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Objective To understand the public mental health status and related influencing factors during the epidemic of coronavirus disease 2019（COVID-19）. Methods A structured questionnaire was used to conduct a questionnaire survey of the research subjects through an online platform. The public mental health status was assessed using the Symptom Checklist (SCL-90). Logistic regression analysis was used to analyze related influencing factors. Results The survey included 1 078 eligible questionnaires, of which 252 (23.38%) were positive on the SCL-90 scale. For each SCL-90 factor, the highest positive rate was anxiety (41.28%), followed by horror (35.16%), and depression (33.21%). Multivariate logistic regression analysis showed that from Hubei (OR=1.64, P=0.014), male (OR=1.37, P=0.036), medical related occupations or professions (OR=1.57, P=0.008), and high concern over the epidemic (OR=2.19, P=0.013) and known people with suspected or confirmed cases (OR=2.75, P<0.001) were risk factors influencing public mental health. Conclusion The mental health problems of the population during the epidemic of COVID-19 were serious, especially in Hubei. Male groups, medical workers, and people with relatives and friends who have a case need to pay attention to their own mental health. The government should increase the publicity of mental health knowledge to effectively prevent the occurrence and development of mental illness in these people.
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Objective To investigate the clinical efficacy and prognostic factors of hepatectomy for hepatocellular carcinoma (HCC).Methods The retrospective case-control study was conducted.The clinicopathological data of 789 HCC patients who were admitted to the Sichuan Cancer Hospital Affiliated to School of Medicine of University of Electronic Science and Technology of China from January 2009 to January 2016 were collected.There were 669 males and 120 females,aged from 42 to 60 years,with a median age of 52 years.Surgical procedures were determined according to the preoperative and intraoperative comprehensive evaluations of patients.Observation indicators:(1) situations of surgical treatment;(2) postoperative pathological examinations of patients;(3) follow-up and survival situations;(4) prognostic factors analysis.Follow-up using outpatient examination and telephone interview was performed to detect patients' survival up to May 2017.Normality of measurement data was done using the K-S test.Measurement data with skewed distribution were represented as M (range).Count data were described as absolute number or percentage.The survival rate and survival curve were respectively calculated and drawn by the Kaplan-Meier method.The univariate analysis and multivariate analysis were done using the Log-rank test and COX regression model,respectively.Results (1) Situations of surgical treatment:all the 789 patients underwent successful hepatectomy,liver volume dissected accounting for 32.5％ (range,17.0％-52.0％) of the total liver volume.Of the 789 patients,413 underwent anatomical hepatectomy including 116 of hepatic segmentectomy,136 of right hemihepatectomy,77 of left hemihepatectomy,57 of left lateral lobe hepatectomy,27 of central hepatectomy,376 underwent nonanatomical hepatectomy including 344 of partial hepatectomy,17 of extended right hemihepatectomy,15 of extended left hemihepatectomy.Volume of intraoperative blood loss was 400 mL (range,200-500 mL) in the 789 patients and 173 had intraoperative blood transfusion.Of the 789 patients,240 had postoperative complications (68 with postoperative severe complications),including 65 of liver insufficiency,37 of ascites and pleural effusion,37 of pulmonary complications,19 of infectious complications,17 of cardiovascular complications,17 of abdominal hemorrhage,11 of gastrointestinal complications,9 of neruologic complications,8 of postoperative bile leakage,10 of other complications,11 of death;the same patient can merge multiple complications.The 229 survival patients with complications were cured by symptomatic supportive treatment.Duration of postoperative hospital stay was 9 days (range,7-11 days).(2) Postoperative pathological examinations.Results of postoperative pathological examinations showed 17 patients with bile duct tumor thrombus,92 with naked eye tumor thrombus at portal vein branches and 167 with microvascular invasion.Of the 789 patients,High-,moderate-,low-differentiated carcinoma were detected in 19,678,92 patients,respectively.(3) Follow-up and survival situations:690 of the 789 patients were followed up for 1-96 months,with a median time of 21 months.The l,3,5-year overall survival rates were 82.1％,66.1％,59.2％ in the 789 patients.(4) Prognostic factors analysis:results of univariate analysis showed that level of preoperative alphafetoprotein (AFP),Child grade of preoperative liver function,Barcelona clinic liver cancer staging,tumor diameter,surgical procedure of hepatectomy,volume of intraoperative blood loss,intraoperative blood transfusion,postoperative complications,postoperative severe complications,bile duct tumor thrombus,portal vein tumor thrombus,vascular invasion were related factors affecting prognosis of HCC patients after hepatectomy (x2 =8.603,8.864,39.970,28.978,6.376,26.144,8.955,6.596,9.910,7.288,37.566,19.183,P＜0.05).Results of multivariate analysis showed that tumor diameter,volume of intraoperative blood loss,portal vein tumor thrombus were independent factors affecting prognosis of HCC patients after hepatectomy (hazard ratio =1.085,1.000,2.259,95％ confidence interval:1.053-1.118,1.000-1.001,1.621-3.146,P＜0.05).Conclusion Hepatectomy for HCC has a good safety,with satisfactory clinical efficacy.Tumor diameter,volume of intraoperative blood loss,portal vein tumor thrombus are independent factors affecting prognosis of HCC patients after hepatectomy.
