ABSTRACT
Objective:To systematically review the profile of lymph node dissection (LND) for patients with intrahepatic cholangiocarcinoma (ICC) in China.Methods:Using the key words "intrahepatic cholangiocarcinoma" "intrahepatic cholangiocellular carcinoma" "lymph node dissection" "lymphadenec-tomy" "lymph node metastasis", the databases including China Zhiwang, Wanfang, Weipu, Sinomed, PubMed, Embase, Web of Science, Scopus, Cochrane Library were systematically searched. Cohort studies or randomized controlled clinical trials with intraoperative LND documentation and with analysis on the clinicopathologic characteristics or prognostic influences on patients with ICC were included into this meta-analysis from the date of database creation to April 20, 2022. The risk of bias in non-randomized controlled trials was evaluated using the Newcastle-Ottawa scale. A meta-analysis of preoperative imaging lymph node enlargement rates, LND rates, and pathological lymph node metastasis rates were performed using R software.Results:Thirty-three relevant studies that met the systematic evaluation criteria were included, all of which were retrospective cohort studies. All these publications were of medium to high quality. Patients’ enrollment ranged from 1993 to 2020. Patients were enrolled from 20 provinces/autonomous regions/municipalities with a total of 39 medical centers and 4 278 patients. The meta-analysis indicated that the LND rate, preoperative imaging lymph node enlargement rate, pathological lymph node metastasis rate were 47.8%(95% CI: 41.3%-54.3%), 18.5%(95% CI: 7.5%-29.6%) and 51.2%(95% CI: 43.8%-58.6%), respectively. Subgroup analysis showed the LND rate was 36.0%(95% CI: 27.0%-45.0%) in studies with a median year of enrollment before 2010, 48.3% (95% CI: 38.1%-58.6%) in studies from 2010 to 2017, and 53.3%(95% CI: 43.3%-63.2%) in studies after 2017. The LND rates were statistically different in the studies in the different periods of patient enrollment ( P=0.032). Conclusion:The meta-analysis indicated that the overall LND rate for ICC in China was not high but showed an increasing tendency.
ABSTRACT
Objective To explore the effect of operating room active warming intervention on maternal hypothermia after planned cesarean. Methods According to the random number table method, from December 2016 to December 2017, 92 patients after heart failure were divided into the control group of 45 patients and the experimental group with 47 patients. Patients in the control group were conducted with the routine warming intervention, while warmed IV fluids combined with forced-air warming as active warming intervention was processed in the experimental group. The core temperature, the incidence of hypothermia, bedside shivering assessment scale, thermal comfort scores and new-born Apgar score between the two groups of patients were compared. Results Compared with the control group, the field of core temperature were significantly higher than those in the control group (F=5.96, P <0.01). The frequency of hypothermia and tremor in the observation group were 15 times, 3 times, which was significantly lower than that in the control group (27 times, 12 times)(χ2=4.50, 6.00,P<0.05). The severity of shivering in the observation group was 1.56 ± 0.25, which was significantly lower than that in the control group 2.04 ± 0.13(t=11.63, P<0.01). The temperature comfort score of the observation group was 42.31±2.65, which was significantly higher than 32.04 ± 1.53 of the control group (t=22.63, P<0.01). There was no statistically significant difference between the two groups in the field of Apgar score (P>0.05). Conclusion Operating room active warming intervention may have a beneficial effect on maternal hypothermia after planned cesarean, but the relevant efficacy was not shown in the field of Apgar score.
ABSTRACT
Objective To evaluate the effect of early aerosol inhalation on sore throat of the patients after double lumen endobronchial intubation. Methods 90 patients scheduled for thoracic surgery were randomly assigned to 3 groups,30 cases in each group: control group (Group C), early aerosol inhalation group (group one) and later aerosol inhalation group (group two). All patients were sent to PACU after extubation.The patients in group C were intraveously injected with 6 mL saline , those in group one were treated with aerosol inhalation of 1mg budesonide, while the patients in group two with budesonide at the same dosage 2 h later. Patients were examined with indirect laryngoscopy 6 h after surgery. The cases of vocal cord congestion and glottis edema were recorded. The degree of pharyngolaryneal pain was assessed with the Visual Analogue Scale (VAS) when they were sent to PACU , 6 , 24 and 48 hours after surgery . Results The rates of vocal cord congestion and glottis edema in group one were lower than those in group C and group 2, 6 h after surgery (P < 0.05). The pharyngolaryneal VAS in group one was significantly lower than that in group C and group 2 , 6 and 24 h after operation (P < 0.05), but there was no statistical difference between them 48 h after surgery between 3 groups. Conclusions Aerosol inhalation of budesonide after double lumen endobronchial intubation for the patients scheduled for thoracic surgery during early postoperative stage can reduce the incidences of vocal cord congestion and glottis edema, inhibit airway inflammation, significantly reduce the extent of the POST. The effect is better than that of the lateraerosol inhalation of budesonide.
