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Purpose: This study aimed to investigate the effect of virtual reality (VR) technology in children after surgery for concomitant strabismus. Methods: A total of 200 children with concomitant exotropia or concomitant esotropia were randomly divided into a training group and a control group according to the single even number random method (100 cases in each group). Patients in the training group received VR intervention training within 1 week after surgery. Patients in the control group did not receive any training. Results: Six months after the surgery, the orthophoria (the far or near strabismus degree was ?8?) rate was significantly higher in the training group than in the control group (P = 0.001), while the eye position regression rate (compared to the strabismus degree within 1 week after the surgery, the amount of regression >10?) was significantly lower in the training group than in the control group (P = 0.001). Six months after the surgery, the number of children with simultaneous vision and remote stereovision was significantly higher in the training group than in the control group (P = 0.017 and 0.002, respectively). The differences in the number of patients with peripheral stereopsis, macular stereopsis, and stereopsis in macular fovea centralis at 1, 3, and 6 months after the surgery between the training and the control groups were not statistically significant (P = 0.916, 0.274, and 0.302, respectively). Conclusion: The intervention of VR technology after strabismus correction effectively improved children’s visual function and maintained their eye position
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Objective To analyze the serological markers and surgical indicators associated with biliary complications after orthotopic liver transplantation, explore their influencing factors and predictive indicators. Methods A retrospective analysis was performed for the clinical data of 101 patients who underwent orthotopic liver transplantation in Renmin Hospital of Wuhan University from January 2016 to June 2022, according to the presence or absence of biliary complication (BC) at 6 months after surgery, they were divided into BC group with 21 patients and non-BC group with 80 patients.The t -test or the Mann-Whitney U test was used for comparison of continuous data between groups, and the chi-square test was used for comparison of categorical data between groups.Univariate and multivariate Logistic regression analyses were performed, and the receiver operating characteristic (ROC) curve was used to evaluate the predictive performance of combined indicators. Results Among the 101 patients, 21(20.8%) experienced BC.The multivariate Logistic regression analysis showed that MELD score (odds ratio[ OR ]=0.134, 95% confidence interval[ CI ]: 0.031-0.590, P =0.008), SⅡ/Alb ( OR =1.415, 95% CI : 1.181-1.696, P =0.001), and plasma transfusion volume ( OR =1.001, 95% CI : 1.000-1.002, P =0.032) were independent risk factors for the development of BC in patients after liver transplantation.MELD score, SⅡ/Alb, plasma transfusion volume, MELD+SⅡ/Alb, and MELD+SⅡ/Alb+plasma transfusion volume had an area under the ROC curve of 0.712, 0.870, 0.712, 0.900, and 0.918, respectively, in predicting BC after liver transplantation. Conclusion SⅡ/Alb, plasma transfusion volume and MELD score are independent risk fators for BC after liver transplantation.The combination of three indicators has good predictive value and clinical guiding significance for BC after liver transplantation.
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ObjectiveTo investigate the dietary preference and nutritional knowledge needs of the elderly people who dined at meal service sites. MethodsUsing the form of stratified and convenience sampling method with self-designed questionnaire was used， in November 2021， to select 700 elderly people who dine at meal service sites in 7 jurisdictions in Shanghai were selected， and a self-designed questionnaire was used to investigate the basic information. Results91.64% of the elderly surveyed would eat at relatively fixed meal service sites， and the total Dietary Diversity Score （DDS9） was 3.56±1.46. 41.45% of the elderly with diseases preferred unhealthy cooking methods. Only 8.03% of the surveyed seniors said they were unwilling to accept targeted and personalized nutrition tips and reminders. Multivariate logistic regression analysis showed that the probability reaching the “understanding” level of “Food Guide Pagoda for Chinese Residents” and “Four Principles Recommended by the Core Dietary Guidelines for the Elderly” was different in the elderly with different education levels. The willingness of the elderly to expect to receive different nutrition tips and reminders was related to whether they cared about the corresponding contents. There was a statistically significant difference （P<0.05） among the elderly who were concerned about different health problems in terms of the willingness to receive different nutritional tips. There were significant differences in the proportion of elderly people with different health status for intervention （χ2=5.402， P<0.05）. ConclusionThe elderly who dine at meal service sites are highly dependent on the sites， have a low level of dietary diversification， and do not have a high degree of understanding of nutrition-related knowledge， and have a high demand for targeted nutritional interventions. Nutritional interventions for the sick elderly should be piloted through multiple channels.
