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In February 2022, the world′s first gallbladder reporting and data system (GB-RADS) for the assessment of gallbladder wall thickening on ultrasonography was published in the form of an international expert consensus. The GB-RADS system classifies gallbladder wall thickening into six levels (GB-RADS 0?5), with gradually increasing risk of malignancy. It is mainly based on the following features: symmetry and extent (focal versus circumferential) of involvement, layered appearance, intramural features (including intramural cysts and echogenic foci), and interface with the liver. The proposed system is important for the standardized diagnosis and treatment of gallbladder diseases. The authors interpret the consensus, introduce the evaluation points and classification standards, and suggest the future applications and research directions.
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Objective:To compare the safety apnea time during endotracheal intubation in the patients from different altitudes using oxygen reserve index (ORI).Methods:Sixty American Society of Anesthesiologists physical status Ⅰor Ⅱ patients, aged 18-70 yr, undergoing elective surgery requiring tracheal intubation under general anesthesia and requiring catheterization via arterial puncture, were included.Among the patients, 30 cases who had long lived at an altitude of 1 500-3 000 m in Qinghai Province People′s Hospital (Xining, 2 200 m above sea level) served as middle-altitude group, and 30 Tibetan patients who had long lived at an altitude >3 000-meter area in Yushu People′s Hospital (Yushu, 3 600 m above sea level) served as high-altitude group.The patients were preoxygenated for 5 min before induction of anesthesia, and then endotracheal intubation was performed with a video laryngoscope.Before induction (T 0), at 3 min of pre-oxygenation (T 1), and at 5 min of pre-oxygenation (T 2), arterial blood was collected for blood gas analysis, and PaO 2 was recorded, ORI and SpO 2 were simultaneously recorded.The time from the beginning of intubation to the time when ORI was decreased to 0 and the time from the beginning of intubation to the time when SpO 2 was decreased to 98% were recorded. Results:Compared with middle-altitude group, the time from the beginning of intubation to the time when ORI was decreased to 0 and the time from the beginning of intubation to the time when SpO 2 was decreased to 98% were significantly prolonged ( P<0.05), and no significant change was found in SpO 2, ORI and PaO 2 at each time point in high-altitude group ( P>0.05). Conclusions:The safety apnea time during endotracheal intubation is longer in the patients at high altitudes (altitude > 3000 m) than those at the moderate altitudes (altitude 1500-3000 m).
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Objective@#To investigate the effect of nursing intervention on information-motivation-behavioral skill (IMB) model in patients with adjuvant chemotherapy after radical resection of upper thoracic esophageal squamous cell carcinoma.@*Methods@#A total of 128 patients with adjuvant chemotherapy after radical resection of esophageal squamous cell carcinoma from December 2016 to June 2018 were enrolled. The random number table method was used to divide them into control group (64 cases) and study group (64 cases). The control group received routine nursing, and the study group took the IMB model of nursing intervention on the basis of the control group. The intervention time was 2 months. Postoperative rehabilitation (feeding time, time to get out of bed, and length of hospital stay), pre-intervention self-efficacy score (Strategies Used by People to Promote Health, SUPPH), European Organization for Research and Treatment of Cancer-Quality of Life-Core 30 Questionnaire (EORTC-QLQ-C30), complications (reflux esophagitis, chest cavity), the incidence of effusion, infection, anastomotic leakage, and satisfaction of nursing work were compared.@*Results@#The feeding time of the study group was (3.39±0.72) d, the time of getting out of bed (2.26±1.02) d, the length of hospital stay (9.19±1.68) d, which was shorter than that of the control group (4.48±0.81), (4.07±1.55), (12.26±2.35) d, the difference was statistically significant (t=8.046, 7.804, 8.502, P<0.05). After intervention, the self-decision, self-decompression, and positive attitude scores of the two groups were higher than those before the intervention, and the study group was (11.19±1.28), (28.37±2.79), (39.98±5.01), respectively, higher than the control group. The differences were statistically significant (t= 7.239, 5.036, 5.057, P < 0.05). After intervention, the social function, emotional function, role function and physical function score of the two groups were higher than those before the intervention, and the study group were (69.02±6.87), (70.61±7.65), (69.68±6.80), (72.55±6.51). The scores were higher than those of the control group (61.13±7.03), (63.64±7.44), (60.22±7.05), and (65.86±6.08), and the difference was statistically significant (t=5.225-6.422, P<0.05). The complication rate was 7.81% (5/64) in the study group and 20.31% (13/64) in the control group. The difference was statistically significant (χ2=4.137, P <0.05). The nursing job satisfaction of the study group was 92.19% (59/64), which was higher than that of the control group 79.69% (51/64). The difference was statistically significant (χ2=4.137, P<0.05).@*Conclusions@#The intervention of IMB model in the treatment of patients with adjuvant chemotherapy after radical resection of upper esophageal squamous cell carcinoma can effectively improve their self-efficacy, reduce postoperative complications, shorten the postoperative rehabilitation time, and improve the quality of life of patients and improve the satisfaction of their nursing work.
