Medicine
-
Recurrence of hepatocellular carcinoma (HCC) after liver transplantation (LT) remains a major therapeutic challenge. In recent years, new molecular-targeted therapies, such as cabozantinib, have been approved for the treatment of advanced HCC. However, clinical experience with these new drugs in the treatment of HCC in the LT setting is very limited. ⋯ In conclusion, this report highlights the tolerability and effectiveness of cabozantinib for the treatment of HCC recurrence after LT. We show that our patient with a late recurrence of HCC after LT benefitted from intensive multimodal therapy concepts, including surgery, RFA, and systemic therapy.
-
Chronic obstructive pulmonary disease (COPD) is a widespread, heterogeneous disease characterized by chronic inflammation of the airway and the gradual blockage of air flow due to bronchial obstruction. At present, a large number of traditional Chinese medicine injections (TCMIs) has been applied in the clinical treatment of COPD. However, there is insufficient evidence of evidence-based medicine of the interaction between them. Therefore, the purpose of this study is through the network meta-analysis to evaluate the efficacy and safety of the different TCMIs treatment of COPD, offering reference and evidence for clinical application. ⋯ The results of this study will evaluate the efficacy and safety of TCMI in the treatment of COPD, and provide decision-making references for future clinical and scientific research.
-
There is a lack of evidence supporting the association between carbon monoxide (CO) poisoning and acute kidney injury (AKI). Hence, the present study aimed to evaluate the association between CO poisoning and AKI. From 2000 to 2011, we identified patients diagnosed with CO poisoning from the inpatient claims data. ⋯ The hazard ratios and 95% confidence interval (CI) were calculated in the models. Compared with the control cohort, patients with severe CO poisoning were 3.77 times more likely to develop AKI (95% CI = 2.20-6.46), followed by those with less severe CO poisoning (adjusted hazard ratio = 2.21, 95% CI = 1.61-3.03). The findings of this nationwide study suggest an increased risk of AKI in patients with CO poisoning.
-
Comparative Study
Comparison of the effects of retroperitoneoscopic ureterolithotomy and ureteroscopic lithotripsy in the treatment of upper ureteral calculi.
This study compares the efficacy of retroperitoneoscopic ureterolithotomy (RPUL) and ureteroscopic lithotripsy (URL) in the treatment of upper ureteral calculi. The clinical data of 150 patients with upper ureteral calculi who underwent RPUL and 136 patients who underwent URL between January 2014 and October 2019 were retrospectively analyzed. The operation time, postoperative hospital stay, operation success rate, stone clearance rate, and surgical complications were evaluated between the two groups. ⋯ Both RPUL and URL had the advantages of low trauma and fast recovery rate for patients with upper ureteral calculi. However, patients who underwent RPUL showed higher success and fewer complication rate. RPUL might be a safe and effective laparoscopic method for the treatment of patients with upper ureteral calculi.
-
Clinical Trial
Echocardiographic assessment of left atrial function for prediction of efficacy of catheter ablation for atrial fibrillation.
Proper selection for catheter ablation (CA) for atrial fibrillation (AF) is still an issue. Echocardiographic assessment of left atrium (LA) is complex and challenging. Speckle tracking echocardiography (STE) with recent standardized LA deformation analysis allows for the quantitative assessment of various LA function parameters. ⋯ The opportunity of CA success was 135 fold higher for each 1% increase in global LASr. The receiver operating characteristic (ROC) analysis identified global LASr and left atrial conduit strain (LAScd) as the most powerful parameters for predicting of CA outcome with an area under the curve of 0.896 and 0.860, respectively, in the whole study group, and 0.922 and 0.938, respectively, in patients with not enlarged LA. In patients with paroxysmal AF and normal standard echocardiographic assessment, parameters reflecting LA compliance - reservoir and conduit strain, are independent and strong predictors of CA outcome.