Safety and efficacy of transcatheter arterial embolization in autosomal dominant polycystic kidney patients with gross hematuria: Six case reports

BACKGROUND To retrospectively report the safety and efficacy of renal transcatheter arterial embolization for treating autosomal dominant polycystic kidney disease(ADPKD)patients with gross hematuria.CASE SUMMARY The purpose of this study is to retrospectively report the safety and efficacy of renal transcatheter arterial embolization for treating ADPKD patients with gross hematuria.Materials and methods:During the period from January 2018 to December 2019,renal transcatheter arterial embolization was carried out on 6 patients with polycystic kidneys and gross hematuria.Renal arteriography was performed first,and then we determined the location of the hemorrhage and performed embolization under digital subtraction angiography monitoring.Improvements in routine blood test results,routine urine test results,urine color and postoperative reactions were observed and analyzed.Results:Renal transcatheter arterial embolization was successfully conducted in 6 patients.The indices of 5 patients and the color of gross hematuria improved after surgery compared with before surgery.No severe complication reactions occurred.CONCLUSION For autosomal dominant polycystic kidney syndrome patients with gross hematuria,transcatheter arterial embolization was safe and effective.

FXR agonist GW4064 alleviates endotoxin-induced hepatic inflammation by repressing macrophage activation

AIM: To examine the effect of farnesoid X receptor (FXR) activation by GW4064 on endotoxin-induced hepatic inflammation in nonalcoholic fatty liver disease (NAFLD) and the underlying mechanism.

Risk factors and predictive model of adrenocortical insuffi ciency in patients with traumatic brain injury

BACKGROUND:Neuroendocrine dysfunction after traumatic brain injury(TBI)has received increased attention due to its impact on the recovery of neural function.The purpose of this study is to investigate the incidence and risk factors of adrenocortical insuffi ciency(AI)after TBI to reveal independent predictors and build a prediction model of AI after TBI.METHODS:Enrolled patients were grouped into the AI and non-AI groups.Fourteen preset impact factors were recorded.Patients were regrouped according to each impact factor as a categorical variable.Univariate and multiple logistic regression analyses were performed to screen the related independent risk factors of AI after TBI and develop the predictive model.RESULTS:A total of 108 patients were recruited,of whom 34(31.5%)patients had AI.Nine factors(age,Glasgow Coma Scale[GCS]score on admission,mean arterial pressure[MAP],urinary volume,serum sodium level,cerebral hernia,frontal lobe contusion,diff use axonal injury[DAI],and skull base fracture)were probably related to AI after TBI.Three factors(urinary volume[X4],serum sodium level[X5],and DAI[X8])were independent variables,based on which a prediction model was developed(logit P=-3.552+2.583X4+2.235X5+2.269X8).CONCLUSIONS:The incidence of AI after TBI is high.Factors such as age,GCS score,MAP,urinary volume,serum sodium level,cerebral hernia,frontal lobe contusion,DAI,and skull base fracture are probably related to AI after TBI.Urinary volume,serum sodium level,and DAI are the independent predictors of AI after TBI.

Nursing Study on Reducing the Incidence of Bleeding and Exudation after PICC Catheterization by Blunt Separation Combined with Early Sheath Removal

Objective:To compare the effects of blunt separation combined with early sheath removal and conventional catheterization on the incidence of bleeding,exudation and subcutaneous congestion after peripherally inserted central catheter(PICC).Methods:250 patients with PICC catheterization in our hospital were selected,including 125 in the control group and 125 in the observation group.The conventional catheterization method was used in the control group:The sheath was removed by scalpel skin expansion and complete tube delivery in place.The observation group used blunt separation combined with early sheath removal.The success rate of one-time sheath delivery,immediate bleeding,24-hour bleeding and exudation were compared.Results:The success rate of sheath delivery in the observation group was 100%;The amount of immediate blood loss and blood loss 24h after catheterization in observation group was obviously lower than that in the control group,with statistical significance(P<0.05).There were 6 cases of exudation in the control group and no exudation in the observation group.There was significant difference in the incidence between the two groups(P<0.05);There were 10 cases of subcutaneous congestion in the control group and 2 cases of subcutaneous congestion in the observation group.There was significant difference in the incidence between the two groups(P<0.05);Conclusion:Blunt separation combined with early sheath removal can reduce the occurrence of local blood and fluid leakage after PICC catheterization.

