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Objective:To analyze the clinical effect of real-time virtual sonography (RVS) surgical navigation combined with indocyanine green fluorescence imaging technology in the anatomical liver segmentectomy for hepatocellular carcinoma (HCC).Methods:The clinical data of 35 patients who underwent anatomical liver segmentectomy using RVS surgical navigation combined with indocyanine green fluorescence imaging technology in the Department of Hepatobiliary Surgery of Peking University International Hospital from January 2020 to January 2022 were retrospectively analyzed. There were 22 males and 13 females, aged (60.0±10.0) years. RVS is real-time virtual sonography, which fuses real-time intraoperative ultrasound images with corresponding preoperative CT or MRI images to guide the surgical plane. Methods of operation, time of operation, intraoperative blood loss, operative margin, hospital stay and postoperative complications were analyzed. Postoperative complications were graded by Clavien-Dindo system. The 1-year overall survival and tumor-free survival rates of patients were followed up by outpatient or telephone review.Results:Anatomical liver segmentectomy was performed on 36 patients, including 1 patient (2.9%) of segment Ⅱ, 1 patient (2.9%) of segment Ⅲ, 5 patients (14.3%) of segment Ⅳ, 6 patients (17.1%) of segment Ⅴ, 10 patients (28.6%) of segment Ⅵ, 7 patients (20.0%) of segment Ⅶ, 4 patients (11.4%) of segment Ⅷ, and 1 patient (2.9%) of segments Ⅴ+ Ⅷ. The operation time of 35 patients was (310.2±81.6) min, with an intraoperative blood loss of [ M( Q1, Q3)] 390.0(250.0, 500.0) ml. The hospital stay was (11.6±2.1) d. There was no postoperative death. Postoperative complications occurred in 3 cases (8.6%), of which 2 cases (5.7%) were ascites, Clavien-Dindo grade Ⅰ; Postoperative hemorrhage occurred in 1 case (2.9%), Clavien-Dindo grade Ⅱ. HCC was confirmed by pathology in all cases, and the operative margins were negative. The median follow-up time was 14 months (12 to 20 months). The 1-year overall survival rate after surgery was 100.0%(35/35), three patients (8.6%) had tumor recurrence, and the 1-year tumor-free survival rate was 91.4% (32/35). Conclusion:RVS surgical navigation combined with indocyanine green fluorescence imaging technology could be feasible in anatomical segmental hepatectomy for HCC.
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Objective:To investigate the status quo of stress response, self-care and job performance among nurses in emergency department, and to analyze whether self-care has a mediating effect between stress response and job performance.Methods:This was a cross-sectional survey. From February to April 2022, 467 emergency department nurses from 11 tertiary hospitals in Changsha were investigated and analyzed by using random cluster sampling method, general data questionnaire, Stress Response Questionnaire, Self-Compassion Scale and Nursing Performance Scale.Results:The total score of nurses′ Stress Response Questionnaire was (78.02 ± 26.78) points, the total score of Self-Compassion Scale was (81.75 ± 22.23) points, and the total score of Nursing Performance Scale was (74.05 ± 21.57) points. Stress response was negatively correlated with self-care and work performance ( r=-0.452, -0.572, both P<0.01), and self-care was positively correlated with work performance ( r=0.515, P<0.01). Self-care played a partial mediating role between stress response and job performance, accounting for 26.98% of the total effect. Conclusions:Self-care is an intermediary variable between emergency department nurses′ stress response and work performance. Nursing managers should pay attention to emergency department nurses′self-care and stress response levels, and evaluate them regularly in order to take timely intervention measures to improve their self care ability, reduce stress response, and improve work performance of emergency department nurses.
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Objective:To analyze the research hotspots and trends in the field of Traditional Chinese Medicine (TCM) for cervical cancer at home and abroad in recent 30 years through visualization method.Methods:By setting "cervical cancer" and "TCM" as the research subjects, the articles were retrieved from CNKI, Wanfang, VIP, SinoMed, PubMed, and Web of Science Core database (WoS) from January 1, 1992 to January 1, 2022. Citespace 5.8 R3 software was used to conduct visual analysis on the authors, institutions and keywords included in the articles.Results:A total of 1 123 Chinese articles and 573 English articles were included. The number of articles issued showed a gradual upward trend; the author with the largest number of Chinese publications was Jin Zhe, and the author with the largest number of English publications was Chen Guo. The institution with the largest number of Chinese publications was Beijing University of Chinese Medicine; the institution with the largest number of English publications was Chinese Academy of Medical Sciences. Keywords co-occurrence of the top 3 Chinese keywords in the network frequency (excluding the search words) were "cervical erosion", "urinary retention" and "Yunnan Baiyao"; English keywords were "HeLa cell", "bibliometric", and "information monitoring system". Chinese keywords formed 11 clusters and 25 emergent words; English keywords formed 9 clusters and 17 emergent words.Conclusions:The research content in the field of TCM of cervical cancer about knowledge map in the past 30 years at home and abroad is rich. TCM can play the role of antagonizing human papillomavirus, enhancing immune function, regulating TCM constitution, improving quality of life and so on. At present, the research hotspot is the mechanism exploration of cervical cancer and the curative effect research of clinical complications, and the research trend is clinical curative effect research.