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Parkinson's disease （PD） is a neurodegenerative disease that seriously endangers the health of the middle-aged and elderly people. The main clinical manifestations include motor symptoms such as bradykinesia， static tremor， and myotonia and non-motor symptoms like constipation， mental disorders， sleep disorders， and autonomic nervous dysfunction. Its etiology and pathogenesis have not been fully understood， and the clinical efficacy is not satisfactory. By searching the relevant literature in China and abroad in recent years， this paper summarized the etiology， pathogenesis， and treatment of PD in both traditional Chinese medicine （TCM） and western medicine as well as the integrated TCM and Western medicine treatment. In general， liver and kidney deficiency is recognized by domestic experts in related fields as the main pathogenesis of PD. The abnormal aggregation of α-synuclein， oxidative stress， mitochondrial dysfunction， ubiquitin-proteasome system dysfunction， neuroinflammation， autophagy， microbiota-gut-brain axis regulation， and excitatory neurotoxicity are closely related to the pathogenesis of this disease. At present， treatment based on syndrome differentiation， empirical formulae from famous doctors， single Chinese herbs， and acupuncture and moxibustion are mainly adopted for the tackling of PD in TCM. Western medicine is still dominated by drug replacement therapy， supplemented by such surgical treatments as traditional immunotherapy， neurotrophic factors， and deep brain stimulation （DBS）， rehabilitation and exercise therapy， and scientific nursing. Gene therapy has become a new technical means for the treatment of this disease in recent years. In addition， the combined therapy of TCM and Western medicine has received increasing importance. This paper reviewed the pathogenesis and treatment of PD in TCM and Western medicine， so as to provide reference for its clinical diagnosis and treatment.
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Objective To investigate whether Royal Free Hospital Nutritional Prioritizing Tool (RFH-NPT) is more suitable than Nutritional Risk Screening 2002 (NRS-2002) in nutritional risk screening for patients with liver cirrhosis, as well as the applicability of subjective global assessment (SGA) in the nutritional assessment of patients with liver cirrhosis. Methods A total of 113 patients with liver cirrhosis who were hospitalized in Renmin Hospital of Wuhan University from August 2020 to June 2021 were enrolled. RFH-NPT and NRS-2002 were used for nutritional risk screening, and SGA was used for nutritional assessment. The results of these tools were compared with the Global Leadership Initiative on Malnutrition (GLIM) criteria, and sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated for the three tools. The receiver operating characteristic (ROC) curve was plotted and the area under the ROC curve (AUC) was calculated for each screening tool, and the association between nutritional status and short-term prognosis was analyzed. The independent samples t -test or the Mann-Whitney U test was used for comparison of continuous data between two groups, and the chi-square test was used for comparison of categorical data between two groups. The Spearman correlation analysis was used to analyze the correlation of GLIM criteria with NRS2002, RFH-NPT and SGA. Results According to the GLIM criteria, 69.9% of the patients were diagnosed with malnutrition, and RFH-NPT and NRS2002 screened out that 72.6% and 51.3%, respectively, of the patients had nutritional risk, while SGA assessment showed that 57.5% of the patients had malnutrition. Compared with NRS2002, RFH-NPT had a higher degree of correlation with the GLIM criteria ( r =0.764, P < 0.001), higher sensitivity (94.9%) and NPV (87.1%), and a better predictive value (AUC=0.872, 95% confidence interval [ CI ]: 0.786-0.957). Under the GLIM criteria, SGA had good specificity (88.2%) in the diagnosis of malnutrition in patients with liver cirrhosis, with fair sensitivity (77.2%), good correlation ( r =0.607, P < 0.001), and good predictive value (AUC=0.827, 95% CI : 0.744-0.911). Based on the GLIM criteria, SGA assessment, and RFH-NPT assessment, the patients with nutritional risk or malnutrition tended to have a longer length of hospital stay ( Z= -3.301, -2.812, and -3.813, all P < 0.05) and a higher rehospitalization rate ( χ 2 =3.957, 6.922, and 6.766, all P < 0.05). Based on the GLIM criteria and NRS2002 assessment, the patients with nutritional risk or malnutrition had a significant increase in mortality rate within 3 months ( χ 2 =4.511 and 0.776, both P < 0.05). Conclusion Under the GLIM criteria, RFH-NPT is more suitable than NRS2002 for nutritional risk screening of patients with liver cirrhosis, and SGA also has good applicability in nutritional assessment of patients with liver cirrhosis. In addition, GLIM criteria, SGA, and RFH-NPT are associated with the clinical outcome of patients.
