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Multidisciplinary,three-dimensional and individualized comprehensive treatment for severe/critical COVID-19

Liver Research 2020年第3期4卷 109-117页

作者： Medical Panel of Severe/Critical COVID-19,the third affiliated hospital of Sun Yat-sen University the third affiliated hospital of Sun Yat-sen University GuangzhouChina

Severe/critical cases account for 18e20% of all novel coronavirus disease 2019(COVID-19)patients,but their mortality rate can be up to 61.5%.Furthermore,all deceased patients were severe/critical *** main reasons for the high mortality of severe/critical patients are advanced age(>60 years old)and combined underlying *** patients with comorbidities show decreased organ function and low compensation for damage such as hypoxia and inflammation,which accelerates disease *** lung is the main target organ attacked by severe acute respiratory syndrome coronavirus 2(SARSCoV-2)while immune organs,liver,blood vessels and other organs are damaged to varying *** volume is increased,and mild active inflammation and focal necrosis are observed in the portal *** particles have also been detected in liver ***,multidisciplinary teams(MDTs)and individualized treatment plans,accurate prediction of disease progression and timely interventions are vital to effectively reduce ***,a“multidisciplinary three-dimensional management,individualized comprehensive plan”should be *** treatment plan complies with three principles,namely,multidisciplinary management of patients,individualized diagnosis and treatment plans,and timely monitoring and intervention of *** members are mainly physicians from critical medicine,infection and respiratory disciplines,but also include cardiovascular,kidney,endocrine,digestion,nerve,nutrition,rehabilitation,psychology and specialty *** to a patient's specific disease condition,an individualized diagnosis and treatment plan is formulated(one plan for one patient).While selecting individualized antiviral,anti-inflammatory and immunomodulatory treatment,we also strengthen nutritional support,psychological intervention,comprehensive rehabilitation and timely and full-course intervention to develop overall and special nursing *** response to the rapid

关键词： Severe acute respiratory syndrome coronavirus 2(SARS-CoV-2) Novel coronavirus disease 2019(COVID-19) Severe COVID-19 Critical COVID-19 Treatment Multidisciplinary teams

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卫气虚证诊断规范

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北京中医药大学学报 2024年第8期47卷 1177-1179页

作者：北京中医药大学福建中医药大学河南中医药大学天津中医药大学第二附属医院广州中医药大学第二附属医院云南中医药大学第三附属医院王天芳不详

1范围本文件规定了卫气虚证诊断标准与卫气虚证严重程度评定。本文件适用于中、西医医疗机构,健康管理机构及中医治未病机构的医务工作者,对18周岁及以上具有卫气虚证表现的亚健康及疾病人群的卫气虚证诊断与程度评定。

关键词：卫气虚证诊断规范

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Canal Wall Reconstruction Mastoidectomy

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Journal of Otology 2007年第1期2卷 52-55页

作者： LIU Wei Department of Otolaryngology Head and Neck Surgery, third affiliated hospital, Sun Yat-Sen University, Guangzhou 510630, China Department of Otolaryngology Head and Neck Surgery Third Affiliated Hospital Sun Yat-Sen University Guangzhou 510630 China

Objective To investigate the advantages of canal wall reconstruction(CWR) mastoidectomy, a single-stage technique for cholesteatoma removal and posterior external canal wall reconstruction, over the open and closed procedures in terms of cholesteatoma recurrence. Methods: Between June 2002 and December 2005, 38 patients (40 ears) with cholesteatoma were admited to Sun Yat-Sen Memorial hospital and received surgical treatments. Of these patients, 25 were male with ages ranging between 11 and 60 years(mean = 31.6 years) and 13 were female with ages ranging between 20 and 65 years (mean = 38.8 years). Canal wall reconstruction(CWR)mastoidectomy was performed in 31 ears and canal wall down(CWD) mastoidectomy in 9 ears. Concha cartilage was used for ear canal wall reconstruction in 22 of the 31 CWR procedures and cortical mastoid bone was used in the remaining 9 cases. Results At 0.5 to 4 years follow up, all but one patients remained free of signs of cholesteatoma recurrence, i.e., no retraction pocket or cholesteatoma matrix. One patient, a smoker, needed revision surgery due to cholesteatoma recurrence 1.5 year after the initial operation. The recurrence rate was therefore 3.2% (1/31). Cholesteatoma recurrence was monitored using postoperative CT scans whenever possible. In the case that needed a revision procedure, a retraction pocket was identified by otoendoscopy in the pars flacida area that eventually evolved into a cholesteatoma. A pocket extending to the epitympanum filled with cholesteatoma matrix was confirmed during the revision operation, A decision to perform a modified mastoidectomy was made as the patient refused to quit smoking. The mean air-bone gap in pure tone threshold was 45 dB before surgery and 25 dB after(p < 0.05). There was no difference between using concha cartilage and cortical mastoid bone for the reconstruction regarding air-bone gap improvement, CT findings and otoendoscopic results. Conclusion CWR mastoidectomy can be used for most pati

