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@#A 54-year-old asymptomatic man underwent a video-assisted thoracoscopic left pneumonectomy for squamous-cell carcinoma. During the surgery, a complete left pericardial defect was unexpectedly discovered, but no special intervention was made. The preoperative chest CT was reciewed, which showed the heart extended unusually to the left, but the left pericardial defect was not evident. The operation time was 204 min and the patient was discharged from hospital upon recovery 9 days after the surgery. The pathological result indicated moderately differentiated squamous-cell carcinoma (T2N1M0, stage ⅡB), and metastasis was found in the parabronchial lymph nodes (3/5). The patient did not receive chemotherapy after the surgery, and there was no signs of recurrence 6 months after the surgery. Complete pericardial defects usually do not endanger the lives of patients, and if the patient is asymptomatic, pneumonectomy is feasible.
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Objective:This article explores the treatment of stage I thoracoscopic segmentectomy and lobectomy. The clinical efficacy of non-small cell lung cancer is to provide relevant evidence for clinical decision-making.Method:Computer searches were conducted on PubMed, the Cochrane Library, Embase, Web of Science, Science Direct, Ovid Medline, Scopus database, and Google Scholar. The search time was from the establishment of the library to March 2019. A comparative study of thoracic segmental resection and lobectomy for clinical stage I NSCLC was performed and meta-analysis was performed using Revman 5.3 software.Restlus:A total of 16 retrospective clinical controlled studies were included in the study, with a total of 2 090 patients, including 696 in the thoracoscopic segmental resection group and 1 394 in the thoracoscopic lobectomy group. Meta-analysis showed that for clinical stage Ⅰ NSCLC, the incidence of complications after laparoscopic resection and lobectomy( RR=0.78, 95% CI: 0.59-1.02, P=0.07), postoperative recurrence rate( RR=0.78, 95% CI: 0.52-1.17, P=0.23), postoperative hospital stay( MD=-0.27, 95% CI: -0.58 to -0.05, P=0.10) and 5-year survival rate( RR=0.94, 95% CI: 0.87-1.03, P=0.17), tumor-free survival time( RR=0.95, 95% CI: 0.92-1.09, P=0.34), operation time( MD=-0.43, 95% CI: -10.10-9.25, P=0.93) The difference was not statistically significant, but laparoscopic lung segmentectomy can reduce intraoperative blood loss( MD=-23.81, 95% CI: -42.00 to -5.63, P=0.01), shortening Posterior chest tube drainage time( MD=-0.31, 95% CI: -0.51 to -0.12, P=0.002), but in the lymph node dissection, the segmentectomy was less than the lobectomy, the number of lymph node dissection( MD=-4.89, 95% CI: -7.57 to -2.20, P=0.0004). Percentage of postoperative/preoperative FVC%( MD=7.50, 95% CI: 5.81-9.18, P<0.00001) and 1-year postoperative/preoperative FEV1%( MD=8.26, 95% CI: 6.43-10.09, P<0.00001). The difference was statistically significant. Conclusion:In The course of clinical stage I NSCLC treatment, the two procedures were similar in terms of postoperative complications, operation time, recurrence rate, 5-year survival rate, tumor-free survival time and hospital stay, and fewer lung segments in lymph node dissection. In lobectomy, thoracoscopic segmental resection is better in terms of intraoperative blood loss and postoperative chest drainage time. Thoracoscopic segmentectomy may be more suitable for early stage non-small cell lung cancer. treatment method.
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Objective To explore the interventional effect of two different methods in the prevention of chemotherapy phlebitis caused by 5-fluorouracil.Methods Eighty cases of patients treated with cisplatin+5-fluorouracil (PF) chemotherapy in the First Affiliated Hospital of Guangxi Medical University from May 2015 to July 2016 were selected and divided into the observation group and control group according to admission time,40 cases in each group.The observation group was smeared with 2% anisodamine along the direction of vein puncture after peripheral venous puncture success,while the control group was smeared with mucopolysaccharide polysulphate emulsion paste.The occurrence of phlebitis and degree of local pain after intervention were compared between the two groups.The blood biochemical indexes and inflammatory factors levels before and after intervention were compared too.Results After the intervention,the distribution of phlebitis level and local pain degree had statistical difference between the two groups (Z=2.57,2.53;P=0.01);the observation group was superior to the control group in the aspects of phlebitis lesion degree and local pain alleviation;WBC,MPV and PDW in the observation group had statistical difference between before and after intervention;WBC,PLT and PCT in the control group had statistical difference between before and after intervention (P0.05).Conclusion 2% anisodamine can effectively prevent and alleviate the occurrence of 5-FU caused chemotherapy phlebitis and local pain.At the same time,PLT can provide a basis for preventing chemotherapy phlebitis.
