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@#Objective To explore the safety and feasibility of preferential manual bronchoplasty in single-port video-assisted thoracoscopic surgery (VATS) upper lobectomy. Methods The clinical data of 457 patients with non-small cell lung cancer who underwent single-port VATS lobectomy in the Department of Thoracic Surgery of Peking University First Hospital from March 2020 to March 2022 were retrospectively analyzed. The patients were divided into a preferential manual bronchoplasty group and a traditional single-port VATS lobectomy group with a 1 : 1 propensity score matching for further research. Results A total of 204 patients were matched, and there were 102 patients in each group. There were 50 males and 52 females aged 62.2±10.1 years in the preferential bronchoplasty group, and 49 males and 53 females aged 61.2±10.7 years in the traditional single-port VATS group. The preferential bronchoplasty group had shorter surgical time (154.4±37.0 min vs. 221.2±68.9 min, P<0.01), less bleeding (66.5±116.9 mL vs. 288.6±754.5 mL, P=0.02), more lymph node dissection (19.8±7.5 vs. 15.2±4.7, P<0.01), and a lower conversion rate to multi-port or open surgery (2.3% vs. 13.8%, P=0.04) in left upper lobe resection. In the right upper lobe resection surgery, there was no statistical difference in postoperative results between two groups. There was no perioperative death or occurrence of bronchopleural fistula in both groups. Conclusion Compared with traditional single-port VATS upper lobectomy, preferential bronchoplasty has similar safety and feasibility. In addition, priority bronchoplasty in left upper lobectomy has the advantages of shorter surgical time, less bleeding, more lymph node dissection, and lower conversion rate to multi-port or open surgery.
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Objective@#To investigate factors influencing adolescent idiopathic scoliosis (AIS), and to provide a scientific basis for effective prevention and treatment programs.@*Methods@#A questionnaire survey was conducted among 6 757 students who participated in the scoliosis screening program for primary and middle school students in Zhongshan City, China from April 2019 to March 2020. Visual examination and Adams flexion test were used to measure the rotation angle of trunk. For each student, individual and family demographics, family history of scoliosis, daily postural habits, school bag carrying habits, vision, health, school environment, and physical activity were collected by questionnaire. Factors influencing AIS were analyzed using Chi square test and multivariate Logistic regression.@*Results@#The positive screening rate for AIS was 2.0%(135 cases). Multivariate Logistic regression analysis revealed that female gender, no family history of AIS, standing with lumbar spine tilted forward, habit of leaning to the left when seated, and a monthly family income of >10 000 yuan were related to the occurrence of AIS in adolescents ( OR =3.01, 0.38, 2.29, 1.74, 0.44, P <0.05).@*Conclusion@#Female students aged 10-16 years with a family history of scoliosis in Zhongshan are identified as a high risk group for scoliosis screening. Developing proper standing and sitting habits helps to reduce the risk of AIS in adolescents.
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BACKGROUND@#It is common for patients with lung cancer to have concomitant coronary artery disease, some of them have underwent coronary stenting and accepted antiplatelet therapy. Whether antiplatelet agents should be continued in the perioperative period remains controversial, especially in patients requiring lung cancer resection with coronary artery stents. We reviewed the data of our institute to clarify the perioperative outcomes of this specific population.@*METHODS@#We retrospectively analyzed the data on patients who underwent pulmonary resection for lung cancer following coronary stent placement between January 2013 and September 2019 in the Department of Thoracic Surgery in Peking University First Hospital. All of them discontinued oral antiplatelet agents before operation at least 5 days. The primary outcomes were the cardiovascular morbidity and mortality in hospital.@*RESULTS@#111 patients were identified and included in the analysis. The time intervals between stenting and lung surgery were 1-3 months, 3-12 months, and more than 12 months in 6.3%, 13.5% and 80.2% of the patients, respectively. Sublobectomy, lobectomy, biolobectomy, pneumonectomy and sleeve lobectomy were performed in 10.8%, 71.2%, 9.0%, 2.7% and 6.3% of the patients. The overall incidences of cardiovascular complications were 11.6%, including unstable angina (n=1, 0.9%), hypotention (n=1, 0.9%), congestive heart failure (n=2, 1.8%) and new-onset atrial fibrillation (n=10, 9.0%). There was no perioperative death. No major adverse cardiac events (MACE) occurred.@*CONCLUSIONS@#It was safety to discontinued oral antiplatelet agents before operation, with no MACE and death in perioperative period.
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Objective To investigate the effect of simple vertebral canal decompression for treating degree 1 senile degenerative lumbar spondylolisthesis .Methods 62 cases of degree 1 senile degenerative lumbar spondylolisthesis from January 1998 to January 2012 were retrospectively analyzed .The patients were surgically treated by simple vertebral canal decompression and included 20 males and 42 females ,aged from 65-82 years(mean 68 years) ,with the disease history of 2-7 years(average 3 .3 years) .The clini-cal effects in average postoperative 2 years and 8 .2 years were evaluated by Japanese Orthopaedic Association Scores (JOA ) and Visual Analogue Scale/Score(VAS) .Results The preoperative JOA score was 9 .7 in average and the JOA scores in average post-operative 2 years and 8 .2 years were 11 .7 and 12 .8 respectively(P<0 .05);the preoperative VAS score averaged 7 .8 ,which after operation were 2 .3 and 2 .6 respectively(P<0 .05) .Complications were observed in 16 cases .4 cases accepted reoperation .Conclu-sion In the basis of the actively controlling other organ systems diseases in perioperative period ,simple vertebral canal decompression is an effective method for treating degenerative vertebral canal spondylolisthesis and can obtain the satisfactory therapeutic effect .