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Objective:To compare the dose distribution among CyberKnife, Tomotherapy, Edge, Triology and γ-knife in stereotactic body radiation therapy (SBRT) for pancreatic cancer.Methods:Clinical data of 10 panreatic cancer patients receiving CyberKinife treatment were retrospectively analyzed. The treatment plans were designed by five apparatuses from five centers according to the uniform requirement. All plans were transferred to MIM system for the extraction of parameters, which mainly included D min, D mean and D max of PTV, conformity index (CI), new conformity index (nCI), homogeneity index (HI), gradient index (GI), coverage, D max and dose-volume of the stomach and bowel. Results:The best CI and nCI were obtained in Triology ( P<0.001), and the worst HI was found in γ-knife ( P<0.001). The best GI was found in CyberKnife, followed by γ-knife and Tomotherapy, and Edge showed the worst GI ( P<0.001). The highest D min of PTV was found in both Edge and Triology, while lower D min of PTV was found in CyberKnife and Tomotherapy ( P<0.001). Additionally, γ-knife provided the highest D mean and D max of PTV ( P<0.001). Regarding the organs at risk, the lowest D max and D 5cm 3 of the bowel ( P<0.001), D max of the stomach ( P=0.003), D max( P=0.001), D 5cm 3 ( P<0.001) and D 10cm 3 ( P=0.005) of the duodenum, D max( P<0.001) and D 0.35cm 3 ( P<0.001) of the spinal cord were found in CyberKnife. The highest D max of the bowel was found in γ-knife. Furthermore, the highest D 5cm 3 of the duodenum was demonstrated in Edge ( P<0.001) and Tomotherapy provided the highest D max( P<0.001) and D 0.35cm 3 of the spinal cord ( P<0.001). Conclusions:All five radiotherapy apparatuses can meet the requirement of SBRT for pancreatic cancer. More rapid dose fall-off could be obtained via CyberKnife and γ-knife. Triology and Edge provide better target conformity. CyberKnife can better protect the gastrointestinal tract.
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Hepatectomy is a common surgical procedure for hepatic surgeries, and due to its high complexity, the mortality rate after hepatectomy is as high as 30%. As one of the most common postoperative complications, posthepatectomy liver failure (PHLF) directly affects the disease-free survival and overall survival of patients after hepatectomy. Although there are great improvements in liver surgeries in the past ten years, PHLF cannot be avoided due to the condition and liver reserve function of patients before surgery. Although current techniques can significantly reduce the mortality rate of PHLF and bring more opportunities to patients, how to effectively evaluate the risk of PHLF and guide prevention and treatment strategies is still a major concern of liver surgeons. This article reviews the recent research on PHLF, including the definition, risk factors, preoperative evaluation, and prevention and treatment of PHLF, so as to provide a reference for reducing PHLF and performing effective treatment.
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@#AIM:To systematically evaluate the effect of trypan blue capsule staining on corneal endothelial cells in phacoemulsification. <p>METHODS: RCTs on the use of trypan blue for capsular staining in phacoemulsification were retrieved from China Knowledge Network(CNKI), Wanfang Database, Weipu Database, SinoMed, PubMed, SpringerLink, Clinicalkey, Medline, Cochrane Library, Web of Science, OVID, Embase. The search time was from the establishment of the databases to April 2019.The Meta-analysis of the included literature was made by Revman 5.3 and R 3.7.<p>RESULTS: Eight trials included 378 eyes were selected. Meta-analysis showed that the number of corneal endothelial cell loss between 0.02%, 0.06% or 0.1% trypan blue capsule staining group(193 eyes)and non-stained or placebo staining group(185 eyes)changed without statistical significance \〖Within 1mo after operation(<i>WMD</i>=-10.47, 95% <i>CI</i>=-26.44-5.61, <i>P</i>=0.20); 1mo after operation(<i>WMD</i>=-60.72, 95% <i>CI</i>=-170.92-49.49, <i>P</i>=0.28)\〗. The percentage of corneal endothelial hexagonal cell loss at 1mo after operation changed without statistical significance(<i>WMD</i>=0.50, 95% <i>CI</i>=-2.09-3.09, <i>P</i>=0.71). The central corneal thickness(CCT)at 1mo after operation changed without statistical significance(<i>WMD</i>=3.10, 95% <i>CI</i>=-5.77-11.98, <i>P</i>=0.49). The coefficient of variation(CV)changed without statistical significance(<i>WMD</i>=-1.00, 95% <i>CI</i>=-2.86-0.86, <i>P</i>=0.29).<p>CONCLUSION: 0.02%, 0.06% or 0.1% trypan blue capsule staining in phacoemulsification have no significant effect on the number and function of corneal endothelial cells.
