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Objective:To investigate the efficacy of dexmedetomidine combined with transversus abdominis plane block in laparoscopic radical resection of colorectal cancer and its effect on serum CXCL8 level.Methods:A total of 72 patients who planned to undergo laparoscopic radical resection of colorectal cancer in Changzhou Hospital of Traditional Chinese Medicine from March 2017 to March 2021 were selected as the research subjects, and they were divided into transversus abdominis plane block anesthesia group (group A) and dexmedetomidine combined with transversus abdominis plane block anesthesia group (group B) by random number table method with 36 cases in each group. The operation time, intraoperative blood loss, fluid supplementation, visual analogue score (VAS) and Ramsay sedation score at different times after operation, and serum CXCL8 level after operation were compared between the two groups of patients. The adverse reactions of the two groups of patients were compared.Results:There was no significant difference in operation time and fluid supplementation between the two groups (both P > 0.05). The VAS scores of patients in group B at 4, 8 and 24 hours after operation were lower than those in group A [(2.8±0.6) points vs. (4.2±1.2) points, (2.1±1.0) points vs. (3.4±1.1) points, (1.8±0.4) points vs. (2.5±0.7) points, all P < 0.05], and the Ramsay sedation scores of patients in group B at 4, 8 and 24 hours after operation were higher than those in group A [(4.3±1.2) points vs. (2.7±0.7) points, (3.5±1.1) points vs. (2.2±1.0) points, (2.4±0.9) points vs. (1.6±0.6) points, all P<0.05]. Serum CXCL8 levels of patients in group B at 2, 24 and 48 hours after operation were lower than those in group A [(78±16) ng/ml vs. (87±19) ng/ml, (68±14) ng/ml vs. (75±15) ng/ml, (52±10) ng/ml vs. (61±13) ng/ml, all P<0.05]. The incidence rates of adverse reactions in group A and group B were 8.3% (3/36) and 13.9% (5/36), and the difference was not statistically significant ( P > 0.05). Conclusions:Dexmedetomidine infusion during laparoscopic radical resection of colorectal cancer under general anesthesia combined with transversus abdominis plane block can help reduce postoperative pain, increase sedative effect, and reduce serum CXCL8 level.
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Objective:To observe the clinical value of hysteroscopy combined with transvaginal ultrasound in the differential diagnosis of different causes of abnormal uterine bleeding(AUB).Methods:From September 2017 to September 2019, 260 patients with AUB who were treated in Zhuji People's Hospital were selected in the study.All patients had histopathological examination results, which was the gold standard.At the same time, hysteroscopy, transvaginal ultrasound and the combined detection were performed.The diagnostic value of each test method for different etiology of AUB was compared.Results:The coincidence rate of hysteroscopy combined with transvaginal ultrasound(96.54%) in the overall identification of AUB of different causes was significantly higher than that of hysteroscopy (84.6%) and transvaginal ultrasound (70.77%) (χ 2=21.653, 63.131; P=0.000, 0.000); while the missed detection rate and misdiagnosis rate (2.69%, 0.77%) were significantly lower than those of hysteroscopy (10.38%, 5.00%) and transvaginal ultrasound (19.32%, 10.00%) (χ 2=12.588, 8.306, 36.432, 21.742; P=0.000, 0.004, 0.000, 0.000). The diagnostic sensitivity and accuracy of combined detection for organic AUB (97.00%, 96.54%) were significantly higher than those of hysteroscopy (88.41%, 87.31%) and transvaginal ultrasound alone (78.54%, 76.54%), and the diagnostic specificity of combined detection for organic AUB (92.59%) was significantly higher than that of transvaginal ultrasound (59.26%), the differences were statistically significant(χ 2=12.691, 14.919, 36.959, 44.637, 8.206; P=0.000, 0.000, 0.000, 0.000, 0.004). Conclusion:Hysteroscopy combined with transvaginal ultrasound can improve the efficiency of differential diagnosis of AUB.
