OBJECTIVE To investigate the associations between the blood concentrations of low-density lipoprotein cholesterol(LDL-C)and the clinical features of haemorrhagic stroke.METHODS This study analysed the data from patien...OBJECTIVE To investigate the associations between the blood concentrations of low-density lipoprotein cholesterol(LDL-C)and the clinical features of haemorrhagic stroke.METHODS This study analysed the data from patients with acute haemorrhagic stroke at a comprehensive stroke centre from 2013 to 2018.Patients were stratified into three groups according to their baseline LDL-C levels:<70,70 to<100 and≥100 mg/dL.We used multivariate logistic regression models to analyse the associations between LDL-C and the risks of having severe neurological deficits(National Institute Health Stroke Scale[NIHSS]scores≥15)and unfavourable outcomes(modified Rankin Scale[mRS]scores>2)at discharge.RESULTS Six-hundred and six patients were analysed.Their median age was 58 years.Among the patients,75(12%)patients had LDL-C levels<70 mg/dL,194(32%)patients had LDL-C levels between 70 to<100 mg/dL and the other 337(56%)patients had LDL-C levels≥100 mg/dL.Patients with higher LDL-C levels were less likely to suffer severe neurological deficits(LDL-C:70 to<100 vs.<70 mg/dL,adjusted odds ratio[OR]:0.29,95%CI:0.15–0.57;LDL-C:≥100 vs.<70 mg/dL,adjusted OR=0.27,95%CI:0.15–0.51)and to have unfavourable outcomes at discharge(LDL-C:70 to<100 vs.<70 mg/dL,adjusted OR=0.50,95%CI:0.29–0.87 and LDL-C:≥100 vs.<70 mg/dL,adjusted OR=0.46,95%CI:0.28–0.78).CONCLUSIONS An LDL-C level<70 mg/dL was independently associated with severe neurological deficits of haemorrhagic stroke and may increase the risks of unfavourable outcomes at discharge.展开更多
This paper summarizes the study and application of monoclonal antibodies (McAbs)against haemorrhagic fever with renal syndrome (HFRS) virus in our department over the past sever-al years. The following six points are ...This paper summarizes the study and application of monoclonal antibodies (McAbs)against haemorrhagic fever with renal syndrome (HFRS) virus in our department over the past sever-al years. The following six points are discussed: (1) establishment and characterization of thehybridoma cell lines secreting McAbs against HFRS virus and hemagglutinin of the virus: (2) theantigenic analysis of HFRS viruses in China by McAbs: (3) purification and application of theMcAbs: (4) purification and characterization of HFRS virus 50K stnactural protein by McAba-affini-ty chromatography and the McAbs possessing different characteristics: (5) detection of HFRS virusantigen in peripheral blood lymphocytes from HFRS patients by the McAb-IFAT; and (6)development of McAb-ELISA indirect sandwich methods, and detection of HFRS virus antigen andIgM, IgG and/or HI antibodies in human and animals. The results of the studies show that theMcAbs can be used for early diagnosis, epidemiological investigation, preparation of vaccine andimmunotherapy of HFRS.展开更多
Background:Data on severe and extensive burns in China are limited,as is data on the prevalence of a range of related gastrointestinal(GI)disorders[such as stress ulcers,delayed defecation,opioid-related bowel immotil...Background:Data on severe and extensive burns in China are limited,as is data on the prevalence of a range of related gastrointestinal(GI)disorders[such as stress ulcers,delayed defecation,opioid-related bowel immotility,and abdominal compartment syndrome(ACS)].We present a multicentre analysis of coincident GI dysfunction and its effect on burn-related mortality.Methods:This retrospective analysis was conducted on patients with severe[≥20%total burn surface area(TBSA)]and extensive(>50%TBSA or>25%full-thickness TBSA)burns admitted to three university teaching institutions in China between January 1,2011 and December 31,2020.Both 30-and 90-day mortality were assessed by collating demographic data,burn causes,admission TBSA,%full-thickness TBSA,Baux score,Abbreviated Burn Severity Index(ABSI)score,and Sequential Organ Failure Assessment(SOFA)score,shock at admission and the presence of an inhalation injury.GI dysfunction included abdominal distension,nausea/vomiting,diarrhoea/constipation,GI ulcer/haemorrhage,paralytic ileus,feeding intolerance and ACS.Surgeries,length of intensive care unit(ICU)stay,pain control[in morphine milligram equivalents(MME)]and overall length of hospital stay(LOHS)were recorded.Results:We analyzed 328 patients[75.6%male,mean age:(41.6±13.6)years]with a median TBSA of 62.0%(41.0%–80.0%);256(78.0%)patients presented with extensive burns.The 90-day mortality was 23.2%(76/328),with 64(84.2%)of these deaths occurring within 30 d and 25(32.9%)occurring within 7 d.GI dysfunction was experienced by 45.4%of patients and had a significant effect on 90-day mortality[odds ratio(OR)=14.070,95%confidence interval(CI)5.886–38.290,P<0.001].Multivariate analysis showed that GI dysfunction was associated with admission SOFA score and%full-thickness TBSA.Overall,88.2%(67/76)of deceased patients had GI dysfunction[hazard ratio(HR)for death of GI dysfunction=5.951],with a survival advantage for functional disorders(diarrhoea,constipation,or nausea/vomiting)over GI ulcer/haemorrhage(P<0.001).Conclusion:Patients with severe burns have an unfavourable prognosis,as nearly one-fifth died within 90 d.Half of our patients had comorbidities related to GI dysfunction,among which GI ulcers and haemorrhages were independently correlated with 90-day mortality.More attention should be given to severe burn patients with GI dysfunction.展开更多
