Effect of glutamine enteral nutrition + low molecular weight heparin on systemic inflammatory response in patients with severe pneumonia

Objective: To investigate the effect of glutamine enteral nutrition + low molecular weight heparin on systemic inflammatory response in patients with severe pneumonia. Methods:A total of 52 patients with severe pneumonia who were hospitalized in this hospital between January 2017 and October 2017 were divided into glutamine group (n=26) and control group (n=26) by random number table method. Control group received conventional enteral nutrition+ low molecular weight heparin treatment, glutamine group were treated with glutamine nutrient solution on the basis of the therapy for control group, and both therapies lasted for 7 d. The differences in serum levels of inflammatory factors, oxidative stress indexes and myocardial injury indexes were compared between the two groups before and after treatment. Results: Before treatment, serum levels of inflammatory factors, oxidative stress indexes and myocardial injury indexes were not significantly different between the two groups. After 7 d of treatment, serum inflammatory factors IL-10 and IL-18 levels of glutamine group were higher than those of control group whereas IL-17, sTREM-1 and PCT levels were lower than those of control group;serum oxidative stress indexes MDA and LHP levels were lower than those of control group whereas GSH-Px and CAT levels were higher than those of control group;serum myocardial injury indexes α-HBDH, cTnⅠ, NT-ProBNP and LDH levels were lower than those of control group. Conclusion: glutamine enteral nutrition + low molecular weight heparin can effectively relieve systemic inflammatory response and oxidative stress response, and reduce the myocardial injury in patients with severe pneumonia.

Cerebral infarction after drug-eluting bead bronchial arterial chemoembolization due to the mechanical force-mediated opening of an errant passage

To the Editor:Drug-eluting bead bronchial arterial chemoembolization(DEB-BACE)has been proven to be a feasible and well-tolerated treatment option for patients with non-small cell lung cancer(NSCLC)who are ineligible for or refuse to receive standard chemotherapy.[1]Here,we report a rare complication of multiple cerebral embolic infarcts,mainly in the posterior cerebral circulation,in a patient with squamous cell lung cancer who was performed with DEB-BACE.To our knowledge,this complication has rarely been reported in patients with NSCLC undergoing DEB-BACE.Approval was obtained from our Institutional Review Board and patient for the publication of this case report.

Tenofovir vs.entecavir on recurrence of hepatitis B virus-related hepatocellular carcinoma beyond Milan criteria after hepatectomy

Background:Hepatectomy for hepatocellular carcinoma(HCC)beyond the Milan criteria is shown to be beneficial.However,a high rate of post-operative HCC recurrence hinders the long-term survival of the patients.This study aimed to investigate and compare the impacts of tenofovir(TDF)and entecavir(ETV)on the recurrence of hepatitis B viral(HBV)-related HCC beyond the Milan criteria.Methods:Data pertaining to 1532 patients who underwent hepatectomy and received antiviral therapy between January 2014 and January 2019 were collected from five centers.Recurrence-free survival(RFS)analysis was performed using the Kaplan-Meier method.Cox proportional hazards regression analysis was performed to determine prognostic factors for HCC recurrence.Results:The analysis incorporates 595 HBV-related HCC patients.The overall 5-year RFS was 21.3%.Among them,533 and 62 patients received ETV and TDF treatment,respectively.The 1-,3-,and 5-year RFS rates were 46.3%,27.4%,and 19.6%,respectively,in the ETV group compared with 65.1%,41.8%,and 37.2%,respectively,in the TDF group(P<0.001).Multivariate analysis showed that TDF treatment(hazard ratio[HR]:0.604,P=0.005),cirrhosis(HR:1.557,P=0.004),tumor size(HR:1.037,P=0.008),microvascular invasion(MVI)(HR:1.403,P=0.002),portal vein tumor thrombus(PVTT)(HR:1.358,P=0.012),capsular invasion(HR:1.228,P=0.040),and creatinine levels(CREA)(HR:0.993,P=0.031)were statistically significant prognostic factors associated with RFS.Conclusions:Patients with HCC beyond the Milan criteria exhibited a high rate of HCC recurrence after hepatectomy.Compared to the ETV therapy,TDF administration significantly lowered the risk of HCC recurrence.

Incidence and clinical correlates of anger attacks in Chinese patients with obsessive-compulsive disorder

Objective: Anger attacks have been observed in patients with obsessive-compulsive disorder(OCD), often triggered by obsessional triggers. However, few studies have reported the clinical characteristics and correlates of anger attacks among Chinese patients with OCD. Methods: A total of 90 adults with a primary diagnosis of OCD, ranging from 15 to 78 years old, participated in the study. Participants were administered the Rage Outbursts and Anger Rating Scale(ROARS), Yale-Brown Obsessive-Compulsive Scale-Second Edition, and Brown Assessment of Beliefs Scale by a trained clinician. Patients completed the Obsessive-Compulsive Inventory-Revised and Depression Anxiety Stress Scale-21. Results: A total of 31.3% of participants reported anger outbursts in the past week, and ROARS scores had no significant correlation with age, duration of illness, OCD severity, depression, or stress. However, ROARS scores were negatively related to education level, and positively related to obsessing symptoms and anxiety. Conclusions: These data suggest that anger attacks are relatively common in Chinese patients with OCD. The severity of anger attacks is related to educational level, obsessing symptoms, and anxiety, which may be a latent variable reflecting executive functioning and emotion regulation skills.