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Objective@#To investigate the attitude to death, work engagement and organizational citizenship behaviors (OCB) in emergency nurses, and to analyze the relationships among them.@*Methods@#Two hundred and fifty-one emergency nurses were investigated with Chinese version of Death Attitude Profile-Revised (DAP-R), the Medical Personnels Work Engagement questionnaire and Medical Staffs, Organizational Citizenship Behavior questionnaire.@*Results@#The attitude to death in emergency nurses was relatively positive and the total score of DAP-R was 103.49±14.76.There were significant differences on the score of nursing ages, emergency working years and religious beliefs (F=4.584, 6.159, 5.251, P<0.01). The neutral acceptance to death was positively correlated with the work engagement (r=0.098, P<0.01) , the work engagement was negatively correlated with death avoidance (r=-0.177, P<0.01) .The neutral acceptance to death was positively correlated with the OCB, civic responsibility and responsible behavior (r=0.155, 0.161, 0.202, P<0.05 or 0.01).@*Conclusion@#The attitude to death has significant influence on work engagement and OCB in emergency nurses. Nursing administrators should through establishing an effective strategies to improve the positive attitude to death and OCB level. Ultimately, give full play to the role of the emergency department nurse in terminal care and quality of emergency medical care can be improved.
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Objective: To analyze the contents of flavonoids in Astragali Radix before and after sodium pyrosulfite solution soa-king, so as to provide reliable methods for scientifically evaluating and effectively controlling the quality of Astragali Radix. Methods:After sodium pyrosulfite solution soaking, the contents of calycosin glucoside, ononin, formononetin and pterostilbene were analyzed by HPLC-DAD. Results: Calycosin glucoside, ononin, formononetin and pterostilbene showed a good linear relationship within the range of 0. 048-60. 000 μg·ml-1, 0. 019-30. 000 μg·ml-1, 0. 019-40. 000 μg·ml-1and 0. 019-40. 00 0μg·ml-1, respectively. After sodium pyrosulfite solution soaking, the contents of calycosin glucoside and ononin decreased, furthermore, with the increase of sodium sulfite solution concentration and soaking time, the decrease trend was more obvious, and the differences between the high concentra-tion group and the normal group were 2-3 times. The content of formononetin was essentially the same, while the difference in pterostil-bene content between the high concentration groups and the normal group was 10 times. Conclusion: After sodium pyrosulfite solution soaking, the contents of flavonoid glycoside components are reduced, therefore, it is not advisable to use sodium pyrosulfite solution soaking to achieve keeping fresh, mothproof and prolonging the shelf life of Astragali Radix.
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Objective:To investigate the chemical constituents in the rattan of Rubia argyi L.. Methods:The air-dried rattan of Rubia argyi L. was powdered and extracted three times by 75% ethanol with refluxing. After removing the solvent under the reduced pressure,the crude extract was dissolved in water,and then filtrated and extracted by petroleum ether and ethyl acetate to obtain crude extract after removing petroleum ether and ethyl acetate. The compounds were isolated and purified by silica gel column chromatogra-phy,reversed-phase silica gel column chromatography and Sephadex LH-20 gel column chromatography,and then identified based on physicochemical properties and spectral analysis(1 H-NMR and 13C-NMR). Results:Totally 13 compounds were isolated from the rat-tan of Rubia argyi L.,and characterized as secoisolariciresinol(1),xanthopurpurin(2),daucosterol(3),dehydroabietic acid(4), 2-hydroxy-1-methoxy-anthraquinone(5),β-sitosterol(6),lirioresinol A(7),2-hydroxy-7-methyl-9,10-anthraquinone(8),strych-novoline (9), ciwujiatone (10), 3,4-divanillyltetrahydrofuran (11), 2-(4-hydroxypheny) -6-(3-methoxy-4-hydroxyphenyl)-3,7-dioxabicyclo[3,3,0]octane (12), and (6S,9R)-vomifoliol (13).Conclusion: The compounds 1-13 are isolated from the rattan of Rubia argyi L. for the first time and the compounds 1,2,4,5 and 7-13 are first isolated from Rubia L..
