Analysis of characteristics and influencing factors of cervical lymph node skip metastasis in papillary thyroid carcinoma / 国际外科学杂志

Objective:To analyze the characteristics and influencing factors of the patients with cervical lymph node skip metastasis of papillary thyroid carcinoma (PTC), as to guide the precise treatment of lateral area.Methods:The clinicopathological data of 237 patients with PTC initially diagnosed and treated in Xuanwu Hospital Capital Medical University from Feb 2014 to Mar 2022 were analyzed retrospectively. Among them, there were 217 positive in the central area, and 20 negative, with skip rate 8.4%. The age, sex, pathological type, glandular lobe involvement, tumor size, number of tumor lesions, primary lesion location, and capsule invasion were statistically compared. Measurement data with normal distribution were represented as Mean±SD, and comparison between groups was conducted using the t test. The measurement data of non normal distribution are expressed by M( Q1, Q3), and the Mann Whitney U test is used for comparison between groups. Comparison between groups of count data was conducted using the chi-square test, correction chi-square or Fisher exact probability. Results:Multivariate analysis showed that age ≥ 55 years old( OR: 6.032, 95% CI: 1.692-21.504, P=0.006), female( OR: 23.459, 95% CI: 2.181-252.341, P=0.009), tumor ≤5 mm( OR: 79.453, 95% CI: 7.570-833.891, P<0.001)and located in the upper lobe( OR: 3.446, 95% CI: 1.325-8.962, P=0.011) were independent risk factors for skip metastasis. The patients with skip metastasis had a smaller total number of cervical lymph node metastases( Z=-2.81, P=0.005), smaller total number of neck dissection lymph nodes( Z=-6.62, P<0.001) and less lymph nodes metastases in level Ⅳ( Z=-2.54, P=0.011) than patients with non-skip metastasis. Conclusions:Skip metastasis often occurred with age ≥55 years, female, tumor size less than 5mm and located in the upper lobe. For these patients, careful evaluation for the lateral area is required.

Correlation of OCA2 gene rs4778137 single nucleotide polymorphism with the prognosis of early breast cancer patients receiving epirubicin-based regimen chemotherapy / 肿瘤研究与临床

Objective:To investigate the correlation of OCA2 gene rs4778137 single nucleotide polymorphism with the prognosis of early breast cancer patients receiving epirubicin-based regimen chemotherapy.Methods:The data of 152 patients with early breast cancer who received epirubicin combined with cyclophosphamide and docetaxel (EC-T regimen) chemotherapy in the First People's Hospital of Ziyang from April 2010 to January 2013 were retrospectively analyzed. OCA2 gene rs4778137 single nucleotide polymorphism of peripheral venous blood before chemotherapy was detected. The follow-up was up to April 2017, recurrence and disease-free survival (DFS) were analyzed. DFS of patients with different rs4778137 locus genotype in patients with different estrogen receptor (ER)/progesterone receptor (PR) expressions, human epithelial factor receptor 2 (HER2) expressions and Ki-67 positive index were analyzed.Results:The median follow-up time was 60 months (28-80 months). There were 2 cases of lost follow-up and 26 cases of recurrence. Among 150 patients with follow-up results, 68 cases (45.33%) of rs4778137 genotype were CC genotype, 47 cases (31.33%) of GC genotype and 35 cases (23.33%) of GG genotype. There were significant differences in N staging, HER2 expression and ER/PR expression among patients with or without recurrence ( χ2 value was 5.79, 6.08 and 6.05; P value was 0.016, 0.014 and 0.014, respectively). The 5-year DFS rate of 150 breast cancer patients was 82.2%, and there was no significant difference in DFS among patients with different rs4778137 locus genotype ( χ2 = 2.35, P = 0.167). Cox regression analysis showed that N staging and ER/PR expression were independent influencing factors of DFS in breast cancer patients (all P < 0.05). Among 71 ER/PR-negative patients, there was a statistically significant difference in DFS of patients with different rs4778137 locus genotype ( χ2 = 6.52, P = 0.030). Among 79 ER/PR-positive patients, 60 HER2-positive patients and 90 HER2-negative patients, 118 cases with Ki-67 positive index >14% and 32 cases with Ki-67 positive index≤14%, there were no statistically significant differences in DFS of patients with different rs4778137 locus genotype (all P > 0.05). Conclusions:The DFS of ER/PR-negative patients with early breast cancer who received epirubicin-based regimen chemotherapy is correlated with OCA2 gene rs4778137 single nucleotide polymorphism. Patients with GG genotype at rs4778137 locus have better prognosis.