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Objective To investigate the effect of nursing intervention on information-motivation-behavioral skill (IMB) model in patients with adjuvant chemotherapy after radical resection of upper thoracic esophageal squamous cell carcinoma. Methods A total of 128 patients with adjuvant chemotherapy after radical resection of esophageal squamous cell carcinoma from December 2016 to June 2018 were enrolled. The random number table method was used to divide them into control group (64 cases) and study group (64 cases). The control group received routine nursing, and the study group took the IMB model of nursing intervention on the basis of the control group. The intervention time was 2 months. Postoperative rehabilitation (feeding time, time to get out of bed, and length of hospital stay), pre-intervention self-efficacy score (Strategies Used by People to Promote Health, SUPPH), European Organization for Research and Treatment of Cancer-Quality of Life-Core 30 Questionnaire (EORTC-QLQ-C30), complications (reflux esophagitis, chest cavity), the incidence of effusion, infection, anastomotic leakage, and satisfaction of nursing work were compared. Results The feeding time of the study group was (3.39±0.72) d, the time of getting out of bed (2.26±1.02) d, the length of hospital stay (9.19±1.68) d, which was shorter than that of the control group (4.48±0.81), (4.07±1.55), (12.26±2.35) d, the difference was statistically significant (t=8.046, 7.804, 8.502, P<0.05). After intervention, the self-decision, self-decompression, and positive attitude scores of the two groups were higher than those before the intervention, and the study group was (11.19±1.28), (28.37±2.79), (39.98±5.01), respectively, higher than the control group. The differences were statistically significant (t=7.239, 5.036, 5.057, P<0.05). After intervention, the social function, emotional function, role function and physical function score of the two groups were higher than those before the intervention, and the study group were (69.02 ± 6.87), (70.61 ± 7.65), (69.68±6.80), (72.55±6.51). The scores were higher than those of the control group (61.13±7.03), (63.64±7.44), (60.22±7.05), and (65.86±6.08), and the difference was statistically significant (t=5.225-6.422, P<0.05). The complication rate was 7.81% (5/64) in the study group and 20.31% (13/64) in the control group. The difference was statistically significant (χ2=4.137, P<0.05). The nursing job satisfaction of the study group was 92.19% (59/64), which was higher than that of the control group 79.69% (51/64). The difference was statistically significant (χ2=4.137, P<0.05). Conclusions The intervention of IMB model in the treatment of patients with adjuvant chemotherapy after radical resection of upper esophageal squamous cell carcinoma can effectively improve their self-efficacy, reduce postoperative complications, shorten the postoperative rehabilitation time, and improve the quality of life of patients and improve the satisfaction of their nursing work.
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Objective To describe the effects of surgical intervention on the prognosis in non-small-cell lung cancer patients with pleural carcinomatosis detected at thoracotomy.Methods Retrospectively analyzed clinical data from 54 patients who have unexpected malignant pleural nodules and/or malignant pleural effusions first detected at thoracotomy from January 2009 and December 2013.The effects of surgical intervention on the prognosis were also discussed.Results Sixteen cases had only biopsy,whereas 38 (70.4％) cases had primary tumor resection.The median survival time of 54 patients with pleural carcinomatosis were 23 months.The overall 1 and 5-year survival rates were 64％ and 18％,respectively.Primary tumor resection had significantly better outcome compared with biopsy(MST:respectively,24 vs 15 months,5-year survival rate 39％ vs 6％,P ＜0.05).Univariate analysis showed that primary tumor resection,no smoking history,lower T and N stage has favorable survival(P ＜ 0.05).Multivariate analysis showed that the best N stage(P =0.002) and adenocarcinoma(P =0.035) were favorable prognostic factors in these patients.Conclusion For patients with pleural careinomatosis first detected at thoracotomy,limited primary tumor resection may have survival benefits,lower T and N stage for them was associated with better survival.
