Association Between Constipation and a Reduction in Lower Limb Muscle Strength in Preoperative Patients with Thoracic Spinal Tumors / 中国医学科学杂志(英文版)

Objective To investigate the clinical symptoms experienced by patients with thoracic spinal tumors and verify the associated symptoms that are predictive of a decline in muscle strength in the lower limbs. Methods A single-center, retrospective cross-sectional study was conducted on in-patients diagnosed with epidural thoracic spinal tumors between January 2011 and May 2021. The study involved a review of electronic medical records and radiographs and the collection of clinical data. The differences in clinical manifestations between patients with constipation and those without constipation were analyzed. Binary logistic regression analyses were performed to identify risk factors associated with a decline in muscle strength in the lower limbs.Results A total of 227 patients were enrolled, including 131 patients with constipation and 96 without constipation. The constipation group had a significantly higher proportion of patients who experienced difficulty walking or paralysis compared to those without constipation prior to surgery (83.2% vs. 17.7%, χ2 = 99.035,P < 0.001). Constipation (OR = 9.522, 95%CI: 4.150-21.849, P < 0.001) and urinary retention (OR = 14.490, 95%CI: 4.543-46.213, P < 0.001) were independent risk factors for muscle strength decline in the lower limbs. Conclusions The study observed that patients with thoracic spinal tumors who experienced constipation symptoms had a higher incidence of lower limb weakness. Moreover, the analysis revealed that constipation and urinary retention were independent risk factors associated with a preoperative decline in muscle strength of lower limbs.

Preoperative risk factors analysis of pulmonary hypertension crisis during perioperative period for caesarean section of woman with severe pulmonary hypertension / 中华危重病急救医学

Objective To analyze preoperative risk factors of perioperative pulmonary hypertension crisis (PHC) for pregnant woman with severe pulmonary artery hypertension (PAH), and approach its clinical value. Methods A retrospective analysis was conducted. The clinical data from 152 pregnant women with severe PAH underwent cesarean delivery admitted to Beijing Anzhen Hospital from January 1st 2008 to December 31st 2016 was collected. The patients were divided into two groups according to with perioperative PHC or not. Through the case management system, age, height, weight, gestational age, pregnancy time, type of PAH, emergency or selective surgery, New York Heart Association (NYHA) cardiac function classification, and preoperative ultrasound left ventricular ejection fraction (LVEF), left ventricular diastolic final diameter (LVEDD), the pulmonary artery systolic pressure (sPAP) estimated by ultrasonic TI method, radial artery systolic blood pressure (SBP) and diastolic blood pressure (DBP), heart rate (HR), pulse oxygen saturation (SpO2) without oxygen, oral sildenafil ingestion, having Swan-Ganz catheter placement or not, and whether used norepinephrine or not, as well as the occurrence of perioperative PHC and clinical outcomes were collected. Possible preoperative risk factors were compared between the two groups by single factor and multiple factors logistic regression analysis. The receiver-operating characteristic curve (ROC) was plotted to assess the diagnostic value of various risk factors.Results A total of 152 patients were screened. Ten patients got heart surgery under general anesthesia at the same time, and 4 patients experiencing cesarean section with general anesthesia were excluded. 138 patients were enrolled finally, 27 patients underwent perioperative PHC (19.57%), and 17 patients died with a mortality of 62.96%. Compared with non-PHC group, the patients in PHC group were older (years: 25.07±3.55 vs. 27.64±4.82), had a poor cardiac function (NYHA cardiac function classification: 3.22±0.64 vs. 2.85±0.53), a smaller LVEDD (mm: 38.78±4.76 vs. 43.91±9.67), lower SpO2 without oxygen (0.83±0.12 vs. 0.92±0.06) and oral sildenafil ingestion rate (29.63% vs. 56.76%), and higher sPAP estimated by ultrasonic TI method [mmHg (1 mmHg = 0.133 kPa): 113.41±24.73 vs. 99.35±21.10] and DBP (mmHg: 79.63±13.23 vs. 75.23±12.14), more having Swan-Ganz catheter placement (85.19% vs. 57.66%), more Eisenmenger syndrome (70.37% vs. 37.84%), and more emergency operation (48.15% vs. 23.42%, allP ≤ 0.1). The variables with statistically significant differences showed by single factor analysis were collected, and it was shown by multiple factors logistic regression analysis that LVEDD [odds ratio (OR) = 0.878, 95% confidence interval (95%CI) = 0.796-0.968,P = 0.009], whether oral taken sildenafil (OR = 0.161, 95%CI = 0.051-0.515,P = 0.002) or not, SpO2 at room air (OR = 0.882, 95%CI = 0.829-0.938,P = 0.000), Swan-Ganz catheter placement or not (OR = 6.186, 95%CI = 1.533-24.964,P = 0.010) were independent risk factors of perioperative PHC in pregnant women with severe PAH. It was shown by ROC curve analysis that the area under the ROC curve (AUC) of four factors mentioned above combined diagnosis for PHC was 0.878 (P = 0.000) with the sensitivity of 88.89% and specificity of 76.58%.Conclusions PHC is very dangerous for gravida with severe PAH, and the mortality rate is very high. LVEDD, oral sildenafil, SpO2 at room air, Swan-Ganz catheter placement or not were independent risk factors of perioperative PHC for severe PAH maternal. Four preoperative factors of perioperative PHC joint diagnosis accuracy were higher.

