primary HCC patients were selected from the Huangshi Central Hospital and Hubei Province Cancer Hospital from January 2019 to September 2020. Clinicopathological data of all patients were collected. The expression of AGGF1 and CD34 in cancer tissues of 90 HCC patients was detected by immunohistochemistry, and microvascular density (MVD) was calculated. The patients were followed up for three years. The relationship between AGGF1 and serum angiopoietin-2 (Ang-2) content, MVD, clinicopathological parameters and postoperative prognosis was analyzed.Results:The positive rate, relative expression level and MVD value of AGGF1 in HCC tissues were significantly higher than those in adjacent tissues (all P<0.05). The relative expression of AGGF1 in cancer tissues was positively correlated with the MVD value ( r=0.716). Serum Ang-2 content and MVD in AGGF1-positive patients were significantly higher than those in AgGF1-negative patients (all P<0.01). AGGF1 expression in HCC tissues was significantly correlated with tumor differentiation, tumor size, (China Liver Cancer (CNLC) staging, lymph node metastasis, vascular invasion, and postoperative recurrence and metastasis (all P<0.01). Kaplan-Meier analysis showed that the 2- and 3-year survival rates of patients with high AGGF1 expression were significantly lower than those of patients with low AGGF1 expression (all P<0.01). Multivariate analysis showed that CNLC stage, lymph node metastasis, vascular invasion, AGGF1 expression, postoperative recurrence and metastasis were the influencing factors for postoperative survival of HCC patients (all P<0.05). Conclusions:The high expression of AGGF1 can promote the angiogenesis of HCC, and is significantly correlated with invasion and metastasis and poor prognosis, which can be a potential evaluation indicator of HCC clinical prognosis.

Anti-seizure medications (ASMs) are the main therapy for epilepsy.There are many kinds of ASMs with complex mechanism of action, so it is difficult for pharmacists to examine prescriptions.This paper put forward some suggestions on the indications, dosage forms/routes of administration, appropriateness of usage and dosage, combined medication and drug interaction, long-term prescription review, individual differences in pathophysiology of children, and drug selection when complicated with common epilepsy, for the reference of doctors and pharmacists.

Objective: To compare the efifcacy of direct and pre-dilated atherectomy (RA) for treating the patients with calciifed coronary lesions. Methods: A total of 137 coronary artery disease (CAD) patients received RA treatment in our hospital from 2010-04 to 2014-09 were retrospectively studied. The ischemic related lesions were all deifned as calciifed coronary lesions. The patients were divided into 2 groups: Direct RA group,n=81 and Pre-dilated RA group, the patients received balloon dilatation followed by RA,n=56. The procedural features, complications, in-hospital and 1 year occurrence rates of major cardiaccerebral vascular events (MACCE) were compared between 2 groups. Results: Compared with Pre-dilated RA group, Direct RA group had the less pre-stent balloon application,P=0.000 and the higher maximum post-dilatationpressure,P=0.004; lower rate of in-operative complication (14.8% vs 32.1%),P=0.016; higher rate of acute lumen gain (128.52±75.77) % vs (77.12±27.01) %,P=0.004; lower MACCE occurrencerate(7.3% vs 23.6%) at 1 year period,P=0.006.Cox regression analysis presented that the following indexes were related to MACCE occurrence within 1 year of RA treatment: balloon dilatation before RA (HR=8.166, 95% CI 1.872-35.614,P=0.005), left main disease (HR=13.649, 95% CI 2.983-62.440,P=0.001), minimum post-operative lumen area (HR=0.583, 95% CI 0.378-0.879,P=0.010), post-dilatation (HR=0.066, 95% CI 0.013-0.332,P=0.001) and EF>40% (HR=0.019, 95% CI 0.002-0.158, P=0.000). Conclusion: Direct RA had the lower MACCE occurrence rate at 1 year period, this might be related to less operative complication and the optimal lumen gain.

Objective To summarize the nursing experience of nursing ocular hypertensive patients having undergone vitrectomy for proliferative diabetic retinopathy.Methods Twenty-one ocular hypertensive patients having undergone vitrectomy for proliferative diabetic retinopathy were assisted to take the correct posture.They were closely observed for timely detection of ocular symptoms and signs and asked to take antihypertensive drugs.At the same time,those with neovascular glaucoma and laser iris neovascular glaucoma plasty were carefully nursed.Results Among the 21 patients(25 eyes),15 patients(18 eyes)had intraocular pressure normalized by way of medicine treatment,the intraocular pressure in another two eyes normalized after laser peripheral iridoplasty;the pressure in another one normalized after laser peripheral iridoplasty combined with peripheral iridectomy and another 4 eyes developed with neovascular glaucoma.Conclusion Combined with the operation,postoperative observation and nursing of postoperative high intraocular pressure can effectively reduce the incidence of ocular hypertension after pars plana vitrectomy for proliferative diabetic retinopathy.

