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【Objective】 To explore the correlation between CSAG1 expression and the prognosis and tumor-infiltrating lymphocytes in renal clear cell carcinoma (RCCC), and to predict the survival and tumor progression. 【Methods】 The gene expression profiles and clinical information of CSAG1 were downloaded from the Cancer Genome Atlas (TCGA). Based on the differential mRNA expression, GO annotation and KEGG pathway analysis were performed. The relationship between CSAG1 and tumor immune infiltration was assessed with Tumor Immunoassay Resource (Timer 2.0) database. The mRNA expression of CSAG1 in human RCCC specimens was validated with qRT-PCR. 【Results】 CSAG1 expression was significantly higher in RCCC tissues than in normal tissues (P<0.05). The qRT-PCR results revealed that the mRNA level of CSAG1 was consistent with that predicted by bioinformatic analysis. The KEGG analysis and GO annotation indicated high GSAG1 expression in RCCC was related to transmembrane transport, tricarboxylic acid cycle and lysosome. CSAG1 expression was positively related to the infiltration of pDC, aDC, CD8+ T cells, cytotoxic cells, TFH, TH1 cells, Tem, NK CD56dm cells, Treg and T cells, but negatively correlated with macrophage infiltration. 【Conclusion】 CSAG1 may be associated with poor prognosis of RCCC and become a potential immunotherapy target.
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【Objective】 To investigate the efficacy and safety of single position transabdominal and extraperitoneal laparoscopic radical nephroureterectomy in the treatment of upper tract urothelial carcinoma (UTUC). 【Methods】 Clinical data of 31 UTUC cases treated in our hospital during Nov.2018 and Jun.2022 were retrospectively analyzed, including 11 tumors in the right side, and 20 in left side. There were 14 cases of renal pelvic carcinoma, 16 cases of ureter carcinoma, and 1 case of renal pelvic carcinoma plus ureter carcinoma. 【Results】 All surgeries were successfully performed without conversion to open surgery. The mean operation time was (81.45±19.80) min, and the estimated blood loss was (69.03±24.13) mL. No serious perioperative complications were observed. The average postoperative hospital stay was (6.13±2.44) d, and the median follow-up was 28 (3.0-49.0) months. At the last follow-up, 2 patients died, 3 had recurrence, but no contralateral recurrence was observed. 【Conclusion】 Single position transabdominal and extraperitoneal laparoscopic radical nephroureterectomy is safe, effective and feasible in the treatment of UTUC. It is worth clinical popularization.
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【Objective】 To explore the safety and efficacy of a modified one-piece posterior laparoscopic total nephroureterectomy with cystic sleeve resection in the treatment of upper urinary tract uroepithelial carcinoma (UTUC). 【Methods】 A total of 24 patients treated during Jan. and Jun. 2022 were involved, including 16 males and 8 females, aged 62 to 90 (average 73) years. The UTUC was in the left side in 15 cases, and in the right side in 9 cases. There were 10 cases of renal pelvis tumor, 6 cases of upper ureteral tumor and 8 cases of lower ureteral tumor. 【Results】 All operations were successful without conversion to open surgery. The operation time ranged from 60 to 100 minutes, average (71.25±9.80) minutes. The intraoperative bleeding volume was 20 to 200 mL, average (30.03±8.13) mL. No significant intraoperative or postoperative complications occurred. The postoperative hospital stay was 4 to 7 days, average (5.83±1.44) days. Bladder perfusion chemotherapy was performed after surgery. 【Conclusion】 The modified one-piece posterior laparoscopic total nephroureterectomy plus cystic sleeve resection for UTUC is an effective and feasible procedure with satisfactory tumor control, which is worth further promotion in clinical practice.
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Objective To explore the clinical effects of modified pedicled pectoralis major myocutaneous flaps(PMMFs) in repairing postoperative defects following head and neck malignant tumor radical operation.Methods Twenty-eight patients with surgical defects after head and neck malignant tumor operation in this hospital from September 2013 to January 2017 were selected and performed the repairing reconstruction by modified PMMFs,then observed and followed up for the survival of the flaps.Results All 28 cases were followed-up for 3-36 months,all modified PMMFs survived.Using modified PMMFs to repair surgical defects following head and neck malignant tumor operation had the advantages of high survival rate and less trauma;meanwhile the swallow and language function could obtain the maximal recovery.Conclusion Using modified PMMFs to repair surgical defects following head and neck malignant tumor operation has good clinical curative effect and is worth clinical application.
