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Objective: To compare the efficacies between open surgery and axillary non-inflatable endoscopic surgery in papillary thyroid carcinoma (PTC). Methods: A retrospective analysis was performed on 343 patients with unilateral PTC treated by traditional open surgery (201 cases) and transaxillary non-inflating endoscopic surgery (142 cases) from May 2019 to December 2021 in the Head and Neck Surgery of Sichuan Cancer Hospital. Among them, 97 were males and 246 were females, aged 20-69 years. 1∶1 propensity score matching (PSM) was performed on the enrolled patients, and the basic characteristics, perioperative clinical outcomes, postoperative complications, postoperative quality of life (Thyroid Cancer-Specific Quality of Life), aesthetic satisfaction and other aspects of the two groups were compared after successful matching. SPSS 26.0 software was used for statistical analysis. Results: A total of 190 patients were enrolled after PSM, with 95 cases in open group and 95 cases in endoscopic group. Intraoperative blood losses for endoscopic and open groups were [20 (20) ml vs. 20 (10) ml, M (IQR), Z=-2.22], postoperative drainage volumes [170 (70)ml vs. 101 (55)ml, Z=-7.91], operative time [135 (35)min vs. 95 (35)min, Z=-7.34], hospitalization cost [(28 188.7±2 765.1)yuan vs. (25 643.5±2 610.7)yuan, x¯±s, t=0.73], postoperative hospitalization time [(3.1±0.9)days vs. (2.6±0.9)days, t=-3.24], and drainage tube placement time [(2.5±0.8) days vs. (2.0±1.0)days, t=-4.16], with statistically significant differrences (all P<0.05). There was no significant difference in surgical complications (P>0.05). There were significant diffferences between two groups in the postoperative quality of life scores in neuromuscular, psychological, scar and cold sensation (all P<0.05), while there were no statistically significant differences in other quality of life scores (all P>0.05). In terms of aesthetic satisfaction 6 months after surgery, the endoscopic group was better than the open group, with statistically significant difference (χ2=41.47, P<0.05). Conclusion: Endoscopic thyroidectomy by a gasless unilateral axillary approach is a safe and reliable surgical method, which has remarkable cosmetic effect and can improve the postoperative quality of life of patients compared with the traditional thyroidectomy.
Subject(s)
Male , Female , Humans , Thyroid Cancer, Papillary/surgery , Retrospective Studies , Quality of Life , Thyroid Neoplasms/pathology , Endoscopy , Thyroidectomy/methodsABSTRACT
[Objective]To analyze the advantages of transparent cap assisted endoscopy in the diagnosis and treatment of duode-nal diseases.[Methods]From September 2014 to December 2015,62 cases with suspicious duodenal diseases in the endoscopy cen-ter of our hospital randomly divided into transparent cap group(n=31)and routine group(n=31)according to the time sequence. The visual field resolution,success rate of image capture and operating time were compared in 2 groups.[Results]Thirty cases in transparent cap group had clear visual field definition ,which was obviously higher than 9 cases in conventional group (96.8% vs 29%,P < 0.001). Twenty-three cases in transparent cap group and 8 cases in routine group were successfully captured(90.3% vs 25.8%,P < 0.001). The average operating time of the transparent cap group was significantly shorter than that of the conventional group(150+58 vs 95+36 seconds,P=0.004).[Conclusion]Transparent cap endoscope examination is more effective in the treat-ment of duodenal diseases,and the image capture is higher and the operation time is shorter.
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Objective To explore patients' recognition and demand for enhanced-CT examination-related knowledge. Method A self-designed questionnaire was used to investigate the recognition and demands for the knowledge among 295 patients who receiving enhanced-CT examination for the first time. Results The awareness rate of enhanced-CT examination related knowledge was 19.0%~51.5%and the demand rate was 62.4%~87.1%. The routes by which the patients acquired the knowledge included lecturing by medical staff personnel, reading the handouts and watching video. Conclusions The level of patients'recognition about the enhanced-CT examination related knowledge is low, but their demands for it is high. Therefore, the medical personnel should improve patients'awareness of enhanced-CT examination related knowledge in various ways.
