Notes

Antenatal and also perinatal components having an influence on neonatal blood pressure level: an organized assessment.
assist clinicians in predicting the prognosis of HCC patients with LN metastasis and may provide a rationale for treatment options.
Although the peripherally inserted central catheter (PICC) has been widely utilized, there is still a lack of large sample size-based relevant risk factor investigation for the children with blood diseases in a single center of China.

We performed a retrospective cohort study through including a total of 2,974 cases aged 0-18 years with blood diseases and PICC insertion. Success rates of different PICC operation techniques were compared. Targeting the common PICC-related complications, we performed the univariate and multivariate logistic regression analyses. Then, based on the screened risk factors, the prediction modeling analysis of binary logistic regression was conducted.

The "B-ultrasound plus Seldinger technology" showed a higher success rate of PICC placement than the "non-assistive blind insertion". The catheter type was closely linked to the occurrence of catheter occlusion. The age, insertion site, and catheter type might be the risk factors of phlebitis, while the insertion site, operation season, and catheter type might be associated with catheter fracture. Furthermore, based on these risk factors, we established the nomogram prediction models of phlebitis, rash occurrence, and catheter fracture, respectively, which shows a good predictive ability and a moderate level of predictive accuracy.

Our findings first shed new light on the preoperative estimation of the risk factors of PICCrelated complications for the children with blood diseases in China.
Our findings first shed new light on the preoperative estimation of the risk factors of PICCrelated complications for the children with blood diseases in China.
The prognosis of descending necrotizing mediastinitis (DNM), especially that extending inferiorly to the carina, remains poor. The identification of additional prognostic factors may improve the prognosis.

We retrospectively analyzed six patients who underwent thoracic surgery for DNM extending to the anterior and posterior mediastinum inferior to the carina (Endo classification type IIB) from 2014 to 2020. We reviewed their characteristics, clinical course, causative bacteria, and treatment to investigate their prognostic factors.

The median patient age was 62 years. Five patients were men and one patient was a woman. The causative disease in three of the patients was pharyngolaryngeal, and for the others, it was an odontogenic infection. Five patients had sepsis and four had disseminated intravascular coagulation (DIC) at surgery. Four patients had polymicrobial infections of aerobic and anaerobic bacteria, all of whom showed gas bubbles on a chest computed tomography scan and detection of Streptococciotic therapy and aggressive drainage and surgery.
Providing high-quality training to residency students during the coronavirus 2019 (COVID-19) pandemic has been a goal of our institution. Since 2108, we began to take microlectures to students teaching. Microlectures are online presentations, and the microlecture teaching method has many advantages, such as a short teaching time, situational resource composition, diverse communication, strong pertinence and can attend microlectures from home. The aim of the present study was to evaluate the advantages of the microlecture teaching method on students in standardized residency training.

Students from our department were randomly divided into the traditional teaching group (control group) and the microlecture teaching group (observation group). The teaching duration for both groups was 3 months. All students were assessed on basic knowledge of the neurology before enrollment. After the teaching session, the students were assessed on teaching effect, theoretical operation, and clinical practice satisfaction. The students also evaluated the teachers, and the teachers evaluated the students.

A total of 84 students participated in the study and were divided equally into the observation group (42 students) and the control group (42 students). The results showed that the rate of reaching the standard of teaching effect, achievement of theory and operation, satisfaction with clinical practice, the student's grades by teachers, and student satisfaction with teachers were significantly higher in the observation group than in the control group (all P<0.05).

The microlecture teaching method can effectively improve the clinical teaching effect for neurology students and should be adopted in clinical teaching, especially during the COVID-19 pandemic.
The microlecture teaching method can effectively improve the clinical teaching effect for neurology students and should be adopted in clinical teaching, especially during the COVID-19 pandemic.
Ischial pressure sores often recur, the surgical choice often troubled the surgeon, because surgery repair should consider future reconstructive procedures. The purpose of this article is to present a new surgical option for the reconstruction of primary or recurrent ischial pressure sores by using an inferior gluteal artery of the descending branch perforator flap.

A study involving patients suffering from ischial pressure sores was performed from March 2016 to August 2020. Patients with large defects, for which direct closure was not possible, underwent reconstructive surgery using an inferior gluteal artery descending branch perforator flap. Collected data included age, diabetes, wound culture, size of the wound, whether or not negative pressure therapy was received, operative time, intraoperative blood loss, and postoperative complications. Patients were followed up through outpatient visits or by telephone.

Five patients with ischial pressure sores (four primary and one recurrent) underwent reconstructive surgery with inferior gluteal artery descending branch perforator flap. One patient received colostomy and wound negative pressure therapy before lesion reconstruction. All patients successfully recovered without postoperative complications. The follow-up period ranged from 4 to 31 months. No wound disruption or recurrence was recorded.

