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Experts Office
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2016 Vol. 39, No. 4
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2016, 39(4): 345-349.
doi: 10.3969/j.issn.1674-4500.2016.04.01
Abstract:
Objective To explore the CT findings of renal oncocytoma. Methods The imaging and clinical data of 8 cases of RO with pathology confirmed renal oncocytoma were retrospectively analyzed. Results On plain CT scans, 8 patients had unilateral solitary lesion of which were round or lobulated. All lesion protruded the outline of kidney. CT value of tumor substantial part was 22-36 Hu, average 31 Hu in 8 cases. Eight cases were rich blood supply on enhanced CT scans, CT value of tumor substantial part was 103-187 Hu in the cortico-medullary phase, the average strengthening rate was rised 94 Hu than plain CT. CT value was 82-151 Hu in the parenchymal phase, the average strengthening rate was rised 74 Hu than plain CT. CT value was 86-117 Hu and decreased slightly in the excretory phase, the average strengthening rate was rised 70 Hu than plain CT. central scars was found in 2 cases, Segmental Enhancement Inversion in 2, Calcification in 1 cases, spoke-wheel-like enhancement in 1, hemorrhage in 1 fat in 1. Conclusion When the plain CT scans showed isodensity or low density tumor with round or lobulated protruding the outline of kidney, Tumor with rich blood supply on enhanced CT scans, tumor substantial showed significantly enhancement in the cortico-medullary phase, was decreased in the parenchymal phase and excretory phase, the low-density area of tumors heterogeneous enhancement of in the cortico-medullary phase, which showed reduce or disappear Gradually in the parenchymal phase and excretory phase. with progressively filled, at the same time, no tumor thrombus within the renal vein and inferior vena cava, and no swelling large lymph nodes around abdominal aorta and renal hilum, Renal oncocytoma is a differential diagnosis to choose.
2016, 39(4): 350-352.
doi: 10.3969/j.issn.1674-4500.2016.04.02
Abstract:
Objective To investigate the value of Multi-slice spiral CT and magnetic resonance (MR) imaging in Brucella spondylitis. Methods The imaging findings of 36 patients with brucellosis spondylitis retrospectively analyzed. The patients were performed 64 layer 128 slice spiral CT and MRI. Results In MRI, 29 had 2 lumbar, 5 had 3 lumbar and 2 had four lumbar vertebrae involvement. Three had the first lumbar, 6 had the second lumbar, 15 had the third lumbar, 24 had the fourth lumbar, 18 had the fifth lumbar and 3 had the first sacral vertebra involvement. Thirty patients had different degrees intervertebral disc involvement. There were 21 patients had the positive findings of intervertebral space narrowing, however, 15 patients had no obvious narrowing. Twenty-seven patients had different levels of paraspinal soft tissue swelling. In CT, 27 had two lumbar and 4 had three lumbar vertebrae involvement. Additionally vertebral destruction was detected in 63 vertebrae. There were 6 cases had no obvious vertebral destructions and 9 cases had no significant vertebral soft tissue swelling. Compared with CT, MRI is a highly sensitive imaging technique in showing the vertebral marrow edema and soft tissue involvement, but lack in the ability of showing tiny vertebral destruction. Conclusion The combination of MSCT and MRI can improve the diagnosis of Brucella spondylitis, especially in the involvement degrees and scope.
2016, 39(4): 356-358.
doi: 10.3969/j.issn.1674-4500.2016.04.04
Abstract:
Objective To explore the application value of real time ultrasound imaging technique in thyroid papillary carcinoma. Methods We retrospectively analyzed thyroid papillary carcinoma patients and thyroid benign nodules of our hospital between September 2013 to September 2014, with 30 cases in each group. All the patients before thyroid ultrasound examination and postoperative pathological biopsy specimens confirmed papillary thyroid carcinoma and benign thyroid nodules. The results of pathological diagnosis, ultrasound image features and real-time ultrasound imaging results were compared and analyzed. Results Papillary carcinoma of thyroid nodule calcification most as microcalcification, nodules rough edge, nodular aspect ratio was more than or equal to 1, the difference wa statistically significant (P < 0.05). The number of nodules in the papillary carcinoma group was significantly higher than that in the benign group, and the number of nodules in the papillary carcinoma group was significantly higher than that in the benign group, and the difference was statistically significant (P < 0.05). Conclusion Real time ultrasound imaging can accurately evaluate the relative hardness of thyroid nodules, which has important application value in the differential diagnosis of benign and malignant thyroid tumors and papillary thyroid carcinoma.
