Clinical effect of local and systemic zoledronic acid in the treatment of giant cell tumor of bone / 国际肿瘤学杂志

Objective:To investigate the clinical effect of local and systemic zoledronic acid in the treatment of giant cell tumor of bone.Methods:The clinical data of 42 patients with giant cell tumor of bone who were treated in the Department of Joint and Sports Medicine Surgery of Shandong Provincial Third Hospital from January 2000 to January 2017 were retrospectively analyzed. According to whether zoledronic acid was used during and after operation, the patients were divided into zoledronic acid group ( n=21) and non zoledronic acid group ( n=21). The perioperative indexes, pain visual analogue scale (VAS), international Musculoskeletal Tumor Society (MSTS) score of lower extremity function, adverse reactions and the postoperative recurrence were compared between the two groups. Results:The operative time of zoledronic acid group and non zoledronic acid group were (158.4±20.5) min and (169.5±19.5) min, the intraoperative bleeding volume were (236.3±9.7) ml and (228.2±16.5) ml, the postoperative drainage volume were (163.3±7.4) ml and (161.4±9.3) ml, and the healing time of incision were (13.8±2.1) d and (14.0±2.0) d, respectively, with no significant difference ( t=-1.798, P=0.080; t=1.936, P=0.062; t=0.733, P=0.468; t=-0.290, P=0.774). The preoperative VAS scores of zoledronic acid group and non zoledronic acid group were 6.54±1.76 and 6.72±1.51 respectively, the MSTS scores were 13.56±2.35 and 12.79±1.98 respectively, and the differences were not statistically significant ( t=-0.356, P=0.724; t=1.148, P=0.258). The VAS scores of the two groups were 1.32±0.31 and 1.92±0.19 at 4 weeks after operation, 0.93±0.29 and 1.47±0.38 at 3 months after operation respectively, and the differences were statistically significant ( t=-7.562, P<0.001; t=-5.177, P<0.001). The VAS scores of the two groups were 0.31±0.12 and 0.35±0.23 at the last follow-up, with no significant difference ( t=0.707, P=0.485). The MSTS scores of zoledronic acid group and non zoledronic acid group were 24.89±3.86 and 21.82±2.95 at 4 weeks after operation, 26.78±2.57 and 24.62±2.62 at 3 months after operation respectively, and the differences were statistically significant ( t=2.896, P=0.006; t=2.697, P=0.010). The MSTS scores of the two groups were 27.31±2.21 and 26.69±2.93 at the last follow-up, with no significant difference ( t=0.774, P=0.443). The postoperative recurrence time of the two groups was (9.79±2.58) months and (7.31±1.73) months respectively, and the difference was statistically significant ( t=3.659, P=0.001). There was no significant difference in recurrence Campanacci grade and recurrence tumor location between the two groups ( U=7.000, P=0.860; χ2=1.062, P>0.999). The occurrence rates of fever in zoledronic acid group and non zoledronic acid group were 23.81% (5/21) and 4.76% (1/21), the occurrence rates of myalgia were 19.05% (4/21) and 4.76% (1/21), the incidences of influenza like symptoms were 14.29% (3/21) and 0 (0/21), the occurrence rates of gastrointestinal reaction were 9.52% (2/21) and 4.76 (1/21), and the differences were not statistically significant ( χ2=1.750, P=0.186; χ2=0.980, P=0.341; χ2=1.436, P=0.231; χ2<0.001, P>0.999). All the patients had no serious adverse reactions such as liver and kidney function damage and mandible necrosis. Conclusion:Local and systemic application of zoledronic acid in the treatment of giant cell tumor of bone can improve the early postoperative pain and limb function, delay the recurrence time, and can be used as an auxiliary treatment of giant cell tumor of bone.

Clinical effect of minimally invasive painless Carisolv iodide removal technique in the treatment of dental caries / 中国基层医药

Objective To investigate the clinical effect of minimally invasive painless iodide removal technique in the treatment of dental caries.Methods From January 2017 to October 2017,60 patients with dental caries in Xiaogang Hospital of Beilun District were selected and divided into observation group(n=50)and control group(n=50).The patients in the control group were treated by traditional dental drill dehumidification technique,and the patients in the observation group were treated by minimally invasive painless iodide removal technique.The clinical effects of the two groups were compared and analyzed.Results The total effective rate,the severe pain during treatment and the slight pain sensation of the observation group were 94％,0％,14％,respectively,which were better than those of the control group(72％,10％,46％),the differences between the two groups were statistically significant(χ2 =11.254,5.011,9.451,all P<0.05).Conclusion The use of Carisolv iodine can reduce the use of anesthetic,or reduce the necessity of using the needle,which can reduce the pain and discomfort of the patients.There is a choice to remove caries,will not damage the normal dental tissue,can reduce the occurrence of complications,which can prolong the life of teeth and reduce the probability of infection,thus to prevent tissue around the tooth from being damaged.

