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Objective:To investigate the influencing factors of textbook outcomes in liver surgery (TOLS) after radical resection of gallbladder carcinoma.Methods:The retrospective case-control study was conducted. The clinicopathological data of 530 patients who underwent radical resection of gallbladder carcinoma in 15 medical centers, including the First Affiliated Hospital of Army Medical University et al, from January 2014 to January 2020 were collected. There were 209 males and 321 females, aged (61±10)years. Patients underwent radical resection of gallbladder carcinoma, including cholecystectomy, hepatectomy, invasive bile duct resection, and lymph node dissection. Observation indicators: (1) situations of TOLS; (2) influencing factors of TOLS. Measure-ment data with normal distribution were represented as Mean± SD, and comparison between groups was conducted using the independent sample t test. Measurement data with skewed distribution were represented as M( Q1, Q3), and comparison between groups was conducted using the Mann-Whitney U test. Count data were described as absolute numbers or percentages, and comparison between groups was conducted using the chi-square test. Comparison of ordinal data between groups was conducted using the Mann-Whitney U test. The univariate analysis was conducted using the corresponding statistical methods based on data type, and variables with P<0.10 were included in multivariate analysis. Multivariate analysis was conducted using the Logistic stepwise regression model. Results:(1) Situations of TOLS. All 530 patients underwent radical resection of gallbladder carcinoma, and there were 498 cases achieving R 0 resection, 508 cases without ≥grade 2 intra-operative adverse events, 456 cases without postoperative grade B and grade C biliary leakage, 513 cases without postoperative grade B and grade C liver failure, 395 cases without severe com-plications within postoperative 90 days, 501 cases did not being re-admission caused by severe com-plications within postoperative 90 days. Of the 530 patients, 54.53%(289/530) of patients achieved postoperative TOLS, while 45.47%(241/530) of patients did not achieve postoperative TOLS. (2) Influencing factors of TOLS. Results of multivariate analysis showed that American Society of Anesthesiologists classification >grade Ⅱ, preoperative jaundice, T staging as T3?T4 stage, N staging as N2 stage, liver resection as right hemi-hepatectomy, and neoadjuvant therapy were independent factors influencing TOLS in patients undergoing radical resection of gallbladder carcinoma ( odds ratio=2.65, 1.87, 5.67, 5.65, 2.55, 3.34, 95% confidence interval as 1.22?5.72, 1.18?2.95, 2.51?12.82, 2.83?11.27, 1.41?4.63, 1.88?5.92, P<0.05). Conclusion:American Society of Anesthesiologists classification >grade Ⅱ, preoperative jaundice, T staging as T3?T4 stage, N staging as N2 stage, liver resection as right hemi-hepatectomy, and neoadjuvant therapy are independent factors influencing TOLS in patients undergoing radical resection of gallbladder carcinoma.
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Objective:To investigate the inhibitory effect of esomeprazole on proliferation and chemosensitizing effect of breast cancer cells.Methods:Human MBA-MD-231, MCF-7 breast cancer cell line and human Huh7 liver cancer cell line were cultured by conventional methods; cells were treated with different concentrations of esomeprazole, and CCK8 kit was used to detect the proliferation of different tumor cells after stimulation. Cells were treated with different concentrations of esomeprazole, and the effects of esomeprazole on cell cycle of different cells were analyzed by flow cytometry. Cells were treated with different concentrations of paclitaxel and epirubicin combined with esomeprazole, and CCK8 kit was used to detect the proliferation of different tumor cells after stimulation. Measurement data were expressed as mean ± standard deviation ( ± s), and analysis of variance was used for comparison among multiple groups. Results:CCK8 results showed that esomeprazole could inhibit the proliferation of MBA-MD-231 cells, MCF-7 cells and Huh7 cells in a dose-dependent manner. Flow cytometry results showed that cells in G 0/G 1 phase were significantly increased by esomeprazole treatment. Esomeprazole can enhance the inhibitory effect of paclitaxel and epirubicin on the proliferation of MBA-MD-231 cells and MCF-7 cells, and improve the chemosensitivity. Conclusion:Esomeprazole blocks breast cancer cell MBA-MD-231, MCF-7 and liver cancer cell Huh7 in G 0/G 1 phase, thereby inhibiting cell proliferation. Esomeprazole can enhance the inhibitory effect of chemotherapeutic drugs on the proliferation of MBA-MD-231 and MCF-7 cells.
