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With the development of modern medical standards,autoimmune diseases and their associ-ated successive osteoporosis have received increasing attention in recent years.Patients with autoimmune diseases,due to the characteristics of the disease and the prolonged use of glucocorticoid hormone thera-py,may affect the bone formation and bone absorption of the patient,followed by severe successive osteo-porosis,thereby increasing the risk of osteoporotic vertebral fractures.Vertebral compression fractures of the spine are common fracture types in patients with osteoporotic fractures.Osteoporosis is a common complication after glucocorticoid therapy in patients with autoimmune diseases.Percutaneous vertebro-plasty(PVP)and percutaneous kyphoplasty(PKP)are minimally invasive operation and are commonly used surgical methods for the treatment of osteoporotic vertebral compression fractures.However,due to the operation of spinal puncture during the operation,there are serious surgical risks such as bone cement leakage,spinal epidural hemorrhage,subdural hemorrhage,and subarachnoid hemorrhage in both PVP and PKP.As a result,it is necessary to evaluate the patient's body before surgery carefully,especially in the case of blood coagulation.This article reports a case of autoimmune disease patient admitted to Peking University People's Hospital due to lumbar 4 vertebral compression fracture combined with Sj?gren's syn-drome.The patient's preoperative examination showed that the activated partial thromboplastin time(APTT)was significantly prolonged.After completing the APTT extended screening experiment and lu-pus anticoagulant factor testing,the multi-disciplinary team(MDT)of Peking University People's Hospi-tal jointly discussed the conclusion that the patient's test results were caused by an abnormal self-immuni-ty anti-copulant lupus(LAC).Based on the results of the laboratory examination,the patient was con-sidered to be diagnosed with combined antiphospholipid syndrome(APS).For such patients,compared with the patient's tendency to bleed,we should pay more attention to the risk of high blood clotting in the lower limbs of the patient,pulmonary clots and so on.With timely anti-coagulation treatment,the patient safely passed the peripheral period and was successfully discharged from the hospital.Therefore,for pa-tients with autoimmune diseases with prolonged APTT in the perioperative period,doctors need to careful-ly identify the actual cause and carry out targeted treatment in order to minimize the risk of surgical and perioperative complications and bring satisfactory treatment results to the patients.
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BACKGROUND:The number of hip fracture patients with dementia is increasing with an aging population,posing challenges for surgical treatment. OBJECTIVE:To determine the effect of dementia on postoperative complications in older patients with hip fractures. METHODS:Patients aged over 60 years old with hip fractures from 2000 to 2019 at Chinese PLA General Hospital were included.Dementia patients with a preexisting diagnosis of dementia at admission were identified.Each dementia patient was matched,for age±5 years,gender,and fracture type with 10 non-dementia patients.The differences in postoperative complications were compared between the two groups,including pneumonia,respiratory failure,gastrointestinal bleeding,urinary tract infection,surgical site infection,deep venous thrombosis,pulmonary embolism,angina pectoris,arrhythmia,heart failure,myocardial infarction,stroke,and death.The impact of dementia on major complications was evaluated using multivariate conditional logistic regression. RESULTS AND CONCLUSION:A total of 2 887 patients were included,of whom 125(4.3%)were dementia patients and matched with 1 243 non-dementia patients.The average age of dementia patients was(80.6±7.4)years;64.8%were female;53.6%were intertrochanteric fractures,and 46.4%were femoral neck fractures.Major complications occurred in 25(20.0%)patients with dementia and 123(9.9%)patients without dementia(P<0.01).The risk of major complications was 200.0 per 1 000 persons(95%CI,139.3-278.6)in dementia patients and 99.0 per 1 000 persons(95%CI,83.6-116.9)in non-dementia patients.Multivariate conditional logistic regression showed that a 2-fold risk of major postoperative complications after hip fracture surgery was found in dementia patients than in those without dementia(adjusted OR,2.11;95%CI,1.08-4.10).The results show that dementia is an independent risk factor for postoperative complications in elderly patients with hip fractures.Appropriate preoperative risk assessment and corresponding preventive and therapeutic measures should be given to this vulnerable population to mitigate postoperative complications.
