Animal model-based simulation training for three emergent and urgent operations of penetrating thoracic injuries / 中华创伤杂志(英文版)

PURPOSE@#To develop animal models of penetrating thoracic injuries and to observe the effects of the animal model-based training on improving the trainees' performance for emergent and urgent thoracic surgeries.@*METHODS@#With a homemade machine, animal models of lung injuries and penetrating heart injuries were produced in porcine and used for training of chest tube drainage, urgent sternotomy, and emergent thoracotomy. Coefficient of variation of abbreviated injury scale and blood loss was calculated to judge the reproducibility of animal models. Five operation teams from basic-level hospitals (group A) and five operation teams from level III hospitals (group B) were included to be trained and tested. Testing standards for the operations were established after thorough literature review, and expert questionnaires were employed to evaluate the scientificity and feasibility of the testing standards. Tests were carried out after the training. Pre- and post-training performances were compared. Post-training survey using 7-point Likert scale was taken to evaluate the feelings of the trainees to these training approaches.@*RESULTS@#Animal models of the three kinds of penetrating chest injuries were successfully established and the coefficient of variation of abbreviated injury scale and blood loss were all less than 25%. After literature review, testing standards were established, and expert questionnaire results showed that the scientific score was 7.30 ± 1.49, and the feasibility score was 7.50 ± 0.89. Post-training performance was significantly higher in both group A and group B than pre-training performance. Post-training survey showed that all the trainees felt confident in applying the operations and were generally agreed that the training procedure were very helpful in improving operation skills for thoracic penetrating injury.@*CONCLUSIONS@#Animal model-based simulation training established in the current study could improve the trainees' performance for emergent and urgent thoracic surgeries, especially of the surgical teams from basic-level hospitals.

Effect of kangaroo mother care on lactation, uterine involution and neonatal pain / 中国实用护理杂志

Objective:To explore the effect of kangaroo mother care (KMC) on lactation, uterine involution of parturients and neonatal pain.Methods:A total of 200 parturients who gave birth at full term in our hospital from January 2019 to June 2019 and their newborns were selected as the research objects, they were randomly divided into control group and observation group of 100 pairs each. The control group received routine obstetric postpartum care and the observation group received KMC. The KMC cognition, postpartum lactation and uterine involution, neonatal pain during neonatal heel blood collection were compared between the two groups.Results:The cognition of KMC in the observation group was significantly better than that in the control group, and the difference was statistically significant ( χ 2 value was 24.700, P<0.01). The first lactation time of parturients in the observation group was (41.25±3.20) hours after birth, which was earlier than (54.17±2.20) hours in the control group, there was significant difference between the two groups ( t value was 2.378, P value was 0.019). The breast pain Ⅰ degree (20 cases), Ⅱ degree (56 cases), Ⅲ degree (24 cases) in observation group were significantly lighter than those in control group (62, 27, 11 cases respectively) 72h after delivery, the differences were statistically significant ( t value was 12.166, P value was 0.011). The parturients of sufficient lactation in the observation group (73 cases) were more than those in the control group (34 case),the differences was statistically significant ( χ 2 value was 30.570, P value was 0.000). The uterine fundus of the observation group decreased by (3.06±1.26) cm and (1.67 ±0.43) cm at 24h and 48h postnatally, which were better than those of the control group (1.97±0.92) cm and (1.23±0.18) cm,the differences were statistically significant ( t value was 3.162, P value was 0.002; t value was 2.689, P value was 0.009). In the process of heel blood collection after 72h of delivery in both groups, the pain scores of the observation group during and after blood collection were 4.92±0.33 and 2.37±1.27 respectively, which were lower than those of the control group (5.57±1.37 and 5.01±1.09), and the differences were statistically significant ( t value was 2.035, P value was 0.046; t value was 2.579, P value was 0.011). The heart rates of the observation group during and after blood collection were (121.36±22.13) and (142.55±23.91) beats/min, respectively, which were lower than (152.64±18.21) and (156.79±17.37) beats/min of the control group, the difference were statistically significant ( t value was 2.375, P value was 0.018; t value was 2.126, P value was 0.037). The blood oxygen saturation of the observation group during and after blood collection were 0.967 2±0.013 7 and 0.985 5 ±0.022 4 respectively, which were significantly higher than 0.891 7±0.116 5 and 0.914 5±0.137 8 of the control group ( t value was 2.036, P value was 0.046; t value was 2.017, P value was 0.047). Conclusions:The implementation of KMC can promote lactation, accelerate uterine involution, and relieve the pain of neonats during neonatal heel blood collection; Strengthening the health education of KMC can improve the cognition of parturients and their families about KMC, which has positive significance in promoting maternal and infant health and is worthy of clinical application.