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Objective To explore the effects of dynamic axial compressive strain on the mRNA expression of bone formation related-genes in osteoblasts seeded in 3D silk fibroin scaffolds. Methods In the experimental group, MC3T3-E1 cells were seeded in 3D scaffolds and then subjected to dynamic axial compressive strain (at amplitude of 5% and frequency of 1 Hz, 30 min/day for 20 days), while in the control group, MC3T3-E1 cells were cultured statically without any mechanical stimulation. The gene expression of alkaline phosphatase (ALP), collagenⅠ(COL-Ⅰ), runt-related transcription factor 2 (Runx2), osterix (Osx), osteocalcin (OCN) was detected by real-time PCR. Results Under cyclic axial compressive strain, the Runx2, Osx and COLⅠmRNA levels increased by 280%, 68.9% and 79.6%, respectively, while the ALP and OC mRNA levels also up-regulated by 10.7% and 26.9%, respectively. There were significant differences in mRNA expression of osteogenesis-related genes between the experimental group and control group (P＜0.05). Conclusions Under the stimulation of cyclic axial compressive strain, the osteogenic differentiation of osteoblasts seeded in the silk fibroin scaffolds is promoted, with a significant up-regulation in the mRNA expression of COLⅠ, Runx2, Osx and OCN, which suggests that the stimulation of compressive stress at physiologic magnitude could be one of important mechanisms in promoting fracture healing. This research finding will be important for the clinic application of mechanical stimuli-mediated cell therapy for bone defection.
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Objective To study the anxiety and depression in patients with amyotrophic lateral sclerosis(ALS).Method One hundred and seventy-four ALS patients were evaluated by self-rating anxiety scale(SAS)and self-rating depression scale(SDS) to study the anxiety and depression in them.Results In 174 ALS patients,21 had anxiety(12.07%)and 65 the depression(37.36%). The scores of SAS and SDS in the ALS patients were significantly higher than the national norm(P<0.05).The depression incidence in the female patients was significantly higher than the male(P<0.05).Conclusions Anxiety and depression are more severe than those in ALS patients than those in normal people.Psychological support is important for these patients,especially for those female patients.
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ObjectiveTo study the effects of oral administration of mannitol and intramuscular injection of anisodamine in magnetic resonance enteroclysis.Methods After complete intestinal cleaning,29 patients undergoing magnetic resonance enteroclysis were orally administered with 5% oral isotonic mannitol solution 2000 mL and treated with intramuscular injection of anisodamine before the operation.The adverse reactions were observed,the image quality was inspected and the dilatation of small bowel was detected.Results All of the patients lived through the magnetic resonance enteroclysis.Two patients contracted Crohn’s disease with mild nausea consciousness.Conclusion For magnetic resonance imaging,preoperative oral administration of 2.5% oral isotonic mannitol solution and intramuscular injection of anisodamine after complete intestinal cleaning is beneficial for fully expanding the small intestine,achieving quality imaging and therefore improving the diagnosis of small intestinal lesions.
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Objective To analyze the clinical feasibility of unilateral transforaminal lumbar interbody fusion (TLIF) for treating lumbar degenerative diseases by finite element method. Methods Based on CT scan data, three-dimensional (3D) finite element models of the normal L3-5 segments under physiological status (intact lumbar model), L4/5 with unilateral pedicle screw fixation plus interbody fusion (unilateral TLIF model) and L4/5 with bilateral pedicle screw fixation plus interbody fusion (bilateral TLIF model) were established by using Mimics, Pro/E, ANSYS software, respectively. Preload of 500 N and load of 10 N•m torque were applied on the superior surface of the L3 segment to simulate 5 physiological activities: body upright, flexion, extension, left lateral bending and right axial rotation. The deformation and stress distributions in vertebral body, vertebral discs, pedicle screw and cage under different loads were then recorded and analyzed to compare mechanical properties of the two fixation methods. Results The deformation of L3-5 segments fixed with unilateral TLIF or bilateral TLIF decreased as compared to the intact lumbar model; the stresses in cage reached the maximum in both unilateral TLIF model and bilateral TLIF model during back extension, meanwhile peak stresses on pedicle screws in unilateral TLIF were significantly higher than those on bilateral TILF model, with the peak stress of 463.39 MPa during back extension. ConclusionsUnilateral TLIF can be selected as a method for treating lumbar degenerative diseases; however, its stability was inferior to bilateral TLIF due to the higher peak stress. Therefore, less stretch exercises may be safe for patients during rehabilitation to avoid surgery failure or pedicle screw fracture.
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@#ObjectiveTo investigate the human resources arrangement of rehabilitation wards in general hospital.MethodsAll works of the nurses in a rehabilitation ward within 7 days were recorded with data of average man hour of Taiwan's Hospital as the standards, the daily working hours of the related number of the nurses were calculated correctly on the missing items.Resultsthe ratio of beds to nurses was 1∶0.45, the work consumed the longest time was transfusion, others followed were medical observation, distribution of medicines, prevention of bedsore, change of bed sheets and health education and so on.ConclusionThe number of hours of rehabilitation care is to be increased; it will be more reasonable to arrange rehabilitation care training in the evenings.