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Ischemic stroke is one of the leading causes of death and disability worldwide. In Han dynasty, HUA Tuo proposed the original preventive medicine idea that "with good blood circulation, the disease cannot be born", which opened a broad space for the cross-research of blood-related mechanical factors and pharmacology. In the pathogenesis of ischemic stroke, mechanical factors comprehensively affect the function and crosstalk of platelets and endothelial cells. In recent years, as the well-known effects on thrombosis and stroke, more attention has been paid to hemodynamic factors as the participants involved in pathological mechanisms and potential therapeutic targets of ischemic stroke. The mechanical force ion channel Piezo1 widely exists on the surface of many types of cells. Besides being regulated by chemical and endogenous substances, Piezo1 responds to different mechanical conditions, regulates the opening and closing of channels, and activates different downstream signaling pathways. Piezo1 is now regarded as an important connection between mechanical and biochemical signals. A variety of Chinese medicine can affect the activity of Piezo1 protein, which may prevent and treat thrombotic diseases such as ischemic stroke through Piezo1 protein. In this paper, the effects of Piezo1 protein on the physiological and pathological functions of endothelial cells and platelet under different mechanical conditions and the role of Piezo1 in the process of thrombosis were reviewed, as well as the effects of Chinese medicine, chemical medicine, and endogenous substances targeting Piezo1 channel. These could provide new ideas for further exploring the mechanisms of Chinese medicines in activating blood circulation, developing new drugs, and deepening biomechanical-pharmacology research.
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OBJECTIVE@#To prepare customized porous silicone orbital implants using embedded 3D printing and assess the effect of surface modification on the properties of the implants.@*METHODS@#The transparency, fluidity and rheological properties of the supporting media were tested to determine the optimal printing parameters of silicone. The morphological changes of silicone after modification were analyzed by scanning electron microscopy, and the hydrophilicity and hydrophobicity of silicone surface were evaluated by measuring the water contact angle. The compression modulus of porous silicone was measured using compression test. Porcine aortic endothelial cells (PAOECs) were co-cultured with porous silicone scaffolds for 1, 3 and 5 days to test the biocompatibility of silicone. The local inflammatory response to subcutaneous porous silicone implants was evaluated in rats.@*RESULTS@#The optimal printing parameters of silicone orbital implants were determined as the following: supporting medium 4% (mass ratio), printing pressure 1.0 bar and printing speed 6 mm/s. Scanning electron microscopy showed that the silicone surface was successfully modified with polydopamine and collagen, which significantly improved hydrophilicity of the silicone surface (P < 0.05) without causing significant changes in the compression modulus (P > 0.05). The modified porous silicone scaffold had no obvious cytotoxicity and obviously promoted adhesion and proliferation of PAOECs (P < 0.05). In rats bearing the subcutaneous implants, no obvious inflammation was observed in the local tissue.@*CONCLUSION@#Poprous silicone orbital implants with uniform pores can be prepared using embedded 3D printing technology, and surface modification obviously improves hydrophilicity and biocompatibility of the silicone implants for potential clinical application.
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Animais , Ratos , Suínos , Silício , Implantes Orbitários , Células Endoteliais , Porosidade , Silicones , Impressão TridimensionalRESUMO
Objective:To explore the value of immediate bedside blood culture in the adjustment of antibiotics for children with bloodstream infections in pediatric intensive care units(PICU).Methods:Retrospective analysis of children in PICU at Henan Children′s Hospital from May 2017 to March 2021 was conducted.The cases were divided into laboratory blood culture(LBC) group and satellite blood culture(SBC) group according to different blood culture methods.The difference in the time to blood culture incubation, time to blood culture positivity, microbial results time and antibiotic adjustment time were compared between two groups.Results:A total of 3 720 blood cultures were completed in 2 718 children, including 1 888 in LBC group and 1 832 in SBC group, with a positive rate of 3.5% in LBC group and 4.9% in SBC group, and a significantly higher positive rate in SBC group compared to LBC group( χ2=3.954, P=0.046). The differences in age, sex, site of infection, survival rate at 28 d after discharge, pediatric critical illness score, and pediatric risk of mortality Ⅲ score between LBC group and SBC group with positive blood cultures were not statistically significant ( P>0.05). Children in SBC group had significantly shorter specimen receipt time, time to obtain microbiological results, and antibiotic adjustment time than those in LBC group[0.33(0.03, 1.78) h vs. 3.38(1.38, 7.29) h, (57.40±21.92) h vs. (68.14±21.26) h, and (52.53±27.23) h vs. (66.41±28.57) h, all P<0.05]. Conclusion:Immediate bedside blood culture shortens the time from culture to final result reporting, increases the positive rate of blood culture, and saves time on accurate antibiotic treatment for critically ill children.