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Phospholipids and their metabolites play an important role in a variety of cellular processes including cell-cell adhesion, cell growth and differentiation, apoptosis, phagocytosis as well as storage of energy. In this study, the phospholipid composition of cancer tissue and adjacent normal tissue from humans and animals were analyzed by internal extractive electrospray ionization mass spectrometry ( iEESI-MS ) . Extractive solvent at high voltage (+5. 5 kV) was injected into tissue samples using a fused silica capillary at a flow rate of 0. 5-1 μL/min, producing fine charged droplets containing analytes of tissue samples at the tip of the sample. Charged droplets were directly sampled to the atmospheric inlet of a mass spectrometer. Out of 21 different ratios of CH3 OH ∶H2 O solvent mixture, the ratio CH3 OH ∶ H2 O=30∶70 ( V/V ) showed the optimal phospholipids extraction and visibility in MS. A large number of phospholipids from different tissue samples ( such as cancer tissue and adjacent normal tissue of lung cancer, esophageal cancer tissue, pork, beef, porcine heart and porcine lung) were obtained simultaneously by iEESI-MS analysis. The experimental results demonstrated that iEESI-MS was characterized by minimal sample pretreatment, low sample consumption, and rapid analysis ( the analysis time per sample was less than 1 min) , and the selectivity and sensitivity of iEESI-MS could be improved by choosing proper solvent. Importantly, the experimental results provided new information for further studies of phospholipids in biological tissues.
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Objective:To investigate the changes of the vertical height and width of the alveolar bone six months after the alveolar ridge preservation in periodontal compromised molar sites of severe alveolar bone defects with clinical direct measurement,parallel periapical radiographs,and cone-beam computed tomography (CBCT),and to analyze the effect of the three different methods of measurement.Methods:In this study,20 subjects requiring tooth extraction on account of periodontal disease with a total of 23 ex-tracted molars were enrolled.Extractions were performed atraumatically and patients were received alveo-lar ridge preservation procedure with Bio-Ossand Bio-Gide.Clinical direct measurements were taken after tooth extraction and during the implant surgery 6 months later,CBCT scans and parallel periapical radiographs were taken immediately after ridge preservation and 6 months later.The changes of alveolar ridge width and vertical height after six months were measured and analyzed through the above-mentioned three methods and the similarities and differences of the measured effect were compared.Results:There were no significant difference of alveolar vertical height in the center of the extraction sites,the center of distal aspect,and distobuccal aspect between the clinical direct measurements and the CBCT measure-ments (P>0.05),alveolar vertical height in other points and alveolar width measurements were statical-ly significant (P cally significant (P>0.05).The change of the alveolar height in the center of the extraction socket after six months measured by parallel periapical was (5.84 ±4.28)mm,which was closed to the clinical di-rect measurement and the CBCT measurement.Conclusion:Clinical direct measurement and CBCT measurement were largely consistent in the evaluation of the alveolar bone height and width after the alveolar ridge preservation using deproteinized boving bone mineral (DBBM,Bio-Oss)and bioabsor-bable collagen membrane (Bio-Gide)in periodontal compromised molar sites of severe bone defects.
