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may be recommended as an alternative tool for supplemental oxygen for the prevention of hypoxemia during gastroscopy with propofol mono-sedation in obese patients.

During gastroscopy with propofol mono-sedation in obese patients, the WNJT, when compared with a nasal cannula for supplemental oxygen, can significantly reduce the occurrence of hypoxemia and improve both arterial oxygenation and satisfaction among anesthetists and physicians. The use of the WNJT may, however, lead to epistaxis in a few patients. In view of this clinically acceptable risk-benefit ratio, the WNJT may be recommended as an alternative tool for supplemental oxygen for the prevention of hypoxemia during gastroscopy with propofol mono-sedation in obese patients.

The spine is the most common location of metastatic diseases. Treating a metastatic spinal tumor depends on many factors, including patients' overall health and life expectancy. The present study was conducted to investigate prognostic factors and clinical outcomes in patients with vertebral metastases.

To investigate prognostic factors and their predictive value in patients with metastatic spinal cancer.

A retrospective analysis of 109 patients with metastatic spinal cancer was conducted between January 2015 and September 2017. The prognoses and survival were analyzed, and the effects of factors such as clinical features, treatment methods, primary lesions and affected spinal segments on the prognosis of patients with metastatic spinal cancer were discussed. The prognostic value of Frankel spinal cord injury functional classification scale, metastatic spinal cord compression (MSCC), spinal instability neoplastic score (SINS) and the revised Tokuhashi score for prediction of prognosis was explored in pafunctional classification scale, MSCC, SINS and revised Tokuhashi score were helpful in predicting the prognosis of patients with metastatic spinal cancer.

The World Health Organization reported that 28637952 people worldwide had been infected with severe acute respiratory syndrome coronavirus 2, the causative agent of coronavirus disease 2019 (COVID-19), by September 13.

The aim was to investigate whether long-term use of renin-angiotensin-aldosterone system (RAAS) inhibitors for the treatment of hypertension aggravates the performance of COVID-19 patients with hypertension.

This was a retrospective analysis of lung computed tomography (CT) data and laboratory values of COVID-19 patients with hypertension who were admitted to Huoshenshan Hospital, Wuhan, Hubei Province, between February 18 and March 31, 2020. Patients were divided into two groups. Group A included 19 people who were long-term users of RAAS inhibitors for hypertension; and group B included 28 people who were randomly selected from the database and matched with group A by age, sex, basic diseases, and long-term use of other antihypertensive drugs. All patients underwent a series of CT and le clinical process.

Chest CT is an important imaging tool to monitor the characteristics of COVID-19 and the degree of lung injury. Chronic use of RAAS inhibitors is not related to the severity of COVID-19, and it does not worsen the clinical process.

Coronary artery disease (CAD) is one of the leading causes of death and disease burden in China and worldwide. A practical and reliable prediction scoring system for CAD risk and severity evaluation is urgently needed for primary prevention.

To examine whether the prediction for atherosclerotic cardiovascular disease risk in China (China-PAR) scoring system could be used for this purpose.

A total of 6813 consecutive patients who underwent diagnostic coronary angiography were enrolled. The China-PAR score was calculated for each patient and CAD severity was assessed by the Gensini score (GS).

Correlation analysis demonstrated a significant relationship between China-PAR and GS (

= 0.266,

< 0.001). In receiver operating characteristic curve analysis, the cut-off values of China-PAR for predicting the presence and the severity of CAD were 7.55% with a sensitivity of 55.8% and specificity of 71.8% [area under the curve (AUC) = 0.693, 95% confidence interval 0.681 to 0.706,

< 0.001], and 7.45% with a sensitivity of 58.8% and specificity of 67.2% (AUC = 0.680, 95% confidence interval 0.665 to 0.694,

< 0.001), respectively.

The China-PAR scoring system may be useful in predicting the presence and severity of CAD.

The China-PAR scoring system may be useful in predicting the presence and severity of CAD.

Dermatofibrosarcoma protuberans (DFSP) is a rare low-grade malignant soft tissue tumor characterized by rosette-like infiltrative growth. Postoperative recurrence of this tumor is very common.

To evaluate the risk factors related to recurrence after wide local excision (WLE) of DFSP and to guide clinical diagnosis and treatment.

The medical records of 44 DFSP patients confirmed by pathology at our hospital from 2012 to 2019 were retrospectively reviewed. Sodium palmitate The relationship between clinical features, tumor characteristics, treatment, and recurrence risk were analyzed, and the possible risk factors for postoperative tumor recurrence were evaluated.