ABSTRACT
We report a case of a 35-year-old right-handed male patient with drug-resistant mesial temporal lobe epilepsy who developed ipsilateral occipital hematoma after right temporal anterior lobectomy and amygdalohippocampectomy. Patient did not report taking any drugs with anticoagulant effect, such as aspirin or valproate. There was no past history of hypertension and the pre-operation tests were normal. Pre-operative brain magnetic resonance imaging revealed no abnormality in the right occipital lobe. Overdraining of cerebrospinal fluid may have triggered this remote cerebellar hemorrhage.
ABSTRACT
Objective: To investigate the association between the CYP3A5 genetic polymorphism and the serum concentrations of carbamazepine (CBZ), to provide guidance for individualized drug dosing. Methods: Eighty-four epilepsy patients taking CBZ were included in this study. Their clinical data were recorded and CBZ serum concentrations were measured. The CYP3A5 6986 genetic polymorphism was assessed using a polymerase chain reaction-restriction fragment length polymorphism (PCRRFLP) assay. Patients were divided according to genotype into CYP3A5 expressor (CYP3A5*1/*1 genotype and CYP3A5*1/*3 genotypes) and non-expressor groups (CYP3A5*3/*3). The two groups were compared for the total dose of CBZ, dose of CBZ/kg body weight, serum drug concentration, dose-corrected serum concentration, and standardized serum concentration. Results: The total dose of CBZ and the dose of CBZ/kg body weight was higher in the CYP3A5 expressor group than the non-expressor (P = 0.043 and P = 0.014, respectively). The dose-corrected and standardized serum concentrations were lower in the CYP3A5 expressor group than the non-expressor (P = 0.001 and P < 0.001, respectively). There was however, no signifi cant difference in serum drug concentration between the two groups (P = 0.487). Conclusions: There was a close relationship between CYP3A5 genetic polymorphism and the serum concentrations of carbamazepine.
ABSTRACT
Objecltive To intensify the coordination and nursing in the operation room in order to prevent surgical site infection after gastrointestinal operation. Methods 337 medical history of patients received gastrointestinal operation and third rate healing from 1999 to 2006 were collected. A series of intensified measures were applied to surgical site infection from 2003 gradually, including invocation of new surgical handwashing method, modified skin disinfection manner, adoption of degreasing with ethanol first before disinfection with iodophor, placement of incision protector and clean bag for incision protection after entering abdomen, changing to use new gastrointestinal anastomofic thimerosal,standardization of operation order and clean manage-ment in operation room. The incidence rate of surgical site infection after gastrointestinal operation of patients from 1999 to 2002 and from 2003 to 2006 underwent χ2 test. Results The incidence rate of surgical site in-fection after gastrointestinal operation greatly decreased after adoption of intensified nursing intervention, Signifi-cant difference existed in rate of patients with third rate healing between the year 1999 to 2002 and 2003 to 2006. Conclusions Modified nursing intervention for surgical incision after gastrointestinal operation can de-crease incision infection rate evidently.
ABSTRACT
The developing situation of "big image" makes the medical imaging become an increasingly huge and complicated system.It offers higher request to the medical imaging teaching.The internship of last term is always influenced by attending the graduate student's entrance examination and looking for job,the effect of teaching can't be assured,and it especially important to do well in field trip,thus it can reduce or avoid the phenomenon of "practice after graduate".
ABSTRACT
With the increasingly strengthening of economic globalization and higher education internationalization,medical imageology as an important intersecting science in life sciences has more and more international communion and cooperation.In China many hospitals and medical colleges require large quantities of medical imageology professionals,and it is very necessary and important to develop the bilingual education in medical imageology,though a series of problems appear in the process.