Impact of preoperative comorbidities on abdominal complications after laparoscope-assisted total gastrectomy for gastric cancer / 中华消化外科杂志

Objective To investigate the impact of preoperative comorbidities on the abdominal complications after laparoscope-assisted total gastrectomy (LATG) for gastric cancer.Methods The retrospective casecontrol study was conducted.The clinical data of 1 657 gastric cancer patients who underwent LATG at the Fujian Medical University Union Hospital between January 2008 and December 2015 were collected.There were 175 patients with postoperative abdominal complications,including 78 without preoperative comorbidities and 97 with preoperative comorbidities (52 with 1 comorbidity,30 with 2 comorbidities and 15 with more than 3 comorbidities).Analysis method and observation indicators:(1) risk factors analysis of abdominal complications after LATG;(2) risk assessment of abdominal complications after LATG:independent influencing factors of risk factors analysis were expressed as dependent variables,alignment diagram was built and then consistency index was calculated;(3) comparisons of abdominal complications among the patients with different kinds of comorbidities after LATG;(4) multivariate analysis of abdominal complications in patients with comorbidities after LATG;(5)follow-up situations.Follow-up using outpatient examination and telephone interview was performed to detect postoperative survival of patients up to May 2016.The univariate analysis and multivariate analysis were respectively done using the chi-square test and Logistic regression model.The survival rate was calculated by the Kaplan-Meier method.Results (1) Risk factors analysis of abdominal complications after LATG:results of univariate analysis showed that age,body mass index (BMI),number of preoperative comorbidities,operation time and estimated volume of intraoperative blood loss were related factors affecting abdominal complications of patients after LATG (X2 =4.487,16.602,10.361,4.567,7.482,P＜0.05).Results of multivariate analysis showed that BMI,number of preoperative comorbidities and estimated volume of intraoperative blood loss were independent factors affecting abdominal complications of patients after LATG [OR =1.966,1.204,1.423,95％confidence interval (CI):1.355-2.851,1.014-1.431,1.013-1.999,P＜0.05].(2) Risk assessment of abdominal complications after LATG:BMI,number of preoperative comorbidities and estimated volume of intraoperative blood loss were expressed as dependent variables,and the alignment diagram on risk prediction of abdominal complications after LATG was built,with a consistency index of 0.703.(3) Comparisons of abdominal complications among the patients with different kinds of comorbidities after LATG:numbers of patients without comorbidity,with 1 comorbidity,2 comorbidities and ≥3 comorbidities were detected in 21,8,13,3 patients with intra-abdominal infection and 13,10,9,5 patients with anastomotic leakage and 6,3,6,2 patients with intra-abdominal bleeding,respectively,with statistically significant differences (X2 =10.677,10.436,9.245,P＜0.05).(4) Multivariate analysis of abdominal complications in patients with comorbidities after LATG:BMI ≥25 kg/m2 and estimated volume of intraoperative blood loss ＞ 82 mL were independent risk factors affecting abdominal complications of patients with preoperative comorbidities after LATG (OR =2.104,1.771,95％ CI:1.307-3.387,1.146-2.738,P＜0.05).(5) Follow-up situations:of 1 657 patients,1 568 were followed up for 4-99 months,with a median time of 47 months.Ninety-seven patients with preoperative comorbidities undergoing LATG had postoperative abdominal complications and were followed up.During follow-up,5-year survival rate of patients was 58.1％,and 5-year survival rate of 97 patients with preoperative comorbidities undergoing LATG and with postoperative abdominal complications was 57.4％.Conclusion Preoperative comorbidities are independent factors affecting abdominal complications of patients after LATG.

