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Objective:To explore the safety, effectiveness, economy and surgical techniques of bronchial priority treatment in single-port thoracoscopic right upper lobectomy by comparing it with conventional single-port thoracoscopic right upper lobectomy.Methods:Clinical data of 72 patients who underwent single-port thoracoscopic right upper lobectomy from Mar. 2019 to Feb. 2022 were collected. According to different surgical treatment sequences, the patients were divided into observation group (bronchial priority treatment, 36 cases) and control group (conventional surgery, 36 cases). The general clinical characteristics, operation time, intraoperative blood loss, postoperative hospital stay, postoperative complications, postoperative pain score, and number of staplers used in the two groups were compared.Results:All operations were successfully completed without conversion to thoracotomy. There was no significant difference between the two groups in clinical characteristics, intraoperative blood loss [ (25.3±12.8) ml vs 32.5±14.2) ml, P>0.05], postoperative hospital stay[ (4.7±1.6) d vs (4.9±1.5) d, P>0.05], postoperative pain score [ (3.3±1.1), (4.8±1.4), (3.7±1.1) vs (3.5±1.2), (5.5±1.4), (4.1±1.4), P>0.05], number of lymph node dissection (9.1±1.8 vs 8.3±1.7, P>0.05), or postoperative complications (16.7% vs 27.8%, P>0.05). Compared with the control group, the observation group had significant advantages in the operation time [ (87.2±6.1) vs (106.4±21.8) min, P<0.05] and the number of staplers used (3.7±0.8 vs 5.8±1.3, P<0.05) . Conclusions:Single-port video-assisted thoracoscopic right upper lobe resection with bronchial priority treatment is safe and effective. It simplifies the surgical procedure, reduces the use of disposable consumables, does not increase the risk of perioperative period, and has clinical application prospects.
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Objective:By comparing the advantages and disadvantages of different forms of purse suture, to explore how to minimize the incidence of anastomotic complications after cervical anastomosis of esophageal cancer.Methods:The clinical data of 45 patients with esophageal cancer who underwent mediastinal endoscopy combined with laparoscopic radical resection of esophageal cancer from Jan.2019 to Jun.2020 in Department of Thoracic Surgery, Henan Chest Hospital were selected. In the observation group, 22 cases were sutured with spiral packing at the esophageal stump, and in the control group, 23 cases were sutured with conventional loading forceps. The clinical effects of the two groups were objectively evaluated.Results:There was no significant difference between the two groups in operation time, intraoperative blood loss or hospitalization days ( P>0.05) . In terms of postoperative complications, the incidence of anastomotic leakage and anastomotic stenosis in the observation group (4.54%, 9.09%) was significantly lower than that in the control group (17.39%, 39.13%) , and there was significant difference in the incidence of anastomotic stenosis ( P<0.05) . Conclusion:The spiral continuous suture of esophageal stump can reduce the incidence of anastomotic fistula/anastomotic stenosis without increasing surgical trauma or prolonging operation time, which is worthy of clinical application.
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Objective:To investigate the developmental behavior of early term infants at 6 months and its difference from that of complete full-term infants.Methods:A healthy maternal and infant birth cohort in maanshan city, established in Maanshan Maternal and Child Health Hospital from June 2015 to June 2016. Birth outcomes were copied from the hospital electronic medical record system after delivery. The Chinese Ages and Stages Questionnaires was used to assess developmental behavior. The chi-square test and multivariate unconditional logistic regression model were used to analyze the differences in the behavioral development of early and full term infants.Results:The birth rate of early term infants was 24.74% (500/2 021). The detection rates of communication, gross motor, fine motor, problem solving and individual-social areas in early term infants were 2.1%, 3.2%, 6.1%, 6.3% and 2.7%, respectively. The detection rate of problem-solving area in early term infants was significantly higher than that in the full-term infants (6.3% vs. 3.7%, χ 2=5.42, P<0.05). After controlling for confounding factors, compared with full-term infants, the risk of problem-solving area in early infants was significantly increased ( OR=1.65, 95%CI:1.01-2.70, P<0.05). Conclusion:The risk of behavioral retardation in Early term infants is significantly higher than that in full-term infants, and long-term follow-up and appropriate early development promotion interventions are needed to improve their quality of life.