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Objective:To investigate the effect of free thenar perforator flap on repair of finger pulp defect.Methods:From September 2019 to November 2021, 79 cases of finger injuries complicated with defects in the pulp of fingers received free thenar perforator flap transfer surgery for reconstruction of finger pulps in the Department of Hand and Foot Surgery, Taizhou Hospital, Zhejiang Province. The patients were 51 males and 28 females, aged from 17 to 52(37.5±5.2) years old. There were 34 finger-pulp defects of index fingers, 15 of middle fingers, 26 of ring fingers and 4 of little fingers. All patients were treated with free thenar perforator flaps sized 2.0 cm×2.5 cm-3.0 cm×3.5 cm. All thenar perforator flaps were pedicled with the perforator artery and subcutaneous superficial vein in the thenar region, and the vessels were anastomosed with the proper palmar digital artery and dorsal digital vein, respectively. At the same time, subcutaneous nerve and proper palmar digital nerve were sutured to reconstruct the sensation of flaps. During the operation, the dominant perforating branch of thenar was found being originated from the superficial palmar branch of radial artery in 27 cases, from the superficial palmar arch in 21 cases, from the perforating branch of metacarpophalangeal proper artery of thumb in 11 cases, from the radial artery in 10 cases and from the main artery of thumb in 10 cases. The origins of nerves within the flaps were found from the superficial branch of radial nerve(24 cases), the terminal branch of lateral cutaneous nerve of forearm(22 cases) and the palmar branch of median nerve(33 cases). The operation time was (96.7±10.7) minutes. The donor site for the flap was closed directly without skin grafting. Most of the follow-up were conducted through the visit of outpatient clinic and the patients from other regions were reviewed via telephone or WeChat.Results:All perforator flaps survived completely and the flap donor sites healed smoothly. Follow-up lasted for (20.5±3.8) months. The reconstructed finger pulp was not bulky and the texture was satisfactory. TPD of the flaps was (5.6±0.9) mm. Only a linear scar left in the flap donor sites without significant affect on thenar function.Conclusion:The vascular anatomy of thenar perforator flap is constant, which helps to regain sensations of the flap. The texture and thickness of the flap are similar to those of the finger. It is ideal for reconstruction of defect of finger pulp.
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Objective:To investigate the effect of pioglitazone on white matter injury after cerebral ischemia-reperfusion in mice and its mechanism.Methods:Forty-two young male C57BL/6J mice were randomly divided into sham operation group, model group, and pioglitazone group ( n=14 in each group). The model of cerebral ischemia-reperfusion was induced by transient middle cerebral artery occlusion with suture-occluded method. On the 3 rd and 7 th day after the establishment of the model, the neural function was assessed by the adhesive removal test. The mice were killed on the 7 th day after the establishment of the model. HE staining was used to detect the extent of cerebral infarction. Immunofluorescence staining and Western blot analysis were used to detect the degree of white matter damage and the changes of microglia phenotype. Results:On the 7 th day after cerebral ischemia-reperfusion, the adhesive removal time in the PGZ group was significantly shortened compared with the model group ( P<0.05), the percentage of cerebral infarction volume was significantly reduced ( P<0.05), the ratio of MBP/NF200 fluorescence intensity in the cortical and striatal areas was significantly increased (all P<0.05), and the number of CD16 +/Iba1 + microglia was significantly decreased ( P<0.01), while the number of CD206 +/Iba1 + microglia tended to increase, but there was no statistical difference. Conclusion:Pioglitazone may reduce the degree of white matter injury and nerve function damage in mice with cerebral ischemia-reperfusion, and its mechanism may be associated with regulating the transformation of microglia from M1 type to M2 type.