Dear editor,Traumatic orbital haemorrhage is an unfortunate complication with potential vision-threatening consequences.[1-3]The collection of blood can occur anywhere along the potential free orbital spaces,[4]but th...Dear editor,Traumatic orbital haemorrhage is an unfortunate complication with potential vision-threatening consequences.[1-3]The collection of blood can occur anywhere along the potential free orbital spaces,[4]but the subperiosteal collection of the blood is an important clinical variant where careful and timely intervention can give commendable rewards to the surgeon as well as to the patient.[1,2]Subperiosteal hematoma could be traumatic or non-traumatic,in turns,the non-traumatic cases may be due to bleeding tendency as in cases of leukaemia.展开更多
Objective To evaluate the role of multidetector computed tomography-angiography(MDCTA) for management of life-threatening spontaneous retroperitoneal haemorrhage(SRH).Methods A retrospective analysis of the medical re...Objective To evaluate the role of multidetector computed tomography-angiography(MDCTA) for management of life-threatening spontaneous retroperitoneal haemorrhage(SRH).Methods A retrospective analysis of the medical records of all SRH patients admitted to our hospital from January 1,2005 to November 31,2014 was performed.SRH was defined as unrelated to invasive procedures,surgery,trauma,abdominal tumor or aortic aneurysm.Life-threatening SRH was defined as hemodynamic instability with hypotension.Sixteen cases met the inclusive criteria.Patients' characteristics,clinical presentation,imaging of MDCTA,treatment modalities,morbidity,and follow-up data were analyzed.Results The group of 16 patients included 11 men and 5 women,with a mean age of 51.5 ± 16.4years.All patients underwent MDCTA scan examinations,and active contrast media(CM) extravasation were found in 9 patients.Angiography was performed for 8 patients in the CM extravasation group.Bleeding vessels were found in 7 patients who underwent successful embolization.One patient in the CM extravasation group did not undergo angiography and died of bleeding.Seven patients without active CM extravasation underwent conservative management.Bleeding was controlled for all these 7 patients,and 1 patient died of multiple organ failure.Fourteen patients survived from SRH were successfully discharged.One patient died of heart failure during follow-up.Conclusion MDCTA was useful in the diagnosis of SRH and proved to be predictive for the outcome of conservative treatment and early intervention.展开更多
Objective:To evaluate the clinical effects of the abdominal aorta block in controlling haemorrhage during operations of the gynecologic tumor. Methods: From July 1965 to January 2005. we collected patients (n = 49) of...Objective:To evaluate the clinical effects of the abdominal aorta block in controlling haemorrhage during operations of the gynecologic tumor. Methods: From July 1965 to January 2005. we collected patients (n = 49) of gynecologic tumor complicated with haemorrhage during operations, who were divided into 3 groups: preventive blocking group (PG, n=12), treatment blocking group (TG, n = 20) used abdominal aorta block technique with sterilized cotton band and silica gel tube, and control group (CG, n = 17) which were used the regular haemostatic methods, such as ligature, suture and ribbon gauze packing. During operations, the vital signs including the amount of bleeding and transfusion were measured. Results: Compared with the CG, the amount of bleeding and transfusion in the PG and TG decreased significantly (P<0. 01). After using the technique, 32 cases of haemorrhage were controlled completely. All patients finished operation smoothly in the end and the vital signs were stable. The vision field of operation was clear and the operating time was shortened dramatically (3. 0 h vs 5. 7 h and 3. 8 h vs 5. 7 h, P< 0. 01). No complications caused by the block occurred in the post-operation. Conclusion: Lower abdominal aorta block is safe and effective in controlling haemorrhage during operations of the gynecologic tumor.展开更多
基金the National Natural Science Foundation of China(No.82001242).