Primary closure versus T-tube drainage following laparoscopic common bile duct exploration in acute cholangitis cases / 国际外科学杂志

Objective To compare the clinical efficacy of primary closure versus T-tube drainage after laparoscopic common bile duct exploration in acute cholangitis cases.Methods The clinical data of 100 patients with acute cholangitis undergoing laparoscopic common bile duct exploration from January 2012 to December 2014 were reviewed.54patients received primary closure of the common bile duct and 46 patients were subjected to T-tube drainage after choledochotomy.Results One hundred patients underwent the surgery successfully.Compared with the T-tube group,the operation time(96.72 min vs 123.00 min,P =0.001),intraoperative blood loss(27.13 ml vs 38.48 ml,P =0.009),postoperative gastrointestinal function recovery time(1.57 d vs 2.33 d,P=0.003) and postoperative hospital stay(6.19 d vs 9.20 d,P=0.000) were significantly less in the primary closure group.There were no statistical differences in the incidence of postoperative drainage (309.22 ml vs 212.46 ml,P =0.070),drainage time (3.96 d vs 4.02 d,P =0.875),incidence of bile leakage(9.3％ vs 0,P =0.060) and postoperative bleeding rate(5.1％ vs 2.2％,P =0.622) between these two groups.Conclusion Laparoscopic common bile duct exploration with primary closure of the common bile duct is an effective and safe procedure in acute cholangitis cases compared with T-tube drainage.

Measurements of resting energy expenditure in surgical critically ill patients with mechanical ventilator / 国际外科学杂志

Objective To compare the differences between measured resting energy expenditure calculated by the indirect calorimetry with the resting energy expenditure calculated by the Harris-Benedict formula and weight formula in the mechanically ventilated surgical critically ill patients in SICU.Methods Patients mechanically ventilated in SICU of Xuanwu Hospital,from April 2014 to April 2015 were measured resting energy expenditure by the indirect calorimetry with the resting energy expenditure calculated by the Harris-Benedict formula and weight formula in the 1st,the 3rd and the 5th day.There were twenty-nine patients enrolled,thirteen males and sixteen females,measured the resting energy expenditure 188 times.The distribution of metabolism level was studied,and the resting energy expenditure measured by three methods were calculated and evaluated by paired sample t test.Results There were 177 times(62.24％)of low metabolism level,59 times(31.38％)of normal metabolism level,and 12 times(6.38％)of high metabolism level.Eighteen patients used these three methods to calculate the energy expenditure on 1st,3rd and 5th day:indirect calorimetry (1 627.11 ± 323.63) kcal,(1 614.67± 308.93) kcal,(1 576.11 ± 263.96) kcal;Weight formula (1 479.44 ± 200.24) kcal,(1 488.40 ± 227.72) kcal,(1434.14 ± 216.56) kcal;Harris-Benedict formula (1 777.43 ± 253.00) kcal,(1 730.08 ± 265.18) kcal,(1 689.33 ± 236.69) kcal.The results calculated from Harris-Benedict formula and the weight formula were significantly different fiom calculated from indirect calorimetry (P ＜ 0.05).Resting energy expenditure by Harris-Benedict formula was significantly higher than calculated from indirect calorimetry (All P ＜ 0.05).Resting energy expenditure by weight formula was significantly lower than calculated from indirect calorimetry(All P ＜ 0.05).Conclusions Although Harris-Benedict formula and weight formula is convenient in clinical use,while the results calculated by them is significant different from the results calculated by indirect calorimetry.So clinical nutrition support should rely on indirect calorimetry as far as possible.

The design of PBL combined with CBL teaching course for standardized training of clinicians based on the clinical decision thinking mode / 中华医学教育探索杂志

To design teaching course of problem-based learning (PBL) combined with case-based learning (CBL) for standardized training of clinicians based on clinical decision thinking mode (CDTM) of diagnosis and treatment process for primary liver cancer. The CDTM of treatment choice for primary liver cancer is multi-scheme selection model. The general decision rule includes decision condition, action plan and decision tree. For the theoretical study of clinical decision rules, it is suitable to design PBL teaching, but it is suitable to design CBL teaching course for clinical decision-making practice. The teaching course of PBL combined with CBL is conducive to improving the ability of clinicians' clinical decision thinking step by step.

