简介：无

简介：无

简介：AbstractExposure to outdoor air pollution has been consistently associated with asthma. In this study, we reviewed the epidemiological studies published within the last 5 years on the association between outdoor air pollution and exacerbation and onset of asthma. A large number of studies have been published within the last 5 years. Short-term exposure to outdoor air pollution is associated with exacerbation of pre-existing asthma, manifested as worsening of symptoms and increasing of asthma-related emergency room visits and hospital admissions. Furthermore, increasing evidence suggests that long-term exposure to outdoor air pollution can result in onset of asthma. Children are more susceptible to outdoor air pollution. Future studies should be conducted to explore the mechanisms underlying the association between air pollutants and onset of asthma, including gene involvement. In addition, disentangling the effect of a mixture of air pollutants and identifying the key components of air pollution will complete the existing evidence. More importantly, a better understanding is required on the future impact of air pollution on asthma under a changing climate.

简介：AcuterheumaticfeverisinitiatedbygroupAstreptococcalphar-yngitis.Thisisfollowedbyalatentperiodof2-6weeks,afterwhichtheclinicalsyndromeofacuterheumaticfeverevolves,characterizedbypolyarthritis,carditis,chorea,erythemamarginatumandsubcutaneousnodules.Thesefeaturesmayoccursinglyorinanycombination.

简介：

简介：AbstractObjective:Acute pancreatitis (AP) results in systemic inflammatory responses and activates coagulation pathways. We intend to investigate the risk and hospital outcomes of acute venous thromboembolisms (VTE) in patients with AP.Methods:We retrospectively analyzed patients with AP from 2016 to 2019 using the National Inpatient Sample database. Primary outcome was the effect of VTE on the length of stay, inpatient costs, and mortality. Hierarchical multivariate logistic regression models were built using univariate screens.Results:The study included 909,354 weighted discharges with AP. 2.1% of cases had an acute VTE. The length of stay was 5.9 days longer in the hospital of AP patients with VTE compared to AP with no VTE (P <.001). Total hospital charge per patient was $71,914 in patients with VTE compared to AP with no VTE (P < .001). Mortality was higher in AP patients with VTE compared to AP with no VTE (adjusted odds ratio [AOR] 4.2, 95% confidence interval [CI]: 3.4-5.3, P <.001). AP was associated with an increased VTE risk during inpatient stay (AOR 1.06, 95% CI 1.04-1.1, P <.001) There was an increased association of lower and upper extremity deep venous thrombosis with AP without necrosis (AOR 6.9, 95% CI 6.4-7.4, P <.001) and AP with infected necrosis (AOR 12.2, 95% CI 10.6-14.1, P <.001) but not in AP without necrosis (AOR 0.77, 95% CI 0.74-0.81, P <.001).Conclusion:VTE in AP increases length of stay and inpatient costs. The prognosis is poor in such patients, with increased inpatient mortality compared to no VTE. AP with necrosis can increase chances of all VTE subtypes; however, AP without necrosis does not increase upper and lower extremity VTE risk.

简介：

简介：无

简介：AbstractPurpose:Malnutrition is a common problem among hospitalized patients, especially among traumatic brain injury (TBI) patients. It is developed from hypermetabolism and the condition may worsen under the circumstance of underfeeding or incompatible dietary management. However, the data of nutrient intake especially calorie and protein among TBI patients were scarce. Hence, this study aimed to determine the calorie and protein intake among acute and sub-acute TBI patients receiving medical nutrition therapy in hospital Sultanah Nur Zahirah, Terengganu.Methods:This observational study involved 50 patients recruited from the neurosurgical ward. Method of 24 h dietary recall was utilized and combined with self-administered food diaries for 2-8 days. Food consumptions including calorie intake and protein intake were analyzed using Nutritionist PRO™ (Woodinville, USA) and manual calculation based on the Malaysian food composition database (2015).Results:Patients consisted of 56% males and 44% females with the median age of 28.0 (IQR = 22.8-36.5) years, of which 92% were diagnosed as mild TBI and the remaining (8%) as moderate TBI. The Glasgow coma scale (GCS) was adopted to classify TBI severity with the score 13-15 being mild and 9-12 being moderate. The median length of hospital stay was 2 (IQR = 2.0-3.3) days. Calorie and protein intake improved significantly from day 1 to discharge day. However, the intake during discharge day was still considered as suboptimal, i.e. 75% of calorie requirement, whilst the median protein intake was only 61.3% relative to protein requirement. Moreover, the average percentages of calorie and protein intakes throughout hospitalization were remarkably lower, i.e. 52.2% and 41.0%, respectively.Conclusion:Although the calorie and protein intakes had increased from baseline, hospitalized TBI patients were still at a risk to develop malnutrition as the average intakes were considerably low as compared to their requirements. Optimum nutrient intakes especially calorie and protein are crucial to ensure optimum recovery process as well as to minimize risks of infection and complications.

