iASPP is an inhibitory member of the apoptosis-stimulating proteins of P53 （ASPP） family. iASPP is over expressed in several malignant tumors and potentially affects cancer progression. However, the expression and p...iASPP is an inhibitory member of the apoptosis-stimulating proteins of P53 （ASPP） family. iASPP is over expressed in several malignant tumors and potentially affects cancer progression. However, the expression and potential role of iASPP in oral tongue squamous cell carcinoma （OTSCC） have not been addressed. In our study, we detected iASPP expression in OTSCC by immunohistochemistry, iASPP expression is up-regulated in OTSCC tissues. Moreover, in clinical pathology specimens, we found that increased iASPP expression correlates with poor differentiation and lymph node metastasis. Using multicellular tumor spheroids （MTS） and flow cytometry, we demonstrated that iASPP down-regulation arrests OTSCC cells at the G0/G1 phase, induces OTSCC cell apoptosis and inhibits OTSCC cell proliferation. These results indicate that iASPP plays a significant role in the progression of OTSCC and may serve as a biomarker or therapeutic target for OTSCC patients.展开更多
With the rapid development of emergency medicine,emergency physicians are working around the clock,[1]including additional workloads due to sudden public health emergencies and disasters.Occupational risks for emergen...With the rapid development of emergency medicine,emergency physicians are working around the clock,[1]including additional workloads due to sudden public health emergencies and disasters.Occupational risks for emergency physicians are significantly high due to an increasing number of patients with acute and severe diseases,an increased workload.展开更多
BACKGROUND With the continuous progress of surgical technology and improvements in medical standards,the treatment of gastric cancer surgery is also evolving.Proximal gastrectomy is a common treatment,but double-chann...BACKGROUND With the continuous progress of surgical technology and improvements in medical standards,the treatment of gastric cancer surgery is also evolving.Proximal gastrectomy is a common treatment,but double-channel anastomosis and tubular gastroesophageal anastomosis have attracted much attention in terms of surgical options.Each of these two surgical methods has advantages and disadvantages,so it is particularly important to compare and analyze their clinical efficacy and safety.AIM To compare the surgical safety,clinical efficacy,and safety of double-channel anastomosis and tubular gastroesophageal anastomosis in proximal gastrectomy.METHODS The clinical and follow-up data of 99 patients with proximal gastric cancer who underwent proximal gastrectomy and were admitted to our hospital between January 2018 and September 2023 were included in this retrospective cohort study.According to the different anastomosis methods used,the patients were divided into a double-channel anastomosis group(50 patients)and a tubular gastroesophageal anastomosis group(49 patients).In the double-channel anastomosis,Roux-en-Y anastomosis of the esophagus and jejunum was performed after proximal gastric dissection,and then side-to-side anastomosis was performed between the residual stomach and jejunum to establish an antireflux barrier and reduce postoperative gastroesophageal reflux.In the tubular gastroesophageal anastomosis group,after the proximal end of the stomach was cut,tubular gastroplasty was performed on the distal stump of the stomach and a linear stapler was used to anastomose the posterior wall of the esophagus and the anterior wall of the stomach tube.The main outcome measure was quality of life 1 year after surgery in both groups,and the evaluation criteria were based on the postgastrectomy syndrome assessment scale.The greater the changes in body mass,food intake per meal,meal quality subscale score,and total measures of physical and mental health score,the better the condition;the greater the other indicators,the展开更多
BACKGROUND Under physiological conditions,sputum produced during acute exacerbation of chronic obstructive pulmonary disease(AECOPD)can move passively with the cilia in the airway;the sputum is gradually excreted from...BACKGROUND Under physiological conditions,sputum produced during acute exacerbation of chronic obstructive pulmonary disease(AECOPD)can move passively with the cilia in the airway;the sputum is gradually excreted from the depth of the airways through the stimulation of the coughing reflex on the sensory nerve on the surface of the airway.However,when the sputum is thick,the cough is weak,or the tracheal cilia are abnormal,sputum accumulation may occur and affect the exchange of oxygen and carbon dioxide in the lung.Furthermore,the presence of pathogenic microorganisms in sputum may cause or aggravate the symptoms of pulmonary infection in patients,which is the main factor leading to AECOPD.Therefore,promoting effective drainage of sputum and maintaining airway opening are key points requiring clinical attention.AIM To explore the effect of refined nursing strategies in patients with AECOPD and dysphagia.METHODS We selected 126 patients with AECOPD and difficulty of expectoration at our hospital,and divided them into a refined care group and a routine care group,with 63 cases each,using a random number table.The two groups of patients were treated with expectorant,anti-infection,oxygen inhalation,and other basic treatment measures;patients in the refined care group were given refined nursing intervention during hospitalization,and the routine care group received conventional nursing intervention.The differences in sputum expectoration,negative pressure suction rate,blood gas parameters,dyspnea score measured through the tool developed by the Medical Research Council(MRC),and quality of life were compared between the two groups.RESULTS After 7 d of intervention,the sputum expectoration effect of the refined care group was 62.30%,the effective rate was 31.15%,and the inefficiency rate was 6.56%.The sputum expectoration effect of the routine care group was 44.07%,the effective rate was 42.37%,and the inefficiency rate was 13.56%.The refined care group had better sputum expectoration than the routine care group(P<0.05展开更多
BACKGROUND Bariatric surgery is one of the most effective ways to treat morbid obesity,and postoperative nausea and vomiting(PONV)is one of the common complications after bariatric surgery.At present,the mechanism of ...BACKGROUND Bariatric surgery is one of the most effective ways to treat morbid obesity,and postoperative nausea and vomiting(PONV)is one of the common complications after bariatric surgery.At present,the mechanism of the high incidence of PONV after weight-loss surgery has not been clearly explained,and this study aims to investigate the effect of surgical position on PONV in patients undergoing bariatric surgery.AIM To explore the effect of the operative position during bariatric surgery on PONV.METHODS Data from obese patients,who underwent laparoscopic sleeve gastrectomy(LSG)in the authors’hospital between June 2020 and February 2022 were divided into 2 groups and retrospectively analyzed.Multivariable logistic regression analysis and the t-test were used to study the influence of operative position on PONV.RESULTS There were 15 cases of PONV in the supine split-leg group(incidence rate,50%)and 11 in the supine group(incidence rate,36.7%)(P=0.297).The mean operative duration in the supine split-leg group was 168.23±46.24 minutes and 140.60±32.256 minutes in the supine group(P<0.05).Multivariate analysis revealed that operative position was not an independent risk factor for PONV(odds ratio=1.192,95%confidence interval:0.376-3.778,P=0.766).CONCLUSION Operative position during LSG may affect PONV;however,the difference in the incidence of PONV was not statistically significant.Operative position should be carefully considered for obese patients before surgery.展开更多
