Indwelling Needle Puncture and Irrigation in the Conservative Treatment of Breast Abscess During Non-Lactation Period.

The objective of this study is to observe the effect of indwelling needle puncture and irrigation in the conservative treatment of breast abscesses in the non-lactation period. Non-lactating breast abscess patients were treated at the Daping Medical Breast Surgery Clinic, Chongqing. In the Incisive drainage group, 21 patients were treated with conventional incision and drainage. In the Indwelling needle group, 20 patients were treated by puncture and irrigation with a 20 G indwelling needle. The pain VAS scores and wound satisfaction in the Indwelling needle group were significantly lower than those in the Incisive drainage group (P < 0.001), and the cure time and complications were also significantly lower in the Indwelling needle group (P < 0.05). The cure rates of the two groups were similar (P > 0.05). There was a difference in the duration of illness, location, and number of pus cavities between the treatment failure and the treatment recovery (P < 0.05). However, there was no difference in the size of the pus cavity and the maximum amount of pus aspiration (P > 0.05). The indwelling needle can be used as an effective tool for puncture and irrigation of single breast abscess in a non-lactation period, potentially for non-invasive treatment of breast abscesses.

Initial Clinical Application of Enhanced Recovery After Transoral Robotic Thyroidectomy.

Background: The enhanced recovery after surgery (ERAS) protocol has been widely adopted across various surgical subspecialties. Transoral robotic thyroidectomy (TORT) has grown in popularity in the past decade. Therefore, this study aimed to discuss the initial application of ERAS in TORT. Methods: We retrospectively analyzed the clinical data of 95 patients who had undergone TORT in our department from April 2020 to March 2022. All patients were treated using the ERAS protocol. Results: TORT was successfully performed in all 95 patients. Postoperative histopathological examination revealed papillary carcinoma. The average operative time, hemorrhage volume, length of postoperative stay, and pain score (24 hours after surgery) were 227.32 ± 44.37 minutes, 35.81 ± 23.45 mL, 1.37 ± 0.62 days, and 2.11 ± 0.54, respectively. Sixty patients received an analgesia pump, with no significant difference in pain scores between the patients with and without the pump (P > .05). Eight patients experienced transient mandibular numbness, and two experienced transient hoarseness postoperatively. Of the 24 cases of total thyroidectomy/bilateral subtotal thyroidectomy (ST) or lobectomy with isthmusectomy plus contralateral ST patients, 8 developed transient hypoparathyroidism. No common complications, such as incision infection, hematoma/effusion formation, coughing while drinking, or permanent hoarseness/hypocalcemia, were reported. Conclusion: Our initial outcomes demonstrate that implementing an ERAS protocol in TORT is safe and feasible.

Rapidly reconstructing the active surface of cobalt-based perovskites for alkaline seawater splitting.

As a potential oxygen evolution reaction (OER) catalyst, Co-based perovskites have received intensive attention. However, Sr readily accumulates on their surface, and makes them inert toward the OER. Herein, we propose a simple but versatile electrochemical reduction method to reconstruct the active surface of Co-based perovskites within a few seconds. By this method, Sr rapidly precipitates from Co-based perovskites, accompanied by the introduction of Sr and oxygen vacancies. After reconstruction, the electrochemical active surface areas of Co-based perovskites greatly increase, and the OER overpotential of the optimized SrNb0.1Co0.7Fe0.2O3-δ (ER-SNCF-20s) reaches 278 mV at 10 mA cm-2. This can be explained by the decrease of overpotentials at the rate-determining step. Using ER-SNCF-20s, the splitting voltage of alkaline natural seawater can reach 1.56 V at 10 mA cm-2, and remains steady for 300 h. This effort offers a feasible method for reconstructing the active surface of Co-based perovskites.

The Chinese herb Xiaoaiping protects against breast cancer chemotherapy-induced alopecia and other side effects: a randomized controlled trial.