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Objective To compare the efficacy of lymph nodes(LNs) dissection between video-assisted thoracic surgery (VATS) and thoracotomy in the treatment of clinical stage Ⅰ lung cancer.Methods A comprehensive search of PubMed,Ovid Medline,EMBASE,Web of Science,ScienceDirect,the Cochrane Library,Scopus database and Google Scholar was performed to identify studies comparing VATS and thoracotomy in LNs dissection.The data was analyzed by RevMan 5.3 software and SPSS 18.0.Results After selection,23 articles met the inclusion criteria.2 316 patients were involved in VATS group and 3 346 patients were involved in Open group.Meta analysis showed that less total LNs(95％ CI:-1.64--0.60,P ＜ 0.0001),totalLNsstations(95％CI:-0.61--0.01,P=0.04) andN1 LNs(95％CI:-0.28--0.02,P=0.02)were dissected in VATS group.On the left side,more LNs were dissected in VATS group(95％ CI:0.51-3.22,P =0.007).The same number of mediastinal LNs (95％ CI:-0.74-0.15,P =0.20),mediastinal LNs stations (95％ CI:-0.20-0.14,P =0.76),right side LNs (95 ％ CI:-1.52-2.23,P =0.71) were harvested in both groups.Conclusion In the surgical treatment of clinical stage Ⅰ lung cancer,less total LNs,total LNs stations and N1 LNs were dissected in VATS group,while more left side LNs were harvested by VATS.The same number of mediastinal LNs,mediastinal LNs stations right side LNs were harvested in the two groups.This conclusion still needs to be further proved by more high-quality and large-scale RCTs.
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Objective To explore clinical value of the single-hale video-assisted thoracoscope surgery in lung surgery.Methods In our hospital from January 2015 to June 2015, a total of 60 patients was performed with lung partial resection line thoracoscope surgery, 28 routine puckering traditional video-assisted thoracoscope treatment, in the same period 32 underwent video-assisted thoracoscope surgery.Intraoperative blood loss, operating time, postoperative pain degree, and postoperative chest such as flow rate were compared between two groups.Results Two groups of patients had no perioperative death and severe complications.Intraoperative blood loss and operating time were no significant significance between single-and double-hole operation groups.The degree of postoperative pain score was (0.8 ± 0.5) in puckering thoracoscope group, and (1.2 ± 0.6) in traditional thoracoscope group, with significant difference (P =0.009).Conclusions Single-hole thoracoscope surgery in the treatment of lung diseases is feasible and reliable compared to traditional thoracoscope surgery, and patients can effectively reduce postoperative pain, and improve the quality of life.
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Objective To study the expression profile of microRNAs in the lung adenocarcinoma tissue and its expression in CD133+ lung cancer cells .Methods The specimens of adenocarcinoma tissue and pericarcinomatous tissue were collected for con-ducting the microRNA expression chip analysis .The flow cytometry(FCM ) was adopted to sort and culture CD133+ A549 cells in serum-free medium for 2 weeks .The positive rate of CD133+CD44+ in those cells was assayed .The expression of miRNA-892b and miRNA-4686 in CD133+ A549 cells were detected by real-time qPCR .Results Compared with the pericarcinomatous tissue ,27 miRNAs expressions in the lung adenocarcinoma tissue were up-regulated(P<0 .05) and 6 miRNAs expressions were down-regula-ted(P<0 .05) .The positive rate of cancer stem like cells CD 133+CD44+ was 75 .0% .The expression of miRNA-892b and miRNA-4686 in CD133+ A549 cells was higher than A549 cells(P<0 .01) .Conclusion Abnormal expression profile of miRNAs in lung ad-enocarcinoma tissue ,and miRNA-892b and miRNA-4686 may play a certain role to maintain the biological characteristics of CD133+ lung cancer cells .
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Objective To observe the relations ot vWF,DD concentration and venous thrombosis caused by detaining needle of different time.Sensitive indicators for early prediction of venous thrombosis would be seeked so as to provide theoretical and experimental basis for the selection of intervention time.Methods The detaining needle were placed in the vein of rabbit ears with transfusion.The changes of vWF and DD concentration for the mannitol group and the saline group were measured in different retention time,while the venous thrombosis caused by detaining needle was observed pathologically.Results The results of serological test:(1)vWF concentration:when the needle was detained for 1 day,the vWF concentration of two groups peaked.(2)DD concentration:after the needler was set,the DD concentration of both groups was higher than those before detaining needler.When the needle was detained for 1 day and 3 days,the DD concentration was significantly different from those before using detaining needle.Result of pathological observation:When the needle was detained for 1 day,the venous throm-bosis rate was 100％ for both groups with a moderate degree of thrombosis.Conclusions Detection of the concentration of vWF and DD has certain reference value for predicting detaining needle-induced venous thrombosis.In order to prevent venous thrombosis,intervention should be carried out as soon as possible after detaining needle was set.
