Objective To review the l iterature about the development of resection and reconstruction of sacral tumors. Methods Based on an extensive review of the latest l iterature concerned, we analyzed the cl inical research on resection and reconstruction of the sacral tumor. Results The development of resection and reconstruction of the sacral tumor in the fields of modus operandi and biomechanics provided a new cl inical concept for the therapy of the sacral tumor. Conclusion On the basis of the research of biomechanics, the therapy of the sacral tumor has a bright future.
摘要:目的: 研制貝克曼CX系列全自動生化分析儀電解質配套試劑盒。方法 評價自配電解質試劑盒的主要性能指標:準確度、精密度、線性范圍、穩定性和相關性,并與原裝試劑進行臨床標本測定結果比較。結果 自配試劑盒測定定值血清Na+、K+、Cl平均相對偏差均小于2%;批內精密度、批間精密度較好,變異系數(%)均小于2%;與原裝試劑測定結果高度正相關,相關系數〖WTBX〗r 均大于099。結論 自配試劑完全可以取代進口試劑進行臨床應用。Abstract: Objective: To develop ISE(ion selective electrode) reagent for Beckman CX series automatic chemistry analyzer. Methods : Validation the main performances of selfmade reagent, including accuracy, precision, linear range, stability, and relevance, and carried clinical comparison test with the original reagent kit. Results : The main performances of selfmade reagent achieved the experimental anticipated request. As analyzing the valued serum, the average relative deviations of Na+,K+,Clwere less than 2%; withinrun precision and betweenrun precision were good,coefficient of variations were less than 2%; the selfmade reagent was highly correlated with the original reagent kit,correlation coefficient was greater than 099 Conclusion : Selfmade reagent could substitute the original reagent kit for clinical laboratory.
Objective
We probed how to predict left ventricular ejection fraction (LVEF) of the ischaemic cardiomyopathy (ICM) patients would be improved apparently after revascularization.
Methods
Between July 2010 and December 2015, 245 ICM patients (30%≤LVEF≤40%) with coronary bypass grafting (CABG) were retrospectively observed. Among them, 146 patients were accompanied by ischemic mitral regurgitation (IMR) (146/245, 59.6%), and 41 patients underwent mitral valvuloplasty or replacement because of more than moderate IMR. There were 13 patients early death, and other 232 patients who were followed up over 6 months were divided into two groups based on whether or not post-operative LVEF increased by 10%: a LVEF recovered group (group A, 124 patients) and a non-recovered group (group B, 108 patients).
Results
Preoperative NT-proBNP in the group A was significantly higher than that in the group B (P=0.036). There were less patients with myocardial infarction in the group A than that in the group B (P=0.047), and more with angina pectoris in the group A than that in the group B (P=0.024). There was no significant difference in the extent of mitral regurgitation or mitral surgery between the groups A and B (P>0.05). There were lower left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD) and left ventricular end-diastolic volume (LVEDV) in the group A than those in the group B (P<0.05). Multivariate analysis revealed that preoperative LVEDD dilated apparently and no angina pectoris existed before surgery were independent risk factors for LVEF with no recovery in the ICM patients (30%≤LVEF≤40%) after revascularization. The LVEDD of 245 patients (including 13 early deaths) was 41-71 mm. We found that the ICM patients with LVEDD ≥60 mm were more likely to signify the unfavourable prognosis (χ2=8.63, P=0.003, OR=2.21, 95% confidence interval 1.25 to 3.91).
Conclusion
Preoperative LVEDD dilated and no angina pectoris before surgery are independent risk factors for LVEF with no recovery in the ICM patients (30%≤LVEF≤40%) after revascularization. LVEDD≥60 mm can be regarded as the preoperative forecasting factors for the unfavourable prognosis in the ICM patients (30%≤LVEF≤40%) after revascularization.
Patient reported outcome measures (PROM) are widely used in clinical research and practice. To aid the interpretation of PROM, researchers have proposed the minimal important difference (MID), the smallest change or difference that patients perceive as important. However, the estimation methods of MID are numerous and inconsistent, which brings difficulties to selecting the optimal MID estimate to interpret PROM results. To address this issue, a research team from McMaster University in Canada has proposed an approach for selecting the optimal MID. This method includes three core steps: evaluating the credibility of MID estimates, assessing the consistency among credible MID estimates, and selecting the optimal value based on contextual factors. The credibility evaluation instrument for anchor-based MID examines five core criteria, including the data sources of PROM and anchor, the interpretability of anchor, the correlation between anchor and PROM, the precision of MID estimates, and the judgment of anchor thresholds. When there are multiple credible MID estimates, the optimal MID estimate is selected by evaluating the consistency among the estimates and considering contextual factors that affect the variability among the estimates, such as the type of intervention, follow-up time, and disease severity. In addition, the team provided recommendations to improve the reporting quality of MID studies. This article provides a detailed introduction and interpretation of these developments, aiming to enhance researchers' and clinicians' understanding and application of MID, thereby supporting clinical research and healthcare decision-making.