2016, 39(4): 359-362.
doi: 10.3969/j.issn.1674-4500.2016.04.05
Abstract:
Objective To explore the effect of group psychological therapy on anxiety and Cortisol and Sleep in gastric cancer patients. Methods Totally 78 patients previously diagnosed with gastric cancer, and finished active treatment, were equally randomized into observation group and control group. 39 patients joined the intervention group, which consisted of 8 consecutive, weekly sessions of 90 minutes each in length, whereas another 39 served as control subjects without receiving any psychological interventions during this study. All participants completed baseline measures and post-intervention measures(8 weeks later or after 8 times interventions) by Self-Rating Anxiety Scale (SAS), and Cortisol and AIS. Results there are no significant differences(P>0.05)between this two groups patients on SAS and Cortisol and AIS before the treatment. After the treatment, anxiety(t=-2.72, P < 0.01) and Cortisol(-2.44, P < 0.05)and AIS(t=-3.00, P < 0.01) of patients were all decreased. SAS and Cortisol and VAS level in both groups had significant differences. Conclusion This study provides evidence for the positive effect of group psychological therapy for gastric cancer patients on SAS, Cortisol and sleep.
Objective To explore the effect of group psychological therapy on anxiety and Cortisol and Sleep in gastric cancer patients. Methods Totally 78 patients previously diagnosed with gastric cancer, and finished active treatment, were equally randomized into observation group and control group. 39 patients joined the intervention group, which consisted of 8 consecutive, weekly sessions of 90 minutes each in length, whereas another 39 served as control subjects without receiving any psychological interventions during this study. All participants completed baseline measures and post-intervention measures(8 weeks later or after 8 times interventions) by Self-Rating Anxiety Scale (SAS), and Cortisol and AIS. Results there are no significant differences(P>0.05)between this two groups patients on SAS and Cortisol and AIS before the treatment. After the treatment, anxiety(t=-2.72, P < 0.01) and Cortisol(-2.44, P < 0.05)and AIS(t=-3.00, P < 0.01) of patients were all decreased. SAS and Cortisol and VAS level in both groups had significant differences. Conclusion This study provides evidence for the positive effect of group psychological therapy for gastric cancer patients on SAS, Cortisol and sleep.
2016, 39(4): 363-365.
doi: 10.3969/j.issn.1674-4500.2016.04.06
Abstract:
ObjectiveTo detect FBN1 mutation by screening FBN1 gene from 4 patients with Marfan syndrome(MFS)to investigate the correlation between the gene mutation and the MFS. MethodsGenomic DNAs were extracted from whole blood sample of the 4 patients. All 65 exons of FBN1 were amplified by polymerase chain reaction (PCR) followed by Sanger sequencing analysis respectively. ResultsTwo mutations of the FBN1 were found in 2 out of the 4 MFS patients respectively. One was a missense mutation of 7892G>A(C2631Y)and the other frame shift mutation of 6258delC, which producing a premature termination condon (PTC). Both of the mutations were not reported previously. ConclusionThe 2 FBN1 gene mutations are possibly the pathogenesis of the 2 MFS patients.
2016, 39(4): 366-368.
doi: 10.3969/j.issn.1674-4500.2016.04.07
Abstract:
ObjectiveTo compare the short-term outcomes between single lumen endotracheal tube anesthesia (SLET) anddouble lumen endotracheal tube anesthesia (DLET) in minimally invasive esophagectomy. MethodsClinical data of 94 patients who received minimally invasive Mckeown esophagectomy for esophageal cancer form January 2014 to December 2015 were retrospectively analyzed. ResultsThere was less operation bleeding (205.6±62.1 mL vs 277.9±219.9 mL, P=0.028) more left laryngeal recurrent nerve chain lymph nodes (3.4±5.5 vs 1.2±2.5, P=0.043) and mediastinal lymph nodes (19.1±14.2 vs 13.7±9.2, P=0.037) harvested in SLET group compared to DLET group. There was no significant difference in operative duration, number of total dissected lymph nodes and right laryngeal recurrent nerve chain lymph nodes, mean duration of hospitalization, mean duration of ICU stay and operative complications. ConclusionThe short-term outcomes are better in SLET than in DLET group because of its lower cost, easy to use and good exposure of operation field. It facilitates mediastinal lymphadenctomy and reducing bleeding.