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Objective:To understand the progress, maternal morbidity, and maternal and infant outcomes in pregnant women with non-severe primary immune thrombocytopenia (ITP) during two consecutive pregnancies.Methods:This study retrospectively analyzed the clinical data of 40 patients with non-severe ITP who had two pregnancies and were treated at Peking University People's Hospital between June 2010 and June 2020. Platelet counts at different stages of pregnancy, treatments, maternal complications and neonatal outcomes were compared with Chi-square test, Fisher's exact test, paired sample t-test, non-parametric Wilcoxon signed rank test, independent sample t-test or non-parametric Mann-Whitney U test. Results:Among the 40 patients, 18 were diagnosed before and 22 were first diagnosed during the first gestation. Platelet counts and treatments in the 18 patients prior to their first conception were not significantly different from those in the 40 patients before their second pregnancy (all P>0.05). No significant difference in the average platelet count and thrombocytopenia severity at each stage of pregnancy, and maternal bleeding score or drug treatment was observed between the two pregnancies (all P>0.05), neither in the incidence of gestational hypertension, gestational diabetes, premature rupture of membranes, premature delivery, or anemia (all P>0.05). The incidences of postpartum hemorrhage and severe postpartum hemorrhage in the second pregnancy were 30.0%(12/40) and 22.5%(9/40), respectively, which were both higher than those in the first gestation [(7.5%(3/40) and 5.0%(2/40); χ2=6.64, 5.17; P=0.010, 0.023]. The amount of postpartum hemorrhage was higher in the second pregnancy than in the first [500 ml(213-795 ml) vs 300 ml(163-400 ml), Z=-2.34, P=0.019]. There was no significant difference in birth weight, the incidence of passive ITP or intracranial hemorrhage, or mortality between the neonates of the first and second pregnancy group (all P>0.05). The lowest platelet count in neonates within one week after birth in the second pregnancy group was (202.2±106.7)×10 9/L, which was lower than that of the first [(222.5±91.8)×10 9/L, Z=-2.04, P=0.041]. Conclusions:Non-severe ITP is not worse in the second pregnancy than in the first. In women with non-severe ITP, the incidence of maternal complications is not increased in the second pregnancy, but the risk of postpartum hemorrhage and the incidence of neonatal passive immune thrombocytopenia are raised.
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Objective:To investigate the effectiveness and safety of nasojejunal tube placement in children by gastroscopic drafting method.Methods:We retrospectively analyzed the clinical data of children with nasojejunal tube placement from January 2016 to December 2021 in our hospital, and compared the operation time, successful rate and complications of nasojejunal tube placement in the gastroscopic wire drawing method retraction group(observation group)and the gastroscopic foreign body clamp placement method placement group(control group).Results:All of the 167 cases, 65 cases were in observation group and 102 cases in control group.There were no significant differences in sex and age between two groups( P>0.05). The operation time was(6.7±0.8)min in observation group and(8.2±1.3)min in control group, and the difference was statistically significant( t=8.312, P<0.001). The successful rate was 100% in observation group and 96% in control group.One child in control group complicated with the mucosal erosion and bleeding in the duodenal bulb, while the observation group with no erosion, bleeding, perforation, and other complications. Conclusion:The gastroscopic wire drawing method of nasojejunal tube placement has a shorter operation time, higher successful rates, and lower complication rates, which is significantly superior to the gastroscopic foreign body clamp placement method.
