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Objective:To investigation for common hepatic cartery lymph node metastasis of esophageal squamous cell carcinoma.Methods:From 2015 to 2017, 413 patients with esophageal squamous cell carcinoma who were dissected the common hepatic cartery lymp node were admitted in Cancer Hospital of Sichuan. The relationship between metastatic of rates of common hepatic cartery lymp node and the clinical data including sex, age, tumor site, diameter of tumor, invasion depth, differentiation degree, pathological stage, neurovascular invasion status were reviewed retrospectively.Results:A total of 10 649 lymph nodes were dissected.The lymph node metastatic rate was 45.27%(187/413), and the metastatic lymph node ratio was 7.96%(848/10 649). Lymph nodes adjacent to the middle esophagus, cervical esophagus, cardia of stomach had a higher metastatic rate, while the Lymph nodes adjacent to the hilar, supraclavicular, common hepatic cartery had a lower metastatic rate.A total of 775 lymph nodes were dissected in common hepatic cartery.The lymph node metastatic rate was 7.02%(29/413), and the metastatic lymph node ratio was 4.51%(35/775). To analysis the relationship between metastatic of rates of common hepatic cartery lymp node and the clinical data.We conclusion that the common hepatic artery lymph node metastatic rates of upper, middle and lower esophageal squamous cell carcinoma were 2.89%(2/69), 5.35%(12/224) and 12.50%(15/120), with significant difference.The common hepatic artery lymph node metastatic rates of patients with diameter of tumor under 3 cm, 3-5 cm and above 5 cm were 5.20%(9/173), 5.52%(9/163)and 14.28%(11/77), with significant difference.The common hepatic artery lymph node metastatic rates of sex, age, tumor site, diameter of tumor, invasion depth, differentiation degree, pathological stage, neurovascular invasion status, with no significant difference.Conclusion:The metastatic rates of common hepatic artery lymph node in esophageal squamous cell carcinoma is lower. For the upper thoracic esophageal cancer with tumor diameter under 5 cm, the dissection of common hepatic lymph node can be ommitted in surgery.
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Objective To investigate the effect of pressure ulcer risk warning system in the pressure ulcer management in patients undergoing thoracolumbar fracture surgery.Methods A retrospective case control study was performed to analyze the clinical data of 120 patients with thoracolumbar fracture who underwent posterior thoracolumbar pedicle screw fixation and intervertebral bone graft fusion surgery at People's Hospital of Henan Province from October 2016 to September 2018.There were 76 males and 44 females,aged 45-80 years [(59.2 ± 7.2) years].A total of 60 patients received treatment and care under the pressure ulcer early warning system (early warning group),while 60 patients were given assessment form for pressure ulcer management (control group).The time of filling in the assessment form,the implementation score of pressure ulcer prevention measures,the incidence of pressure ulcer,visual analogue pain score (VAS) and patient satisfaction were compared between the two groups.Results In the control group and early warning group,the time of filling in the form was (121.5 ± 9.0) minutes and (11.3 ± 2.0) minutes (P ＜ 0.01),the implementation score of pressure ulcer prevention measures was (85.9 ± 3.8) points and (96.0 ± 2.2)points (P ＜ 0.01),and the pressure ulcer incidence was 25％ (15 patients) and 3％ (two patients),respectively (P ＜0.01).In the control group,the preoperative VAS was (7.3 ± 1.3) points,and the VAS at 6 hours,24 hours,48 hours,72 hours after operation were (3.7 ± 1.1) points,(3.2 ± 0.9) points,(2.4 ± 1.0) points,(2.3 ± 0.8) points,respectively.In the early warning group,the preoperative VAS was (7.4 ± 1.3) points,and the VAS at 6 hours,24 hours,48 hours,72 hours after operation were (2.9 ± 0.7) points,(2.4 ± 0.7) points,(1.8 ± 0.7) points,(1.6 ± 0.8) points,respectively.There was no significant difference in preoperative VAS between the two groups (P ＞ 0.05),while significant differences were found between the postoperative VAS (P ＜ 0.01).The satisfaction score in the control group was (94.6 ± 1.4) points,while that of the early warning group was (98.3 ± 1.1) points (P ＜ 0.01).Conclusion For patients undergoing posterior thoracolumbar pedicle screw fixation and intervertebral bone graft fusion surgery,the pressure ulcer risk warning system is convenient and reduces the incidence of pressure ulcer,thus alleviating patients'pain and improving patients' satisfaction.
