Analysis of the status quo of early postoperative pain belief in patients with mixed hemorrhoids and its influencing factors / 中国实用护理杂志

Objective:To investigate the current situation of early postoperative pain beliefs in patients with mixed hemorrhoids and its influencing factors, and to provide a basis for formulating targeted intervention measures.Methods:Totally 242 postoperative patients with mixed hemorrhoids who were treated in Guilin Integrated Traditional Chinese and Western Medicine were selected by convenience sampling method from January 2020 to January 2021 as the research object. The general information questionnaire, Pain Belief and Perception Scale, Visual Analogue Scale, Positive and Negative Emotion Scale were used to investigate. Multiple linear regression was used to analyze the factors influencing of early postoperative pain beliefs in patients with mixed hemorrhoids.Results:The total score of early postoperative pain belief in patients with mixed hemorrhoids was -21-30 (5.32 ± 2.57) points; the results of multiple linear regression analysis showed that age, education level, anal visual analogue score, and negative emotion scores were main factors affecting their pain beliefs ( r=0.736, P<0.05). Conclusions:Patients with mixed hemorrhoids have negative pain beliefs in the early postoperative period. Patients with advanced age, primary/junior high school, high anal pain intensity, and high negative emotion scores are more likely to have negative pain beliefs. Nursing staff should promptly formulate targeted intervention measures according to the main influencing factors in order to reduce the occurrence of negative beliefs about pain.

Qualitative study of pain catastrophic experience of patients after mixed hemorrhoid surgery / 中国实用护理杂志

Objective:To deeply understand the pain perception and experience of patients after mixed hemorrhoid surgery, so as to provide reference for taking targeted intervention measures to relieve pain symptoms.Methods:Purpose sampling method was used to conduct semi-structured in-depth interviews with 9 patients with postoperative pain of mixed hemorrhoids admitted to Guilin Hospital of Integrated Traditional Chinese and Western Medicine from February to March 2021, and Colaizzi phenomenological analysis method was used to analyze data and refine themes.Results:The pain perception and experience of patients after mixed hemorrhoid surgery can be summarized into 5 themes: fear of pain, persistent negative thinking about pain, perception of inability to cope with pain, emotional expectation, and expectation of Traditional Chinese Medicine nursing techniques.Conclusions:Patients after mixed hemorrhoid surgery have many burdens and needs in terms of pain experience. Medical staff must establish a complete pain management system for patients after mixed hemorrhoid surgery, aiming at the catastrophic pain experience of patients, correcting their cognitive level of pain management, and satisfying patients Alleviate the need for pain, establish an effective emotional and family support system, improve its pain self-management ability, and promote postoperative recovery.

Evaluation of plan quality for IMPT and VMAT in the treatment of patients with prostate cancer / 中华放射医学与防护杂志

Objective@#To study the dosimetric characteristics and plan quality of PTV-based intensity modulated proton radiotherapy (IMPT) and volumetric-modulated arc therapy (VMAT) plans for prostate cancer, so as to provide a reference for clinical application.@*Methods@#A total of 10 prostate cancer cases were included in this retrospective study. IMPT and RapidArc plans were designed by RayStation and Eclipse TPS based on PTV, respectively. For each case, IMPT plans were generated using multiple field optimization (MFO) technique with two parallel-opposed lateral fields, whereas RapidArc plans were generated using double-arc technique (two full arcs). Final dose calculation of IMPT was conducted by pencil beam(PB) and Monte Carlo (MC) algorithm, respectively, with adopted data model from the pencil beam scanning (PBS) proton therapy system of IBA Protues Plus(IBA Group, Belgium); The data model originated from the linear accelerator of Varian Clinac iX (Varian Medical Systems, America) was used for RapidArc plans. Dosimetric parameters of DVH and dose distribution were used to compare the dose differences in targets and organs at risk (OARs) between these two treatment techniques.@*Results@#For targets, HIs of PB-IMPT and MC-IMPT were slightly better than that of RapidArc , but CI of IMPT was slightly lower than that of RapidArc; D1% of PB-IMPT was significantly better than those of MC-IMPT and RapidArc (Z=-2.805, -2.803, P<0.05). PB-IMPT and MC-IMPT achieved better protection than RapidArc on rectum V30(Z=-2.191, -1.988, P<0.05)and Dmean(Z=-2.599, -2.497, P<0.05), bladder V30(Z=-2.701, -2.701, P<0.05), V40(Z=-2.395, -2.395, P<0.05)and Dmean(Z=-2.701, -2.701, P<0.05). There was no significant difference between PB-IMPT and MC-IMPT plans for prostate cancer, except for the D1% [(73.86±67.34) Gy vs.(75.45±2.01) Gy] (RBE) and HI [(0.040±0.010) vs. (0.058±0.020)] of the target.@*Conclusions@#Both techniques can meet the clinical requirements, but IMPT showed significant dosimetric advantages compared with RapidArch by reducing the dose to OARs and improving the plan quality.