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Objective To systemic evaluate postoperative pulmonary function between segmentectomy and lobectomy in patients with early stage non-small cell lung cancer.Methods Computer searched was performed up to September 2016 at the Cochrane Library,PubMed,EMBASE,CBM,CNKI,VIP and Wanfang database,collected postoperative pulmonary function between segmentectomy and lobectomy in Patients with early stage Non-Small Cell Lung Cancer.Study selection,data collection and critical assessment of the included studies were performed according to the recommendations of the Cochrane Collaboration.Results Eight studies included 308 segmentectomy and 386 lobectomy were identified for inclusion.FVC％ (MD =9.91,95％ CI:3.53-16.30,P =0.002),postoperation / preoperation FVC％ (MD =6.74,95％ CI:5.52-7.79,P ＜0.05),FEV1％ (MD =13.25,95％ CI:10.25-16.26,P ＜ 0.05),postoperation / preoperation FEV1％ (MD =7.18,95 ％ CI:5.88-8.48,P ＜ 0.05) showed significant difference.Conclusion Pulmonary function index was superior to lobectomy after segmentectomy in patients with early stage lung cancer,and segmentectomy resection was more beneficial to preserve lung function.
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Objective To describe the effects of surgical intervention on the prognosis in non-small-cell lung cancer patients with pleural carcinomatosis detected at thoracotomy.Methods Retrospectively analyzed clinical data from 54 patients who have unexpected malignant pleural nodules and/or malignant pleural effusions first detected at thoracotomy from January 2009 and December 2013.The effects of surgical intervention on the prognosis were also discussed.Results Sixteen cases had only biopsy,whereas 38 (70.4％) cases had primary tumor resection.The median survival time of 54 patients with pleural carcinomatosis were 23 months.The overall 1 and 5-year survival rates were 64％ and 18％,respectively.Primary tumor resection had significantly better outcome compared with biopsy(MST:respectively,24 vs 15 months,5-year survival rate 39％ vs 6％,P ＜0.05).Univariate analysis showed that primary tumor resection,no smoking history,lower T and N stage has favorable survival(P ＜ 0.05).Multivariate analysis showed that the best N stage(P =0.002) and adenocarcinoma(P =0.035) were favorable prognostic factors in these patients.Conclusion For patients with pleural careinomatosis first detected at thoracotomy,limited primary tumor resection may have survival benefits,lower T and N stage for them was associated with better survival.
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Objective To systemic evaluate postoperative pulmonary function between segmentectomy and lobectomy in patients with early stage non-small cell lung cancer.Methods Computer searched was performed up to September 2016 at the Cochrane Library,PubMed,EMBASE,CBM,CNKI,VIP and Wanfang database,collected postoperative pulmonary function between segmentectomy and lobectomy in Patients with early stage Non-Small Cell Lung Cancer.Study selection,data collection and critical assessment of the included studies were performed according to the recommendations of the Cochrane Collaboration.Results Eight studies included 308 segmentectomy and 386 lobectomy were identified for inclusion.FVC％ (MD =9.91,95％ CI:3.53-16.30,P =0.002),postoperation / preoperation FVC％ (MD =6.74,95％ CI:5.52-7.79,P ＜0.05),FEV1％ (MD =13.25,95％ CI:10.25-16.26,P ＜ 0.05),postoperation / preoperation FEV1％ (MD =7.18,95 ％ CI:5.88-8.48,P ＜ 0.05) showed significant difference.Conclusion Pulmonary function index was superior to lobectomy after segmentectomy in patients with early stage lung cancer,and segmentectomy resection was more beneficial to preserve lung function.
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Objective To develop a method for determination of ultra-trace 2-chlorovinylarsonic acid(CVAOA)in human urine specific to lewisite exposure. Methods The conditions for dispersive liquid-phase microextraction(DLPME)were optimized by orthogonal experiments with results as follows:a mixture of 250μl methanol(dispersive solvent),250μl ethyl acetate(extraction sol?vent),and 3,4-dimercaptotoluene(DMT)(derivatization reagent,using 1∶100 mole ratio of CVAOA to DMT)was injected into 1 ml urine when pH was adjusted to 1. In the next 60 min,the CVAOA was derivated and the CVAOA-DMT derivative was extracted simul?taneously at 90℃. The derivative was then analyzed by gas chromatography/tandem mass spectrometry-select reaction monitoring〔GC/MS/MS(SRM)〕. Results The linear calibration extended from 50 pg/ml to 1μg/ml(r2=0.9999)with the relative standard deviations (RSD)less than 10%. The limit of detection was 18 pg/ml and the limit of quantitation was 56 pg/ml,which was much lower than that of the reported DLPME methods. When detecting human urine samples with low,middle and high spiked concentrations(0.5,5 and 50 ng/ml)of lewisite,the analysis accuracies ranged from 98.2%to 104%and the RSD ranged from 6.9%to 8.9%. Conclusion The method developed in this study has high specificity and sensitivity as well as good precision and accuracy. It is s imple and can be readi?ly applied to the exposed sample analysis.