2016, 39(4): 369-372.
doi: 10.3969/j.issn.1674-4500.2016.04.08
Abstract:
ObjectiveTo study the investigation and analysis of statins poor adherence to cardiovascular adverse events. MethodsFrom January 2015 to January 2016, We selected 1248 cases of patients of coronary atherosclerotic heart disease, ischemic stroke, cardiovascular disease such as diabetes, high blood pressure, blood in our hospital, according to the requirements of the diagnosis and treatment principle of long-term use of statins was 1020 patients as the research object, which adhered to the treatment of primary disease, and follow-up the patients, according to the patients compliance was good or bad into good compliance group (n=502) and poor compliance group (n=518), analyzed the relationship between with cardiovascular adverse events, incidence rate of cardiovascular adverse events occurring time, pathogenesis, drug (or continuous) discontinuation of time previously and ages. ResultsThe incidence of cardiovascular adverse events of poor compliance group was significantly higher than good compliance group, with statistical significance (P < 0.05); Proportion of adverse cardiovascular events in patients of more than 60 years old was significantly higher than with less than 60 patients, with statistical significance (P < 0.05); The proportion of adverse cardiovascular events in patients of time greater than 1 year was significantly higher than patients with less than 1 year, with statistical significance (P < 0.05); The proportion of adverse cardiovascular events in patients of duration more than 5 years was significantly higher than patients with less than 5 years, statistically significant (P < 0.05); The proportion of adverse cardiovascular events in patients of intermittent medication of patients more than 1 year was significantly higher than patients with less than 1 year, with statistical significance (P < 0.05); Logistic multivariate regression analysis was older than 60, withdrawal more than 1 year, more than 5 years and more than 1 year were occurring statins with poor compliance risk factors of cardiovascular adverse events. ConclusionStatins poor compliance of patients are more likely to happen in cardiovascular adverse events, and older than 60, withdrawal more than 1 year, more than 5 years and more than 1 year is occurring statins with poor compliance risk factors of cardiovascular adverse events.
2016, 39(4): 373-375.
doi: 10.3969/j.issn.1674-4500.2016.04.09
Abstract:
ObjectiveTo explore the difference of survival time between patients with severe and severe patients treated with bronchoalveolar lavage (BAL). MethodsA total of 149 critical patients who received mechanical ventilator were enrolled and divided into the BAL and non-BAL groups. We performed 2 years followed-up and compared the survival times of 2 groups through Kaplan-Meier analysis. ResultsThe APACHE II and the acute physiology score II declined significantly after treatment for 2 groups. APACHE II as well SAPS II in the BAL group were significantly lower than those in the non-BAL group. There were 5 (6.94%) and 7 (9.10%) patients died during the first week, but the difference of mortality between the two groups was not significant (χ2=0.168, P=0.682). The longest survival time in BAL group was 124 weeks and the patient was censored, but the longest survival time in the non-BAL group was just 104 weeks. The arithmetic mean and median of survival times in BAL group were 33.2 and 25.0 weeks, respectively. Kaplan-Meier analysis showed that the survival times in the BAL group were apparently longer than those in the non-BAL group (χ2=4.419, P=0.036). ConclusionAlthough there is no significant difference of survival rate between the BAL and non-BAL group, patients in the BAL group have significantly longer survival times than those in the non-BAL group. Our study indicates that BAL can improve the prognosis for the critical patients who received mechanical ventilator.
2016, 39(4): 376-378.
doi: 10.3969/j.issn.1674-4500.2016.04.10
Abstract:
ObjectiveTo explore the efficiency of pre-operative CD8+CD28-T cells to predict recurrence for patients with renal cell carcinoma (RCC). MethodsPreoperative detection of 33 cases with kidney cancer in RCC patients with peripheral blood CD8+CD28-Treg content, for 60 months of follow-up, postoperative observation of CD8+CD28-Treg and recurrence relations, and compared with preoperative neutral grain/lymphocyte ratio (NLR) were compared. ResultsA total of 9 cases of patients with recurrence, accounted for 27.27%, the average recurrence time mean for 24 months after surgery; Patients with recurrence of CD8 + CD28-Treg and NLR numerical group were greater than the recurrence (P=0.034, 0.041).Subjects work curve (ROC) analysis showed that CD8+CD28- there was a significant correlation with RCC Treg and NLR, the area under the curve (AUC) were 0.819 and 0.703 (P=0.004 and 0.004), and when CD8+ CD28-Treg was 8.21%, the sensitivity of the recurrence of its predictions for 92.6%, 90.5%, significantly higher than that of NLR. ConclusionPreoperative CD8+CD28-Treg in predicting recurrence of patients with RCC has ideal accuracy, for the cell percentage is higher than 8.21% of patients with preoperative need strengthen follow-up of 2 years after surgery.