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Objective:To investigate the effect of body mass management and mindfulness therapy on obese patients with polycystic ovary syndrome (PCOS).Methods:A total of 68 patients with PCOS admitted to Haikou People's Hospital(Haikou Hospital Affiliated to Central South Xiangya Medical College) from January to December 2018 were divided into observation group and control group by random digits table method, 34 cases in each group. The observation group was treated with body quality management combined with mindfulness therapy, and the control group was treated with routine nursing intervention. The total cholesterol (TC), triglyceride (TG), fasting blood glucose (FPG), 2 h postprandial blood glucose (2 hPPG), insulin (PINS), fasting insulin (FINS), Self Perceived Burden Scale (SPBS), quality of life score in the two groups were evaluated.Results:There was no significant difference in TC and TG between the two groups before intervention ( P>0.05); after 12 weeks of intervention, TC, TG were (4.21 ± 0.20), (1.60 ± 0.20) mmol/L in the observation group and (4.50 ± 0.31), (1.95 ± 0.55) mmol/L in the control group, there were significant differences between the two groups ( t values were 4.584, 3.487, P<0.01). There was no significant difference in FPG, 2 hPPG, PINS and FINS between the two groups before intervention and FPG, 2 hPPG after 12 weeks of intervention ( P>0.05); PINS, FINS were (72.60±28.46),(16.02±3.00)mU/L in the observation group and (102.61±50.10),(18.10±4.22)mU/L in the control group, there were significant differences between the two groups ( t values were 3.037, 2.342, P<0.01 or 0.05). There was no significant difference in the SPBS score between the two groups before intervention ( P>0.05); after 12 weeks of intervention, the SPBS score was (26.15 ± 2.02) in the observation group and (31.03 ± 1.00) in the control group, there was significant difference between the two groups ( t value was 12.624, P<0.01). There was no significant difference in the quality of life score between the two groups before intervention ( P>0.05); after 12 weeks of intervention, the scores of quality of life energy, sleep emotion, social life and physical activity were (80.62 ± 3.50), (79.10 ± 3.62), (75.02 ± 3.00), (77.26 ± 2.87) in the observation group and (71.23±4.02),(72.59±3.65),(69.20±4.11),(69.20±4.47) in the control group, there were significant differences between the two groups( t values were 7.234-10.272, P<0.01). Conclusions:The application of body mass management and mindfulness therapy can effectively improve the glucose and lipid metabolism level of obese PCOS patients, reduce the burden of psychological self perception, and improve the quality of life.
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Epilepsy is a common chronic nervous system disease, about one third of patients with intractable epilepsy, which brings a heavy burden to the society. At present, the specific etiology and drug-resistant mechanism are still unclear. Minimally invasive, reliable and economic biomarkers are of great help to improve the diagnosis and prognosis of drug-resistant epilepsy. In recent years, microRNA has gradually become a research hotspot of intractable epilepsy and is expected to become a biomarker. This paper briefly reviews the microRNA related to intractable epilepsy.
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In recent years, the prevalence of metabolic diseases, including obesity, diabetes, nonalcoholic fatty liver disease, and metabolic syndrome, increased significantly. Fatigue is common in metabolic diseases and may lead to functional disability. This complicated feeling imposes a huge influence on patients with metabolic diseases physically and psychologically, which seriously affects the quality of life and brings serious burden to the social economy. There were an increasing number of researches on fatigue and metabolic diseases. This article reviews the evidences of the linkages between fatigue and metabolic diseases.
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Objective To analyze the deployment of medical linear accelerators at 26 hospitals in China, and suggest on the deployment of such accelerators. Methods From June 2017 to November 2018, a total of 26 hospitals were surveyed by stratified random sampling. Descriptive analysis of the deployment and staffing of medical linear accelerators at 26 hospitals, and the deployment appropriateness of the medical linear accelerator was evaluated using the TOPSIS method. Results The number of medical linear accelerators in different types of hospitals was significantly different. The proportion of imported equipment at tertiary hospitals was 80% (12/15) and the proportion of imported equipment at secondary hospitals was 9% (1/11). The professional staff was deployed basically reasonable, and there was a shortage of physicists at some hospitals. The suitability of medical linear accelerators at tertiary hospitals was better than that of secondary hospitals, 80% (12/15) of tertiary hospitals received " good" and above ratings, while 91% (10/11) of the secondary hospitals received " general" and below ratings. Conclusions Hospitals should carry out the allocation of large-scale medical equipment based on their own situations and requirements. Efforts should be paid on training of professional technicians for radiotherapy. It is important to strengthen the management of planning, access and supervision of medical equipment.