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Objective To investigate the analgesic effect of different concentrations of medetomidine and ropivacaine on knee arthroscopy in elderly patients in the orthopedics department. Methods 72 patients were di-vided into 4 groups,and from February 2016-September 2017 ,different concentrations of dexmedetomidin and ropivacaine were given to the patients after the operation,and compared the analgesic effects and adverse reactions of each group. Results The duration of analgesia in groups C and D were longer than group A and B and there were significant differences in the amount of fentanyl in the 4 groups after 24 h(F = 79.633,P < 0.05 )and there was no significant difference in the incidence of adverse reactions between the 4 groups(P > 0.05);1,3,6, 10,16,24 h after operation,The VAS scores in group C and D were significantly lower than those in group A and B(P < 0.05 ). Conclusion Dexmedetomidine plus ropivacaine can effectively improve the analgesic effect after knee arthroscopy,0.50 g/kg was the best concentration of dexmedetomidin.
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Objective To explore the feasibility and efficacy of transcatheter closure of ventricular septal defect (VSD) through radial artery combined femoral vein approach. Methods A total of 11 patients with congenital VSD, who were admitted to authors' hospital during the period from June 2017 to November2017, were enrolled in this study. The patterns of lesion included intracristal type (n=3) and perimembranous type (n=8), and in 3 patients the VSD was associated with concant ventricular septal aneurysm. Transcatheter closure of VSD via radial approach was carried out in all patients. The mean age of the patients was (37.82±12.44) years old, and the average body weight was (62.79±14.95) kg. The transthoracic echocardiography (TTE) showed that the mean diameter of VSD was (5.87±1.91)mm. The effect of transcatheter closure therapy was assessed by intraoperative TTE and left ventriculography. All patients were followed up with electrocardiogram and TTE at 24 hours and one, 3, 6 months after transcatheter closure therapy. Results Successful closure was achieved in 10 patients, and one patient had to be transferred to surgery because the catheter could not pass through the defect. The mean diameter of the implanted occluders was (7.50±3.60)mm, the average procedural time and fluoroscopy time were (47.20±5.45) min and (13.00±3.65) min respectively. The postoperative average in-bed time was (99.00±11.97) min. Two patients developed radial artery spasm during the operation. During the follow-up period lasting for a mean of (3.50±1.90) months, no serious complications, such as dropping of occluder, residual shunt, atrioventricular block, aortic regurgitation, radial artery occlusion, etc. occurred in the 10 patients. Conclusion For the treatment of VSD, transcatheter closure through radial artery combined with femoral vein approach is safe and effective. Therefore, this technique is worthy of clinical application.
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Objective To analyze the role of telehealth?based dialysis registration systems in real?time and dynamic reflection of renal anemia in hemodialysis (HD) patients, and discuss the prospect of its application in dialysis registration management. Methods The Red China project was to build up a dialysis registration system based on the WeChat mobile terminal platform. Demographic and baseline laboratory parameters such as age, gender, primary disease, dialysis age, creatinine were recorded in this system. Hemoglobin (Hb) level was monthly recorded. The platform generated Hb statistics report for each HD center monthly, including the detection rate, target rate and the distribution level of Hb, and released it to physicians through the WeChat terminal of mobile phone. After that, physicians could change the treatment of anemia individually on basis of this report. Here the demographic and baseline laboratory parameters, the detection rate, target rate, the average level and the distribution of Hb from June 2015 to October 2017 after the project launched were analyzed. Results From June 2015 to October 2017, 8392 maintenance HD patients from 28 HD centers in Shanghai were enrolled, of whom 5059(60.3％) were male.The average rate age was (60.5 ± 13.7) years old. Baseline average Hb was (108.3±16.0) g/L. Baseline detection rate and target rate were 54.2％and 47.5％, respectively. After 28 months follow?up, the detection rate of Hb increased from 54.2％ to 73.6％ (P<0.001), the target rate of Hb increased from 47.5％ to 56.1％ (P<0.001), and the level of average Hb rose from (108.3±16.0) g/L to (110.7±16.0) g/L. The difference between average Hb in two consecutive months was less than 1.3 g/L. Conclusions The telehealth?based dialysis registration system can timely report the anemia situation of HD patients, which may improve the awareness rate of anemia, the degree of attention and the compliance of anemia monitoring, so as to improve the detection rate and target rate of Hb and reduce the fluctuation of Hb, which helps to maintain the HD patients to correct anemia in a timely, stable and long?term way. The telehealth?based dialysis registration system, as an improved mode of dialysis registration is a promising way for long?term management of renal anemia in dialysis patients.