Application of different nasal feedings in enteral nutrition for elderly patients with severe brain hemorrhage / 现代临床护理

Objective To explore the effect of different nasal feedings in enteral nutrition for elderly patients with severe brain hemorrhage. Methods Eighty elderly patients with severe brain hemorrhage were assigned into the observation group and control group according to the odd and even numbers at admission with 40 in each group. The control group was treated with graded injection nasal feeding, and the observation group was treated with continuous infusion nasal feeding. The nutrition indicators and enteral nutrition complications were compared between the two groups. Result The nutrition indicators in the observation group were better than those in the control group and the rate of enteral nutrition complications in the observation group was lower than that in the control group (P<0.05). Conclusion Continuous infusion nasal feeding can improve the nutritional status of elderly patients with severe cerebral hemorrhage and effectively reduce the incidence of complications of enteral nutrition. So it is worthy of clinical application.

A investigation on cognitive attitude towards male nurses and operational skills of male nurses in different population of five top hospitals in Chengdu / 中国实用护理杂志

Objective We sought to learn the cognition and attitude of doctors,nurses,patients and patients' family members for male nurses and compare the differences in nursing skills between men and women in order to provide basic information and a basis for further improving the quality of hospital care and promote the comprehensive development of nursing disciplines.Methods Some doctors,female nurses,patients and their family members of patients from the five top hospitals were randomly selected as research subjects to investigate the cognitive attitudes towards male nurses.50 male nurses from the five top hospitals were randomly selected,then 50 female nurses with the same academic level and specialty were selected as the control group,and nursing skills were compared between the two groups.Results This study investigated a total of 304 doctors,522 female nurses,258 patients,176 patients' family members.The cognition attitude to male nurses by doctors,female nurses,patients and their families showed statistically significant differences.Emergency department,operating room,intensive care unit were four departments which were considered to be in great need of male nurses.The differences were statistically significant between men and women nurses in scores of aseptic technique,intravenous infusion operation,suction operation,single unarmed CPR skills.Pearson correlation analysis was conducted between education,working years and scores and total score of four operation skills,the results showed that working life was correlated with aseptic technique score of female nurses,the correlation coefficient was 0.409,the scores of the remaining skills did not showed correlation with education and working years yet.Conclusions Doctors,female nurses,patients and patients' families showed a certain degree of acceptance and positive attitude to male nurses.Male nurses showed advantages in the emergency department,operating room,intensive care unit and other nursing post.Male and female nurses demonstrated the same level of basic nursing skills.

Information management system for the medical laboratory animals in military: design and application / 中华医学科研管理杂志

To improve efficiency and quality of the laboratory animal in military research institutes,we designed an information management system for which employs advanced technology and provides convenience.Its functions,and operating methods and else are introduced so as to provide reference for elevation level of the scientific research management.

Patient safety monitoring indicators based on medical complaints / 中华医院管理杂志

Objective To build the indicators system to collect patient safety monitoring information, focusing on medical complaints. Methods With such methods as literature review and expert advice, building the system for medical complaints collection and monitoring. Such indicators are modified and improved in pilot operations. Results The framework of the medical complaint monitoring indicators system is built in five dimensions, comprising 8 grade-1 indicators including patient complaint causes and hospital cause analysis, and 20 grade-2 indicators. Conclusion These indicators are scientific and operable to detect adverse patient safety events.

Prolene hernia system in the tension-free repair operation of inguinal saddle hernia / 国际外科学杂志

Objective To explore the therapeutic efficacy and operation experience of Prolene Hernia System (PHS) in the tension-free repair operation of inguinal saddle hernia. Methods All 41 cases using PHS were selected as the subjects of this study and the results were analyzed. Results All patients were performed operation under the local anesthesia, and lasted from 25 min to 60 min. They had been keeping in ward for observation from 24 h to 72 h. No serotal swelling, hematoma, and incisional wound infection hap-pened after the operation. The follow-up time had been lasting from 6 months to 42 months, and none of pa-tients catehed a relapse or had the sensation of the foreign bodies. Conclusions Using PHS is safe and ef-fective in the tension-free repair operation, and it is more suited to inguinal saddle hernia. The key of opera-tion success is attaching importance to operation skills.

