Medicine
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To compared the effectiveness and safety of single standard mini percutaneous nephrolithotripsy (SM-PCNL) combined with retrograde intrarenal surgery (RIRS) and multiple standard mini percutaneous nephrolithotomy (MSM-PCNL) in the treatment of octopus stone of 2 to 4 cm. The clinical data of SM-PCNL combined with RIRS and MSM-PCNL for octopus stone with a 2 to 4 cm diameter from October 2019 to December 2022 were analyzed retrospectively, and propensity score matching was used to screen patients. The matched patients were paired, and the operation time, complications, postoperative pain, tubeless rate, stone-free rate (SFR), and postoperative hospital stay were further compared between the 2 groups. 88 patients underwent SM-PCNL combined with RIRS (combined group), and 143 patients underwent MSM-PCNL (multiple channel group). ⋯ In postoperative pain (4.00 ± 0.74 vs 5.00 ± 0.74, P = .00), tubeless rate (44.90% vs 20.41%, P = .01), hemoglobin drop (9.38 ± 7.48 vs 14.22 ± 7.69, P = .01), postoperative hospital stay (3.37 ± 1.09 vs 5.08 ± 1.29, P = .00), the combined group was significantly better than the multiple channel group. Regarding operation time, the combined group was more than the multiple channel group (103.27 ± 27.61 vs 78.39 ± 19.31, P = .000). For octopus stone with a diameter of 2 to 4 cm, the effectiveness and safety of SM-PCNL combined with RIRS were similar to those of MSM-PCNL The surgeon should carefully evaluate the patient's physical condition, stone characteristics, and expectations before the operation and assist the patient in choosing an appropriate plan.
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Observational Study
Is there a faster and easier method for assessing the severity of acute mesenteric ischemia?
Acute mesenteric ischemia (AMI) is a potentially fatal abdominal emergency. The estimation of the severity of AMI is of great importance since changes in disease severity may have different impacts on the treatment options. This study aims to define laboratory and radiological parameters that can successfully predict the severity of AMI. ⋯ The measurement of neutrophil/lymphocyte ratio, WBC, NEUT, and albumin levels can be used to predict the severity of AMI. We believe that evaluating these laboratory parameters will greatly prevent possible morbidity and mortality in the patient. Also, we were able to observe that the parameters used in predicting AMI severity can be verified with rapid and low-cost radiological imaging techniques.
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To explore the effect of homogenized nursing interventions for bladder irrigation after urological surgery in primary hospitals, and to further analyze the incidence of postoperative complications according to the different nursing methods. The experiment selected 110 patients with urological disorders who underwent bladder irrigation, and the subjects were admitted to the hospital from January 2020 to October 2023. The subjects were chronologically divided into a control group and an experimental group, with the admission time of the control group being between between January 2020 and October 2022. ⋯ The relative risks of the 4 complications were 1.836, 1.445, 1.993, and 2.138, respectively, which were significantly lower than those of conventional nursing intervention. In the ROC analysis, the AUC values of the 4 complications were 0.832, 0.731, 0.746, and 0.723, respectively. proving the superiority of homogenized care in preventing postoperative complications. Homogenized nursing intervention can effectively reduce the incidence of postoperative complications in patients with urological postoperative bladder irrigation, improve patients' symptoms and prognosis, and improve the quality of care and patients' quality of life.
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The objective of this study was to establish a nausea-free ward model and evaluate the effect of an intervention procedure guided by this model on chemotherapy-induced nausea and vomiting (CINV) in cancer patients. A total of 105 chemotherapy patients from March to September 2022 before the establishment of nausea-free ward in the Chongqing Jiulongpo District People's Hospital were selected as the control group as well as 105 chemotherapy patients from March to September 2023 after the establishment of nausea-free ward as the intervention group. The intervention group was managed by comprehensive standardized CINV management on the basis of the control group. ⋯ The nausea score, vomiting score, and total score of the intervention group were significantly lower than the control group (all P-value <.05). Our study found CINV symptoms and quality of life can be significantly improved by the application of the nausea-free ward model. The nausea-free ward model is instructive in clinical practice and can guide clinical work as well as bring management experience to clinical workers.
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Nonalcoholic steatohepatitis (NASH) is an important etiology of hepatocellular carcinoma (HCC), and there is no established therapy for this syndrome. Rapid-onset obesity with hypothalamic dysfunction, hypoventilation, autonomic dysregulation, and neural crest tumor (ROHHAD(NET)) is an extremely rare syndrome considered to be life-threatening, with death occurring around 10 years of age. We present the oldest known autopsy case of this syndrome that developed HCC. This case provided important information on not only improving the course of this syndrome, but also understanding the natural history and therapeutic modalities of NASH and HCC. ⋯ At age 21, she died from accidental acute pancreatitis, subsequent liver failure and pulmonary hemorrhage. Autopsy revealed that the HCC was mostly necrotized. This case was valuable not only for other ROHHAD(NET) syndrome cases, but also in improving our understanding of the natural history of NASH and HCC.