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1.
Anuj Shrestha Zeeshan Jawa Kathryn L. Koch Amy B. Rankin Qun Xiang Anand Padmanabhan Matthew S. Karafin Joshua J. Field 《Journal of clinical apheresis》2015,30(6):353-358
Red cell exchange (RCE) is a common procedure in adults with sickle cell disease (SCD). Implantable dual lumen Vortex (DLV) ports can be used for RCE in patients with poor peripheral venous access. We performed a retrospective cohort study of RCE procedures performed in adults with SCD. The main objective of the study was to compare the inlet speed, duration of procedures and rate of complications performed through DLV ports to those performed through temporary central venous and peripheral catheters. Twenty‐nine adults with SCD underwent a total of 318 RCE procedures. Twenty adults had DLV ports placed and 218 procedures were performed using DLV ports. Mean length of follow‐up after DLV port placement was 397 ± 263 days. Six DLV ports were removed due to infection and 1 for malfunction after a mean of 171 ± 120 days. Compared to temporary central venous and peripheral catheters, DLV port procedures had a greater rate of procedural complications, a longer duration, and a lower inlet speed (all P < 0.01). When accounting for the maximum allowable inlet speed to avoid citrate toxicity, 40% of DLV port procedures were greater than 10% below maximum speed, compared to 7 and 14% of procedures performed through temporary central venous and peripheral catheters (P < 0.0001). In conclusion, DLV ports can be used for RCE in adults with SCD, albeit with more procedural complications and longer duration. The smaller internal diameter and longer catheter of DLV ports compared to temporary central venous catheters likely accounts for the differences noted. J. Clin. Apheresis 30:353–358, 2015. © 2015 Wiley Periodicals, Inc. 相似文献
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Sophocarpine attenuates toll‐like receptor 4 in steatotic hepatocytes to suppress pro‐inflammatory cytokines synthesis 下载免费PDF全文
3.
Shengxuan Cao Chen Wang Xin Ma Xu Wang Jiazhang Huang Chao Zhang Li Chen Xiang Geng Kan Wang 《Journal of orthopaedic research》2019,37(8):1860-1867
Patients with mechanic ankle instability experience increased tibiotalar and subtalar joint laxity. However, in vivo joint kinematics in functional ankle instability (FAI) patients and lateral ankle sprain (LAS) copers, especially during dynamic activities, are poorly understood. Ten FAI patients, 10 LAS copers, and 10 healthy controls were included in this study. A dual fluoroscopic imaging system was used to analyze the tibiotalar and subtalar joint kinematics during stair descent. Five key poses of stair descent were analyzed. Kinematic data from six degrees of freedom were calculated utilizing a solid modeling software. The range of motion and joint positions in each degree of freedom were compared among the three groups. The tibiotalar joints of FAI patients and LAS copers were significantly more inverted than those of healthy controls during the foot strike (p = 0.016, = 0.264). The subtalar joints of FAI patients were significantly more anteriorly translated (pose 2, p = 0.003, = 0.352; pose 3, p < 0.001, = 0.454; pose 4, p = 0.004, = 0.334), inverted (pose 4, p = 0.027, = 0.234; pose 5,p = 0.034, = 0.221), and externally rotated (pose 4, p = 0.037, = 0.217; pose 5; p = 0.004, = 0.331) than those of healthy controls during the mid‐stance and the heel off. The FAI patients showed excessive tibiotalar inversion and subtalar joint hypermobility during stair descent. Meanwhile, the LAS copers maintained subtalar joint stability, and only showed excessive tibiotalar inversion in foot strike. These data provide insight into the mechanisms behind the development of FAI after initial LAS. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 37:1860–1867, 2019 相似文献