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Objective To review the role of extrahepatic bile duct resection in patients with hepatocellular carcinoma with bile duct tumor thrombi.Methods The Pubmed,Wan Fang and China Science and Technology Journal Database were reviewed systematically.Any case reports or studies involving treatment of hepatocellular carcinoma with bile duct tumor thrombi were included in this literature search.Two authors independently assessed the studies for inclusion and extracted the data.Univariate analysis was used to compare the baseline characteristics and the Kaplan-Meier method was used for analyzing survival and diseasefree survival outcomes.Results Using predetermined inclusion criteria,16 studies which included 170 patients entered into this study.All these patients underwent surgical resection of hepatocellular carcinoma and bile duct tumor thrombi.Based on the Satoh classification,45 patients were type Ⅰ,107 patients type Ⅱ and 18 patients type Ⅲ.Twenty-four patients underwent liver resection combined with extrahepatic bile duct resection.The remaining 146 patients underwent liver resection combined with thrombectomy.The 1-,3-,and 5-year survival rates of all the patients were 73.4％,41.5％ and 21.8％,and the corresponding recurrences free survival rates were 62.5％,29.2％ and 13.1％,respectively.On Kaplan-Meier analysis,there were no significant differences in the survival outcomes between the 2 groups of patients,(P ＞ 0.05).The 1-,3-,and 5-year survival rates of the extrahepatic bile duct resection group were 66.7％,41.7％ and 12.5％,and those of the thrombectomy group were 74.6％,41.3％ and 23.8％,respectively.On subgroup analysis (Satoh type Ⅱ and Ⅲ),no significant differences were observed between the two groups (P ＞0.05).The 1-,3-,and 5-year survival rates of the extrahepatic bile duct resection group were 65.2％,38.0％ and 13.0％,and those of the thrombectomy group were 72.8％,39.5％ and 20.9％,respectively.Conclusion Extrahepatic bile duct resection did not improve the overall survival of patients with hepatocellular carcinoma with bile duct tumor thrombi.
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Objective To determine the efficacy of liver cancer resection combined with splenectomy for patients with hepatocellular carcinoma with hypersplenism.Methods Among 35 patients with hepatocellular cancer and hypersplenism treated from March 2004 to January 2006 at our hospital,12 patients accepted simultaneous liver cancer resection and splenectomy (the splenectomy group)and 23 only accepted liver cancer resection (the non-splenectomy group).The liver function,platelets and white blood cells were analyzed retrospectively.Results All the operations were successfully carried out.Within 1 week after operation,the white blood cell count increased from (3.2 ± 1.7) × 109/L to (8.5±-5.3) × 109/L,the platelet count increased from (52.6±23.7) × 109/L to (245.3±94.6) ×109/L(P＜0.01) in the group of patients with combined splenectomy,while little change occurred in the non-splenectomy group.The liver function in the splenectomy group recovered to the preoperational value within 1 week.Two years after operation,7 (58.3％) patients were still surviving in the splenectomy group and the mean tumor-free survival was (16.4 ± 4.3) months compared with (14.3 ±5.2) months in 10 (43.5％) patients in the non-splenectomy group,(P＜0.005).Conclusion Liver cancer resection combined with splenectomy was efficacious to hepatocellular cancer with hypersplenism.
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Objective To investigate β-lactamase gene and class 1 integron gene from 60 clinical Acinetobacter baumannii isolates.Methods The minimal inhibitory concentrations (MICs) for 16 antibiotics widely used were determined using the standard broth microdilution method.The β-lactamase gene,class 1 integron gene and adeB gene were determined by PCR and then sequenced.Results Fifty-three strains of the 60 A.baumanii isolates were multi-drug resistant.OXA-23 gene was detected positive in six A.baumanii isolates,which were all resistant to more than five antimicrobial agents including carbapenem and showed high resistance to many antibiotics.Thirtyeight strains earring PER-1 gene showed higher resistance to cephalosporins than those without this gene (P＜0.01).Class 1 integron gene was positive in 45 strains,which exhibited significantly higher multiple resistance than those without this gene (P＜0.01).Twenty-five strains carrying both class 1 integron and PER-1 genes had a markedly higher multiple resistance (P＜0.01),but not in resistant level,compared to the 7 strains without these two genes.Conclusion Class 1 integron and β-lactamase gene may be the causes of muhidrug-resistance of A.baumanii.The strains carrying OXA-23 gene always showed multiple and high resistance to several antibiotics,so effective measures must be taken to control the epidemic of these strains.
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Objective: To investigate the effects of adrenaline on pharmacodynamics and pharmacokinetics of bupivacaine for interscalene plexus block. Method:Sixteen ASA gradeⅠ-Ⅱadult patients undergoing shoulder or upper limbs operation were randomly divided into two groups (n=8)). The plexus block was induced with 0.75％ bupivacaine 2 mg/kg or 0.75％ bupivacaine 2mg/kg plus 1:200 000 adrenaline. Clinical effects and plasma concentration,the Cmax and Tmax were compared between two groups. Result:The time to reach peak analgesia and the duration of analgesia were longer in adrenaline group than in control group(P