ABSTRACT
Objective:To summarize the clinical data and experience of pure single-port lumpectomy non-lipolysis breast-conserving surgery (PSLN-BCS) in patients with early-stage breast cancer.Methods:A retrospective analysis was conducted on 400 patients who underwent breast-conserving surgery for early-stage breast cancer in the Second Department of Breast Surgery at Harbin Medical University Cancer Hospital from Jan. 2022 to Jan. 2023. Patients were divided into two groups: PSLN-BCS group ( n=200) and conventional breast-conserving surgery (C-BCS) group ( n=200). The surgical time, intraoperative blood loss, postoperative drainage within three days, and short-term (3 months to 6 months after surgery) complications, including the incidence of residual fluid after drain removal and incision infection were observed. Long-term (6 months after surgery) complications, including the incidence of skin and pectoralis major muscle adhesions in the surgical area and cosmetic results after breast-conserving surgery, were also evaluated. Statistical analysis was performed using R language, and quantitative data were expressed as mean ± standard deviation ( ± s) and analyzed using t-test, while count data were analyzed using χ2 test. A p-value less than 0.05 was considered statistically significant. Results:PSLN-BCS had a longer average surgical time than C-BCS (198.341min vs 62.961min, P<0.001, 95% CI:132.028 vs 138.732). PSLN-BCS had less intraoperative bleeding (18.824 ml vs 22.627 ml, P=0.003, 95% CI: -6.294 vs -1.311) and lower postoperative drainage volume (346.157 ml vs 406.191 ml, P<0.001, 95% CI: -70.571-a-49.496). There were no significant differences in short-term postoperative complications such as subcutaneous fluid accumulation ( χ2=2.33, P=0.127) or incisional infection ( χ2=0.14, P=0.708) between the two groups. The incidence of skin and muscle adhesions in the surgical area was lower in patients who underwent PSLN-BCS at 6 months postoperatively ( χ2=11.58, P<0.001). Patients who received PSLN-BCS achieved better cosmetic outcomes, with a statistically significant difference ( χ2=273.00, P<0.001) compared to those who received C-BCS. Conclusion:Pure single-port lumpectomy non-lipolysis breast-conserving surgery is a safe and effective treatment option for early-stage breast cancer and can be considered as a surgical option for patients with cosmetic requirements.
ABSTRACT
Objective@#To investigate the correlation between blood glucose and aneurysm rupture, and analyze the correlation factors of aneurysm rupture.@*Methods@#The clinical data of 128 patients with intracranial aneurysms in the First Affiliated Hospital of Kunming Medical University from January 2017 to August 2018 were retrospectively analyzed. Among them, intracranial aneurysm rupture was in 85 cases (rupture group), and unruptured was in 43 cases (unruptured group). The patient′s clinical features and aneurysm morphological features were recorded.@*Results@#The blood glucose, daughter sac rate and regularity of morphology rate in ruptured group were significantly higher than those in unruptured group: (6.74 ± 2.61) mmol/L vs. (5.77 ± 2.11) mmol/L, 60.00% (51/85) vs. 11.63% (5/43), and 68.24% (58/85) vs. 30.23% (13/43), the aneurysm width was significantly smaller than that in unruptured group: (4.53 ± 2.25) mm vs. (5.67 ± 2.68) mm, and there were statistical differences (P<0.05 or <0.01). There were no statistical difference in gender, age, blood pressure, diabetes, hypertension, smoking history, glycosylated hemoglobin, blood lipids, aneurysm length, aneurysm neck, aneurysm length ratio to neck between 2 groups (P>0.05). Univariate Logistic regression analysis result showed that blood glucose, aneurysm width, daughter ascus and irregular shape were the risk factors of rupture of aneurysm (P<0.05 or <0.01). Multivariate Logistic regression analysis result showed that blood glucose, aneurysm width, daughter sac and irregular shape were the independent risk factors of rupture of aneurysm (OR = 1.364, 0.709, 9.441 and 3.935; 95% CI 1.073 to 1.734, 0.565 to 0.889, 2.879 to 30.963 and 1.330 to 11.646; P = 0.011, 0.003, 0.000 and 0.013). The patients were grouped again according to the aneurysm width, and univariate Logistic regression analysis result showed that aneurysm width ≤ 3 mm was the risk factors of rupture of aneurysm (OR = 0.294, 95% CI 0.094 to 0.916, P = 0.035).@*Conclusions@#Irregular shape and daughter sac of aneurysm are the independent risk factors of aneurysm rupture, but aneurysm rupture has nothing to do with recent blood sugar levels.
ABSTRACT
Objective To investigate the effect of rivaroxaban in the treatment of deep vein thrombosis (DVT) after total hip replacement (THR) in elderly patients with diabetes mellitus and its influence on plasma D-dimer level.Methods 25 elderly patients with diabetes undergoing elective hip replacement (group B) and 25 elderly patients without diabetes mellitus (group A) were enrolled in this study.The two groups were orally given rivaroxaban for 2 weeks after operation.The results of color Doppler diagnosis of DVT were compared between the two groups,and the content of D-dimer in plasma was detected.Results Before and after operation,the INR between the two groups had no statistically significant differences (P ＞ 0.05).The D-dimer levels of the two groups before operation were obviously.lower than those postoperative 2 and 7 days (t =3.145,P ＜ 0.05).Preoperative D-dimer value was slightly lower than those postoperative 14 days (P ＞ 0.05),the value of postoperative 2 days was significantly higher than those postoperative 7 and 14 days (t =3.763,P ＜ 0.05),the value of postoperative 7 days was significantly higher than those postoperative 14 days (t =2.876,P ＜0.05).There was no DVT in thetwo groups of A and B,and no severe bleeding occurred in the two groups.Conclusion Rivaroxaban in the treatment of elderly diabetic patients with THR surgery,can effectively reduce the formation of lower extremity DVT.At the same time,through detection of plasma D-dimer content can accurately judge the occurrence of DVT,which has guiding significance for prevention and treatment of DVT.