Acceptance tests of beam performance for pencil beam scanning (PBS) proton system of IBA / 中华放射肿瘤学杂志

Objective:To explore the beam performance of GTR 360° PBS dedicated nozzle for IBA Proteus Plus proton system and evaluate the beam characteristics of PBS during acceptance test procedure (ATP) to meet the precision and safety requirements of clinical treatment.Methods:According to the requirements of acceptance tests, the beam tests of PBS mainly included: test of integrated depth dose (IDD), test of maximum field size at the maximum and minimum ranges, field uniformity and informative PBS tests for the GTR 360°, test of lateral dose uniformity in a single field uniform dose in a cube, test of longitudinal dose uniformity in a single field uniform dose in a cube, and test of monitor unit reproducibility and proportionality.Results:The maximum deviation measured of range, fall back accuracy and distal fall-off was 0.03 g/m 2, 0.01 g/m 2 and 0.078 g/m 2, respectively. Maximum field size at the maximum and minimum ranges was 30.2 cm×40.2 cm and 30.1 cm×40.1 cm, respectively. During the different gantry angles and ranges, the lowest γ passing rate of a pattern plan was 97%, the maximum deviation of the centrical beam spot size at the X and Y axes was -0.16 mm and -0.21 mm, and the worst symmetry was 0.80%. Compared with the centrical beam spot, the maximum size deviation of the other beam spots was 0.11 mm and 0.14 mm at the X and Y axes, and the maximum position accuracy deviation of the beam spot was 0.60 mm and 0.43 mm at the X and Y axes. The maximum deviation of lateral dose uniformity at at the X and Y axes was 0.55% and 0.80% in the high energy region, and 0.6% and 0.75% in the low energy region. The maximum deviation of longitudinal dose uniformity was 0.79% in the high energy region, and 2.22% in the low energy region. The monitor unit (MU) reproducibility factor was 0.106% and the maximum proportionality deviation was 0.67%. Conclusion:The dedicated nozzle of PBS has passed all the beam performance acceptance tests, which meet the requirements of all parameters, and the whole system yields relatively high accuracy, repeatability and good stability.

Evaluation of plan quality for IMPT and VMAT in the treatment of patients with prostate cancer / 中华放射医学与防护杂志