Research and development of information management system of laboratory animals / 中华医学科研管理杂志

To improve work etffciency and service quality of the laboratory animals, this paper nitroduces an information management system with advanced technology, convenience and good dissemination, which contained main system function, and operating method, etc.

Focal adhesion kinase and cancer / 基础医学与临床

Focal adhesion kinase(FAK),the non-receptor tyrosine kinase,has been implicated in regulating a number of fundamental biological signal transudation pathways that control cell proliferation,survival,adhesion,motility.Many researches have reported that FAK highly expressed in many cancers and involved in the process of cancer development,such as initial,progress,metastasis,multi-drug resistance of cancer.FAK has been the hotpot in cancer research,and it will be a new target in cancer therapy.

Comparison of imageology, electrophysiology and clinical characteristics between simple leukoaraiosis and Binswanger's disease / 中国组织工程研究

BACKGROUND: Leukoaraiosis is a group of changes in image. Since the firm pathogenic mechanism on leukoaraiosis has been unknown, the evaluation at the earlier stage of the disease has not been emphasized commonly and there is rather less recognition of the alternations on its electrophysiological system.OBJECTIVE: To probe into the clinical characteristics and alternations on image and evoked potential in simple leukoaraiosis and subcortical arteriosclerotic encephalopathy(Binswanger' s disease) and carry on the comparison with healthy people.DESIGN: Retrospective comparative study based on patients and healthy people.SETTING: Department of neurological internal medicine of one university hospital and department of neurological internal medicine of one railway central hospital.PARTICIPANTS: Outpatients or inpatients with cerebral vascular disorders in Qilu Hospital Affiliated to Shandong University were collected from August 1995 to March 2000. Totally 114 cases were leukoaraiosis, of which, 79 cases were males and 35 cases females. And 41 cases were Binswanger' s disease,of which, 28 cases were males and 13 cases females. Fifty healthy aged people who received routine physical check were randomized from the clinic of the hospital as the control.METHODS: The analysis was carried on the risk factors, clinical characteristics and CT exam in 114 cases of leukoaraiosis and 41 cases of Binswanger' s disease, of which, 74 leukoaraiosis cases and 35 Binswanger' s disease cases had received cranial MRI exam. Of those, 43 cases of simple leukoaraiosis associated with hypertension, 30 cases of Binswanger' s disease and 50 cases in the normal control were selected to carry on the examinations of body-sensory evoked potential, brain stem auditory evoked potential and visual evoked potential.coronary heart disease, diabetes, hyperlipemia, smoke, cerebral apoplexy,evoked potential and visual evoked potential.RESULTS: According to practical management analysis, 114 cases of leukoaraiosis, 41 cases of Binswanger' s disease and 50 cases in the control were diversification, mainly characterized as slightly declining of memory and loss of gait stability. Hypertension is predominated anong risk factors in Binswanger' s disease group (95.1% ), mainly characterized as physical signs of local neural focus, obvious cognitive disturbance and cerebral in CT exam that 70.2% (80/114) of cases presented brain whiter-matter abnormity in type Ⅰ. It was indicated in MRI exam that 72% (53/74) of cases presented brain whiter-matter abnormity, type Ⅰ, 27% (20/74) presented type Ⅱ and 1% (1/74) presented type Ⅲ. For Binswanger's disease patients, it was indicated in MRI exam that 54% (19/35) of cases presented brain white-matter abnormity, type Ⅲ, and 46% (16/35) presented type Ⅳ.Symmetrical extension of bilateral ventricles presented in Binswanger' s disbody-sensory evoked potential was 84% (36/43), of which, the mild abnormity occupied 60% (26/43) and moderate abnormity 23% (10/43); The abnormity rate of brain stem auditory evoked potential was 63% (27/43) and that of visual evoked potential was 54% (23/43). In Binswanger' s disease group, the abnormity rate of body-sensory evoked potential was 97% (29/30),of which, mild abnormity was 7% (2/30), moderate abnormity was 47%(14/30) and severe abnormity was 43% (13/30); The abnormity rate of brain stem auditory evoked potential was 87% (26/30) and that of auditory evoked potential was 83% (25/30).CONCLUSION: The risk factors of simple leukoaraiosis are diversified,without obvious physical signs of local neural focus. The diagnosis of it is mainly depended on abnormity Ⅰ of brain white matter described in images,manifested as remarkable dysfunction of cerebral eletrophysiology. Binswanger' s disease patients are mainly characterized as hypertension, relevantly obvious cognitive disturbance and common seizure of cerebral apoplexy. Abnormity Ⅲ of brain white matter indicated in CT exam, abnormity Ⅲ or Ⅳ of that in MRI exam are the image evidence for diagnosis. Remarkable abnormity also presents in cerabral electrophysiology, in which, abnormal body-sensory evoked potential is especially significant.