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Objective To explore the effect of rational emotive therapy on self-esteem status of breast cancer patients.Methods 118 cases of breast cancer patients were randomly divided into the control group and the observation group with 59 cases in each group.The control group received routine care,and the observation group received rational emotive therapy on the basis of routine care.The self-esteem status of the two groups of patients was assessed before and after the intervention respectively with State Self-Esteem Scale (SSES).Results The score of behavior self-esteem,social self-esteem,appearance self-esteem and the total score of self-esteem of the patients in two groups before intervention showed no significant difference,but the above scores were higher in the observation group than those in the control group after intervention.Conclusions Rational emotive therapy can improve self-esteem status of breast cancer patients,thereby improve the mental health of the patients.
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Objective To evaluate the effect of relaxation training combined with listening to music on controlling the pain of patient with intracranial aneurysm before interventional therapy.Methods To determin the pain degree and subjective reception of the patients on admission and after relaxation training combined with listening to music.Results Pain degree relieved obviously after relaxation training combined with listening to music[(7.31±2.24)vs(3.76±2.12),P＜0.01];self-made questionnaire showed the positive evaluation of relaxation training combined with listening to music was 95%.Conclusion Relaxation training combined with listening to music can relieve the pain and general malaise bacause of absolute bedrest before interventional therapy.
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Objective To improve the sleep quality of patients by evaluating the effect of relaxation training in combination with listening to music on sleep quality of patients with intracranial aneurysm who underwent endovascular interventional therapy. Methods 55 patients who reached the entrance standard were divided into the observation group (28 cases)and the control group(27 cases).The control group received routine nursing measures. The observation group were given relaxation training in combination with listening to music based on routine nursing measures. The sleep quality was appraised by Pittsburgh Sleep Quality Index (PSQI) and patients subjective feeling was investigated by self-designed questionnaires. Results The relaxation training in combination with listening to music ameliorated the sleep quality in the observation group compared with that of the control group(P＜0.01).Conclusion The relaxation training in combination with listening to music could improved the sleep quality of patients with intracranial aneurysm who underwent endovascular interventional therapy.
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Objective To approach the effect of bed exercise for patients with intracranial aneurysm undergoing neural interventional treatment. Methods Ninety-six patients with intracranial aneurysm were divided into the test group(50 cases) and control group(46 cases).The control group received routine nursing, while the test group carried out bed exercise base on routine nursing. The incidence of complica-tions and changes of life quality were compared between the 2 groups. Results Lower incidence of com-plications took place in the test group than the control group(P ＜ 0.05).But changes in pulse rate and blood were not significant (P ＞ 0.05).The score of life quality in the physical domain and psychological domainwere not statistically different between the two groups (P ＜ 0.01 ),but no evident difference was seen in the domain of social relationship and environmental domain (P ＞ 0.05). Conclusions Bed exercise could al-leviated the anxiety and trepidation of patients with intracranial aneurysm,decrease the incidence of compli-cations such as body pain caused by absolute bed rest,thus improve patients' life quality.
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Objective To study the effect of relaxation therapy on sleeping quality of patients with post cran- iocerebral traumatic syndrome. Methods 90 cases with sleep disorders were randomly divided into the treatment group and the control group. The control group was given routine care and the treatment group was given relaxation therapy combined with routine care. Take pittsburgh sleep quality index (PSQI) as evaluation criteria. Results There was significant difference between the two groups( P < 0.01 ). Sleep quality was more improved by relaxation therapy in the experimental group than that of the control group. Conclusion Relaxation therapy can effectively im- prove sleep quality in patients with post craniocerebral traumatic syndrome.
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OBJECTIVE To analyze the correlation factors of nosocomial infection in patients after receiving craniocerebral operation.METHODS Totally 388 hospitalized patients after receiving craniocerebral operation from Jan 2006 to Dec 2006 were studied retrospectively.RESULTS From them 45 pateints were suffering from nosocomial infection and total incidence of nosocomial infection was 11.59%.Among them,60.0% was lower respiratory tract infection,11.11% was surgical wound infection and 8.89% was upper respiratory infection.Aging,length of stay and invasive operation(deep vein needle detaining,trachea incision,tracheal intubation,urinary canal and drainage tube dwelling) were the main correlation tactors.CONCLUSIONS Minimizing invasive operation and early removing various kinds of dwelling tubes,using antibiotics correctly,improving hospitalizd environment and strengthening wards management are the measures to reduce nosocomial infection according its correlation factors.