Objective To study the dosimetric characteristics and plan quality of PTV-based intensity modulated proton radiotherapy (IMPT) and volumetric-modulated arc therapy (VMAT) plans for prostate cancer,so as to provide a reference for clinical application.Methods A total of 10 prostate cancer cases were included in this retrospective study.IMPT and RapidArc plans were designed by RayStation and Eclipse TPS based on PTV,respectively.For each case,IMPT plans were generated using multiple field optimization (MFO) technique with two parallel-opposed lateral fields,whereas RapidArc plans were generated using double-arc technique (two full arcs).Final dose calculation of IMPT was conducted by pencil beam (PB) and Monte Carlo (MC) algorithm,respectively,with adopted data model from the pencil beam scanning (PBS) proton therapy system of IBA Protues Plus (IBA Group,Belgium);The data model originated from the linear accelerator of Varian Clinac iX (Varian Medical Systems,America) was used for RapidArc plans.Dosimetric parameters of DVH and dose distribution were used to compare the dose differences in targets and organs at risk (OARs) between these two treatment techniques.Results For targets,HIs of PB-IMPT and MC-IMPT were slightly better than that of RapidArc,but CI of IMPT was slightly lower than that of RapidArc;D1 of PB-IMPT was significantly better than those of MC-IMPT and RapidArc (Z =-2.805,-2.803,P ＜ 0.05).PB-IMPT and MC-IMPT achieved better protection than RapidArc on rectum V30 (Z =-2.191,-1.988,P＜ 0.05) and D (Z =-2.599,-2.497,P＜0.05),bladder V30 (Z=-2.701,-2.701,P＜0.05),V40 (Z=-2.395,-2.395,P＜0.05) and D (Z =-2.701,-2.701,P ＜ 0.05).There was no significant difference between PB-IMPT and MC-IMPT plans for prostate cancer,except for the D1％ [(73.86t67.34) Gy vs.(75.45±2.01) Gy] (RBE) and HI [(0.040±0.010) vs.(0.058±0.020)] of the target.Conclusions Both techniques can meet the clinical requirements,but IMPT showed significant dosimetric advantages compared with RapidArch by reducing the dose to OARs and improving the plan quality.

Effect of PhysioTouch on Upper Limb Lymphedema after Breast Cancer Surgery / 中国康复理论与实践

Objective:To investigate the effect of PhysioTouch on upper limb lymphedema after breast cancer surgery. Methods:From September, 2017 to August, 2018, 42 patients with upper limb lymphedema after breast cancer operation were randomly divided into control group (n = 21) and experimental group (n = 21). Both groups accepted complex decongestion therapy, while the experimental group accepted PhysioTouch in addition, for four weeks. They were assessed with difference of upper limb volume, Disabilities of the Arm, Shoulder and Hand (DASH), and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire of Breast Cancer (EORTC QLQ‐BR23) before and after treatment. Results:All the indexes significantly improved in both groups after treatment (t > 17.925, P < 0.001), and improved more in the experimental group than in the control group (t > 2.407, P < 0.05). Conclusion:Combination of PhysioTouch can further relieve upper limb edema after breast cancer operation, and improve their shoulder-hand function and quality of life.

Changes of inflammatory factors after hepatic cystic echinococcosis surgery and intervention of ulinastatin in Qinghai area / 中国血吸虫病防治杂志

Objective To observe the changes of inflammatory factors after the hepatic cystic echinococcosis surgery and explore the intervention effect of ulinastatin on postoperative inflammatory factors. Methods Sixty patients with hepatic cystic echinococcosis were selected and randomly divided into a control group and ulinastatin intervention group according to whether or not use ulinastatin. The peripheral venous blood was extracted in all the patients and the levels of IL-6, IL-8, IL-9, and IL-10 were detected by the ELISA method on the day before operation, 1 day, 3 days, 5 days and 7 days after operation, respectively. The data was statistical analyzed to detect the relationships between/among the inflammatory factors mentioned above and ulina-statin and time. Results The variation of the levels of IL-6, IL-8, IL-9, and IL-10 were changed by the intervention of ulina-statin at different time. The differences of the levels of IL-6, IL-8, IL-9, and IL-10 between the ulinastatin intervention group and the control group were not significant on the day before operation, 1 day and 3 days after operation (t = -1.15 to 1.82, all P > 0.05), but the levels of IL-6, IL-8, IL-9, and IL-10 of the ulinastatin intervention group were significantly lower than those of the control group and there were statistically significant differences 5 days and 7 days after the operation (t = 3.22 and 23.51, both P<0.05) . Conclusion Ulinastatin has a good effect in inhibiting the inflammatory factors and can protect and repair the postoperative hepatic injury as well in patients with hepatic cystic echinococcosis.

