ABSTRACT
The Ly-6 and uPAR (LU) domain-containing proteins represent a large family of cell-surface markers. In particular, mouse Ly-6A/Sca-1 is a widely used marker for various stem cells; however, its human ortholog is missing. In this study, based on a systematic survey and comparative genomic study of mouse and human LU domain-containing proteins, we identified a previously unannotated human gene encoding the candidate ortholog of mouse Ly-6A/Sca-1. This gene, hereby named LY6A, reversely overlaps with a lncRNA gene in the majority of exonic sequences. We found that LY6A is aberrantly expressed in pituitary tumors, but not in normal pituitary tissues, and may contribute to tumorigenesis. Similar to mouse Ly-6A/Sca-1, human LY6A is also upregulated by interferon, suggesting a conserved transcriptional regulatory mechanism between humans and mice. We cloned the full-length LY6A cDNA, whose encoded protein sequence, domain architecture, and exon-intron structures are all well conserved with mouse Ly-6A/Sca-1. Ectopic expression of the LY6A protein in cells demonstrates that it acts the same as mouse Ly-6A/Sca-1 in their processing and glycosylphosphatidylinositol anchoring to the cell membrane. Collectively, these studies unveil a novel human gene encoding a candidate biomarker and provide an interesting model gene for studying gene regulatory and evolutionary mechanisms.
Subject(s)
Humans , Membrane Proteins/genetics , Pituitary Neoplasms/genetics , BiomarkersABSTRACT
Objective: To evaluate the effect of depth of remission of induction chemotherapy on the overall prognosis of limited stage small cell lung cancer (L-SCLC). Methods: The study was a retrospective, L-SCLC patients who contained complete imaging data and underwent consecutive standardized treatments at the Department of Thoracic Radiation and Medical Oncology, Zhongnan Hospital of Wuhan University between January 2013 and June 2021 were included. To delineate the volume of tumor before and after induction chemotherapy and to calculate the depth of remission caused by the induced chemotherapy. The time receiver operating characteristic (timeROC) method was used to determine the optimal predictors for prognosis, multi-factor analysis using Cox risk proportional model. Results: A total of 104 patients were included in this study. The median PFS and OS of this cohort were 13.7 months and 20.9 months, respectively. It was observed by timeROC analysis that residual tumor volume after induction chemotherapy had the optimal predictive value of PFS at 1 year (AUC=0.86, 95% CI: 0.78~0.94) and OS at 2 years (AUC=0.76, 95% CI: 0.65~0.87). Multivariate analysis showed residual tumor volume after induction chemotherapy was the independent prognostic factor to PFS (HR=1.006, 95% CI: 1.003~1.009, P<0.01) and OS (HR=1.009, 95% CI: 1.005~1.012, P<0.001). For those whose residual tumor volume remitted to less than 10 cm(3) after induction chemotherapy, the favorable long-term outcomes could be achieved, regardless of their initial tumor load. Conclusion: The depth of remission of induction chemotherapy could be a promising prognostic predictor to the L-SCLC and provide the individualized treatment guidance.
Subject(s)
Humans , Small Cell Lung Carcinoma/pathology , Lung Neoplasms/pathology , Induction Chemotherapy , Retrospective Studies , Neoplasm, Residual , PrognosisABSTRACT
Objective:In order to accurately evaluate the postoperative rehabilitation of gynecological robotic surgery, a prediction model for evaluating postanesthesia care unit (PACU) extubation time and hospital stay in gynecological robotic surgery was established.Methods:The clinical data of gynecological patients who underwent robotic surgery in Xiangya Third Hospital of Central South University from October 2015 to May 2017 were retrospectively analyzed, and the data were screened to evaluate the postoperative recovery of patients from two aspects: PACU extubation time and postoperative hospital stay. Binary logistic regression was used to screen out the factors affecting PACU extubation time and postoperative hospital stay, and the prediction model was preliminarily established and verified.Results:Finally, there were 456 patients and 30 variables analyzed in the binary logistics regression. According to these variables, the prediction model of the postoperative recovery evaluation after gynecological robotic surgical procedures was established. Among them, age, intraoperative amount of atracurium and midazolam were independent risk factors affecting PACU extubation time (all P<0.05). American Society of Anesthesiologists (ASA) grade, intraoperative amount of midazolam, intraoperative bleeding and operation time were independent risk factors affecting postoperative hospital stay (all P<0.05). All models passed Hosmer lemeshow test (all P>0.05); The areas under the receiver operating characteristic curve (ROC) were 0.647 and 0.806, respectively. Conclusions:The prediction model of PACU extubation time and the postoperative hospitalization time has been established.