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@#AIM:To systematically evaluate the effect of trypan blue capsule staining on corneal endothelial cells in phacoemulsification. <p>METHODS: RCTs on the use of trypan blue for capsular staining in phacoemulsification were retrieved from China Knowledge Network(CNKI), Wanfang Database, Weipu Database, SinoMed, PubMed, SpringerLink, Clinicalkey, Medline, Cochrane Library, Web of Science, OVID, Embase. The search time was from the establishment of the databases to April 2019.The Meta-analysis of the included literature was made by Revman 5.3 and R 3.7.<p>RESULTS: Eight trials included 378 eyes were selected. Meta-analysis showed that the number of corneal endothelial cell loss between 0.02%, 0.06% or 0.1% trypan blue capsule staining group(193 eyes)and non-stained or placebo staining group(185 eyes)changed without statistical significance \〖Within 1mo after operation(<i>WMD</i>=-10.47, 95% <i>CI</i>=-26.44-5.61, <i>P</i>=0.20); 1mo after operation(<i>WMD</i>=-60.72, 95% <i>CI</i>=-170.92-49.49, <i>P</i>=0.28)\〗. The percentage of corneal endothelial hexagonal cell loss at 1mo after operation changed without statistical significance(<i>WMD</i>=0.50, 95% <i>CI</i>=-2.09-3.09, <i>P</i>=0.71). The central corneal thickness(CCT)at 1mo after operation changed without statistical significance(<i>WMD</i>=3.10, 95% <i>CI</i>=-5.77-11.98, <i>P</i>=0.49). The coefficient of variation(CV)changed without statistical significance(<i>WMD</i>=-1.00, 95% <i>CI</i>=-2.86-0.86, <i>P</i>=0.29).<p>CONCLUSION: 0.02%, 0.06% or 0.1% trypan blue capsule staining in phacoemulsification have no significant effect on the number and function of corneal endothelial cells.
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@#Objective To explore the training mode for improving the innovative scientific research ability of postgraduates of thoracic surgery. Methods Twenty-two postgraduate students enrolled in the Department of Thoracic Surgery, Ruijin Hospital from September 2016 to June 2019 were targeted for training, and the teachers were 13 doctors in our department. Training methods included grant-based learning, formative learning and translational medical learning. In addition to the postgraduate education provided by the medical school, the training content also included more than 50 lectures about thoracic surgery, including surgical video explanation, perioperative management of thoracic surgery, interpretation of clinical guidelines, and intensive reading of the literature; it also included half-year clinical internship, 100 surgical operations and management of 5 medical beds in ward. Results Clinical ability of the postgraduates were improved. Six postgraduate students enrolled in 2016 graduated successfully. They published 15 SCI papers and won more than 20 awards. Conclusion Cultivating postgraduates of thoracic surgery oriented by innovative scientific research ability is conducive to the comprehensive understanding of thoracic diseases and the ability of innovative translation research.