Inferior gluteal artery descending branch perforator flap treatment of ischial pressure sores is a simple and feasible method for preserving the inferior gluteal artery's main vascular perforators and could be used as a future surgical option.
Inferior gluteal artery descending branch perforator flap treatment of ischial pressure sores is a simple and feasible method for preserving the inferior gluteal artery's main vascular perforators and could be used as a future surgical option.Ovarian hyperstimulation syndrome (OHSS) is a rare but serious complication of assisted reproductive technology application. The incidence of stroke symptoms associated with OHSS is lower than that of abdominal symptoms, which may occur in severe OHSS situation. If tissue plasminogen activator (tPA) is not applicable, mechanical thrombectomy (MT) is recommended for acute cerebral artery occlusion within 6 hours of symptom onset according to the current guidelines. However, the current experience and evidence is insufficient, whether acute cerebral artery occlusion associated with OHSS can be treated with MT. A 21-year-old woman underwent an ovulation induction with gonadotropin-releasing hormone agonist. Two days later, she presented with abdominal distension and diarrhea. Ascites and enlarged ovaries were confirmed by ultrasound. She was highly suspected of OHSS in by the Department of Obstetrics and Gynecology. Three days later, she presented with right-side hemiplegia, superficial coma, and aphasia, and rision associated with OHSS.Breast cancer is rare in men and there is no report of male breast cancer (MBC) with ureteral metastasis. In this study, we report the first case of MBC with ureteral metastasis. A 60-year-old man was diagnosed with triple negative breast cancer (TNBC) with local lymph nodes metastasis (TNM stage T4N3M0). After surgery, chemotherapy and radiotherapy he was diagnosed with ureter metastasis because of hematuria. This patient took a Precitype gene test (immune index and PAM50) after several lines of treatment and the result indicated that this was a Luminal A subtype case as well as HER-2 mRNA positive, which was quite different from his immunohistochemical staining. Because of his poor condition and he could not tolerate chemotherapy, we adjusted his therapeutic regimen with endocrine therapy and antiHER-2 therapy according to the gene expression analysis with the informed consent of the patient and his families. However, it seemed that there was no obvious efficacy and he passed away five months later. In our opinion, MBC patients with urinary symptoms should be considered for the possibility of metastasis although urinary metastasis in breast cancer is rare. We still need more research about gene expression analysis and more evidence of treatment recommendations for MBC.We present the case of a 53-year-old woman with a history of maintenance hemodialysis through arteriovenous fistula, CUFF catheter (cuffed tunneled catheter) and artificial vascular graft successively. read more Some signs of superior vena cava syndrome have presented including chronic edema in the face and left arm and varicose veins. Both CT (computed tomography) and angiography showed narrowing and occlusion in multiple veins, especially the right innominate vein, superior vena cava, inferior vena cava, left jugular vein, and bilateral common iliac veins. The first attempt at recanalization of the AVG (arteriovenous graft) failed due to severe occlusion of central venous. Finally, the patient was treated with a minimally invasive surgical approach involving percutaneous direct superior vena cava puncture driven by a single bend and vascular snare that were placed in the right atrium via hepatic vein percutaneous direct puncture under a double C arm angiographic device. The initial attempt failed with RUPS 100 (Cook, Chicago, USA) and was complicated by pericardial tamponade. The second attempt succeeded and the catheter was placed without hindrance and edema or varicose veins and its patency has remained for over 18 months following the intervention. It is the first successful case of sharp recanalization in combined superior and inferior vena cava syndromes with long-segment occlusion. This creative approach to providing vascular access offers a novel way to address refractory lesions in central veins.Adenoid cystic carcinoma (ACC) of the lacrimal sac is an extremely rare disease with a poor prognosis. There is currently no standard treatment for this malignancy. Radical surgical excision followed by radiotherapy and chemotherapy is the preferred treatment for localized ACC of the lacrimal sac. Apatinib has shown efficacy in recurrent/metastatic ACC. The role of apatinib in combination with concurrent chemoradiotherapy in patients with non-operated localized advanced ACC is not clear. Here, we report a 30-year-old man with a 1-year history of epiphora of the left eye and nasal congestion who was diagnosed as ACC of the lacrimal sac. The computed tomography (CT) scan showed the tumor invading the left orbit and left maxillary sinus. He refused surgical resection and instead received combined apatinib and nedaplatinbased concurrent chemoradiotherapy. He experienced moderate adverse effects such as nausea, hypertension, myelosuppression that were well controlled after symptomatic supportive care. Complete response was observed 3 weeks following the treatment.
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