ABSTRACT
B-cell precursor acute lymphoblastic leukemia (BCP-ALL) is characterized by genetic alterations with high heterogeneity. Precise subtypes with distinct genomic and/or gene expression patterns have been recently revealed using high-throughput sequencing technology. Most of these profiles are associated with recurrent non-overlapping rearrangements or hotspot point mutations that are analogous to the established subtypes, such as DUX4 rearrangements, MEF2D rearrangements, ZNF384/ZNF362 rearrangements, NUTM1 rearrangements, BCL2/MYC and/or BCL6 rearrangements, ETV6-RUNX1-like gene expression, PAX5alt (diverse PAX5 alterations, including rearrangements, intragenic amplifications, or mutations), and hotspot mutations PAX5 (p.Pro80Arg) with biallelic PAX5 alterations, IKZF1 (p.Asn159Tyr), and ZEB2 (p.His1038Arg). These molecular subtypes could be classified by gene expression patterns with RNA-seq technology. Refined molecular classification greatly improved the treatment strategy. Multiagent therapy regimens, including target inhibitors (e.g., imatinib), immunomodulators, monoclonal antibodies, and chimeric antigen receptor T-cell (CAR-T) therapy, are transforming the clinical practice from chemotherapy drugs to personalized medicine in the field of risk-directed disease management. We provide an update on our knowledge of emerging molecular subtypes and therapeutic targets in BCP-ALL.
Subject(s)
Humans , B-Lymphocytes , Mutation , Oncogene Proteins, Fusion/genetics , Precursor B-Cell Lymphoblastic Leukemia-Lymphoma , Precursor Cell Lymphoblastic Leukemia-LymphomaABSTRACT
Objective:To explore the appropriate radiotherapy time and method in the treatment of patients with brain metastases (BM) due to from non-small cell lung cancer (NSCLC) harboring epidermal growth factor receptor (EGFR) mutation.Methods:Totally 69 EGFR-mutant NSCLC patients with BM treated in Zhongnan Hospital of Wuhan University from January 2014 to September 2018 were retrospectively reviewed. The patients were divided into two groups according to the time of brain radiotherapy, including the upfront radiotherapy group ( n=45) who received concurrent brain radiotherapy and EGFR-tyrosine kinase inhibitors(TKI)treatments and deferred radiotherapy group ( n=24) who received brain radiotherapy after intracranial progression during EGFR-TKI treatment. The upfront radiotherapy group was further divided into two groups, the group treated with WBRT concurrent with EGFR-TKI ( n=20) and the group treated with SRS concurrent with EGFR-TKI ( n=25). Overall survival (OS), progression-free survival (PFS) and intracranial progression-free survival (iPFS) time were evaluated. Results:The median OS of 69 patients was 31.2 months. For the upfront and deferred radiotherapy groups, the 1-, 2- year OS were 95%, 64% and 80%, 35%, the difference between the two groups was statistically significant. On subgroup analysis, the upfront WBRT, upfront SRS and deferred radiotherapy groups 1-, 2- year OS were 95%, 96%, 80% and 42%, 88%, 35%. Moreover, the upfront SRS group was associated with improved OS relative to the deferred radiotherapy group ( HR: 0.10, 95% CI: 0.23-0.46, P=0.003), but the upfront WBRT and deferred radiotherapy groups shared similar OS ( HR: 0.54, 95% CI: 0.21-1.32, P=0.180). There were no significant difference in iPFS and PFS between the upfront and deferred radiotherapy groups( P>0.05). Conclusions:Upfront brain radiotherapy prolonged the survival of BM patients metastasized from EGFR-mutant NSCLC. SRS concurrent with EGFR-TKI may be superior to WBRT concurrent with EGFR-TKI in the treatment of BM metastasized from EGFR-mutant NSCLC.