ObjectiveTo analyze factors affecting the recovery of postoperative left ventricular function in patients with valvular disease combined with heart failure with reduced ejection fraction [HFrEF, left ventricular ejection fraction (LVEF)<40%].MethodsThe clinical data of 98 patients with valvular disease combined with HFrEF who underwent surgeries in our hospital from January 2011 to June 2018 were retrospectively analyzed, including 75 males and 23 females aged 9-78 (55.3±11.9) years.ResultsA total of 15 patients were dead after the operation, including 4 deaths within 3 months and 11 mid-long-term deaths after the operation. Ninety-one patients were followed up for more than 6 months (10 months to 8.6 years). The postoperative cardiac function (NYHA) of 91 patients was classⅠ-Ⅱ, the LVEF of 18 (19.8%) patients increased more than 10%, that of 47 (51.6%) patients maintained at the preoperative level, and that of 26 (28.6%) patients decreased. Postoperative LVEF was more prone to recover in HFrEF patients with sinus rhythm before operation (P=0.038), valvular disease mainly in aortic valve (P=0.026), obvious reduction of left ventricular end diastolic diameter in early postoperative period (P=0.017), and higher systolic pulmonary artery pressure (SPAP) before operation (P=0.018). The risk factors for postoperative LVEF deterioration included large left atrium before operation (P=0.014), smaller left ventricle end systolic diameter before operation (P=0.003), and fast heart rate after operation (P=0.019). ConclusionMitral valve prolapse patients with obviously increased left ventricular diameter should receive operation as soon as possible. HFrEF patients with aortic valve disease should receive operation positively. The operation efficacy is satisfactory in the HFrEF patients with high SPAP.
Objective To identify risk factors for death in patients with rhabdomyolysis-induced acute kidney injury (RI-AKI) treated with continuous renal replacement therapy (CRRT), then to develop and validate the efficacy of prediction models based on these risk factors. Methods Clinical data and prognostic information of patients with RI-AKI requiring CRRT from 2008 to 2019 were extracted from the MIMIC-IV 2.2 database. The enrolled patients were divided into a training set and a test set at a ratio of 7∶3. LASSO regression, random forest (RF) and extreme gradient boosting (XGBoost) were used to identify the risk factors affecting patients’ 28-day survival in the training set, then to develop logistic model, RF model, support vector machine (SVM) model and XGBoost model. The accuracy of above prediction models and the area under the receiver operating characteristic curve (AUC) were calculated in the test set. Results A total of 175 patients were included. Lactic acid, age, Acute Physiology Score Ⅲ, hemoglobin, mean arterial pressure and body mass index measured at intensive care unit admission were identified as the six risk factors affecting 28-day survival of enrolled patients by LASSO regression, RF and XGBoost. The accuracy of the logistic model, RF model, SVM model and XGBoost model in the test set was 0.75, 0.79, 0.79 and 0.81, with the AUC of 0.82, 0.85, 0.87 and 0.87, respectively. Conclusion The XGBoost model, incorporating six risk factors including lactic acid, age, Acute Physiology Score Ⅲ, hemoglobin, mean arterial pressure, and body mass index assessed at the time of admission to the intensive care unit, demonstrates superior clinical predictive performance, thereby enhancing the clinical decision-making process for healthcare professionals.
ObjectiveTo analyze the restoration of intervertebral height and lordosis of fusion segment after open-transforaminal lumbar interbody fusion (Open-TLIF) and minimally invasive-TLIF (MIS-TLIF).MethodsBetween January 2013 and February 2016, patients who treated with TLIF due to lumbar degenerative diseases and met the selection criteria were selected as the study objects. Among them, 41 patients were treated with open-TLIF (Open-TLIF group), 34 patients were treated with MIS-TLIF (MIS-TLIF group). There was no significant difference between the two groups (P>0.05) in gender, age, body mass index, disease type, disease duration, pathological segment, and other general data. The intraoperative bleeding volume, hospital stay, visual analogue scale (VAS) score of waist and leg, and Oswestry disability index (ODI) were recorded before and after operation. The anterior disc height (ADH), posterior disc height (ADH), and segmental lordosis (SL) of fusion segment were measured by X-ray film before and at 6 months after operation. The differences of ADH, PDH, and SL between pre- and post-operation were calculated.ResultsThe intraoperative bleeding volume and hospital stay in Open-TLIF group were significantly higher than those in MIS-TLIF group (t=14.619, P=0.000; t=10.021, P=0.000). All incisions healed by first intention without early complications. All patients were followed up 6-24 months (mean, 12.6 months) in Open-TLIF group and 6-24 months (mean, 11.5 months) in MIS-TLIF group. The preoperative VAS scores of waist and leg and ODI of the two groups significantly improved (P<0.05). There was no significant difference in VAS scores and ODI between the two groups before operation and at 2 weeks and 6 months after operation (P>0.05). Imaging examination showed the good intervertebral fusion. There was no significant difference in ADH, PDH, and SL between the two groups before operation and at 6 months after operation (P>0.05). The differences of ADH, PDH, and SL between the two groups were not significant (P>0.05). The ADH, PDH, and SL after operation significantly increased in the two groups (P<0.05).ConclusionOpen-TLIF and MIS-TLIF show similar effectiveness and radiological change in the treatment of single lumbar degenerative diseases and the improved intervertebral height and lordosis, but MIS-TLIF can significantly reduce hospital stay and intraoperative blood loss.