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Objective:To establish the fingerprint analysis method for the root of Rosa laevigata Michx from different regions by UPLC. Methods:The column was ACQUITY UPLC? Phenyl(2.1 mm × 100 mm,1.7 μm). The mobile phase consisted of methanol-water with gradient elution. The flow rate was 0. 2 ml·min-1 , the detection wavelength was 210 nm, the column temperature was 30℃, and the injection volume was 3 μl. Results:The fingerprint consisted of 15 common peaks. The range of similarity for twelve bat-ches of the root of R. laevigata Michx was 0. 489-0. 942. And the reference fingerprint of the root of R. laevigata Michx was estab-lished by UPLC. Conclusion:The fingerprint method is simple and reproducible, which can provide basis for the quality control and the medicinal resources exploration.
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Objective To explore the effects of prostaglandin E1 (PGE1) on the expression of Apaf-1 and TLR4 in rats with cerebral ischemia-reperfusion(CIR) injury.Methods 32 healthy adult male Wistar rats were randomly divided into four groups,which were sham operated group (n=8),CIR model group (n=8) and PGE1 pretreated groups (low dose,12 μg · kg-1;high dose,24 μg · kg-1,n =8).Rat model of cerebral ischemia/reperfusion was established by bilateral common carotid artery ligation.The expression of Apaf-1 and TLR4 was detected with immunohistochemical staining method in hippocampus and epencephalon.Results After 20 min of ischemia and reperfusion for 24 h,compared with sham operated group (Apaf-1:hippocampus (0.87±0.78),epencephalon (0.67 ±0.43);TLR4:hippocampus (2.43 ± 1.17),epencephalon (1.97± 1.033)),the number of positive cells of Apaf-1 (hippocampus (11.83± 2.26);epencephalon(5.80±1.30) and TLR4 (hippocampus(16.90±2.86);epencephalon(12.90±2.66)) was increased in CIR model group (P＜0.05).Compared with CIR model group,the positive cell numbers of Apaf-1 (hippocampus:low dose(9.83±2.12),high dose(5.50± 1.17);epencephalon:low dose(4.87± 1.38),high dose(2.73±1.172)) and TLR4 (hippocampus:low dose (11.53± 2.40),high dose (9.13 ± 2.54);epencephalon:low dose (9.07 ± 2.07),high dose (4.47 ± 1.68)) were reduced dose-dependently in PGE 1 pretreatment all group (all P ＜0.05).Conclusion PGE1 can inhibit the expression of Apaf-1 and TLR4 in hippocampus and epencephalon of rat with cerebral ischemia-reperfusion injury.
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Objective To investigate the current status and influencing factors of work engagement in emergency nurses, put forward a feasible strategy, improve the emergency department nurses work engagement for the emergency department to build effective human resource management to provide the reference. Methods A total 226 emergency nurses from 8 hospital of first-class in Tianjin city were recruited by the convenience sampling method and investigated with a self designed, the Medical Personnel′s Work Engagement Questionnaire. Results The total score of Medical Personnel′s Work Engagement Questionnaire was 111-166(137.32 ± 12.48) points and the scores were the highest in interpersonal concordance (4.20 ± 0.46) points and the lowest in work vigor (3.01 ± 0.61) points. Variance analysis and multiple linear regression analysis showed that gender, employment category and number of years as an emergency nurses were the influencing factors of work engagement, which could explain 51.3%of the variance. Conclusions Work engagement emergency of nurses is at a relatively moderate-to-high level, through establishing an effective incentive mechanism, increasing social benefits, accelerating the construction of emergency specialist nurse training system and paying attention to occupational development, work engagement level and quality of emergency medical care can be improved.
