Table of Content

20 December 2021, Volume 36 Issue 12

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Risk factors of lung cancer with pulmonary embolism:a meta-analysis

Huang Ping, Liu Hanyun, Li Yuhong

2021, 36(12):  1061-1066.  doi:10.3969/j.issn.1004-583X.2021.12.001

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Objective To evaluate the risk factors of lung cancer with pulmonary embolism systematically. Methods By January 2021, pertinent literature on risk factors of lung cancer with pulmonary embolism were included form PubMed, Embase, CNKI, Wanfang database and others. Two researchers independently completed the literature screening, data extraction and quality evaluation of the included literature. RevMan5.4 software and Stata16.0 software were used to conduct meta-analysis. Results A total of 25 studies involving 3480 patients were included. Meta-analysis results show that the risk factors of pulmonary embolism in patients with lung cancer include adenocarcinoma (OR =2.06, 95% CI [1.75, 2.44], P <0.01), tumor stage (stage Ⅲ-Ⅳ)( OR =2.67, 95% CI [2.19, 3.26], P <0.01), chemotherapy (OR =2.69, 95% CI [2.08, 3.47], P <0.01), deep vein catheterization (OR =2.66, 95% CI [1.68, 4.19], P<0.01), albumin<30 g/L(OR=6.65, 95% CI [2.91, 15.18], P<0.01), D dimer>500 g/L (OR =5.87, 95% CI [2.12, 16.27], P <0.01), white blood cells >11×10⁹/L(OR =8.26, 95% CI [4.50, 15.13], P <0.01) and chronic obstructive pulmonary disease(OR =1.51, 95% CI [1.16, 1.95], P <0.01). Conclusion The risk factors for pulmonary embolism with lung cancer are adenocarcinoma, tumor staging (stage Ⅲ-Ⅳ), chemotherapy, deep venous catheterization, albumin <30 g/L, D-dimer >500 ng/mL, white blood cell >11×10⁹/L and chronic obstructive pulmonary disease(COPD). Due to limited quality and quantity of the included studies, more high-quality articles are needed to verify the conclusions.

Safety of lumbar drainage on aneurysm subarachnoid hemorrhage in patients: a meta-analysis

Ma Hongmei, Li Yuemei, Li Xiaofang, Pan Shiqin

2021, 36(12):  1067-1072.  doi:10.3969/j.issn.1004-583X.2021.12.002

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Objective To evaluate the effect of lumbar drainage (LD) on cerebral aneurysms subarachnoid hemorrhage (aSAH). Methods A randomized controlled trials (RCTs) of LD on cerebral aSAH were searched from PubMed, Cochrane Library, Elsevier Science Direct, Springer, China academic Journal full-text Database (CNKI),Wanfang, China Biomedical Literature Database (CBM), and other databases. Methodological quality of the included literatures were evaluated by using Cochrane Handbook for Systematic Reviews of Interventions, and Meta-analysis was performed by using RevMan 5.2 software. Results Totally 11 literatures were inclused,including 1216 patients.Meta-analysis results showed that in terms of efficacy and safety of clinical treatment for aSAH was better in continuous LD group (experimental group) than control group, the incidence of neurological impairment was lower than in control group (MD =0.33, 95%CI [0.21-0.51], P<0.01), and the incidence of cerebral vasospasm was lower than in control group (MD =0.20, 95%CI [0.12-0.34], P<0.01), the incidence of hydrocephalus was lower than in control group (MD =0.25, 95% CI [0.14-0.43], P<0.01), the mortality was lower than in control group (MD=0.40, 95%CI [0.23-0.70], P<0.01), but other adverse events were higher than those in control group (SMD=3.24, 95%CI [1.63-6.47], P=0.008). Conclusion The safety of continuous LD for aSAH in patients is better than other treatment methods. We need to consider the unsafety factors will lead to adverse events, due to lower methodology quality is in this literature, the efficacy and safety still need to be further verified.