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Objective@#To evaluate the postoperative quality of life after surgery of patients with hepatic hemangioma.@*Methods@#The retrospective and descriptive study was conducted. The clinical data of 104 patients who underwent surgery for hepatic hemangioma at Shengjing Hospital of China Medical University from September 2011 to February 2017 were collected. There were 28 males and 76 females, aged (49±8)years, with a range of 27-78 years. Enucleation of hepatic hemangioma or hepatectomy was selected according to tumor location of patients. Observation indicators: (1) surgical and postoperative situations; (2) assessment of quality of life in patients; (3) assessment of quality of life in patients comorbid with other chronic digestive diseases. Measurement data with normal distribution were represented as Mean±SD, and measurement data with skewed distribution were represented as M (range). Repeated data were analyzed using repeated ANOVA. Count data were represented as absolute numbers.@*Results@#(1) Surgical and postoperative situations: of 104 patients, 67 underwent enucleation of hepatic hemangioma, 37 underwent hepatectomy. The tumor diameter, volume of intraoperative blood loss, duration of postoperative hospital stay were (10±4)cm, 200 mL (range, 10-3 000 mL), (11±5)days. Seven patients had complications, including 5 of massive abdominal ascites, 1 of abdominal infection, and 1 of pulmanory obstruction. There was no death occurred. (2) Assessment of quality of life in patients with hepatic hemangioma: the total scores of Gastrointestinal-related Quality of Life Index (GIQLI), the scores of subjective symptoms, physiological status, mental and psychological status, and social activities were 121.0±8.3, 69.2±4.1, 18.5±2.6, 19.5±1.8, and 13.8±1.4 at preoperation. The above indices were 121.9±6.9, 71.2±3.8, 17.2±2.5, 19.6±2.3, and 13.8±1.3 of 104 patients with hepatic hemangioma at one month after surgery, respectively. The above indices were 127.8±6.2, 73.2±3.6, 19.8±2.5, 20.8±2.4, and 14.1±1.0 at 6 months after surgery. There were significant differences in changing trends of above indices (F=68.4, 64.6, 71.4, 17.8, 3.3, P<0.05). The scores of subjective symptoms and physiological status at one month after surgery showed significant differences compared with those of preoperation (t=-5.780, 6.640, P<0.05), but the total scores of GIQLI, the scores of mental and psychological status, and social activities showed no difference (t=-1.569, -0.705, 0.240, P>0.05). The total scores of GIQLI, scores of subjective symptoms, physiological status, and mental and psychological status at 6 months after surgery showed significant differences compared with those of preoperation (t=-8.897, -9.919, -5.375, -5.024, P<0.05), but the score of social activities showed no difference(t=-1.919, P>0.05). The total scores of GIQLI, the scores of subjective symptoms, physiological status, mental and psychological status, and social activities at 6 months after surgery were significantly different from those at one month after surgery (t=-10.835, -6.787, -12.277, -4.560, -2.476, P<0.05). (3) Assessment of quality of life in hepatic hemangioma patients comorbid with other chronic digestive diseases: 29 of 104 patients were comorbid with chronic gastritis, biliary diseases, and appendicitis. For the 29 patients comorbid with other chronic digestive diseases, the total scores of GIQLI, the scores of subjective symptoms, physiological status, mental and psychological status, and social activities were 117.5±7.5, 67.8±4.2, 17.4±2.2, 19.0±1.5, and 13.2±1.3 at preoperation. The above indices were 118.7±6.9, 69.5±4.5, 16.7±2.0, 19.2±1.9, and 13.2±1.3 at one month after surgery, respectively. The above indices were 124.6±6.5, 70.9±4.5, 19.8±2.1, 19.9±2.4, and 14.0±0.9 of 29 patients comorbid with other chronic digestive diseases at 6 months after surgery. There were significant differences in changing of the total scores of GIQLI, the scores of subjective symptoms, physiological status, and social activities (F=15.0, 9.0, 27.6, 7.5, P<0.05), except the score of mental and psychological status (F=1.6, P>0.05) . The scores of subjective symptoms and physiological status at one month after surgery showed significant differences compared with those of preoperation (t=-2.612, 2.191, P<0.05), but the total scores of GIQLI, the scores of mental and psychological status, and social activities showed no difference (t=-1.128, -0.587, -0.157, P>0.05). The total scores of GIQLI, scores of subjective symptoms, physiological status, and social activities at 6 months after surgery showed significant differences compared with those of preoperation (t=-4.002, -3.441, -4.604, -3.266, P<0.05), but the score of mental and psychologica status showed no difference (t=-1.522, P>0.05). The total scores of GIQLI, the scores of subjective symptoms, physiological status, and social activities at 6 months after surgery were significantly different from those at one month after surgery (t=-4.819, -2.313, -7.081, -3.172, P<0.05), but the score of mental and psychological status had no significant difference (t=-1.154, P>0.05).@*Conclusions@#The quality of life in patients with hepatic hemangioma can be improved by surgery. Surgical treatment is still effective for improvement of the total scores of GIQLI, the scores of subjective symptoms, physiological status, and social activities for those combined with other digestive diseases.