文摘OBJECTIVE To investigate the associations between the blood concentrations of low-density lipoprotein cholesterol(LDL-C)and the clinical features of haemorrhagic stroke.METHODS This study analysed the data from patients with acute haemorrhagic stroke at a comprehensive stroke centre from 2013 to 2018.Patients were stratified into three groups according to their baseline LDL-C levels:<70,70 to<100 and≥100 mg/dL.We used multivariate logistic regression models to analyse the associations between LDL-C and the risks of having severe neurological deficits(National Institute Health Stroke Scale[NIHSS]scores≥15)and unfavourable outcomes(modified Rankin Scale[mRS]scores>2)at discharge.RESULTS Six-hundred and six patients were analysed.Their median age was 58 years.Among the patients,75(12%)patients had LDL-C levels<70 mg/dL,194(32%)patients had LDL-C levels between 70 to<100 mg/dL and the other 337(56%)patients had LDL-C levels≥100 mg/dL.Patients with higher LDL-C levels were less likely to suffer severe neurological deficits(LDL-C:70 to<100 vs.<70 mg/dL,adjusted odds ratio[OR]:0.29,95%CI:0.15–0.57;LDL-C:≥100 vs.<70 mg/dL,adjusted OR=0.27,95%CI:0.15–0.51)and to have unfavourable outcomes at discharge(LDL-C:70 to<100 vs.<70 mg/dL,adjusted OR=0.50,95%CI:0.29–0.87 and LDL-C:≥100 vs.<70 mg/dL,adjusted OR=0.46,95%CI:0.28–0.78).CONCLUSIONS An LDL-C level<70 mg/dL was independently associated with severe neurological deficits of haemorrhagic stroke and may increase the risks of unfavourable outcomes at discharge.
文摘This paper summarizes the study and application of monoclonal antibodies (McAbs)against haemorrhagic fever with renal syndrome (HFRS) virus in our department over the past sever-al years. The following six points are discussed: (1) establishment and characterization of thehybridoma cell lines secreting McAbs against HFRS virus and hemagglutinin of the virus: (2) theantigenic analysis of HFRS viruses in China by McAbs: (3) purification and application of theMcAbs: (4) purification and characterization of HFRS virus 50K stnactural protein by McAba-affini-ty chromatography and the McAbs possessing different characteristics: (5) detection of HFRS virusantigen in peripheral blood lymphocytes from HFRS patients by the McAb-IFAT; and (6)development of McAb-ELISA indirect sandwich methods, and detection of HFRS virus antigen andIgM, IgG and/or HI antibodies in human and animals. The results of the studies show that theMcAbs can be used for early diagnosis, epidemiological investigation, preparation of vaccine andimmunotherapy of HFRS.
基金study was approved respectively by the Ethics Committee for Clinical Research and Animal Trials of the First Affiliated Hospital of Sun Yat-sen University([2021]014)Zhongshan People's Hospital(K2021-049)and Dongguan People's Hospital(DRYA2021-054-A1).
