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Objective@#To analyze the risk factors of cervical anastomotic leakage after thoracoscopic-lapacoscopic esophagectomy.@*Methods@#530 patients with esophageal cancer underwent thoracoscopic-lapacoscopic esophagectomy at the Cancer Hospital, Chinese Academy of Medical Sciences from Jan 2011 to Dec 2015. The demographic, surgical and clinical data of patients were retrospectively analyzed. Multivariate logistic regression was used to evaluate risk factors of cervical anastomotic leakage in these patients.@*Results@#A total of 530 patients undergoing thoracoscopic-lapacoscopic esophagectomy were enrolled in this study. There were 421 males and 109 females. The mean age was (59.40±8.08) years old, and 91 patients with cervical anastomotic leakage. Sigle factor analysis revealed that the risk grading by American Society of Aneshesiologists, previous history of chest surgery, respiratory comorbidity, diffusion capacity for carbon monoxide of the lung, operation time, anastomosis, average days of postoperative hospitalization, death within 30 days after surgery, respiratory complications, pleural effusion or empyema, and poor healing of the incision were statistically associated with cervical anastomotic leakage (all P<0.05). Multivariate analysis showed that previous history of chest surgery, hepatic insufficiency, manual anastomosis, prolonged postoperative hospitalization, and poor healing of the incision were independent risk factors for cervical anastomotic leakage after thoracoscopic-lapacoscopic esophagectomy (all P<0.05).@*Conclusions@#Previous history of chest surgery, hepatic insufficiency, poor healing of the incision, manual anastomosis and prolonged postoperative hospitalization were significantly associated with cervical anastomotic leakage after thoracoscopic-lapacoscopic esophagectomy. It′s important to strengthen perioperative nursing and surgical techniques to prevent anastomotic leakage after thoracoscopic-lapacoscopic esophagectomy.
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Objective To analyze whether free fatty acids(FFA)are associated with anxiety and depression in elderly patients with chronic heart failure(CHF).Methods A cross-sectional study was conducted in patients by using questionnaires.According to the Zung Self-Rating Anxiety Scale (SAS) and the Self-Rating Depression Scale(SDS),126 patients were divided into the depression group (n=94),non-depression group (n =32),and anxiety group (n =48),and non-anxiety group (n =78).The difference in FFA levels between the two groups was analyzed.Moreover,the association of FFA with anxiety and depression was analyzed Results The incidence of anxiety in elderly patients with CHF was 38.1％(48 cases),and the incidence of depression was 74.6％ (94 cases).FFA levels were higher in both the anxiety and depression groups than in the non-anxiety and non-depression groups [(559.9 ± 256.2)μmol/L vs.(393.8 ± 147.8) μmol/L,(573.8 ± 264.7)μmol/L vs.(483.2 ± 225.2)μmol/L,P＜0.05 and 0.01)].The FFA level was positively correlated with SAS and SDS in elderly patients with CHF(r=0.214 and 0.275,P＜0.05 and 0.01).Multivariate regression analysis showed that the FFA level was a risk factor for elderly CHF patients with anxiety(β=0.074,95％CI:0.024～0.125,P=0.004)and depression(β=0.084,95％CI:0.022～0.145,P=0.008).Conclusions FFA levels are correlated with anxiety and depression in elderly patients with CHF.The FFA level is a risk factor for anxiety and depression in elderly patients with CHF.Psychological intervention should be carried out early in CHF patients with high levels of FFA to reduce the incidence of anxiety and depression.
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BACKGROUND@#Simultaneity multiple primary lung cancer always is a rare disease, but in recent years due to the progress of the diagnosis and treatment means detection rate increased. This study summarized the clinical data of 31 cases of synchronous multiple primary lung cancer (sMPLC) analysis, further to explore the diagnosis, treatment and prognosis of MPLC.@*METHODS@#Sum up the clinical data of 31 cases of simultaneous multiple primary lung cancer, the diagnostic method, surgical methods, pathology, were retrospectively analyzed.@*RESULTS@#All the patients are thoracoscope surgery, no deaths. Thin high resolution computed tomography (CT) in preoperative found multiple lung nodules. Lesions located in the same side of the same period surgical treatment, the operation method is given priority to with under the thoracoscope lung + the lobectomy; Lesions located in bilateral, all staged operation, the time interval for 3 months-4 months.@*CONCLUSIONS@#Thin layer distinguish CT preoperative diagnosis is the best way to simultaneous multiple primary lung cancer. Multiple primary lung cancer incidence of ipsilateral lung at the same time higher than that of bilateral lung (23:8), type, around 94%, the most common histology to adenocarcinoma, 80.6% (25/31). Primary lesions under thoracoscope lobectomy plus the lobectomy of secondary lesions is the most commonly used.