Background:The aim of this prospective randomized study was to evaluate the impact of visual guidelines(picture book)and parents tutoring on pediatric urological surgery on parent's stress and anxiety,the number o...Background:The aim of this prospective randomized study was to evaluate the impact of visual guidelines(picture book)and parents tutoring on pediatric urological surgery on parent's stress and anxiety,the number of postoperative contacts,and complications.Materials and methods:Following institutional ethical committee approval,a special picture book reflecting different stages of the convalescent period following multiple types of pediatric urological surgery was developed.Parents were randomly divided into 2 groups in which 33 parents in Group 1 received the picture book in addition to routine instructions prior to the surgery and 31 in Group 2 received only routine postoperative instructions.The parents were asked to answer a questionnaire(Amsterdam Preoperative Anxiety and Information Scale)regarding the level of anxiety before surgery and immediately after surgery in the recovery room.The number of postoperative parent's calls,nonplaned emergency room visits,and complications were recorded.Results:No statistically significant difference in perioperative parental anxiety was found(p=0.88).The visual tutoring group had a significantly lower rate of emergency room admissions(6.6%vs.18.6%,p=0.0433),however parents from this group made a higher number of postoperative calls(9.9%vs.3.1%,p=0.38).Two(6.6%)from the tutoring group expressed their desire to omit visual counseling in future surgical preparation and 4(13.2%)did not have an opinion.Overall satisfaction with regards to the preoperative counseling and information and the number of postoperative complications was similar in both groups.Conclusions:Visual tutoring does not add any value to parental anxiety but seems helpful in reducing postoperative emergency room visits.Some parents preferred to exclude visual information from future preoperative counseling.展开更多
BACKGROUND The nursing working environment is an important subsystem in the hospital environment.A good working environment could have a positive impact on nurses.However,the work-family conflict and unsatisfactory wo...BACKGROUND The nursing working environment is an important subsystem in the hospital environment.A good working environment could have a positive impact on nurses.However,the work-family conflict and unsatisfactory working environment could significantly reduce their working enthusiasm,efficacy as well as the overall quality of the nursing,increase their fatigue,and thereby compromise their career status.AIM To explore the possible status quo and to analyze the correlation between work environment perception and the work-family conflict among nurses in the operating room.METHODS A total of 312 operating room nurses from two first-class hospitals at Grade 2 and two first-class hospitals at Grade 3 in China from May to September 2017 were included in this research using the cluster sampling method.The data,including the general information questionnaire,the practice environment scale of the nursing work index(PES-NWI),and the work-family conflict scale,were systematically collected.Pearson correlation analysis was applied to analyze the correlation between the two scores,with influencing factors analyzed by hierarchical regression analysis.RESULTS A total of 312 questionnaires were issued,and the response rate and effective questionnaire rate were both 96.15%(300/312).The total scores of the PES-NWI scale and the work-family conflict scale were 3.07±0.43(vs maximum up to 4 points)and 52.32±8.79(vs maximum up to 90 points),respectively.The scores of the PES-NWI scale were negatively correlated with that of work-family conflict scale(all P<0.05).The perception of the nursing work environment and the number of night shifts per month were the major factors contributing to the workfamily conflict(all P<0.05).CONCLUSION The nursing work environment and the work-family conflict among nurses in the operating room were both found at a medium level with a negative correlation between the two.展开更多
BACKGROUND Chronic gastritis(CG) is an inflammatory disease of the gastric mucosa. Shenling-bai-zhu san(SLBZS), a traditional Chinese medicine formula, is widely used for treating CG. Nevertheless, its effects are cur...BACKGROUND Chronic gastritis(CG) is an inflammatory disease of the gastric mucosa. Shenling-bai-zhu san(SLBZS), a traditional Chinese medicine formula, is widely used for treating CG. Nevertheless, its effects are currently unclear.AIM To determine the clinical evidence and potential mechanisms of SLBZS for the treatment of CG.METHODS We systematically searched 3 English(PubMed, Embase, Medline) and 4 Chinese databases(Cochrane Library Central Register of Controlled Trials, China National Knowledge Infrastructure database, Wanfang Data Knowledge Service Platform,and the VIP information resource integration service platform) without language or publication bias restriction. Qualified studies were selected according to pre-set inclusion and exclusion criteria. RevMan 5.3 software was used for meta-analysis and literature quality assessment, Stata 14.0 software was used for sensitivity analysis, GRADE profiler 3.6 was used to evaluate the quality of evidence. And then, network pharmacology analysis was applied to primary research the mechanisms of action of SLBZS on CG.RESULTS Fourteen studies were finally included, covering 1335 participants. Meta-analysis indicated that:(1) SLBZS was superior to conventional therapies [risk ratio(RR):1.29, 95% confidence interval(CI): 1.21 to 1.37, P < 0.00001];(2) SLBZS was better than conventional therapies [RR: 0.24, 95% confidence interval(95%CI): 0.11 to 0.55, P = 0.0007] in terms of recurrence rate and reversal of Helicobacter pylori positivity(RR: 1.20, 95%CI: 1.11 to 1.30,P < 0.00001);and(3) The safety of SLBZS for CG remains unclear. According to the GRADE method, the quality of evidence was not high. Besides, SNZJS might treat CG by acting on related targets and pathways such as EGFR tyrosine kinase inhibitor resistance, the PI3K-Akt signaling pathway, and others.CONCLUSION SLBZS might be useful in treating CG, but long-term effects and specific clinical mechanisms of it maintain unclear. More samples and high-quality clinical experiments should be assessed and verified 展开更多
Objective： To assess the medical community＇s awareness and practice regarding delirium in the intensive care unit （ICU）. Methods： One hundred and ten predesigned questionnaires were distributed to ICU practition...Objective： To assess the medical community＇s awareness and practice regarding delirium in the intensive care unit （ICU）. Methods： One hundred and ten predesigned questionnaires were distributed to ICU practitioners in the affiliated hospitals of Zhejiang University. Results： A total of 105 valid questionnaires were collected. Totally, 55.3% of the clinicians considered that delirium was common in the ICU. Delirium was believed to be a significant or serious problem by 70.5% of respondents, and under-diagnosis was acknowledged by 56.2% of the respondents. The incidence of ICU delirium is even more under-estimated by the pediatric doctors compared with their counterparts in adult ICU （P〈0.05）. Primary disease of the brain （agreed by 82.1% of the respondents） was believed to be the most common risk factor for delirium. None of the ICU professionals screened delirium or used a specific tool for delirium assessment routinely. The vast majority （92.4%） of respondents had little knowledge on the diagnosis and the standard treatment of delirium. Conclusions： Although delirium is considered as a serious problem by a majority of the surveyed ICU professionals, it is still under-recognized in routine critical care practice. Data from this survey show a disconnection between the perceived significance of delirium and the current practices of monitoring and treatment in ICU in China.展开更多
