Application of 3D reconstruction and Hookwire to localize pulmonary nodules in thoracoscopic pulmonary segmentectomy / 中国胸心血管外科临床杂志

@#Objective    To investigate the clinical value of 3D CT combined with CT-guided Hookwire for localizing small pulmonary nodules in thoracoscopic pulmonary segmentectomy. Methods    From December 2017 to February 2019, 39 patients received thoracoscopic pulmonary segmentectomy in our hospital, including 14 males and 25 females with a mean age of 51.33±11.17 years. Before operation, we used Mimics Medical 20.0 to re-establish the anatomy of lung and locate the small pulmonary nodules with Hookwire guided by CT. Based on the position of Hookwire needle, 3D CT images and simulated surgical methods, thoracoscopic pulmonary segmentectomy was performed accurately. Results    The surgery was successfully completed in 39 patients without a transfer to open procedure. The mean operation time, mean intraoperative blood loss, mean postoperative hospital stay, mean thoracic tube drainage time were 148.97±28.56 min, 27.95±17.57 mL, 6.95±1.68 d, 4.21±1.95 d, respectively. Postoperative complications occurred in 5 patients (12.82%), including atrial fibrillation in 1, pulmonary infection in 1, chylothorax in 1, intrathoracic hemorrhage in 1 and pneumothorax in 1. All actual surgical margins were larger than 3.0 cm. Conclusion    The application of preoperative 3D CT combined with CT-guided Hookwire to localize small pulmonary nodules is helpful for accurate anatomical segmental resection of the lung, making the operation safe .

Transcatheter arterial chemoembolization for hepatocellular carcinoma complicated by portal vein tumor thrombosis: prognostic analysis / 介入放射学杂志

Objective To investigate the potential prognostic factors in patients with hepatocellular carcinoma (HCC) complicate by portal vein tumor thrombosis (PVTT) who are treated with transcatheter arterial chemoembolization (TACE). Methods The complete clinical data of a total of 46 patients with HCC complicate by PVTT, who were treated with TACE during the period from January 2010 to March 2016, were retrospectively analyzed. Clinical material database was established. Kaplan-Meier test was adopted to analyze the survival rate and the COX risk ratio model was used to screen out the independent prognostic factors. Life table method was employed to calculate the survival time. Results The 6-, 12-, 18- and 24-month survival rates were 51. 2％, 28. 9％, 23. 4％ and 10. 2％, respectively. The median survival time was 6. 7 months. According to mRECIST standard, complete remission (CR) was obtained in one patient (2. 1％), partial remission (PR) in 11 patients (23. 9％), stable disease (SD) in 16 patients (34. 8％) and progress disease (PD) in 18 patients (39. 2％). Multivariate analysis indicated that local tumor response, ascites, cholinesterase, and arteriovenous fistula were the independent factors affecting the prognosis. Conclusion The independent prognostic factors that affect the survival time of HCC patient include local tumor response, ascites, cholinesterase and arteriovenous fistula. (J Intervent Radiol, 2018, 27: 266-271)

Investigation about the use of antibiotics for type Ⅰ incision thyroid surgery / 中国基层医药

Objective To investigate the use of antibiotics for type Ⅰ incision thyroid surgery of our hospital,so as to provide guidance for reasonable clinical use of antibiotics.Methods A total of 149 discharged patients of Xinhua Hospital,who underwent the type Ⅰ incision thyroid surgery from Jun 2015 to Jun 2016,were enrolled in the study.There were 117 cases underwent unilateral thyroid surgery,and there were 32 cases underwent bilateral thyroid surgery.According to the operation condition,the application of antibiotics in perioperative period,the number of days in hospital,the total cost of hospitalization,the infection situation and so on were analyzed.Results There were 69 cases(58.97％) who were perioperative prophylactic use of antibiotics,of which unilateral surgery 117 cases,and there were 20 cases(62.50％) who were perioperative prophylactic use of antibiotics,of which bilateral surgery 32 cases.The hospitalization days and hospitalization cost of the antibiotics used group were higher than those of the antibiotics unused group.All the cases were well stage wound healing,and one case occurred nosocomial infection.Conclusion It is not worthy for the prophylactic use of antibiotics for the type Ⅰ clean incision thyroid surgery to prevent the nosocomial infection,furthermore,the hospitalization days and hospitalization cost of patients increased.