2016, 39(4): 379-382.
doi: 10.3969/j.issn.1674-4500.2016.04.11
Abstract:
ObjectiveTo evaluate the feasibility of the patient-specific intraoperative guides for acetabular fractures through the technolgy of 3D printing and digit design. MethodsTwenty patients with acetabular fractures were collected in this study. Data of CT scanning were imported into Mimics17.0 software for 3D anatomical modeling, virtual fracture reduction, virtual surgery and the design of intraoperative guides. 3D printing technique was used to print the reducted model and the patient-specific intraoperative guides for simulating the surgery. Finally, the real operation was compared with virtual preoperative design in terms of the direction and the length of screws. ResultsA total of 107 screws were implanted with intraoperative guides. The direction of screws were in high accordance with the digital design. The length of screws are compared with Paired-samples T Test and P=0.476. There are 7 screws direction deviation in 1-5°, no screw implangted in the joint. ConclusionThe 3D printing technology combine with virtual surgery for acetabular fractures is feasible and effective to improve patient-specific intraoperative guides planning by surgery simulation in virtual and reality. Secondly, the combination of Three-Dimensional Printing and virtual surgical procedure can provide a patient-specific preoperative planning in acetabular fractures
2016, 39(4): 383-386.
doi: 10.3969/j.issn.1674-4500.2016.04.12
Abstract:
ObjectiveTo elevate the long-term efficacy and outcome of tenofovir and entecavir in treatment of hepatitis B virus-related cirrhosis. MethodsWe retrospectively analyzed laboratory and clinical data of 120 HBV-related cirrhotic patients without liver transplantation, who were treated with tenofovir/entecavir therapy from July 2012 to August 2015. 62 and 58 patients were initiated tenofovir and entecavir, respectively. Follow up period was 20 (7-42) months for tenofovir and 21(7-44) months for entecavir. ResultsAt the end of 1 year, levels of HBV DNA < 20 IU/mL were achieved in 92% and 90.6% of patients, and alanine aminotransferase normalized in 57.3% and 56.5% of patients who received tenofovir and entecavir, respectively. At the last visit, Child-Turcotte-Pugh scores improved among 31% of patients who received tenofovir, 29.2% of those who received entecavir, and remained stable in 65% and 63.2% patients, respectively, in both groups. The 3-year cumulative rate of liver decompensation, hepatocellular carcinoma, and cirrhosis-related complications were 3.1%, 1.9%, 2.1% and 2.9%, 2.2%, 2.4% respectively. ConclusionTenofovir and entecavir are effective and potent drugs for prolonged treatment of HBV cirrhosis and improved the overall clinical course.
2016, 39(4): 387-389.
doi: 10.3969/j.issn.1674-4500.2016.04.13
Abstract:
ObjectiveTo investigate the optimal way of delivery on near-term or term pregnancy complicated with fetal growth restriction. MethodsA retrospective study was conducted on clinical data of 146 singleton, head delivery pregnant women with fetal growth restriction and delivered≥36 weeks of gestation from January 2010 to September 2015. Comparison of maternal and fetal outcomes was performed between the study group (delivered vaginally) and the control group (delivered by cesarean section). ResultsNo statistical difference of pregnancy complications was observed between the study group and the control group. The pregnant women in the study group delivered later than those in the control group (t=3.941, P < 0.001). The hospital stay of the pregnant women in the study group was also shorter than those in the control group (t=-3.870, P < 0.001). The rates of the meconium-stained amniotic fluid and neonatal asphyxia were not statistically different between the study group and the control group (χ2=1.490, P=0.222; χ2=0.216, P=0.642). Comparing to the control group, the rate of the neonates admitted to the neonatal intensive care unit (NICU) in the study group was decreased (χ2=12.280, P < 0.001) and the hospital stay of the neonates in the study group was shorter (t=-3.230, P=0.002). ConclusionThe pregnant women with fetal growth restriction who delivered after 36 weeks of gestation, those who delivered vaginally would not increase the risk of adverse perinatal outcomes than those who delivered by cesarean section. And the hospital stay of the mothers and neonates could also be decreased in the women who delivered vaginally.
