Medicine
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Observational Study
Simpler and safer anastomosis by pancreaticogastrostomy using a linear stapler after pancreaticoduodenectomy.
Postoperative pancreatic fistula (POPF) remains a major and serious problem after pancreaticoduodenectomy (PD). In its presence, pancreatic juice may leak from the main duct or branches of the pancreatic stump. To prevent this, we have applied a newly modified anastomosis of pancreaticogastrostomy (PG) using a linear stapler (stapled PG). ⋯ Three patients showed POPF grade B and 2 patients exhibited POPF grade C. Stapled PG after PD may reduce clinically relevant POPF. Because our sample size was small, the further accumulation of cases is required to validate this method.
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Observational Study
Small prostate associated with higher incidence of detrusor underactivity and tendency of combination with bladder stone in patients with bladder outlet obstruction.
Benign prostate hyperplasia is the leading cause of lower urinary tract symptoms due to bladder outlet obstruction (BOO) in elderly male patients. The impact of prostate volume (PV) on clinical and urodynamic characteristics was evaluated in those patients with BOO requiring prostate de-obstruction maneuvers in this study. We retrospectively reviewed the clinical data of 301 patients underwent transurethral resection of prostate due to combination with urinary retention (UR) alone and bladder stone (BS) alone. ⋯ Significant higher proportion of UR was found in patients with moderate (18%) and large prostate (47.6%) when compared to that of small prostate (3.7%), whereas higher proportion of BS was found in patients with small prostate (96.7%) compared to that of moderate (82%) and large (52.4%) prostate. Lower incidence of DU was discovered in large prostate (31.9%) compared with small (55.6%) and moderate (47.2%) prostate. BOO patients with small prostate were associated with less severity of BOO but higher incidence of DU and had a tendency of occurrence of BS, which gave a support for the theory that multifactor involved in the formation of BS rather than BOO only.
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This study evaluates the diagnostic accuracy of ultrashort echo time (UTE)-MRI for detecting pulmonary nodules and image quality. A total of 46 patients at our hospital underwent unenhanced computed tomography (CT) and UTE-MRI. The image quality and number of nodules detected using CT were used as the gold standards. ⋯ For blood vessels, subsegment blood vessels could also be displayed with clear walls and uniform signals (Kendal Wa = 0.823, P < .001), indicating strong consistency. Compared to CT, UTE-MRI can detect pulmonary nodules with a high detection rate, relatively good image quality, and strong consistency between observers. The development of UTE-MRI can provide a novel imaging method for the detection and follow-up of pulmonary nodules and diagnosis of pneumonia by reducing ionizing radiation.
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Traditional general anesthesia in elderly lung cancer patients undergoing pulmonary lobectomy may lead to hemodynamic fluctuations and postoperative complications. To optimize anesthesia efficacy, this study explores the application of combined anesthesia (general anesthesia combined with thoracic paravertebral block) in such surgeries. We evaluated the improvement of pulmonary oxygenation function, hemodynamic stability, and respiratory compliance in elderly lung cancer patients undergoing pulmonary lobectomy with combined anesthesia. ⋯ Additionally, patients in the treatment group showed faster recovery of cognitive function, better sleep quality, and a relatively lower incidence of postoperative complications. Combined anesthesia demonstrates unique advantages in pulmonary lobectomy for elderly lung cancer patients, optimizing intraoperative hemodynamic stability, promoting postoperative pulmonary function recovery, accelerating cognitive function recovery, improving sleep quality, and potentially reducing the risk of postoperative complications. This finding provides a new effective strategy for anesthesia management in elderly lung cancer patients.
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Observational Study
Study on the clinical characteristics, treatment, and outcome influencing factors of severe pneumonia complicated with ARDS.
To investigate the clinical characteristics, treatment methods, and factors influencing the prognosis of patients with severe pneumonia complicated by Acute Respiratory Distress Syndrome (ARDS), aiming to provide references for clinical decision-making and improve patient outcomes. A retrospective analysis was conducted on 118 patients with severe pneumonia complicated by ARDS treated at our hospital from June 2018 to December 2022. Based on treatment outcomes, patients were divided into a death group (n = 75) and a survival group (n = 43). ⋯ This indicates that an increase in age and a decrease in oxygenation index are associated with a significantly higher risk of mortality, while shorter mechanical ventilation duration is related to poorer prognosis. Advanced age, lower oxygenation index, and shorter duration of mechanical ventilation are unfavorable prognostic factors in patients with severe pneumonia complicated by ARDS. These findings aid clinicians in identifying high-risk patients, optimizing treatment plans, and improving patient prognosis.