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Objective:To explore the clinical value of quantitative parameters on spectral CT in predicting the invasiveness of lung adenocarcinoma manifesting as ground-glass nodules (GGN).Methods:The clinical and imaging data of 129 patients with pathologically confirmed lung adenocarcinoma who were surgically resected in the First Affiliated Hospital of Zhengzhou University from March to October 2022 were retrospectively analyzed, including 45 males and 84 females, aged from 33 to 81. According to the pathological results, they were divided into the minimally invasive adenocarcinoma (MIA) group ( n=64) and the invasive adenocarcinoma (IAC) group ( n=65). All patients underwent enhanced spectral CT within two weeks before surgery. The iodine density map, Z-Effective (Z eff) map, and electron density (ED) map were reconstructed on the post-processing workstation, and the spectral parameters, including normalized iodine concentration (NIC), arterial enhancement fraction (AEF), Z eff, and ED were measured and calculated. Conventional CT features were analyzed, including maximum diameter, CT value, nodule types, margin, lobulation sign, spiculation sign, bubble sign, pleural retraction sign, abnormal vascular sign, and air bronchial sign. The clinical features, conventional CT characteristics and spectral CT parameters of two groups were compared using the independent sample t test, the Mann-Whitney U test, and the χ 2 test. Multivariate logistic regression analysis was used to evaluate the independent risk factors of lung adenocarcinoma invasiveness, and the model was constructed. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the performance of parameters and models in predicting the invasiveness of lung adenocarcinoma. Results:There were significant differences between the MIA group and IAC group in maximum diameter, CT value, nodule type, margin, spiculation sign, pleural retraction sign, air bronchial sign, venous phase NIC, AEF, venous phase Z eff, arterial phase ED, venous phase ED ( P<0.05). Multivariate logistic regression analysis showed that the maximum diameter (OR=1.183, 95%CI 1.062-1.318), CT value (OR=1.004, 95%CI 1.001-1.007), venous phase NIC (OR=1.185, 95%CI 1.083-1.298), AEF(OR=0.975, 95%CI 0.957-0.994), venous phase Z eff (OR=0.031, 95%CI 0.005-0.196) were independent influence factors for the invasiveness of lung adenocarcinoma. The conventional CT model was established with the maximum diameter and CT value, and the spectral CT model was established with venous phase NIC, AEF, and venous phase Z eff. The combined model was established with all the parameters above. Areas under the ROC curve of the conventional CT model, the spectral CT model, and the combined model for predicting the invasiveness of lung adenocarcinoma were 0.828, 0.854, and 0.902, respectively. Conclusion:The quantitative parameters of double-layer detector spectral CT can be used as an indicator to predict the invasiveness of lung adenocarcinoma manifesting as GGN, and AEF has the highest diagnostic efficacy. Spectral CT combined with conventional CT features can further improve the diagnostic efficiency.
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The First Affiliated Hospital of Sun Yat-sen University has made many lasting contributions to gastrointestinal surgery in Guangdong Province and even in China. The Department of Gastrointestinal Surgery was established at the First Affiliated Hospital of Sun Yat-sen Medical College in 1965, which opened the prelude to the development of gastrointestinal surgery in Guangdong. This article summarizes the evolution of gastrointestinal surgery and highlights the milestones specific to the field of gastrointestinal surgery in Guangdong Province, China. Main features and trends of gastrointestinal surgery in Guangdong Province are analyzed as well.
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Objective To explore the relationship among emotional resilience,stress and school adjustment.Methods Adolescent life events check-list,adolescent emotional resilience scale and school adjustment scale of middle school students were conducted among 394 junior high school students.Results (1)The emotional resilience score and emotion recovery score of male junior high school students(46.07±8.56,24.43±5.80) were higher than that of female ones(44.39±8.39,23.27±5.37),and the differences were statistically significant(t=1.97,2.05,P＜0.05).The total score of emotional resilience(45.46±8.50,44.83±8.56) was not statistically related with whether they were the only children(t=0.68,P=0.50).The emotional resilience score and positive emotion score of rural junior high school students(44.04±8.53,20.63±5.35)were lower than that of urban ones (46.46± 8.34,22.15 ±4.72),and the differences were statistically significant(t=-2.86,-2.99,P＜0.01).The total score of emotional resilience (47.23±7.82,44.63±8.45,43.00±8.97) in different grades was statistically significant (F=8.86,P=0.00),and the first grade students were higher than the second and third year students.(2)Psychological stress was negatively related with emotional resilience and school adjustment(r=-0.23～-0.35,P＜0.01),and emotional resilience was positively correlated with school adjustment(r=0.12 ～ 0.29,P＜0.01).The relationship between stress and school adjustment were mediated by positive emotion and emotional recovery (the mediating effect were 11.11％,21.15％).Conclusion Frotional resilience plays a mediating role between psychological stress and school adjustment.