Situation of ischemic stroke-related residual dysfunction in patients and its influencing factors in community

Zhang Qin, Wang Shubin, Su Xuan, Yuan Rui, Gao Mengxi, Guo Liru

2021, 36(12):  1073-1078.  doi:10.3969/j.issn.1004-583X.2021.12.003

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Objective To survey the situation of residual dysfunction of ischemic stroke (IS) in patients and its influencing factors in community. Methods This study included IS patients who admitted to the community health service centers in Shijiazhuang City ( Taoyuan Community, Yuqiang Community, Dongyuan Community) from May to September 2020. A questionnaire focusing on those target population were performed which supplied by the platform named “Wenjuanxing”. The general address data and stroke-related data was collected by general practitioners in the community, and to screen influencing factors for stroke-related residual dysfunction. Results There are 122 males (52.6%) and 110 females (47.4%) in out of involved 232 IS patients, of which 99 patients (42.7%) had sequelae. Multivariate logistic regression analysis suggested that the main influencing factors for stroke-related residual dysfunction were whether dyslipidemia, coronary heart disease, long-term mental stress, regular exercise, recurrence of stroke, and glucose stability (P<0.05). Conclusion For IS patients, the influencing factors for stroke-related residual dysfunction are dyslipidemia, coronary heart disease, long-term mental stress, recurrence of stroke; Protective factors for those was regular exercise and glucose stability. Proper diet, aerobic exercise and drug intervention is capable controlling patient's glycemia, blood lipids and weight in the normal range, which has positive significance in preventing and reducing stroke-related residual dysfunction.

Correlation analysis of nutritional status and prognosis for heart failure in elderly women

Li Heng, Li Yonghui, Wang Lin, He Feng

2021, 36(12):  1079-1082.  doi:10.3969/j.issn.1004-583X.2021.12.004

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Objective To explore the application value of mini nutritional assessment short-form version(MNA-SF) for assessing nutritional status of heart failure(HF) in elderly women and its relationship with poor prognosis. Methods The data of 279 elderly HR women, who treated in our hospital from January 1, 2018 to January 1, 2020 were enrolled to analyze the clinical characteristics. MNA-SF score was used to assess the nutritional status, and the correlation between MNA-SF score and prognosis was explored. Results Malnutrition rate of cardiac function level Ⅳ in those patients was significantly higher than that of cardiac function level Ⅱ, Ⅲ (93.3% vs 69.4%,76.3%,P=0.035). MNA-SF was negatively related to N-terminal pro-B-type natriuretic peptide (NT-proBNP)(r=-0.382, P<0.01), NT-proBNP level of malnutrition patients was significantly higher than that of normal patients (P<0.01)and with significantly higher the adverse incidence for HR(28.6% vs 12.1%, P=0.007). Conclusion For elderly HR women the incidence of malnutrition is common. MNA-SF score can be used to evaluate for their nutritional status, with great significance for prognosis.

Manifestation and correlation of deceleration capacity and heart rate deceleration runs and heart rate variability of myocardial ischemia in patient

Yu Dan

2021, 36(12):  1083-1086.  doi:10.3969/j.issn.1004-583X.2021.12.005

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Objective To investigate the manifestation and correlation of heart rate deceleration capacity(DC), heart rate deceleration runs(DRs) and heart rate variability(HRV) in patients with myocardial ischemia(MI), in order to provide reference for MI. Methods From october 2019 to August 2020, totally 86 patients with chronic MI were enrolled, of which 59 inpatients with asymptomatic myocardial ischemia(SMI) were regarded as treatment group A, 27 patients with angina pectoris(AP) as treatment group B, 60 healthy adults suspected MI admitted to our hospital were comprised control group, 24h dynamic electrocardiogram(DCG) were monitored, the correlation of DC, Drs and HRV were compared in groups. Results DC, DRs (DR4, DR8) were lower in two treatment groups than in control group (all P<0.05); standard deviation(SD) of all normal to normal(NN) intervals(SDNN), standard deviation of the 5-min average of N-N intervals(SDANN), square root of the mean squared difference of successive RR intervals(RMSSD), percetange of adjacent NN intervals differing by more than 50 milliseconds (pNN50) were lower in two treatment groups than in control group (all P<0.05) ; The above indexes were slightly lower in treatment group A than in treatment group B, but the differences were not statistically significant (all P>0.05). A significant positive correlation were found between DC, DR2, DR4, DR8 and SDNN, SDANN, RMSSD, pNN50 in MI patients (all P<0.05). Conclusion The levels of DC, DRs, HRV in MI patients are lower in comparison with healthy people; and DC, DRs are significantly positively correlated with HRV. DC, DRs, HRV can provide reference for clinical examination of MI.