关键词： Mastoidectomy Ear canal Reconstruction Cholesteatoma

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Spiral CT localization of pancreatic function-ing islet cell tumors

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Hepatobiliary & Pancreatic Diseases International 2004年第4期3卷 616-619页

作者： Qing Xu, Wen-Hua Chen and Qing-Juan Huang Nanjing, China Department of Radiology, First affiliated hospital of Nanjing Medical University, Nanjing 210029, China Department of Radiology, third affiliated hospital of Suzhou Univer- sity, Changzhou 213003, China Department of Radiology First Affiliated Hospital of Nanjing Medical University Nanjing 210029 China. xuqingst@***

BACKGROUND: Surgeons are always concerned about the localization of pancreatic functioning islet cell tumor. If the tumor is accurately localized before operation, resection of the pancreatic body and tail without intention can be avoided. The purpose of this study was to evaluate spiral CT localization of pancreatic functioning islet cell tumors and CT techniques. METHODS: CT manifestations in 6 patients with clinically and pathologically proved pancreatic functioning islet cell tumors ware analyzed retrospectively. RESULTS: In 4 patients with insulinomas and 2 patients with glucagonomas, 5 were localized accurately by CT be- fore surgery and 1 was detected retrospectively. The en- hancement of tumors was greater than that of normal pan- creas in arterial phase and pancreatic parenchymal phase. Four patients showed mild high-density and 2, iso-density in the portal venous phase. CONCLUSION: Spiral CT multi-phase enhanced scan with 1.5 ml/kg contrast agent and 2-5 mm slice width can loca- lize functioning islet cell tumors accurately.

关键词： islet cell tumor spiral CT enhanced scan

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Collagen proportionate area of liver tissue determined by digital image analysis in patients with HBV-related decompensated cirrhosis

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Hepatobiliary & Pancreatic Diseases International 2011年第5期10卷 497-501页

作者： Shi-Bin Xie, Chao Ma, Chao-Shuang Lin,Ying Zhang, Jian-Yun Zhu and Wei-Min Ke Department of Infectious Disease, third affiliated hospital, Sun Yat-Sen University, Guangzhou 510630, China Department of Infectious Disease Third Affiliated Hospital Sun Yat-Sen University Guangzhou 510630 China

BACKGROUND: The accurate assessment of the degree of hepatic fibrosis plays a critical role in guiding the diagnosis, treatment and prognostic assessment of chronic liver diseases. Liver biopsy is currently the most reliable method to evaluate the severity of hepatic fibrosis. However, liver biopsy is an invasive procedure associated with morbidity and mortality, and has several limitations in patients with decompensated cirrhosis. There is no report on the collagen proportionate area (CPA) of liver tissue in the decompensated stage of cirrhosis. This study aimed to determine the CPA of resected liver tissue samples from patients with HBV-related decompensated cirrhosis using digital image analysis, and to analyze the relationship between the CPA and liver functional reserve. METHODS: Fifty-three resected liver tissue samples from liver transplant patients with chronic hepatitis B-induced decompensated cirrhosis were stained with Masson’s trichrome, and the CPA in these samples was quantitatively determined using digital image analysis. The values of relevant liver function just before liver transplantation, the CPA in liver tissue, and their correlation were analyzed. RESULTS: The mean CPA at the decompensated stage of cirrhosis was 35.93±14.42% (11.24%-63.41%). The correlation coefficients of the CPA with a model for end-stage liver disease score, serum total bilirubin and international standard ratio of prothrombin B were 0.553, 0.519 and 0.533, respectively (P<0.001). With increasing CPA values, the three indices reflecting liver functional reserve also changed ***: The degree of fibrosis may be correlated with the functional reserve. With the advancement of fibrosis, the liver functional reserve is attenuated accordingly.