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OBJECTIVE To study the protective effect of Orychophragmus violaceus(OV)seed against acute hepatotoxicity induced by the traditional Chinese Medicine Cortex Dictamni in mice. METHODS Twenty-five mice were randomly divided into 5 groups:control group,Cortex Dictamni group(70 g · kg-1)and OV seed groups(36,54 and 72 g · kg-1). OV Seed groups were orally adminis?tered with the aqueous extract of OV seed for 4 consecutive days while the other groups were ig given water. On the 4th day,Cortex Dictamni group and OV seed groups were ig given the aqueous extract of Cortex Dictamni,and normal control group was ig given water. Twenty-four hours later,all the mice had their blood and liver samples taken after anesthesia. The serum chemical parameters were measured, including glutamic oxaloacetic transaminase (GOT),glutamate pyruvate transaminase (GPT) and lactate dehydrogenase(LDH),as well as malondialdehyde(MDA),glutathione(GSH)and oxidized glutathione(GSSG)levels in the liver. GSH/GSSG ratio was calculated. Histopathologic changes in the liver were observed and the area was calculated after HE staining. RESULTS Compared with normal control group,Cortex Dictamni(70 g · kg-1)increased the serum GOT,GPT and LDH levels by 500, 140 and 40 fold(P<0.01). OV seed reduced serum GOT,GPT and LDH levels increased by Cortex Dictamni(P<0.05,P<0.01),by as much as 62%,75% and 99% for GPT,70%,82% and 98% for GOT,and 55%,75%and 96%for LDH,respectively. The level of MDA and the ratio of GSH/GSSG in Cortex Dictamni group were 1.39 ± 0.58 and(3.53 ± 1.27)μmol · g-1,a 10-fold increase and 40%decline compared with normal control group(P<0.01). OV seed of 72 g·kg-1 lowered the level of MDA by 22%(P<0.05),and OV seed(36,54 and 72 g · kg-1)increased the GSH/GSSG ratio by 47%,42%and 54%(P<0.05). Histopathologic results showed that OV seed alleviated the liver damage induced by Cortex Dictamni from(64.1±8.5)%to(37.5±7.1)%and (20.0±0.8)%(P<0.01). CONCLUSION OV seed can effectively protect mice from the acute hepatotoxicity induced by Cortex Dictamni.
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Objective To observe the analgesia effect of combination of continuous femoral nerve block and oral analgesics after total knee arthroplasty and the impact on early rehabilitation of knee.Methods Sixty patients scheduled for unilateral total knee arthroplasty were randomly divided into two groups.One group was the multimodal analgesia group (group M)and the other was patient controlled intravenous analgesia group (PCIA)(group Ⅰ),30 patients in each group.In group M, patients were given celecoxib (200 mg,bid)and oxycodone (10 mg,bid)two days before operation, then received continuous femoral nerve block followed by oral acetaminophen (100 mg,tid)and oxyc-odone (20 mg,bid)three days after operation.In group I,patients took no medicine before operation and only received PCIA after operation.The two groups were compared with postoperative visual ana-logue scale(VAS)scores at 6,12,24,48 h at rest,during active training and continuous passive movement,range of motion of the knee joint during active training and continuous passive movement, the first time of ambulation,length of hospital stay,range of motion of the knee joint at hospital dis-charge and the incidence of complications.Intravenous dezocine 5 mg was given when VAS score was higher than 5,which was recorded.Results Compared with group Ⅰ,the VAS scores at rest,during active and continuous passive movement at postoperative 6,12,24,48 and 72 h in group M were de-creased significantly (P <0.05).The range of motion of the knee joint during active training and con-tinuous passive movement at postoperative 24,48 and 72 h in group M was increased significantly(P<0.05).The first time of ambulation(2.5±0.8)d and length of hospital stay(9.1±2.3)d in group M were shorter significantly than the first time of ambulation (3.3 ±0.7)d and length of hospital stay (10.8±2.0)d in group I (P <0.05 ).The range of motion of the knee joint(95.6 ± 1 7.2)°in group M at hospital discharge was greater significantly than the range of motion of the knee joint (82.5± 1 5.2 )° in group I (P < 0.05 ).The incidence of nausea and vomiting (3.3%),uroschesis (6.7%)in group M was lower significantly than the incidence of nausea and vomiting (30.0%), uroschesis (26.7%)(P < 0.05 ).Additional use dezocine (3.3%)was lower significantly than additional use dezocine (40.0%)(P <0.05).Conclusion Compared to patient controlled intravenous analgesia,combination of continuous femoral nerve block and oral analgesics can effectively alleviate postoperative pain in patients undergoing total knee arthroplasty,which is beneficial to early postop-erative knee function recovery.