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Pathology is an important basic course in higher vocational nursing,with a wealth of humanistic education.But in the actual teaching process,the humanistic education is often ignored because of too much basic knowledge teaching.Our teaching and research section used questionnaire to find the gaps between current situation,goal of humanistic education and students' needs.By enhancing teachers' humanistic awareness and discovering the entrance to humanistic education,we targeted to professional ideological education,guided students to pay attention to humanistic education and helped them to cultivate humanistic caring capability,and students all had good evaluation on it.It helped to solve the problem of both teaching and education to students in short time under pressure.
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<p><b>OBJECTIVE</b>To investigate the expression and significance of miR-125a and anti-apoptotic protein Mcl-1 in intestinal tissue after massive small bowel resection in intestinal adaptation.</p><p><b>METHODS</b>Sprague-Dawley rats (54 male rats, 8-week old) were divided into 3 groups randomly, including two control groups. Rats in the experiment group were subjected to 70% massive small bowel resection. Rats in the resection group underwent simple intestinal resection and anastomosis. Rats in the control group underwent laparotomy alone. A 5 cm intestine approximately 1 cm distal to the anastomosis was harvested a week after operation. Expression of Mcl-1 was assessed by immunohistochemistry and real-time PCR was used to detect the expression of miR-125a in intestinal tissue.</p><p><b>RESULTS</b>The positive expression of Mcl-1 in the experiment group was 18.8%(3/16), significantly lower than that in the control group(76.5%, 13/17) and the resection group (83.33%, 15/18)(both P<0.01). The expression of miR-125a in the experiment group was 1.92, significantly higher than that in the control group (1.01) and the resection group (1.05)(both P<0.01).</p><p><b>CONCLUSION</b>miR-125a and anti-apoptotic protein Mcl-1 may play an important role in intestinal adaptation process and they may regulate each other through a certain pathway.</p>
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Animals , Male , Rats , Anastomosis, Surgical , Disease Models, Animal , Intestine, Small , Metabolism , General Surgery , MicroRNAs , Metabolism , Myeloid Cell Leukemia Sequence 1 Protein , Metabolism , Rats, Sprague-Dawley , Short Bowel Syndrome , MetabolismABSTRACT
Objective To discuss the teaching method and effect of teaching-learn-do integration mode in the Basic Nursing Technology.Methods Students of two classes of grade 2010 and two classes of grade 2011 in our nursing college were randomly divided into the experimental group and the control group,they respectively adopted teaching-learn-do integration teaching mode and first-theory-after-practice traditional teaching method.The teaching effect of the two groups by theory and skills testing was compared.Results The experimental groups were better than the control groups in two grades in skill examination results.For the theoretical examination results,the experimental group of grade 2011 was better than the control group,while the two groups of grade 2010 were undifferentiated in theoretical examination.Conclusions Teaching-learn-do integration mode can not only improve students' operating skills,but also promote the theoretical learning,and improve the students' learning ability of independent innovation,suitable for practical and technical-strong course teaching in Basic Nursing Technology.
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Objective To investigate the relationship between brain natriuretic peptide (BNP)and heart function in elderly patients with acute myocardial infarction.Methods All data were taken from the hospitalized cases with acute myocardial infarction from December 2008 to August 2010.100 patients aged from 60 to 97 were enrolled.The data were divided into 4 groups (group 1,24 cases; group 2,32 cases,group 3,23 cases; group 4,21 cases) respectively according to Killip's classification.Left ventricular function was measured by echocardiography.Plasma BNP was determined with enzyme immunoassay.Results Compared with non heart failure group and normal group,heart failure group had much higher plasma BNP concentrations.The plasma BNP level had positive correlation with left ventricular end diastolic diameter (r =0.27,P ＜ 0.01) and left ventricular end-diastolic dimension (r=0.37,P＜0.01),while,had a negative correlation with left ventricular ejection fraction (r =-0.38,P ＜ 0.01).Conclusions Plasma BNP level was significantly elevated which could evaluate the heart function in elderly patients with acute myocardial infarction.