文摘Background:Data on severe and extensive burns in China are limited,as is data on the prevalence of a range of related gastrointestinal(GI)disorders[such as stress ulcers,delayed defecation,opioid-related bowel immotility,and abdominal compartment syndrome(ACS)].We present a multicentre analysis of coincident GI dysfunction and its effect on burn-related mortality.Methods:This retrospective analysis was conducted on patients with severe[≥20%total burn surface area(TBSA)]and extensive(>50%TBSA or>25%full-thickness TBSA)burns admitted to three university teaching institutions in China between January 1,2011 and December 31,2020.Both 30-and 90-day mortality were assessed by collating demographic data,burn causes,admission TBSA,%full-thickness TBSA,Baux score,Abbreviated Burn Severity Index(ABSI)score,and Sequential Organ Failure Assessment(SOFA)score,shock at admission and the presence of an inhalation injury.GI dysfunction included abdominal distension,nausea/vomiting,diarrhoea/constipation,GI ulcer/haemorrhage,paralytic ileus,feeding intolerance and ACS.Surgeries,length of intensive care unit(ICU)stay,pain control[in morphine milligram equivalents(MME)]and overall length of hospital stay(LOHS)were recorded.Results:We analyzed 328 patients[75.6%male,mean age:(41.6±13.6)years]with a median TBSA of 62.0%(41.0%–80.0%);256(78.0%)patients presented with extensive burns.The 90-day mortality was 23.2%(76/328),with 64(84.2%)of these deaths occurring within 30 d and 25(32.9%)occurring within 7 d.GI dysfunction was experienced by 45.4%of patients and had a significant effect on 90-day mortality[odds ratio(OR)=14.070,95%confidence interval(CI)5.886–38.290,P<0.001].Multivariate analysis showed that GI dysfunction was associated with admission SOFA score and%full-thickness TBSA.Overall,88.2%(67/76)of deceased patients had GI dysfunction[hazard ratio(HR)for death of GI dysfunction=5.951],with a survival advantage for functional disorders(diarrhoea,constipation,or nausea/vomiting)over GI ulcer/haemorrhage(P<0.001).Conclusion:Patients with severe burns have an unfavourable prognosis,as nearly one-fifth died within 90 d.Half of our patients had comorbidities related to GI dysfunction,among which GI ulcers and haemorrhages were independently correlated with 90-day mortality.More attention should be given to severe burn patients with GI dysfunction.
文摘Dear editor,Traumatic orbital haemorrhage is an unfortunate complication with potential vision-threatening consequences.[1-3]The collection of blood can occur anywhere along the potential free orbital spaces,[4]but the subperiosteal collection of the blood is an important clinical variant where careful and timely intervention can give commendable rewards to the surgeon as well as to the patient.[1,2]Subperiosteal hematoma could be traumatic or non-traumatic,in turns,the non-traumatic cases may be due to bleeding tendency as in cases of leukaemia.
文摘Objective To evaluate the role of multidetector computed tomography-angiography(MDCTA) for management of life-threatening spontaneous retroperitoneal haemorrhage(SRH).Methods A retrospective analysis of the medical records of all SRH patients admitted to our hospital from January 1,2005 to November 31,2014 was performed.SRH was defined as unrelated to invasive procedures,surgery,trauma,abdominal tumor or aortic aneurysm.Life-threatening SRH was defined as hemodynamic instability with hypotension.Sixteen cases met the inclusive criteria.Patients' characteristics,clinical presentation,imaging of MDCTA,treatment modalities,morbidity,and follow-up data were analyzed.Results The group of 16 patients included 11 men and 5 women,with a mean age of 51.5 ± 16.4years.All patients underwent MDCTA scan examinations,and active contrast media(CM) extravasation were found in 9 patients.Angiography was performed for 8 patients in the CM extravasation group.Bleeding vessels were found in 7 patients who underwent successful embolization.One patient in the CM extravasation group did not undergo angiography and died of bleeding.Seven patients without active CM extravasation underwent conservative management.Bleeding was controlled for all these 7 patients,and 1 patient died of multiple organ failure.Fourteen patients survived from SRH were successfully discharged.One patient died of heart failure during follow-up.Conclusion MDCTA was useful in the diagnosis of SRH and proved to be predictive for the outcome of conservative treatment and early intervention.
文摘Objective:To evaluate the clinical effects of the abdominal aorta block in controlling haemorrhage during operations of the gynecologic tumor. Methods: From July 1965 to January 2005. we collected patients (n = 49) of gynecologic tumor complicated with haemorrhage during operations, who were divided into 3 groups: preventive blocking group (PG, n=12), treatment blocking group (TG, n = 20) used abdominal aorta block technique with sterilized cotton band and silica gel tube, and control group (CG, n = 17) which were used the regular haemostatic methods, such as ligature, suture and ribbon gauze packing. During operations, the vital signs including the amount of bleeding and transfusion were measured. Results: Compared with the CG, the amount of bleeding and transfusion in the PG and TG decreased significantly (P<0. 01). After using the technique, 32 cases of haemorrhage were controlled completely. All patients finished operation smoothly in the end and the vital signs were stable. The vision field of operation was clear and the operating time was shortened dramatically (3. 0 h vs 5. 7 h and 3. 8 h vs 5. 7 h, P< 0. 01). No complications caused by the block occurred in the post-operation. Conclusion: Lower abdominal aorta block is safe and effective in controlling haemorrhage during operations of the gynecologic tumor.