ABSTRACT
During the epidemic of coronavirus disease 2019 (COVID-19), the infection of the elderly population will bring great challenges to clinical diagnosis and treatment, outcome and management.Combined with the characteristics of anesthesia and the pathophysiological characteristics of COVID-19 on lung function impairment in elderly patients, Chinese Society of Anesthesiology formulated the " Recommendations for anesthesia management and infection control in elderly patients with COVID-19″. This recommendation expounds preoperative visit and infection control, anesthesia management protocol, anesthesia monitoring, anesthesia induction/endotracheal intubation, anesthesia maintenance and infection control, intraoperative lung protection strategy, anti-stress and anti-inflammatory management, hemodynamic optimization, infection control during emergence from anesthesia, and postoperative analgesia in elderly patients with COVID-19, and provides the reference for the safe and effective implementation of anesthesia management in elderly patients during the prevention and control of COVID-19 epidemic.
ABSTRACT
Objective@#To investigate postoperative recurrent pattern of the thoracic esophageal squamous cell carcinoma (TESCC), aiming to provide a basis for the delineation of postoperative radiotherapy volume for TESCC.@*Methods@#Clinical data of 66 TESCC patients who recurred after the radical esophagectomy in Zhongnan Hospital of Wuhan University from 2011 to 2017 were retrospectively analyzed. According to the AJCC 8th edition-defined classification of esophageal carcinoma, regional lymph node stations 1 to 8M were defined as the upper-middle mediastinum region (UMMR), and stations 8Lo, 9 and 15 were defined as the inferior mediastinum region (IMR), stations 16 to 20 were regarded as the upper abdominal lymph node region (UAR).@*Results@#Among all 66 patients, 41 cases (62%) experienced loco-regional recurrence alone, 25 cases (38%) presented with distant metastasis alone. A total of 54 patients with 148 lymph node recurred after treatment. The highest risk region of lymph node recurrence was UMMR (118/148, 80%), after that, followed by UAR (24/148, 17%). With regard to 9 cases of UAR, 6 patients had lower TESCC, and 8 patients (89%) were graded as ≥ pathological stage Ⅲ.@*Conclusions@#The highest risk region of lymph node recurrence is UMMR in TESCC patients undergoing radical esophagectomy, which should be considered as the target volume in postoperative radiotherapy. For patients with lower TESCC ≥ pathological stage Ⅲ, UAR might be the target volume with cautions. Anastomosis and IMR are probably not the routine treatment volumes.
ABSTRACT
Objective To analyze the clinical efficacy and prognosis of stereotactic body radiation therapy (SBRT) for pulmonary oligometastases.Methods Medical records of 104 patients with SBRT for pulmonary oligometastases in our hospital between 2012 and 2018 were retrospectively reviewed.SBRT was performed by intensity modulated radiation therapy (IMRT) technique before December 2015,and by helical tomotherapy (HT) technique in others.The local control (LC),progression-free survival (PFS) and overall survival (OS) were estimated using the Kaplan-Meier method.Cox-regression was used for univariate analyses and multivariate analyses.The radiotherapy-related adverse events were evaluated by NCICTCAE V4.0.Results The 1-,2-and 3-year LC rates were 86.6％,75.9％ and 72.3％,respectively.The 1-,2-and 3-year PFS rates were 40.9％,28.4％ and 22.1％,respectively.The 1-,2-and 3-year OS rates were 75.9％,53.2％ and 43.53％,respectively.The median OS time was 26.6 months.Multivariate analyses showed that the pathologic type of primary tumor,the volume of lung oligometastases and the carcino-embryonic antigen (CEA) level before SBRT were the independent prognostic factors of LC (x2 =28.66,P＜0.05).The way of tumor progression after SBRT was the independent prognostic factor of OS (x2=40.01,P＜0.05).Meanwhile,there were no significant differences in the LC and OS between HTSBRT and IMRT-SBRT.Radiation pneumonitis was the major adverse event of SBRT (n =25,24.04％).Less than 7％ patients experienced grade 2 and above radiation pneumonitis.Conclusions SBRT shows high local control rates and tolerable adverse events in the treatment of pulmonary oligometastases.There were no significant differences in the clinical efficacy and adverse events between HT-SBRT and IMRT-SBRT,which means they are all suitable for clinical application.
