ObjectiveTo investigate the effect of posture nursing by specially-assigned person and psychological nursing on patients after vitrectomy combined with intraocular silicone oil tamponade. MethodsFrom February 2012 to February 2013, traditional nursing method or posture nursing by specially-assigned person and psychological nursing was carried out respectively for 140 patients who had undergone vitrectomy and intraocular silicone oil tamponade. Adverse effects and retina reattachment effect were compared between the two nursing methods. ResultsAdverse effects after the surgery were significantly fewer in the experimental group than in the control group (P<0.05). The number of patients with retina reattachment in the experimental group was significantly higher than that in the control group (P<0.05). ConclusionPosture nursing by specially-assigned person and psychological nursing reduce postoperative adverse consequences significantly, and achieve the expected operative effect.
目的 探讨替比夫定治疗乙肝e抗原（HBeAg）阳性慢性乙型肝炎（CHB）患者72周的疗效及预测因素的分析。 方法 选择2007年9月－2012年9月符合入选标准的82例CHB患者接受替比夫定治疗72周，于治疗前基线、治疗后每3个月查丙氨酸氨基转移酶（ALT）、乙肝病毒DNA（HBV DNA）、乙肝病毒血清标志物，观察治疗期间累计生化学应答率、完全病毒学应答率(CVR)、HBeAg血清学转换率（SR）及耐药率，分析基线ALT水平[分为＜5 ULN（正常值检测下限）组及≥5 ULN组]、HBV DNA水平（分为＜107 copies/mL组及≥107 copies/mL组）、24周HBV DNA水平（＜3 log 10 copies/mL组及≥3 log 10 copies/mL组），预测72周CVR及SR。 结果 172周累计生化学应答率、CVR、SR、耐药率分别为86.6%、81.7%、42.7%、18.2%；2基线ALT≥5 ULN对72周SR有预测价值（χ2=5.651，P=0.017），HBV DNA＜107 copies/mL对CVR有预测价值（χ2=7.083，P=0.008）；324周HBV DNA＜103 copies/mL对72周CVR及SR均有预测价值（χ2=27.339，5.131；P=0.000，0.023）。 结论 替比夫定初治HBeAg阳性CHB患者疗效及安全性好，治疗24周HBV DNA＜103 copies/mL是72周疗效的最佳预测指标。
ObjectiveTo explore the preoperative evaluation result of multidetector computed tomography (MDCT) in aortic stenosis (AS) patients with bicuspid aortic valve (BAV) undergoing transcatheter aortic valve replacement (TAVR) in order to summarize relevant experience.MethodsA total of 33 consecutive AS patients who underwent TAVR in Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University from March 2016 to June 2020 were enrolled, and the preoperative evaluation characteristics of MDCT were compared between tricuspid aortic valve (TAV) and BAV.ResultsIn the 33 patients, whose mean age was (74±6) years, 22 were male and 11 were female, 17 were with BAV and 16 were with TAV. The medium (lower quartile, upper quartile) of calcification score was 360 (192, 1 034) mm3. There were 12 cases of artificial valve model to be speculated Downsize, including 9 calcific BAV cases (75%).ConclusionThe calcific BAV has a higher ratio of Downsize in the TAVR procedure.
Stroke is one feared complication after transcatheter aortic valve replacement (TAVR). It affects the prognosis of TAVR, leading to a decline in the survival rate and quality of life of patients, while increasing the economic burden of patients. In recent years, a variety of cerebral embolic protection devices have been used to reduce the incidence of stroke during TAVR and improve the prognosis, some of which have been approved for clinical use. However, there are many controversies about their safety and effectiveness. This article reviews the definitions, short-term and long-term incidences, and risk factors of TAVR-related stroke, and elaborates on recent large-scale studies of different cerebral embolic protection devices.
Severe symptomatic native aortic regurgitation (AR) is associated with poor prognosis. Surgical aortic valve replacement is presently the main choice of treatment according to current guidelines. The data of safety and efficacy of transcatheter aortic valve replacement (TAVR) for patients with pure native AR were limited. In this paper, a case of AR patient with heart failure was reported. After preoperative CT evaluation and operation plan, the postoperative symptoms improved significantly. Bundle branch block and retroperitoneal hematoma appeared during hospitalization. After the treatment, the patient’s condition improved. Before the discharge, cardiac ultrasound indicated that the reflux was significantly improved, no perivalvular leakage was observed, and cardiac function was improved. AR remains a challenging pathology for TAVR. TAVR is a feasible and reasonable option for carefully selected patients with pure AR.
It has been 20 years since the first transcatheter aortic valve replacement (TAVR) was performed internationally in 2002, and the development of TAVR technology in China has also been more than 10 years. The reliability of TAVR has been clinically proven, and it has also brought good benefits to patients with aortic stenosis. With the gradual progress of technology, TAVR has a trend to surpass surgical aortic valve replacement and become the mainstream surgery for patients with aortic stenosis. This article will review the relevant issues in the development of TAVR technology in recent years, based on existing research, and provide certain clinical references for the future development of TAVR technology.
Coronavirus disease 2019 (COVID-19) is highly contagious, and the route of transmission is dominated by respiratory droplets and contact transmission. At present, the disease prevention and control are difficult. In order to prevent and control COVID-19 and prevent its spread in the hospital, West China Hospital of Sichuan University has set up isolation wards in the center of infectious diseases. The work norms for isolation ward were formulated. This may help to strengthen the prevention and treatment of COVID-19, effectively control the epidemic situation, as well as protect the health and safety of the public and medical staff. This article introduces the specific settings, diagnosis and treatment specifications, and hospital infection prevention and control strategies of the isolation ward of West China Hospital of Sichuan University, shares the work experience of isolation wards, aims to provide a reference for other hospitals to effectively prevent the spread of COVID-19 in hospitals and curb the spread of COVID-19.