2016, 39(4): 390-392.
doi: 10.3969/j.issn.1674-4500.2016.04.14
Abstract:
ObjectiveTo analyze the silicone gel dressings clinical effect of prevention and treatment of hyperplastic scar. MethodsA total of 136 cases of hyperplastic scar patients were randomly divided into control group and treatment group, 68 cases in each group have patients. Control patients treatment method is to use the viscous soft silicone patches, the treatment group patients treatment is the use of silicone gel dressings topical focus area, two groups of patients were continued for 3 months, 6 months after scar rating, using the grading result evaluation of the therapeutic effect of two kinds of treatments. ResultsAfter 3 months and 6 months treatment, the lesion scar VSS score of he patients in two groups significantly reduced compared with before treatment(P > 0.01); The treatment group were treated by silicone gel dressing treatment for 3 months, 6 months after scar VSS score difference no statistical significance compared with the control group(P > 0.05); After 6 months treatment, the effective rate of the control group was 87.7%, the treatment group was 90.9%, there is no significant difference in the two groups(P > 0.05). ConclusionSilicone hydrogel dressings for prevention and treatment of hyperplasia of scar clinical curative effect exact, long-term prognosis and self-adhesive silicone film no significant difference, but at the grassroots level of clinical application.
2016, 39(4): 393-394.
doi: 10.3969/j.issn.1674-4500.2016.04.15
Abstract:
2016, 39(4): 395-396.
doi: 10.3969/j.issn.1674-4500.2016.04.16
Abstract:
ObjectiveTo investigate the effect of Simotang given by nose jejunal nutrition tube on early recovery of gastrointestinal function in patients with gastric cancer. MethodsA total of 50 patients with gastric cancer after operation were divided into the Simotang group (25 cases) and the control group (25 cases). The patients in Simotang group were given 20 mL Simotang every 8 h and then given 20 mL saline to wash the tubes. The patients in control group were treated with 40 mL saline every 8 h. The bowel sound recovery time, the first anal exhaust time and the incidence of abdominal distension were compared between the groups. ResultsThe bowel sound recovery time (22.96±4.69 h) of the Simotang group was significantly shorter than the control group(29.44±4.26 h). The first anal exhaust time(36.64±4.19 h) of Simotang group was significantly shorter than the control group(41.84±4.00 h). Both the differences between 2 groups were statistically significant(P < 0.01). ConclusionEarly given Simotang by nose jejunal nutrition tube can benefit the recovery of gastrointestinal function in patients with gastric cancer after operation.
2016, 39(4): 397-402.
doi: 10.3969/j.issn.1674-4500.2016.04.17
Abstract:
ObjectiveTo investigate expression of Notch ligands (Jagged 1 and Jagged 2) and the effects of Budesonide in airway remodeling in mice with asthma. MethodsThirty C57BL/6 male mice were randomly divided into 3 groups (10 mice/group) including control group, asthma group, and Budesonide group. The pathological changes of the airway were assessed by hematoxylin and eosin staining. The cytokines in the lung homogenate were assessed by ELISA. The immunohistochemistry and western blot was used to estimate the expression of Jagged1 and Jagged2 in the lung tissues. The correlations among them were also analyzed. ResultsCompared with the control group, the expressions of IL-4/5/13, Jagged1 and Jagged2 in the lung tissues were significantly increased (P < 0.01 or 0.001), but decreased significantly in the Budesonide-treated asthma group. Both Jagged1 and Jagged2 were positively correlated with the cytokines, mucus production and collagen deposition (P < 0.001). ConclusionJagged 1 and Jagged 2 may be associated with airway remodeling in mice with asthma. Budesonide can improve airway remodeling, possibly by decreasing the expression of Jagged1 and Jagged2.
2016, 39(4): 403-405.
doi: 10.3969/j.issn.1674-4500.2016.04.18
Abstract:
ObjectiveTo analyze the complication and self-care consciousness for the 343 patients with chronic bronchitis of acute stage who were hospitalized in Tumushuke People's Hospital of Xinjiang. MethodsA total of 343 patients with chronic bronchitis of acute stage were enrolled in Tumushuke People's Hospital of Xinjiang. The differences in incidence rates of complications, self-care consciousness between the Uyghur and Han nationality were compared through chi-square test. Results(1) Complicated with old pulmonary tuberculosis: Incidence rates of male were higher than female for the 2 nationalities.The gender difference was more significant for Uyghur nationality when compared to Han ones (P < 0.01, OR=0.883); (2) Complicated with old cerebral infarction: Both male and female incidence rates were higher than those in Uyghur nationality, and the difference of male incidence rates between the two nationalities was significant (P < 0.05); (3) Complicated with diabetes mellitus type 2: The female incidence rates were higher than male ones for Uyghur nationality (P < 0.01), but male higher than female for Han nationality (P < 0.01). The female incidence rates in Uyghur nationality were higher than those in Han nationality (P < 0.01); (4) The rates of self-care consciousness in Han nationality were significantly higher than those in Uyghur nationality (61.4% vs 33.3%, P=0.000). The non-consciousness rates of self-care were significantly higher than consciousness ones for the Uyghur nationality (P=0.000), whereas there was no significant difference of self-care rates between consciousness and non-consciousness for Han nationality (P=0.056). ConclusionThe differences of complication rates of old pulmonary tuberculosis and diabetes mellitus type 2 are significant between Uyghur and Han nationality, which could be due to the factors of region, diet and living habit. The self-care consciousness is weak for patients of Uyghur nationality, and it could be one of the main reasons resulting in the high incidence rates of acute exacerbation for the patients with chronic bronchitis in Tumushuke Xinjiang.