关键词： collagen proportionate area digital image analysis decompensated cirrhosis chronic hepatitis B

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Correlations of portal hypertensive gastropathy of hepatitis B cirrhosis with other factors

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Hepatobiliary & Pancreatic Diseases International 2002年第4期1卷 527-531页

作者： Wei-Dong Pan Rui-Yun Xun You-Ming Chen the Department of General Surgery Department of Contagious Diseases third affiliated hospital, Zhongshan University, Guangzhou 510630, China Department of General Surgery Third Affiliated Hospital Zhongshan University Guangzhou 510630 China. panweidong1968@***

Objective: To study the clinical relations of portal hy- pertensive gastropathy (PHG) of hepatitis B cirrho- sis to other factors. Methods: Three groups of subjects were studied pro- spectively at our hospital from March 2000 to March 2001: 159 hepatitis B cirrhotic patients with portal hypertension, 114 hepatitis B cirrhotic patients with- out portal hypertension, and 97 control subjects. Free portal vein pressure (FPP) was measured dur- ing surgery. Liver function was assessed by Pugh's modification of Child's criteria. The area of liver collagen fibrin was studied using color image analysis system. Esophageal varices were identified by Dagra- di grading. Gastric varices were identified according to Northern Italian Endoscopic Council (NIEC) grading. Hypersplenism was assessed with the reduc- tion of WBC, HGB and PLT. Hepatitis B virus in the gastric mucosa was detected by immunizing histo- chemistry. Helicobacter pylori (H. pylori) organisms were identified by rapid urease testing and/or exami- nation of the stained biopsy specimens (haematoxylin and eosin). To analyze the correlation between these endoscopic signs at the gastric level and other fac- tors. Results: The differences of FPP among the three groups (patients with grade Ⅰ, Ⅱ, and Ⅲ gastropa- thy) were not significant. There was no correlation between Child-Pugh classification grading and the se- verity of gastropathy (P=0. 153). The differences of the area of liver collagen fibrin among the three grade gastropathy were not statistically significant (P =0. 801). There was a significant difference in the prevalence of severe PHG among grade Ⅰ, Ⅱ, Ⅲ, Ⅳ and Ⅴ esophageal varices (P<0. 001). PHG was present in a similar percentage of patients with gas- tric varices compared with those without gastric vari- ces (P=0. 209). There was a significant difference in the severity between PHG and hypersplenism (P= 0. 003). Seven patients with PHG had no microscopic evidence of hepatitis B virus infection in the gastr

关键词： portal vein hypertension gastric mucosa gastric endoscopy stomach histopathology hepatitis B virus cirrhosis

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Retrospective Analysis of Nosocomial Infections in the Intensive Care Unit of a Tertiary hospital in China During 2003 and 2007

Retrospective Analysis of Nosocomial Infections in the Inten...

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第二届传染病诊治高峰论坛暨2009年浙江省感染病、肝病学术年会

作者： Department of Infectious Diseases the third affiliated hospital to Wenzhou Medical CollegeRui' an Zhejiang 325200 China. Ji Guang Ding Qing Feng Sun Liang Hong Jin Xian Yang Department of Laboratories the third affiliated hospital to Wenzhou Medical College Rui' an Zhejiang 325200 China Ke-Cheng Li Department of Infection and Liver Diseases The First affiliated hospital to Wenzhou Medical College Wenzhou Zhejiang 325000 China Ming Hua Zheng Department of Infectious Diseases Shanghai Changzheng hospital Shanghai 200003 China Xiao Hui Miao Wu Ni Intensive Care Unit the third affiliated hospital to Wenzhou Medical College Rui' an Zhejiang 325200 China Zhan Wei Ruan Department of hospital Infection Management the third affiliated hospital to Wenzhou Medical College Rui' an Zhejiang 325200 China Rui Wei Zhou Hai Jiao Zhou Department of Natural Products Chemistry School of Pharmacy Wenzhou Medical College Wenzhou Zhejiang 325035 China Wen Fei He

BACKGROUND Nosocomial infections,also called healthcare acquired infections or health care-associated infections,is defined by the CDC as a localized or systemic condition resulting from an adverse reaction to the presence of an infectious agent(s) or its toxin(s),without any evidence that the infection was present or incubating at the time of admission to the acute care *** infections have become an important public health issue

关键词： Retrospective Analysis of Nosocomial Infections in the Intensive Care Unit of a Tertiary hospital in China During 2003 and 2007

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Roux-en-Y choledochojejunostomy using novel magnetic compressive anastomats in canine model of obstructive jaundice

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Hepatobiliary & Pancreatic Diseases International 2012年第1期11卷 81-88页