Objective:To evaluate the efficacy and safety of pegaspargase plus GEMOX (pegaspargase, gemcitabine, oxaliplatin) regimen in the initial treatment of nasal NK/T-cell lymphoma. Methods: Twelve preliminarily diagnosed nasal NK/T-cell lymphoma patients in Tianjin Medical University Cancer Institute and Hospital from June 2011 to March 2012 were analyzed. All patients took the pegaspargase plus GEMOX regimen (gemcitabine 800-1 000 mg/m2 on days 1 and 8, oxaliplatin 130 mg/m2 on day 1, and pegaspargase 2 500 IU/m2 on day 2), every three weeks for one cycle. The efficacy and toxicity of the regimen were evaluated in the follow-up treat-ment. Results:After two cycle treatments, 1 patient dropped out of treatment because of acute pancreatitis;the remaining 11 patients had response, in which 1 achieved complete response , 7 had partial response, 2 had stable disease, and 1 had progressive disease. The objective response rate was 72.7%, and the disease control rate was 90.9%. The 2-year overall survival rate was 90.9%. With median 6-cycle P-GEMOX regimen treatment, 81.8% of 11 patients presented side effects, primarily myelosuppression and hepatic dysfunc-tion. Conclusion:Pegaspargase plus GEMOX regimen showed high efficacy on the initial treatment of nasal NK/T-cell lymphoma pa-tients, but the incidence of adverse effect was still high.

Objective:To evaluate the clinical effect of minimally invasive extraction of impacted supernumerary teeth.Methods :35 cases of impacted supernumerary teeth were included.Excluding extraction contraindications,preoperative X-ray or dental CT examina-tion was executed to find out the location of the impacted teeth and adjacent anatomical structures.According to the location,operation approach was selected to extract the impacted supernumerary teeth using minimally invasive apparatus.Intraoperative and postoperative feeling of the patients and the complications were recorded.Results:Operation time lasted from 1 0 to 40 minutes,average 1 5 minutes. All patients maintained good comfort in the operation.8.6% patients had postoperative adverse reactions such as mild pain and discom-fort.None had serious reactions.Conclusion:Minimally invasive extraction of impacted supernumerary teeth has less complication and less uncomfort.

The aim of this paper is to study the methods of 3D visualization and the 3D interactive clipping of CT/MRI image sequence in arbitrary orientation based on the Visualization Toolkit (VTK). A new method for 3D CT/MRI reconstructed image clipping is presented, which can clip 3D object and 3D space of medical image sequence to observe the inner structure using 3D widget for manipulating an infinite plane. Experiment results show that the proposed method can implement 3D interactive clipping of medical image effectively and get satisfied results with good quality in short time.
Algorithms ; Image Interpretation, Computer-Assisted ; methods ; Imaging, Three-Dimensional

Bendamustine is a kind of nitrogen mustard derivatives consisting of a 2-chloroethylamine alkylating group and a benzimidazole ring.This special structure grants its anti-cancer mechanism different from other common alkylating agents with double function.Since approved,bendanustine has been widely used to treat henatologic malignancies and solid tumors such as breast cancer.In 2008,the FDA approved bendamustine injection for the treatment of chronic lymphocytic leukemia and indolent B cell non-Hodgkin's lymphoma.In recent years,scholars in China and abroad have carried out a series of clinical researches on single bendamustine and bendamsutine combinational chemotherapy,especially in hematologic malignancies,which obtained certain clinical efficacy.In this paper,the pharmacological actions,pharmacokinetics and clinical progress of bendamustine in lymphoma and leukemia are reviewed.

The aim of this paper is to study the methods of 3D visualization and the 3D interactive clipping of CT/MRI image sequence in arbitrary orientation based on the Visualization Toolkit (VTK). A new method for 3D CT/MRI reconstructed image clipping is presented, which can clip 3D object and 3D space of medical image sequence to observe the inner structure using 3D widget for manipulating an infinite plane. Experiment results show that the proposed method can implement 3D interactive clipping of medical image effectively and get satisfied results with good quality in short time.