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The prevention and treatment of posthepatectomy liver failure (PHLF) is a difficult problem for hepatectomy. PHLF is characterized by many risk factors, limited treatment methods and high mortality. There are many factors that lead to the insufficient quantity or quality of postoperative remnant liver cells, such as the comorbid conditions of patients, underlying disease of the liver, excessive liver resection and so on, which are increase the incidence of PHLF. However, the therapeutic treatment of PHLF is limited at present, the key to reduce the morbidity and mortality of PHLF lies in the accurate evaluation and screening of high-risk patients. This paper reviewed the relevant literature on the definition, risk factors and clinical prevention and treatment of posthepatectomy liver failure.
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The prevention and treatment of posthepatectomy liver failure (PHLF) is a difficult problem for hepatectomy.PHLF is characterized by many risk factors,limited treatment methods and high mortality.There are many factors that lead to the insufficient quantity or quality of postoperative remnant liver cells,such as the comorbid conditions of patients,underlying disease of the liver,excessive liver resection and so on,which are increase the incidence of PHLF.However,the therapeutic treatment of PHLF is limited at present,the key to reduce the morbidity and mortality of PHLF lies in the accurate evaluation and screening of high-risk patients.This paper reviewed the relevant literature on the definition,risk factors and clinical prevention and treatment of posthepatectomy liver failure.
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Objective To evaluate the postoperative quality of life after surgery of patients with hepatic hemangioma.Methods The retrospective and descriptive study was conducted.The clinical data of 104 patients who underwent surgery for hepatic hemangioma at Shengjing Hospital of China Medical University from September 2011 to February 2017 were collected.There were 28 males and 76 females,aged (49±8)years,with a range of 27-78 years.Enucleation of hepatic hemangioma or hepatectomy was selected according to tumor location of patients.Observation indicators:(1) surgical and postoperative situations;(2) assessment of quality of life in patients;(3)assessment of quality of life in patients comorbid with other chronic digestive diseases.Measurement data with normal distribution were represented as Mean±SD,and measurement data with skewed distribution were represented as M (range).Repeated data were analyzed using repeated ANOVA.Count data were represented as absolute numbers.Results (1) Surgical and postoperative situations:of 104 patients,67 underwent enucleation of hepatic hemangioma,37 underwent hepatectomy.The tumor diameter,volume of intraoperative blood loss,duration of postoperative hospital stay were (10±4)cm,200 mL (range,10-3 000 mL),(11±5)days.Seven patients had complications,including 5 of massive abdominal ascites,1 of abdominal infection,and 1 of pulmanory obstruction.There was no death occurred.(2) Assessment of quality of life in patients with hepatic hemangioma:the total scores of Gastrointestinal-related Quality of Life Index (GIQLI),the scores of subjective symptoms,physiological status,mental and psychological status,and social activities were 121.0±8.3,69.2±4.1,18.5±2.6,19.5± 1.8,and 13.8± 1.4 at preoperation.The above indices were 121.9±6.9,71.2±3.8,17.2±2.5,19.6±2.3,and 13.8± 1.3 of 104 patients with hepatic hemangioma at one month after surgery,respectively.The above indices were 127.8±6.2,73.2±3.6,19.8±2.5,20.8±2.4,and 14.1±1.0 at 6 months after surgery.There were significant differences in changing trends of above indices (F=68.4,64.6,71.4,17.8,3.3,P＜0.05).The scores of subjective symptoms and physiological status at one month after surgery showed significant differences compared with those of preoperation (t=-5.780,6.640,P＜0.05),but the total scores of GIQLI,the scores of mental and psychological status,and social activities showed no difference (t =-1.569,-0.705,0.240,P＞0.05).The total scores of GIQLI,scores of subjective symptoms,physiological status,and mental and psychological status at 6 months after surgery showed significant differences compared with those of preoperation (t =-8.897,-9.919,-5.375,-5.024,P＜ 0.05),but the score of social activities showed no difference(t =-1.919,P＞0.05).The total scores of GIQLI,the scores of subjective symptoms,physiological status,mental and psychological status,and social activities at 6 months after surgery were significantly different from those at one month after surgery (t =-10.835,-6.787,-12.277,-4.560,-2.476,P＜0.05).