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Adult , Aged , Female , Humans , Male , Middle Aged , Lung Neoplasms , Diagnosis , Diagnostic Imaging , General Surgery , Neoplasms, Multiple Primary , Diagnosis , Diagnostic Imaging , General Surgery , Retrospective Studies , Tomography, X-Ray ComputedABSTRACT
AIM:To investigate the neuroprotective effect of hydrogen sulfide ( H2 S) after cardiopulmonary re-suscitation in rats with cardiac arrest ( CA) , and to explore the effects of H2 S on neuron autophagy.METHODS:The CA model was established through asphyxia.Male Wistar rats were randomly divided into sham group, model group and NaHS group.The levels of beclin-1 and LC3 II/I were measured by Western blot at 2 h, 4 h, 12 h and 24 h after the restoration of spontaneous circulation (ROSC).At 12 h after ROSC, the formation of autophagic vacuole with LC3 dots was deter-mined by immunohistochemical ( IHC) method.The phenomenon of neuron autophagy was observed under transmission electron microscope.The numbers of apoptotic neurons were counted by TUNEL staining at 72 h after ROSC.The neurolo-gic deficit score ( NDS) was used to evaluate the neurologic function after ROSC.RESULTS: The level of beclin-1 was gradually increased in model group, but it was increased and then gradually recovered in NaHS group ( P<0.05 ) .The conversion of LC3 II in the cerebral cortex was the same as beclin-1.The results of IHC showed that LC3-positive nuclei in model group were more than those in NaHS group ( P<0.05) .The number of autophagic vacuole in model group was more than that in NaHS group (P<0.05).The number of the TUNEL-positive cells in model group was more than that in NaHS group (P<0.05).The NDS of the animals in NaHS group after ROSC was lower than that in model group(P<0.05). CONCLUSION:H2 S inhibits neuronal autophagy, decreases apoptosis and improves neurologic function in CA rats after ROSC.
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Objective To describe our experience and method of reconstruction after resection of tumors around inner canthus and nasion in the elderly. Methods The line between outer and inner canthus was considered during reconstruction.If the surface of wound after resection was above this line,glabellar flap was used to reconstruct the upper part and the residual defect was repaired with advancement of lower eyelid and rotation of flap.If the surface of wound was below this line,lower eyelid flap was used and the residual defect was reconstructed with glabellar flap. Results All flaps survived without any significant complications.9 cases among 15 patients were followed up from 1 to 24 months.Repaired tissues all matched well with surrounding tissue in color,texture,and outline.Eyelid and medial canthal were not disturbed and there was no tumor recurrence.Scars were smoothy,soft and hidden with satisfactory appearance and vision. Conclusions Single local flap or combined local skin flaps around the nasion and inner canthus is one of reconstruction methods to get satisfactory cosmetic effect or facial morphology.
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Objective To study the direct inhibition of Ginsenoside-Rg3(GS-Rg3) on human keloid fibroblasts cultivated in vitro and its possible mechanism.Methods The effects of GS-Rg3 with different concentrations(25,50,100 and 200 mg?L~(-1)) on proliferation activity of fibroblast hyperplasia at different time were detected by viable count and MTT chromometry.Results Compared with control group,GS-Rg3 inhibited the proliferation of keloid fibroblasts.The inhibition increased with the prolongation of time and the increasing of concentration.And the max inhibitory concentration was 100 mg?L~(-1).Conclusion Gs-Rg3 can inhibit the proliferation of human keloid fibroblasts cultivated in vitro.And the inhibition will increase with the prolongation of time and the increasing of concentration.
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Objective To investigate the effects of ginsenoside Rg3 (GS-Rg3) on the hypertrophic scars of rabbit ears and provide experimental foundation for study on its inhibition on the hypertrophic scars. Methods Hypertrophic scars were proved on 24 white rabbits,of which the whole level of the skin was excised for 2 cm?2 cm,4-6 points for each ear,controlled by itself. GS-Rg3 0.1 mL(concentration 3 g?L-1) was injected into experimental group and the same volume of saline solution into control group,once every three days regionally. The scar tissues were collected 2,4 and 6 weeks after the injection respectively,the thickness of the scar,structure under the microscope,and the expressions of PCNA,Bcl-2 and Bax were observed. Results In control group,three weeks after the epithelization of the wound,the thickness of the hypertrophic tissue was 3-4 times of ventro ear skin. Under microscope,the dermis was hyperplasia and got thicker,consisted with amount of fibroblast cells,collagen and vessels,the collagen was untidy,nodule or vortex,and the cartilage could be observed in some region.In experimental group, six weeks after the injection,the skin got thinner,the collagen became neath and the quantity of the vessels decreased. In the hypertrophic scars,there was high expression of PCNA,the percent of positive cells was higher (39.55%?6.07%) compared normal tissue (11.18%?1.71%).In GS-Rg3 group,the expression of Bcl-2 was gradually decreased two weeks after injection and obviously decreased six weeks later,there was significant difference compared with before injection (P