Abstract We aim to analyze the clinical characteristics of obstructive sleep apnea hypopnea syndrome (OSAHS) in children. Polysomnography (PSG) and nasopharynx lateral film were performed, and clinical data were collected in 469 children who came to the outpatient department due to "snoring during sleep with mouth opening breathing, hard breathing or suffocation". Among the enrolled children, 123 (22.6%) were diagnosed with OSAHS, with 70 were mild and 53 were moderate-severe. Percentage of adenoid hypertrophy was higher in OSAHS patients ( p <0.01), instead of tonsil enlargement. The OSAHS children were agged 5 (4, 7). Compared with PS, the percentage of snoring, apnea, dyspnea, increased nocturia, and daytime sleepness were significsntly higher in moderate-severe patients ( p <0.01). In OSAHS groups, AHI, ODI, Longest time of apnea were increased, while minimum SpO2 and mean SpO2 during sleep were decreased significantly ( p <0.01) than PS. Time ratio of NREM1 was elevated in moderate-severe OSAHS patients ( p <0.01). Time ratio of REM was elevated in mild patients( p <0.01). Compared with the preschoolers, the percentage of leg movement and sleepness were significsntly higher in school-agers ( p <0.05). The youngers had higher time ratio of NREM3 and better sleep efficieny (p<0.01). However, AHI(p<0.05) and ODI(p<0.01) were higher in elder OSAHS significantly. Snoring (OR =5.745, p < 0.01), adenoid hypertrophy (OR =4.381, p < 0.01), apnea (OR =2.670, p < 0.001), dyspnea (OR =1.975, p < 0.01), and CRP (OR =1.172, p < 0.001) were independent risk factors for OSAHS. Conclusion AHI, ODI, Longest time of apnea, minimum SpO2 and mean SpO2 should be considered and analyzed simultaneously in diagnosis. The school-age OSAHS patients seems to more serious than the preschoolers. Snoring, apnea, dyspnea, adenoid hypertrophy, and CRP are risk factors for OSAHS.
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To compare perioperative outcomes between transumbilical laparoendoscopic single-site surgery (TU-LESS) and conventional multi-port laparoscopic surgery (MLS) in patients with endometrial cancer (EC), and evaluate the safety, feasibility, and efficacy of the "Chopstick Technique" TU-LESS. The single-center retrospective study included 535 patients who underwent surgical treatment between August 2018 and August 2021. Patients treated with the "Chopstick Technique" TU-LESS were assigned to the TU-LESS group, and those treated with MLS were assigned to the MLS group. After propensity score matching, 39 patients in the TU-LESS group and 76 patients in the MLS group were included. The age of the included patients was (50.8±7.8) years, and there were no significant differences between the TU-LESS and MLS groups in terms of age, body mass index, obstetric history, history of abdominal and pelvic surgery, International Federation of Gynecology and Obstetrics (FIGO) 2014 staging, or histological grade (all P>0.05). The TU-LESS group had a longer operative time compared to the MLS group [(175.2±57.1) vs (152.9±56.4) min, P=0.048], but had lower postoperative visual analog scale pain scores [1 (1, 2) vs 2 (2, 3) scores, P<0.001] and higher postoperative incision satisfaction scores [(5.7±0.5) vs (5.2±0.7) scores, P=0.001]. There were no significant differences between the two groups in terms of intraoperative blood loss, number of pelvic and paraaortic lymph nodes removed, incidence of perioperative complications, or length of postoperative hospital stay (all P>0.05). Compared to traditional laparoscopic techniques, the "chopstick technique" TU-LESS had advantages, such as less postoperative pain and higher patient satisfaction with the incision, with a similar efficacy to MLS.
