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The Values of the Prognostic Nutrition Index and the Patient Generated-Subjective Global Assessment during the Nutritional Assessment of Patients with Gastrointestinal Tumors

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Journal of Nutritional Oncology 2021年第3期6卷 134-139页

作者： Jian Jian Wei Hong Xia Yan Qi Li Pancreatic and Gastric Surgery ward Cancer Hospital Chinese Academy of Medical ScienceBeijing 100021China Breast Surgery ward Cancer Hospital Chinese Academy of Medical ScienceBeijing 100021China

Objective To compare the value and consistency among the Patient Generated-Subjective Global Assessment(PG-SGA)and the Prognostic Nutrition Index(PNI)for assessing nutritional status in gastrointestinal tumor *** 251 patients from gastric cancer surgical ward from January 2019 to January 2020 were recruited through convenience sampling in this respective *** screening and assessment were conducted for 251 gastrointestinal tumor patients using the nutritional risk screening 2002(NRS 2002)PG-SGA,and the *** was calculated using the serum albumin level and the total lymphocyte count obtained from the patients’routine laboratory examination when they were admitted to the *** receiver operating characteristic(ROC)of the PG SGA and the PNI were plotted with the NRS 2002 used as the gold standard,and the diagnostic value of the PG-SGA and PNI was reflected by the area under the curve(AUC),sensitivity,specificity and Youden *** then determined the optimal cut-off for the PNI and tested the consistency of the PG-SGA and *** The optimal cut-off point for the PNI was calculated to be *** AUC of the PG-SGA was 0.908(95%CI 0.871-0.944).The sensitivity was 89.9%,specificity was 76.2%and the Youden index was *** AUC of the PNI was 0.594(95%CI 0.516-0.572).The sensitivity was 73.8%,specificity was 44.3%and the Youden index was *** the consistency test,the kappa value was 0.838(P<0.001).Conclusion The PNI is of limited value for assessing malnutrition,although it did have good consistency with the *** combination of the PNI and PG-SGA can be used for diagnosing assessing malnutrition in clinical practice.

关键词： Prognostic nutrition index Patient generated-subjective global assessment Nutritional risk screening 2002 Nutritional assessment Cut-offs Consistency test

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Severe pneumonia and acute myocardial infarction complicated with pericarditis after percutaneous coronary intervention:A case report

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World Journal of Clinical Cases 2022年第10期10卷 3222-3231页

作者： Wei-Chao Liu Shun-Bao Li Chen-Feng Zhang Xiang-Hui Cui The Third ward of the Department of Cardiology Baoding No.1 Central HospitalBaoding 071000Hebei ProvinceChina

BACKGROUND Cases of severe pneumonia complicated with acute myocardial infarction(AMI)with good prognosis after percutaneous coronary intervention(PCI)are rare,especially those with postoperative pericarditis and intestinal *** SUMMARY A 53-year-old male patient was admitted to the emergency department of our hospital because of paroxysmal chest tightness for 4 d,aggravated with chest pain for 12 *** symptoms,electrocardiography,biochemical parameters,echocardiography and chest computed tomography confirmed the diagnosis of severe pneumonia complicated with *** patient was treated with antiplatelet aggregation,anticoagulation,lipid regulation,vasodilation,anti-infective agents and direct *** patient was discharged after 3 wk of ***-up showed that the patient was asymptomatic without *** For patients with severe pneumonia complicated with AMI,PCI and antibiotic therapy is a life-saving strategy.

关键词： Severe pneumonia Acute myocardial infarction Percutaneous coronary intervention Pericarditis Intestinal obstruction Case report

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2015年肝脏肿瘤NCCN临床实践指南更新与解读

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中国实用外科杂志 2015年第3期35卷 283-286页

作者：刘连新李轲宇 Hepatic Surgical ward of the First Affiliated Hospital of Harbin medical University

2015年肝脏肿瘤V1版美国国立综合癌症网络(NCCN)指南变更重点包括:在肝细胞癌的筛查中明确了超声检查作为首选方式的重要性;外科手术部分提出了对于略超出美国器官共享网络移植标准的病人可以考虑肝移植;此外,超出米兰标准但降期治疗后... 详细信息

