Medicine
-
Mesenteric abscess, a rare abdominal infection, is regularly mostly secondary to inflammatory bowel disease, diverticula of the small intestine, or tuberculosis. Primary mesenteric abscesses are extremely rare. If not diagnosed and treated in a timely manner, it may lead to serious consequences; computerized tomography is highly beneficial for the diagnosis of this disease; timely surgical intervention, judicious use of antibiotics, and adequate nutritional support are crucial in the management of this disease. ⋯ Primary mesenteric abscess is a local tissue infectious disease. Whereas we should consider the physical basic condition of the patient during therapeutic process. We believe adequate postoperative drainage, rational use of antibiotics based on bacterial culture, early ambulation after surgery, and adequate nutritional support might be key points for successful therapy.
-
Invasive pulmonary aspergillosis (IPA) is an uncommon but life-threatening disease. The disease often occurs in immunocompromised patients or critically ill patients. Here, we reported that IPA occurred in a non-immunocompromised host. ⋯ The immunocompetent adults can develop invasive pulmonary aspergillosis if they are exposed to high-risk environments. IPA in non-immunocompromised host should arouse the vigilance of clinicians.
-
Impact of microcirculation status from mortality of critically ill population has been investigated for decades, but the prognosis of early initial microcirculation disturbance in critically ill population in the intensive care unit remains to be explored. The cohort study was conducted using the medical information database for intensive care IV. Critically ill adult in intensive care unit have been enrolled and categorized by early microcirculation status. ⋯ Some patients with a highest lactate level >2.2 mmol/L on the firstly day of admission (n = 1468) were then extracted for further analysis. 735 patients received in the initial microcirculation disturbance group as well as 733 patients were in the hyperlactatemia group. In those with elevated lactate, the 28-day mortality of early microcirculation disturbance was higher than that of hyperlactatemia alone (7-day mortality [16.19% vs 12.68%; Adjusted hazard ratio 1.35, 95% confidence intervals 1.03 to 1.78, P = .029], 28-day mortality [33.33% vs 27.28%; adjusted HR 1.34, 95% confidence interval 1.11 to 1.67, P = .002]). Early microcirculatory disturbances (increased PV-ACO2/CA-VO2 ratio and higher initial blood lactate level) were more reliable predictors of in-hospital mortality than early isolated lactate elevation.
-
In lobectomy of patients with lung cancer, the principle of operation is to cut off the pulmonary vein first, but it is often not taken seriously in clinical practice. We conducted this research to compare the impact of different sequences of pulmonary vessel ligation on the long-term survival of patients. This cohort study included 1239 patients treated surgically with video-assisted thoracoscopic lobectomy from January 2015 to December 2019 at The Second Affiliated Hospital of Nanchang University. ⋯ Meanwhile, the survival advantage of VF was achieved in almost all subgroups, particularly in the pathological tumor node metastasis stage I-II group and squamous cell carcinoma group. We obtained no significant differences in perioperative indications (operation time, hospital stay, etc) between VF and artery-first group. With better overall survival and disease-free survival, especially for pathological stage I-II squamous cell carcinoma, vein-first ligation should be strictly observed in lobectomy for patients with non-small cell lung cancer.
-
Neuralgic amyotrophy (NA) is a clinically acute or subacute disease. To study the characteristics of brachial plexus magnetic resonance neurography (MRN) in patients with NA, and to explore the clinical application value of MRN combined with electromyography (EMG) in the diagnosis of NA. ⋯ The main feature of MRN in patients with NA was that it was unilateral brachial plexus asymmetric involvement. The diagnostic effect of MRN was better than that of EMG. The combined diagnosis of MRN and EMG can help clinicians diagnose NA accurately.