ABSTRACT
Objective To investigate postoperative recurrent pattern of the thoracic esophageal squamous cell carcinoma (TESCC),aiming to provide a basis for the delineation of postoperative radiotherapy volume for TESCC.Methods Clinical data of 66 TESCC patients who recurred after the radical esophagectomy in Zhongnan Hospital of Wuhan University from 2011 to 2017 were retrospectively analyzed.According to the AJCC 8th edition-defined classification of esophageal carcinoma,regional lymph node stations Ⅰ to 8M were defined as the upper-middle mediastinum region (UMMR),and stations 8Lo,9 and 15 were defined as the inferior mediastinum region (IMR),stations 16 to 20 were regarded as the upper abdominal lymph node region (UAR).Results Among all 66 patients,41 cases (62％) experienced locoregional recurrence alone,25 cases (38％) presented with distant metastasis alone.A total of 54 patients with 148 lymph node recurred after treatment.The highest risk region of lymph node recurrence was UMMR (118/148,80％),after that,followed by UAR (24/148,17％).With regard to 9 cases of UAR,6 patients had lower TESCC,and 8 patients (89％) were graded as ≥ pathological stage Ⅲ.Conclusions The highest risk region of lymph node recurrence is UMMR in TESCC patients undergoing radical esophagectomy,which should be considered as the target volume in postoperative radiotherapy.For patients with lower TESCC ≥ pathological stage Ⅲ,UAR might be the target volume with cautions.Anastomosis and IMR are probably not the routine treatment volumes.
ABSTRACT
To study the chemical constituents of Achyranthes aspera. Methods: The constituents were separated and purified by silica gel, ODS column chromatography, and recrystallization, and their structures were identified on the basis of physicochemical properties and spectral data. Results: Nine compounds were isolated and identified as 5,2’-dimethoxy-6- (methoxymethyl)-7-hydroxy-isoflavonol (1), oleanolic acid (2), oleanolic acid 28-O-β-D-glucopyranosyl ester (3), codonolactone (4), 3-formylindole (5), indole-3-carboxylic acid (6), 4-[2-formyl-5-(methoxymethyl)-1H-pyrrol-1-yl] butanoic acid (7), 3-hydroxy- 1-(4-hydroxy-3,5-dimethoxy-phenyl)-1-propanone (8), and 2-(2-phenoxyethoxy)-ethanol (9). Conclusion: Compound 1 is a new compound named as achyranthesketone A, and compounds 4-9 are isolated from this plant for the first time.
ABSTRACT
Objective:To evaluate the safety and efficacy of ultrasound guidance for percutaneous balloon pulmonary valvuloplasty (PBPV) in comparison with conventional X-ray guidance.Methods:Our research included in 2 groups:Ultrasound group,n=102 patients with PBPV under ultrasound guidance in our hospital from 2013-03 to 2016-08 and X-ray group,n=280 patients with PBPV under traditional X-ray guidance in our hospital at the same period of time.Post-operative effect was evaluated by echocardiography and compared between 2 groups.Results:The patients' age,body weight,pulmonary artery diameter,immediate post-operative pulmonary transvalvular pressure gradient (PTPG),the in-hospital time and cost were similar between 2 groups,P＞0.05.The success rate of operation in Ultrasound group and X-ray group was 99.0％ vs 100％,P=0.267.In the ultrasound group,1 patient was converted to a conventional surgery due to right ventricular outflow tract muscle spasm after dilation.The operation time in X-ray group was longer than Ultrasound group,(38.9±9.2) min vs (34.6±10.0) min,P＜0.001.The X-ray exposure time was (3.9±1.2) min in X-ray group.The mean follow-up time was (25.5±13.2) months and PTPG in Ultrasound group and X-ray group were (16.2±4.3) mmHg and (15.3±4.5) mmHg,P=0.120.No serious complications as death,peripheral vascular injury,cardiac perforation and pericardial effusion occurred in either group.Conclusion:PBPV under complete ultrasound guidance may not only avoid radiation and contrast agent,but also keep the safety and efficacy of minimally invasive conventional percutaneous interventional treatment.