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Objective@#To explore the effects of Oxcarbazepine combined with Levetiracetam treatment on electroencephalography (EEG) and serum levels of S-100β, glial fibrillary acidic protein (GFAP) in children with epilepsy.@*Methods@#One hundred and ten children with epilepsy who were admitted to Zhumadian Central Hospital from March 2016 to May 2017 were selected as research subjects.The random number table method was used to divide 55 patients into combined group (treated with Oxcarbazepine plus Levetiracetam) and 55 patients in control group (only treated with Oxcarbazepine). The clinical efficacy, EEG background activity, serum S-100β and GFAP levels were compared between the 2 groups after treatment.@*Results@#The control rate of the combined group was 69.09%, the markedly effective was 18.18%, the effective was 9.09%, and ineffective was 3.64%; the control group had a control rate of 52.73%, markedly effective 20.00%, effective 20.00%, and ineffective 7.27%, respectively.The differences between the 2 groups were statistically significant (Z=-2.012, P=0.044). Before and after treatment, the background activity of EEG in both groups was dominated by alpha wave activity.There was no significant difference in the activity rate of alpha wave, theta wave and delta wave between the 2 groups (all P>0.05). Before treatment, there was no significant difference in serum S-100β and GFAP levels between the 2 groups (all P>0.05). After treatment, serum S-100β [(0.415±0.086) μg/L, (0.473±0.091) μg/L], GFAP [(2.60±0.44) ng/L, (2.93±0.40) ng/L] in the combined group and the control group were significantly lower than before treatment, and the differences were statistically significant (t=6.339, 6.703, 3.001, 3.364, all P<0.05). After treatment, serum S-100β and GFAP levels in the combined group were significantly lower than those in the control group, and the differences were statistically significant (t=3.435, 4.116, all P<0.05).@*Conclusions@#Oxcarbazepine combined with Levetiracetam is superior to Oxcarbazepine alone in the treatment of children with epilepsy, as it can reduce the levels of S-100β and GFAP and is worthy of clinical application.
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@#Objective To analyze the clinical characteristics of spinal cord injury patients with postoperative adhesive intestinal obstruction, and summarize the clinical experience of diagnosis and treatment. Methods 35 spinal cord injury patients with postoperative adhesive intestinal obstruction in our department from August 2008 to August 2013 were reviewed. Results All of them had a history of abdominal surgery for various reasons, 22 cases received sigmoid colon pouch procedure and 13 cases received cholecystectomy. 25 cases suffered T10-L1 spinal cord injury, 10 cases suffered cervical spinal cord injury; 26 cases (74.3%) received non-operative treatment and recovered, 9 cases (25.7%) were transferred to surgery. Conclusion There is no typical clinical symptom and sign in spinal cord injury patients with adhesive intestinal obstruction after abdominal surgery, so early diagnosis is difficult, and the imaging examination is necessary. When non-operation treatment is not effective to these patients, surgical treatment should be timely carried out.
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Objective To analyze the clinical characteristics of spinal cord injury patients with postoperative adhesive intestinal obstruc-tion, and summarize the clinical experience of diagnosis and treatment. Methods 35 spinal cord injury patients with postoperative adhesive intestinal obstruction in our department from August 2008 to August 2013 were reviewed. Results All of them had a history of abdominal surgery for various reasons, 22 cases received sigmoid colon pouch procedure and 13 cases received cholecystectomy. 25 cases suffered T10-L1 spinal cord injury, 10 cases suffered cervical spinal cord injury;26 cases (74.3%) received non-operative treatment and recovered, 9 cases (25.7%) were transferred to surgery. Conclusion There is no typical clinical symptom and sign in spinal cord injury patients with adhe-sive intestinal obstruction after abdominal surgery, so early diagnosis is difficult, and the imaging examination is necessary. When non-opera-tion treatment is not effective to these patients, surgical treatment should be timely carried out.
