Prognosis and risk factors of lung cancer with acute exacerbation of COPD in Tongchuan City / 公共卫生与预防医学

Objective To analyse the prognosis and risk factors of lung cancer with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) in Tongchuan City, and to provide a theoretical basis for improving the prognosis of patients with lung cancer complicated with AECOPD. Methods A total of 280 patients with lung cancer combined with AECOPD admitted to Tongchuan People's Hospital from January 2021 to August 2022 were selected and divided into survival group and death group according to whether the patients survived during hospitalization. Serum carcinoembryonic antigen (CEA), cytokeratin 19 fragment (CYFRA 21-1) and other tumor markers were compared between the two groups. Lung function was measured by lung function instruments, and the levels of forced expiratory volume in one second (FEV1), forced vital capacity (FVC), FEV1/FVC and other lung function indicators were compared between the two groups. The patients' clinical data were collected from the medical record system, and univariate analysis and logistic regression were used to analyze the independent risk factors affecting the prognosis of patients with lung cancer complicated with AECOP. Results The values of FEV1, FVC and FEV1/FVC in the death group were significantly lower than those in the survival group (P<0.05). Serum CEA and CYFRA 21-1 levels in the death group were significantly higher than those in the survival group (P<0.05). Multiple logistic regression analysis showed that albumin level <35 g/L (OR=2.728), TNM stage III to IV (OR=2.416), multidrug-resistant bacterial infection (OR=2.982), and GOLD grade III to IV (OR=3.417) were independent risk factors for death in patients with lung cancer complicated with AECOPD in Tongchuan City (P<0.05). Conclusion Patients with lung cancer complicated with AECOPD in Tongchuan City have a high risk of death during hospitalization, especially patients with TNM stage III to IV and GOLD grade III to IV. Multi-drug resistant bacteria infection should be actively controlled to improve the albumin level of patients, which is conducive to the prognosis of patients.

Comparison of harmonic scalpel and conventional technique in the surgery for breast cancer: A systematic review and meta-analysis

BACKGROUND: Harmonic scalpel is considered as a promising surgical tool for breast cancer, while its advantage over conventional approach is still controversial. Therefore, we performed this meta-analysis to compare the outcomes of harmonic scalpel and conventional tools in the surgery for breast cancer. MATERIALS AND METHODS: Studies reporting the outcomes of harmonic scalpel and conventional technologies were systematically searched from online databases, PubMed and EMBASE up to April 30, 2018. Data were presented as odds ratio, risk ratio (RR), and mean difference (MD) with 95% confidence interval (CI). RESULTS: Intraoperative blood loss (I2 = 96%, P < 0.05, MD = −68.78, 95% CI −93.31 to −44.24), seroma (I2 = 3%, P = 0.41, RR = 0.63, 95% CI 0.46–0.86) and hematoma formation (I2 = 0%, P = 0.64, RR = 0.41, 95% CI 0.23–0.73), drainage volume (I2 = 89%, P < 0.05, MD = −105.33, 95% CI −161.33 to −49.33) and time (I2 = 93%, P < 0.05, MD = −2.18, 95% CI −3.75 to −0.61), necrosis (I2 = 35%, P = 0.20, RR = 0.37, 95% CI 0.16–0.86), surgical duration (I2 = 79%, P < 0.05, MD = −8.49, 95% CI −16.56 to −0.43), and hospital stay (I2 = 97%, P < 0.05, MD = −0.94, 95% CI −1.74 to −0.14) are significantly different between the two groups. CONCLUSIONS: Harmonic scalpel is superior to conventional tools in terms of decreasing intraoperative blood loss, seroma and hematoma formation, drainage volume and time, necrosis prevalence, surgical duration, and hospital stay, which should be strongly recommended in the surgery for breast cancer.

