Medicine
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Observational Study
Assessment of fetal cardiac diastolic function of gestational diabetes mellitus using dual-gate Doppler.
Gestational Diabetes Mellitus (GDM), as a common complication of pregnancy, has an increasing trend globally. GDM leads to maternal complications and fetal complications. Fetal cardiac diastolic dysfunction is strongly associated with GDM. ⋯ Fetal right ventricular function is a potential key point to study to enable an early detection for fetal diastolic dysfunction since the alteration and damage are more likely to happen in right ventricular. Measurement of E/e' ratio using DD method is considered as a promising method in fetal cardiac diastolic function assessment. Well or poorly control of the GDM does not have significant influence on the fetal diastolic function thus an early detection of GDM and GDM induced fetal cardiac dysfunction is necessary.
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Concurrent kidney and ureteral stones are always complicated and a clinical challenge. Improvements in endoscopic equipment have led to the widespread adoption of retrograde intrarenal surgery, which has a good stone clearance rate. On the other hand, laparoscopic ureterolithotomy (LUL) has been reported to be non-inferior to retrograde flexible ureteroscopy in stone-free rate and the need for axillary procedures, and to have a significantly lower rate of post-operative sepsis compared to retrograde flexible ureteroscopy. We describe a case managed with LUL followed by laparoscope-assisted retrograde intrarenal surgery (LA-RIRS) in a single operation for a large upper ureteral stone and small renal stones, which is usually challenging and requires axillary procedures. ⋯ LUL with LA-RIRS with a stone basket for renal stone extraction is a safe and feasible technique, and no step surgery or axillary procedures were needed in our case. If clinical cases with a huge stone burden over the ureter are indicated for LUL with concurrent small renal stones, LUL with LA-RIRS can be an alternative option.
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Hypersplenism causes thrombocytopenia, which may lead to the reduction or discontinuation of chemotherapy. Partial splenic embolization (PSE) is an effective treatment for thrombocytopenia associated with hypersplenism. However, there have been no reports of patients with gastric cancer who have resumed and continued chemotherapy after PSE for splenic hypersplenism associated with tumor infiltration.Here, we report two cases in which we performed PSE for hypersplenism associated with gastric cancer that had invaded the splenic vein. Chemotherapy was continued in both cases. ⋯ PSE seems to be a useful treatment for thrombocytopenia with splenomegaly associated with advanced gastric cancer and may allow continuation of chemotherapy.
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Observational Study
Predictors for intraoperative heart failure in children undergoing foreign-body removal.
This study aimed to determine the predictors for intraoperative heart failure (HF) in children undergoing foreign-body removal. The clinical data of all children with tracheobronchial foreign-body aspiration admitted to the First, Second, and Fourth Affiliated Hospitals of Harbin Medical University between January 1996 and September 2018 were analyzed. The variables with significant difference in univariate analysis were involved into the multivariate Logistic model to determine the predictors for intraoperative tachycardia. ⋯ Between the children HF and those without HF, the differences were pronounced in history of allergy, history of asthma, congenital heart disease, preoperative respiratory infection, retention time of foreign bodies, duration of operation, and poor anesthesia effect (P < .05). Multivariate analysis results showed that history of allergy (odds ratio [OR]: 1.395, 95% confidence interval [95% CI]: 1.202-1.620, P < .001), congenital heart disease [OR: 3.071, 95% CI: 1.141-8.264, P < .001], preoperative respiratory infection [OR: 2.345, 95% CI: 1.027-5.355, P = .043], retention time of foreign bodies [OR: 1.013, 95% CI: 1.010-1.016, P < .001], duration of operation [OR: 1.030, 95% CI: 1.027-1.033, P < .001], and poor anesthesia effect [OR: 1.125, 95% CI: 1.117-1.134, P < .001] were identified as the influencing factors for intraoperative HF. In conclusions, for children undergoing foreign-body removal, history of allergy, congenital heart disease, preoperative respiratory infection, retention time of foreign bodies, duration of operation, and poor anesthesia effect are associated with an increased risk of intraoperative HF.
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Cervical intraepithelial neoplasia (CIN) is the abnormal growth of cells on the surface of the cervix that could potentially lead to cervical cancer. In the present study, we investigated whether measuring the neutrophil-lymphocyte ratio (NLR) can be useful for predicting the risks of developing cervical lesions. This is a retrospective analysis of 212 women who were enrolled in this study. ⋯ The median of the NLR was higher in the HPV16-persistent groups than in the HPV-negative group. In conclusion, a high NLR value independently predicts CIN and the stage of CIN. The NLR may help doctors evaluate outcomes of patients received conization and choose alternative therapies for patients with high NLR value.