ABSTRACT
Objective To study the inhibitory effect of antigliomatin on the expression of vascular endothelial growth factor(VEGF) in rat C6 brain glioma cells.Methods The rat brain glioma cells was cultivated with the stationary culture technique.The different rat C6 brain glioma cells groups were treated with 2,4,8,and 16 ng?L-1 antigliomatin for 72 h in vitro and then the inhibitory effect of antiglioma on the expression of VEGF was observed with immunohistochemical method.Results The cytoplasm and(or) nucleus of most VEGF positive cells were stained to yellow brown.VEGF expressed significantly in cytoplasm of the rat C6 glioma cells in control group.The density of the VEGF positive cells was decreased in glioma compared with control group after treated with antigliomatin for 72 h(P
ABSTRACT
Objective To investigate the expression of connexin CX43 using hybridization techniques after GABA restraining receptor gene was transferred into the supramammillary of hypothalamus in Kainic acid(KA) induced epileptic rats.Methods Twenty-four male Wistar rats were divided into four groups: control group(n=2),surgery group(n=2),KA group(n=10) and GABA restraining receptor gene transferred group(GABA group)(n=10).No treatment was given to the control group.Physiological saline(1 ?L) was injected into right amygdala of rat in surgery group.In KA group,KA(1 ?L,1 ?g) was injected into the amygdala of rat to build epileptic model.In GABA group,the GABA restraining receptor gene(400 nL,40 ng) was transferred into the supramammillary of hypothalamus by HVJ-liposome 48 h before KA was injected into amygdala.The expressions of CX43 mRNA and morphological changes different time(3 h,6 h,24 h,3d,7d) were observed by in situ hybridization in each group.Results In control group and surgery group,the morphological manifestations were normal,and the hippocampus structures were complete.In KA group,swell and degenerative hippocampus neurons were showed and deteriorated with time.In GABA group,the degeneration and necroses of hippocampus neurons were relatively alleviated.The positive expression of CX43 mRNA was few in control group and surgery group.And in KA group it increased with time.In GABA group,the positive expression of CX43 mRNA was fewer than that of KA group at every period.Conclusion The expression of CX43 mRNA in hippocampus can be decreased by transferring GABA receptor gene into hypothalamus.
ABSTRACT
Objective To investigate the charateristics of pathological changes in hippocampal subregions in rats with epilepsy induced with different doses kainic acid(KA) ,discuss the etiology and pathway of epileptic wave.Methods 30 male Wistar rats were randomly divided into control group,low(0.025 ?g) and high(0.1 ?g) dose KA injection groups with 10 rats each.KA was focally injected into the right amygdala by a glass micropipette connected to an air pressure system to make epilepsy model.The pathological characteristics in hippocampal subregions in rats with epilepsy induced with different doses KA were observed.Results Compared with control group,high dose KA injection mainly caused neuron loss in the CA3 region,while pyramidal and dentate granule cells were evenly distributed with normal shape and size.Low dose KA injection caused severe damage in both CA1 and CA3 regions.Dentate granule cells didn't show any pathological change and neuron loss in low dose injection.Conclusion The pathological changes in hippocampal subregions in rats with epilepsy induced with KA are different with different doses KA,it might be related to the pathway of epileptic wave and the specific properties of hippocampus.
ABSTRACT
@#ObjectiveTo investigate the quality of life (QOL) of the epilepsy patients and the factors affected the QOL.Methods200 cases were investigated using the Quality of Life in Epilepsy Inventory 10 (QOLEI-10) and the Washington Psychosocial Seizure Investigate (WPSI). 200 healthy persons were chosen as normal control group. ResultsThe QOL of the patient group were significantly poor as compared with that of normal control group(P<0.01). The factors that the patients always faced with were disability in the attack control, short in money, unemployment, restriction of movement, disability in intercommunication, psychological disorder (depress, strain, anxiety, dread, shame feel, cognitional dysfunction, etc.), as well as the difficult to get professional curtains, taking medicine improperly and side effects of the medicine. Conclusions The factors mentioned, which were usually neglected by many doctors, do affect the QOL of epilepsy patients, and hinder the epilepsy treatment effectively.