ABSTRACT
Objective:To evaluate the safety and efficacy of ultrasound guidance for percutaneous balloon pulmonary valvuloplasty (PBPV) in comparison with conventional X-ray guidance.Methods:Our research included in 2 groups:Ultrasound group,n=102 patients with PBPV under ultrasound guidance in our hospital from 2013-03 to 2016-08 and X-ray group,n=280 patients with PBPV under traditional X-ray guidance in our hospital at the same period of time.Post-operative effect was evaluated by echocardiography and compared between 2 groups.Results:The patients' age,body weight,pulmonary artery diameter,immediate post-operative pulmonary transvalvular pressure gradient (PTPG),the in-hospital time and cost were similar between 2 groups,P＞0.05.The success rate of operation in Ultrasound group and X-ray group was 99.0％ vs 100％,P=0.267.In the ultrasound group,1 patient was converted to a conventional surgery due to right ventricular outflow tract muscle spasm after dilation.The operation time in X-ray group was longer than Ultrasound group,(38.9±9.2) min vs (34.6±10.0) min,P＜0.001.The X-ray exposure time was (3.9±1.2) min in X-ray group.The mean follow-up time was (25.5±13.2) months and PTPG in Ultrasound group and X-ray group were (16.2±4.3) mmHg and (15.3±4.5) mmHg,P=0.120.No serious complications as death,peripheral vascular injury,cardiac perforation and pericardial effusion occurred in either group.Conclusion:PBPV under complete ultrasound guidance may not only avoid radiation and contrast agent,but also keep the safety and efficacy of minimally invasive conventional percutaneous interventional treatment.
ABSTRACT
Postoperative cognitive dysfunction (POCD) is thought to be a mild cognitive disorder.It means that patients without cognitive diseases before surgery suffer from subtle changes in psychomotility,personality,social skills and cognitive function after the surgery.A decline in memory is the core characteristics of these symptoms.POCD is mainly seen in the elderly people following surgery.It can prolong hospital stay,reduce quality of life,increase mortality,and thus aggravate the burden of public health.It is urgent to take precautions to reduce the incidence.The precise mechanism of POCD remains unclear.Previous studies have shown that inflammation plays an important role in it.Sterile surgery can result in peripheral inflammation.Through several pathways,the signals from the peripheral immune response were sent to central system.Due to the individual difference,the degree of the central neuroinflammation was also heterogeneous.Some inflammations may lead to the occurrence of POCD.In order to prevent POCD,we should focus on the anti-inflammatory therapy.
ABSTRACT
Objective To investigate isolation of pathogens from bile and clinical characteristics of patients with hepatobiliary diseases.Methods Bacterial culture result of bile and related clinical data of patients with hepatobiliary diseases in a hospital were collected and analyzed by retrospective survey.Results A total of 406 bile specimens from patients with hepatobiliary diseases were collected,the positive rate of culture was 64.53％.Of 262 positive specimens,62.21％ (n =163),32.83％ (n =86),and 4.96％ (n =13) were isolated single pathogen,2 kinds of pathogens,and 3 kinds of pathogens respectively.374 pathogenic strains were isolated,242 (64.71％),131 (35.02 ％),and 1 (0.27 ％) were gram-negative bacteria,gram-positive bacteria,and fungus respectively.Patients with cirrhosis of liver,history of hepatobiliary surgery,and cholelithiasis had higher isolation rates of pathogens from bile than control group(all P＜0.05),isolation rates of pathogens from bile in patients with cholelithiasis of different sites were varied;but there was no significant differences among patients of different age,gender,and whether or not with hepatobiliary tumors(all P＞0.05).There were no statistical difference in constitute of pathogenic species from bile between patients with and without gallstones,as well as with and without history of hepatobiliary surgery(both P＞0.05);while constitute of pathogenic species from bile between patients with and without cirrhosis of liver was statistically different(x2 =14.058,P =0.001).Conclusion Pathogens from bile in patients with hepatobiliary diseases are mainly Enterobacteriaceae and Enterococcus spp.which caused single infection.Positive culture rate of pathogens from bile is higher in patients with cholelithiasis,history of hepatobiliary surgery,and liver cirrhosis.