2015年肝脏肿瘤V1版美国国立综合癌症网络(NCCN)指南变更重点包括:在肝细胞癌的筛查中明确了超声检查作为首选方式的重要性;外科手术部分提出了对于略超出美国器官共享网络移植标准的病人可以考虑肝移植;此外,超出米兰标准但降期治疗后符合标准的病人也可考虑移植;强调局部治疗在非手术治疗方式中的重要性并更新经动脉放射栓塞(TARE)、调强放射疗法(IMRT)及质子束疗法(PBT)等治疗手段。NCCN临床实践指南为临床提供了借鉴,由于种族不同、地域有别以及肿瘤的异质性,更新后的标准需要接受临床实践的检验才能达到进一步完善。

关键词：肝细胞癌美国国立综合癌症网络调强放射疗法质子束疗法

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Low-dose immune tolerance induction for severe hemophilia A inhibitor patients:Immunosuppressants are generally not necessary for inhibitor-titer below 200 BU/mL

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Pediatric Investigation 2024年第2期8卷 91-100页

作者： Zhengping Li Jie Sun Zekun Li Zhenping Chen Guoqing Liu Wanru Yao Xiaoling Cheng Gang Li Yingzi Zhen Di Ai Yaohan Zhou Qianqian Mao Man-Chiu Poon Runhui Wu Hemophilia Comprehensive Care Center Hematology DepartmentHematology CenterBeijing Key Laboratory of Pediatric Hematology-OncologyKey Laboratory of Major Diseases in ChildrenNational Key Discipline of Pediatrics(Capital Medical University)Ministry of EducationBeijing Children’s HospitalCapital Medical UniversityNational Center for Children’s HealthBeijingChina Hematologic Disease Laboratory Hematology DepartmentHematology CenterBeijing Key Laboratory of Pediatric Hematology-OncologyKey Laboratory of Major Diseases in ChildrenNational Key Discipline of Pediatrics(Capital Medical University)Ministry of EducationBeijing Pediatric Research InstituteBeijing Children’s HospitalCapital Medical UniversityNational Center for Children’s HealthBeijingChina Department of Pharmacy Beijing Children’s HospitalCapital Medical UniversityNational Center for Children’s HealthBeijingChina Departments of Medicine Pediatrics and OncologyUniversity of Calgary Cumming School of MedicineCalgaryCanada

Importance:It remained unclear that the efficacy comparison between low-dose immune tolerance induction(LD-ITI)incorporating immunosuppressants(IS)when severe hemophilia A(SHA)patients had inhibitor-titer≥200 Bethesda Units(BU)/mL(LD-ITI-IS^(200) regimen)and LD-ITI combining with IS when SHA patients had inhibitor-titer≥40 BU/mL(LD-ITI-IS^(40) regimen).Objective:To compare the efficacy of the LD-ITI-IS^(200) regimen with that of the LD-ITI-IS^(40) regimen for SHA patients with high-titer ***:A prospective cohort study on patients receiving LD-ITI-IS^(200) compared to those receiving LD-ITI-IS^(40) from January 2021 to December *** received LD-ITI[FVIII 50 IU/kg every other day].IS(rituximab+prednisone)was added when peak inhibitor tier≥200 BU/mL in the LD-ITI-IS^(200) regimen and≥40 BU/mL in the LD-ITI-IS^(40) *** is defined as a negative inhibitor plus FVIII recovery≥66%of the ***:We enrolled 30 patients on LD-ITI-IS^(200) and 64 patients on LD-ITI-IS^(40),with similar baseline clinical characteristics.A lower IS-use rate was discovered in the LD-ITI-IS^(200) regimen compared to the LD-ITI-IS^(40) regimen(30.0%vs.62.5%).The two regimens(LD-ITI-IS^(200) ***-ITI-IS^(40))had similar success rate(70.0%vs.79.7%),median time to success(9.4 vs.10.6 months),and annualized bleeding rate during ITI(3.7 vs.2.8).The cost to success was lower for LD-ITI-IS^(200) than for LD-ITI-IS^(40)(2107 vs.3256 US Dollar/kg).Among patients with peak inhibitor-titer 40-199 BU/mL,10 non-IS-using(on LD-ITI-IS^(200) regimen)and 28 IS-using(on LD-ITI-IS^(40) regimen)had similar success rates(70.0%vs.78.6%)and time to success(9.0 vs.8.8 months).Interpretation:In LD-ITI,IS are not necessary for inhibitor titer<200 BU/mL.