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Objective To evaluate the feasibility, efficacy and safety of new nano material occluder of single rivet type (left-disk with no-hub) in treating ventricular septal defect (VSD) in order to provide experimental basis for clinical application. Methods A total of 26 healthy adult dogs were selected for this study . Under thoracotomy , VSD model was established through fluoroscopically-guided percutaneous puncturing of the right ventricular free wall. The models were randomly and equally divided into the study group(n=13, using nano material VSD occluder) and the control group(n=13, using double-hub nitinol occluder). Every two dogs from each group were sacrificed each time at one, 2, and 3 months after percutaneous closure of VSD with corresponding occluder, the tissue samples were collected and sent for gross examination as well as for the optical and electronic microscopy study;the blood concentration of nickel ion was also determined. The state of endothelialization after implantation of the new type occluder was evaluated, and the complications such as residual shunt and superficial thrombus formation were recorded. The results were analyzed. Results By open chest operation with small incision and percutaneous puncturing of the right ventricular free wall, VSD model was successfully established in all 26 dogs. The success rate of the implantation of the VSD occluder in the study group was 100%, while it was 91.7% in the control group. One, 2, 3 and 6 months after the implantation, the heart specimens of 25 dogs were removed and gross examination showed that neither occluder displacement nor alloy wire fracture occurred in both groups. No thrombus formation or vegetation attached on the disk surface was observed. One month after the procedure , in the study group the bilateral disk surfaces of the occluder were covered with thin layer transparent tissue , which were proved to be composed of the fibrous tissue and endothelial cells through pathologic and electronic microscopy study. Six months after implantation, the superficial tissue of the occluder became further thickened and the occluder edge became fused with the surrounding heart tissue. Conclusion The design of the new VSD nano materials occluder, which has a left-disk with no hub, is very scientific. Compared with double-hub nitinol occluder, the new device can shorten the time of complete endothelialization and effectively occlude the VSD. Therefore, this new nano material occluder has promising prospect in clinical application.