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Objective To investigate the correlative factors affecting the plasma D-dimer level in elderly patients. Methods Five hundred and seventy-eight hospitalized elderly patients were included in this study. All participants were di-vided into normal group (＜0.4 mg/L) and elevated group (≥0.4 mg/L) according to the plasma D-dimer value,which was mea-sured by automated quantitative turbidimetric latex agglutination test. The differences in clinical indicators were compared be-tween two groups. The factors leading to the increased plasma levels of D-dimer in elderly patients were also analyzed. Results It was found that the patient age, C-reactive protein, prothrombin time, proportions of type 2 diabetes mellitus, ma-lignant tumor, bacterial pneumonia and (or) acute exacerbation of chronic bronchitis were significant higher in elevated group than those of normal group (P＜0.05), but the levels of total cholesterol and low density lipoprotein cholesterol were lower in elevated group than those of normal group (P＜0.05). There was a positive correlation between serum level of D-dimer and age, C-reactive protein (r=0.254 and 0.265, P ＜ 0.05). Binary logistic regression analysis showed that the factors affecting plasma D-dimer level of elderly patients were aging, elevated C-reactive protein level, existing of malignant tumor, type 2 dia-betes mellitus, and bacterial pneumonia and (or) acute exacerbation of chronic bronchitis. Conclusion Aging, existing of type 2 diabetes mellitus, malignant tumor, or acute inflammatory state were the important factors leading elevated plasma D-dimer levels in elderly patients.
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Objective To compare the feasibility and safety of pancreaticogastrostomy versus pancreaticojejunostomy after pancreaticoduodenectomy. Methods A retrospective study was performed on 37 patients who underwent pancreaticoduodenectomy for duodenal carcinoma or pancreatic head tumors at the First Hospital of Sun Yat-sen University from April 2006 to December 2010.Pancreatic anastomosis was carried out either using pancreaticogastrostomy (n＝ 19) or pancreaticojejunostomy (n=18).The operative time,intraoperative bHood Hoss,postoperative pancreatic Heak,mortaHity and Hength of hospitaH stay were compared between the two groups. ResuHts The mean operative time,intraoperative bHood Hoss,incidence of pancreatic fistuHa,mortaHity rate and mean Hength of postoperative hospitaH stay were (372.1 ±79.5) min vs (351.0±69.2) min; (693.5± 412.8) mH vs (645.1±488)ml; 10.5％ (2/19) vs 11.1％ (2/18); 5.3％ (1/19) vs 5.6％ (1/18); and (17.5± 8.9)d vs (16.1± 7.6)d,respectively.The differences between the two groups were not statistically significant.Conclusion Pancreaticogastrostomy appears to be a feasible and safe alternative to pancreaticojejunostomy for the pancreatic remnant after pancreaticoduodenectomy.
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ObjectiveTo investigate the relationship between tumor-infiltrating mast cell (TIM) and the clinicopathological and prognostic factors of patients with colorectal cancer.MethodsA total of 282 cases of paraffin-embedded colorectal cancer specimens were obtained from the First Affiliated Hospital of Sun Yat-sen University from January 2002 to December 2005.The density of TIM was determined by immunohistochemical staining.According to the mean TIM density detected [ ( 8.4 + 6.5 )/HPF ],all the patients were divided into low-TIM density group (mean TIM density ＜8.4/HPF) and high-TIM density group (mean TIM density ＞8.4/HPF).The clinicopathological factors and the prognosis of patients between high-TIM density group and low-TIM density group were compared.All data were analyzed using the t test or chi-square test.The survival curve was drawn using the Kaplan-Meier method,and the survival of the patients was analyzed by the Log-rank test.The clinicopathological factors were analyzed retrospectively with the univariate and multivariate COX regression model.ResultsTIM was detected in all the patients with colorectal cancer.Significant differences were observed in the number of patients in N stage and TNM stage between patients in the high-TIM density group and those in the lowTIM density group (x2 =6.025,7.410,P ＜ 0.05 ).All patients were followed up till September 2010,the 5-year overall and tumor-free survival rates of patients were 82.9％ and 63.1％ in the low-TIM density group,79.0％ and 59.3％ in the high-TIM density group,with significant difference between the 2 groups (P ＜ 0.05 ).COX proportional hazard regression model revealed that high density of TIM was associated with short overall survival time and tumor-free survival time of colorectal cancer patients ( RR =2.119,95 ％ CI 1.326- 3.386; RR =2.084,95 ％ CI 1.357-3.199,P ＜0.05).The resuhs of multivariate analysis showed that high density of TIM was the independent factor influencing the overall survival time and tumor-free survival time (RR =1.651,95％ CI 1.009-2.702; RR =1.680,95％ CI 1.074-2.629,P ＜ 0.05 ).ConclusionHigh density of TIM is correlated with the N stage and TNM stage of colorectal cancer,and it is an independent predictor of poor survival for patients with colorectal cancer.