2016, 39(4): 406-410.
doi: 10.3969/j.issn.1674-4500.2016.04.19
Abstract:
ObjectiveTo investigate factors influencing nursing compliance of pediatric inpatient, and provide evidence for improving nursing compliance in such patients. MethodsThirty nurses were implemented the interview with self-designed questionnaire for the families of pediatric inpatients. Patients with poor compliance of nursing were selected as observation group, good compliance of nursing as control group.We compared age, the number of caregivers, their families psychological factors, nurse-patient match and other differences between the two groups. ResultsIn 121 cases, the good compliance was 59.5%, and the poor compliance was 40.5%. Univariate chi square analysis identified 8 factors influencing the compliance. Multivariate Logistic regression analysis showed that the independent predictors of poor compliance were: family education level, anxiety and fear level of families, cognitive level of the disease, treatment, communication with nurses and complex program. ConclusionThe effective means to improve the nurse patient relationship and improve the nursing compliance of pediatric patients can be improve the efficiency of nursing care, improve the health education of hospitalized patients, with good social support and strengthen nurse patient communication.
2016, 39(4): 411-413.
doi: 10.3969/j.issn.1674-4500.2016.04.20
Abstract:
ObjectiveTo explore the effection on using QCC to reduce the unplanned extubation rates of the ENT inpatients with intravenous catheter. MethodsThe QCC was established and built up the theme of decrease of the unplanned extubation rate of intravenous catheter'. We investigated current status, analyzed the factors, set up the the goals, made out the corresponding measure and compared the unplanned extubation rates before and after measures implementation. ResultsAfter QCC activities, the unplanned extubation rate reduced from 63.01% to 32.5% with passing the goal attainment rate 4.32%. ConclusionThe QCC activites can effectively reduce the unplanned extubation rate of intravenous catheter, alleviat the suffering of patients with multiple venipunctrure, ensure timely treatment of patients, to ensure the patient outcomes.
2016, 39(4): 414-415.
doi: 10.3969/j.issn.1674-4500.2016.04.21
Abstract:
2016, 39(4): 416-419.
doi: 10.3969/j.issn.1674-4500.2016.04.22
Abstract:
ObjectiveTo explore the effects of failure mode and effect analysis (FMEA) on postpartum hemorrhagerates in critically ill obstetric patients． Methods106 critically illobstetric patients applying FMEA theory were divided into observation group, while 100 cases of severe maternal into control group given routine nursing care, Failure mode and effect analysis(FMEA) model was used to analyze the main reasons of postpartum hemorrhage ratesin critically ill obstetric patients, To compare the incidence rate of two groups of postpartum hemorrhage. ResultsAfter implementation of methods of FMEA, the RPN in the failure mode was all lowered. Compared with control group, the rate of postpartum hemorrhage in observation groupwas decreased(P < 0.05). ConclusionsThe FMEA model can be effective in reducing the rate of postpartum hemorrhagein critically illobstetric patients．
2016, 39(4): 420-424.
doi: 10.3969/j.issn.1674-4500.2016.04.23
Abstract:
This paper summarized the main research progress which was relevant to the potential mechanisms of secondary blood-brain barrier (BBB) dysfunction in adults' intracerebral hemorrhage (ICH). ICH correlated with many causes, illustrating with examples, cerebral vascular malformations, coagulopathies, high blood pressure and Alzheimer's disease. Remarkable achievement of the cell and molecular signal level has been obtained on the etiologies of BBB dysfunction after ICH. Hemoglobin, thrombin, iron of blood compositions and the inflammatory reaction to them have a big impact on BBB dysfunction after ICH. Knowing the mechanisms underlying the secondary BBB dysfunction after ICH is significant for studying the pathogenesis of cerebral hemorrhagic stroke.
This paper summarized the main research progress which was relevant to the potential mechanisms of secondary blood-brain barrier (BBB) dysfunction in adults' intracerebral hemorrhage (ICH). ICH correlated with many causes, illustrating with examples, cerebral vascular malformations, coagulopathies, high blood pressure and Alzheimer's disease. Remarkable achievement of the cell and molecular signal level has been obtained on the etiologies of BBB dysfunction after ICH. Hemoglobin, thrombin, iron of blood compositions and the inflammatory reaction to them have a big impact on BBB dysfunction after ICH. Knowing the mechanisms underlying the secondary BBB dysfunction after ICH is significant for studying the pathogenesis of cerebral hemorrhagic stroke.