The analysis of risk factor and the establishment of pre-operation warming score system for infection after intracavity lithotripsy in upper urinary tract calculi / 中华泌尿外科杂志

Objective To discuss the risk factor of infection after intracavity lithotripsy in upper urinary tract calculi,and establish a pre-operation warming score system.Methods From Jan.2013 to May 2016,412 upper urinary calculi patients who underwent intracavity lithotripsy were analyzed to evaluate the associated risk factors before operation and infection after operationg by non-conditional logistic regression analysis.The pre-operation warming score system was established by giving those risk factor 1-4 point based on OR value.The best threshold was then determined by ROC curve.Results Diabetes mellitus,infection history,renal calculus and uretero-pelvic junction calculus,stone burden,the degree of hydronephrosis and the gender of female were high-risk factors contributed to infection after intracavity lithotripsy,which were given 3,3,3,2,2,2point respectively based on their OR value(8.660,7.046,3.723,2.675,2.256,1.891),and the patients who got high socre were more likely to suffered infection.The sensitivity and specificity of the wanning score system for infection after intracavity lithotripsy were 74.3％ and 84.0％ respectively when its truncation point was 7.5 point(total score was 15 piont).Conclusions Patients who got more than 7.5 point according to the wanning score system were high risk groups of infection after intracavity lithotripsy.

Comparative study of extracorporeal shock wave lithotripsy one day before percutaneous nephrolithotomy for complicated renal calculi / 中国内镜杂志

Objective To discuss whether preoperative extracorporeal shock wave lithotripsy (ESWL) could improve the efficacy of percutaneous nephrolithotomy (PCNL) for complicated renal calculi. Methods 160 cases of complicated renal calculi patients were divided into observation group (80) and control group (80) at random. Take conventional PCNL treatment for control group, and ESWL treatment one day before conventional PCNL treatment for observation group. Record the operation time, intraoperative blood loss, postoperative calculi clearance rate, complications, treatment costs, hospital stays of two groups of patients, then compare the curative effects between the two groups. Results Results are very different in the two groups, and the therapeutic effect of observation group is much better than control group (P < 0.05). Conclusions For complicated renal calculi, compared with conventional PCNL, in reducing the residual stone rate shorting the operation time, reducing the operation number, complications, treatment costs and the length of hospital stay, PCNL preoperative ESWL have obvious advantages. It is a kind of both economic and safe and effective treatment method.