Background:Hypothermia is associated with many adverse clinical outcomes in pediatric patients,and thus,it is important to an effective and safe method for preventing peri-operative hypothermia and its associated adve...Background:Hypothermia is associated with many adverse clinical outcomes in pediatric patients,and thus,it is important to an effective and safe method for preventing peri-operative hypothermia and its associated adverse outcomes in pediatric patients.This study aimed to investigate the effect of forced-air warming blankets with different temperatures on changes in the transforming growth factor-β(TGF-β),tumor necrosis factor(TNF)-α,interleukin(IL)-1β,and IL-10 levels in children undergoing surgical treatment for developmental displacement of the hip(DDH).Methods:The study included 123 children undergoing surgery for DDH under general anesthesia.The patients were randomly assigned to three groups,using a random number table:the 32,38,and 43°C groups according to the temperature setting of the forced-air warming blankets.For each patient,body temperature was recorded immediately after anesthesia induction and intubation(T0),at initial incision(T1),at 1 h after incision(T2),at2 h after incision(T3),at the end of surgery(T4),immediately upon return to the ward after surgery(T5),and then at 12 h(T6),24 h(T7),36 h(T8),and 48 h(T9)after the surgery.The serum levels of TGF-β,TNF-α,IL-1β,and IL-10 were measured at To and T4 for all groups.Results:The number of patients with fever in the 38°C group was significantly less than those in the 32 and 43°C groups(x^2=6.630,P=0.036).At To,the body temperatures in the 38 and 43°C groups were significantly higher than that in the 32°C group(F=17.992,P<0.001).At T2,the body temperature was significantly higher in the 43°C group than those in the 32 and 38°C groups(F=12.776,P<0.001).Moreover,at T4,the serum levels of TGF-β(F=3286.548,P<0.001)and IL-10(F=4628.983,P<0.001)were significantly increased in the 38°C group,and the serum levels of TNF-α(F=911.415,P<0.001)and IL-10(F=322.191,P<0.001)were significantly decreased in the 38°C group,compared with the levels in the 32 and 43°C groups.Conclusion:Force-air warming blankets set at 38°C maintained stable body temp展开更多
Objective: The aim of this study was to explore the correlation between psychological resilience and social support and anxiety in obstetric nurses and to provide theoretical basis for improving the mental health of o...Objective: The aim of this study was to explore the correlation between psychological resilience and social support and anxiety in obstetric nurses and to provide theoretical basis for improving the mental health of obstetric nurses.Methods: In this study, 190 obstetric nurses were included, using the general information questionnaire and The Connor-Davidson Resilience Scale(CD-RISC), Social Support Rating Scale, and survey of Self-evaluation of Anxiety Scale.Results: There are differences in the type of work and the score of psychological resilience(P<0.05), obstetric nurses’ resilience score was 65.58±10.65; self-rating anxiety score of obstetric nurses was 36.89±6.87; and social support score of obstetric nurses was44.3717.86. The psychological elasticity score and anxiety were negatively related(P<0.01), whereas the resilience score and total score of social support were positively related(P<0.01).Conclusions: Obstetric nurses have many responsibilities and stress. Nursing managers should focus on obstetric nurses’ mental health, lighten the obstetric nurses’ anxiety, and thus improve their mental flexibility and optimize the quality of nursing service better,with more passion into work.展开更多
This article introduces the concept and mode of narrative education in addition to the application of narrative education in clinical nursing education. A summary is presented of the application of narrative education...This article introduces the concept and mode of narrative education in addition to the application of narrative education in clinical nursing education. A summary is presented of the application of narrative education in this clinical nursing context from several aspects, including providing a display platform and various other teaching forms for the teachers＇ use, promoting the professional quality of teachers and students, and facilitating the teaching of abstract concepts.展开更多
AIM： To summarize the performing essentials and analyze the characteristics of remote Zeus robot-assisted laparoscopic cholecystectomy. METHODS： Robot-assisted laparoscopic cholecystectomy was performed in 40 patien...AIM： To summarize the performing essentials and analyze the characteristics of remote Zeus robot-assisted laparoscopic cholecystectomy. METHODS： Robot-assisted laparoscopic cholecystectomy was performed in 40 patients between May 2004 and July 2005. The operating procedures and a variety of clinical parameters were recorded and analyzed. RESULTS： Forty laparoscopic cholecystectomy procedures were successfully completed with Zeus robotic system. And there were no post-operative complications. Total operating time, system setup time and performing time were 100.3±18.5 min, 27.7±8.8 min and 65.6±18.3 min, respectively. The blood loss and postoperative hospital stay were 30.6±10.2 mL and 2.8±0.8 d, respectively. Camera clearing times and time used for operative field adjustment were 1.1±1.0 min and 2.0±0.8 rain, respectively. The operative error was 7.5%. CONCLUSION： Robot-assisted laparoscopic cholecystectomy following the principles of laparoscopic operation has specific performing essentials. It preserves the benefits of minimally invasive surgery and offers enhanced ability of controlling operation field, precise and stable operative manipulations.展开更多
Diftuse idiopathic skeletal hyperostosis （DISHL also known as Forestier＇s disease, was originally reported by Forestier and Rotes-Querol in 1950. It is a common but underdiagnosed skeletal disease characterized by m...Diftuse idiopathic skeletal hyperostosis （DISHL also known as Forestier＇s disease, was originally reported by Forestier and Rotes-Querol in 1950. It is a common but underdiagnosed skeletal disease characterized by massive ossification of the anterior longitudinal ligament of several vertebral bodies. The most common symptom of cervical DISH is dysphagia due to mechanical compression of the esophagus. Reports of cervical myelopathy associated with DISH are rare. Here, we present a case describing a DISH patient with cervical myelopathy who was effectively treated by a carefully designed surgical procedure.展开更多
Background： MicroRNAs （miRNAs） are key regulators during tumor initiation and progression. MicroRNA-375 （MiR-375） has been proven to play a tumor-suppressive role in various types of human malignancies; however, ...Background： MicroRNAs （miRNAs） are key regulators during tumor initiation and progression. MicroRNA-375 （MiR-375） has been proven to play a tumor-suppressive role in various types of human malignancies; however, its biological role in clear cell renal cell carcinoma （ccRCC） remains unclear. The purpose of this study was to explore the biologic role as well as the underlying mechanism of miR-375 in ccRCC progression. Methods： Quantitative polymerase chain reaction （qPCR） was applied to test the expression of miR-375 in tissues and cell lines by t-test. Functional experiments were used to investigate the biological role of miR-375 utilizing a gain-of-function strategy. The target of miR-375 was investigated by bioinformatic analysis and further verified by luciferase reporter assay, qPCR, Western blotting, and functional experiments in vitro. Results： Our study demonstrated that miR-375 was significantly downregulated in ccRCC tissues （cancer vs. normal, 0.804 ±0.079 vs. 1.784 ± 0.200, t = 5.531 P 〈 0.0001 ） and cell lines, and loss ofmiR-375 expression significantly associated with advanced Fuhrman nuclear grades （Grade Ⅲ and Ⅳ vs. Grade Ⅰ and Ⅱ, 1.000 ± 0.099 vs. 1.731 ± 0.189, t = 3.262 P = 0.003）. Functional studies demonstrated that miR-375 suppressed ccRCC cell proliferation, migration, and invasion （all P 〈 0.05 in both 786-0 and A498 cell lines）. Multiple miRNA target prediction algorithms indicated the well-studied oncogene YWHAZ as a direct target ofmiR-375, which was further confirmed by the luciferase reporter assay, qPCR, and Western blotting. Moreover, restoration of YWHAZ could rescue the antiproliferation effect ofmi R-375. Conclusions： The data provide the solid evidence that miR-375 plays a tumor-suppressive role in ccRCC progression, partially through regulating YWHAZ. This study expands the antitumor profile ofmiR-375, and supports its role as a potential therapeutic target in ccRCC treatment.展开更多