2016, 39(4): 425-427.
Abstract:
Hepatic fibrosis is a recurrent and diffuse lesion in the hepar, and it is a necessary stage in the development of chronic hepatic disease. Prevention of the occurrence and development of hepatic fibrosis has important significance to hepatic cirrhosis and even hepatocarcinoma, but the early discovery and diagnosis of the hepatic fibrosis presents some difficulty. Though liver biopsy is the gold standard, it is difficult to be popularized because of its trauma. With the continuous development of science and technology, and the deepening understanding of the occurrence and development of hepatic damage, hepatic fibrosis and hepatocarcinoma, all kinds of non-invasive methods for diagnosis of hepatic fibrosis have been proposed and widely used. This paper reviews the research progress of these techniques.
Hepatic fibrosis is a recurrent and diffuse lesion in the hepar, and it is a necessary stage in the development of chronic hepatic disease. Prevention of the occurrence and development of hepatic fibrosis has important significance to hepatic cirrhosis and even hepatocarcinoma, but the early discovery and diagnosis of the hepatic fibrosis presents some difficulty. Though liver biopsy is the gold standard, it is difficult to be popularized because of its trauma. With the continuous development of science and technology, and the deepening understanding of the occurrence and development of hepatic damage, hepatic fibrosis and hepatocarcinoma, all kinds of non-invasive methods for diagnosis of hepatic fibrosis have been proposed and widely used. This paper reviews the research progress of these techniques.
2016, 39(4): 428-431.
doi: 10.3969/j.issn.1674-4500.2016.04.24
Abstract:
Glucagon-like peptide-1 receptor agonist(GLP-1RA) is a new type of antidiabetic drug, structure transformation of long-acting GLP-1RA can prolong its half-life, great attention has been paid to this convenient weekly using drug(exenatide LAR、albiglutide、dulaglutide), which had been listed abroad, while it has not been marketed in our nation. A series of studies present either in monotherapy or replace basal insulin and prandial insulin treatment can reduce HbA1c、weight and the risk of hypoglycemia effectively with a low serious adverse events rate. Gastrointestinal and local injection reaction are the main adverse events which need to be improved in the future.
Glucagon-like peptide-1 receptor agonist(GLP-1RA) is a new type of antidiabetic drug, structure transformation of long-acting GLP-1RA can prolong its half-life, great attention has been paid to this convenient weekly using drug(exenatide LAR、albiglutide、dulaglutide), which had been listed abroad, while it has not been marketed in our nation. A series of studies present either in monotherapy or replace basal insulin and prandial insulin treatment can reduce HbA1c、weight and the risk of hypoglycemia effectively with a low serious adverse events rate. Gastrointestinal and local injection reaction are the main adverse events which need to be improved in the future.
2016, 39(4): 432-436.
doi: 10.3969/j.issn.1674-4500.2016.04.26
Abstract:
Cancer-derived extracellular vesicles contain various cancer-associated molecules, such as overexpressed oncoproteins, glycoproteins, mRNAs, various non-coding RNAs and DNA fragments. They have been shown to propagate phenotypic traits, such as drug resistance, increased proliferation rate, invasiveness and to mediate cancer-induced immunosuppression. Therefore, cancer-derived extracellular vesicles have gained increasing attention as cancer biomarkers and therapeutic targets. Unlike circulating tumor cells they are highly abundant in biofluids and, on the contrary to single-molecule circulating biomarkers, they protect their molecular cargo against degradation and may carry molecular signatures associated with specific phenotypes. Herein, we summarize studies investigating extracellular vesicles biomarkers in breast cancer and propose scenarios for various clinical applications of EV-based biomarkers in the management of breast cancer. Furthermore, we provide an overview of recent findings regarding the cancer-promoting effects of breast cancer-derived extracellular vesicles and discuss opportunities for blocking EV-mediated signaling as a therapeutic strategy for breast cancer.