(3) Assessment of quality of life in hepatic hemangioma patients comorbid with other chronic digestive diseases:29 of 104 patients were comorbid with chronic gastritis,biliary diseases,and appendicitis.For the 29 patients comorbid with other chronic digestive diseases,the total scores of GIQLI,the scores of subjective symptoms,physiological status,mental and psychological status,and social activities were 117.5±7.5,67.8±4.2,17.4±2.2,19.0±1.5,and 13.2±1.3 at preoperation.The above indices were 118.7±6.9,69.5±4.5,16.7±2.0,19.2±1.9,and 13.2±1.3 at one month after surgery,respectively.The above indices were 124.6±6.5,70.9±4.5,19.8±2.1,19.9±2.4,and 14.0±0.9 of 29 patients comorbid with other chronic digestive diseases at 6 months after surgery.There were significant differences in changing of the total scores of GIQLI,the scores of subjective symptoms,physiological status,and social activities (F=15.0,9.0,27.6,7.5,P＜0.05),except the score of mental and psychological status (F=1.6,P＞0.05).The scores of subjective symptoms and physiological status at one month after surgery showed significant differences compared with those of preoperation (t =-2.612,2.191,P＜0.05),but the total scores of GIQLI,the scores of mental and psychological status,and social activities showed no difference (t =-1.128,-0.587,-0.157,P＞0.05).The total scores of GIQLI,scores of subjective symptoms,physiological status,and social activities at 6 months after surgery showed significant differences compared with those of preoperation (t =-4.002,-3.441,-4.604,-3.266,P＜0.05),but the score of mental and psychologica status showed no difference (t =-1.522,P ＞ 0.05).The total scores of GIQLI,the scores of subjective symptoms,physiological status,and social activities at 6 months after surgery were significantly different from those at one month after surgery (t =-4.819,-2.313,-7.081,-3.172,P＜0.05),but the score of mental and psychological status had no significant difference (t =-1.154,P＞0.05).Conclusions The quality of life in patients with hepatic hemangioma can be improved by surgery.Surgical treatment is still effective for improvement of the total scores of GIQLI,the scores of subjective symptoms,physiological status,and social activities for those combined with other digestive diseases.
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Objective To investigate the perioperative risk factors for posthepatectomy liver failure (PHLF) in patients with hepatocellular carcinoma (HCC).Methods Data of 322 cases of liver resection for HCC were retrospectively analyzed from Sep 2013 to Sep 2018.Logistic regression was used to analyze the risk factors for PHLF.The receiver operating characteristic (ROC) curve was used to analyze the predictive power of the ALBI score and the Child-Pugh score for PHLF.Results Child-Pugh score,ALBI score,intraoperative bleeding amount,ICG R15 and liver fibrosis,peritoneal effusion were independent factors affecting PHLF of HCC patients(P ＜ 0.05).ROC analysis of Child-Pugh and ALBI scores predicting PHLF showed that area under the ROC was respectively 0.621 (95％ CI:0.531-0.712) in the Child-Pugh score and 0.729 (95％ CI:0.645-0.812)in the ALBI score.The best critical value,sensitivity and specificity of PHLF that were predicted by ALBI score were-2.74,71.7％ and 71.4％,respectively.Conclusions The prognostic power of the ALBI score was greater than that of the Child-Pugh score in predicting PHLF.
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Blood stasis is mostly seen as the etiology and pathogenesis of orthopedics and traumatology diseases, among which the theory that retention of body fluid comes from blood stasis is the most classical one. Thus, it is meaningful to find out whether the mutual blockage of blood stasis and the body fluid is the key point of orthopedics and traumatology diseases. By consulting the ancient books, the significance of removing blood stasis and body fluid therapy was verified from different aspects, and removing blood stasis and body fluid therapy was proposed to be the principle of treating orthopedics and traumatology diseases.