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Objective To study the effects of permissive hypercapnia (PHC) on inflammatory factors of pulmonary tuberculosis patients with one-lung ventilation (OLV).Methods Sixty pulmonary tuberculosis patients with selective thoracic operation who were hospitalized at Hangzhou Red-cross Hospital from October 2010 to October 2013 were randomized into three groups by means of random digits table.Twenty patients were enrolled as control group whose arterial partial pressure of carbon dioxide (PaCO2) was maintained at 35-45 mmHg (1 mmHg=0.133 kPa),20 patients as lower PHC group whose PaCO2 were maintained at 50-55 mmHg,and 20 patients as higher PHC group whose PaCO2 were maintained at 56-60 mmHg.The concentrations of serum interleukin (IL)-6 and IL-8 were measured at the time when the patients were in supine position by two-lung ventilation after induction of anesthesia (T1),15 minutes (T2) and 30 minutes after OLV (T3) in lateral position,two hours (T4) and 6 hours after operation (T5).Quantitative data were analyzed by t-test.Results IL-6 at T3 time point in the three groups increased significantly compared with T1 time point (control group:[4.94± 1.60] pg/mL vs [3.32±1.34] pg/mL,t=3.47,P＜0.01; lower PHC group:[5.38±1.42] pg/mL vs [3.69±1.35] pg/mL,t=3.86,P＜0.01; higher PHC group:[5.57±± 1.34] pg/mL vs [3.50 ± 1.22] pg/mL,t=5.11,P＜0.01).IL-8 at T4 time point increased significantly compared with T1 time point (control group:[342.09±56.12] pg/mL vs [194.58 ± 30.07] pg/mL,t =10.36,P＜0.01; lower PHC group:[349.48±43.49] pg/mL vs [193.16±26.27] pg/mL,t=13.80,P＜0.01; higher PHC group:[351.55±38.13] pg/mL vs [186.02±21.08] pg/mL,t=16.99,P＜0.01).IL-6 at the T4 and T5 time points in both lower PHC group and higher PHC group decreased significantly compared with control groupatthe same time points (T4..[38.49± 9.70] and [43.41± 9.01] pg/mL vs [62.35±7.83] pg/mL,t=8.56 and 7.10,both P＜0.01; T5:[56.39±7.47] and [54.77±7.12] pg/mL vs [107.32± 13.97] pg/mL,t=-14.38 and-14.99,both P＜0.01].Conclusions The serum IL-6 and IL-8 levels in pulmonary tuberculosis patients with OLV increase after selective thoracic operation.PHC through low tidal volume could decrease the release of IL-6 and attenuate the pulmonary inflammatory injury in the tuberculosis patients with operation.
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Hepatolithiasis is a kind of mixed stone disease which mainly depends on pigment stone.However,the etiology is not clear and the pathogenesis is very complex.A lot of studies confirmed that helicobacter pylori played an important role in the occurrence and development of disease.This paper mainly expounds the problems concerning the characteristic of helicobacter pylori and its connection with hepatolithiasis, its state in the formation of hepatolithiasis.
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Objective To investigate the effects of Huaier Granule combined with TAC chemotherapy on immunologic function and prognosis in triple negative breast cancer patients after operation.Methods Ninty-two cases of Ⅰ-ⅢA stage triple negative breast cancer patients entered the study.They were randomly divided into control group and research group.Only TAC chemotherapy was affected in control group of 42 cases, while Huaier Granule combined with TAC chemotherapy was applied in research group of 50 cases.And we gave Huaier Granule to patients in the first day of chemotherapy.The changes of T cell subset, NK cell were detected in the patients respectively in the first day before therapy and after therapy.The five-year disease-free survival rate and overall survival rate were also observed in two groups.Results Compared with control group, the changes of T cell subset, NK cell had no significant differences in research group in the first day before therapy(P ＞0.05).In the first day after therapy, the level of CD4 + (38.16 ± 5.71) ％ in control group was significantly lower than that (44.67 ± 6.47) ％ in research group(P ＜ 0.05).However, the percentage of CD8 + T cells (28.68 ± 4.06) ％ in control group was markedly higher than that (22.85 ± 3.22) ％ in research group (P ＜ 0.05).The level of NK cell (15.75 ± 3.47) ％ in control group was obviously lower than that (19.46 ± 4.22) ％ in research group(P ＜ 0.05).The five-year disease-free survival rate is 28.6％ in control group, however the five-year disease-free survival rate is 42.0％ in research group, there were significant differences between two groups(P ＜ 0.05).Furthermore, the five-year overall survival rate in research group was obviously higher than that in control group(P ＜ 0.01).Conclusions Huaier Granule combined with TAC chemotherapy not only enhances immune function but also improves prognosis and quality of life in triple negative breast cancer patients after operation.It provides a positive exploration for anti-cancer research by integration of traditional and western medicine.