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Objective@#To determine the knowledge, attitudes and practices (KAP) regarding tuberculosis prevention and control among college students in Wuhan, China, while analyzing the factors affecting tuberculosis prevention behavior.@*Methods@#Referring to the National KAP Questionnaire for Tuberculosis Prevention and Control among College Students, which was designed by China Center for Disease Control and Prevention, 22 colleges and universities in Wuhan were selected using a judgment sampling method, and a questionnaire survey was carried out through the online questionnaire platform. The formation of tuberculosis prevention and control behavior among this population was analyzed by single factor and multi factor Logistic regression.@*Results@#The total awareness rate of KAP regarding tuberculosis prevention and control among college students in Wuhan was 79.69%; the awareness rate of core knowledge was 79.28%, and the passing rate was 92.46%. The correct attitude holding rate was 89.69%, while the passing rate was 90.56%. In respect to correct behavior, the formation rate was 72.11%, with a passing rate of 96.62%. The multivariate Logistic regression analysis showed that the following factors were more likely to promote tuberculosis prevention and control behaviors that met the target: female college students ( OR =1.86); college students whose father had a primary school education level, junior high school and equivalent, high school and equivalent, and junior high school students ( OR =2.94, 3.05, 3.17, 3.24 ); no history of tuberculosis ( OR =3.32); the passing knowledge of core knowledge ( OR =9.91), and the passing attitude holding score ( OR =7.35)( P <0.05).@*Conclusion@#The overall awareness rate of KAP regarding tuberculosis prevention and control among college students in Wuhan is acceptable,the mainly influenced factors are gender, history of tuberculosis, awareness rate of core knowledge about prevention and control, attitudes and cognition, and parents educational background.
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OBJECTIVE To develop a whole-process intelligent model of pharmaceutical care for peritoneal dialysis （PD） patients， and to provide a reference for clinical pharmacists to provide standardized PD pharmaceutical care. METHODS The pharmaceutical care mode of PD patients at home and abroad was investigated and analyzed. Based on the actual situation of the First Affiliated Hospital of Soochow University （hereinafter referred to as “our hospital”）， with “home→PD center outpatient→ inpatient department” as the main node， the recycling process of medication reconciliation was optimized. The whole-process intelligent pharmaceutical care model of PD was illustrated by improving the Chinese version of the drug-related problems （DRPs） classification tool， developing the corresponding pharmaceutical care process， and presenting specific cases. RESULTS Based on the medication therapy management （MTM） platform， our hospital had built a closed-loop PD whole-process intelligent pharmaceutical care model of “in-hospital pharmaceutical care （building document）-PD outpatient MTM-home pharmaceutical care （online App management）”. A “double cycle” workflow of “admission→discharge→outpatient” medication reconciliation cycle and “discovery-analysis-intervention-follow-up-record-evaluation” DRPs cycle was formed. CONCLUSIONS The establishment of the whole-process intelligent pharmaceutical care model for PD in our hospital provides experience for standardizing pharmaceutical care for PD patients， and can reduce DRPs.
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Mild cognitive impairment (MCI) is a pre-clinical stage of Alzheimer's disease (AD). In recent years, transcranial direct current stimulation (tDCS), as a neuromodulation technique, has being applied in the field of cognitive intervention for MCI, but its effect is controversial because of many factors. In order to promote the application of tDCS in intervention for MCI, this study performed a systematic review of the previous studies that used tDCS to improve cognitive functions of MCI individuals. The results indicate that tDCS could improve episodic memory, working memory, and language of individuals with MCI, while there is a lack of strong evidence that supports a positive effect of tDCS on attention of individuals with MCI. The placement of electrodes, time course of treatment, and current intensity all affected the intervention effect of tDCS. Future studies should take brain networks underlying cognitive processes and personalized factors such as age and education level into consideration to design better stimulation protocols, and they should be conducted in combination with neuroimaging technologies to evaluate the intervention effect of tDCS more accurately and objectively and to discover the neural mechanisms of tDCS intervention.
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Objective:To investigate the clinical features, treatment methods of metastatic liver leiomyosarcoma (MLL).Methods:The characteristics of 5 cases of MLL were reviewed and summarized. Among them, 4 cases were derived from retroperitoneal leiomyosarcoma and 1 case was derived from uterine leiomyosarcoma. In terms of metastasis time, 1 case was simultaneous liver metastasis and 4 cases were heterochronous liver metastases, all of which were more than 2 years away from the primary tumor resection.Results:One patient died within 2 years after the diagnosis of MLL, and this patient had not undergone surgical treatment for liver metastases. Of the 4 patients who had had the metastasis resection, 2 patients died within 3 years. Currently, 2 patients are alive, 1 patient after 36 months, and 1 patient after 29 months.Conclusion:MLL occurs mostly years after the primary tumor is removed. Currently, surgical treatment is considered to be the main treatment method for MLL, which can significantly prolong the patients survival.