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Objective@#To analyze the hints role of surveillance cultures of Carbapenem-resistant Enterobacteriaceae (CRE) by perianal swabs in patients with hematological diseases, and seek risk factors of CRE bloodstream infection.@*Methods@#The resistance of CRE from 2 914 patients with hematological diseases who cultured perianal swabs, CRE bloodstream infection and risk factors were analyzed during January 2016 to December 2017.@*Results@#In this study, perianal swabs from 2 914 patients with hematological diseases were cultured, 74 patients were CRE positive, and bloodstream infection with CRE was found in 13 of these patients. A total of 87 CRE strains were isolated (The same patient only keep the first one for the same location), including 31 Klebsiella pheuminiae, 43 Escherichia coli, 8 Enterobacter cloacae and 6 other Enterobacteriaceae. The resistance rates to piperacillin / tazobactam, imipenem, meropenam, amikacin, levofloxacin, tigecycline were 91.9%, 74.4%, 98.8%, 17.6%, 74.4% and 8.0%, respectively. Resistance to carbapenem, aminoglycoside, quinolones and tegacycline were highly consistent between two sites from 13 patients, whose both perianal swabs and blood were positive in CRE cultures. Febrile neutropenic time, digestive tract symptoms and perianal infection were independent risk factors for bloodstream infection in patients with perianal swabs positive results, the odds ratios (OR) were 1.10 (P=0.029), 1.13 (P=0.005) and 1.23 (P=0.016), respectively.@*Conclusion@#Perianal swabs surveillance cultures of CRE can be hints for CRE bloodstream infection in patients with hematological diseases, and also can provide suggestions for antibiotics. Long time of febrile neutropenic, digestive tract symptoms and perianal infection can be the early warning for CRE bloodstream infections.
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Objective To assess the clinical efficacy and safety of percutaneous vertebroplasty(PVP)in the treatment of breast cancer patients with vertebral metastases. Methods Retrospective analysis of 83 breast cancer patients with spinal metastases underwent PVP was conducted. The scores of visual analogue,Karnofsky performance status and mobility were evaluated 24 h before and 24 h,1 month,3 and 6 months after PVP. Re-sults All patients were successfully completed the operation with no serious complications. After PVP,all the scores were improved,with a statistically significant difference between 24 h before PVP and 24 h,1 month,3 and 6 months after PVP(P < 0.05). Conclusions PVP can significantly relieve pain and improve the quality of life for breast cancer patients with vertebral metastases.
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Objective To investigate the value of plasma neutrophil gelatinase-associated lipocalin (NGAL),cystatin C (Cys C) and the ratio of urinary N-acetyl-beta-D-glucosaminidase to creatinine (NAG/Crea) combined determination in the diagnosis of early diabetic nephropathy.Methods Collected 67 cases of patients with type 2 diabetes hospitalized in the First Affiliated Hospital of Kunming Medical University from December 2016 to February 2017.According to the value of UALB/Crea was divided into two groups:Diabetic urinary microalbumin normal group (UALB/Crea＜30 mg/gCrea) had 35 patients and early diabetic nephropathy group (namely the trace albuminuria group,UALB/Crea 30 ～ 300 mg/gCrea) had 32 patients.Other selected 20 normal volunteers as control group,compared with a medical group to gather all the staff of the clinical data,using automatic biochemical analyzer detected the plasma NGAL,Cys C and urine NAG/Crea,and adopted the receiver-operating characteristic (ROC) curve of the detection index was analyzed.Results ①Plasma NGAL,Cys C and urinary NAG/Crea of diabetic nephropathy patients was significantly higher than those of healthy control group (Z=-5.740 ～-5.386,P＜0.05).②The areaunder receiver operating characteristic (ROC) curve of plasma NGAL,Cys C and urine NAG/Crea were 0.858,0.911 and 0.714.Conclusion Plasma NGAL,Cys C and urinary NAG/Crea combined determination have a higher value for early diagnosis of diabetic nephropathy.
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Infection is an important cause of higher mortality in patients with hematological diseases than healthy people, and fever is often the only indication of the disease.Clostridium perfringens(C.perfringens)is a grampositive anaerobic bacillus of the Clostridiumgenus, it belongs to the normal flora of the intestinal tract and is not pathogenic in normal condition.However, when intestinal flora is imbalanced due to low hypoimmunity of human body or influenced by such factors as diet, medicine, environment and other factors, it can enter the blood and cause bacteremia.At present, it has never been reported that bacteremia was caused by C.perfringens in patients with malignant hematological diseases accompanied by neutropenia, this article reported the diagnosis and treatment of C. perfringens bloodstream in one patient with malignant hematopathy, so as to provide basis for diagnosis and treatment of the disease.