Analysis of Barriers on Doctor-patient Communication in China / 中国医学伦理学

From four aspects of the social and cultural barriers,the skills and role barriers of medical workers,patient needs and knowledge barriers,and the weakened third person functions in the conflict between doctors and patients,this paper concluded that the old doctor-patient communication mode,the weakening of the trust rela-tionship,the conflict between traditional moral education and modern society characteristics,the lack of communi-cation skills of medical works,the fixation of doctor's identity and role,the diversity of patient's needs,the con-flict between informed consent rights and the mastery of medical information,the weakening functions of third per-son and other barrier factors that affected the smooth communication between doctors and patients.And this paper put forward that in the process of social transformation,both doctors and patients will advance towards common or even shared communication,and the doctor-patient relationship will develop more harmoniously.

Velopharyngeal closure pattern and speech performance among submucous cleft palate patients / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To characterize the velopharyngeal closure patterns and speech performance among submucous cleft palate patients.</p><p><b>METHODS</b>Patients with submucous cleft palate visiting the Department of Cleft Lip and Palate Surgery, West China Hospital of Stomatology, Sichuan University between 2008 and 2016 were reviewed. Outcomes of subjective speech evaluation including velopharyngeal function, consonant articulation, and objective nasopharyngeal endoscopy including the mobility of soft palate, pharyngeal walls were retrospectively analyzed.</p><p><b>RESULTS</b>A total of 353 cases were retrieved in this study, among which 138 (39.09%) demonstrated velopharyngeal competence, 176 (49.86%) velopharyngeal incompetence, and 39 (11.05%) marginal velopharyngeal incompetence. A total of 268 cases were subjected to nasopharyngeal endoscopy examination, where 167 (62.31%) demonstrated circular closure pattern, 89 (33.21%) coronal pattern, and 12 (4.48%) sagittal pattern. Passavant's ridge existed in 45.51% (76/167) patients with circular closure and 13.48% (12/89) patients with coronal closure. Among the 353 patients included in this study, 137 (38.81%) presented normal articulation, 124 (35.13%) consonant elimination, 51 (14.45%) compensatory articulation, 36 (10.20%) consonant weakening, 25 (7.08%) consonant replacement, and 36 (10.20%) multiple articulation errors.</p><p><b>CONCLUSIONS</b>Circular closure was the most prevalent velopharyngeal closure pattern among patients with submucous cleft palate, and high-pressure consonant deletion was the most common articulation abnormality. Articulation error occurred more frequently among patients with a low velopharyngeal closure rate.</p>

Morphological classification and velopharyngeal function analysis of submucous cleft palate patients / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To enhance the accuracy in diagnosis and management of submucous cleft palate via a thorough analysis of its anatomical and functional details.</p><p><b>METHODS</b>Two hundred seventy-six submucous cleft palate cases from 2008 to 2014 were retrospectively investigated. Subgroup analysis were performed on the basis of preoperative velopharyngeal function, palatal morphology, cleft lip concurrence, and patient motives for treatment.</p><p><b>RESULTS</b>Among the included cases, 96 (34.78%) were presented as velopharyngeal competence (VPC), 151 (54.71%) as velopharyngeal insufficiency (VPI), and 29 (10.51%) as marginal VPI (MVPI). Eighty cases (28.99%) also demonstrated cleft lip deformity, and 196 cases (71.01%) were merely submucous cleft palate. Compared with patients with submucous cleft palate only, those with cleft lips exhibited higher rates of complete velopharyngeal closure. The pathological spectrum of submucous cleft palate varied significantly. Only 103 (37.32%) cases met all the three diagnostic criteria proposed by Calnan.</p><p><b>CONCLUSIONS</b>Given that the velopharyngeal closure rate varies among the subgroups, the factors analyzed in this study should be considered in the personalized manage-ment of submucous cleft palate.</p>

Effect of bronchodilators on dyspnea and pulmonary function in patients with COPD at different degrees / 中国生化药物杂志