Detection of serum IL-6 in patients with esophageal carcinoma and its clinical value / 中国基层医药

Objective To explore the clinical significance of detecting serum interleukin (IL)-6 in patients with esophageal squamous cell carcinoma(ESCC).Methods We detected the serum level of IL -6 in 35 patients with ESCC(observation group)and 35 healthy controls (control group)by double antibody sandwich enzyme -linked immunosorbent assay(ELISA),and then analyzed its clinical value.Results The serum levels of IL -6 in the observation group (27.66 ±2.30)ng/L was significantly higher than (17.72 ±3.62)ng/L in the con-trol group (t =11.63,P <0.01).There was significant difference in the serum level of IL -6 in the observation group preoperation and postoperation [(27.66 ±2.30)ng/L vs (23.62 ±3.27)ng/L,t =5.12,P <0.01].The serum level of IL -6 in the observation group preoperation was relevant with clinical stages(χ2 =11.15,P <0.01).Conclusion The change of serum IL -6 level in patients with ESCC is related to the occurrence and development of ESCC,which is an important indication for diagnosis and prognosis.

Application effect of multi-dimensional health education model in the outpatient department of gynecological painless surgery / 中国实用护理杂志

Objective To study the application effect of multi-dimensional health education model in the outpatient department of gynecological painless surgery,and explore more standardized and more effective education method.Methods 2 639 patients were selected in Sir Run Run Shaw Hospital outpatient service of gynecological department from July 2010 to June 2011,and were randomly divided into the control group(1 302 cases) and the intervention group(1 337 cases).The control group adopted conventional health education,the intervention group adopted the multi-dimensional health education.Design form was used to analyze preoperative compliance of the two groups.Results The preoperative compliance of the intervention group was higher than those of the control group,the difference was statistically significant.Conclusions Multi-dimensional health education mode can improve the preoperative education compliance of patients in the outpatient service of department of gynecological painless surgery patients,reduce the rate of operation delay and anesthesia method alteration,reduce patient pain,increase peri-operative nursing quality of painless surgery.

Three Points on Laparoscope Operation to Gallbladder Neck Incarceration Stone(with A Clinical Report of 81 Cases) / 浙江中医药大学学报

[Objective] To discuss the reasonable treatment and skil of gal bladder calculus.[Method] Select 81 cases of such patients, take their clinical data as examples for analysis foundation;and choose relative documents for evidence of theoretic analysis.[Result] 77 cases were successively operated of laparo-scope, 3 transferred for laparotomy owing to difficult anatomy of Colot triangle, 1 made probe of choledoch because of choledocholithiasis;compared with documents results, the incision length, bleeding, operaiotn time, in-hospital time and complications of laparoscope operation, transferred laparotomy in the study were similar to relative documentary reports, the differences had no statistical meaning;the intranperative bleeding, operation period, in-hopital time, complications were better than documents, the differences had statistical meaning. [Conclusion] The correct pre-operation evaluation of disease condition, operation chance and methods selection, 3 operation points were the key of successful operaiton.

Influence of psychological communication on psychological state of elderly patients before destined operation / 中国实用护理杂志

ObjectiveTo discuss the effect of preoperative psychological communication on psychological state of elderly patients before destined operation.Methods136 cases of elderly patients underwent elective operation were divided into the observation group and the control group with 68 cases in each group,the control group was given routine nursing of general surgery,the observation group received targeted psychological communication based upon routine nursing for consecutive 3 days before surgery.The psychological state such as anxiety,depression and fear was compared between two groups.ResultsThe anxiety,depression and fear in the observation group was significantly improved compared with the control group.ConclusionsPreoperative appropriate and targeted psychological communication can alleviate the anxiety,depression and fear of the elderly patients with elective operation,and contribute to the smooth operation.