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ObjectiveTo analyze the clinicopathological features and prognosis of gastric cancer patients with metastatic nodules of perigastric soft tissue. MethodsIn this study,1025 cases of gastric cancer received radical resection.According to the metastasis of perigastric soft tissue,patients were divided into metastatic group ( group MP,n =334 ),non-metastatic group ( group NMP,n =691 ).The clinicopathological features and prognosis were compared between the two groups. ResultsIn group MP,the ratio of upper,middle,lower,total gastric cancer was 25.8％,22.0％,51.4％,0.9％ and the ratio in group NMP was 33.2％,21.3％,41.3％,4.2％ respectively,showing significant higher ratio of upper and total gastric cancer in MP group(P =0.000). In group MP 47.3％ cases with tumor size ≥5 cm,significantly higher than that in NMP group(27％ ) (P =0.000).Lymph node metastatic ratio between 21％ -40％ and 41％ -100％ was found in 24.4％ and 37.3％ in MP group respectively,significantly higher than that of 12.9％,10.8％ in NMP group(P =0.000).20.1％ cases had distal metastasis in group MP,significantly higher than that of 4.1％ in group NMP(P=0.000).In group MP and NMP group,the ratio of Borrmann infiltration typing was 82.1％ vs.64.6％,the ratio of positive CEA was 21.2％ vs.11.4％,the ratio of lower or undifferentiation typing was 78.7％ vs.64.2％,all with significant difference (P =0.000 ). COX regression analysis showed the infiltration depth,organic invasion,lymph node metastatic ratio,M staging,Borrmann typing,metastatic nodules was the independent prognostic factors.Prognosis was significantly poorer in the cases with perigastric soft tissues than without ( P =0.000 ).Stratified analysis showed that irrespective of tumor size,infiltration depth,lymph node metastatic ratio,CEA value,Borrmann typing,differentiation degree,the mean survival time was significantly shorter in MP group than that in group NMP(P ＜ 0.005).In cases without distal metastasis,the prognosis was significant poorer in group MP than that in group NMP ( P =0.000 ),however,there was no significant difference between two groups in cases without distal metastasis ( P =0.076).ConclusionsPerigastric soft tissue metastasis was common in gastric cancer,more frequently seen in tumor ≥5 cm,or with organic invasion,lymph nodemetastaticration ≥ 21％, distalmetastasis, Borrmanninfiltrationtyping, loweror undifferentiation typing,positive CEA. Perigastric soft tissues metastasis was the independent prognotic factor for gastric cancer.