The correlation research between carotid intima-media thickness and enlargement of left atrium and left ventricle for patients with acute cerebral infarction / 实用医学杂志

Objective To investigate the correlation between carotid intima-media thickness (CIMT) and left atrial and left ventricular enlargement in patients with acute cerebral infarction. Methods A total of 224 patients with acute cerebral infarction were included. Based on the thickness of CIMT, it was divided into three groups which were normal CIMT group, thickening CIMT group, and carotid plaque (CP) group, with 57, 97, and 70 patients included respectively. Clinical data were collected, and carotid artery color Doppler ultrasound, cardiac color Doppler ultrasound and other examinations were determined to carry out relevant statistical analysis.Results The left anterior-posterior diameter (LAD) , left atrial diameter index (LADI) , left ventricular end-diastolic septal thickness (IVSD) , and left ventricular mass index (LVMI) in the CP group were all higher than those in the normal CIMT group and thickening CIMT group (P < 0.05). The percentage of the left ventricular end-diastolic diameter (LVEDD) and left ventricular ejection fraction (LVEF) took in the thickening CIMT group were both higher than those in the CP group (P < 0.05). Multi-factor logistic regression analysis indicated that there were statistically significant differences in age, homocysteine and left LVMI (P < 0.05). In the Pearson correlation analysis, CIMT and LADI were positively correlated (r= 0.184, P < 0.01) , and there was a positive correlation between CIMT and LVMI (r = 0.236, P < 0.01). Conclusions Left ventricular enlargement is one of the highrisk factors for CIMT abnormalities in patients with acute cerebral infarction. Left atrial and left ventricular enlargement are closely correlated to the severity of CIMT in patients with acute cerebral infarction, indicating that abnormal CIMT in patients with acute cerebral infarction has a certain predictive effect on left atrial and left ventricular enlargement.

Changes of inflammatory factors after hepatic cystic echinococcosis surgery and intervention of ulinastatin in Qinghai area / 中国血吸虫病防治杂志

Objective To observe the changes of inflammatory factors after the hepatic cystic echinococcosis surgery and explore the intervention effect of ulinastatin on postoperative inflammatory factors. Methods Sixty patients with hepatic cystic echinococcosis were selected and randomly divided into a control group and ulinastatin intervention group according to whether or not use ulinastatin. The peripheral venous blood was extracted in all the patients and the levels of IL-6, IL-8, IL-9, and IL-10 were detected by the ELISA method on the day before operation, 1 day, 3 days, 5 days and 7 days after operation, respectively. The data was statistical analyzed to detect the relationships between/among the inflammatory factors mentioned above and ulina-statin and time. Results The variation of the levels of IL-6, IL-8, IL-9, and IL-10 were changed by the intervention of ulina-statin at different time. The differences of the levels of IL-6, IL-8, IL-9, and IL-10 between the ulinastatin intervention group and the control group were not significant on the day before operation, 1 day and 3 days after operation (t = -1.15 to 1.82, all P > 0.05), but the levels of IL-6, IL-8, IL-9, and IL-10 of the ulinastatin intervention group were significantly lower than those of the control group and there were statistically significant differences 5 days and 7 days after the operation (t = 3.22 and 23.51, both P<0.05) . Conclusion Ulinastatin has a good effect in inhibiting the inflammatory factors and can protect and repair the postoperative hepatic injury as well in patients with hepatic cystic echinococcosis.