简介：

简介：AbstractAcute pancreatitis (AP) is a common and potentially life-threatening pancreatic inflammatory disease. Although it is usually self-limiting, up to 20% of patients will develop into severe AP. It may lead to systemic inflammatory response syndrome and multiple organ dysfunction, affecting the lungs, kidneys, liver, heart, etc. Surviving patients usually have sequelae of varying degrees, such as chronic hyperglycemia after AP (CHAP), pancreatic exocrine insufficiency, and chronic pancreatitis. Lacking specific target treatments is the main reason for high mortality and morbidity, which means that more research on the pathogenesis of AP is needed. Ferroptosis is a newly discovered regulated cell death (RCD), originally described in cancer cells, involving the accumulation of iron and the depletion of plasma membrane polyunsaturated fatty acids, and a caspase-independent RCD. It is closely related to neurological diseases, myocardial infarction, ischemia/reperfusion injury, cancer, etc. Research in the past years has also found the effects of ferroptosis in AP, pancreatic cancer, and AP complications, such as acute lung injury and acute kidney injury. This article reviews the research progress of ferroptosis and its association with the pathophysiological mechanisms of AP, trying to provide new insight into the pathogenesis and treatment of AP, facilitating the development of better-targeted drugs.

简介：Acutepancreatitisduringpregnancyisarareevent,andcanbeassociatedwithhighmaternalmortalityandfetalloss.Gallstonediseaseisthoughttobethemostcommoncausativefactorofacutepancreatitis,but,inmanycases,thecauseremainsunclear.Wereportacaseofa36-year-oldwomanat35wkofgestation,whopresentedwithseverepainconfinedtotheupperabdomenandradiatingtotheback.Thepatientwasdiagnosedwithacuteidiopathicpancreatitis,whichwasmanagedconservatively;sherecoveredwithinseveraldaysandthendeliveredahealthybaby.Thereforeitisimportanttoconsideracutepancreatitiswhenapregnantwomanpresentswithupperabdominalpain,nauseaandvomitinginordertoimprovefetalandmaternaloutcomesforpatientswithacutepancreatitis.

简介：BackgroundApulmonary-infectedpatienthadseverehyponatremiathatlastedtwodaysduringhospitalization.Wecouldnotfindanyhistorysuchasgluttony,liverandgalldisease.Theexaminationofliverfunctionreportedthatthehepaticenzymologyisnormal.InICU,wequicklyfoundhemodiastasereachedatextremelyhighlevel.TheberryCTindicatedthattheheadofpancreasswellingandtheboundarywasobscureandeffusive.Thepatientwasdiagnosedasacutepancreatitis.Thiscaseraisesaquestiontous:Doesseverehyponatremiacauseacutepancreatitis?Ithasnotbeenreported.MethodsWeestablishedacuteanimalmodelofhyponatremiathatdidnotincludeanyotherelectrolytechaos.Aftertheanimalmodelofhyponatraemiacompleted,serumamylaselevelsandpathologicalexaminationwereanalyzed.ResultsThehyponatremiamodels,outof16rats,onlyfourrats'serumsodiumwerelessthan120mmol/L.Inthesefourrats,besidesserumsodium,theremainingelectrolyteswerenormalandserumlipidswereinnormalrange,onlyonerat'sserumamylaseincreasedsignificantlymorethanfourtimesofthenormalcontrolgroupanditspathologicalfindingshintedpancreaticedema.ConclusionsTheexperimentalmodelsuccessfullyduplicatedtheclinicalandpathologicfeaturesofpancreatitisinducedbyhyponatraemia.Throughthiscasereport,wehopethatattentioncanbepaidtochangesinserumamylasewhenhyponatremiaappeared.

简介：Enteralnutritionhasbeenstronglyrecommendedbymajorscientificsocietiesforthenutritionalmanagementofpatientswithacutepancreatitis.Providingsevereacutepancreatitispatientswithenteralnutritionwithinthefirst24-48hofhospitaladmissioncanhelpimproveoutcomescomparedtoparenteralnutritionandnofeeding.Newresearchisfocusinginonwhenandwhattofeedtobestimproveoutcomesforacutepancreatitispatients.Earlyenteralnutritionhavethepotentialtomodulatetheimmuneresponses.Despitethisconsistentevidenceofearlyenteralnutritioninpatientswithacutepancreatitis,clinicalpracticecontinuestovaryduetoindividualclinicianpreference.Achievingtheimmunemodulatingeffectsofenteralnutritionheavilydependonproperplacementofthefeedingtubeandmanaginganytubefeedingassociatedcomplications.Thecurrentarticlereviewstheimmunemodulatingeffectsofenteralnutritionandpro-andprebioticsandsuggestssomepracticaltoolsthathelpimprovethepatientadherenceandtolerancetothetubefeeding.Properselectionofthetypeofthetube,closemonitoringofthetubeforitsplacement,patencyandsecuringitsproperplacementandroutinecheckingthegastricresidualvolumecouldallhelpimprovetheoutcome.Usingpeptide-basedandhighmediumchaintriglyceridesfeedingformulashelpimprovingfeedingtolerance.

