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Objective:To compare the clinicopathological features of patients with false negative and true negative pathological biopsy of sentinel lymph nodes in endometrial cancer, and to explore the related factors of missed diagnosis of sentinel lymph nodes.Methods:From January 2020 to January 2022, 31 patients underwent sentinel lymph node biopsy combined with systematic lymph node resection in the First Affiliated Hospital of Shandong First Medical University were retrospectively analyzed, of which 2 were false negative and 29 were true negative. PubMed literature on sentinel lymph node false negative of endometrial cancer was searched from the establishment of the database to December 2022, with the search terms "Sentinel lymph node" "Endometrial neoplasms" and "False negative" . A total of 15 cases of false negative patients with similar methods to this study were extracted. In the false negative group, there were 17 false negative patients with sentinel lymph node negative but systemically excised lymph node positive, including 2 cases in our hospital and 15 cases in the literature. The true negative group included 29 true negative patients with negative sentinel and systemic lymph nodes, all from our hospital. The clinicopathologic features of the two groups were compared.Results:There were statistically significant differences in tumor grade ( χ2=6.09, P=0.014) , lymph vascular space invasion ( P=0.012) and myometrial invasion ( χ2=9.66, P=0.002) between the two groups. However, there was no significant difference in histological type between the two groups ( χ2=0.19, P=0.661) . Conclusion:There is a risk of false negative for sentinel lymph node biopsy in patients with endometrial carcinoma with high-grade tumor, myometrial invasion ≥1/2 and lymph vascular space invasion.
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Objective:To explore the effect of Dachengqi Decoction on the postoperative recovery of laparoscopic gastrectomy under general anesthesia.Methods:From March 2015 to May 2018, 96 patients with gastric cancer undergoing laparoscopic gastrectomy under general anesthesia in our hospital were selected as the study objects and divided into two groups according to the random number table method. The control group received routine nursing. The observation group received the intervention of Dachengqi Decoction with ultrasonic conductivity on the basis of the control group. The recovery of gastrointestinal function, the levels of gas (serum gastrin), MTL (plasma motilin) and Quality of Recovery 40 (QoR40) were compared between the two groups.Results:The gastrointestinal function indexes of the observation group were better than those of the control group ( P<0.05). Compared with one day before operation, the levels of gas and MTL in the two groups were lower 24 hours after operation, but the levels of GAS and MTL in the observation group were (92.56±5.12), (258.58±5.59) ng/L, which were higher than (52.12±3.15), (185.63±4.12) ng/L in the control group ( t values were 46.608, 72.782, P<0.01). Compared with the pre intervention group, QoR40 scores of the two groups were improved after intervention, and the observation group was (198.56±5.58) points, which was higher than (152.12±2.63) points of the control group ( t value was 52.157, P<0.01). Conclusion:Dachengqi Decoction can promote the recovery of patients after laparoscopic gastrectomy under general anesthesia.
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Objective@#To observe the effects of general anesthesia and intravertebral anesthesia on the patients' temperature, perfusion index(PI) and coagulation function.@*Methods@#From January 2016 to December 2017, 60 patients in the First Hospital of Jiaxing undergoing elective line of great saphenous varicose veins surgery were selected.According to the random number table, the patients were divided into the general anesthesia group(group G, n=30) and intraspinal anesthesia group(group I, n=30). The general condition, operation time, the core temperature(tympanic membrane temperature) before anesthesia(T0), 10 min after anesthesia(T1), 20 min later(T2), 30 min later(T3), and the PI with no-infusion upper limb were recorded.The changes of coagulation function before anesthesia(T0) and after surgery(T4) were observed by extraction of the thrombus(TEG).@*Results@#The core body temperature of T1, T2 and T3 was significantly decreased in both two groups(FG=58.789, P=0.000, FI=2.965, P=0.035), and the hypothermia of group G was greater than that of group I(t1=-2.998, t2=-5.985, t3=-7.705; P<0.05). The PI of T1, T2 and T3 was significantly higher than T0 in both two groups(FG=5.439, P=0.002, FI=3.404 P=0.020), and the increase of group G was greater than that of group I(t1=2.065, t2=2.041, t3=2.649; P<0.05). In group G, TEG examination was significantly prolonged(F=5.482, P=0.023), and no significant changes were observed in group I.@*Conclusion@#The hypothermia of the patients and the increase of PI increased significantly, and the R time index of TEG is prolonged, and the anesthesia in the spinal canal has no obvious effect on the coagulation function.