Application of feedforward control and management of nursing safety blind spot in preoperative fasting time of infants / 中国实用护理杂志

Objectives Using the theory and method of feedforward control management to control the blind spot of nursing safety of preoperative fasting time for children,so that the actual preoperative fasting time for children is close to the standard preoperative fasting time.Methods We established preoperative fasting nursing procedure according to feedforward control based on reasons for common long preoperative fasting time of infants facing expected operation from September 2005 to September 2006.Children facing expected operation were divided into the experimental group(66 cases)and the control group(58 cases).They adopted preoperative fasting nursing procedure after feedforward control and the traditional nursing procedure respectively.Preoperative fasting time between the two groups was compared and analyzed.Results There was significant difference about the preoperative fasting time between the two groups,P＜0.01.The actual preoperative fasting time for infants in the experimental group was close to the standard fasting time.Conclusions Using preoperative fasting nursing procedure with feedforward control,the blind spot of nursing can be partially emilinated,and the actual preoperative fasting time for infants is close to the standard.

Sentimentos e percepções do cliente no pré-operatório de cirurgia cardíaca / Client's feelings and perceptions in the preoperative period of cardiac surgery

Nas últimas décadas, a cirurgia cardíaca tornou-se um procedimento vastamente utilizado no tratamento das doenças cardiovasculares, entretanto, percebe-se que essa intervenção ainda causa grande impacto nos que dela precisam, por relacionar-se ao coração, que é o órgão central do corpo. A partir disso, esta pesquisa tem como objetivo apreender os sentimentos e as percepções do corpo enfermo que se encontra em pré-operatório de cirurgia cardíaca. Trata-se de uma pesquisa qualitativa de abordagem fenomenológica, realizada no Hospital de Clínicas da Universidade Federal do Paraná, e que conta com a participação de 11 sujeitos em pré-operatório de cirurgia cardíaca, entrevistados no período de março a abril de 2004. A análise dos discursos aconteceu em três momentos: descrição, redução e compreensão fenomenológica, dos quais emergiram duas unidades temáticas, que foram categorizadas subjetivamente em Corpos amedrontados - uma realidade a ser transcendida e A esperança de vir-a-ser um novo corpo. A primeira categoria abarca as diversas faces do medo que atinge quem vivencia o pré-operatório, como: da morte causada pela cirurgia, da violação interior, das cicatrizes deixadas, e ainda, o desejo de fuga. A segunda categoria versa sobre a possibilidade de obtenção de uma vida melhor, mediante o novo corpo conquistado com a cirurgia. Foi possível desvelar o fenômeno estudado e mostrar a necessidade de interação entre a enfermeira e o corpo enfermo na situação perioperatória, tendo em vista a promoção do seu bem-estar.

In the last decades the cardiology surgery has become a widely used procedure for cardiovascular diseases, although, is noted that intervention still causes a big impact in those who need it. This impact is due to the people's belief that the heart is the body central organ. Therefore, this research had as an objective to learn the feelings and perceptions of the illness body which is in cardiology surgery pre-operation. This work is a qualitative research with an phenomenological approach, performed in the Hospital de Clinicas of the Parana Federal University, with the sample of 11 persons in pre-operation for cardiology surgery, interviewed during March and April of 2004. The speeches analyses happened in three different moments: a phenomenological description, a reduction and the comprehension, resulting in two thematic units, that were subjectively categorized in Scared bodies - A reality to be transcendental and The hope to be a newly body. The first category encloses the variegated fear faces' that touches whose life is in a pre-operation period, such as: dead caused by the surgery, the inner violation, the scares, and still, the will of scape. The second category related to the possibility of gain a better life through the new body conquered with the surgery. Is was possible to revealed this studied phenomena and discover the necessity of an interaction between the nurse and the sick body in the per-operation situation, looking for his wellness.

Chemoresistance-related factors for preoperative interventional chemotherapy and prognosis in bulky cervical cancer / 介入放射学杂志