Evaluation of plan quality between two treatment planning systems for volumetric modulated arc therapy / 中华放射肿瘤学杂志

Objective To investigate the plan quality between two treatment planning systems (TPSs) for volumetric modulated arc therapy (VMAT). Methods VMAT plans based on Varian Eclipse and Philips Pinnacle TPS were designed for 10 cervical cancer patients (2, 3 Arcs) and 10 prostate cancer patients ( 1, 2 Arcs) . The delivery system of VMAT was Varian ClinaciX machine, and RapidArc was used. The treatment plan quality between the two TPSs was evaluated based on dose distribution, delivery efficiency, and parameter settings. The differences between the two TPSs were compared using paired t-test. Results For cervical cancer patients, the 2-Arc VMAT plans based on the Pinnacle was slightly better than those based on the Eclipse in terms of the conformal index ( CI) of planning target volume ( PTV) , rectum V30 and V40 , and bladder V30 and V40 , and the homogeneity index ( HI) of PTV and PTV1 as well as CI of PTV1 in the Eclips were slightly better than those in the Pinnacle( P<005) Pinnacle were slightly worse than those in the Eclipse ( P>005) . The number of monitor units with 2-Arcs and 3-Arcs plans of the Eclipse was significantly smaller than those in the Pinnacle (P<005). For prostate cancer patients, The 1-arc VMAT plans of the Pinnacle TPS were slightly superior to those of the Eclipse TPS in terms of the HI of PTV, rectumV30 and V40 , and bladderV30 and V40 , but the former was slight inferior to the latter in terms of the CI of PTV (P<005). The number of monitor units of 1-arc and 2-Arcs plans showed no significant difference between the two TPSs (P>005). Conclusions For patients with cervical cancer and prostate cancer, the VMAT plans based on Varian Eclipse and Philips Pinnacle TPS can achieve a clinically acceptable dose distribution and show a little difference in the treatment plan quality. However, we will still need more cases to further study and determine the performance characteristics of the commercial TPSs for optimizing VMAT.

Evaluation of plan quality between two treatment planning systems for volumetric modulated arc therapy / 中华放射肿瘤学杂志

Objective To investigate the plan quality between two treatment planning systems (TPSs) for volumetric modulated arc therapy (VMAT). Methods VMAT plans based on Varian Eclipse and Philips Pinnacle TPS were designed for 10 cervical cancer patients (2, 3 Arcs) and 10 prostate cancer patients ( 1, 2 Arcs) . The delivery system of VMAT was Varian ClinaciX machine, and RapidArc was used. The treatment plan quality between the two TPSs was evaluated based on dose distribution, delivery efficiency, and parameter settings. The differences between the two TPSs were compared using paired t-test. Results For cervical cancer patients, the 2-Arc VMAT plans based on the Pinnacle was slightly better than those based on the Eclipse in terms of the conformal index ( CI) of planning target volume ( PTV) , rectum V30 and V40 , and bladder V30 and V40 , and the homogeneity index ( HI) of PTV and PTV1 as well as CI of PTV1 in the Eclips were slightly better than those in the Pinnacle( P<005) Pinnacle were slightly worse than those in the Eclipse ( P>005) . The number of monitor units with 2-Arcs and 3-Arcs plans of the Eclipse was significantly smaller than those in the Pinnacle (P<005). For prostate cancer patients, The 1-arc VMAT plans of the Pinnacle TPS were slightly superior to those of the Eclipse TPS in terms of the HI of PTV, rectumV30 and V40 , and bladderV30 and V40 , but the former was slight inferior to the latter in terms of the CI of PTV (P<005). The number of monitor units of 1-arc and 2-Arcs plans showed no significant difference between the two TPSs (P>005). Conclusions For patients with cervical cancer and prostate cancer, the VMAT plans based on Varian Eclipse and Philips Pinnacle TPS can achieve a clinically acceptable dose distribution and show a little difference in the treatment plan quality. However, we will still need more cases to further study and determine the performance characteristics of the commercial TPSs for optimizing VMAT.