简介：Objective:Toobservethetherapeuticeffectofclinicaltreatmentofacuteurticariachieflybyelectroacupuncture(EA).Methods:Atotalof180outpatientswithacuteurticariawererandomizedintotreatmentgroupandcontrolgroup.100casesinthetreatmentgroupwereweremanagedbychlorpheniraminemaleateandVitaminC.Results:After3days'treatment,ofthe100and80casesintreatmentandcontrolgroups,79and53werecured,10and6markedlyeffective,5and8effective,and6and13failed,withtheeffectiveratesbeing94.00%and83.75%respectively.Thetherapeuticeffectofelectroacupunturewassignificantlysuperiortothatofmedication(P<0.05).Conclusion:Thewasamoreeffectivetherapyforacuteurticaria.

简介：Theriskofmyocardialinfarctionincreasesinpatientswithdiabetesmellitus.Theincidenceofmyocardialinfarctionissimilarinpatientswithtype2diabeteswithouthistoryofmyocardialinfarctionandinnon-diabeticpatientswithhistoryofmyocardialinfarction.DiabetesmellituswasconsideredasacoronarydiseaseequivalentbytheNationalCholesterolEducationProgram.Strictglycemiccontrolcanimprovethelong-termoutcomeofbothtype1andtype2diabetesmellitus.Whateverwithdiabeticornon-diabetic,strictglycemiccontrolwithintensiveinsulintherapycanreducethemortalityofcriticallyillpatientsinhospital.Aftermyocardialinfarction,therewouldbeaworseoutcomeforpatientswithpoorglycemiccontrol,whateverindiabeticornon-diabeticpatientswithstresshyperglycemia.Meanwhile,strictglycemiccontrolcanimprovetheoutcome.TheguidelineofAmericanCollegeofCardiology/AmericanHeartAssociationin2004onST-elevatedmyocardialinfarctionrecommendedinsulininfusionmaintainingtheeuglycemiaforpatientswithacutemyocardialinfarctionandcomplicatedconditions,whetherwithdiabetesmellitusornot,anditwasconsideredreasonabletoinfuseinsulinforallpatientswithhyperglycemiaduringtheperiodofacutemyocardialinfarction.Thispaperproposedaneffectiveandsafemethodforintravenousinsulininfusiontherapyfordiabeticpatientswithacutemyocardialinfarction.

简介：Managementofthrombusincoronarylesionsremainsachallengethatisfrequentlyencounteredduringprimarypercutaneouscoronaryintervention(PCI)forST-elevationmyocardialinfarction(STEMI)andisusuallyassociatedwithpoorclinicaloutcomes.Atthesametime,theoptimummanagementofsuchlesionsremainsadilemma.Multiplethrombusremovalprocedureshaveemergedwiththeshort-termaimofimprovingmyocardialperfusionandalonger-termaimofdecreasingtheincidenceofbothmajoradversecardiacevents(MACE)andall-causemortality.Inthisreview,wewillhighlightthemainproceduresutilizedforthrombusremovalduringprimaryPCIforSTEMI,withparticularemphasisonaspirationthrombectomy.Wewillalsoapproachpossibletheoriesthatmightexplaintheapparentlackofclinicalbenefitrecentlyshownwithsuchprocedures.

简介：客观：在glucocorticoid之中调查关系受体(GCR)水平，免疫学的分类和在尖锐成淋巴细胞的白血病(所有)的化疗的临床的功效孩子。方法：静脉的血淋巴细胞的GCR水平被受体radioligand绑定试金与童年在50种情况中测量所有和41个正常孩子。有所有的32个孩子的免疫学的分类被ABCimmunoenzymatic方法分析。结果：在正常孩子的静脉的血淋巴细胞的GCR数字是4651

简介：[摘要] 目的：探讨心理护理在急性心衰患者中的应用效果。方法：从2020年1月至2021年3月，来我院治疗的130例急性心衰患者。根据入院编号奇偶性分组：奇数编号的65例进入对照组，采用常规护理方案；偶数编号的65例进入试验组，在此基础上进行心理护理干预。比较临床依从性和负面情绪。结果：试验组依从性优良率更高（96.92%vs86.15%），干预后患者的SAS评分和SDS评分较对照组更低，经检验有统计学差异（P＜0.05）。结论：对急性心衰患者实施心理护理干预，能提高临床依从性、缓解负面情绪，具有推广价值。

简介：AbstractAcute pancreatitis (AP) is a common acute abdominal condition of the digestive system. In recent years, treatment concepts, methods, and strategies for the diagnosis of AP have advanced, and this has played an important role in promoting the standardization of AP diagnosis and treatment and improving the treatment quality of AP patients. On the basis of previous guidelines and expert consensus, this guideline adopts an evidence-based, problem-based expression; synthesizes important clinical research data at home and abroad in the most recent 5 years; and forms 29 recommendations through multidisciplinary expert discussion, including diagnosis, treatment, and follow-up. It is expected to provide evidence support for the treatment of AP in the clinical setting in China.