Background:Robotic assistance has been increasingly employed to improve the operative precision in modern knee surgery.The purpose of the study was to evaluate the trauma effect of one of the first domestically develo...Background:Robotic assistance has been increasingly employed to improve the operative precision in modern knee surgery.The purpose of the study was to evaluate the trauma effect of one of the first domestically developed orthopedic surgical robots in China in a clinical trial of robot-assisted total knee arthroplasty(RA-TKA).Methods:A total of 33 patients who underwent unilateral TKA for end-stage osteoarthritis were randomized to receive RA-TKA(17 cases)or conventional manual TKA(CM-TKA)in our institution in 2020.The trauma effects of the 4 main indicators with 48 sub-indicators in terms of subsectional operative time,inflammation and coagulation markers,physical and radiographical analyses of osteotomy deviation,and postoperative comfort were analyzed.Results:Subsectional operative time analysis showed that the times for bone cutting and gap balancing with RA-TKA were 5.3 and 2.2 min shorter than those with CM-TKA(p=0.010,p=0.02),respectively.Arterial blood gas indicators(partial pressure of carbon dioxide,partial pressure of oxygen and SO2)24 h after RA-TKA,as well as the white blood cell count and neutrophil ratio,were significantly lower than those after CM-TKA(p<0.05).Inflammatory markers at 72 h after surgery showed the increments of C-reactive protein,erythrocyte sedimentation rate and D-dimer of RA-TKA declined by 180.7,22.0 and 1050.0%(p<0.05),respectively,referenced to the preoperative baseline values,as compared to CM-TKA.Mechanical deviation distribution exhibited percentages of region I errors for RA-TKA and CM-TKA of 76.5%and 27.1%(p=0.000),respectively,and the success rates of one-time osteotomy were 94.1%and 62.5%(p=0.039),respectively.Radiographi-cal verification showed RA-TKA was more conducive to achieving mechanical alignment and ideal tibial component azimuths.Postoperative efficacy showed that patients were more comfortable after RA-TKA in terms of reduced administration of tranexamic acid,hydrocortisone and the utilization rate of temporary intensive opioid analgesics.No statistical differ展开更多
Objective: To study the effects of ulinastatin combined with surgery on nerve injury, oxygen free radicals and inflammatory factors production of patients with hypertensive intracerebral hemorrhage. Methods: The patie...Objective: To study the effects of ulinastatin combined with surgery on nerve injury, oxygen free radicals and inflammatory factors production of patients with hypertensive intracerebral hemorrhage. Methods: The patients with hypertensive intracerebral hemorrhage received surgical treatment in our hospital during February 2015 - December 2017 were selected and divided into two groups by random number table. The observation group received ulinastatin combined surgery and the control group received conventional medicine combined with surgery. Before treatment and 1 weeks after treatment, serum levels of nerve damage markers, neurotrophic indexes, oxygen free radicals production indexes and inflammatory cytokines were measured. Results: After treatment, the contents of NSE, VILIP-1, GFAP, S100B, MDA, AOPP, 8-OHdG, NO, ET-1, TNF-α, sICAM-1, sVCAM-1, sICAM-1 of two groups were all decreased, the contents of BDNF, NGF, VEGF, IGF-I were all increased and the decreasing trend of NSE, VILIP-1, GFAP, S100B, MDA, AOPP, 8-OHdG, NO, ET-1, TNF-α, sICAM-1, sVCAM-1, sICAM-1 of observation group was more obvious than that of the control group, the increasing trend of BDNF, NGF, VEGF, IGF-I content was more obvious than that of the control group. Conclusion: The use of ulinastatin combined with surgery in the treatment of hypertensive intracerebral hemorrhage can significantly reduce the damage of nerve function and reduce the production of oxygen free radicals and inflammatory factors.展开更多
To the Editor:Expansive open-door laminoplasty(EOLP)is commonly performed for patients with multi-level cervical myelopathy of various causes.Nevertheless,there are still several complications.Among them,displaced com...To the Editor:Expansive open-door laminoplasty(EOLP)is commonly performed for patients with multi-level cervical myelopathy of various causes.Nevertheless,there are still several complications.Among them,displaced complete fracture of the hinge side and lamina re-closure could result in neurological function deterioration.Chen et a A1*reported that the use of the mini-plate could significantly reduce the incidence of lamina re-closure compared with the traditional suture technique.Nevertheless,the complete fracture rates were around 56.8%for both the mini-plate group and the suture suspension group.Accurately locating the trough position has been reported to lower the incidence of hinge side complete fractures.121 In this study,threedimensional(3D)printed patient-specific drilling templates were fabricated to guide the trough position in EOLP,131 to validate the safety and efficacy of the 3D printed templates.展开更多
BACKGROUND In orthotopic liver transplantation(OLT)recipients,median arcuate ligament syndrome(MALS)is considered a risk factor for hepatic arterial thrombosis(HAT),which is dreadful for OLT recipients.Different alter...BACKGROUND In orthotopic liver transplantation(OLT)recipients,median arcuate ligament syndrome(MALS)is considered a risk factor for hepatic arterial thrombosis(HAT),which is dreadful for OLT recipients.Different alternative surgical procedures have been proposed to overcome the impact of MALS on transplantation,but clinical evidence is still scarce.AIM To evaluate the feasible surgical management of MALS to reduce complications in OLT patients.METHODS Data for 288 consecutive patients who underwent OLT at The First Hospital of Jilin University between January 2017 and July 2020 were retrospectively reviewed.The surgical management of median arcuate ligament(MAL)and modifications to the arterial anastomosis were recorded.The perioperative and long-term prognosis of MALS recipients were noted.Detailed preoperative and postoperative data of patients were analyzed in a descriptive manner.RESULTS Eight patients with MALS were included in this study.The first patient with MALS received no intervention during the primary surgery and developed postoperative HAT.Salvage liver transplantation with MAL division was successfully performed.Gastroduodenal artery(GDA)preservation with splenic artery ligation was performed on three patients,only GDA preservation was performed on two patients,and no intervention was performed on two patients.No patient developed HAT after surgery and postoperative recovery was satisfactory.CONCLUSION The preservation of collateral circulation between the superior mesenteric artery and celiac trunk via the GDA with or without splenic artery ligation is a safe and feasible alternative to MAL division.展开更多