OBJECTIVE: To investigate the effects of the Chinese herbal medicine Xiaoaiping to treat chemotherapy-induced side effects in breast cancer patients. METHODS: Ninety-three adult patients who attended our hospital and met the entry criteria from January 2016 to December 2017 were included. Patients were randomly divided into the control group (routine chemotherapy only) and the combined group (routine chemotherapy and Xiaoaiping). Demographic data and clinical variables were collected, and side effects including alopecia, nausea and vomiting, diarrhea, white blood cell (WBC) count, aspartate aminotransferase (AST) levels, and the quality of life were evaluated. RESULTS: Basic clinical characteristics were not different between the groups. There were significantly fewer patients with alopecia grade 3-4, but significantly more patients with alopecia grade 1-2, in the combined group compared with the control group. Disease-free time for alopecia was longer in the combined compared with the control group. Overall, the side effects were significantly more serious in the control compared with the combined group. Patients in the combined group had better quality of life than the control patients. CONCLUSION: Xiaoaiping can improve alopecia, nausea and vomiting, and diarrhea symptoms, WBC count, AST levels, and the quality of life in breast cancer patients.

Blood coagulation parameters and platelet indices: changes in normal and preeclamptic pregnancies and predictive values for preeclampsia.

BACKGROUND: Preeclampsia (PE) is an obstetric disorder with high morbidity and mortality rates but without clear pathogeny. The dysfunction of the blood coagulation-fibrinolysis system is a salient characteristic of PE that varies in severity, and necessitates different treatments. Therefore, it is necessary to find suitable predictors for the onset and severity of PE. OBJECTIVES: We aimed to evaluate blood coagulation parameters and platelet indices as potential predictors for the onset and severity of PE. METHODS: Blood samples from 3 groups of subjects, normal pregnant women (n = 79), mild preeclampsia (mPE) (n = 53) and severe preeclampsia (sPE) (n = 42), were collected during early and late pregnancy. The levels of coagulative parameters and platelet indices were measured and compared among the groups. The receiver-operating characteristic (ROC) curves of these indices were generated, and the area under the curve (AUC) was calculated. The predictive values of the selected potential parameters were examined in binary regression analysis. RESULTS: During late pregnancy in the normal pregnancy group, the activated partial thromboplastin time (APTT), prothrombin time (PT), thrombin time (TT) and platelet count decreased, while the fibrinogen level and mean platelet volume (MPV) increased compared to early pregnancy (p<0.05). However, the PE patients presented with increased APTT, TT, MPV and D-dimer (DD) during the third trimester. In the analysis of subjects with and without PE, TT showed the largest AUC (0.743) and high predictive value. In PE patients with different severities, MPV showed the largest AUC (0.671) and ideal predictive efficiency. CONCLUSION: Normal pregnancy causes a maternal physiological hypercoagulable state in late pregnancy. PE may trigger complex disorders in the endogenous coagulative pathways and consume platelets and FIB, subsequently activating thrombopoiesis and fibrinolysis. Thrombin time and MPV may serve as early monitoring markers for the onset and severity of PE, respectively.

Antepartum or immediate postpartum renal biopsies in preeclampsia/eclampsia of pregnancy: new morphologic and clinical findings.

BACKGROUND: Preeclampsia (PE) and eclampsia remain leading causes of maternal and fetal mortality worldwide. The kidney is considered the first and most severely affected organ in women with PE/eclampsia. In this study, we analyzed new morphologic features of kidney biopsies and clinical findings in patients with PE or eclampsia at our hospital. METHODS: Eight patients with PE/eclampsia underwent renal biopsies during the antepartum (3/8) or postpartum (5/8) period. Maternal clinical findings, major serological indices, neonatal outcomes, and renal histopathologic and immunofluorescent characteristics were reviewed for each case. RESULTS: Most patients had abnormal serum cholesterol (8/8), triglyceride (6/8), albumin (7/8), and uric acid (5/8). The ratio of blood urea nitrogen (BUN) to serum creatinine (SCr) was elevated in all patients. Five of eight newborns survived. Various degrees of morphologic change were present in the renal glomeruli, and were associated with proteinuria. All patients had deposition of complement factor 4 (C4) in the renal glomeruli and seven had deposition of immunoglobulin M (IgM). CONCLUSION: Endotheliosis, vacuolation of podocytes, proliferation of mesangial cells, and protein casts in the tubule lumens were found in the kidneys of women with PE/eclampsia. Immune depositions of C4 and IgM are major contributors to renal lesions in preeclamptic patients, whose neonates can generally survive. Eclampsia can occur without increased blood pressure.