There were 44 patients in total, including 21 males and 23 females. The median progression free survival was 36 mo (range, 1-240 mo). Twenty patients were treated for the first time, while 24 had previous treatment experience. Forty-two cases were followed for 25.76 ± 22.0 mo, among whom four (9.52%) experienced recurrence after WLE (rate was 9.52%). The recurrP are not specific and are easily misdiagnosed, thus commonly causing the recurrence of DFSP. After incomplete resection, the tumor may rapidly grow. Previous recurrence history may be a risk factor for postoperative recurrence, and tumor location may have an indirect effect on postoperative recurrence; however, we found no significant correlation between sex, age, course of the disease, or tumor size and postoperative recurrence.

The brain is the most complex organ in the human body. Treatment for a glioma always involves a multi-disciplinary team. Nursing care in fast-track surgery or enhanced recovery after surgery is such kind of work implemented by an interdisciplinary team to provide services to patients to improve their outcomes.

To explore the effects of nursing care in fast-track surgery on postoperative pain, psychological state, and patient satisfaction with nursing for glioma.

From June 2018 to June 2020, 138 patients who underwent operation for glioma at Cancer Hospital Affiliated to Chongqing University were selected. They were categorized into groups according to different nursing care that they received. Of them, 69 patients receiving nursing care in fast-track surgery were included in an experimental group, and 69 patients receiving conventional postoperative nursing were included in a control group. Visual analogue scale was used to evaluate postoperative pain in the two groups immediately after the operation an; 0.05). SAS and SDS scores were significantly lower in the observation group than in the control group at 3 d after operation (

< 0.05). The rate of patient satisfaction with nursing was 94.2% in the observation group, which was significantly higher than that (81.2%) of the control group (

< 0.05).

Nursing care in fast-track surgery can relieve postoperative pain, anxiety, and depression, and improve patient satisfaction with nursing in patients with glioma, which is worthy of clinical application.

Nursing care in fast-track surgery can relieve postoperative pain, anxiety, and depression, and improve patient satisfaction with nursing in patients with glioma, which is worthy of clinical application.Coronavirus disease 2019 (COVID-19) continues to pose a significant threat to global health. Primary prevention remains as a major strategy against the pandemic. Current evidence proves that aerosol and droplet-based routes are the main means of transmission of COVID-19 but other ways should be sought in order to prevent possible collateral transmission. The gastrointestinal system may be one such route. Angiotensin converting enzyme 2 is the target entry receptor for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that is abundantly expressed in the gastrointestinal tract. SARS-CoV-2 is able to infect human enterocytes similar to severe acute respiratory syndrome and Middle Eastern respiratory syndrome. Herein this review, we discuss the current knowledge regarding the role of gastrointestinal transmission in transmission and pathophysiology of COVID-19.The coronavirus disease 2019 (COVID-19) epidemic is a major public health emergency characterized by fast spread, a wide range of infections, and enormous control difficulty. Since the end of December 2019, Wuhan has become the first core infection area of China's COVID-19 outbreak. Since March 2020, the domestic worst-hit areas have moved to the Heilongjiang Province due to the increased number of imported COVID-19 cases. Herein, we reported the major COVID-19 outbreak, which caused a rebound of the epidemic in Harbin, China. After the rebound, different levels of causes for the recurrence of COVID-19, including city-level, hospital-level, and medical staff-level cause, were investigated. Meanwhile, corresponding countermeasures to prevent the recurrence of the epidemic were also carried out on the city level, hospital level, and medical staff level, which eventually showed the effect of infection control function in a pandemic. In this study, we described the complete transmission chain, analyzed the causes of the outbreak, and proposed corresponding countermeasures from our practical clinical experience, which can be used as a valuable reference for COVID-19 control.The esophagus is the most commonly affected part of the gastrointestinal system in patients with systemic sclerosis (SSc). Esophageal involvement may lead to a significant reduction in patient quality of life. The exact pathophysiology is complex and not yet fully elucidated. Ultimately, esophageal smooth muscle becomes atrophied and replaced by fibrous tissue leading to severe motility disturbance of the distal esophagus. Symptoms are mainly attributed to gastroesophageal reflux disease and to esophageal dysmotility. Compelling evidence has correlated esophageal involvement to the severity of pulmonary disease. No formed guidelines exist about the diagnostic modalities used to assess esophageal disease in patients with SSc, though upper gastrointestinal endoscopy is the first and most important modality used as it can reveal alterations commonly observed in patients with SSc. Further exploration can be made by high resolution manometry and pH-impedance study. Proton pump inhibitors remain the mainstay of treatment, while prokinetic agents are commonly used as add-on therapy in patients with symptoms attributed to gastroesophageal reflux disease not responding to standard therapy as well as to motility disturbances. Gastroesophageal reflux disease symptoms in patients with SSc are frequently difficult to manage, and new therapeutic modalities are emerging. The role of surgical treatment is restricted and should only be preserved for resistant cases.

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