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@#ObjectiveTo investigate the human resources arrangement of rehabilitation wards in general hospital.MethodsAll works of the nurses in a rehabilitation ward within 7 days were recorded with data of average man hour of Taiwan's Hospital as the standards, the daily working hours of the related number of the nurses were calculated correctly on the missing items.Resultsthe ratio of beds to nurses was 1∶0.45, the work consumed the longest time was transfusion, others followed were medical observation, distribution of medicines, prevention of bedsore, change of bed sheets and health education and so on.ConclusionThe number of hours of rehabilitation care is to be increased; it will be more reasonable to arrange rehabilitation care training in the evenings.
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Objective To investigate the characteristic of sequences of WLAX gene in Campylobacter jejuni(C.jejuni)strains.Methods WLAX gene and the neighbouring sequences were amplified by polymerase chain reaction(PCR).The PCR products were cloned into the vectors of plasmid.The positive recombinants were sequenced and the results were processed by software DNAstar.Results The variation frequency of WLAX sequences in GBS-related C.jejuni was higher than that in non-GBSrelated C.jejuni.The nucleotide sequences of WLAX gene in all the strains in the present study differed from that in genome sequencing strain NCTC11168.The phylogenic tree reflected the regional feature of C.jejuni.Conclusions The probability of sequence variation of WLAX in GBS-related C.jejuni is significantly higher than non-GBS-associated C.jejuni strains,the relation between the variation and GBS-pathogenesis remains to be further confirmed.
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Objective: To establish a multiplex PCR-microarray method for detecting important enteropahogens.Methods: Uniplex and multiplex PCR were performed to obtain the best primer sets for identifying the target bacteria at species and multi-species level.Fluorescent dyes were mixed into PCR reaction to determine whether it can affect the efficiency of amplification.To improve the efficiency of microarray,a 35 pairs primer-labeling system was optimized based on the hybridization results to find the best combination to avoid false negative results.Results: Specific PCR products were all obtained using species-specific primer sets.More preferential amplification may happen when more primer pairs were added to the reaction.The hybridization results showed a positive association between the efficiency of multiplex-PCR and signal intensity.Conventional PCR yielded more products than fluorescent dyes labeled PCR.Thirty-five primers were divided into three different combinations to label target respectively,hybridization results showed a high specificity.Conclusion: Mixing fluorescent dyes into PCR may reduce the efficiency of amplification and hybridization,but may have no effect on the analysis of hybridization results.The hybridization efficiency of microarray depends on the amplification efficiency of multiplex PCR.For microarray target labeling,three primer sets could be used to avoid negative hybridization led by preferential amplification of multiplex-PCR.It indicates that the multiplex PCR-microarray method is an attractive diagnosis tool for the high-throughput identification of enteropathogenic organisms especially for multiple causative agents and epidemiological investigations.
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<p><b>OBJECTIVE</b>To Investigate the differences of sorbitol fermentation related genes and optimize molecular analysis method for distinguishing an epidemic with nonepidemic strains of Vibrio cholerae.</p><p><b>METHODS</b>Sequence analysis on four genes of sugar fermentation stimulation protein, periplasmic maltose-binding protein, periplasmic phosphate-binding protein and periplasmic amino acid-binding protein.</p><p><b>RESULTS</b>In this study, the following data was noticed: for O1 serogroup El Tor biotype V. cholerae, twenty-four epidemic and eight nonepidemic strains were chosen; For O139 serogroup V. cholerae, five epidemic and four nonepidemic strains were chosen. With those genes of sugar fermentation stimulation protein, there were three point mutations. The 106th, 150th, 378th oligonucleotide in epidemic strains were A, A and T, comparing to the nonepidemic strains which were G, G and C. When comparing the protein sequences, epidemic strains had a Threonine at 36th amino acid, whereas nonepidemic strains had an Alanine. The results in O139 serogroup were consistent with those in O1 serogroup El Tor biotype strains. Another two point mutations were found in the genes of periplasmic maltose-binding protein. The 999th, 1003rd oligonucleotides in epidemic strains were A and C, while in nonepidemic which were G and T. For the gene of periplasmic amino acid-binding protein, two point mutations were noticed. The 504th and 690th oligonucleotides in epidemic strains were T and C, but were C and T in nonepidemic. However, no amino acid differences were found in periplasmic maltose-binding protein and periplasmic amino acid-binding protein. For periplasmic amino acid-binding protein gene, there was no difference on oligonucleotide between epidemic and nonepidemic strains.</p><p><b>CONCLUSION</b>Results suggested that SNPs in these genes might serve as a useful tool to distinguish the epidemic strains from nonepidemic strains. The 36th amino acid mutation of sugar fermentation stimulation protein in epidemic and nonepidemic strains might change the activity of the protein which might be associated with sorbitol fermentation.</p>