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Objective To investigate the effect of ultrasound-guided stellate ganglion block ( SGB) on perioperative inflammatory responses and postoperative recovery of gastrointestinal function in patients un-dergoing gastrointestinal surgery. Methods Fifty-five American Society of Anesthesiologists physical classⅠ-Ⅲpatients of both sexes, aged 18-64 yr, weighing 50-75 kg, undergoing elective gastrointestinal sur-gery, were divided into SGB group ( n=18) and control group ( C group, n=37) using a random number table method. Ultrasound-guided SGB was conducted with 0. 5％ ropivocaine 7 ml at the left C6 level in SGB group. The equal volume of normal saline was given under ultrasound guidance at the same site in C group. Peripheral venous blood samples were collected at 5 min before SGB and 2, 4 and 24 h after SGB for deter-mination of plasma tumor necrosis factor-α ( TNF-α) , interleukin ( IL)-1β and IL-6 concentrations by en-zyme-linked immunosorbent assay. The increased level of leukocyte count ( leukocyte count at 24 h after SGB-leukocyte count at 24 h before SGB) was recorded. The recovery time of bowel sounds and anal or sto-ma exhaust time were also recorded. Results Compared with C group, the concentrations of TNF-αat 2 h after SGB and IL-1βat 2, 4 and 24 h after SGB were significantly decreased, the increased level of leuko-cyte count was decreased, and the recovery time of bowel sounds and anal or stoma exhaust time were short-ened in SGB group ( P<0. 05) . Conclusion Ultrasound-guided SGB can reduce perioperative inflammato-ry responses and promote the recovery of postoperative gastrointestinal function in the patients undergoing gastrointestinal surgery.
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Objective:To investigate the effects of different doses of rosuvastatin on lipid levels in elderly patients with CHD complicated with hyperlipidemia.Methods:120 elderly patients with coronary heart disease admitted in our hospital were retrospectively chosen.By lipid examination,they were all hyperlipidemia.According to the dose of rosuvastatin,they were divided into three groups,and 40 cases in each group.They were given 5 mg,10 mg and 20 mg treatment,respectively.After 2 months,the changes of blood lipid level and the clinical effective rate were compared before and after the treatment.Results:①The blood lipid levels HDL-C [(1.17 ± 0.62) mmol / L] was significantly higher than the other two groups.LDL-C [(3.67 ± 0.83) mmol / L],TC [(4.36 ± 0.96) mmol / L] and TG [(1.68 ± 0.94) mmol / L] were significantly lower than those of the other two groups (P ＜0.05).②The effective rate of treatment in the 20mg group (97.5％) was significantly higher than that in the 5mg group (87.5％) and the 10mg group(85.0％).Conclusions:Rosuvastatin can treat coronary heart disease complicated with hyperlipidemia in elderly patients.The dosage of 20 mg can improve the blood lipid level of the patients,is an effective and convenient method,and with high therapeutic efficiency.
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Objective To research the effect of letrozole combined with clomiphene on women with polycystic ovary induced infertility and the effect on matrix metalloproteinases-9(MMP-9),vascular endothelial growth factor(VEGF)and hepatocyte growth factor(HGF)levels.Methods 108 patients with polycystic ovary syndrome combined with infertility from February 2013 to August 2015 in our hospitolwere divided into control group and experimental group by lottery,54 cases in each groups,control group treated with clomiphene,the experimental group based on control group treatment with letrozole,the linical curative effect,MMP-9,VEGF and HGF level,sex hormones,insulin resistance index,adverse drug reactions of two groups were compared.Results The number of ovulation,advantage of ovulation number,normal rate of menstruation,ovulation rate and pregnancy ratesofin experimental group was higherthan the control group,the difference was statistically significant(P<0.05).The MMP-9,VEGF and HGF levels of experimental group was lower than the control group,the difference was statistically significant(P<0.05).The sex hormone level of experimental group was better than that of control group(P<0.05).The adverse reactions was no differences between the two groups.Conclusion The efficacy of letrozole combined with clomiphene in treatment of polycystic induced infertility,can inhibits MMP-9,VEGF and HGF expression,and with high safety.