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Objective To observe the effect of strict designed form for chewing gum on the first anus exhaust and defecation after laparoscopic surgery,and the actual compliance of chewing gum was investigate.Methods Totally 106 patients with abdominal operation in gynaecology department of Shaanxi Provincial People's Hospital from August to December 2016 were classified into chewing gum group and control group according to stratified random sampling.Chewing gum group had 53 cases,and the principle and requirement of chewing gum in patients and relatives were explained before operation.The xylitol chewing gum was chosed and chewed 2 to 3 gums in the 2 hours after operation,chewed about 30 times every minute and last for 15 to 20 minutes each time.From 7∶00 to 22∶00 the interval was 2 hours, and the interval at the rest time must not exceed 3 hours until exhaust.Fifty-three cases in control group received routine nursing,and started to drink a small amount of water 6 hours after operation,and gradually started to eat.Other dietary guidance and medical care measures were identical in both groups.Compared the first anus exhaust time,defecation time,abdominal distension and postoperative hospitalization time in two groups,and the actual compliance of chewing gum was investigated.Results The first anus exhaust time and the first defecation time of chewing gum group were (19.60±7.59) hours and (36.77±17.16) hours respectively,while those of the control group were (33.79±10.54)hours and (53.25±16.92) hours,and the differences were statistically significant(P0.05).The actual compliance investigation of chewing gum was selected in 53 cases with the actual completion of 48 cases(90.6%).The averaged actual chewing number was (4.39±1.35) times,the averaged actual chewing time in each duration was (16.16±2.05) minutes,the average actual chewing interval was (2.38±0.26) hours.Conclusion The well designed form of chewing gum postoperative can shorten the postoperative anus exhaust and defecation time, and it can reduce postoperative abdominal distention.
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Objective To understand the application of Nursing Information Management Software to provide reference for Nursing Information Construction of our country. Methods A self-designed questionnaire was employed and according to stratified sampling principle, 334 nursing managers were enrolled in this study to investigate the awareness of nursing managers on the traditional nursing management model and the application of nursing management software. Results Nearly 96.41％(322/334) of nursing managers believed that the introduction of nursing management software is very necessary, 94.90％(317/334) of managers believed that the use of nursing management software could improve work efficiency in different degrees, and 98.09％(328/334) of nursing managers gave the management software good evaluation. But because of the software features, cost-effective and hospital attention and other reasons, only 52.99％(177/334) of the managers applied the software. Conclusions The use of nursing management software is the only way to develop the nursing work, but its function needs to be further improved, the software also needs to further promote the application.
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@#Objective To observe the effect of the expanding training orthosis on webbed-finger adhesion post burn. Methods From May, 2014 to April, 2016, 37 hands of 33 patients with webbed-finger adhesion post burn were divided into two groups. 21 hands from 18 patients were as experimental group, 16 hands from 15 patients were as control group. The control group accepted routine care, while the experimental group accepted the expanding training orthosis in addition. Their angles between the fingers were measured six months after treatment. Results The angles between the fingers increased in the experimental group after treatment (t>3.060, P<0.01), and were more than those of the control group (t>2.273, P<0.05). Conclusion Application of expanding training orthosis can improve the compliance of the patients with webbed-finger adhesion post burn, and promote hand function recovery.
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Objective To explore the time-effectiveness of acupuncture in treating hypertensive intracerebral hemorrhage (HICH), and to find the best intervention time of acupuncture. Method The eligible HICH patients were randomized into a 2 d acupuncture group, a 7 d acupuncture group, and a 14 d acupuncture group. The National Institute of Health Stroke Scale (NIHSS) and Barthel Index (BI) were adopted for evaluation, and the clinical efficacies of acupuncture intervened at different time points for HICH were observed. Result The treatment efficacy of the 2 d acupuncture was better than that of the 7 d acupuncture group(P<0.05), and the treatment efficacy of the 7 d acupuncture group was better than that of the 14 d acupuncture group(P<0.05). There were no significant between-group differences in comparing the security indexes. Conclusion Acupuncture is safe and effective in treating HICH, and its efficacy is related to the intervention time, the earlier the better.
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Objective:To explore the effect of management mode of correspondence of potencyscale on impro-ving the nurses′job satisfaction and patient satisfaction in the department of neurology and analyze the medical eth-ics. Methods:We selected 37 nurses in the department of neurology. From July 2013 to March 2014, they were provided with the traditional management mode, whereas from March 2014 to June 2015 with management mode of correspondence of potencyscale. The questionnaire survey was conducted to measure the job satisfaction of nurses and the satisfaction degree of patients. Results:After the implementation of management mode of correspondence of potencyscale, the research indexes were significantly higher than before. Conclusion:The management mode of correspondence of potencyscale can improve the nursing staff′s work enthusiasm, patient satisfaction, and the quali-ty of care. Meanwhile, it is the specific practice of nursing ethics.