Objective To investigate the effect of bronchodilators on dyspnea and pulmonary function in patients with chronic obstruction pulmonary disease (COPD) at different degrees.Methods 50 patients with COPD from January 2014 to January 2015 in pneumology department of Tongchuan City People's Hospital were selected.According to the standard of Global initiative for chronic obstructive lung disease (GOLD), the patients were divided into mild degree of 14 cases, moderate degree of 18 cases and severe degree of 18 case.The changes of Borg score of dyspnea, forced expiratory volume in one second (FEV1), forced vital capacity (FVC), peak expiratory flow (PEF) and inspiratory capacity (IC) after received tiotropium bromide inhalation in each group.Results FEV1, FVC, PEF and IC values significant improved in mild, moderate and severe degree groups after received tiotropium bromide inhalation and the values of improvement rate changed significantly with degrees of disease ( P <0.05 ).The improvement rates of FEV1, FVC and IC were highest in patients at severe degree, improvement rate of PEF was highest in patients at mild degree (P<0.05).After received tiotropium bromide inhalation, the Borg score improved significantly compared with that of pre-treatment in mild, moderate and severe degree groups (P<0.05), the improvement rate of Borg score was highest in severe degree group(P<0.05).There were significantly positive correlations between Borg score and FEV1(r=0.372),FVC(r=0.296),PEF(r=0.284),IC(r=0.704)(all P<0.05).Conclusion Bronchodilator could significantly improve dyspnea and lung function in patients with COPD, and the improvement rate of FEV1, FVC and IC is highest in patients with COPD at server degree, PEF is highest at mild degree and Borg score is highest at server degree, which need the comprehensive analysis of each indicators for reversibility of airflow obstruction.

Specific expression of CPS-II in hyperammonemia-injured liver cells / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To study the CPS-II mechanism underlying the pathological process of elevated blood ammonia leading to liver injury.</p><p><b>METHODS</b>An in vitro hyperammonemia hepatocyte cell model was constructed by exposure to various concentrations of NH4Cl. The subsequent changes to cellular morphology were observed by microscopy. to cell apoptosis were determined by flow cytometry, and to mRNA and protein expression of CPS-II were examined by real-time PCR and western blotting, respectively.</p><p><b>RESULTS</b>Exposure to NH₄Cl led to dose-dependent morphological damage, apoptosis and necrosis of the hepatocytes. The apoptosis rate was significantly higher for the high-dose group than for the control (no exposure) group (24.7% ± 2.39% vs. 4.1% ± 0.78%, q =8.06, P less than 0.05). Expression of the CPS-II mRNA was significantly elevated in response to NH₄Cl exposure (vs. the control group; F=191.881, P < 0.05).The CPS-II mRNA expression level increased with increasing NH₄Cl concentration (grey values: 1.040 ± 0.045, 1.641 ± 0.123, 2.285 ± 0.167 and 3.347 ± 0.124, respectively). The CPS-II protein expression level was also significantly enhanced in response to the NH₄Cl exposures (CPS-II protein and internal GAPDH grey value ratios: 0.099 ± 0.0130, 0.143 ± 0.025, 0.161 ± 0.036 and 0.223 ± 0.042, respectively; t=3.825, 3.968 and 6.908, P less than 0.05).</p><p><b>CONCLUSION</b>CPS-II mRNA and protein expression levels become elevated with increase in the NH₄Cl concentrations, suggesting that in addition to the urea cycle, CPS-II may play an important role in the ammonia metabolism under the condition of hyperammonemia.</p>

Correlative factors on the articulation disorder of patients with cleft palate / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To investigate the correlation between articulation, velopharyngeal function, and surgical age by comparing the changes in articulation after velopharyngeal closure is performed. This study is also conducted to investigate the influencing factors of omission change between pre- and post-operation.</p><p><b>METHODS</b>A total of 48 patients, including 18 males and 30 females, mean age (13.3 ± 5.8) years, with non-syndromic cleft lips and palates were selected from January 2011 to December 2011. Their speech data and articulation between pre- and post-operation were retrospectively analyzed using non-parametric tests. Correlation study was performed to analyze the influencing factors of the changes in articulation. P < 0.05 was considered statistically significant.</p><p><b>RESULTS</b>The difference in articulation after velopharyngeal closure occurred was significant (Z = -3.796, P = 0.000). A negative correlation between the ratio of post-operative normal articulation and surgical age (R = -0.487, P = 0.000) was observed. The change in omission was positively correlated with surgical age (R = 0.589, P = 0.000) and gender (R = 0.404, P = 0.047). By comparison, the change in omission was negatively correlated with follow-up time (R = -0.235, P = 0.040).</p><p><b>CONCLUSION</b>Articulation and intelligibility are significantly improved after velopharyngeal closure is performed. These parameters are negatively correlated with surgical age to some extent. In addition, the change in omission is positively correlated with surgical age and gender, whereas the change in omission is negatively correlated with follow-up time.</p>