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Objective To observe the effect of cervical plexus block combined with cervical vertebra traction treatment of cervical spondylosis of nerve root type .Methods 60 cases of nerve root type cervical spondylosis were divided into two groups by coin tossing:group A(n=32) cervical plexus block combined with cervical traction thera-py, group B( n=28) treated by cervical traction therapy ,according to the severity of pain compared two groups of treatment effect.Results after treatment,20d group 10d,30d,90d pain scores were (4.61 ±0.70)%,(3.71 ± 0.57)%,(3.30 ±0.65)%,(4.44 ±1.04)%,group B respectively (5.88 ±1.47)%,(5.61 ±1.35)%,(4.83 ± 0.86)%,(5.50 ±0.87)%,the difference between two groups was statistically significant (t=5.85,1.06,1.30, 7.51,all P<0.01).Conclusion The cervical plexus block combined with cervical traction for treatment of nerve root type of cervical spondylosis is better than the routine treatment of cervical traction ,which is suitable for promotion of primary health care units .
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A total of 17 cases with pelvic limb hyperhidrosis were selected for lumbar sympathetic nerve modulation.The puncture of lumbar sympathetic nerve was guided by computed tomography (CT) through the gap of L2-3 until the needle tip reached the lateral of the second or third lumbar vertebra body and outside of psoas major.A mixture of 1％ lidocaine 3 ml and 30％ Iohexol injection 0.3 ml was injected.If the diffusion of lidocaine was observed between lumbar vertebra body and psoas major.After 15 min,5 ml of absolute alcohol was injected to modulate the lumbar sympathetic nerve.After 5 min,oximetry-derived perfusion index of toe and sole temperature increased (5.9 ± 1.4) folds and (4.16± 0.89) ℃ on average respectively.Pelvic limb hyperhidrosis was all cured within 6 months and one case recurred after a year.There were no occurrences of complications.Lumbar sympathetic nerve modulation guided by CT may be used for treating female pelvic limbs hyperhidrosis.
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We designed a locator for puncture under CT examination.Thirty-three patients of both sexesaged 16-76 yr weighing 46-80 kg undergoing bilateral thoracic or lumber sympathetic nerve block under CT examination were enrolled in this study.One side was punctured under the guidance of the locator,while the other side was punctured by conventional technique.The time consumed during puncture,CT scan adjusting time,the deviation of the needle from the targets and the incidence of puncture complications were recorded.The results showed that compared with the conventional technique,with the locator the time consumed during puncture was significantly shorter,the number of attempts and the deviation of the needle from the target were significantly reduced.The procedure was successfully performed on both side in all patients without serious complications such as hemothorax and pneumothorax.
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Objective To analyze the risk factors of aortic valve calcification,and discuss its correlation with coronary artery disease.Methods A total of 188 patients who underwent coronary angiography (CAG) and transthoracic echocardiography (TTE) were divided into two groups:101cases with aortic valve calcification (AVC) and 87 cases without AVC (NAVC).General data such as sex,age,height,weight and hypertension history,results of blood test such as glucose,lipid and homocysteine(HCY)level were recorded.Results In AVC versus NAVC group,age were (67.0±9.0) years vs.(59.4 ± 6.9) years (t =6.74,P =0.000),men were 36 cases (35.6％) vs.44 cases (50.6％) (t=4.26,P=0.039),hypertension patients were 72 cases (71.3％) vs.50 cases (57.5％)(x2=3.92,P=0.048),total cholesterol were (5.4 ± 1.0) mmol/L vs.(4.5 ± 1.0)mmol/L (t =5.70,P=0.000),triglyceride were (2.2 ± 1.1 ) mmol/L vs.( 1.6 ± 0.8) mmol/L (t =4.04,P =0.000),HCY were (17.6±8.8) μmol/L vs.(14.9±6.6) μmol/L (t=2.86,P=0.028),respectively.One-way analysis showed that age,sex,hypertension,total cholesterol,triglyceride had relationship with aortic valve calcification.When we divided the cases into two groups (with and without coronary disease),there is no significant difference in HCY(t=0.88,P=0.382) between the two groups.Logistic regression indicated that age,total cholesterol,triglycerides,HCY were independent risk factors of aortic valve calcification,the incidence of aortic valve calcification was related with the severity of coronary artery lesion (x2 =9.48,P =0.024 ).Conclusions The independent risk factors of aortic valve calcification are age,cholesterol,triglyceride,HCY.Higher incidence of aortic valve calcification may result in greater severity coronary artery lesion.