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Objective To understand the physical activity of early stage pregnant women and explore its influential factors. Methods From June 2015 to June 2016, 2122 pregnant women with early pregnancy card in Ma An Shan Maternal and Child Health Hospital were selected and surveyed with a questionnaire. The Physical Activity Questionnaire was used to understand the physical activity of pregnant women in their early pregnancy. Analysis of variance and t-test were used to describe the distribution of energy expenditures of physical activity of pregnant women with different demographic characteristics, and multiple linear regression analysis was used to analyze the factors influencing the energy expenditure of their physical activity. Result The duration of activities of sleep and sitting type was (16.56 ± 3.54) h, accounting for 83.38％of total activity time;the energy consumption value was (17.17±5.59) METs·h;mild physical activity time was (2.62±1.86) h, accounting for total time. 13.19％and the energy consumption value was (6.06±4.43) METs·h;the average time of moderate to severe physical activity was (0.68±0.93) h, accounting for 3.42％of total physical activity time, and the energy consumption value was (3.22±4.58) METs·h. In the univariate analysis, the energy expenditures of physical activity between the different groups (t=-3.551), education level (F=1.347), and occupation type (F=1.485) were different, and the difference was statistically significant (P<0.05). In multiple linear regression analysis, different occupational types and education were the energy expenditure levels of physical activity during early pregnancy. Influencing factors (P<0.05). Conclusion Pregnant women have longer periods of sleep and meditation during the first trimester, and shorter duration of physical activity than mild and above;the energy expenditure of physical activity during the first trimester of pregnancy is affected by the occupational type and educational level of the pregnant woman.
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Objective To investigate the second or third trimester pregnancy-related anxiety on small-for-gestational-age infants.Methods This study was based on Ma'anshan Birth Cohort Study (MABC),with 3 040 maternal-singleton pairs finally selected for data analysis,from May 2013to September 2014.The psychological state of pregnancy was evaluated according to a self-developed ‘ anxiety scale for gestation'.Small-for-gestational-age was defined as ‘ having birth weight below the 10th percentile at a particular gestational week',while large-for-gestational-age infants was defined as ‘having birth weight above the 90th percentile'.Birth weight between the 10th and 90th percentile was classified as appropriate-for-gestational age infants.x2 test was used to compare the distribution of characteristics in pregnancy among three groups with different birth weights.Multivariate logistic regression models were conducted to evaluate the associations between third trimester pregnancy-related anxiety and birth weight.Results The incidence rates of small-and large-gestational-age infants were 9.6％ and 16.6％,respectively.Difference between women with only one of the second or third trimester pregnancy-related anxiety syndromes and small-for-gestational-age infants showed no statistical significance.Women with both second and third trimester pregnancy-related anxieties might increase the risk of small-for-gestational-age infants (OR=1.39,95％CI:1.04-1.87).However,there was no significant difference between pregnancy-related anxiety and large-for-gestational-age infants (OR=1.05,95％ CI:0.81-1.35) noticed.Conclusion Women with second and third trimesterpregnancy-related anxiety appeared a risk factor for small-for-gestational-age infants.
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Objective To investigate the second or third trimester pregnancy-related anxiety on small-for-gestational-age infants.Methods This study was based on Ma'anshan Birth Cohort Study (MABC),with 3 040 maternal-singleton pairs finally selected for data analysis,from May 2013to September 2014.The psychological state of pregnancy was evaluated according to a self-developed ‘ anxiety scale for gestation'.Small-for-gestational-age was defined as ‘ having birth weight below the 10th percentile at a particular gestational week',while large-for-gestational-age infants was defined as ‘having birth weight above the 90th percentile'.Birth weight between the 10th and 90th percentile was classified as appropriate-for-gestational age infants.x2 test was used to compare the distribution of characteristics in pregnancy among three groups with different birth weights.Multivariate logistic regression models were conducted to evaluate the associations between third trimester pregnancy-related anxiety and birth weight.Results The incidence rates of small-and large-gestational-age infants were 9.6％ and 16.6％,respectively.Difference between women with only one of the second or third trimester pregnancy-related anxiety syndromes and small-for-gestational-age infants showed no statistical significance.Women with both second and third trimester pregnancy-related anxieties might increase the risk of small-for-gestational-age infants (OR=1.39,95％CI:1.04-1.87).However,there was no significant difference between pregnancy-related anxiety and large-for-gestational-age infants (OR=1.05,95％ CI:0.81-1.35) noticed.Conclusion Women with second and third trimesterpregnancy-related anxiety appeared a risk factor for small-for-gestational-age infants.