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Objective To understand the practical application of drug intervention in elderly patients with chronic heart failure (CHF) for providing evidences and data for a standard treatment. Methods The elderly CHF patients aged at least 60 years who were hospitalized from July 1973 toJuly 2007 in the Second Hospital of Tianjin Medical University and from January 1983 to December 2002 in Tianjin First Center Hospital were enrolled. The age, gender, etiology, heart function and drug therapy were retrospectively analyzed. The patients were divided into 4 groups: group 1973-,group 1980-, group 1990- and group 2000-2007. And the data were collected and analyzed by SPSS 13.0 software. Results A total of 4704 cases were enrolled, of which there were 2430 (51.7%)male and 2274 (48. 3%) female. Mean age was (71.3±-7. 1) years. The patients aged 80 years andover accounted for 12.8% (603/4704). The first three ranking causes were pulmonary heart disease,coronary heart disease and rheumatoid heart disease in group 1973- and 1980-. And those were coronary heart disease, pulmonary heart disease and rheumatoid heart disease in group 1990 and 2000-2007. The combined uses of angiotension converting enzyme inhibitors(ACEI) and β-receptor blocker,and of ACEI, β-receptor blocker and aldosterone antagonist were also increasing year by year. Patients with coronary heart disease, rheumatoid heart disease, pulmonary heart disease and dilated cardiomyopathy had a higher proportion of multiple drugs cotreatment. The differences in the frequency of all drugs use among four groups of CHF had a statistical significance (p＜0.05). The usage of ACEI combined with β-receptor blocker and aldosterone antagonist, and ACEI combined withβ-receptor blocker, diuretic and digitalis was increasing along with the heart function becoming serious. The patients with a heart function of New York Heart Association (NYHA) Ⅱ or Ⅲ class received more β-receptor blocker. And ACEI was used at most in patients with NYHA Ⅲ class. The angiotension Ⅱ receptor blockers(ARB) was used at most in NYHA Ⅲ or Ⅳ class. Conclusions Nitrate, diuretic and digitalis are the main therapeutic agents in hospitalized patients with CHF in some regions of Tianjin. ACEI, β-receptor blocker and ARB are used in a rapid increment. There are still some problems such as standardizing the heart failure treatment and prevention in the elderly.
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Objective To study the feasibility, safety and clinical effects of spleen and splenic vessel-preserving distal pancreatectomy. Methods A retrospective study was performed in 26 patients undergoing distal pancreatectomy for benign or low grade malignant disease with splenectomy (n = 13) or splenic preservation (n = 13 ) at the First Hospital of Sun Yat-sen University and Guangdong General Hospital from May 2002 to April 2009. Results All 26 pancreatectomy with splenectomy or splenic preservation were performed successfully. There was no statistically significant difference between two groups in average operative time[(172±47) min vs. (157±52) min, P ＞ 0.05 ], intraoperative estimated blood loss [( 183 ± 68 ) ml vs. ( 160 ± 51 ) ml, P ＞ 0.05 ], incidence of noninfectious and infection complication and postoperative hospital stay [(10.1±2.2) d vs. ( 12. 1 ± 4. 6 ) d, P ＞ 0.05 ]. The platelet counts examined one week after operation were significantly higher in the distal pancreatectomy with splenectomy group than that in spleen-preserving group [(37.3 ± 12.8)×109/L vs. (54.7 ± 13.2) × 109/L, P＜0.05 ]. Conclusions Spleen-preserving distal pancreatectomy appears to be a feasible and safe procedure in selected cases of benign or low-grade pancreatic malignant disease necessitating a distal pancreatectomy.
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Objective To compare drug therapy in patients suffering from chronic heart failure between Tianjin and Kashi region of Xinjiang autonomous region and to analyse their disparities in drug uses by guideline between the two regions.Methods All data were retrospectively taken from the hospitalized chronic heart failure cases from June 2005 to June 2006 in the 2nd Hospital of Tianjin Medical University and the 2nd People's Hospital of Kashi in Xinjiang respectively.The heart functions level NYHA Ⅱ-Ⅳ were recorded for analysis of drug use in the two regions.Results 749 cases were enrolled,491 from Tinajin and 258 from Kashi of Xinjiang.The average age of group Tianjin[(70.39±10.84)yrs]was older than that[(62.91±12.54)yrs]of group Kashi(t=8.488,P＜0.01).The distribution of≥165 cases in the group Tianjin(75.6%)was higher than that of group Kashi(51.2%)(X2=45.642,P＜0.01).The male cases in group Tianjinwere 264(53.8%)andthatwere 134(51.9%)in group Kashi with no significant differences in sex distribution between the two groups(P＞0.05).The first three etiological diseases were coronary heart disease(84.9%),rheumatic heart disease(5.9%)and dilated cardiomyopathy (3.3%)in group Tianjin,and that were coronary heart disease(63.2%),pulmonary heart disease(19.8%)and dilated eardiomyopathy(6.6%)in group Kashi respectively.The proportions of level NYHA Ⅱ,Ⅲ,Ⅳ on admission were 29.7%,39.1%and 31.2%in group Tianjin respectively,and that were 15.5%,39.5%and 45.0%in group Kashi respectively,with significant difference in heart function levels between the two groups(X2=22.770,P＜0.01).Theusages of nitrides and β-blockers in group Tianjin were more than that in group Kashi(both P＜0.01).The usages of diuretics,digitalis was more in group Kashi(all P＜0.01).There was no difference in ACEI usages between the two groups.The dosages of drugs in group Tianjin achieved the target dosages by the guideline and the dosages in group Kashi did not achieve the targets.The use frequency of β-blockers was more in male cases and＜65yrs respectively of group Tianjin.The usage frequency of uretics and aldosterone antagonist were more in＜65yrs cases of group Kashi and the usages of nitrides,ACEI,B-blockers,calcium antagonists,aldosterone antagonist of male cases were more than that of female cases(all P＜0.05)in this group.The usages of uretics,digitalis,aldostemne antagonist increased following the grading of heart function of the two groups(P＜0.05).Moreover the usage of ACEI decreased following the worsen heart function in group Tainjin and this was not the same in group Kashi.Conclusion There are differences in drug medications for chronic heart failure between Tianjin and Kashi.The majority of treatment drugs in Tianjin is approaching the guideline and there is a gap from guideline in Kashi of Xinjiang,especially on the dosage.