Interpretation of adverse reactions and complications in Chinese expert consensus of Iodine-125 brachytherapy for pancreatic cancer

Owing to the location of the pancreas and its complex anatomical relationship, it is difficult to perform radioactive Iodine-125 seed implantation in patients with pancreatic cancer as it can cause surgical side effects and further complications. To standardize the procedure of radioactive Iodine-125 seed implantation in the treatment of pancreatic cancer and reduce the occurrence of adverse reactions and complications during and after operation, the Chinese Medical Doctor Association of Radioactive Seed Implantation Technology Expert Committee, Committee of Minimally Invasive Therapy in Oncology, Chinese Anti-Cancer Association, and the Radioactive Seed Therapy Branch organized and helped establish an expert consensus in China regarding radioactive Iodine-125 seed implantation in the treatment of pancreatic cancer. This article aims at interpreting the adverse reactions and complications after the implantation of radioactive seeds.

Diagnosis and treatment of patients with lean non-alcoholic fatty liver diseases / 中国实用内科杂志

Lean non-alcoholic fatty liver diseases has become increasingly recognized for its large patient population. Its etiology is complex and related to the interaction of genetic and lifestyle factors. With the development of metabolic omics studies and the novel imaging technologies such as liver fat quantification and ultrasound based elastography, the concepts of its diagnosis and treatment are rapidly updated. This article reviewed the prevalence, clinical metabolic characteristics and therapy of lean non-alcoholic fatty liver diseases.

Current state of lung cancer with chronic obstructive pulmonary disease in China: A bibliometrics analysis / 中国胸心血管外科临床杂志

@#Objective To explore the research state and topics of lung cancer with chronic obstructive pulmonary disease (COPD) in China using the visualization methods. Methods Literature about lung cancer with COPD was searched through WanFang, CNKI, CBM, PubMed, The Cochrane Library and EMbase databases from inception to March 2018 by computer. We used BICOMS software to analyze the main information and produce co-word matrix, gCLUTO software to cluster, and NetDraw and Cytoscape software to draw the pictures. Results There were 304 studies related to lung cancer with COPD which originated from 173 journals including 23 indexed by Chinese Science Citation Database (CSCD) with 42 articles published, accounting for 13.8% of the total number of studies. There were 37 articles from 24 journals indexed by Science Citation Index (SCI) accounting for 12.2% of the total number of studies. The studies grew rapidly since 2012. The study involved 32 provinces, municipalities, and autonomous regions, among which Beijing, Sichuan, Shanghai, Guangzhou and Jiangsu provinces and cities were the main research areas. Sixty-nine high-frequency keywords were obtained with frequency 2 as the threshold, which was clustered into 5 categories by dual cluster analysis. Among them, topic 0 showed pathogenesis and radiological diagnosis of lung cancer with COPD, topic 1 was about the clinical characteristics of different pathological types of lung cancer with COPD and Chinese medicine treatment, topic 2 aimed at the impact of risk factors on surgical complications and the relationship between chemotherapy or targeted therapies and patient survival prognosis, topic 3 involved the pigenetic correlation between lung cancer and COPD and topic 4 was about clinical studies of perioperative comprehensive management of lung cancer patients with COPD. Conclusion The bibliometrics results show that there are considerable-amount achievements on lung cancer combined with COPD in China, and the researches have gradually increased since 2012. Horizontal research topics are extensive, and the focus of the study is to explore the perioperative comprehensive management and basic research of lung cancer with COPD, but the longitudinal themes need to be further studied. The results of some studies have not yet reached a consensus. There are few high-quality multi-center studies and a lack of clinical-directed achievement.

Awareness of occupational low back pain: a survey of 244 midwives / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To investigate the awareness of occupational low back pain and knowledge of related prevention and healthcare measures among midwives, and to determine the incidence of low back pain among them.</p><p><b>METHODS</b>A questionnaire survey was carried out with the use of Roland-Morris Disability Questionnaire (Chinese version) (CRMDQ) among 244 midwives from second- and third-class hospitals in Tianjin, China. Related indices were statistically analyzed.</p><p><b>RESULTS</b>Among 244 midwives who participated in the survey, only 18.4% knew the definition of occupational low back pain, 28.3% knew the pathogenic mechanism, and 54.1% knew its harm. About 9.4%∼85.2% of midwives mastered at least one method for prevention and health care against occupational low back pain. Proper or improper use of human body mechanics was closely related to the development of occupational low back pain (P < 0.01). There was a high proportion of midwives with a demand for application of human body mechanics principle in operation, and the proportion was as high as 99.2%. All the 24 items in CRMDQ were scored, with the lowest score of 1, the highest score of 24, and an average score of 8.5 ± 7.2.</p><p><b>CONCLUSION</b>The awareness rate of occupational low back pain was low among the 244 midwives in this study. The incidence of low back pain, which had influenced the health status and occupational practice, was high among them.</p>