Research and Development of One-off Multifunctional Instrument for Blood Collection and Transfusion / 医疗卫生装备

Objective To develop an one-off multifunctional instrument for blood collection and transfusion.Methods Blood collection pipe,blood sample pipe and blood transfusion pipe were united by means of three-way pipe.Different venipuncture needles could be selected by means of different connectors.Plastic clips and connectors were used to cut off and connect pipes.It was also equipped with pipe warming apparatus,manual pipe seal apparatus and newest venipuncture needles.Results The one-off multifunctional instrument for blood collection and transfusion possessed advanced technology,convenience and good application value.Conclusion The one-off multifunctional instrument for blood collection and transfusion can be applied into blood medical service,all kinds of surgical operations,emergency care,abrupt affairs,and it meets the requirements of war-readiness and medical service for troops in different periods.

Research and Development of Multifunctional Field Blood-Warming Apparatus / 医疗卫生装备

Objective To improve the work efficiency and safety quality of blood transfusion remedy in field battle.Methods Low density polyethylente or glass reinforced plastics was used as raw and processed materials.The polyurethane foam was used as insulation layer.U-shape Mipor bi-pass blood-transfusion tube was used in heating.Results The apparatus is small,easily-carried,flexible and free from power supply.The temperature is regulated by the infusion of cold or hot water.Conclusion Being advanced and convenient,the apparatus has good application value.

Research and Development of Multifunctional Surgical Instrument Case for Operation of Field Battle / 医疗卫生装备

Objective To design a new multifunctional surgical instrument case in order to improve the work efficiency and safety of operation in field battle. Methods Practices of operation in field battle were analyzed retrospectively and the characteristics of modern surgery were investigated. Results A new multifunctional surgical instrument case was designed and its main clinical function and operation methods were explained. Conclusion Multifunctional instrument case has advantages of advanced function and convenient operation. It has good perspective for clinical surgery applying.

Development of Field Multifunctional Blood Warmer / 医疗卫生装备

Objective To improve work efficiency and safety of blood transfusion in the battlefield.Methods Polyurethanes material was adopted to construct the insulation layer.Low density polyethylene,glass reinforced plastics and low-temperature bio-chemical method also got involved in.Results The blood warmer was passive,small,easy-to-carry and mobile,whose temperature regulation was realized by the input of cold or warm water.Conclusion Being advanced and easy-to-operate,the blood warmer has a brilliant future.

Research and Development of Automatic Rinse Assemblage for Cage of Medical Laboratory Animal / 医疗卫生装备

Objective To design a new automatic rinse assemblage for cage of medical laboratory animal in order to improve the work efficiency and safety of laboratory animal center.Methods The practices of laboratory animal were analyzed retrospectively and the animal experiment were investigated.Results The new automatic rinse assemblage for cage of medical laboratory animal was designed and its main function and operation methods were explained.Conclusion The automatic rinse assemblage for cage of medical laboratory animal has advantages of advanced function and convenient operation,and it has good perspective for medical laboratory animal management.

Expression of caspase-4 in Hodgkin's lymphoma and anaplastic large cell lymphoma / 中国病理生理杂志

AIM: This study is based on the result of the study in HL and ALCL employing gene chip technique, in which writer found that there was distinctly different expression of caspase-4 between HL and ALCL cell lines at the level of mRNA. From the point of view, we try to identify at the level of protein whether there is different expression of this gene in HL and ALCL tissues as well. METHODS: HE staining, the monoclonal antibodies CD30 (BerH2), CD15 (C3D-1), CD20 (L26) and CD45RO (UCHL1) were used for selecting the cases of HL and ALCL. Specific high affinitive anti-caspase-4 polyclonal antibody was used by immunohistochemical staining to analyze the expression of caspase-4 in 18 cases of HL and 15 cases of ALCL. RESULTS: The expression of caspase-4 demonstrated a strong positive staining in all ALCL cases (15/15,100%), whereas negative in 16 HL cases (88 8%), while other two cases were weakly stained (11 2%), showing a distinct difference (P