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Objective To analyze the influence of hyponatremia on hospitalization days and hospital mortality of hospitalized patients with chronic heart failure. Methods All data were collected from 2465 patients with chronic heart failure in our hospital between January 1980 and August 2007. According to the admission serum sodium, all the patients were divided into two groups: low serum sodium group (Na+<135 mmol/L) and normal serum sodium group (Na+≥135retool/L). Clinical characteristics, therapeutic conditions and the influence of hyponatremia on prognosis were analyzed between the two groups. Results There were 618 patients in low serum sodium group among 2465 cases. Patients with hyponatremia were more likely to have lower systolic blood pressure and lower left ventricular ejection fraction. Lower admission serum sodium was related with higher concentration of serum angiotensin, aldosterone and higher activity of serum renin. Patients in low serum sodium group had significantly longer hospitalization days (Z=-4.026, P<0.01) and higher rate of hospital mortality (χ2=76.935, P<0.01) than patients in normal serum sodium group. Multivariate logistic regression indicated that lower admission serum sodium was an independent risk factor for hospitalization days (b= 0.928, P<0.01) and hospital mortality (OR=0.928, P<0.01). There was a negative correlation between admission serum sodium and hospitalization days (r=-0.132, P<0.01), and the rate of hospital mortality increased by 24.7for each 3 mmol/L decrease in admission serum sodium level. Conclusions Hyponatremia in hospitalized patients with chronic heart failure is relatively common and is associated with poorer heart function, higher activity of neural hormone and more severe prognosis. It is important to prevent hyponatremia for shortening hospitalization days and improving the prognosis of patients with chronic heart failure.
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Objective To obtain the information of therapies with beta blocker in patients with heart failure in our hospital. Methods 408 hospitalized cases in 2004 and 213 outpatients from April to July in 2005 with chronic heart failure from the cardiology department were collected. Results In hospitalized cases,of 54.9% patients were prescribed beta blocker,and only 4% of them arrived at target dosage and 24.9% of them arrived at half of target dosage. 86.1% of them were given metoprolol. The maximum dosage was (54.25?34.26) mg/d,the mean was equal to the 36.17% of target dosage. Among outpatients,77.5% were taken beta blocker,and only 2.5% of them reached the target dosage and 26.6% of them reached half of target dosage; and 89.7% of them were frequently given the metoprolol,the average dosage was up to 35% of the target dosage. Conclusions There was a great gap between the clinical practice and guideline of beta blocker therapy in patients with chronic heart failure. The prescribed dose of beta blocker was lower than the target dosage.
