The retrieved lymph node (LN) count has been validated as a prognostic factor in various cancers. However, the interaction between LN counts and patients' prognosis in gastric cancer with negative-LN metastasis is not fully studied. Surveillance, Epidemiology, and End Results Program (SEER)-registered gastric cancer patients were used for analysis in this study. Patients operated on for gastric cancer at N0 stage between 2004 and 2012 were identified from the SEER database. The association between the LN counts and survival was assessed using the Cox proportional hazards model. Patients were stratified into 1–4, 5−13, and > 13 subgroups according to LN count cut-off values determined by X-tile program, with the 5-year cause specific survival (CSS) rate of 64.8%, 72.5%, and 79.4%, respectively. LN count was also validated as an independently prognostic factor in multivariate Cox analysis (P < 0.001). In addition, nomograms including LN counts on CSS were established according to all significant factors, and the c-index was 0.703 (95% CI: 0.672−0.734). Further study indicated that patients with no LN metastasis had a decreased risk of death for each patient with LN examined up to approximately 14 LNs. Collectively, our study firmly demonstrated that the number of the retrieved LNs count was an independent prognostic factor for gastric cancer with no LN metastasis. The higher the LN count, the better the survival would be; the best CSS was observed on the LN count more than 14.
This work reports a case of rashes on multiple parts of the body following cesarean delivery caused by routine use of cefuroxime sodium and morphine during the perioperative period. A 29-yearold woman underwent a lower segment cesarean section under combined spinal-epidural anesthesia.During surgery, cefuroxime sodium was administered intravenously following the division of the umbilical cord for the prevention of infection. Morphine hydrochloride was given for analgesia at the end of the procedure. Rashes and pruritus appeared on the patient's abdomen, back and thighs. Cephalosporins and opioids may cause rashes and pruritus. According to the patient's physical signs and the time of drug injection, we considered the rash and pruritus adverse reactions caused by cefuroxime sodium and morphine hydrochloride. After the discontinuation of the medications, antiallergic treatment and the other treatment of symptoms, the patient's symptoms gradually subsided. To this end, we speculate that cefuroxime sodium or morphine hydrochloride cause adverse reactions, including rashes in patients. Physicians, nurses, and clinical pharmacists should closely observe patients who receive these medications. The medications should be at once stopped if an adverse reaction occurs.
A 70-year-old man was admitted to our hospital due to "liver cirrhosis; grade 3 hypertension; pulmonary infection". On May 27, 2019, during upper abdomen plain and enhanced magnetic resonance imaging (MRI) and magnetic resonance cholangiopancreatography (MRCP), the patient experienced anaphylactic shock, manifested as sudden unconsciousness and lack of response, after intravenous administration of gadobenate dimeglumine (Multihance ® ). Gadobenate dimeglumine is a paramagnetic contrast used during diagnostic MRI. It has hepatobiliary specificity with very good imaging performance.A small amount is absorbed by normal liver cells after intravenous injection and excreted via the bile ducts while maintaining the chemical structure of gadobenate dimeglumine. It allows the visualization of local angiogenesis and perfusion, which reflect the hepatic blood supply and recent liver function, thereby providing a reference for clinical diagnosis. Gadobenate dimeglumine intravenous injection may cause adverse reactions such as nausea, dizziness, and anaphylactic shock. Anaphylactic shock is a known serious adverse reaction of gadobenate dimeglumine injection. In this paper, we report a case of gadobenate dimeglumine-induced anaphylactic shock based on the temporal relationship between the onset of symptoms and the injection. The patient received chest compressions and balloon-assisted ventilation in addition to rehydration and volume expansion and vasoactive drugs to maintain blood pressure, etc. The patient died despite treatments. In the clinical, physicians, nurses, and clinical pharmacists should closely monitor patients and promptly discontinue drug administration and provide symptomatic care in case of adverse reactions.
Objective: To explore the clinical effect of the application of Jianpi Huatan Dingxuan Decoction in the treatment of patients with vertigo and phlegm obstruction. Method: The research work was started in Henan Provincial Hospital of Traditional Chinese Medicine. The work will be carried out from October 2019 to October 2020. The patients are all patients with vertigo and phlegm obstruction syndrome who received treatment during this period. 100 of them were selected as this time. The study subjects were randomly divided into two groups, the control group given conventional western medicine treatment and the experimental group given Jianpi Huatan Dingxuan Decoction. The treatment effects of the two groups were compared and analyzed. Results: The treatment efficiency and nursing satisfaction of the experimental group were 96.00% and 94.00% respectively, which were significantly higher than the 82.00% and 78.00% of the control group. Before treatment, the vertebrobasilar blood flow velocity of the patients was relatively low, P>0.05. After the treatment intervention, the vertebral artery blood flow velocity and the basilar artery blood flow velocity of the experimental group were significantly higher than those of the control group. The data differed greatly. P<0.05, the experimental group had better results. Conclusion: The application of Jianpi Huatan Dingxuan Decoction in the treatment of patients with vertigo and phlegm obstruction has a significant effect, which can promote the recovery of patients, improve the effective rate of clinical treatment, and has positive significance for clinical development.
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