Prof.Hongxi Su(苏鸿熙)was born in Tongshan,Jiangsu Province,in January of 1915(Fig.1).He is the pioneer of Chinese cardiosurgery and one of the most renowned Chinese cardiothoracic surgeons,performing the first succes...Prof.Hongxi Su(苏鸿熙)was born in Tongshan,Jiangsu Province,in January of 1915(Fig.1).He is the pioneer of Chinese cardiosurgery and one of the most renowned Chinese cardiothoracic surgeons,performing the first successful intracardiac surgery under extracorporeal circulation,as well as applying artificial blood vessels in aortic-carotid artery bypass surgery,shaping the cardiosurgery landscape of China.展开更多
基金supported by grants from the Science and Technology Planning Project of Guangdong (2009B060700037, 2009B080701009, 2011B080701014)
文摘iASPP is an inhibitory member of the apoptosis-stimulating proteins of P53 （ASPP） family. iASPP is over expressed in several malignant tumors and potentially affects cancer progression. However, the expression and potential role of iASPP in oral tongue squamous cell carcinoma （OTSCC） have not been addressed. In our study, we detected iASPP expression in OTSCC by immunohistochemistry, iASPP expression is up-regulated in OTSCC tissues. Moreover, in clinical pathology specimens, we found that increased iASPP expression correlates with poor differentiation and lymph node metastasis. Using multicellular tumor spheroids （MTS） and flow cytometry, we demonstrated that iASPP down-regulation arrests OTSCC cells at the G0/G1 phase, induces OTSCC cell apoptosis and inhibits OTSCC cell proliferation. These results indicate that iASPP plays a significant role in the progression of OTSCC and may serve as a biomarker or therapeutic target for OTSCC patients.
基金Beijing Key Specialized Department for Major Epidemic Prevention and Control (Construction Project)National Major Science and Technology Projects (2017ZX10305501)Beijing Social Science Foundation Planning Project (17SRC019)。
文摘With the rapid development of emergency medicine,emergency physicians are working around the clock,[1]including additional workloads due to sudden public health emergencies and disasters.Occupational risks for emergency physicians are significantly high due to an increasing number of patients with acute and severe diseases,an increased workload.
文摘BACKGROUND With the continuous progress of surgical technology and improvements in medical standards,the treatment of gastric cancer surgery is also evolving.Proximal gastrectomy is a common treatment,but double-channel anastomosis and tubular gastroesophageal anastomosis have attracted much attention in terms of surgical options.Each of these two surgical methods has advantages and disadvantages,so it is particularly important to compare and analyze their clinical efficacy and safety.AIM To compare the surgical safety,clinical efficacy,and safety of double-channel anastomosis and tubular gastroesophageal anastomosis in proximal gastrectomy.METHODS The clinical and follow-up data of 99 patients with proximal gastric cancer who underwent proximal gastrectomy and were admitted to our hospital between January 2018 and September 2023 were included in this retrospective cohort study.According to the different anastomosis methods used,the patients were divided into a double-channel anastomosis group(50 patients)and a tubular gastroesophageal anastomosis group(49 patients).In the double-channel anastomosis,Roux-en-Y anastomosis of the esophagus and jejunum was performed after proximal gastric dissection,and then side-to-side anastomosis was performed between the residual stomach and jejunum to establish an antireflux barrier and reduce postoperative gastroesophageal reflux.In the tubular gastroesophageal anastomosis group,after the proximal end of the stomach was cut,tubular gastroplasty was performed on the distal stump of the stomach and a linear stapler was used to anastomose the posterior wall of the esophagus and the anterior wall of the stomach tube.The main outcome measure was quality of life 1 year after surgery in both groups,and the evaluation criteria were based on the postgastrectomy syndrome assessment scale.The greater the changes in body mass,food intake per meal,meal quality subscale score,and total measures of physical and mental health score,the better the condition;the greater the other indicators,the
文摘BACKGROUND Under physiological conditions,sputum produced during acute exacerbation of chronic obstructive pulmonary disease(AECOPD)can move passively with the cilia in the airway;the sputum is gradually excreted from the depth of the airways through the stimulation of the coughing reflex on the sensory nerve on the surface of the airway.However,when the sputum is thick,the cough is weak,or the tracheal cilia are abnormal,sputum accumulation may occur and affect the exchange of oxygen and carbon dioxide in the lung.Furthermore,the presence of pathogenic microorganisms in sputum may cause or aggravate the symptoms of pulmonary infection in patients,which is the main factor leading to AECOPD.Therefore,promoting effective drainage of sputum and maintaining airway opening are key points requiring clinical attention.AIM To explore the effect of refined nursing strategies in patients with AECOPD and dysphagia.METHODS We selected 126 patients with AECOPD and difficulty of expectoration at our hospital,and divided them into a refined care group and a routine care group,with 63 cases each,using a random number table.The two groups of patients were treated with expectorant,anti-infection,oxygen inhalation,and other basic treatment measures;patients in the refined care group were given refined nursing intervention during hospitalization,and the routine care group received conventional nursing intervention.The differences in sputum expectoration,negative pressure suction rate,blood gas parameters,dyspnea score measured through the tool developed by the Medical Research Council(MRC),and quality of life were compared between the two groups.RESULTS After 7 d of intervention,the sputum expectoration effect of the refined care group was 62.30%,the effective rate was 31.15%,and the inefficiency rate was 6.56%.The sputum expectoration effect of the routine care group was 44.07%,the effective rate was 42.37%,and the inefficiency rate was 13.56%.The refined care group had better sputum expectoration than the routine care group(P<0.05
文摘BACKGROUND Bariatric surgery is one of the most effective ways to treat morbid obesity,and postoperative nausea and vomiting(PONV)is one of the common complications after bariatric surgery.At present,the mechanism of the high incidence of PONV after weight-loss surgery has not been clearly explained,and this study aims to investigate the effect of surgical position on PONV in patients undergoing bariatric surgery.AIM To explore the effect of the operative position during bariatric surgery on PONV.METHODS Data from obese patients,who underwent laparoscopic sleeve gastrectomy(LSG)in the authors’hospital between June 2020 and February 2022 were divided into 2 groups and retrospectively analyzed.Multivariable logistic regression analysis and the t-test were used to study the influence of operative position on PONV.RESULTS There were 15 cases of PONV in the supine split-leg group(incidence rate,50%)and 11 in the supine group(incidence rate,36.7%)(P=0.297).The mean operative duration in the supine split-leg group was 168.23±46.24 minutes and 140.60±32.256 minutes in the supine group(P<0.05).Multivariate analysis revealed that operative position was not an independent risk factor for PONV(odds ratio=1.192,95%confidence interval:0.376-3.778,P=0.766).CONCLUSION Operative position during LSG may affect PONV;however,the difference in the incidence of PONV was not statistically significant.Operative position should be carefully considered for obese patients before surgery.