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@#Objective To investigate the relationship between neurogenic bowel dysfunction (NBD) and substance P in rats suffering from spinal cord injury (SCI). Methods 60 male Sprague-Dawley rats, weighted (220±40) g, were randomly divided into three groups: sham group (n=20), normal group (n=20) and model group (n=20) and then were subdivided into subgroups of 24 h, 1 week, 3 weeks, and 5 weeks respectively after SCI. SCI model was established at thoracic 10 segment of rat with NYU impactor device. The colon tissue of the rats was resected and stored. Substance P in serum and tissue was measured by ELISA. The tissue was examined by real-time RT-PCR and Western blotting to analyze the expression of substance P. Results The colon intestinal transmission function decreased and delineated at minimum value at 3 weeks in the model group. There was statistical significance with respect to the content of substance P in serum and tissue between the sham group and model group at 3 weeks. The expression of substance P in the sham group was (3.12±0.51) times of the model group (P<0.05). Conclusion Substance P may take part in NBD after SCI in rats.
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@#Objective To explore the change of sexual life quality and its influencing factors of premenopausal breast cancer patients.Methods 94 premenopausal breast cancer patients were included. Changes in Sexual Functioning Questionnaire short-form (CSFQ-14) was used and part of its items was changed. Their sexual life was evaluated before and after treatment by using depth interview and anonymous methods. Results 94 cases received face-to-face communication and study. 88 (93.6%) questionnaires were received, in which 81 (92.1%) questionnaires were effective. Their sexual life quality and sexual satisfaction significantly decreased and there was significant difference in the CSFQ-14 score (P<0.001) before and after treatment. The ratio of bad, worse, and worst sexual life were 39.5%, 29.6%, and 14.8% respectively after treatment. 65.4% of the patients had no sexual activity. The reasons included medical related factors, fear of cancer metastasis and recurrence, physical discomfort, poorer body image, partner sexual attitudes changed, life stress, common psychological problems, traditional ideas and so on. Conclusion Sexual dysfunction was obvious and sexual life quality significantly decreased in premenopausal breast cancer patients after treatment. Patients' physical and mental damage, the change of body image and spouse's attitude are significant influencing factors. It is necessary to give sexual rehabilitation guidance to patients and their spouses.
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@#Objective To compare the incidence of limb dysfunction, sensory disturbance and lymphedema after different treatment methods in breast cancer patients, and evaluate the clinically relevant factors of limb dysfunction. Methods According to the different processing operation of axillary lymph nodes, 235 patients with breast cancer during 2005 to 2012 were divided into axillary lymph node dissection group in Mastoscopy (group A, n=120) and routine axillary lymph node dissection group (group B, n=115). The flexion, extension, abduction, adduction activity of the ipsilateral shoulder were compared with the contralateral, and the circumference of the up-and-down 15 cm of both upper limbs olecroanon were measured. The incidence of limb dysfunction of the patients was followed up in 6 months, 1 year and 2 years. Results There was no significant difference in limb activity and sensory disturbance between 2 groups 6 months, 1 year and 2 years after operation (P>0.05), the incidence of limb lymphedema was higher in group B than in group A (P<0.05). Radiotherapy was related with limb lymphedema in both groups (P<0.05). Conclusion Compared with the conventional axillary lymph node dissection, endoscopic axillary lymph node dissection can reduce the incidence of limb lymphedema after operation, but there was no significant difference in the limb activity and sensory disturbance between 2 groups. Postoperative radiotherapy is a risk to increase the occurrence of limb lymphedema.
