Objective To investigate the early diagnosis and effective treatment of Fournier syndrome. Methods The clinical data of 385 patients with perianal abscess in this hospital between 2006 and 2009 were retrospectively analyzed for screening the patients with complication of Fournier syndrome. Results Fournier syndrome was detected in 6 patients （1.56%）， who were all cured by treating with early incision and drainage, complete debridement, effective antibiotics, and supporting therapy. Conclusions Perianal abscess can induce Fournier syndrome of perineal, genital, and abdominal wall regions, which spreads rapidly and progressively, so early diagnosis and extensive surgical debridement play a decisive role on the prognosis.
ObjectiveTo analyze the clinical features, laboratory examination, imaging findings, treatment and outcome of influenza A H1N1 virus infection in China, so as to improve the clinicians' understanding of the disease.MethodsOne patient with influenza A H1N1 pneumonia was reported in this hospital. The databases of CNKI, VIP network and Wanfang data were systematically consulted. After removing the duplicate and deleting the incomplete literature published between January 1989 and August 2019, 62 literatures were included, involving 880 patients. Hence, 881 patients in total were included. The clinical manifestations, laboratory examination, imaging manifestations, treatment and prognosis were analyzed.ResultsThere were 477 males and 404 females, aged from 50 days to 86 years old, with an average age of (20.4 ±10.0) years. The most common clinical symptoms were fever (99.4%, 876/881), followed by cough (85.0%, 749/881), expectoration (38.1%, 336/881), sore throat (37.0%, 326/881) and dyspnea (33.7%, 297/881), asthenia and general pain (33.5%, 295/881) and so on. Laboratory examination in the leukocyte decreased in 249 patients (28.3%), neutrophil increased in 143 patients (16.2%) and leukocyte increased in 141 patients (16.0%). Myocardial injury was found in 370 patients (42.0%), liver injury in 303 patients (34.4%) and renal insufficiency in 84 patients (9.5%). The main imaging manifestations were spotted, patchy or flaky shadows (41.8%, 362/866) in varying degrees, with consolidation shadows (19.3%, 167/866), thickening of lung texture (11.3%, 98/866), ground glass shadows (4.5%, 39/866), and pleural effusion (5.5%, 48/866). The most common treatments were anti-virus, anti-infection, anti-inflammation, mechanical ventilation and symptomatic support. Comprehensive treatment resulted good effects. There were 37 deaths and the mortality rate was 4.2%. The main cause of death was respiratory failure.ConclusionsInfluenza A H1N1 virus infection is a preventable, controllable and treatable infectious disease, which is similar to the general influenza virus. After active comprehensive treatment, most of the influenza A (H1N1) can be cured and the prognosis is benign.
Objective To analyze the current research status, hotspots and development trends in the field of evidence-based health policy briefs at home and abroad. Methods Computer searches of Web of Science Core Collection and CNKI databases for studies related to evidence-based health policy briefs were conducted, and the timeframe of the searches was from the establishment of the databases to August 6, 2024. Charticular, VOSviewer and CiteSpace software were used to visualize and analyze the countries, institutions, journals, authors and keywords of the included literature. Results A total of 145 relevant studies were included, of which 141 were in English and 4 were in Chinese. The number of articles in English showed an overall increasing trend; the country with the largest number of articles was the United States; the organization with the largest number of articles was the World Health Organization; the journal with the largest number of articles was Frontiers in Public Health; and the hot keywords in recent years focused on the food and nutritional safety system, cardiovascular disease, obesity, impact, and public health policy. The research related to "healthcare" and "knowledge translation" is expected to become a frontier hotspot. The number of Chinese studies was relatively small, and the research content involved policy briefs and policy brief methodology in the field of public health. Conclusion Future research may focus on policy briefs on health care, food and nutrition, cardiovascular disease, obesity and other health issues, their impact and the use of policy briefs in the formulation of public health policies. Currently, there is a significant difference between domestic and foreign research in the field of evidence-based health policy briefs, foreign research has tended to mature, while the domestic is still in the embryonic stage, there is an urgent need to enrich the methodological system, enrich the content of the study, and in the future, we can learn from the advanced experience of foreign countries and integrate multidisciplinary research methods, in order to promote the improvement and sustainable development of the field of evidence-based health policy briefs in China.