Synthesis of Naphthalimide-based Biothiols Probe and Detection of Amino Acids Containing Sulfhydryl Groups / 分析化学

A novel probe (DNSBN) towards biothiols on the basis of 4-hydroxynaphthalimide as fluorophores and 2, 4-dinitrobenzenesulfonyloxy group as specific recognition site was designed and synthesized.The result of absorption and fluorescence spectral analyses indicated that the probe had high sensitivity and selectivity towards cysteine (Cys), homocysteine (Hcy) and glutathione (GSH), and the detection was not affected by other 17 kinds of natural amino acids.Meanwhile, it was confirmed that DNSBN was a ratiometric probe through the fluorescence titration experiment, and the fluorescent intensity at 555 nm had a high linear relationship with biothiols concentration in the range of 0-20 μmol/L.The detection limits (3σ) of Cys, Hcy and GSH were 25.9, 92.0 and 77.9 nmol/L, respectively.The absorption, emission and mass spectra indicated that biothiols could be engaged in nucleophilic substitution reaction with 2,4-dinitrobenzenesulfonate, which induced the sulfonic esters decomposed.With the departure of receptor unit, the d-PeT progress (donor-excited photoinduced electron transfer) was blocked with an obvious colorimetric and fluorescence change.Finally, HeLa cell imaging experiments verified that DNSBN had good biocompatibility and could be used to detect exogenous biothiols.

Region Ⅵ lymph nodes dissection in treatment of 38 cases with cN0 papillary thyroid carcinoma / 中华内分泌外科杂志

Objective To discuss the significance of region Ⅵ lymph nodes dissection in treatment of patients with clinical cervical nodes negative(cN0)papillary thyroid carcinoma(PTC).Methods Clinical data of 38 cases of cN0 PTC treated with region Ⅵ lymph nodes dissection were retrospectively analyzed.The related literature was reviewed.The cervical nodes dissection scope and the key operation points in treatment of cN0 PTC were discussed.Results No permanent recurrent laryngeal nerve injury or parathyroid damage happened.14 cases(36.84％)had occult lymph node metastasis to region Ⅵ lymph nodes.After more than 5 years of follow-up,all the cases had excellent life quality.3 cases(7.89％)were found lymph node metastasis to lateral cervical region and they were given functional neck dissection.No recurrence or metastasis occurred to the 3 cases during more than 2 years of follow-up.Conclusion Region Ⅵ lymph node dissection in treatment of cN0 PTC is safe,reliable,and with less complications.

The impact of long-term alcohol drinking heavily on the attention networks / 中国基层医药

Objective To explore the impact of alcohol to attention networks.Methods The attention network test was performed in 33 alcoholics and 27 normal controls on the efficiency of three anatomically defined attentional networks:alerting,orienting and executive control.Results The orienting network function was significantly lower(t =-3.72,P ＜0.01 ) in alcoholics (26.7 ± 38.6) ms than that in normal controls (51.8 ± 22.3 ) ms.The executive networks effects was higher and the alerting networks effects was lower in alcoholics than in normal controls,however without significant difference ( P ＞ 0.05 ).Conclusion The parietal lobe and cholinergic system may be more significantly affected by the alcohol.

Study on Reoperation Treatment of Differentiated Thyroid Carcinoma in Teenager: A Report of 36 Cases / 中国医师杂志

Objective To study the causes of misdiagnosis for differentiated thyroid carcinoma in teenager, the re-operative indication and style as well as the prevention of complication. Methods The clinical data of 36 cases of re-operative treatment for differentiated thyroid carcinoma in teenager from 1991 to 2002 were analyzed retrospectively.Results The incidence of residual cancer and cervical lymphnode metastasis in the patients was 38.9% and 30.5% respectively. The re-operative complications included 2 cases of hoarseness, and 3 cases of hand and foot spasm. Five-year and ten-year survival rates after reoperation were 90.4% and 88.9%, respectively. Conclusion Thyroid nodules in teenager should be guarded against malignancy. FNAB(Fine-Needle Aspiration Biopsy) is helpful for diagnosis before the operation, and pathological observation of frozen section during operation must be performed as routine examination. Choosing suitabel operative style could raise the operative excision rate and quality of life. The improved operation skill could reduce the operative complications.

Clinical Application of the Upper Part Gluteus Maximum Myocutaneous Flap to the Repair of Huge Sacarl Pressure Sores / 中国医师杂志

Objective To explore a safe,high efficiency and rapid approach for the repair of huge sacral pressure sores. Methods From 1993 to 2001,17 cases of huge sacral pressure sore were repaired using the pedicled upper part gluteus maximum myocutaneous flap .Results The outcome of repair in stage Ⅰ was satisfactory in all the cases during the followed-up period for 1～9 years,the size of the flap ranged from 16cm?10cm to 10cm?8cm,No recurrence was occurred,The function of gluteus in donor areas was keeped maximally. Conclusions The method is a good treatment for huge sacral pressure sores. It possesses the advantages of easiness to perform,rich blood supply,no necessity of free skin graft in the donor areas,less complications,high success rate. The treatment can be completed in one stage.It is worthy of popularization.