关键词： Hemophilia A High-titer inhibitor Immune tolerance induction Immunosuppressant Low-dose

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Impact of failure mode and effects analysis-based emergency management on the effectiveness of craniocerebral injury treatment

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World Journal of Clinical Cases 2022年第2期10卷 554-562页

作者： Xiao-Lan Shao Ya-Zhou Wang Xiong-Hui Chen Wen-Juan Ding Department of Emergency Surgery ward 48 First Affiliated Hospital of Soochow UniversitySuzhou 215000Jiangsu ProvinceChina

BACKGROUND Craniocerebral injuries encompass brain injuries,skull fractures,cranial soft tissue injuries,and similar ***,the incidence of craniocerebral injuries has increased dramatically due to the increased numbers of traffic accidents and aerial work injuries,threatening the physical and mental health of *** To investigate the impact of failure modes and effects analysis(FMEA)-based emergency management on craniocerebral injury treatment *** Eighty-four patients with craniocerebral injuries,treated at our hospital from November 2019 to March 2021,were selected and assigned,using the random number table method,to study(n=42)and control(n=42)*** in the control group received conventional management while those in the study group received FMEA theory-based emergency management,based on the control ***-and post-interventions,details regarding the emergency situation;levels of inflammatory stress indicators[Interleukin-6(IL-6),C-reactive protein(CRP),and procalcitonin(PCT)];incidence of complications;prognoses;and satisfaction regarding patient care were evaluated for both *** For the study group,the assessed parameters[pre-hospital emergency response time(9.13±2.37 min),time to receive a consultation(2.39±0.44 min),time needed to report imaging findings(1.15±4.44 min),and test reporting time(32.19±6.23 min)]were shorter than those for the control group(12.78±4.06 min,3.58±0.71 min,33.49±5.51 min,50.41±11.45 min,respectively;P0.05);post-intervention serum indicator levels were lower in both groups than pre-intervention ***,serum levels of IL-6(17.35±5.33 pg/mL),CRP(2.27±0.56 mg/L),and PCT(0.22±0.07 ng/mL)were low

关键词： Craniocerebral injury Failure modes and effects analysis theory Emergency management Treatment effect

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Post-Exposure Prophylaxis against HBV and HIV Infection in Health Care Workers

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Advances in Infectious Diseases 2013年第3期3卷 193-199页

作者： Azar Hadadi Mojgan Karbakhsh Mehrnaz Rasoolinejad Mahboobeh Haji Abdolbaghi Nahid Hadadi Shirin Afhami Negin Esmaeelpour-Bazzaz Internal Medicine ward Sina Hospital Tehran University of Medical Sciences Tehran Iran

Healthcare Workers (HCWs) are constantly at risk of exposure to viral infections such as hepatitis B virus (HBV), human immune deficiency virus (HIV) and hepatitis C virus (HCV). We aim at demonstrating the results of a three-year period of a surveillance program in Iran with the prospective follow-up of HCWs exposed to blood-borne viruses. HCWs who had experienced an occupational exposure to HBV, HCV or HIV from September 2005 to 2008 were enrolled in the study. Age, gender, route of exposure, type of fluid, type of virus, job, department, working shift, work experience, wearing gloves when exposed, history of HBV vaccination and the serum level of anti HBs antibody were recorded for all participants through an individual interview. Serum samples were taken from both HCWs and the sources of exposure and were tested by enzyme linked immunosorbent assay (ELISA). The data were gathered through questionnaires completed by a nurse under the supervision of a specialist of infectious diseases. In this study, 100 HCWs who were occupationally exposed to HIV, HCV or HBV were included. Most exposures had occurred among nurses (35%), followed by residents (29%), interns (18%), housekeepers (7%), the lab staff (6%), and specialists (5%). Most of the exposures had occurred in emergency (21%) and surgical (20%) wards. The most common route of exposure was percutaneous injuries (77%) and the most common cases had contacted with needles and angiocaths (71.1%) during injection or opening vein routes (21%). Establishing a surveillance system for registering the occurrence of occupational hazardous exposures, performing prophylactic measures and following up the exposed is a necessity in hospitals so that the number of exposures and occupational diseases among the HCWs can be decreased.