AbstractIntroduction: Early-stage breast cancer treated with adjuvant radiotherapy with two different techniques, Tomotherapy (TOMO) and intensity-modulated radiation therapy (IMRT) and their acute adverse events in terms of skin toxicity, localized edema, sore throat, tracheal mucositis, nausea, mucositis oral, esophagitis and pneumonitis outcomes are compared. Material/methods: A retrospective cohort study was conducted on adverse events comparing IMRT and TOMO in early-stage breast cancer, we reviewed the data of female patients who received lumpectomy or mastectomy for breast cancer in the Oncology Department of the First Affiliated Hospital, Army Medical University from September 2021 to February 2024. A total of 315 female patients were enrolled in this study, including 130 in the TOMO group and 185 in the IMRT group. In this study, the adverse events of the two groups of patients were compared and analyzed. Results: The median age of this retrospective cohort was 47 years (range, 20–74 years). The length of follow-up was 3 months. 185 patients (59%) received IMRT and 130 patients (41%) underwent TOMO. No significant difference was observed in terms of menopausal status, laterality, pathology, estrogen receptor status, progesterone receptor status, triple negative, clinical T stage, clinical N stage or Surgical methods. Negative HER-2 over-expression was found in 38% and 51% of TOMO and IMRT group respectively (P = 0.053).With regard to the the degree of tumor differentiation,the Poor-Moderate differentiation was 69% in TOMO group while 81% in IMRT group(P = 0.052).There was 66% and 55% of TOMO and IMRT group respectively receiving Hormone therapy(p = 0.5). But there is no statistical differences in demographic and tumor characteristics between TOMO group and IMRT group. The comparison adverse events between TOMO and IMRT shown that there were no significant differences in localized edema, sore throat, tracheal mucositis, nausea, mucositis oral, esophagitis between the TOMO and the IMRT groups. Compared these two groups, the TOMO group had a higher proportion of 3–4 grade skin toxicity [16.2% (TOMO) versus 7.6% (IMRT), P = 0.017]. The pneumonitis in the TOMO group was lower than the IMRT group [0.0% (TOMO) versus 4.3% (IMRT), P = 0.016]. Conclusions: Compared to IMRT, TOMO decreases the incidence of radiation Pneumonitis but fail to improve acute skin toxicity. Base on our research, TOMO may contribute to higher odds for acute skin toxicity, which should be payed more attention by clinicians.
Abstract Background Treating red blood cells (RBCs) with dithiothreitol (DTT) is a wildly-recommended to overcome the interference of anti-CD38 immunotherapy with blood compatibility testing. Nevertheless, DTT can be hard to obtain in clinical laboratory, while its use in routine practice may be time-consuming. In the following study, we explored the feasibility of using a commercial 2-mercaptoethanol (2-ME) working solution or the time-saving polybrene method to mitigate the daratumumab (DARA) interference. Materials and Methods Antibody screening and cross-matching were performed using 2-ME or DTT-based indirect antiglobulin tests (IATs) and polybrene method (human IgG anti-E same IATs titer as DARA as positive control) on 37 samples, and these samples were from patients enrolled in the “Several methods resolve the interference of anti-CD38 monoclonal antibody on blood compatibility tests” clinical trial ( www.chictr.org.cn identifier: ChiCTR2000040761). Most clinically important blood group antigens on RBCs were detected after treatment with 2-ME or DTT. Hemoglobin values were compared after 69 units RBCs were transfused with compatible cross-matching results by a 2-ME-based method or polybrene test. Results Treating RBCs with 2-ME eliminates the DARA interference with the antibody screening or cross-matching; yet, K antigen is denatured during treatment. DARA with 2+ agglutinations of anti-E control does not interfere with antibody screening and cross-matching via polybrene method. After RBCs transfusion with a negative cross-matching test by 2-ME-based IATs or polybrene method, hemoglobin significantly increased without adverse transfusion reactions. Conclusion 2-ME-based IATs or polybrene method could be used to mitigate DARA interference as DTT.
Recrossing the compromised side branch (SB) with a balloon is sometimes technically challenging. The aim of this study was to evaluate whether in-stent anchoring (ISA) is safe and effective to facilitate SB balloon delivery for final kissing.One hundred and fifty-nine consecutive patients were included (166 bifurcation lesions) in this prospective, single-center registry. ISA was used as a bailout method after unsuccessful SB crossing using conventional techniques, including low-profile balloons. Technique success was defined as SB balloon delivery and final kissing.Kissing-balloon delivery was successfully performed with conventional strategies in 149 of 166 lesions (89.8%). In the remaining 17 lesions (10.2%), recrossing of the main vessel stent strut was not successful; therefore, ISA was attempted. The balloon successfully crossed the stent struts, and final kissing was achieved in 15 of 17 lesions (88.2%). Total final kissing was achieved in 164 of 166 lesions (98.8%), with success rates of 100% in the single-stent group and 97.6% in the two-stent group. Two cases without balloon delivery had complex bifurcation lesions with severe calcification. There was no vessel dissection in the anchoring zone.ISA is safe and effective for recrossing stent struts when conventional low-profile balloons have failed. However, large-scale trials are warranted for further evaluation.
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