文摘Background:The aim of this prospective randomized study was to evaluate the impact of visual guidelines(picture book)and parents tutoring on pediatric urological surgery on parent's stress and anxiety,the number of postoperative contacts,and complications.Materials and methods:Following institutional ethical committee approval,a special picture book reflecting different stages of the convalescent period following multiple types of pediatric urological surgery was developed.Parents were randomly divided into 2 groups in which 33 parents in Group 1 received the picture book in addition to routine instructions prior to the surgery and 31 in Group 2 received only routine postoperative instructions.The parents were asked to answer a questionnaire(Amsterdam Preoperative Anxiety and Information Scale)regarding the level of anxiety before surgery and immediately after surgery in the recovery room.The number of postoperative parent's calls,nonplaned emergency room visits,and complications were recorded.Results:No statistically significant difference in perioperative parental anxiety was found(p=0.88).The visual tutoring group had a significantly lower rate of emergency room admissions(6.6%vs.18.6%,p=0.0433),however parents from this group made a higher number of postoperative calls(9.9%vs.3.1%,p=0.38).Two(6.6%)from the tutoring group expressed their desire to omit visual counseling in future surgical preparation and 4(13.2%)did not have an opinion.Overall satisfaction with regards to the preoperative counseling and information and the number of postoperative complications was similar in both groups.Conclusions:Visual tutoring does not add any value to parental anxiety but seems helpful in reducing postoperative emergency room visits.Some parents preferred to exclude visual information from future preoperative counseling.
文摘BACKGROUND The nursing working environment is an important subsystem in the hospital environment.A good working environment could have a positive impact on nurses.However,the work-family conflict and unsatisfactory working environment could significantly reduce their working enthusiasm,efficacy as well as the overall quality of the nursing,increase their fatigue,and thereby compromise their career status.AIM To explore the possible status quo and to analyze the correlation between work environment perception and the work-family conflict among nurses in the operating room.METHODS A total of 312 operating room nurses from two first-class hospitals at Grade 2 and two first-class hospitals at Grade 3 in China from May to September 2017 were included in this research using the cluster sampling method.The data,including the general information questionnaire,the practice environment scale of the nursing work index(PES-NWI),and the work-family conflict scale,were systematically collected.Pearson correlation analysis was applied to analyze the correlation between the two scores,with influencing factors analyzed by hierarchical regression analysis.RESULTS A total of 312 questionnaires were issued,and the response rate and effective questionnaire rate were both 96.15%(300/312).The total scores of the PES-NWI scale and the work-family conflict scale were 3.07±0.43(vs maximum up to 4 points)and 52.32±8.79(vs maximum up to 90 points),respectively.The scores of the PES-NWI scale were negatively correlated with that of work-family conflict scale(all P<0.05).The perception of the nursing work environment and the number of night shifts per month were the major factors contributing to the workfamily conflict(all P<0.05).CONCLUSION The nursing work environment and the work-family conflict among nurses in the operating room were both found at a medium level with a negative correlation between the two.
文摘BACKGROUND Chronic gastritis(CG) is an inflammatory disease of the gastric mucosa. Shenling-bai-zhu san(SLBZS), a traditional Chinese medicine formula, is widely used for treating CG. Nevertheless, its effects are currently unclear.AIM To determine the clinical evidence and potential mechanisms of SLBZS for the treatment of CG.METHODS We systematically searched 3 English(PubMed, Embase, Medline) and 4 Chinese databases(Cochrane Library Central Register of Controlled Trials, China National Knowledge Infrastructure database, Wanfang Data Knowledge Service Platform,and the VIP information resource integration service platform) without language or publication bias restriction. Qualified studies were selected according to pre-set inclusion and exclusion criteria. RevMan 5.3 software was used for meta-analysis and literature quality assessment, Stata 14.0 software was used for sensitivity analysis, GRADE profiler 3.6 was used to evaluate the quality of evidence. And then, network pharmacology analysis was applied to primary research the mechanisms of action of SLBZS on CG.RESULTS Fourteen studies were finally included, covering 1335 participants. Meta-analysis indicated that:(1) SLBZS was superior to conventional therapies [risk ratio(RR):1.29, 95% confidence interval(CI): 1.21 to 1.37, P < 0.00001];(2) SLBZS was better than conventional therapies [RR: 0.24, 95% confidence interval(95%CI): 0.11 to 0.55, P = 0.0007] in terms of recurrence rate and reversal of Helicobacter pylori positivity(RR: 1.20, 95%CI: 1.11 to 1.30,P < 0.00001);and(3) The safety of SLBZS for CG remains unclear. According to the GRADE method, the quality of evidence was not high. Besides, SNZJS might treat CG by acting on related targets and pathways such as EGFR tyrosine kinase inhibitor resistance, the PI3K-Akt signaling pathway, and others.CONCLUSION SLBZS might be useful in treating CG, but long-term effects and specific clinical mechanisms of it maintain unclear. More samples and high-quality clinical experiments should be assessed and verified
文摘Objective： To assess the medical community＇s awareness and practice regarding delirium in the intensive care unit （ICU）. Methods： One hundred and ten predesigned questionnaires were distributed to ICU practitioners in the affiliated hospitals of Zhejiang University. Results： A total of 105 valid questionnaires were collected. Totally, 55.3% of the clinicians considered that delirium was common in the ICU. Delirium was believed to be a significant or serious problem by 70.5% of respondents, and under-diagnosis was acknowledged by 56.2% of the respondents. The incidence of ICU delirium is even more under-estimated by the pediatric doctors compared with their counterparts in adult ICU （P〈0.05）. Primary disease of the brain （agreed by 82.1% of the respondents） was believed to be the most common risk factor for delirium. None of the ICU professionals screened delirium or used a specific tool for delirium assessment routinely. The vast majority （92.4%） of respondents had little knowledge on the diagnosis and the standard treatment of delirium. Conclusions： Although delirium is considered as a serious problem by a majority of the surveyed ICU professionals, it is still under-recognized in routine critical care practice. Data from this survey show a disconnection between the perceived significance of delirium and the current practices of monitoring and treatment in ICU in China.