ABSTRACT
Objective:To observe the effect of parecoxib on neutrophil-to-lymphocyte ratio (NLR)after the modified radical mastectomy,and to explore its potential mechanisms for inhibition ofperioperative inflammation.Methods:A total of 40 breast cancer patients undergone the modified radical mastectomy were randomly divided into a parecoxib group (n=20) and a control group (n=20).The parecoxib group received intravenous parecoxib (40 mg,5 mL) during general anesthesia induction,post-operative day 1 and day 2;the control group received intravenous normal saline (5 mL) at the corresponding time points.Their peripheral bloods were collected for routine test in the morning of the surgery day (T1),and Day 1 (T2),Day 3 (T3) and Day7 (T4) after the surgery, and NLRwas calculated.Results:Compared with T1,NLR in the control group at T2 and T3 was significantly increased (P＜0.05),but not at T4 (P＞0.05);NLR in the parecoxib group was sharply increased at T2 (P＜0.01),and returned to preoperative levels at T3 and T4 (P＞0.05).NLR in the parecoxib group was significantly lower than that in the control group at T2 (P＜0.05),but there were no significant difference between the two groups at other time points (P＞0.05).Conclusion:Parecoxib can restrain the inflammatory responses and improve immune function of the breast cancer patients by suppressing the elevation of NLR after the modified radical mastectomy,which is expected to improve the prognosis of the breast cancer patients.
ABSTRACT
Recently, novel Psidium meroterpenoids were reported in the guava leaves. According to careful analysis of the spectral data of literatures, the spectroscopic characteristics and biosynthetic pathway of Psidium meroterpenoids were summarized in this paper. The results showed that Psidium meroterpenoids had distinct spectroscopic features and reasonable biosynthetic routines, however the number order of carbon atoms was not consistent in the reported literatures. It was concluded that Psidium meroterpenoids were the characteristic chemical constituents of Psidium guajava Linn.
Subject(s)
Magnetic Resonance Spectroscopy , Plant Leaves , Chemistry , Psidium , Chemistry , Spectrum Analysis , Terpenes , ChemistryABSTRACT
<p><b>OBJECTIVE</b>To assess the effects of dexmedetomidine (Dex) on propofol dosage in target-controlled infusion (TCI) and hemodynamics in patients undergoing laparoscopic surgery under general anesthesia.</p><p><b>METHODS</b>Sixty patients undergoing laparoscopic surgery under general anesthesia were randomly divided into control group (n=30) and the Dex group (n=30). The patients in Dex group received a loading dose of Dex (1 µg/kg, infused within 10 min) before the surgery followed by continuous infusion at the rate of 0.3 µg·kg(-1)·h(-1) till the end of the surgery, and the control patients received saline infusion in the same manner. Heart rate, blood pressure, bispectral index (BIS), and propofol dose in TCI were recorded during induction and maintenance of anesthesia. The incidence of hypotension and bradycardia were observed during and after the surgery.</p><p><b>RESULTS</b>No difference was found in the incidence of hypotension and bradycardia between the control group and Dex group (P>0.05), but heart rate and blood pressure were lower in Dex group during extubation (P<0.05). The dose of propofol in TCI was significantly less in Dex group than in the control group (P<0.05).</p><p><b>CONCLUSION</b>Dex can reduce hemodynamic abnormalities caused by extubation and decrease the dosage of propofol in TCI, and may serve as an ideal adjuvant drug for general anesthesia.</p>
Subject(s)
Humans , Anesthesia, General , Blood Pressure , Bradycardia , Dexmedetomidine , Therapeutic Uses , Heart Rate , Hemodynamics , Hypotension , Laparoscopy , Propofol , Therapeutic UsesABSTRACT
Objective: To compile and evaluate the Chinese version of perioperative nursing quality assessment scale, detect and verify the reliability and validity of evaluation scale, and establish a scientiifc evaluation system. Methods: We applied Tuija Leinonene and Helena Leino-kilpi scales as the theoretical framework, and established perioperative nursing quality assessment scale by translation, language study, and expert consultation. hTe questionnaire survey population was 276 patients who had surgery and 200 nurses working in the operating rooms at the 3 Affliated Hospitals of Central South University. hTe scale was tested validity and reliability. Results: Perioperative nurse quality evaluation scale consisted of 32 items and 7 dimensions, including body care, receive information, support, respect, medical staff characteristics, environment and nursing process. The test-retest reliability of scale was 0.977 for patients and 0.997 for nurses. hTe split half reliability of scale was 0.761 for patients and 0.887 for nurses. hTe Cronbach's α of total scale for the patients was 0.918, and the Cronbach's α of factors was 0.658-0.838. hTe Cronbach's α of total scale for the nurses was 0.932, and the Cronbach's α of factors was 0.650-0.836. hTe correlation coeffcient of scale for the patients was 0.363-0.603; the factors and the total correlation coeffcient was 0.535-0.788. hTe correlation coeffcient of scale for the nurses was 0.410-0.700; the factors and the total correlation coeffcient was 0.743-0.902. Conclusion: The Chinese version of the perioperative nursing quality assessment scale is a measurement instrument with a high level of validity and reliability for Chinese society and can be used to determine the quality of perioperative nursing care in our country.