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Objective To observe the influence of oleanolic acid on the ethology of 9-month-old mice,the completeness of synapsis structure and the expression of cAMP-response element binding protein (CREB) in cortex and hippocampus.Methods Thirty 9-month-old healthy male SMAP8 mice were randomly divided into model group,oleanolic acid group and aricept group,and with 10 rats in each group,while 10 healthy male mice of the same age and species as normal group.Oleanolic acid group and aricept group were given intragastric administration with corresponding drugs,while the normal group and model group were given the same amount of physiological saline.4 weeks later,the ethology changes were observed by Morris water maze and morphology changes of hippocampus neurons were viewed by electron microscope and the expression of CREB was detected by Western Blot.Results (1)Morris water maze results suggested that compared with the normal group,the latency time in the model group mice was longer,which were ((83.33±4.96) s,(75.13±6.01) s,(71.75±7.77) s,(63.40± 8.93) s,(60.97±8.38) s),while compared with the model group,the latency time in the oleanolic acid group and the aricept group was remarkably shorter (P＜ 0.05),which were (75.97± 4.49) s,(64.98± 4.93) s,(64.16± 6.23) s,(53.47±5.99) s,(47.91±7.64) s and (71.30±7.65) s,(63.32±7.57) s,(59.82±4.69) s,(52.28±5.90) s,(46.22±7.27) s respectively.In the spatial probe trial,compared with tbe normal group,the crossing times of the model was less,while compared with the model one,the crossing times of the oleanolic acid group and the aricept group was more(P＜0.05).(2)Compared with the normal group,the number of synapses in the model group was smaller,in which the synaptic cleft was mixed with the front of synapses severely swollen,uninform synaptic vesicles and few clear outlines of mitochondrias.While the oleanolic acid group and the aricept group had clear synapses outlines with the front of synapses slightly swollen,intensive and uniform synaptic vesicles and clear mitochondrias with their cristae not easy to be seen.(3) The Western Blot showed that compared with the normal group,there was a decline in the CREB expression both in the cortex and hippocampus in the model group,while compared with the model group,there was a rise in the oleanolic acid group as well as the aricept group(P＜0.05).Conclusion Oleanolic acid can improve the learning and memorizing of model rats,which is possibly related to the increased expression of CREB protein to protect the synapses structure of model mice.
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Objective To discuss the prevention and management method for chylous fistula after neck lymph node dissec‐tion .Methods Totally 1 793 cases of neck lymph node dissection in this department from January 2005 to September 2014 were retrospectively analyzed .The clinical data in the cases of chylous fistula occurred after operation were summarized .Results Twenty one cases of chylous fistula occurred ,accounting for 1 .17% ,in which 13 cases were cured by the local compressed bandaging and continuous negative pressure drainage;5 cases adopted the conventional method for 2-3 d ,but under the ineffective condition ,then they were treated by combining with somatostatin pumping (somatostatin 6 mg+0 .9% normal saline 48 mL ,2 mL/h ,lasting for 24 h ,for successive 2-3 d) and finally cured;3 cases were cured after reoperation .Conclusion Prevention is the best treatment for chylous fistulas ,local compression bandage plus continuous negative pressure drainage is the main method for treatment of chylous fistulas after neck dissection .The combined therapy with somatostatin can increase the close rate of chylous fistulas;for the patients with long persistent time ,large drainage volume and invalid conservative therapy should adopt the remedial measure of operation .
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Objective To open pterygopalatine artery using autologous blood clot clogged the middle cerebral artery, resulting in cerebral infarction model of middle cerebral artery in the distal blood supply area.Methods Open PPA, ligation of ECA, embolus through CCA blood flow, rushed into the MCA distal embolus, cause infarction model. According to Bederson rating score the neural function.TTC staining to determine the infarction volume.Results Comparison of two operation models, scores were increased, and white infarcted area appears.There is no significant differences detected by statistical analysis.Conclusion Open PPA manufacturing cerebral infarction model rats of autologous blood clots could shorten the operation time, reduce the mortality rate.
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Objective To investigate the primary repair methods and efficacy of island pedicled pectoralis major muscle flap in soft tissue defect after the operation of head and neck malignant tumors .Methods From April 2011 to September 2012 ,27 patients from this hospital who underwent primary repair using island pedicled pectoralis major muscle flap after a head and neck extensive soft tissue defect were investigated ,including 11 cases of tongue cancer defect ,2 cases of parotid gland defect ,3 cases of gum cancer defect ,2 cases of oropharyngeal cancer defect ,9 cases of floor of the mouth cancer defect .Results 27 patients were safety in periop-erative ,27 cases of island pectoralis major muscle flap survived ,patients were satisfied with both the appearance and function .There was postoperative neck hematoma in 1 patient ,it was eliminated through timely remove the hematoma and hemostasis completely ;There was 1 case of removing the epidermal necrolysis skin as flap necrosis ,while it was acceptable efficacy as the muscle flap sur-vival and surface granulation repaired .Conclusion Island pectoralis major muscle flap obtains unique advantages in repairing a large area of soft tissue defect in head and neck cancer patients after operation ,such as abundant of tissue ,a constant arterial anatomy of thoracoacromial ,easy to operate ,rich blood supply ,strong resistance to infection ,high survival rate and so on .A fine surgery opera-tion is the key of island pectoralis major muscle flap survival .