作者： Chao Fan,Xiao-Peng Yan,Shi-Qi Liu,Chun-Bao Wang,Jian-Hui Li,Liang Yu,Zheng Wu and Yi Lv Department of Hepatobiliary Surgery and Department of Pathology,First affiliated hospital,School of Medicine,Xi’an Jiaotong University,Xi’an 710061,China Department of Surgical Oncology,third affiliated hospital,School of Medicine,Xi’an Jiaotong University,Xi’an 710068,China [a] Department of Hepatobiliary Surgery School of Medicine Xi'an Jiaotong University Xi'an 710061 Xi'an China [b] Department of Pathology First Affliated Hospital School of Medicine Xi'an Jiaotong University Xi'an 710061 Xi'an China [c] Department of Surgical Oncology Third Affliated Hospital School of Medicine Xi'an Jiaotong University (Shaanxi Provincial People's Hospital) Xi'an 710068 Xi'an China

BACKGROUND:The traditional hand-sewn Roux-en-Y choledochojejunostomy is technically complicated,and the incidence of postoperative complications has remained high.A set of novel magnetic compressive anastomats was introduced to facilitate choledochojejunostomy and improve the prognosis of ***:After ligating the common bile duct for 7 days,16 dogs were randomly divided into two groups (n=8 per group).Anastomats were used in the study group,and the traditional hand-sewn method was used in the control group for standard Roux-en-Y *** compared the operation time,incidence of complications,gross appearance,and pathological disparity in stoma between the two groups in 1-month and 3-month follow-up ***:The time spent on constructing the anastomosis for the study group was significantly *** no anastomotic stenosis occurred in the two groups,the narrowing rate of biliary-enteric anastomosis was much higher in the control *** was one case of bile leakage in the control group,whereas no bile leakage occurred in the study group.A smoother surface,an improved layer apposition,and a lower local inflammatory response were identified in the anastomosis of the study ***:The structures of the novel magnetic compressive anastomats are simple,and they are time-saving,safe and efficient for performing Roux-en-Y choledocho- jejunostomy procedures in a canine model of obstructive jaundice.

关键词： anastomosis,Roux-en-Y choledochostomy jaundice,obstructive magnetic compressive anastomats

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Therapeutic efficiency of short anterior urethral stricture treated with endourethral surgery combined with iridium 192 radiotherapy

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Journal of Pharmaceutical Analysis 2010年第4期22卷 281-284页

作者： Wei-Xing Qu1,Da-Lin He1,Shang-Shu Ding1,Yong-Yi Cheng2,Qing Wang31.Department of Urology,the First affiliated hospital,Medical School of Xi’an Jiaotong University,Xi’an 710061 2.Department of Urology,the third affiliated hospital,Medical School of Xi’an Jiaotong University,Xi’an 710068 3.Department of Radiology,the third affiliated hospital,Medical School of Xi’an Jiaotong University,Xi’an 710068,China Department of Urology First Affiliated Hospital Medical School of Xi'an Jiaotong University Xi'an 710061 China Department of Urology Third Affiliated Hospital Medical School of Xi'an Jiaotong University Xi'an 710068 China Department of Radiology Third Affiliated Hospital Medical School of Xi'an Jiaotong University Xi'an 710068 China

Objective To assess the therapeutic efficiency of short anterior urethral stricture treated with endourethral surgery combined with iridium 192 radiation therapy in order to decrease the recurrence rate after endourethral *** A total of 286 patients with anterior urethral stricture(stricture length ranging from 0.5 to 2.5 cm,averaging at 1.6 cm)were divided randomly into two groups after internal urethrotomy and cicatrix *** radiation group of 173 patients was treated as soon as possible with iridium 192 radiation therapy on the stricture sections while the control group of 113 patients was *** recurrence rate was compared between the two groups during one year’s *** Among all the 286 successful operations,stricture recurred in 19 patients of the radiation group(recurrence rate of 10.98%)and in 62 ones of the control group(recurrence rate of 54.86%),with a significant difference(P=0.003).Conclusion It is an effective way to prevent recurrence by treating patients as early as possible with iridium 192 radiation on the stricture sections after endourethral operation on anterior urethral stricture.

关键词： short anterior urethral stricture iridium 192 radiation therapy endourethral surgery

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Papular Mycosis Fungoides:A New Clinic Variant of Early and Benign Mycosis Fungoides?

Papular Mycosis Fungoides:A New Clinic Variant of Early and ...

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中华医学会第十八次全国皮肤性病学术年会

作者： Hong Shen affiliated third hospital of Hangzhou,Anhui Medical University

Case Report A 27-year-old man was refereed to our dermatology clinic for evaluation of persistent reddish-brown papules on his left chest and axillary(Figs 1A to 1C).He complained of asymptomatic papules without *** did not have a prior history of mycosis fungoides(MF) and denied the intake of any ***,papules of variable size,ranging from 1 1 mmto3 5mm,were distributed on his

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