齐齐哈尔市城市防洪堤险工弱段成险因素分析

在论述堤体、堤基岩性组成的基础上,对险工弱段成险因素进行了分析,提出预防和消险措施。

城市防洪堤成险分析及消险措施

齐齐哈尔市城市防洪堤堤体、堤基的岩性组成比较复杂,险工弱段受诸多因素的控制和影响。文章在论述堤体堤基岩性组成的基础上,对险工弱段成险因素进行分析,提出预防和消险措施。

Vena cava thrombosis after vena cava filter placement： Incidence and risk factors

Background The objective of this study was to assess the clinical safety and efficacy of vena cava filter （VCF） placement, with particular emphasis on the incidence and risk factors of inferior vena cava thrombosis （VCT） after VCF placement. Methods Clinical data of patients with venous thromboembolism （VTE）, with or without placement of VCF, were analyzed in a retrospective single-center audit of medical records from January 2005 to June 2009. The collected data included demographics, procedural details, filter type, indications, and complications. Results A total of 168 cases of VTE （82 with VCF; 86 without VCF） were examined. Over a median follow-up of 24.2 months, VCT occurred in 18 of 82 patients with VCFs （11 males, 7 females, mean age 55.4 years）. In 86 patients without VCFs, VCT occurred in only 6 individuals （4 males, 2 females） during the study period. VCT was observed more frequently in patients fitted with VCFs than in those without VCFs （22% vs. 7.0%）. Conclusions The incidence of VCT in patients with VTE after VCF implantation was 22% approximately. Anticoagulation therapy should be continued for all patients with VCF placement, unless there is a specific contraindication. Almost all instances of VCT in patients with VCF implants in our study occurred after stopping anticoagulation treatment. The use of VCFs is increasing, and more trials are needed to confirm their benefit and accurately assess their safety.

Association of hepatitis C virus infection and diabetes

Epidemiologic studies have suggested a relation between hepatitis C virus (HCV) infection and diabetes mellitus. HCV infection is emerging as a metabolic disease, and diabetes mellitus as a risk factor for HCV infection. However, some data on the prevalence of antibodies to HCV in patients with diabetes are conflicting. These seroprevalence data should be interpreted with caution. Some potential bias may occur in those clinic-based studies that target a specif ic disease group. In this letter we explain some reasons for these conflicting studies.

Tumour seeding after percutaneous cryoablation for hepatocellular carcinoma

AIM:To assess the rate and risk factors for tumour seeding in a large cohort of patients.METHODS:Over an 8-year period,1436 hepatocellular carcinoma(HCC) patients with 2423 tumour nodules underwent 3015 image-guided percutaneous cryoablation sessions [1215 guided by ultrasonography and 221 by spiral computed tomography(CT)].Follow-up CT or magnetic resonance imaging was performed every 3 mo.The detailed clinical data were recorded to analyse the risk factors for seeding.RESULTS:The median follow-up time was 18(range 1-90) mo.Seeding was detected in 11 patients(0.76%) at 1-24(median 6.0) mo after cryoablation.Seeding occurred along the needle tract in 10 patients and at a distant location in 1 patient.Seeded tumours usually showed similar imaging and histopathological features to the primary HCCs.Univariate analyses identified subcapsular tumour location and direct subcapsular needle insertion as risk factors for seeding.Multivariate analysis showed that only direct subcapsular needle insertion was an independent risk factor for seeding(P = 0.017;odds ratio 2.57;95%CI:1.47-3.65).Seeding after cryoablation occurred earlier in patients with poorly differentiated HCC than those with well or moderately differentiated HCC [1.33 ± 0.577 mo vs 11.12 ± 6.896 mo;P = 0.042;95%CI:(-19.115)-(-0.468)].CONCLUSION:The risk of seeding after cryoablation for HCC is small.Direct puncture of subcapsular tumours should be avoided to minimise seeding.

Association between small intestinal bacterial overgrowth and deep vein thrombosis

Objective:Small intestinal bacterial overgrowth(SIBO)has been associated with several diseases.The association between SIBO and deep vein thrombosis(DVT)has not been investigated.This study was aimed to investigate the frequency and risk factors for the development of DVT in patients tested for SIBO.Methods:All 321 eligible patients were included from the Cleveland Clinic Gastrointestinal Motility Lab databank from January 2008 to January 2014.Patients who were evaluated with glucose hydrogen/methane breath test as well as Doppler ultrasonography for suspected DVT were included.Patients with catheter-related DVT were excluded.The primary outcomes were the frequency and risk factors(including SIBO)for DVT in this patient population.Results:Of the 321-case cohort,144 patients(44.9%)tested positive for SIBO,and 53(16.5%)had ultrasonographic findings of DVT.SIBO evaluation before the evaluation of DVT occurred in 201 patients(median time from the breath test to ultrasonography:27 months;interquartile range[IQR]:11.0–45.0 months),and SIBO evaluation after evaluation for DVT occurred in 120 patients(median time from ultrasonography to the breath test:30 months;IQR:11.8–54.3 months).In the univariate analysis,DVT was associated with family history of thromboembolic events(35.8%vs 16.0%,P=0.001),chronic kidney diseases(CKD;26.4%vs 13.4%,P=0.019)and the presence of SIBO(69.8%vs 39.9%,P50.001).In themultivariate analysis,family history of thromboembolic events(odds ratio[OR]:3.39;95%confidence interval[CI]:1.67–6.87;P50.001),CKD(OR:2.23;95%CI:1.04–4.74;P=0.037),and the presence of SIBO(OR:3.27;95% CI:1.70–6.32;P50.001)remained independently associated with DVT.Conclusion:SIBO was found to be associated with DVT.The nature of this association warrants further investigation.

Non-surgical porto-mesenteric vein thrombosis is associated with worse long-term outcomes in inflammatory bowel diseases

Objective:Our aim was to assess the risk factors for non-surgery-related portal and mesenteric vein thrombosis(PMVT)and its impact on the outcomes of inflammatory bowel diseases(IBD).Methods:All patients with a concurrent diagnosis of IBD and PMVT between January 2004 and October 2013 were identified from the electronic medical record(study group;n=20).Patients were matched for age,sex,and IBD phenotype with control IBD patients who had no PMVT,with a ratio of 1:3(control group;n=60).Risk factors for PMVT and IBD-related outcomes at one year after diagnosis of PMVT were compared between the two groups.Results:Of the 20 patients in the Study group,6(30%)had UC,14(70%)had CD and 11(55%)were male.On multivariable analysis,inpatient status(odds ratio[OR]6.88;95%confidence interval[CI]1.88-25.12)and baseline corticosteroid use(OR 4.39;95%CI 1.27-15.19)were found to be independent risk factors for the development of PMVT.At one-year follow-up,PMVT patients were more likely to have an adverse outcome of IBD,including subsequent emergency room visit(26.3%vs.1.7%;P=0.003),hospitalization for medical management(60.0%vs.20.0%;P=0.001)or IBD-related surgery(65.0%vs.26.7%;P=0.003)than the non-PMVT controls.In multivariable analysis,PMVT(OR 5.19;95%CI 1.07-25.28)and inpatient status(OR 8.92;95%CI 1.33-59.84)were found to be independent risk factors for poor outcome,whereas baseline immunomodulator use(OR 0.07;95%CI 0.01-0.51)was found to be a protective factor.Conclusions:IBD patients who were inpatients or receiving corticosteroid therapy had an increased risk of the development of PMVT.The presence of PMVT was associated with poor clinical outcomes in IBD.