Medicine
-
We aim to assess factors that affect overall survival in patients with primary small intestinal gastrointestinal stromal tumors (GISTs) who had undergone R0 resection. ⋯ In this study, larger tumor size, high Ki67 index, high mitotic index, the occurrence of tumor rupture, and use of imatinib were independent unfavorable prognostic indicators.
-
We explored factors related to health-related quality of life (HRQOL), including psychiatric symptoms and stigma related to Middle East respiratory syndrome coronavirus (MERS-CoV) infection, among MERS-CoV survivors during the recovery period. Sixty-three MERS-COV survivors were recruited from five hospitals for a cohort study, one year after their infection in 2015. The subjects' demographic information and medical conditions associated with MERS-CoV were recorded. ⋯ Depression, chronic fatigue, posttraumatic stress symptoms and stigma were negatively correlated with the SF-8 PCS and MCS. Multivariate logistic regression analysis showed that the PCS was associated with stigma (OR 8.66, 95% CI 1.96-38.23), whereas MCS was associated with depression (OR 26.62, 95% CI 3.56-198.85). The estimated HRQOL of MERS-CoV survivors during recovery was poor and appeared to be associated with depression and MERS-related stigma.
-
Maximum aortic computed tomography value (CTV) is difficult to control because of variations in cardiac function and patient physique. Therefore, to improve early-phase aortic enhancement on dynamic computed tomography (CT), we developed an estimated cardiac index fractional dose (eciFD). The eciFD protocol is a novel and original protocol for administering fractional dose (FD), representing the amount of iodine per unit body weight per injection duration, based on cardiac index (cardiac output divided by body surface area) as estimated by age in early-phase dynamic CT. ⋯ The combination of eciFD protocol with BT provided a particularly high percentage of patients with ACTV≥300 (86.4%). The eciFD protocol was useful for improving aortic contrast enhancement. These findings need to be validated in a randomized controlled study.
-
Our primary objective was to investigate the clinical features, diagnosis, treatment and prognosis of hepatic perivascular epithelioid cell tumour (PEComa). Thirty-five cases of pathologically proven hepatic PEComa that were treated in the Department of Hepatobiliary Centre of the First Affiliated Hospital of Nanjing Medical University from January 2008 to February 2019 were retrospectively analysed, and the literature was also reviewed. Twenty-nine females and 6 males were included in this study. ⋯ Hepatic PEComas are a rare type of tumours that mainly occur in young and middle-aged women. The lack of clinical manifestations and imaging findings increases the difficulty of determining a preoperative diagnosis, which mainly depends on the results of pathological examinations. Surgery is currently the only effective treatment, and long-term clinical follow-up is necessary due to the aggressive behaviour and relapse of hepatic PEComa in some patients.
-
Breakage of the intramedullary nail is a rare complication after proximal femoral nail antirotation (PFNA) in intertrochanteric fracture treatment. The purpose of this study was (1) to investigate the frequency of nail breakage among the patients who were treated for mechanical failure after PFNA for intertrochanteric/pertrochanteric fracture, and (2) to determine the risk factors for nail breakage in PFNA treatment of intertrochanteric fracture. To identify mechanical failure after internal fixation using PFNA, we retrospectively reviewed the data of 35 patients (35 hips) who required reoperation after PFNA with a helical blade for intertrochanteric/pertrochanteric fracture between June 2005 and June 2018. ⋯ A larger horizontal offset (the horizontal distance from the lateral surface of the IM nail and the medial tip of helical blade) was associated with an increased risk of nail breakage. A CCD angle of 130° has a shorter lever arm for the load of stress from the fulcrum, meaning a higher stress for nail breakage, although there was no association between CCD angle and breakage of the nail. Our study suggested that higher horizontal offset and a higher CCD angle can increase the risk of breakage of the PFNA nail at the aperture for the helical blade.