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Gastric schwannoma is a tumor originating from mesenchymal tissue. The clinical incidence is relatively rare, accounting for 6.3% of all gastric stromal tumors. The tumor is more likely to occur in the body of the stomach and usually originates from the gastric submucosal nerve. Most gastric schwannomas do not have any clinical symptoms. Imaging examination can play a diagnostic role, but the diagnosis still requires pathological examination, especially S-100 protein which is the gold standard for the diagnosis of gastric schwannomas. Gastric schwannoma usually needs to be distinguished from gastrointestinal stromal tumors and gastrointestinal autonomic nerve tumors. In terms of treatment, complete surgical resection is the first choice.
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Sepsis is essentially a result from immunological dissonance provoked by severe insults such as fulminant infection,severe trauma and extensive burns.It originates from excessive inflammatory responses and develops into immune paralysis or immunosupression.It has been demonstrated that cellular immune response plays a vital role in the pathogenesis of sepsis.In the stage of excessive inflammation,several kinds of immune cells are activated by pathogen-associated molecular patterns (PAMPs) or damage-associated molecular patterns (DAMPs) and subsequently produce a vast number of pro-inflammatory cytokines,while during the stage of immune paralysis,excessive apoptosis could result in decrease of immune cells with functional compromise.Inhibitory or regulatory immune cell subsets eventually dominate the direction of immune response and the production of inhibitory cytokines is enhanced.For clinical practice,surveillance of changes and shift in overall immune function is a basis for immunotherapy,especially to immunomodulation therapy.However,there is still a lack of adequate indexes or markers for integral evaluation of host immune state in the development of sepsis.
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Objective To compare the effect of percutaneous intraluminal radiofrequency ablation ( RFA ) combined with biliary stenting and that of percutaneous transhepatic puncture combined with biliary stenting .Methods A total of 56 patients with unresectable malignant obstructive jaundice were reviewed retrospectively .Among them, 25 patients had received percutaneous intraluminal RFA combined with biliary stenting ( RFA group) while another 31 patients had been simultaneously selected for the simple biliary stent implantation ( stent group ) .The changes of the serum total bilirubin ( TB) and direct bilirubin ( DB) before and after 7-14 days of treatment , surgical complications , stent median patency and the median survival were observed.Follow-up information was obtained through telephone reviews or check-up records. Results The technical success rate was 100%.No procedure-related peritonitis or perforation occurred .There were respectively 3 cases with cholangeitis in RFA group and 3 in stent group.All the cases was controlled by effective clinical treatment.There was obvious statistically significant difference after treatment in TB and DB in the two groups (P<0.01, P<0.01).TB and DB fell by (149.05 ±110.71) and (96.93 ±69.12)μmol/L after 7-14 days in RFA group vs (151.40 ±94.47) and (94.21 ±67.36)μmol/L in stent group.The changes of the two groups were of no statistical significances .The stent patenmedian time was 122 ( 9 -550 ) and 157 ( 16 -510 ) d, while the median survival was 125(9-550) and 163 ( 16 -520 ) d.The difference was of no statistical significance .Conclusion Percutaneous intraluminal RFA combined with biliary stenting and percutaneous transhepatic puncture combined with biliary stenting are both safe and feasible therapeutic options for unresectable malignant obstructive jaundice .There is no statistically significant diffference between the two groups in the recent and long-term curative effects .
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Objective:To investigate the relationship between emotion variability and assessment of psychiat-ric symptoms in middle school students,and validate that by structure equation modeling.Method:A total of 129 junior middle school students aged 13 -15 years were selected and assessed with the SCL-90 scale for psychiatric symptoms,the Adolescent Daily Emotion Regulation Questionnaire (ADERQ)for emotion regulation strategies, daily reconstruction method (DRM)for emotion variability during two weeks.Results:The students had higher positive emotion score than negative emotion score [(2.7 ±0.7)vs.(1.4 ±0.3),P <0.001],and higher negative emotion variability than positive emotion variability [(0.4 ±0.1 )vs.(0.3 ±0.1 ),P =0.012].Positive emotion variability and negative emotion variability were positively correlated with total scores of SCL-90 (r =0.34,0.24;Ps <0.001).Structural equation modeling revealed positive emotion variability,negative emotion variability and e-motion regulation strategy of cognitive appraisal had a direct effect on psychiatric symptoms (the path coefficient were 0.21,0.28,-0.24;Ps <0.001),cognitive immersed strategy had a direct effect on psychiatric symptoms and negative emotion variability(the path coefficient was 0.14,0.13,P =0.037,P =0.041).Conclusions:It suggests that both negative emotion variability and positive emotion variability play an important role in psychiatric symp-toms.