Analysis on risk factors of postoperative hemorrhage of endoscopic submucosal dissection in early gastric cancer

Lu Xunda, Feng Zhijie, Ji Chenguang, Yin Kaige, Liu Li

2021, 36(12):  1087-1091.  doi:10.3969/j.issn.1004-583X.2021.12.006

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Objective To systematically analyze the risk factors of postoperative hemorrhage of endoscopic submucosal dissection (ESD) in early gastric cancer (EGC). Methods A total of 281 EGC patients who underwent ESD treated in the second Hospital of Hebei Medical University from January 2017 to February 2021 were analyzed retrospectively. These patients were divided into control group and postoperative bleeding group on the basis of occurrence of postoperative hemorrhage. The previous history, inpatient medical records, pathologic diagnosis, report on endoscopy were collected, and the key observation was sex, age, whether or no preoperative antiplatelet therapy, whether with hypertension, diabetes, ischemic angiopathy; tumor location, endoscopic classification, histological classification, tumor diameter, operation time; whether complicated by ulcer, vascular tumor thrombus; whether block resection or complete resection; whether or no postoperative bleeding, as well as the postoperative bleeding time, ect. The risk factors for postoperative hemorrhage of ESD in EGC patients were analyzed by univariate and multivariate Logstic regression. Results There were 16 cases with postoperative bleeding (5.69%, 16/281) in out of 281 EGC patients, with bleeding time was from day 1 to day 9 postoperation; of which 8 cases (50.0%, 8/16) had postoperative bleeding within 24 hours, 10 cases (62.5%, 10/16) had postoperative bleeding within 48 hours, 1 patient had two consecutive bleeding within 48 hours, and 1 patient developed hemorrhagic shock, those patients successed in hemostasis under endoscope.The independent risk factor for postoperative hemorrhage of ESD in EGC patients was preoperative antiplatelet therapy (OR=0.051, 95% CI 0.011-0.230, P<0.01), operation time ≥2 hours (OR=0.048, 95% CI 0.009-0.263, P<0.01) and complication by ulcer (OR=0.038, 95% CI 0.007-0.193, P<0.01). Conclusion Independent risk factor for postoperative hemorrhage of ESD in EGC patients was operation time more than 2 hours, preoperative antiplatelet therapy, complication by ulcer.

Analysis of bacterial distribution, resistance and risk factor of death of bacterial infection in leukemia patients

Shen Ziyuan, Kang Haiquan, Sang Wei, Yan Dongmei

2021, 36(12):  1092-1096.  doi:10.3969/j.issn.1004-583X.2021.12.007

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Objective To investigate the characteristics of bacterial distribution, resistance and risk factor of death of bacterial infection in leukemia patients. Methods The clinical data of 168 leukemia inpatients complicated by bacterial infection admitted to the Affiliated Hospital of Xuzhou Medical University from January 2015 to December 2019 were collected. WHONET 5.6 and SPSS 19.0 software were used to count the bacterial species, resistance, etc. Logistic regression was used to analyze the risk factor of death. Results A total of 472 bacterial strains were isolated from serum of those 168 patients, the accounted of gram-negative bacterium and gram-positive bacterium were 73.1% and 26.9% respectively. Escherichia coli (28.1%) was most common among bacterium, followed by Klebsiella pneumoniae (19.1%) and Pseudomonas aeruginosa (18.8%). The highest resistance rates were Pseudomonas aeruginosa against ceftriaxone with the rate of 100%, the resistance rates were Staphylococcus aureus against oxacillin with the rate of 50%, and there was no resistance against vancomycin, teicoplanin and linezolid. Serum albumin level (OR=0.879, 95%CI 0.776-0.996, P=0.044) and stenotrophomonas maltophilia infection (OR=2.726, 95%CI 1.241-3.095, P=0.005) were associated with mortality in leukemic patients. Conclusion Bacterial infection is the most common complication and risk factor of death in leukemic patients. By understanding the pathogenic strain and resistance, strengthen the care of patients, and so as to carry out reasonable empirical treatments.