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ObjectiveTo observe the effects of Huatan Tongluo on the Bederson's scores,the permeability of blood-brain barrier and ultrastructure of hippocampus endothelial cells after thrombolysis in acute cerebral infarction.To provide experimental evidence for the prevention of bleeding after thrombolysis in acute cerebral infarction with Huatan Tongluo.Methods 120 SD male rats were randomly divided into sham group,model group,rt-PA group,Huatan Tongluo combined rt-PA low-dose group,Huatan Tougluo combined rt-PA medium-dose group and Huatan Tongluo combined rt-PA high-dose group( each group was divided in 6h,24h,3d,7d four-phase).MCAO rats were prepared by self-embolus method.rt-PA group and Huatan Tongluo combined rt-PA groups were given rt-PA through tail vein injection and three doses of Huatan Tongluo to treat.To observe the Bederson's scores in rat on four-phase.To detect the permeability of blood-brain barrier(BBB) by the Evans Blue dye ( EB dye) and watch the ultrastructure of hippocampus endothelial cells in ischemic region by electron microscopy.Results 1.Bederson's scores:Compared with model group,rt-PA group,Huatan Tongluo combined rt-PA low-dose group,Huatan Tongluo combined rt-PA medium-dose group and Huatan Tongluo combined rt-PA high-dose group significantly lower(P＜0.01 ) ; Compared with rt-PA group,Huatan Tongluo combined rt-PA medium-dose groups and high-dose groups was significantly lower(P ＜ 0.05).2.EB dye:Compared with model group,rt-PA group,Huatan Tongluo combined rt-PA low-dose group,Huatan Tongluo combined rt-PA medium-dose group and Huatan Tongluo combined rt-PA high-dose group (P ＜ 0.01 ) ; Compared with rt-PA group ( 6h:( 236.72 ± 79.79 ) ng/g; 24h:(229.72 ±22.18)ng/g;3d:(163.34 ±24.45)ng/g;7d:(133.21 ±25.09)ng/g),Huatan Tongluo combined rt-PA medium-dose groups (6h:( 121.63 ± 33.27) ng/g;24h:( 153.78 ± 60.67 ) ng/g;3d:( 76.05 ± 27.11 ) ng/g;7d:(72.97 ±25.81 ) ng/g) and high-dose groups (6h:( 123.11 ±23.65) ng/g;24h:( 138.36 ±52.36)ng/g;3d:(83.00 ±32.00)ng/g;7d:(75.06 ± 13.97) ng/g) was significantly lower(P＜ 0.01 ).3.Electron microscopy:Compared with model group,treatment groups all protected the endothelial cells.In 24h,the Huatan Tongluo combined rt-PA high-dose group was best.At 3d and 7d,the Huatan Tongluo combined rt-PA medium-dose group was best.ConclusionHuatan Tongluo combined rt-PA to thrombolysis can protect the blood-brain barrier and endothelial cells of hippocampal's ischemic region.After thrombolytic,to adjust the medicine drug concentration at different time can play a better treatment results.
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OBJECTIVE To investigate the properties of nosocomial infections among acute stroke victims,analyze the risk factors associated with these infections,and find out effective methods of care and management.METHODS Between Jan 2003 to Dec 2006,428 cases of stroke victims were studied to analyze the special properties and risk factors related to hospital infections among them.RESULTS Their nosocomial infection rate was 8.93%,repetitive infection rate was 9.41%,and the top five infected sites were the lower respiratory tract,digestive tract,urinary tract,upper respiratory tract and skin,with their respective rates as 47.66%,17.76%,15.19%,9.81%and 6.31%.The occurrence of hospital infections was associated with stroke as well as the quality of the nursing care process,invasive procedures,duration of stay in the hospital,dietary conditions,etc.CONCLUSIONS Nosocomial infection is still a high frequent complication in cerebral stroke and those related factors should be paid attention.To effectively decrease nosocomial infections related to stroke,it is necessary to improve nursing care and supervision as well as control over the quality of care.
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0.0125) incision of trachea,and oral and pharyngeal portion,but no correlation with hands of nurse and external environment(P
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The holistic nursing care which central is “nursing procedure” require nurse to find the health problems of patients and solve them.But in professional nursing,it is urgent and generates that how to master and give correctly nursing diagnosis.In this article,we sum up and analysis 542 cases of the nursing diagnosis about 175 stroke patients.Then give the trend of centralized distribution and limitation about diagnosis.After it,we give the way to solve them.