基金grants from the Guangzhou Institute of Pediatrics/Guangzhou Women and Children's Medical Center(No.YIP-2018-037 and YIP-2019-061).
文摘Background:Hypothermia is associated with many adverse clinical outcomes in pediatric patients,and thus,it is important to an effective and safe method for preventing peri-operative hypothermia and its associated adverse outcomes in pediatric patients.This study aimed to investigate the effect of forced-air warming blankets with different temperatures on changes in the transforming growth factor-β(TGF-β),tumor necrosis factor(TNF)-α,interleukin(IL)-1β,and IL-10 levels in children undergoing surgical treatment for developmental displacement of the hip(DDH).Methods:The study included 123 children undergoing surgery for DDH under general anesthesia.The patients were randomly assigned to three groups,using a random number table:the 32,38,and 43°C groups according to the temperature setting of the forced-air warming blankets.For each patient,body temperature was recorded immediately after anesthesia induction and intubation(T0),at initial incision(T1),at 1 h after incision(T2),at2 h after incision(T3),at the end of surgery(T4),immediately upon return to the ward after surgery(T5),and then at 12 h(T6),24 h(T7),36 h(T8),and 48 h(T9)after the surgery.The serum levels of TGF-β,TNF-α,IL-1β,and IL-10 were measured at To and T4 for all groups.Results:The number of patients with fever in the 38°C group was significantly less than those in the 32 and 43°C groups(x^2=6.630,P=0.036).At To,the body temperatures in the 38 and 43°C groups were significantly higher than that in the 32°C group(F=17.992,P<0.001).At T2,the body temperature was significantly higher in the 43°C group than those in the 32 and 38°C groups(F=12.776,P<0.001).Moreover,at T4,the serum levels of TGF-β(F=3286.548,P<0.001)and IL-10(F=4628.983,P<0.001)were significantly increased in the 38°C group,and the serum levels of TNF-α(F=911.415,P<0.001)and IL-10(F=322.191,P<0.001)were significantly decreased in the 38°C group,compared with the levels in the 32 and 43°C groups.Conclusion:Force-air warming blankets set at 38°C maintained stable body temp
基金supported by The National Social Science Fund of China(No.15BRK023)
文摘Objective: The aim of this study was to explore the correlation between psychological resilience and social support and anxiety in obstetric nurses and to provide theoretical basis for improving the mental health of obstetric nurses.Methods: In this study, 190 obstetric nurses were included, using the general information questionnaire and The Connor-Davidson Resilience Scale(CD-RISC), Social Support Rating Scale, and survey of Self-evaluation of Anxiety Scale.Results: There are differences in the type of work and the score of psychological resilience(P<0.05), obstetric nurses’ resilience score was 65.58±10.65; self-rating anxiety score of obstetric nurses was 36.89±6.87; and social support score of obstetric nurses was44.3717.86. The psychological elasticity score and anxiety were negatively related(P<0.01), whereas the resilience score and total score of social support were positively related(P<0.01).Conclusions: Obstetric nurses have many responsibilities and stress. Nursing managers should focus on obstetric nurses’ mental health, lighten the obstetric nurses’ anxiety, and thus improve their mental flexibility and optimize the quality of nursing service better,with more passion into work.
文摘This article introduces the concept and mode of narrative education in addition to the application of narrative education in clinical nursing education. A summary is presented of the application of narrative education in this clinical nursing context from several aspects, including providing a display platform and various other teaching forms for the teachers＇ use, promoting the professional quality of teachers and students, and facilitating the teaching of abstract concepts.
基金Supported by the Jieping Wu Medical Foundation, No.2003-49-A
文摘AIM： To summarize the performing essentials and analyze the characteristics of remote Zeus robot-assisted laparoscopic cholecystectomy. METHODS： Robot-assisted laparoscopic cholecystectomy was performed in 40 patients between May 2004 and July 2005. The operating procedures and a variety of clinical parameters were recorded and analyzed. RESULTS： Forty laparoscopic cholecystectomy procedures were successfully completed with Zeus robotic system. And there were no post-operative complications. Total operating time, system setup time and performing time were 100.3±18.5 min, 27.7±8.8 min and 65.6±18.3 min, respectively. The blood loss and postoperative hospital stay were 30.6±10.2 mL and 2.8±0.8 d, respectively. Camera clearing times and time used for operative field adjustment were 1.1±1.0 min and 2.0±0.8 rain, respectively. The operative error was 7.5%. CONCLUSION： Robot-assisted laparoscopic cholecystectomy following the principles of laparoscopic operation has specific performing essentials. It preserves the benefits of minimally invasive surgery and offers enhanced ability of controlling operation field, precise and stable operative manipulations.
文摘Diftuse idiopathic skeletal hyperostosis （DISHL also known as Forestier＇s disease, was originally reported by Forestier and Rotes-Querol in 1950. It is a common but underdiagnosed skeletal disease characterized by massive ossification of the anterior longitudinal ligament of several vertebral bodies. The most common symptom of cervical DISH is dysphagia due to mechanical compression of the esophagus. Reports of cervical myelopathy associated with DISH are rare. Here, we present a case describing a DISH patient with cervical myelopathy who was effectively treated by a carefully designed surgical procedure.
基金This work was supported by the grants from the National Natural Science Foundation of China （No. 81702521） and Provincial Natural Science Foundation of Shandong （No. ZR2017PH019 and No. ZR2018BH018）.
文摘Background： MicroRNAs （miRNAs） are key regulators during tumor initiation and progression. MicroRNA-375 （MiR-375） has been proven to play a tumor-suppressive role in various types of human malignancies; however, its biological role in clear cell renal cell carcinoma （ccRCC） remains unclear. The purpose of this study was to explore the biologic role as well as the underlying mechanism of miR-375 in ccRCC progression. Methods： Quantitative polymerase chain reaction （qPCR） was applied to test the expression of miR-375 in tissues and cell lines by t-test. Functional experiments were used to investigate the biological role of miR-375 utilizing a gain-of-function strategy. The target of miR-375 was investigated by bioinformatic analysis and further verified by luciferase reporter assay, qPCR, Western blotting, and functional experiments in vitro. Results： Our study demonstrated that miR-375 was significantly downregulated in ccRCC tissues （cancer vs. normal, 0.804 ±0.079 vs. 1.784 ± 0.200, t = 5.531 P 〈 0.0001 ） and cell lines, and loss ofmiR-375 expression significantly associated with advanced Fuhrman nuclear grades （Grade Ⅲ and Ⅳ vs. Grade Ⅰ and Ⅱ, 1.000 ± 0.099 vs. 1.731 ± 0.189, t = 3.262 P = 0.003）. Functional studies demonstrated that miR-375 suppressed ccRCC cell proliferation, migration, and invasion （all P 〈 0.05 in both 786-0 and A498 cell lines）. Multiple miRNA target prediction algorithms indicated the well-studied oncogene YWHAZ as a direct target ofmiR-375, which was further confirmed by the luciferase reporter assay, qPCR, and Western blotting. Moreover, restoration of YWHAZ could rescue the antiproliferation effect ofmi R-375. Conclusions： The data provide the solid evidence that miR-375 plays a tumor-suppressive role in ccRCC progression, partially through regulating YWHAZ. This study expands the antitumor profile ofmiR-375, and supports its role as a potential therapeutic target in ccRCC treatment.