Minimally invasive percutaneous compression plating versus dynamic hip screw for intertrochanteric fractures: a randomized control trial / 中华创伤杂志(英文版)

<p><b>OBJECTIVE</b>Intertrochanteric femur fracture is a common injury in elderly patients. The dynamic hip screw (DHS) has served as the standard choice for fixation; however it has several drawbacks. Studies of the percutaneous compression plate (PCCP) are still inconclusive in regards to its efficacy and safety. By comparing the two methods, we assessed their clinical therapeutic outcome.</p><p><b>METHODS</b>A total of 121 elderly patients with intertrochanteric femur fractures (type AO/OTA 31.A1-A2, Evans type 1) were divided randomly into two groups undergoing either a minimally invasive PCCP procedure or a conventional DHS fixation.</p><p><b>RESULTS</b>The mean operation duration was significantly shorter in the PCCP group (55.2 min versus 88.5 min, P<0.01). The blood loss was 156.5 ml±18.3 ml in the PCCP group and 513.2 ml±66.2 ml in the DHS group (P<0.01). Among the patients treated with PCCP, 3.1% needed blood transfusions, compared with 44.6% of those that had DHS surgery (P<0.01). The PCCP group displayed less postoperative complications (P<0.05). The mean American Society of Anesthesiologists score and Harris hip score in the PCCP group were better than those in the DHS group. There were no significant differences in the mean hospital stay, mortality rates, or fracture healing.</p><p><b>CONCLUSION</b>Due to several advantages, PCCP has the potential to become the ideal choice for treating intertrochanteric fractures (type AO/OTA 31.A1-A2, Evans type 1), particularly in the elderly.</p>

Effect of aspirin plus clopidogrel therapy on aspirin resistance after off-pump coronary artery bypass surgery / 中国医学科学院学报

<p><b>OBJECTIVE</b>To investigate the effect of the anti-platelet effect of aspirin plus clopidogrel on off-pump coronary artery bypass (OPCAB) grafting and the possible side effects of such therapy.</p><p><b>METHODS</b>Sixty patients who underwent standard OPCAB were randomized immediately after surgery in two groups: the aspirin alone group of 30 patients who received aspirin (100 mg) daily; and the combination group of 30 patients who received clopidogrel (75 mg) plus aspirin (100 mg) daily. Platelet aggregation in response to arachidonic acid (PLAA) and adenosine diphosphate (PLADP) were measured at baseline (before surgery) and 1-6, 8, and 10 days after the medication. Postoperative bleeding and other perioperative parameters were compared between these two groups.</p><p><b>RESULTS</b>There were no significant differences between the two groups in perioperative findings including average number of distal anastomosis, operative time, postoperative bleeding, ventilation time, and intensive care unit stay (all P>0.05). The proportion of patients with the PLAA above 20% value was significantly lower in the combination group than those in the aspirin alone group (32.1% vs 62.1%, P<0.05). PLAA of two groups one and two days after taking aspirin or plus clopidogrel were (24.2±31.9)% vs. (49.6±32.6)% and (13.8±27.2)% vs. (37.6±37.4)%, respectively (P<0.05). No obvious postoperative complication was noted in both groups. Multivariate analysis showed that clopidogrel administration was independently correlated with aspirin resistance (P=0.044, OR = 0.09;95% CI=0.07-0.48).</p><p><b>CONCLUSION</b>Early combined use of aspirin plus clopidogrel after OPCAB can remarkably reduce OPCAB-related aspirin resistance and enjoy similar safety.</p>

Effects of pravastatin on the proliferation and invasion of human hepatocarcinoma HepG2 cell line / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To observe the effects of pravastatin on the proliferation and invasion of human hepatocarcinoma HepG2 cell line.</p><p><b>METHODS</b>The effects of pravastatin on the proliferation, migration and invasion of HepG2 cells was observed by MTT assay, Boyden chamber assay and motility assay. p38 activity was measured, and the expression of p-p38, MKP-1, RhoC and MMP-2 was analyzed by Western blot.</p><p><b>RESULTS</b>Pravastatin inhibited the proliferation of HepG2 cells. The intracellular p38 activity and expressions of p-p38, RhoC and MMP-2 were decreased, while MKP-1 expression was elevated in pravastatin treated cells. In addition, pravastatin inhibited the invasion and motility.</p><p><b>CONCLUSION</b>Pravastatin can inhibit the proliferation and invasion of HepG2 cells.</p>