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Objective@#To investigate the effect of pre-pregnancy weight and the increase of gestational weight on fetal growth restriction.@*Methods@#From May 2013 to September 2014, a total of 3 474 pregnant women who took their first antenatal care and willing to undergo their prenatal care and delivery in Ma 'anshan Maternity and Child Care Centers were recruited in the cohort study. Excluding subjects without weight data before delivery (n=54), pregnancy termination (n=162), twins live births (n=39), without fetal birth weight data (n=7), 3 212 maternal-singleton pairs were enrolled for the final data analysis. Demographic information of pregnant woman, pregnancy history, disease history, height and weight were collected. In the 24th-28th, 32nd-36th gestational week and childbirth, three follow-up visits were undertaken to collect data of pregnancy weight, pregnancy vomiting, gestational hypertension, gestational diabetes mellitus, newborn gender and birth weight. χ2 test was used to compare the detection rate of fetal growth restriction in different groups. Multivariate unconditional logistic regression model and spreadsheet were used to analyze the independent and interaction effect of pre-pregnancy weight and the increase of gestational weight on fetal growth restriction.@*Results@#The incidence of fetal growth restriction was 9.7%(311/3 212). The incidence of fetal growth restriction in pre-pregnancy underweight group was 14.9% (90/603), higher than that in normal pre-pregnancy weight group (8.7% (194/2 226)) (χ2=24.37, P<0.001). The incidence of fetal growth restriction in inadequate increase of gestational weight group was 17.9% (50/279), higher than the appropriate increase of weight group (11.8% (110/932)) (χ2=36.89, P<0.001). Multivariate unconditional logistic regression analysis showed that compared with normal pre-pregnancy weight group, pre-pregnancy underweightwas a risk factor for fetal growth restriction, with RR (95%CI) at 1.76 (1.34-2.32); Compared with the appropriate increase of gestational weight group, inadequate weight increase during pregnancy was a risk factor for fetal growth restriction, with the RR (95%CI) at 1.70 (1.17-2.48). No additive model interaction [relative excess risk of interaction, attributable proportions of interaction, the synergy index and their 95%CI were 0.75 (-2.14-3.63), 0.21 (-0.43-0.86) and 1.43 (0.45-4.53), respectively] or multiplication model interaction (RR (95%CI): 1.00 (0.44-2.29)) existed between pre-pregnancy underweight and inadequate increase of gestational weight on fetal growth restriction.@*Conclusion@#Pre-pregnancy underweight and inadequate increase of gestational weight would increase the risk of fetal growth restriction without interaction.
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Objective To explore the correlation between pregnancy-related anxiety and serum 25 (OH)D level during early pregnancy. Methods A radioimmunoassay was used to determine the serum 25 (OH)D levels of 2 122 early pregnant women in Maanshan Maternal and Child Health Care Hospital, from June 2015 to 2016. Data were collected using a questionnaire. Results The mean serum 25(OH)D level was(29.71±32.27)nmol/L.About 15.2% of the subjects had adequate,22.6% had insufficient,45.1% had deficient,and 17.1% had severely deficient serum 25(OH)D levels.The type of housing and testing seasons were significantly associated with the serum 25(OH)D level.Single factor logistic regression analysis results show that pregnancy-related anxiety incidence in the group deficient in 25(OH)D was higher than that in the adequate group, which has a statistically significant difference (P<0.05). After adjusting for the maternal age,BMI,and educational level,multivariate logistic regression analysis results showed that the difference was statistically significant. Conclusion The serum 25(OH)D level in early pregnant women was inadequate. Furthermore, lack of serum 25(OH)D in early pregnancy and pregnancy-related anxiety were negatively correlated.