基金Innovative technology in military and clinical medicine(2018JSLC0035)Technological Innovation and Application Demonstration Project of Chongqing(cstc2018jscxmsyb0541)+1 种基金Continual Medical Education Project of Chongqing(2020-04-07-067)Central Committee Guiding Local Technology Development Project(0028).
文摘Background:Robotic assistance has been increasingly employed to improve the operative precision in modern knee surgery.The purpose of the study was to evaluate the trauma effect of one of the first domestically developed orthopedic surgical robots in China in a clinical trial of robot-assisted total knee arthroplasty(RA-TKA).Methods:A total of 33 patients who underwent unilateral TKA for end-stage osteoarthritis were randomized to receive RA-TKA(17 cases)or conventional manual TKA(CM-TKA)in our institution in 2020.The trauma effects of the 4 main indicators with 48 sub-indicators in terms of subsectional operative time,inflammation and coagulation markers,physical and radiographical analyses of osteotomy deviation,and postoperative comfort were analyzed.Results:Subsectional operative time analysis showed that the times for bone cutting and gap balancing with RA-TKA were 5.3 and 2.2 min shorter than those with CM-TKA(p=0.010,p=0.02),respectively.Arterial blood gas indicators(partial pressure of carbon dioxide,partial pressure of oxygen and SO2)24 h after RA-TKA,as well as the white blood cell count and neutrophil ratio,were significantly lower than those after CM-TKA(p<0.05).Inflammatory markers at 72 h after surgery showed the increments of C-reactive protein,erythrocyte sedimentation rate and D-dimer of RA-TKA declined by 180.7,22.0 and 1050.0%(p<0.05),respectively,referenced to the preoperative baseline values,as compared to CM-TKA.Mechanical deviation distribution exhibited percentages of region I errors for RA-TKA and CM-TKA of 76.5%and 27.1%(p=0.000),respectively,and the success rates of one-time osteotomy were 94.1%and 62.5%(p=0.039),respectively.Radiographi-cal verification showed RA-TKA was more conducive to achieving mechanical alignment and ideal tibial component azimuths.Postoperative efficacy showed that patients were more comfortable after RA-TKA in terms of reduced administration of tranexamic acid,hydrocortisone and the utilization rate of temporary intensive opioid analgesics.No statistical differ
文摘Objective: To study the effects of ulinastatin combined with surgery on nerve injury, oxygen free radicals and inflammatory factors production of patients with hypertensive intracerebral hemorrhage. Methods: The patients with hypertensive intracerebral hemorrhage received surgical treatment in our hospital during February 2015 - December 2017 were selected and divided into two groups by random number table. The observation group received ulinastatin combined surgery and the control group received conventional medicine combined with surgery. Before treatment and 1 weeks after treatment, serum levels of nerve damage markers, neurotrophic indexes, oxygen free radicals production indexes and inflammatory cytokines were measured. Results: After treatment, the contents of NSE, VILIP-1, GFAP, S100B, MDA, AOPP, 8-OHdG, NO, ET-1, TNF-α, sICAM-1, sVCAM-1, sICAM-1 of two groups were all decreased, the contents of BDNF, NGF, VEGF, IGF-I were all increased and the decreasing trend of NSE, VILIP-1, GFAP, S100B, MDA, AOPP, 8-OHdG, NO, ET-1, TNF-α, sICAM-1, sVCAM-1, sICAM-1 of observation group was more obvious than that of the control group, the increasing trend of BDNF, NGF, VEGF, IGF-I content was more obvious than that of the control group. Conclusion: The use of ulinastatin combined with surgery in the treatment of hypertensive intracerebral hemorrhage can significantly reduce the damage of nerve function and reduce the production of oxygen free radicals and inflammatory factors.
文摘To the Editor:Expansive open-door laminoplasty(EOLP)is commonly performed for patients with multi-level cervical myelopathy of various causes.Nevertheless,there are still several complications.Among them,displaced complete fracture of the hinge side and lamina re-closure could result in neurological function deterioration.Chen et a A1*reported that the use of the mini-plate could significantly reduce the incidence of lamina re-closure compared with the traditional suture technique.Nevertheless,the complete fracture rates were around 56.8%for both the mini-plate group and the suture suspension group.Accurately locating the trough position has been reported to lower the incidence of hinge side complete fractures.121 In this study,threedimensional(3D)printed patient-specific drilling templates were fabricated to guide the trough position in EOLP,131 to validate the safety and efficacy of the 3D printed templates.
基金Supported by the Science and Technology Department of Jilin Province,No.20190101002JH.
文摘BACKGROUND In orthotopic liver transplantation(OLT)recipients,median arcuate ligament syndrome(MALS)is considered a risk factor for hepatic arterial thrombosis(HAT),which is dreadful for OLT recipients.Different alternative surgical procedures have been proposed to overcome the impact of MALS on transplantation,but clinical evidence is still scarce.AIM To evaluate the feasible surgical management of MALS to reduce complications in OLT patients.METHODS Data for 288 consecutive patients who underwent OLT at The First Hospital of Jilin University between January 2017 and July 2020 were retrospectively reviewed.The surgical management of median arcuate ligament(MAL)and modifications to the arterial anastomosis were recorded.The perioperative and long-term prognosis of MALS recipients were noted.Detailed preoperative and postoperative data of patients were analyzed in a descriptive manner.RESULTS Eight patients with MALS were included in this study.The first patient with MALS received no intervention during the primary surgery and developed postoperative HAT.Salvage liver transplantation with MAL division was successfully performed.Gastroduodenal artery(GDA)preservation with splenic artery ligation was performed on three patients,only GDA preservation was performed on two patients,and no intervention was performed on two patients.No patient developed HAT after surgery and postoperative recovery was satisfactory.CONCLUSION The preservation of collateral circulation between the superior mesenteric artery and celiac trunk via the GDA with or without splenic artery ligation is a safe and feasible alternative to MAL division.
文摘Prof.Hongxi Su(苏鸿熙)was born in Tongshan,Jiangsu Province,in January of 1915(Fig.1).He is the pioneer of Chinese cardiosurgery and one of the most renowned Chinese cardiothoracic surgeons,performing the first successful intracardiac surgery under extracorporeal circulation,as well as applying artificial blood vessels in aortic-carotid artery bypass surgery,shaping the cardiosurgery landscape of China.