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Objective To study the clinical nurses and nursing students' cognition of clinical nurse specialist (CNS) and provide the basis for promoting the development of CNS.Methods Quantitative and qualitative research were adopted in this study.One hundred and ninety clinical nurses and nursing students were investigated with a questionnaire about the cognition of CNS,and the qualitative research was conducted on 9 clinical nurses selected by purposive sampling method.Results Most participants realized the importance of CNS and 78.4％ of them wished to be an excellent CNS.The cognition was different between the two groups,especially in terms of ability,working performance and status.Conclusions We should improve the clinical nurses and nursing students' cognition of CNS,and cultivate them with the core competence of CNS.Meanwhile,improving the status and confirming the role must be done to promote the development of CNS in China.
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Objective To know the present situation and the different humanistic caring abilities among college nursing students,so as to provide reference for education training strategy of nursing humanity care.Methods A total of 396 college nursing students were investigated by using the nursing students' humanistic caring ability scale.Results The total score of nursing students' humanistic caring ability was (110.85±21.57),with a scoring rate of 61.59％.Statistically significant differences of humanistic caring ability were found among students of different education levels,different genders and different colleges.Conclusions The level of nursing students' humanistic caring ability was low,so nursing schools and clinical teaching hospitals should strengthen the training of students' humanistic caring ability according to the characteristics of different education level,and take effective training strategies to improve college nursing students' humanistic caring ability.
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Objective Design the "Nursing Obstetrics and Gynecology" network courses, and then observe the teaching effect of it. Methods The rational design of technical solutions, development and application of information resources and modem educational technology. Results The "Nursing Obstetrics and Gynecology" network courses prompt satisfaction teaching more than 90%. Conclusions "Nursing Ob-stetrics and Gynecology" network courses make our teaching program is brand new, as "Nursing Obstetrics and Gynecology" network courses of discipline and quality building a solid foundation, especially for the cultivation of young teachers to provide direct help.
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The critical thinking as the important component of clinical synthesis skill,has become one of students'core competencies of the contemporary medical education.In pathology teaching process,encouraging students to raise doubts and difficulties,case teaching,the reflective teaching are effective ways to raise medical students' critical thinking.
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AIM: To investigate the expression of extracellular matrix metalloproteinase inducer(EMMPRIN) and endothelin converting enzymes(ECE) in non-small-cell lung carcinoma(NSCLC),and their relationship with lymphoid metastasis and prognosis.METHODS: Expression of EMMPRIN and ECE in 77 cases of patients with NSCLC was detected immunohistochemically.The relationship of the expression of EMMPRIN and ECE with tumor size,histological type,differentiation,lymphoid metastasis,clinical stage,and prognosis were analyzed.RESULTS: The expressive rate of EMMPRIN and ECE was 66% and 45%, respectively.The expression of EMMPRIN and ECE was associated positively with lymphoid metastasis(both P0.05).The expression of EMMPRIN was associated with the expression of HGF in NSCLC(P
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AIM:To investigate the expression of extracellular matrix metalloproteinase inducer(EMMPRIN)and hepatocyte growth factor(HGF)in non-small-cell lung carcinoma(NSCLC)and their relationship with lymphoid metastasis and prognosis.METHODS:Expression of EMMPRIN and HGF in 77 cases of patients with NSCLC was detected immunohistochemically.The relationship of expression of EMMPRIN and HGF with tumor size,smoking,histological type,differentiation,lymphoid metastasis,clinical stage,and prognosis was analyzed.RESULTS:The expressive rates of EMMPRIN and HGF were 68% and 44%,respectively.The expressions of EMMPRIN and HGF were associated positively with lymphoid metastasis(r=0.371 and 0.339,P0.05).The expression of EMMPRIN was associated with the expression of HGF in NSCLC.CONCLUSION:The expression of EMMPRIN and HGF is associated with lymphoid metastasis and prognosis in NSCLC.Overexpression of EMMPRIN and HGF implies infavourable prognosis in NSCLC.