Reconstruction of anterior mouth floor defects with depressor labii inferioris flap: a preliminary report / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To investigate the method and efficacy of reconstruction of anterior mouth floor defects with depressor labii inferioris flap.</p><p><b>METHODS</b>Between March 2010 and August 2011, 4 patients with cancer in the anterior part of oral floor underwent tumour resection and simultaneous reconstruction with depressor labii inferioris flap. The patients were followed up for 2 - 18 months. The survival of the flaps, mobility of tongue and esthetic outcome of lip and mental region were evaluated.</p><p><b>RESULTS</b>All the flaps survived completely, tongues moved well, and functional and esthetic results were good.</p><p><b>CONCLUSIONS</b>The depressor labii inferioris flaps are suitable for repairing defects of anterior oral floor.</p>

Applied anatomy of supraclavicular artery island flap and preliminary clinical report on reconstruction of tongue / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To study the anatomy of supraclavicular artery island flap and report the clinical application of the island flap for the reconstruction of tongue defects.</p><p><b>METHODS</b>The branch, origination, course, length and diameter of transverse cervical artery and supraclavicular artery were observed on 20 flaps of 10 adult cadavers perfused with lead oxide-gel, and the draining veins were also observed. The supraclavicular artery island flaps were used to reconstruct the defects following tongue cancer ablation in 4 patients, and the data concerning functional impairment, aesthetic outcome and donor site morbidity were analyzed.</p><p><b>RESULTS</b>The transverse cervical artery were originated from the thyrocervical trunk or subclavical artery, and separated into deep branch and superficial branch above the middle third of the clavicle. The supraclavicular artery were originated from superficial branch of the transverse cervical artery and extended to backward and outward, and run over surface of trapezius, acromial end of clavicle and deltoid fascia, and then penetrated the deep fascia and go into skin and subcutaneous tissue of supraclavicular and shoulder regions. The distance between the origins of the supraclavicular and transverse cervical arteries was on average 4.3 cm, and the distance between the origin of supraclavicular artery and the point where it penetrated the deep fascia was on average 3.6 cm. The external diameter of the transverse cervical artery was on average 2.7 mm, and the external diameter of supraclavicular artery was on average 1.1 mm. Two supraclavicular comitant veins ran adjacent to the supraclavicular artery and drained into the transverse cervical vein and external jugular vein respectively. In the clinical study, 3 flaps survived completely and part of the skin paddle of the flap in one case exhibited necrosis. The contour and function of tongues were restored well and there was no limitation of shoulder motion in all 4 cases.</p><p><b>CONCLUSIONS</b>The supraclavicular artery island flap with supraclavicular artery as nutrient vessel is reliable for reconstruction of oral, maxillofacial and neck defects, and it can be used as a free flap equipped with the transverse cervical artery.</p>

Value of EBNA1-IgA and EA-IgG in serological diagnosis of nasopharyngeal carcinoma / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To evaluate the value of EBNA1-IgA and EA-IgG in serological diagnosis of nasopharyngeal carcinoma (NPC).</p><p><b>METHODS</b>The serum EBNA1-IgA and EA-IgG of 56 patients with NPC and 58 healthy adults were detected by ELISA. The sensitivity, specificity, positive predictive value, accuracy rate and odds ratio of the two tests used singly or in combination were compared with each other.</p><p><b>RESULTS</b>The sensitivity of EBNA1-IgA (91.07%) was higher than that of EA-IgG (87.50%), while the specificity of EA-IgG (87.93%) was higher than that of EBNA1-IgA (84.48%). The combination of EBNA1-IgA and EA-IgG could enhance the specificity (94.83%), positive predictive value (0.9375), likelihood ratio (15.5435) and odds ratio (75.0000) for serological diagnosis of NPC. Forty-five patients showed both positive EBNA1-IgA and positive EA-IgG. A positive EA-IgG was detected in 4 out of 5 patients with negative EBNA1-IgA and a positive EBNA1-IgA was founded in 6 out of 7 patients with negative EA-IgG.</p><p><b>CONCLUSION</b>Although relatively high sensitivity and specificity could be obtained by either EBNA1-IgA or EA-IgG test alone, the combination of these two tests with a complementary effect is able to enhance the reliability of serological diagnosis of NPC as most patients have positive ENBA1-IgA and EA-IgG concurrently.</p>