Efficacy comparison between pull and surgical technique for removal of peritoneal dialysis catheter

Cheng Huidong, Si Bolin, Hua Qin, He Jianqiang, Gui Lanlan

2021, 36(12):  1097-1101.  doi:10.3969/j.issn.1004-583X.2021.12.008

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Objective To compare the effecacy of pull and surgical technique for removal of peritoneal dialysis (PD) catheter. Methods We retrospectively analyzed 88 patients undergone PD catheter removal admitted to Affiliated Hospital of Jiangsu University during the past decade (2011-2020). intra-operative and post-operative were performed on the two groups which comprised 39 (pull technique) and 49 (surgical technique) patients. The tension test of the catheter in pull technique group was conducted to explore resistance of PD catheter. Results In comparative trials, operating duration, pain score and proportion of patients with blood loss than 10 ml of pull technique patients were less than those of surgical technique patients (P<0.05); Similar infection rate was found between groups; decreased fracture (pull) in PD catheter was in opposite to its life extension. Conclusion Pull technique for PD catheter is convenient and safe then worthy of promotion.

Predictive value of uKIM-1 and uL-FABP levels on early renal function injury in patients with pregnancy-induced hypertension syndrome

Zheng Junxia, Ou Jinghua

2021, 36(12):  1102-1105.  doi:10.3969/j.issn.1004-583X.2021.12.009

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Objective To analyze the value of urinary kidney injury molecules (uKIM-1) and urinary hepatic fatty acid binding protein(uL-FABP) in predicting early renal damage in patients with pregnancy induced hypertension syndrome(PIH). Methods Totally 100 PIH inpatients from October 2019 to October 2021 were included in the study, the patients were divided into renal function injury group (60 ml/min≤eGFR<90 ml/min, 42 cases) and non renal function injury group (eGFR≥90 ml/min, 58 cases) based on glomerular filtration rate(GFR). The levels of uKIM-1 and uL-FABP on admission were measured, ROC was used to analyze the predictive value of uKIM-1 and uL-FABP levels for early renal damage in PIH patients. The predictive value of uKIM-1 combined with uL-FABP on early renal damage in PIH patients were assessed by consistency analysis. Results The levels of uKIM-1 and uL-FABP were significantly higher in renal function injury group than in non renal function injury group, and the difference was statistically significant (P<0.05). The receive operating characteristic(ROC) curve analysis showed that the area under the curve(AUC) of uKIM-1 and uL-FABP in predicting early renal damage in PIH patients were 0.834 and 0.894 respectively (all P<0.05). The result of the consistency analysis showed that totally 39 positive involved out of 100 cases, with 0.929 for sensitivity, 0.931 for specificity, 0.930 for accuracy, and 0.857 for kappa. Conclusion The levels of uKIM-1 and uL-FABP can be used to predict early renal damage in PIH patients, and the combined examination can obtain better sensitivity and specificity, which has the value of clinical promotion.

Correlation between serum TGF-β1, IL-17 levels and prognosis of patients with acute pyelonephritis treated with cefotaxime sodium

Tang Chunxia, Xue Yuxi, Wang Wei

2021, 36(12):  1106-1109.  doi:10.3969/j.issn.1004-583X.2021.12.010

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Objective To investigate the correlation between serum transforming growth factor-β1 (TGF-β1), interleukin-17 (IL-17) and the prognosis of patients with acute pyelonephritis (AP) treated with cefotaxime sodium. Methods Totally 60 AP patients treated with cefotaxime sodium in our hospital from July 2019 to July 2021 were selected and divided into poor prognosis group and good prognosis group according to the prognosis of patients after two weeks of treatment. Patients in both groups received detection of serum TGF-β1 and IL-17 levels before treatment, and the correlation between serum TGF-β1 and IL-17 and the prognosis of AP patients treated with cefotaxime sodium was analyzed. Results Totally 60 AP patients were treated with cefotaxime sodium including 8 cases with poor prognosis (13.33%) and 52 cases with good prognosis (86.67%); Logistic regression analysis showed that high serum TGF-β1 and IL-17 levels were correlated with poor prognosis of patients (OR>1, P<0.05). Receiver operating characteristic curve (ROC curve) was drawn, and the results showed that the serum TGF-β1 and IL-17 levels predicted the prognosis of AP patients treated with cefotaxime sodium alone or in combination, with areas under curve (AUC)>0.8, which had certain prediction value, among which the joint prediction value was the highest. Conclusion The levels of serum TGF-β1 and IL-17 are closely related to the prognosis of AP patients treated with cefotaxime sodium, clinically, which may predict the prognosis of this patients.