Investigation and Ethical Countermeasures for Blood-borne Occupational Exposure in Medical Workers in General Hospitals / 中国医学伦理学

Objective:To understand general hospital medical staff status quo and characteristics of blood -borne occupational exposure , analysis its ethics factor , to make the prevention countermeasures of blood -borne oc-cupational exposure to provide scientific basis .Methods:From January 2013 to December floor all the medical staff of blood -borne occupational exposure cases were retrospectively analyzed .Results:A total of 101 medical staff blood-borne occupational exposure , which is given priority to with the nurse , accounted for 60 .40%;More con-centrated in under 30 employees, accounted for 70.29%;Occupational exposure personnel distribution in the ma-jority with surgical department (42.57%), followed by the physician (36.63%);Wards (60.40%), the operat-ing room (15.84%) and therapy (11.88%) are the sites of occupational exposure often happen;Sharp injury in the composition of the ratio of 87.12%, in the first place, in which a proportion (23.76%), pull out the needle (18.81%) and blood (15.84%), surgical suture (14.85%) and transfusion injection (13.86%) as the sharp injury of frequent occurrence of occupational exposure;Exposure is given priority to with hepatitis b ( 61 .38%) . Conclusion:Medical staff blood-borne occupational exposure risk is high , the hospital infection control personnel must pay attention to occupational exposure of the whole education , strengthen the administration of the occupation-al exposure of ethics , reduce the risk of occupational exposure and injury .

Comparison of the Efficacy and Safety of Low Molecular Weight Heparin and Rivaroxabanon in the Preven-tion of Deep Venous Thrombosis after Spinal Surgery / 中国药房

OBJECTIVE:To compare the efficacy and safety of low molecular weight heparin and rivaroxaban in the preven-tion of deep venous thrombosis after spinal surgery. METHODS:Totally 276 patients with high risk factors after spinal surgery were randomly divided into control group and observation group. The patients in the two groups were used elastic stockings to physi-cally prevent deep venous thrombosis from the postoperative first day to continue 3 months;based on it,control group was subcuta-neously injected with 1 low molecular weight heparin from the postoperative first day,once a day. Observation group was orally treated with 1 Rivaroxaban tablet,once every night. The treatment course for 2 groups was 2 weeks. The clinic data was observed, including clinical efficacy,superficial femoral vein diameter(FSV),popliteal vein diameter(POPV),prothrombin time(PT),fi-brinogen degradation products(FIB)and D- dimer(DD)before and after treatment,incidence of deep venous thrombosis and ad-verse reactions. RESULTS:There were no significant differences in the total effective rate and deep venous thrombosis and inci-dence of ADR between 2 groups(P>0.05). After 3 months,compared with before,there were no significant differences in the FSV and POPV between 2 groups (P>0.05);POPV in control group was significantly lower than before and observation group, there was statistical significance(P0.05);the FIB and D-D were significantly higher than before,there was statistical significance(P0.05);after 4 weeks,PT in 2 groups was significantly high-er than before,there was statistical significance(P0.05);FIB and D-D were significantly higher than before,and observation group was lower than control group,there was statisti-cal significance(P<0.05). CONCLUSIONS:Both efficacy and safety of low molecular weight heparin and rivaroxaban in the pre-vention of deep venous thrombosis after spinal surgery are good. However,rivaroxaban is better than low molecular weight heparin in improving blood coagulation function.

Clinical analysis of colon ischemia complicating with operated abdominal aortic aneurysm / 中华外科杂志

OBJECTIVE To investigate the etiology, prevention and treatment of colon ischemia after operation for abdominal aortic aneurysm (AAA). METHOD Seven of 140 cases complicated with colon ischemia who had received AAA operation were analyzed retrospectively. RESULTS Three cases underwent emergency operation. The seven cases were subjected to removal of AAA, implantation of prosthesis, and ligation of the inferior mesenteric artery. Two cases had the ligation of the bilateral internal iliac artery (IIA). Epilateral IIA was ligated in 2 cases. Bowel resection was carried out in 3 cases, 1 of which received reconstruction of the inferior mesenteric artery (IMA). Three cases received conservative therapy, but died from multiply organ failure. CONCLUSION Correct prevention and management of colon ischemia can effectively reduce the operative morbidity of AAA patients.