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BACKGROUND:Shear mechanical properties of lumbar trabecular bone should be understood in treating osteoporosis,bone remodeling,bone reconstruction,as well as the choice of fracture fixed equipment.OBJECTIVE:To explore whether the shear mechanical properties of lumbar trabecular bone is different in young and aged normal fresh cadavers.METHODS:Experimental samples were from 4 normal fresh corpse,aged 22,28,70 and 75 years,were provided by Department of Anatomy,Norman Bethune Medical University.Spinal column thoracic vertebra L_2-L_5 specimen were obtained from corpse within 1 hour and cut into 40 min×5 mm×5 mm pieces.The specimen were tested on electronic universal testing machine with speed of 5 mm/min,the shear load,stress,strain and other data would be printed automatically,and the morphology of fracture surface was observed.RESULTS AND CONCLUSION:Majority of the fracture surfaces were comminuted,minority were transverse or oblique fracture.The macroscopic observation showed that trabecular arranged compact in the thoracic vertebra cancellous bone of the youth group,which was sparse arrangement and presented with senile osteoporosis in the aged group.The shear force,shear stress and strain of the youth group was greater than that of the aged group[(37.19±3.25),(28.34±3.42) N;(1.49+0.13),(1.13±0.14) MPa;(1.40±0.50)%,(0.90±0.20)%,P＜0.05].It demonstrated that the impact mechanics properties of thoracic vertebra cancellous bone are different between the youth and aged groups.
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BACKGROUND:Tracheal injury suture and the development of a new tracheal prosthesis all need to understand the tensile mechanical properties of tracheal cartilage.so as to repair and rebuild tracheal function.Previous researches on the biomechanics of artificial trachea are many reported.while the biomechanics of human tracheal cartilage is reported less.OBJECTIVE:To investigate the mechanical properties of tracheal cartilage using one-dimensional tensile test method.METHODS:Two fresh cadaver specimens of normal human trachea.with the informed consents of their families.were involved.The specimens were thaw at room temperature,and then tracheal cartilage specimens were cut using scalpel into 20 samples at the length of 25 mm,width 5 mm,thickness 1.8-2.2 mm.The 20 tracheal cartilage samples were subjected to one-dimensional tensile test with Shimadzu electronic universal testing machine Japan,at the tensile test speed of 5 mm/min.The tensile maximum load,maximum displacement,maximum stress,maximum strain,elastic modulus and stress-strain curve of the specimens were observed.RESULTS AND CONCLUSION:The maximum load of human cadaver tracheal cartilage was(60 946±10.377)N,maximumdisplacementwas(1.973±0.159)mm,maximum stresswas(6.229±1.125)Mpa,maximum strainwas(32.825±2.776)%.Tracheal cartilage stress-strain curves was changed along with the index,the initial low slope of the curye was due to the direction of imposed tension was similar with the arrangement of collagen structure,the steep slope represented the tensile strength of collagen.To describe the tracheal cartilage stress-strain relationship in a one-dimensional tension,15 stress-strain data of the tracheal cartilage experimental data adopted polynomial by the least square fitting method,to obtain stress(δ)-strain(ε)relationship forrnula:σ(ε)=-0.111 3e~5+1.602 1e~4-7.821 6e~3+17.995 1e~2+3.624e.It is indicated that tracheal cartilage has a strong capacity to bear Joad and resist deformation,reflecting their viscoelastic mechanical properties of both flexibility and viscosity,supporting that the mechanical properties of cartilage is positively related to cartilage collagen content.