Evaluation value of severity and prognosis of Lung ultrasound combined with serum NT-proBNP and sFlt-1 on acute respiratory distress syndrome in patient

Ma Guilan, Min Ju

2021, 36(12):  1110-1113.  doi:10.3969/j.issn.1004-583X.2021.12.011

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Objective To explore the evaluation value of lung ultrasound combined with serum N-terminal pro-brain natriuretic peptide(NT-proBNP) and soluble vascular endothelial growth factor receptor(sFlt-1) in evaluating the severity and prognosis of acute respiratory distress syndrome(ARDS). Methods Totally 138 ARDS patients were enrolled as the research subjects who treated in our hospital from April 2018 to October 2020. The subjects were classified into severe group (OI≤100 mmHg, 58 cases), moderate group (100 mmHg<OI≤200 mmHg, 51 cases), and mild group (200 mmHg<OI≤300 mmHg, 29 cases) based on oxygenation index (OI). Lung ultrasound score(LUS), serum NT-proBNP, and sFlt-1 levels were compared in groups. The 28-day disease outcome of ARDS patients was counted, and ARDS patients were assigned into a poor prognosis group (death, 41 cases) and a good prognosis group (survival, 97 cases) to compare clinical data between groups. Logistic multivariate regression analysis was used to analyze the prognostic factors. A receiver operating characteristic curve(ROC) was drawn to estimate the diagnostic value of LUS combined with NT-proBNP and sFlt-1 levels on ARDS patients prognosis. Results Difference were statistically different in LUS, serum NT-proBNP, and sFlt-1 levels among three groups (P<0.05), which in the severe group were highest in groups (P<0.05), followed by moderate group, and finally the mild group (all P<0.05). Totally 41 (41/138, 29.71%) cases with poor prognosis involved in 138 ARDS patients, Logistic multivariate analysis showed that influencing factors for ARDS patient prognosis were the length of stay in intensive care unit(ICU), LUS, NT-proBNP level, and sFlt-1 level (OR=3.943, 3.736, 3.337, 4.289, P<0.05), the ROC curve showed that the prognostic AUC of the combination of the three on diagnosis of ARDS was 0.896, which was higher than the AUC of LUS, NT-proBNP, and sFlt-1 alone (0.751, 0.844, 0.773). Conclusion For ARDS patients, the combination of the three can assess the severity, and has a high diagnostic efficiency for the prognosis; therefore, it can be used as an important clinical reference index.

Effect of olanzapine on symptoms, safety scores and related serum factors of schizophrenia in patients

Feng Xinmei

2021, 36(12):  1114-1117.  doi:10.3969/j.issn.1004-583X.2021.12.012

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Objective To analyze the effect of olanzapine on relevant scoring of schizophrenia in patients, including the adverse reaction scale (TESS), the Positive and Negative Syndrome Scale (PANSS), the Mini Mental State Examination (MMSE), the Montreal Cognitive Assessment (MoCA), severity of illness (SI); as well as the effect of olanzapine on related factors such as neurobiochemical markers, S100beta protein (S100β), intermediate filament and associated protein, repetin (Rptn), fasting plasma glucose (FPG), 2-h postprandial blood glucose (2hPG), ect. Methods Totally 82 schizophrenic inpatients from March 2018 to January 2020 were selected and divided into two groups as different medication schemes after admission. The observation group was treated with drug intervention of olanzapine and the control group with drug intervention of aripiprazole. Before and after treatment, the levels of S100β, Rptn, FPG and 2hPG was measured, PANSS score, MMSE score, MOCA score, SI score and TESS score were compared between groups. Results There was no significant difference in S100β, Rptn, FPG, 2hPG between groups before treatment (P>0.05). Rptn was higher (P<0.05) and S100β, FPG, 2hPG was lower (P<0.05) in observation group when compared with control group, respectively. Difference of PANSS, MMSE, MoCA, SI scores was no significant between groups before treatment (P>0.05). PANSS, SI scorces in observation group were lower than those in control group (P<0.05) and MMSE, MoCA scores higher than those in control group (P<0.05). There was no significant difference in TESS scores between groups before treatment (P>0.05). TESS scores on weeks 6, week 8 post-treatment in observation group were lower than those in control group (P<0.05). Conclusion PANSS score decreases significantly by the application of olanzapine for schizophrenia, which is capable improving patient's cognitive function, and with high safety.