Microvessel density of follicular thyroid tumors and its clinical implications / 中国普通外科杂志

Objective To investigate the relationship between microvessel density (MVD) and the clinical features of thyroid follicular tumors. MethodsThe immunohistochemical staining was used to determine MVD in 40 cases of follicular thyroid carcinoma (FTC) and 20 cases of follicular adenoma (FA). Results MVD of FTC(228?91)was significantly higher than that of FA (156?73, t =2 763, P

Management of abdominal aortic aneurysm in young adult / 中国普通外科杂志

Objective To assess the clinical manifestation, management and outcome of abdominal aortic aneurysm (AAA) in young adult Methods Retrospective study was made on young AAA patients (

Medullary thyroid carcinoma / 中国普通外科杂志

Objective To assess the results of surgical intervention on patients with medullary thyroid carcinoma(MTC), and determine the value of measuring plasma calcitonin concentration postoperatively. Methods The diagnosis and treatment of 14 patients with MTC from January 1992 to December 1998 were analysed retrospectively. Results The diagnosis of MTC in the 14 patients was confirmed by pathology. Of them, 64.3% of patients had lymph node metastases. According to AJCC staging system, 1 patient was in stage Ⅰ, 7 in stage Ⅱ, 5 in stage Ⅲ and 1 in stage Ⅳ. Of nine patients measured plasma calcitoinin after initial operation, 4 had persisted hypercalcitoninemia. In the 4 patients, MTC in residual thyroid and enarged lymph node were comfirmed by B mode ultrasounography. After re operation, the calcitonin level returned to normal in 3 cases, but one remained in higher level. Postoperative follow up ranged from 2 to 8 years, 2 patients died of the disease. Twelve patients still lived, 6 of them survived more than 5 years. Conclusions The clinical stage of MTC at the time of diagnosis is an important prognostic factor. An aggressive surgical approach at the initial operation is essential to achieve a curative effect in patient with MTC. Measuring plasma calcitonin postoperatively helps to detect residuled MTC or recurrent MTC.

Combined superselective arteriography plus embolization before surgical resection of carotid body tumor / 中国普通外科杂志

ObjectiveTo evaluate the value of preoperative superselective arteriography plus emboliazation before surgery of carotid body tumor(CBT). Methods11 CBT cases hospitalized from 1995 to 1999 underwent this procedure before resection. ResultsThe intraoperative blood loss (350?170 ml) was significantly different in this group compared with that (averaging 650 ml) in patients not undergoing the preoperative embolization, P

Endovascular stent-graft repair of aortic dissection / 中国普通外科杂志

Objective To introduce the experience in endovascular stent graft repair (EVSGR) of thoracoabdominal aortic dissecting aneurysm (TAADA). Methods Retrospective analysis was made on the management of 6 patients with TAADA from October 2000 to June 2001. Results There were six male patients aged 42～72 in this series. Of them, 5 patients with Stanford type B TAADA and one with Stanford A TAADA. Of the 6 patients, The fissures were sealed and the dissections were disappeared completely in 5 cases; one case shifted to open surgery for abdominal aortic fenestration, Rupture of the iliac dissection occurred in 1 case 3 days after EVSGR, then the abdominal aortic fenestration and graft replacement of distal abdominal aorta were performed. One patient died of heart infarction on the third day postoperatively. Five cases were followed-up for 1～9 months, they all were alive and well. Conclusions Endovascular stent graft technique is safe and simple in repairing of TAADA, and abdominal aortic fenestration is an adjuvant procedure.

Detection of telomerase activity by fine needle aspiration biopsy in the diagnosis of thyroid cancer / 中国普通外科杂志

Objective To investigate the value of detection of telomerase activity by fine needle aspiration biopsy (FNAB) of thyroid mass in the preoperative diagnosis of thyroid cancer. Methods Comparation of the results of detection of telomerase activity and biopsy of the of samples of thyroid masses aspirated by fine needle guided by B-us were performed .The results were compared to the postoperative pathological results. Results Of the 32 cases of thyroid carcinomas, the correct diagnostic rate of FNAB was 43.8%, while the positive rate of telomerase activity was 75.0%, the difference between the two examinations was significant ( P

Investigation and analysis on health status in climacteric women of Xi'an City / 西安交通大学学报(医学版)

Objective To explore the climacteric women's mental health status and its influencing factors,and cognition of relevant knowledge about climacteric period.Methods A stratified-cluster sampling method was used to survey with questionnaire 2 500 perimenopausal women aged 40-60 years in 6 districts of Xi'an City.Results ① Of a total of 2 023 individuals,the mean age was 47.38?5.429 years,the average menarche age was 14.31?1.74 years(9-19 years),and the average natural menopause age was 48.9?3.54 years.② Half of the women investigated were worried about their children's education,work,marriage,ecomomic status and housing,and more than half of the women investigated had insufficient knowledge about climacteric period.③ The incidence of climacteric syndromes was 54.9%.There were significant differences between different age group and occupation group(?2=226.14,P