ObjectiveTo investigate the best anatomical classification, surgical timing, procedure and clinical outcomes of congenital vascular ring.MethodsThe clinical data of 58 patients who underwent congenital vascular ring surgery in Pediatric Surgery Center, Fuwai Hospital between 2014 and 2019 were retrospectively analyzed. There were 32 (55.2%) males and 26 (44.8%) females with a median age of 16.5 (2-73) months. Preoperative symptoms, imaging examinations, anatomical classifications, surgical procedures and postoperative recovery were assessed.ResultsThere were 20 (34.5%) patients of double aortic arch, 22 (37.9%) patients of right aortic arch with left arterial duct or ligament, 15 (25.9%) patients of left aortic arch with aberrant right subclavian artery, and 1 (1.7%) patient of circumflex aorta with cervical aorta arch. The median ventilator supporting time was 6.0 (0-648) h, and the median hospital stay time was 14.5 (7-104) d. One patient with coarctation of aorta died of severe pulmonary infection during perioperative period, and the others survived without symptoms and reoperation after discharge. The median follow-up time was 7.0 (1-62) months.ConclusionFor children with unexplained dyspnea and dysphagia, or with right aortic arch, preoperative imaging examinations such as computed tomography or magnetic resonance imaging are required to confirm the diagnosis of vascular ring. Surgical correction of congenital vascular ring is safe and reliable, and can effectively relieve symptoms. The mortality rate and reoperation rate are low, and the follow-up results are satisfactory.
ObjectiveTo explore the clinical effect of mitral valvuloplasty on children with Barlow disease combined with moderate to severe or severe mitral regurgitation.MethodsThe clinical data of 10 patients with Barlow disease combined with moderate to severe or severe mitral regurgitation in Fuwai Hospital from January 2014 to August 2019 were analyzed retrospectively, including 3 males and 7 females, with a mean age of 8.7±7.9 years. Echocardiography before and during the operation confirmed that the mitral valve leaflets were long and swinging, the valve leaflets and the opposite edge protruded into the left atrium and were higher than the level of the mitral valve rings, the mitral valve rings were dilated, the papillary muscles and tendons were long, and the pathological changes after the operation showed mucoid degenertion of the valve leaflets and tendons, and some fibrous foci hyperplasia. Mitral valve repair included implantation of artificial valve ring, implantation of artificial tendon, posterior leaflets sliding, partial resection of posterior leaflets (excluding sliding), valve leaflets folding, tendon folding, papillary muscle splitting and annular valve contraction (excluding artificial valve ring implantation). The technique of mitral valve repair, early clinical results and follow-up echocardiographic data were analyzed.ResultsAll the patients successfully completed the mitral valve repair. The mean time of aortic occlusion was 73.2±17.4 min, and cardiopulmonary bypass time was 99.5±19.8 min. At the same time, 4 patients received tricuspid valve repair and 1 funnel chest correction. There was no reoperation in perioperative period. The 1-year and 5-year survival rates were 100.0% and 100.0%, respectively. The incidence of below moderate mitral regurgitation was 90.0% at postoperative 1 year and 72.0% at postoperative 5 years.ConclusionFor the young children who have Barlow disease and mitral regurgitation, considering the characteristics of heavy lesions, small operation space, and the need to meet the growth and development of valve, it is suggested to adopt the surgical techniques different from those of older children, such as valve ring retraction and tendon folding, if necessary, to adopt "edge to edge" suture, which can shorten aortic occlusion time and achieve good early effects, and its long-term effects still need further follow-up observation. Mitral valvuloplasty technique for Barlow disease similar to that of adults can be used in older children, including implantation of artificial valve ring and implantation of artificial tendon, etc.
ObjectiveTo systematically review the recommendations for antiretroviral therapy in the AIDS guidelines, and summarize the sources of evidence supporting the recommendations, the quality of the evidence and the strength of the recommendations, and the consistency of the recommendations. MethodsWe systematically searched for articles published before Dec 2024 in PubMed, Web of Science, Embase, CNKI, WanFang Data, VIP, CBM, and 9 guideline databases, websites, integrating recommendations. Quality and reporting practices were evaluated using AGREE Ⅱ and RIGHT tools respectively. ResultsThe average score of AGREE Ⅱ was 62 points, the overall reporting rate was 69.68%, and the quality of methodology and reporting specifications were low. Analysis of the recommendation results showed that a total of 57 recommendations for ART therapy were extracted from 18 guidelines, mainly recommending 2 NRTIs combined with third-category drugs. NRTI drugs are mainly based on TDF+FTC (3TC), TAF+FTC, and ABC+3TC. The third category of drugs recommended by various guidelines with relatively high frequency includes INSTI (DTG, BIC, RAL), NNRTI (EFV) and PIs (DRV/r). The third category of drugs recommended with relatively high frequency in alternative therapies includes INSTI (DTG, RAL), NNRTI (EFV, RPV) and PIs (DRV/c). ConclusionThe methodological quality and reporting specifications of the HIV clinical practice guidelines need to be improved. The evidence grading of the guidelines is not standardized, there are differences in the combination of drugs recommended by each guideline, the strength of recommendations and the quality of the evidence are inconsistent, and there are obvious differences in the sources of evidence to support the opinions. In the future, it is necessary to combine high-quality clinical trials or randomized controlled trials, adopt systematic and rigorous evidence level and recommendation grading standards when necessary, and provide high-quality evidence sources to formulate complete guidelines. Specific conditions such as the patient's biological indicators should also be fully considered to clarify which virological and biological indicators ART therapy is suitable for, so as to provide precise treatment.