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Objective To investigate the value of combined detection of plasma matrix metalloproteinase 9 (MMP-9), heparin binding protein (HBP) and interleukin 27 (IL-27) in the early diagnosis of sepsis.Methods A total of 55patients with sepsis in the ICU of People′s Hospital of Chongqing Banan District were selected and divided into sepsis group (24cases), severe sepsis group (17cases) and septic shock group (14patients) according to the severity of illness.Meanwhile, 21patients with non-sepsis local infection were selected as the control group.Record the plasma levels of MMP-9, HBP, IL-27relevant test data, acute physiology and chronic health status scoring system-Ⅱ (APACHE-Ⅱ) scores on admission.Pearson correlation test was used to analyze the correlation between plasma MMP-9, HBP and IL-27levels with PCT and APACHE-Ⅱ.Multivariate logistic regression analysis was used to analyze the correlation between MMP-9, HBP, IL-27and sepsis.The receiver operating characteristic curve (ROC) was used to analyze the combined detection of MMP-9, HBP, and IL-27for the early diagnosis of sepsis.Results The plasma levels of MMP-9, HBP and IL-27in patients with sepsis were significantly higher than those in the control group (P<0.05).The levels of MMP-9, HBP and IL-27 were positively correlated with serum PCT (rMMP-9=0.534, rHBP=0.693, rIL-27=0.627, P<0.05) and APACHE-Ⅱ (rMMP-9=0.574, rHBP=0.723, rIL-27=0.669, P<0.05).Multivariate logistic regression analysis showed that MMP-9, HBP and IL-27were independent risk factors for sepsis (P<0.05).ROC curve analysis suggested that the area under the curve (AUC) of MMP-9, HBP, and IL-27were 0.764 (95%CI=0.755-0.916), 0.713 (95%CI=0.627-0.795) and 0.871 (95%CI=0.762-0.936), combined detection of MMP-9, HBP and IL-27had an AUC value of 0.891 (95%CI=0.822-0.943), which were significantly higher than single detection of MMP-9, HBP and IL-27 (P<0.05).Conclusion Combined detection of plasma MMP-9, HBP and IL-27has a good application value for early diagnosis of sepsis.
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Carbon quantum dots (CQDs) with quantum yield of 14% were successfully synthesized via a simple, low-cost, and green hydrothermal treatment using cigarette filters as carbon source for the first time. The obtained CQDs showed a strong emission at the wavelength of 465â¯nm, with an optimum excitation of 365â¯nm.Sudan I with maximum absorption wavelength at 477â¯nm could selectively quench the fluorescence of CQDs. Based on this principle, a fluorescence probe was developed for Sudan I determination. Furthermore, the quenching mechanism of the CQDs was elucidated. A linear relationship was found in the range of 2.40-104.0⯵mol/L Sudan I with the detection limit (3σ/k) of 0.95⯵mol/L. Satisfactory results were achieved when the method was submitted to the determination of Sudan I in food samples.
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Carbono/química , Filtração , Fluorescência , Naftóis/análise , Pontos Quânticos/química , Produtos do Tabaco/análiseRESUMO
Objective To establish a rat model of Cryptococcus neoformans meningitis. Methods Sprague-Dawley rats were divided into four groups (group A to D). The load of Cryptococcus neoformans was inoculated by intracisternal injection to the animals in Group A (1×105 cfu), Group B (1×106 cfu), Group C (1×107 cfu), and 0.9% NaCl solution to Group D. The rats were observed after inoculation for their clinical symptoms. On day 14 and day 21 after inoculation, cerebrospinal fluid was sampled and cultured for counting of bacterial colonies. The 28-day mortality of the animals was calculated. Results All the animals in group A (1×105 cfu) survived without any apparent clinical symptoms, and associated with decreasing bacteria load. The animals in group B (1×106 cfu) had mild symptoms associated with low mortality rate and slightly increased bacterial load. The animals in group C (1×107 cfu) showed a lot of symptoms and associated with high mortality rate and significantly increased bacteria load. All the animals in group D (0.9% NaCl solution) survived with normal activity. No bacterial colony was cultured from the cerebrospinal fluid. Conclusions Intracisternal injection of 1×107 cfu Cryptococcus neoformans to rats could cause apparent clinical symptoms of meningitis. The 28-day mortality rate of such a rat model of Cryptococcus neoformans meningitis is greater than 80%. An ideal rat model of Cryptococcus neoformans meningitis is established successfully.