Exploration and Analysis on Conversion Model of Chinese Medicine Scientific Achievements into Standards / 世界科学技术-中医药现代化

The smooth conversion of scientific achievements in Chinese medicine to standards acts as a bridge in the industrialization process of scientific achievements. By combining scientific researches and standards development of Chinese medicine, this paper analyzed how to establish a mechanism for mutual supports of scientific research and standards development. Based on different categories of scientific achievements in Chinese medicine, this paper ex-plored models for converting fundamental achievements for public wealth and technical achievements for products in-to standards.

A preliminary study on the consonant articulation of older patients with cleft palate / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To investigate the consonant pronunciation characteristics of older unoperated cleft palate patients.</p><p><b>METHODS</b>One hundred unoperated cleft palate patients (more than 8 years old) were included. Subjective speech assessment was delivered to each patient. The incidence and distribution of varies consonant misarticulation errors consisting of manners and places of articulation were summarized.</p><p><b>RESULTS</b>Consonant misarticulation existed among 86% of all cases. Compensatory misarticulation was observed in 66% patients, while 14% patients demonstrated completely normal articulation. The articulation manners of the highest correction rate, in succession, were nasals, lateral, fricatives, stops, and affricates. The error type of stops and affricates mainly consisted of compensation and omission. The articulation places of the highest correction rate, in succession, were bilabial, alveolar, linguadental, and velar.</p><p><b>CONCLUSION</b>Compensatory, omission, and substitution, which happen in all the stops, fricatives and affricates, are the top three misarticulation. The misarticulation incidence of unaspirated sound is higher than that of aspirated. Compensatory errors a the most common ones in aspirated sounds, while omission and weak pressure are more frequent in unaspirated sounds. Weak pressure is mainly observed in unaspirated consonants. As the articulation spot move backward, the compensation of fricatives and stops deteriorate, the omission of affricates increase.</p>

A study on the application of the perceptual assessment in the diagnosis of the velopharyngeal function / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To investigate the application of the perceptual assessment in the diagnosis of the velopharyngeal function, to provide a reference to the improvement of the velopharyngeal function diagnosis through comparing the consistency between the diagnosis of the perceptual assessment and the objective assessment.</p><p><b>METHODS</b>All subjects (254) were selected from the Department of Cleft Lip and Palate Surgery, West China School of Stomatology, Sichuan University, from 2000-2010. The results of the perceptual and the nasopharyngeal fiberscope (NPF) assessment were retrospectively analyzed, and the consistent rate between the two assessment methods was calculated. The Kappa test and the correlation analysis were performed to analyze the consistency and correlation, and the factors relating to the perceptual assessment were analyzed by the correlation coefficient.</p><p><b>RESULTS</b>There were 254 patients met the inclusion criteria. The consistent number of the patients diagnosed by the perceptual and the objective assessment as velopharyngeal competence (VPC) and velopharyngeal insufficiency (VPI) were 58 and 167 respectively. The consistent rate was 88.58% for all patients, and 66.67% for the VPC patients. The Kappa value was 0.721, Spearman's R=0.751, P<0.05. There were correlation between the hypernasality, the nasal emission and the subjective assessment, and Spearman's R=0.697, 0.590, P<0.05.</p><p><b>CONCLUSION</b>The VPC patients and the VPI patients with moderate and severe hypernasality and nasal emission diagnosed by the perceptual assessment could be exempt from the objective examination. Patients diagnosed with mild hypernasality and nasal emission by the perceptual assessment should be further referred to NPF or other instruments.</p>