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Objective Through detecting the levels of von willebrand factor (vWF) ,vWF-cleaving protease (vWF-cp)before and after percataneous coronary intervention (PCI) in patients with coronary atherosclerotic heart disease ,to evaluate the relationship between them .Methods According to the results of coronary angiography ,study objects were divided into control group (normal) and PCI group ( the diagnosis of coronary heart disease with PCI operation ) .Enzyme-linked immunosorbent assay (ELISA) was carrout to determin the levels of plasma vWF concentration and vWF-cp activity in plasma and statistical analysis .Results The pre-operative ,postoperative vWF levels in plasma in PCI group were significantly higher than that in the normal control group ;The plasma vWF levels after PCI were significantly higher than that in the group before PCI (P< 0 .05) ;vWF-cp level of the PCI group were lower than in the control group ,and postoperation is lower than preoperation ( P < 0 .05) .With the coronary artery lesion worsen ,the plasma level of vWF increased ,while the level of vWF-cp activity decreased .Conclusion vWF and vWF-cp levels with the severity of coronary atherosclerosis and thrombosis risk was increased in different decreased ,which may play an important role in the pathogenesis of acute coronary syndromes .Changes of vWF and vWF-cp level after PCI indicate that interventional therapy can increase the risk of thrombosis to some extent .
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Objective To compare the outcomes between modified McKeown minimally invasive approach and open left chest-neck incision approach esophagectomy for treatment cancer of mid-to-distal thoracic esophagus.Methods We retrospectively analyzed clinical data from 128 patients with mid-to-distal thoracic esophageal cancer who underwent thoracoscopic and laparoscopic esophagectomy from March 2009 to March 2012.One hundred and fifty patients were served as control that underwent open left chest-neck incision approach esophagectomy in the same period.Results All the operations were performed successfully.There was significant difference between modified McKeown minimally invasive approach and open left chest-neck incision approach esophagectomy with regard to respiratory complications (10.9 ％ vs.20.7％),pneumonia (4.7％ vs.11.3 ％),atelectasis (3.1％ vs.10.5 ％,),pleural effusion (3.1％ vs.10.0％) and delayed gastric emptying (8.6 ％ vs.1.3 ％) (P ＜ 0.05).Hospital stay was significantly shorter in the minimally-invasive group than the open group [(11.7 ± 3.6) days vs.(13.9 ± 6.5) days,P＜0.05],and had significantly less blood loss [(88.1 ±41.8) ml vs.(360.5 ±80.6) ml,P＜0.05] and the number of lymph nodes harvested (22.9 ±5.7 vs.16.8 ±4.5,P ＜0.05).No significant differences were observed on the operative time,mortality and other complication between the two groups.Conclusion Modified McKeown minimally invasive approach esophagectomy is techeniqually feasible and safely which have lower blood loss,lower respiratory complication,shorter hospital stay and more number of lymph nodes harvested comparing to open left chest-neck incision approach.
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Objective:To observe the up-regulation of nuclear Clusterin (nCLU)gene on the biological behaviors of human non-small cell lung cancer cell line A549 .Methods:Sense eukaryotic expression vector of nCLU was constructed by cloning the cDNA of nCLU into pIREShyg3 vector. A549 cells were transfected with pIRES-nCLU and pIREShyg3 vectors by lipofectAMINE~(TM) 2000 mediation, respectively. Stable transfected cells were selected by hygromycin B screening. CCK-8 assay was performed to evaluate the effect of nCLU over-expression on cell proliferation in vitro. The expression level of nGLU protein was examined by Western blotting. Cell cycle distribution was detected by FCM with PI staining. The alteration of migration and metastasis potential of A549 cells before and after nCLU gene transfection were assayed by cell chemotactic migration and invasion test. Results:The proliferation speed of the transfected A549 cell clones stably over-expressing nCLU was slowed down. FCM analyses revealed that the percentage of cells in G_0/G_1 phase dramatically increased from (33.54±2.10)% to (63.31±4.30)%. The cell chemotactic migration and invasion potentials were markedly reduced after nCLU gene transfection (P<0.05). Conclusion:Up-regulation of nCLU can greatly inhibited the proliferation and decreased the migration and invasion capabilities of A549 cells.