Dosimetric Verification of SPECT/CT to ¹²⁵I implantation for Pancreatic Cancer

Wu Weixia, Xing Mingquan, Zhou Zhigang, Guo Yanyan, Qiu Xiaohui, Li Xiangzhou

2021, 36(12):  1118-1122.  doi:10.3969/j.issn.1004-583X.2021.12.013

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Objective To explore the feasibility of SPECT/CT imaging applied for dose verification after ¹²⁵I radioactive seed implantation in pancreatic cancer. Methods Eighteen patients with pancreatic cancer were implanted with ¹²⁵I seeds, SPECT/CT imaging was implemented in 24 hours after operation, and the hybride image fusion was implemented. CT images of SPECT/CT imaging were imported into TPS to perform post-operative dose verification, and the isodose curve distribution map was acquired. The radioactive concentration degree surrounding the tumor and isodose distribution curve were observed, the coverage of tumor target region was assessed and recorded overall. The delineated target region on TPS was adjusted for dose calculation, and the mean dose of delineated target region was acquired from DVH chart, and repeated operation was implemented. Mean dose of appropriate regions was respectively calculated. Recalculation and obtainment of mean value were implemented. The correlation analysis between the radioactive count value within the unit of radioactive concentration zone and received mean dose was taken. Results Radioactive count per unit volume of radioactive concentration zone was positively correlated to mean dose received (r=0.422, P<0.01). SPECT/CT imaging could visualize surrounding dose of ¹²⁵I radioactive seeds after implantation to a certain extent. Conclusion SPECT/CT fusion imaging is expected to become a new method of dose verification after implantation of ¹²⁵I radioactive seeds.

Retrospective analysis of of thrombotic antiphospholipid syndrome: in 7 cases

Yin Yuanyuan, Ren Huiling

2021, 36(12):  1123-1127.  doi:10.3969/j.issn.1004-583X.2021.12.014

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Objective To explore the clinical manifestation, laboratory examination, neuroimaging examination, diagnosis and treatment of antiphospholipid syndrome (APS). Methods Collecting the clinical data of 7 patients with thrombotic APS from January 2019 throuh November 2020, retrospectively analyzed their clinical data, auxiliary examinations, treatment measures and neuroimaging. Results Seven cases of antiphospholipid antibodies were all positive, 1 case of thrombosis involved brain, kidney, lung, considering catastrophic APS, 1 case of recurrent arterial and venous thrombosis of lower extremity, 3 cases of lower extremity venous thrombosis, 3 cases of cerebral infarction. Among the cases, there were 2 cases of systemic lupus erythematosus and 1 case of ankylosing spondylitis. The treatment was treated with anticoagulation such as warfarin or rivaroxaban. One patient died of tuberculous meningitis, and the symptoms of the remaining 6 patients improved. Conclusion Thrombotic APS is characterized by venous, arterial or microvascular thrombosis, which is a very heterogeneous disease. Cerebral circulation is the most commonly affected arterial area. The treatment of thrombotic APS should assess the risk of thrombosis and treat it by stratification.

Ornithine carbamoyltransferase deficiency caused by one female newborn: A case report and literature review

Cui Qingyang, Liu Juan, Cao Yinli, Zhang Chunyan, Wang Xicheng

2021, 36(12):  1128-1131.  doi:10.3969/j.issn.1004-583X.2021.12.015

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Clinical data and gene sequencing results of a female newborn with ornithine carbamyltransferase deficiency were analyzed retrospectively. Major symptoms of female newborn (3 days old) were found to have poor response, convulsion, coma and hyperammonemia. The level of citrulline in the blood (4.12 μmol/L) decreased, the level of urine orotic acid increased significantly (166.3 μmol/L). Next generation sequencing (NGS) and qPCR verification showed that exon1-10 of OTC gene was deleted in terms of heterozygosity, the mother carried heterozygous deletion of Exon 2 and Exon 4. The father, sister and twin brother of the female newborn did not carry exon deletion. She acted as the first case with ornithine transcarbamylase deficiency with the deletion of all exons from Exon 1 to Exon 10 for female neonatal onset in China.