ABSTRACT
Objective:To explore whether perioperative intravenous flurbiprofen axetil can reduce the incidence and intensity of chronic pain for breast cancer atfer surgical treatment. Methods:This randomized, double-blind, controlled trial enrolled 60 patients undergoing mastectomy and axillary lymph node dissection under general anesthesia. All patients accepted Hospital Anxiety and Depression Scale (HAD) tests the day before the surgery to evaluate depression and anxiety. hTe patients were randomly assigned to receive either 50 mg lfurbiprofen axetil intravenously 15 minutes before the surgical incision and 6 hours later (group F) or intravenous 5 mL intralipid as a control (group C). All patients received patient-controlled intravenous analgesia (PCIA) with fentanyl postoperatively. Peripheral venous blood samples were drawn before the surgery, at 4 and 24 h atfer the surgery to detect the plasma level of PGE2 and tumor necrosis factor-α(TNF-α). Postoperative fentanyl consumption, Numerical Rating Scale (NRS) scores and adverse effects were recorded at 2, 6, 12, 24 and 48 h after the surgery. hTe duration and intensity of pain were followed up by telephone at the 2nd-12th month atfer the surgery. Results:The incidence of pain at 2, 4, 6, and 12 months after the breast surgery was 33%, 20%, 15%, and 10%, respectively, and the average pain score was 0.77, 0.57, 0.28, and 0.18, respectively. Compared with group C, the scores of pain in group F were significantly lower at 2, 4, 6 and 12 months postoperatively (F=7.758, P=0.007). The incidence of pain in group F was significantly lower at 2, 4 and 6 months postoperatively (P0.05). Preoperatively and at 4 and 24 h atfer the surgery, there was no signiifcant difference in the level of TNF-αbetween the two groups (F=0.530, P=0.470);but plasma concentration of PGE2 in group F was significantly lower than that in group C (F=5.646, P=0.021). No patients developed abnormal bleeding, peptic ulcer, impaired liver or renal function and respiratory depression. Conclusion:Perioperative intravenous infusion of 100 mg flurbiprofen axetil can decrease the intensity and incidence of chronic pain for breast cancer atfer surgical treatment.
ABSTRACT
Objective To investigate the changes in cerebral glucose metabolism induced by postoperative delirium in the elderly patients and the effects of dexmedetomidine on it.Methods Forty-two patients of both sexes aged 65-85 yr with a body mass index of 19-25 kg/m2 undergoing abdominal surgery under general anesthesia were enrolled in this study.Delirium occurred during the first 2 days after operation in 39 out of the 42 patients (29/42).The 29 patients were randomly divided into 2 groups:group delirium without any treatment (group D,n =13) and group delirium + dexmedetomidine (group Dex,n =16).The remaining 13 patients did not develop delirium after operation and served as control group (group C).In group Dex a loading dose of dexmedetomidine 1 μg/kg was administered iv over 10 min after occurrence of delirium followed by continuous infusion at 0.2-0.7μg· kg-1 · h-1.PET scan was performed within the time period in which delirium occurred.18 Fluorine-deoxyglucose was injected for observation of imaging of glucose metabolism.The standard uptake value of glucose of bilateral parietal,temporal and frontal lobes was calculated.Results Delirium was controlled within 30 min after adminnistration of dexmedetomidine.Delirium significantly reduced cerebral glucose metabolism in the bilateral parietal,temporal and frontal lobes in group D as compared with group C (P ＜ 0.05).Dexmedetomidine significantly attenuated the delirium-induced decrease in cerebral glucose metabolic rate of the 3 lobes in group Dex as compared with group D (P ＜ 0.05).Conclusion Postoperative delirium reduces cerebral glucose metabolism and dexmedetomidine can significantly control pastoperative delirium in the elderly patients.