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Objective To investigate the relationship between neurogenic bowel dysfunction (NBD) and substance P in rats suffering from spinal cord injury (SCI). Methods 60 male Sprague-Dawley rats, weighted (220±40) g, were randomly divided into three groups:sham group (n=20), normal group (n=20) and model group (n=20) and then were subdivided into subgroups of 24 h, 1 week, 3 weeks, and 5 weeks respectively after SCI. SCI model was established at thoracic 10 segment of rat with NYU impactor device. The colon tissue of the rats was resected and stored. Substance P in serum and tissue was measured by ELISA. The tissue was examined by real-time RT-PCR and Western blotting to analyze the expression of substance P. Results The colon intestinal transmission function decreased and delineated at minimum value at 3 weeks in the model group. There was statistical significance with respect to the content of substance P in serum and tis-sue between the sham group and model group at 3 weeks. The expression of substance P in the sham group was (3.12 ± 0.51) times of the model group (P<0.05). Conclusion Substance P may take part in NBD after SCI in rats.
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In the thyroid surgery,parathyroid and laryngeal recurrent nerve injury is the most common complications.With the deepening understanding of the laryngeal recurrent nerve anatomy and surgical skills,laryngeal recurrent nerve injury incidence decline,and the prevention of complications of thyroid operation has turned to protect the parathyroid gland from laryngeal recurrent nerve protection.The technique of carbon nanoparticles labeled lymph nodes can effectively protect the parathyroid gland in thyroid surgery.
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ObjectiveStromal cell-derived factor -1 (SDF-1 ) is closely related to the biological characteristics of breast cancer. We aimed to explore whether estrogen affected breast cancer by SDF-1. MethodsThe breast cancer cell line MCF-7 and MRC5 were chosen, and divided into three groups: the control group, the estrogen group and the estrogen + estrogen receptor blocker group. Each group was cultured with different physiological concentrations of 17-β estrogen at certain time, and the same alcohol concentration of 17-β estradiol at different time points, and then the enzyme-linked immunosorbent assay (ELISA) was used to measure the concentration of SDF-1 in culture medium, and the semi-quantitative reverse transcriptionpolymerase chain reaction (RT -PCR) was used to detect the expression of SDF-1 mRNA in each group.ResultsSDF-1 can be detected in the culture medium of both MCF-7 and MRC5 cell lines. All different concentrations of 17-β estradiol may increase the secretion of SDF-1 in MCF-7 cells. When adding 17-β estradiol to the concentration of 107mol/L, the secretion of SDF-1 reached the peak in 2 hours, which was 6 times and 2.7 times that of control group ( P ＜ 0.01 ). The effect could be ehminated by pure estrogen receptor ICI182,780. In addition, the mRNA expression of SDF-1 was consistent with the SDF-1 protein levels-l07 mol/L group. The expression of SDF-1 mRNA was higher than both that of the control group and the blocking group in 2 hours (P ＜ 0.05 ). ConclusionsIn some breast cancer cell lines, physiological concentrations of estrogen can increase the secretion of SDF- 1, and this effect is mainly achieved through the estrogen receptor. Estrogen can influence the biological characteristics of breast cancer by SDF-1.
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@#The American Clinical Practice Guiding -Neurogenic Bowel Management in Adults with Spinal Cord Injury (SCI) had been prepared based on scientific and professional information known about neurogenic bowel management, its causes, and its treatment, in 1998. It will provide reference to China's neurogenic bowel management after SCI in rehabilitation and treatment.
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@#The significantly high prevalences of cholelithiasis in patients with spinal cord injury (SCI) are related to impaired sympathetic innervations to the gallbladder. Sonography before and after the ingestion of a standard fatty meal is usually applied in evaluation of gallbladder function. This paper reviewed the innervations of gallbladder, sonography application in evaluation of gallbladder function and the relationship between SCI and cholelithiasis.