关键词： Post-Exposure Prophylaxis HBV Infection HIV Infection Health Care Workers

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A cross-sectional study on the nurses’attitude towards rapid response system activation for clinically deteriorated patients

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Nursing Communications 2024年第6期8卷 1-8页

作者： Salamah Ahmed Taher Alnajei Jefferson Garcia Guerrero East Jeddah General Hospital/Jeddah First cluster Jeddah 22253Saudi Arabia Fakeeh College for medical Sciences Jeddah 22253 Saudi Arabia

Background:Hospitals have reported that implementing rapid response system activation(RRS)activation has increased patient *** a result,there has been growing interest in identifying factors that lead to successful RRS *** introducing an automated RRS activation system has prompted nurses to be more vigilant about monitoring vital signs,it has not necessarily encouraged them to conduct thorough patient assessments to identify early signs of ***:The current study aimed to assess nurses’attitudes towards RRS activation for clinically deteriorated patients in the clinical units of King Abdul-Aziz ***:A descriptive cross-sectional research design was utilised in the study,and 144 nurses working in the medical and surgical units of King Abdul-Aziz Hospital were recruited to participate using a convenient non-probability sampling ***:The study’s findings reported that nurses have a positive attitude towards RRS benefits(Mean=3.70;SD=0.70).Their overall attitude towards RRS activation among clinically deteriorated patients is still low positive(Mean=2.71;SD=0.61).The nurses’attitudes towards RRS benefits significantly differ among nationalities and the clinical area/unit where they were assigned,with a P-value of 0.0194 and 0.000,*** towards RRS barriers significantly differ among nationality(P-value=0.0037),education level(P-value=0.0032),area of assignment(P-value=0.020),and whether they have a good understanding of abnormal observations(P-value=0.0122).Regarding the nurses’attitude towards management belief,the significant result is only with the clinical area/unit of assignment with a P-value of ***:The current study found a low positive attitude towards RRS activation among ward nurses,especially given that monitoring vital signs is critical to their *** may fear being perceived as clinically inept for redundant activations caused by poor quality,but their attitude t

关键词： rapid response team rapid response system clinically deteriorated patients cardiopulmonary arrest medical-surgical nurses

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Association between the Lung Immune Prognostic Index and mortality in patients with idiopathic inflammatory myopathy-associated interstitial lung disease

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Asian Pacific Journal of Tropical Medicine 2023年第11期16卷 515-521页

作者： Dan Luo Zhihao Zhao Caizheng Li Wenjun Zhu Wei Zhou Lirong He Huifeng Yan Qiaoli Su General Practice ward/International medical Center ward General Practice Medical CenterWest China HospitalSichuan UniversityChengdu 610041China Department of Biomedical Engineering the Chinese University of Hong KongSha TinHong Kong SAR 999077China Department of Respiratory Medicine the Second Affiliated Hospital of Nanchang UniversityNo.1 Minde RoadNanchang 330006China Center for Prevention and Treatment of Cardiovascular Diseases the Second Affiliated Hospital of Nanchang UniversityNanchang 330006China Department of medical Imaging Center the Second Affiliated Hospital of Nanchang UniversityNo.1 Minde RoadNanchang 330006China

Objective:To explore the association between the Lung Immune Prognostic Index(LIPI)and 1-year all-cause mortality in patients with idiopathic inflammatory myopathy related interstitial lung disease(IIM-ILD).Methods:Patients who were diagnosed with IIM-ILD at West China Hospital,Sichuan University from January 2008 to December 2021 were retrospectively included and categorized into three groups based on *** and multivariable Cox proportional hazards models were conducted to explore potential association between the LIPI and patients'***:A total of 1116 patients were screened,and 830 were included in this *** multivariable Cox analysis showed that,compared with patients with poor LIPI,the hazard ratio(HR)for all-cause 1-year mortality was 0.22(95%CI 0.05-0.93,P=0.04)for patients in the good LIPI group(LDH<250 IU/L and dNLR<3).After excluding patients lost to follow-up within one year,a similar result was found for LIPI(HR 0.20,95%CI 0.05-0.86;P=0.03).Conclusions:Good LIPI was independently associated with decreased risk of all-cause 1-year mortality in patients with *** easy-to-obtain index might be served as a potential marker for assessing the prognosis of IIM-ILD.

关键词： Idiopathic inflammatory myopathy Interstitial lung disease Lung Immune Prognostic index All-cause mortality

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Management and implementation strategies of pre-screening triage in children during coronavirus disease 2019 pandemic in Guangzhou, China

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World Journal of Clinical Cases 2021年第12期9卷 2731-2738页