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<p><b>OBJECTIVE</b>To understand the association between the blood glucose levels of pregnant women in second trimester detected by 75 gram oral glucose tolerance test (OGTT) and the birth weight of neonates.</p><p><b>METHODS</b>Demographic information collection and OGTT were conducted for 3 081 pregnant women at ≤14 gestational weeks and 24-28 gestational weeks respectively. Multiple logistic regression analysis was done to identify the factors associated with the birth weight and the risks of large for gestational age (LGA) in three levels (FPG, OGTT-1 h and OGTT-2 h) of OGTT percentile group, multiple linear regression analysis was used to evaluate the relationships between maternal glucose levels and neonate birth weight.</p><p><b>RESULTS</b>Pre-pregnancy obesity (24.0 kg/m2≤BMI<28.0 kg/m2) (OR=1.4, 95%CI:1.0-2.0, P=0.029) and gestational diabetes mellitus (OR=2.4,95% CI: 1.8-3.2, P<0.001) were the risk factors. Pre-pregnancy underweight (BMI<18.5 kg/m2) (OR=1.6, 95%CI: 1.2-2.2, P=0.003), preeclampsia (OR=4.0, 95%CI: 1.9-8.4, P<0.001) increased the risk for small for gestational age (SGA). Multiple linear regression analysis showed neonate birth weight was positive correlated with maternal glucose levels (β were 91.99, 33.60, 32.00, respectively, P<0.001). Percentile groups of each OGTT level was linearly positive associated with increased mean value of neonate birth weight, and so with the risk of LGA.</p><p><b>CONCLUSIONS</b>There were positive correlations between maternal glucose levels and neonate birth weight. The risk of LGA increased with the maternal glucose levels, but there was no statistical association between SGA and maternal glucose levels. FPG level is one of the predictors of LGA. Active surveillance and control of maternal glucose level can effectively reduce the risk of LGA.</p>
Subject(s)
Female , Humans , Infant, Newborn , Pregnancy , Birth Weight , Blood Glucose , Cohort Studies , Diabetes, Gestational , Glucose Tolerance Test , Infant, Small for Gestational Age , Logistic Models , Obesity , Pre-Eclampsia , Pregnancy Trimester, Second , Blood , Risk Factors , ThinnessABSTRACT
The authors model diabetes in rats, and inject the rats with Klotho gene. Then the levels of serum lipoprotein are tested, measuring the thickness of coronary artery intima and the ratio of intima and media to see whether Klotho gene has protective effect of coronary artery in diabetes rats. Extracting the Klotho gene from kidney tissue in the normal SD rats amplifies the target gene by PCR and uses adenovirus as carrier. Then SD rats were randomly divided into model group, control group and the treatment group for diabetes modeling. Transferred the Klotho gene into treatment group and blank adenovirus into control group by the experimenters. Nothing was done for model group. Rats were killed after a successful modeling in the twelfth week, then tested blood low-density lipoprotein, high density lipoprotein, and the coronary artery intima-media thickness. After doing these, intima-media thickness ratio was tested. The high density lipoprotein is 0.67 +/- 0.06 mmol/L in treatment group, 0.48 +/- 0.10mmol/L in control group, 0.47 +/- 0.10mmol/L in model group. The treatment group, control group and model group respectively two independent sample tests. There is statistical significance between treatment group and the other group p<0.01 in treatment group. The low density lipoprotein is 0.44 +/- 0.08 mmol/L in treatment group, 0.45 +/- 0.10mmol/L in control group, 0.44 +/- 0.05mmol/L in model group. Respectively two independent sample test show that there is no statistical significance between treatment group and the other group [p<0.05]. Intima thickness is 1.74 +/- 0.05 micro m in treatment group, 2.23 +/- 0.06 micro m in control group, 2.15 +/- 0.05 micro m in model group. There is statistical significance between treatment group and the other group [p<0.01]. The ratio of intima and media is 0.237 +/- 0.097 in treatment group, 0.308 +/- 0.023 in control group, 0.316 +/- 0.037 in model group, and t test, there is statistical significance between treatment group and the other group [p<0.01]. There is protective effect on coronary after Klotho gene was transferred into diabetic rats