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To investigate the expression of microRNA-34a (miR-34a) in patients with chronic lymphocytic leukemia (CLL) in Xinjiang Uygur and Han nationalities and its prognostic significance. Our data showed that miR-34a expression in Uygur and Han CLL patients was significantly higher than that in their respective healthy controls, while miR-34a levels were similar between Uygur and Han patients. By comparing with known prognostic factors, receiver operating characteristic (ROC) curves showed that miR-34a was a good predictive factor for the prognosis of CLL (demarcation value was 3.567 6). Survival analysis was further performed according to miR-34a expression level, that low expression of miR-34a translated into poor prognosis.
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Background and purpose: With the application of laparoscopy in the liver surgery increasingly widely used, the safety and feasibility of laparoscopic liver resection is gaining recognition gradually. This study aimed to explore the laparoscopic liver resection for the tumor and the feasibility of open liver tumor resection and clinical curative effect. Methods: We retrospectively analysed the clinical data from 37 cases of laparoscopic hepatectomy and 74 patients with open liver resection from Mar. 2015 to Mar. 2016. Measurement data by covariance analysis were obtained, and comparison between groups were made using independent sample with Wilcoxon rank test and statistical value of Z. We collected data including operation time, intra-operative blood loss, post-operative recovery time of gastrointestinal tract, surgical drainage tube after extubation time, length of hospital stay, postoperative complications, hospitalization expenses and other clinical data. Laparoscopic group had 20 males and 17 female aged 18 to 76 (median age 55). Open group had 42 males and 32 females aged 26 to 74 (median age 54). The hepatectomy included ultrasonic knife + unipolar electric coagulation, combined with laparoscopic incision suture. Surgery procedures included 13 cases of local excision in laparoscopic group and 24 cases of liver segment or lobe anatomical resection. Open group had 33 cases of local excision and 41 cases of liver segment or lobe anatomical resection. Results: The average duration of laparoscopic hepatectomy was 149 min (40-204 min). The average duration of open hepatectomy was 142 min (45-190 min). The average intra-operative blood loss was 220 mL (30-570 mL) in laparoscopic group and 360 mL (90-970 mL) in open group. The average length of hospital stay was 4.9 d (3-6 d) in laparoscopic group and 6.8 d (5-9 d) in open group. Gastrointestinal average recovery time was 1.1 days in laparoscopic group and 2.3 days in open group. The average hospitalization expenses were 38760 yuan in laparoscopic group and 39145 yuan in open group. Conclusion:Laparoscopic hepatectomy is a safe, effective and minimally invasive surgery, can be safely used in local, liver segment and half liver resection, worthy of promotion.
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Objective To investigate the changes of the gray matter in patients with rheumatoid arthritis (RA) based on the voxel based morphometry (VBM).Methods 35 patients with RA and 30 healthy volunteers with age,sex and education level matched performed a high-resolution 3D-T1-weighted whole brain structural scan by GE Signa HDxt 1.5T MRI scanner.The high resolution T1WI images were preprocessed by the VBM 12 implemented in the SPM 12 software to display the gray matter structures of the RA patients and the healthy volunteers.T test was used to compare the morphological changes of gray matter between the RA patients and the volunteers.Results The gray matter volume gray matter volume in the right lentiform nucleus,left frontal lobe and left cerebellum posterior lobe significantly decreased in RA patients,and their gray matter volume had no correlation with the clinical indications.The increase of gray matter volume was not found in the RA patients.Conclusion RA patients show decreased gray matter volume in several cerebral regions,which suggests that RA can lead to the brain structural abnormalities.VBM can provide an objective imaging evidence to evaluate the cerebral morphological abnormalities of RA.
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Viral myocarditis (VM) refers to human infections thermophilic myocardium virus that causes the circumscribed or diffuse myocardium-inflammatory lesion.Myocarditis can be caused by a variety of microbial infections,and VM is the most common one.In order to make the medical staff in clinical work have a more in-depth understanding of VM,this paper describes the common rviruses related,VM and its pathogenesis,process.At present,there is no effective drug and treatment method for VM.It is particularly important to further study the pathogenesis of VM on the role of the virus in,and inhibit its role in the further exploration of clinical therapeutic targets,to improve the quality of life of patients with VM and prolong the survival time is of great significance.Studying in-depth virus in the pathogenesis of VM and restraining its function are particularly important for the further exploration of clinical therapeutic targets.It is significant to improve the life quality and prolong the survival time for VM patients.