作者： Xuan Shi Yu-Tao Cai Xian Cai Xiu-Lan Wen Jing-Yan Wang Wen-Cheng Ma Jun Shen Jin-Xia Wu Hai-Yan Liu Jing Sun Pei-Qin He Yan Lin Dan-Yang Zhao Pei-Qing Li Department of Pediatric Emergency Guangzhou Women and Children’s Medical CenterGuangzhou Medical UniversityGuangzhou 510000Guangdong ProvinceChina Outpatient Department of Pediatrics Guangzhou Women and Children’s Medical CenterGuangzhou Medical UniversityGuangzhou 510000Guangdong ProvinceChina Emergency General ward Guangzhou Women and Children’s Medical CenterGuangzhou Medical UniversityGuangzhou 510000Guangdong ProvinceChina Department of Nursing Guangzhou Women and Children’s Medical CenterGuangzhou Medical UniversityGuangzhou 510000Guangdong ProvinceChina Department of Disease Control and Prevention Guangzhou Women and Children’s Medical CenterGuangzhou Medical UniversityGuangzhou 510000Guangdong ProvinceChina

BACKGROUND Emerging infectious diseases are a constant threat to the public’s health and health care systems around the *** disease 2019(COVID-2019),which was defined by the World Health Organization as pandemic,has rapidly emerged as a global health *** evolution and prevention of international implications require substantial flexibility of frontline health care facilities in their *** To explore the effect of the implementation and management strategy of prescreening triage in children during *** The standardized triage screening procedures included a standardized triage screening questionnaire,setup of pre-screening triage station,multi-point temperature monitoring,extensive screenings,and two-way *** order to ensure the implementation of the pre-screening triage,the prevention and control management strategies included training,emergency exercise,and staff *** analysis was performed on the data from all the children hospitalized from January 20,2020 to March 20,2020 at solstice during the pandemic *** were obtained from questionnaires and electronic medical record *** A total of 17561 children,including 2652 who met the criteria for screening,192 suspected cases,and two confirmed cases without omission,were screened from January 20,2020 to March 20,2020 at solstice during the pandemic *** was zero transmission of the infection to any medical *** The effective strategies for pre-screening triage have an essential role in the prevention and control of hospital infection.

关键词： COVID-19 Pre-screening triage Management Implementation Strategies Pandemic

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Risk factors for delirium after surgery for craniocerebral injury in the neurosurgical intensive care unit

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World Journal of Clinical Cases 2022年第21期10卷 7341-7347页

作者： Ri-Yu Chen Chang-Hui Zhong Wei Chen Ming Lin Chang-Fu Feng Chang-Neng Chen Radiology Department Intervention Room Hainan General Hospital(Hainan Affiliated Hospital of Hainan Medical University)Haikou 570311Hainan ProvinceChina Department of Critical Medicine The First Affiliated Hospital of Hainan Medical UniversityHaikou 570100Hainan ProvinceChina Second ward Department of Critical MedicineThe Second Affiliated Hospital of Hainan Medical UniversityHaikou 570311Hainan ProvinceChina

BACKGROUND Postoperative delirium is common in patients who undergo neurosurgery for craniocerebral ***,there is no specific medical test to predict postoperative delirium to *** To explore risk factors for postoperative delirium in patients with craniocerebral injury in the neurosurgery intensive care unit(ICU).METHODS A retrospective analysis was performed in 120 patients with craniocerebral injury admitted to Hainan People’s Hospital/Hainan Hospital Affiliated to Hainan medical University,The First Affiliated Hospital of Hainan medical University,and The Second Affiliated Hospital of Hainan medical University between January 2018 and January *** patients were categorized into groups based on whether delirium *** them,25 patients with delirium were included in the delirium group,and 95 patients without delirium were included in the observation *** regression analysis was used to explore the association between sex,age,educational level,Glasgow coma scale(GCS),complications(with or without concussion,cerebral contusion,hypoxemia and ventricular compression)and site of injury and *** The GCS score above 8 and concomitant disease of cerebral concussion,cerebral contusion,hypoxemia and ventricular compression,and damage to the frontal lobe were associated with delirium in patients admitted to neurosurgical intensive care unit(ICU)(all P<0.05).However,age,sex,administration more than three medicines,and educational level were not significantly associated with the onset of delirium in patients with craniocerebral injury in the neurosurgical ICU(P<0.05).Multivariate logistic regression analysis showed that GCS score above 8,cerebral concussion,cerebral contusion,hypoxemia,ventricle compression,and frontal lobe disorders were independent risk factors for delirium in patients with craniocerebral injury in the neurosurgical ICU(P<0.05).CONCLUSION GCS score,concussive concussion,cerebral contusion,hypoxemia,ventricle compr

关键词： Brain injury Delirium Neurosurgery Intensive care unit Risk factors

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