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Objective To observe and measure the anatomical structure of approach of vertical facial nerve canal and put forward the normal measurement range and the location relationship among the vertical segment of facial nerve canal, the posterior wall of external acoustic meatus and the rear edge of external ear,and discuss the relationship and clinical significance between the mastoid gasification and the vertical segment of facial nerve canal. Methods 1. Evaluate the accuracy of CT image of related structure, using spiral CT in scanning four skull specimens, get the horizontal distances of the vertical segment of facial nerve canal to the posterior wall of external acoustic meatus and the rear edge of external in the axial position, and get the sagittal diameter of mastoid (the horizontal distance from the lowest point of external auditory inferior canal to the rear edge of mastoid) and the height (the vertical distance between the lowest points of the external auditory canal wall to the mastoid tip) in the sagittal position. And then saw the skull specimens to measure the distance in the same lay with CT image, and discuss the statistics difference of the distance between the values of CT imaging measurements and the dry entities cranial measurements on hand. 2. Study on people: 118 patients (236 sides) with non-ear disorders were randomly selected, among which there were 63 females (126 sides) and 55 males (110 sides). They were subjected to maxillofacial CT scan in the same layer that used above, and the horizontal distances of the facial nerve canal to the posterior wall of external acoustic meatus and the rear edge of external ear were measured. In addition, half of the product of diameter and height of the mastoid was defined as mastoid area, which was used to define the extension of mastoid gasification. Then related analysis and regression analysis were done between the vertical segment of facial nerve canal and the posterior wall of external acoustic meatus, as well as the rear edge of external ear. Results 1.Part of the experiment: There was no significantly different on the indicator values between CT image the entity measurements among the four skull specimens (P>0.05). 2. Study on people: There was no significantly different between left side and right side(P>0.05), but significantly different between genders(P<0.05). Between mastoid area and the distance from the vertical segment of facial nerve canal to the posterior wall of external acoustic meatus there is inverse correlation, and the relevance has the remarkable significance. However, there was no correlation between mastoid area and the vertical segment of facial nerve canal to the rear edge of external ear. Conclusion There was some relationship between the location of the vertical segment of facial nerve canal and external acoustic meatus. Anatomic position of vertical facial nerve cancal and the posterior wall of external acoustic meatus can be showed clearly. CT and in combination with primitive axial images may provide reliable evidence for the diagnosis facial nerve dieases and the choice of ear surgery route.
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BACKGROUND:The brachial plexus injury anastomosis suture technique is necessary to understand the mechanics characteristic of brachial plexus nerve stress relaxation.Previous studies mainly focused on single tension mechanics of brechial plexus nerve,but few studies concerning stress relaxation and creeping elasticity.OBJECTIVE:To observe and analyze experimental animal brachial plexus nerve stress relaxation mechanics characteristic in the description manner of function,to provide experimental parameters for clinic.DESIGN,TIME AND SETTING:The experimental observations to use function as a way to describe from 1~(st) to 10~(th_ March,2007 at the Experimental Center of Jilin University.MATERIALS:The experimental male Sprague Dawley rats aged 6 months were provided by Changchun Gaoxin Medicine Animal Experimentation Center.METHODS:The stress relaxation experiment was performed in Experimental animal Brachial plexus Nerve on the the electronic universal testing machine (Shimadzu,Japan).The stress relaxation experiment strain increased speed was 1%/s,setting time of 7 200 seconds.100 empirical data were collected and disposed by one-way linear regression analysis.MAIN OUTCOME MEASURES:The stress relaxation data and curve,the Stress and time change rule were measured.RESULTS:The stress relaxation quantity of animal brachial plexus nerve test specimen at 7 200 s was 0.316 MPa.Stress relaxation curve changed with logarithm.Stress relaxation changed rapidly at 600 seconds,decreased gradually,and reached a balance level at 7 200 seconds.CONCLUSION:The stress relaxation curve changed with the logarithm relations.Brachial plexus has visco-elastic mechanical properties.
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Lipases are important biocatalysts that are widely used in food processing and bio-diesel production. However, organic solvents could inactivate some lipases during applications. Therefore, the efficient cloning and expression of the organic solvent-tolerant lipase is important to its application. In this work, we first found out an organic solvent-tolerant lipase from Staphylococcus saprophyticus M36 and amplified the 741 bp Lipase gene lip3 (GenBank Accession No. FJ979867), by PCR, which encoded a 31.6 kD polypeptide of 247 amino acid residues. But the lipase shared 83% identity with tentative lip3 gene of Staphylococcus saprophyticus (GenBank Accession No. AP008934). We connected the gene with expression vector pET-DsbA, transformed it into Escherichia coli BL21 (DE3), and obtained the recombinant pET-DsbA-lip3. With the induction by 0.4 mmol/L of isopropyl beta-D-thiogalactopyranoside at pH 8.0, OD600 1.0, 25 degrees C for 12 h, the lipase activity reached up to 25.8 U/mL. The lipase expressed was stable in the presence of methanol, n-hexane, and isooctane, n-heptane.