Effect of Psychological Nursing Combined with Health Education on the Quality of Life of Patients with Lung Cancer

Objective:To analyze the effect of psychological nursing combined with health education on the quality of life of patients with lung cancer.Methods:80 patients with lung cancer admitted to our hospital’s Department of Cardiothoracic Surgery from January 2022 to December 2022 were selected as the research objects.Those who received basic nursing care from January to June were classified as the reference group,and those who received psychological nursing and health education from July to December were classified as the combination group,with 40 cases in each group.The combination group was given psychological nursing and health education;the reference group was given primary nursing care.The negative emotions experienced,the nursing satisfaction,the pain levels 1-7 days after operation,and the quality of life of both groups were compared.Results:Before the intervention,there was no statistically significant difference in the negative emotions between the two groups of patients(P>0.05);after the intervention,the combination group experienced significantly less negative emotions compared to the control group(P<0.05).Besides,the nursing satisfaction evaluation indicators such as targeted measures,nursing effects,individualized treatment,and level of professionalism of the combination group were significantly better than those in the reference group(P<0.05).There was no significant difference in the pain level of both groups of patients 1 day after surgery(P>0.05);however,in 3d and 7d after the surgery,the combination group experienced significantly less pain than the reference group(P<0.05).The social skills,physical pain,health status,physiological function,and other quality of life scores in the combined group were significantly higher than those in the reference group(P<0.05).Conclusion:Psychological nursing and health education can improve the quality of life of patients with lung cancer.

Effect of Intensive Nursing on the Incidence of Thrombosis in Patients Undergoing PICC Line Placement

Objective:To explore the effect of intensive nursing on the incidence of thrombosis in patients undergoing PICC line placement.Methods:A total of 50 patients with tumor who underwent PICC line placement in Jiangsu Zhenjiang First People’s Hospital(from January 2019 to January 2020)were randomly selected for this research.According to the random number table method,they were divided into two groups:group A(25 cases)for routine nursing and group B(25 cases)for intensive nursing.The incidence of thrombosis,coagulation indices,quality of life,and nursing satisfaction were compared between the two groups.Results:The incidence of thrombosis of group B was lower than that of group A,and the coagulation indices,quality of life,as well as the nursing satisfaction of group B were higher than those of group A(P<0.05).Conclusion:Intensive nursing can effectively improve the coagulation,reduce thrombosis,and improve the quality of life of patients.The clinical application effect is remarkable,and it should be popularized.

Multiple Myeloma in a Patient with Rectal Cancer

Multiple myeloma is characterized by the accumulation of clonal, malignant plasma cells in the bone marrow. Multiple lytic skeletal lesions in some tumor patients with multiple myeloma are easily considered as bone metastases secondary to tumors, resulting in a missed diagnosis of multiple myeloma. Herein, we report a rare case, in which rectal cancer with multiple myeloma was initially misdiagnosed with bone metastases secondary to rectal cancer, due to the symptoms of multiple lytic sketetal lesions, and ignoring the abnormal plasma cells in the peripheral circulating blood smear. The patient was finally diagnosed with coexistence of rectal cancer and multiple myeloma. The case focuses on the importance of the peripheral circulating blood smear detection.

Association of baseline serum cholesterol with benefits of intensive blood pressure control

Background:Intensive systolic blood pressure(SBP)control improved outcomes in the Strategy of Blood Pressure Intervention in the Elderly Hypertensive Patients(STEP)trial.Whether baseline serum lipid parameters influence the benefits of intensive SBP control is unclear.Methods:The STEP trial was a randomized controlled trial that compared the effects of intensive(SBP target of 110 to<130 mmHg)and standard(SBP target of 130 to<150 mmHg)SBP control in Chinese patients aged 60 to 80 years with hypertension.The primary outcome was a composite of cardiovascular disease events.A total of 8283 participants from the STEP study were included in this post hoc analysis to examine whether the effects of the SBP intervention differed by baseline low-density lipoprotein cholesterol(LDL-C)and non-high-density lipoprotein cholesterol(non-HDL-C)concentrations.Results:Regardless of the randomized SBP intervention,baseline LDL-C and non-HDL-C concentrations had a J-shaped association with the hazard of the primary outcome.However,the effects of the intensive SBP intervention on the primary outcome were not influenced by baseline LDL-C level(P for interaction=0.80)and non-HDL-C level(P for interaction=0.95).Adjusted subgroup analysis using tertiles in LDL-C1(hazard ratio[HR],0.77;95%confidence interval[CI],0.52-1.13;P=0.18),LDL-C2(HR,0.81;95%CI,0.55-1.20;P=0.29),and LDL-C3(HR,0.68;95%CI,0.47-0.98;P=0.04)was provided,with an interaction P value of 0.49.Similar results were showed in non-HDL-C1(HR,0.87;95%CI,0.59-1.29;P=0.49),non-HDL-C2(HR,0.70;95%CI,0.48-1.04;P=0.08),and non-HDL-C3(HR,0.67;95%CI,0.47-0.95;P=0.03),with an interaction P-value of 0.47.Conclusion:High baseline serum LDL-C and non-HDL-C concentrations were associated with increased risk of primary cardiovascular disease outcome,but there was no evidence that the benefit of the intensive SBP control differed by baseline LDL-C and non-HDL-C concentrations.Clinical trial registration:ClinicalTrials.gov,NCT03015311.