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BACKGROUND: It has been shown that patients managed with hemodialysis experience decrease of quality of life. But there are a few reports about the relationship between the self-management behavior such as dietary behavior, taking medicine, management behavior of physical sign etc and health-related quality of life (HRQOL) in hemodialysis patients.OBJECTIVE: To study the relationship between self-management behavior and HRQOL in Chinese hemodialysis patients,especially potential association of self-management behavior variables with indicators of HRQOL in order to improve their quality of life (QOL).DESIGN: Sampling investigation based on hemodialysis patients.SETTING: Nursing department and dialysis center in a university hospital. PARTICIPANTS: This research was completed in the Nursing Department of First Hospital Affiliated to China Medical University. Totally 120hemodialysis patients,63 males and 57 females,aged 19 -79 years old with the mean age of(52 ± 12),were selected from the First and Second Hospital Affiliated to China Medical University,the First Affiliated Hospital of Dalian Medical University,the Central and the Second Hospital of Shenyang Medical College,from July to September 2003. Inclusion criteria: Patients above 18years old,dialysis history more than 3 months with twice or three times every week,understanding the questionnaires and being volunteers. Exclusion criteria: Patients with acute disease and mental disorder.METHODS: Self-administered questionnaire was used to measure self-management behavior and short-form 36 health survey(SF-36) was used to measure HRQOL of patients with hemodialysis. Correlation and multivariate regression analysis were used to test the relationship between self-management behavior and HRQOL.MAIN OUTCOME MEASURES: Self-management behavior and HRQOL.RESULTS: Totally 107 questionnaires were available. Multivariate regression analysis indicated that management of physical,psychosocial activity was the significant factor of.physical component summary(regression coefficient = 2.709,R2 =0. 150,P<0.01),and management of physical sign,psychosocial behavior was the significant factor of mental component summary(regressioncoefficient=1.126,R2=0.041,P<0.05).CONCLUSION: Improving hemodialysis patients' management of physical,psychosocial activity and management of physical sign could help hemodialysis patients to raise their HRQOL.
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<p><b>OBJECTIVE</b>To evaluate the effect of colonic J-pouch coloanal anastomosis after low anterior resection for mid or low rectal cancer on improving defecation and anorectal physiology.</p><p><b>METHODS</b>To make a meta-analysis, prospective randomized controlled trial of with or without colonic J-pouch after low anterior resection for mid or low rectal cancer was conducted. The key words included rectal cancer, J-pouch (or J-pouch) and those randomized from selected reports. The data on bowel function and physiological function of the anal canal and (neo) rectum were meta-analyzed using fixed effect model and random effect model.</p><p><b>RESULTS</b>Eight randomized trails including 378 patients entered this study. After one year follow-up, the functional results showed that there were significant differences in stool frequency per day, urgency and use of medication between colonic J-pouch group and straight coloanal anastomosis group. On physiological function of the anal canal and (neo) rectum, there was significant difference only in rectal compliance between the two groups. But there was no significant difference in other 4 items.</p><p><b>CONCLUSIONS</b>The functional improvement gained from colonic J-pouch coloanal anastomosis continues to benefit the patient with mid or low rectal cancer for at least 12 months. It is necessary to further study about the effect of colonic J-pouch coloanal anastomosis on physiological function of the anal canal and (neo) rectum.</p>
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Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Anal Canal , General Surgery , Anastomosis, Surgical , Methods , Colonic Pouches , Randomized Controlled Trials as Topic , Rectal Neoplasms , General Surgery , Rectum , General Surgery , Treatment OutcomeABSTRACT
Objective To investigate the correlated factors of peritoneal dissemination and lympah node metastasis from gastric cancer, the prognosis of patients with peritoneal dissemination and N_2 lymph node metastasis, and the impact of palliative surgery on the prognosis. Methods Based on our database built from 1994, the clinicopathologic data and the outcomes of the follow-up were analyzed respectively. Results The clinicopathologic factors correlated with peritoneal dissemination included T_4, hepatic metastasis, the primary tumor involving the whole stomach, undifferentiated carcinoma, female sex and lymph node metastasis, while those correlated with lymph node metastasis included the primary tumor involving the whole stomach, Borrmann III, T_2, T_3 and T_4, hepatic metastasis and peritoneal dissemination (P
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Objective To investigate the correlation between clinicopathologic factors and peritoneal dissemination from gastric cancer, and the impact of palliative resection on the prognosis of patients with gastric cancer complicated by peritoneal dissemination. Methods Based on our database built in 1994, the clinicopathologic data and the result of follow-up of all gastric cancer patients were analyzed retrospectively using the software of SPSS. Results One hundred and five out of 792 (13. 3% ) patients with primary gastric cancer were found complicated with peritoneal dissemination. The clinicopathologic factors in patients with peritoneal dissemination were significantly correlated with primary tumor penetrating through serosa, lymph node metastasis, primary tumor involving whole stomach, undifferentiated carcinoma, Borrmann IV and female gender (P