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Objective To evaluate the feasibility and safety of a delivery pathway for the performance of percutaneous left atrial appendage (LAA) occlusion in experimental canine models. Methods Transseptal puncture was performed via femoral vein approach under fluoroscopic and angiographic guidance in 12 experimental dogs. A pigtail catheter was advanced into the left atrium (LA), which was followed by LA angiography. The diameters of the neck of LAA were measured on LAA angiogram obtained in appropriate projection. After the delivery sheath was advanced along the wire into LA, a pigtail catheter was inserted into the ostium of the LAA and the sheath was then advanced over the pigtail into the LAA. LAA angiography was then performed through the delivery sheath to confirm the position of the delivery sheath. One hour after the procedure both electrocardiography (ECG) and transthoracic echocardiography (TTE) were carried out in five dogs to check the results, immediately after which the five dogs were sacrificed to macroscopically observe the damages of the puncture site of inter-atrial septum as well as inside the LA and LAA. One hour and 2 weeks after the procedure TTE was conducted in the remaining 7 dogs and these dogs were followed up for one month. Results One dog died of pericardial tamponade during the operation. In 8 dogs the LAA was clearly displayed in the projection position of right anterior oblique (RAO) 30°/cranial (CRA) 20°,while in 3 dogs the LAA was well visualized in the projection position of RAO 30° , and in one dog in the projection position of RAO 30°/caudal (CAU) 20°. The diameter of LAA neck was (13.6 ± 5.2) mm. The delivery sheath was safely advanced into the LAA along the pigtail catheter in all dogs, and no air embolism, thrombus or pericardial tamponade occurred. Hematoma at puncture point of groin occurred in 2 dogs, which was absorbed through pressure dressing. Macroscopic examination of the heart performed immediately after the operation showed that no bloody pericardial effusion was found, and mild hematoma at posterior wall of LA was seen in one dog and mild damage of the upper-margin intima of LAA was noted in 2 dogs. The mean fluoroscopy time was (10.1 ± 2.5) minutes and the mean operation time was (58 ± 12) minutes. TEE showed no pericardial effusion 2 weeks after the procedure. During the follow-up period of one month no sudden death, stroke or infection occurred. Conclusion This method of placing the delivery sheath into the LAA is clinically safe and effective, and it can reliably establish a pathway to advance the LAA occluder into LAA.
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Objective To discuss the clinical efficacy and safety of improved wire- maintaining technique in performing transcatheter closure of ventricular septal defects. Methods During the period from June 2011 to June 2013 at Changhai Hospital, percutaneous transcatheter closure of ventricular septal defect with improved wire-maintaining technique was carried out in 62 patients. According to the manipulation used , the patients were divided into traditional wire-maintaining technique group (group A, n = 30) and improved wire- maintaining technique group (group B, n = 32). The use of occluder during the procedure, the fluoroscopy time, the operation time and the complications were recorded. Follow-up examinations with ECG, echocardiogram and chest radiograph were performed at 24 hours and at 1 , 3 and 6 months after the procedure. The results were analyzed. Results No statistically significant differences in the use of occluder and in the incidence of complications existed between the two groups (P > 0.05). No severe complications occurred in both groups. The fluoroscopy time and the operation time in group A were (11.96 ± 3.63) min and (53.43 ± 14.48) min respectively, while the fluoroscopy time and the operation time in group B were (9.37 ± 2.77) min and (45.34 ± 10.38) min respectively, and the differences between the two groups were statistically significant (P < 0.05). Conclusion In performing transcatheter closure of ventricular septal defects, the practice.
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Objective To observe the analgesic effect of ultrasound-guided and nerve stimulator after artificial total knee athroplasty(TKA).Methods Forty elective cases receiving TKA under gen-eral anesthesia were randomly allocated into the ultrasound group (group C)and stimulator group (group S).The time for nerve block,onset time and complications were recorded in both groups. Results Compared to group S,the time for nerve block and onset time was significantly shortened in group C (P <0.05).There was no statistical difference in times of pressing analgesic pump and VAS score in postoperative 48 h.One patient suffered from nerve injury and two underwent vascular dam-age and hematoma in group S,while no complication was found in group C.Conclusion Compared to nerve stimulator,ultrasound-guided continuous femoral nerve block(CFNB)may reduce nerve block time and onset time and decrease complications,so that to increase safety of CFNB.