Objective To identify the chemoresistant factors predicting the response to preoperative chemotherapy and clinicopathological prognosis in bulky cervical cancer. Methods 68 patients with bulky cervical carcinoma treated with two courses of intraarterial infusion of cisplatin 80mg, 5 fluorouracil(5Fu) 1500mg and AT 1258 or EADR 60mg, followed by radical hysterectomy and pelvic lymphnodenectomy at our hospital between 1996-1999 were retrospectively reviewed. Expressions of the chemoresistance related proteins, such as P glycoprotein glutathione S transferase ?(GST ?), and proliferating cell nuclear antigen(PCNA) in the tumor cells were examined by immunohistochemistry in previous biopsy specimens. These results were compared with the chemotherapeutic response obtained by gynecological examination and vagina ultrasonic. 68 patients were followed up. SPSS 8.0 was used. Results P glycoprotein expression rate was 31% and GST ? expressioin rate was 51%. There were 38 patients whose PCNA labellings were more than 50% and 30 less than 50%. The total chemotherapeutic response rate was 84%. Chemotherapeutic response rate was significantly correlated with P glycoprotein expression( P =0.013) and PCNA labelling ( P =0.001), but not GST ? expression in the tumor cells. Parautrial involvement and lymph node metastasis were independent factors for prognosis in this group. The survival rate in MDR(+) group was lower than MDR(-) group. No significant correlation between eigher the expression of GST ? or PCNA. Conclusions The expression of P glycoprotein and PCNA is potentially useful for predicting the response to preoperative chemotherapy for cervical cancer. The parautrial involvement and lymph node metastasis were independent prognostic factors for the survival rate including. the expression of P glycoprotein.

Oral Use of Folium Cassiae with Routine Enema for Preoperative Intestinal Cleansing / 广州中医药大学学报

[Objective] To search a suitable preoperative intestinal cleansing method for the operation of colon and rectum. [Methods] A randomized controlled trial was applied in 70 cases before colic and rectal operations. Group A was give:n decoction of Folium Cassiae for oral use and saline enema and Group B was treated with saline enema only. The effect on intestinal cleansing was observed during the operation. [Results] In Group A, 26 cases were remarkably effective in intestinal cleansing, 8 effective, and 1 ineffective and 14, 16 and 5 in Group B respectively ( P

Utility of the Preoperative Electrocardiographic Screening / 대한마취과학회지

In order to evaluate the utility af routine preoperative 12 lead eleetrocardiogram, 4,089 patients aged above 16 years who were scheduled for elective surgical operations under general or regional anesthesia at Chonnam University Hospital from September 1988 to August 1990 were analysed retrospectively in terms of age, sex and specific abnormal ECG findings that may alter anesthetic management. The results were as follows. 1) Among the total 4,089 patients, abnormal ECG findings were noted in 2,094 patients (51.2%) and more frequently noted in male (57.3%, 1,231/2,149) than female (44.5%, 863/1,940), and there was significant inrease in its frequency above the age of middle 6 decades. 2) Ventrieular hypertrophy was noted in 19.3% of the total subjects and more frequently noted in male (24.2%) than female (13.7%), and there was significant increase in its frequency above the age of middle 6 decades. 3) Atrioventricular block was noted in 1.8% of the total subjects with 2.1% of male and 1.5% of female, and there was no significant difference in its frequency between each sex and age. 4) Bundle branch block was noted in 5.3% of the total subjects and more frequently noted in male (6.8%) than female (3.7%), and there was significant increase in its frequency above the age of middle 6 decades. 5) ST-T wave abnormality was noted in 3% of the total subjects and more frequently noted in female (4.2%) than male (2.0%) and there was no significant difference in its frequecy between each age groups in male, but the female in respect to male, showed significant increased frequency from the age of middle 5 decades to middle 7 decades. 6) Myocardial infarction was noted in 1.5% of the total subjects with 1.7% of male and 1.2% of female, and there was no significant difference in its frequency between each sex groups but there was significant increase in its frequency above the age of sixty five. 7) Cardiac arrhythmia was noted in 2.8% of the total subjects with 3.0% of male and 2.5% of female, and there was no significant difference in its frenquecy between each sex groups but there was significant increase above the age of sixty five. From the above results, it is essential to check the preoperative 12 lead ECG before emergency operation, and to keep a more careful cautions in mind during anesthetic management for patients above the age of middle 6 decaeds.