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Objective To investigate the family care needs in patients with primary hepatocellular carcinoma after transcatheter hepatic arterial chemoembolization (TACE).Methods One hundred and twenty patients of hepatocellular carcinoma with non first time of TACE were selected from August 2013 to June 2014 by convenience sampling method.Using a self designed questionnaire form,investigated patients' families care after discharge needs,including psychological demand,nursing requirements and other requirements.The independent factors affecting families psychological needs were analyzed by multi-factor analysis of variance.Results Patients' families care needs in dimensions,psychological demand was the highest score for (3.12±0.81) scores.Care requirements and other requirements were (3.04±0.56),(2.18±0.36) scores,respectively.Each demand entries,understand pain processing requirements was the highest score for (3.78 ±1.02) scores,hospice and funeral support was the lowest for (1.27±0.38) scores.Education degree,and patient relationship were independent factors affecting patients' families psychological demand,P＜0.05.Conclusions TACE reduces quality of life of patients,the role of families in the care of patients is also important.Care needs of families after TACE,the psychological demand should be satisfied first,required at the same time attention to relevant nursing requirements and other requirements;while education from families and relationships with patients are independent factors affecting the psychological needs of patients' family members.
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ObjectiveTo summarize the experiences in surgical and endovascular treatment for isolated iliac artery aneurysm.MethodsData of 17 cases with isolated iliac artery aneurysm were reviewed and analysed retrospectivel.17 cases were examined with color Doppler ultrasounograpy preoperatively,13 cases underwent computed tomographic angiography (CTA),2 cases did digital subtraction angiography (DSA).Artificial graft interposition were performed in 10 cases with unilateral iliac artery aneurysm,endovascular repair were performed in 6 cases.One case was treated by artificial graft interposition after a failed endovascular repair. ResultsPreoperativaly correct diagnosis was established in all 17 cases,and they were cured after operation.The average operative time was (3.7 ± 1.2) h in group of surgical operation,and ( 1.4 ±0.7) h in group of endovascular treatment (P ＜0.05).The length of hospital stay was ( 16 ± 5 ) d for the group of surgical operation,and ( 9 ± 4 ) d for endovascular treatment ( P ＜ 0.05 ).The percentage of blood transfusion was 72.7％ ( 8/11) in the group of surgical operation,and 16.7％ (1/6) in the group of endovascular treatment.There were a ureteral injury and a ectopic embolism happened during the procedure.There were 2 hip claudication and 2 type Ⅰ endoleaks after operation,which subsided after 3 months.ConclusionsArtificial graft interposition or endovascular repair is effective treatment for isolated iliac artery aneurysm which has the advantage of minimally invasiveness and rapid recovery.
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Objective To summarize our experience in management of infected femoral artery pseudoaneurysm caused by addictive drugs injection.Methods Clinical data of 45 cases of infeted femoral artery pseudoaneursysm were reviewed retrospectively.When infected femoral artery pseudoaneurysm was diagnosed,the femoral artery or external iliac artery was ligated and the pseudoaneurysm was resected in all of cases.Anticoagulants and antibiotics were used after operation.Results Lower limbs were salvaged in 44 patients.The ambulation function of affected limb was fine in the short-term.One limb was amputated because of lower limb deep venous thrombosis and gangrene.Thirty-four patients(75.6%) were followed up for 3-12 months,the results were satisfactory.Conclusions Femoral artery or external iliac artery ligation is an effective procedure for management of infected femoral artery pseudoaneurysm.
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Objective To evaluate the methods,applicability and results of cndovascular therapy for Stanford type B aortic dissection.Methods The clinical data of 36 cases of Stanford type B aortic dissection were analysed retrospectively.The stent-grafts were introduced via femoral arteriotomy.Stent-grafts were implanted to blockade tears of aortic dissection under the guidance of DSA.Results In all cases,the aortic dissection tears were blockaded,true lumens were opened,and organs function was restored.There were not complications such as internal hemorrhage due to trauma or stent displacement on CTA 3 and 12 months after endovascular therapywhile 2 cases developed new tears.The caliber of the 36 true lumens was restored to near normal.Twenty-two pseudocoeloms were obliterated,while the others were reduced is size and had varying degrees of thrombosis.Conclusions Endovascular thcrapy is safe and effectivc for the patients with Stanford type B aortic dissection.Its clinical application has a favorable outlook.
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AIM:To optimize the technical parameters indica-daisy dropping pill(Flos chrysanthemi indici) through controlling the influencing factors. METHODS:To take weight variation of pills,comprehensive quality and disintegration time limited as index,the above factors were observed by orthogonal test. RESULTS:Good technological parameters of indica-daisy dropping pill were as follows PEG6000∶PEG400=54∶6 as matrix,dimethicone as refrigerant.Temperature of drug fluids of 70 ℃,internal and external diameter of dropper within 6.2 mm and 9.0 mm,proportion of drug and matrix(1∶3),30 dropping per minute.The weight variation of pills was small,type quality was good and disintegration time limited was short.The water absorbability was smaller than that of granules. CONCLUSION:The finished products are of good quality and appropriate for mass production.