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Multidisciplinary predialysis education and team care (MDC) may slow the decline in renal function in patients with chronic kidney disease (CKD). However, associations between unexpected return during MDC and progression of renal dysfunction have not been characterized in patients with CKD. Our study aimed to determine the association between exacerbation of renal dysfunction and the frequency of unexpected return during follow-up.A total of 437 patients with CKD receiving multidisciplinary care between January 2009 and June 2013 at the Shin-Kong Wu Ho-Su Memorial Hospital were included in this retrospective observational cohort study, and multiple imputations were performed for missing data. The predictor was the frequency of unexpected return for follow-up during the first year after entering MDC. Main outcome was monthly declines in estimated glomerular filtration rates (eGFR). Moreover, the demographic data, comorbidities, history of medication, and routine laboratory data for patients with CKD were collected.Among all patients, 59.7% were male, the mean age at initiation of MDC was 69.4 ± 13.2 years, and the duration of follow-up was 21.4 ± 3.3 months. The subjects were divided into 2 groups according to frequencies of follow-up (≤4 and > 4 visits) during the 1st year of MDC. The patients with CKD were regularly followed up every 3 months as a part of MDC in our hospital, and patients who returned for more than 4 follow-up visits were included in the unexpected return group. In crude regression analyses, unexpected return was significantly associated with higher monthly declines of eGFR (β = 0.092, 95% confidence interval, 0.014–0.170). This association remained after adjustments for multiple variables, and subgroup analyses of unexpected return showed that male gender, older age, CKD stage 1 to 3, hypertension, history of coronary artery disease, and use of renin–angiotensin system blockade were significantly associated with declines in renal function.In conclusion, unexpected return for follow-up during the 1st year of MDC was significantly associated with the deterioration of renal function. 相似文献
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Lin Bo Wang Jian Guo Shen Li Feng Dong Chao Yang Xu Wen Jun Chen Shu Duo Xie Xiang Yang Song Ning Dai Xiao Ming Yuan 《Journal of gastrointestinal surgery》2008,12(8):1359-1363
We previously reported that lymphatic mapping using isosulfan blue can be used to identify sentinel nodes (SNs). This study
was undertaken to evaluate the feasibility of using the SN technique in treating early gastric cancer and to explore its usefulness
for minimal invasive surgery. Twenty-three patients with early gastric cancer who underwent SN biopsy were retrospectively
evaluated. Based on SN evaluation, individualized surgery was performed in five patients with T1N0M0 gastric cancer. When
pathological examination of frozen sections revealed metastasis in SNs, we performed a standard D2 gastrectomy. Laparoscopic
local resection was applied when the SN biopsy was negative. Our results showed that the success rate with SN biopsy in early
gastric cancer was 100%, as were the accuracy, sensitivity, and specificity. All five patients with early gastric cancer had
SNs negative for metastases both by frozen section and by postoperative pathology. Thus, all these patients underwent laparoscopic
local resection without extended lymphadenectomy. We conclude that SN biopsy is a useful tool to individualize the operative
procedure, and laparoscopic local resection can be safely performed using SN guidance in selected patients with early gastric
cancer. 相似文献
10.
目的探讨女性吸毒者的心理防御机制与心理状况及二者的关系.方法分别用防御方式问卷(DSQ)和症状自评量表(SCL-90),对110名女性吸毒者(研究组)和41名女大学生(对照组)进行调查.结果研究组不成熟防御机制、中间型防御机制和掩饰因子评分(4.83±0.97,4.99±0.75,5.98±1.17)显著高于对照组(3.95±0.68,4.26±0.73,5.41±1.34)(P<0.01或P<0.05);研究组SCL-90中9个因子评分均显著高于对照组(P<0.01);相关分析发现,研究组不成熟防御机制与SCL-90中9个因子均存在非常显著正相关(P<0.01),中间型防御机制与SCL-90中的强迫、偏执、躯体化、抑郁存在显著正相关(P<0.01或P<0.05),掩饰因子与SCL-90中的敌对、偏执、强迫呈显著正相关(P<0.01或P<0.05).结论女性吸毒者过多地使用不成熟防御机制及中间型防御机制,心理状况差,且二者存在明显的相关性. 相似文献