Cancer-derived extracellular vesicles contain various cancer-associated molecules, such as overexpressed oncoproteins, glycoproteins, mRNAs, various non-coding RNAs and DNA fragments. They have been shown to propagate phenotypic traits, such as drug resistance, increased proliferation rate, invasiveness and to mediate cancer-induced immunosuppression. Therefore, cancer-derived extracellular vesicles have gained increasing attention as cancer biomarkers and therapeutic targets. Unlike circulating tumor cells they are highly abundant in biofluids and, on the contrary to single-molecule circulating biomarkers, they protect their molecular cargo against degradation and may carry molecular signatures associated with specific phenotypes. Herein, we summarize studies investigating extracellular vesicles biomarkers in breast cancer and propose scenarios for various clinical applications of EV-based biomarkers in the management of breast cancer. Furthermore, we provide an overview of recent findings regarding the cancer-promoting effects of breast cancer-derived extracellular vesicles and discuss opportunities for blocking EV-mediated signaling as a therapeutic strategy for breast cancer.
2016, 39(4): 437-442.
doi: 10.3969/j.issn.1674-4500.2016.04.28
Abstract:
As an effective renal replacement therapy, peritoneal dialysis is widely used in patients with end-stage kidney disease.However, long-term peritoneal dialysis will progress to peritoneal fibrosis even encapsulating peritoneal sclerosis with functional and structural alterations of the peritoneal membrane. Peritoneal fibrosis can cause the failure of ultrafiltration and eventually make patients withdrawal from PD. The objective of this review is to summarize the mechanisms of peritoneal fibrosis from a new perspective, and conclude current and future prospects of interventions in the peritoneal fibrosis.
As an effective renal replacement therapy, peritoneal dialysis is widely used in patients with end-stage kidney disease.However, long-term peritoneal dialysis will progress to peritoneal fibrosis even encapsulating peritoneal sclerosis with functional and structural alterations of the peritoneal membrane. Peritoneal fibrosis can cause the failure of ultrafiltration and eventually make patients withdrawal from PD. The objective of this review is to summarize the mechanisms of peritoneal fibrosis from a new perspective, and conclude current and future prospects of interventions in the peritoneal fibrosis.
Research progress of the relationship between subclinical hyperthyroidism and cardiovascular disease
2016, 39(4): 443-446.
Abstract:
Subclinical hyperthyroidism was defined as a serum thyrotropin (TSH) concen-tration below the nomal range with normal levels of thyroid hormones, which was considered to be an intermediate state between health and clinical hyperthyroidism.Whether subclinical hyperthyroidism increased the risk of cardiovascular disease and should be screened and actively treated, results of the previous relevant researches remain controversial. Recent studies showed that subclinical hyperthyroidism was significantly associated with higher risk of cardiovascular disease and cardiovascular mor-tality. We reviewed the research development of the relationship between subclinical hyperthyroidism and cardiovascular disease.
Subclinical hyperthyroidism was defined as a serum thyrotropin (TSH) concen-tration below the nomal range with normal levels of thyroid hormones, which was considered to be an intermediate state between health and clinical hyperthyroidism.Whether subclinical hyperthyroidism increased the risk of cardiovascular disease and should be screened and actively treated, results of the previous relevant researches remain controversial. Recent studies showed that subclinical hyperthyroidism was significantly associated with higher risk of cardiovascular disease and cardiovascular mor-tality. We reviewed the research development of the relationship between subclinical hyperthyroidism and cardiovascular disease.
2016, 39(4): 447-450.
doi: 10.3969/j.issn.1674-4500.2016.04.29
Abstract:
Section 2, Chapter 7 of the implementation rules of Level 3 General Hospital Accreditation Standards (2011) has clearly put forward a requirement that Level 3 hospitals should collect and analyze the data of severe diseases and operations on in-patients, and thus make proper improvement. Therefore, it is essential for medical practitioners to extract and analyze the data in a scientific, immediate, and efficient method. Since a variety of diseases and operations happen in the hospitals, the analysis work is extremely time-consuming. Hence, we run SPSS to analyze all the data. Its date function, Computer command, Merge Files command, Identify Duplicate Cases command and Custom Table list make the job much easier. Being able to be skillful in running SPSS analyzing the data of severe diseases and operations enables the hospitals to generate accurate and timely data statistical analysis. Therefore, SPSS is worth of further popularization and application.
Section 2, Chapter 7 of the implementation rules of Level 3 General Hospital Accreditation Standards (2011) has clearly put forward a requirement that Level 3 hospitals should collect and analyze the data of severe diseases and operations on in-patients, and thus make proper improvement. Therefore, it is essential for medical practitioners to extract and analyze the data in a scientific, immediate, and efficient method. Since a variety of diseases and operations happen in the hospitals, the analysis work is extremely time-consuming. Hence, we run SPSS to analyze all the data. Its date function, Computer command, Merge Files command, Identify Duplicate Cases command and Custom Table list make the job much easier. Being able to be skillful in running SPSS analyzing the data of severe diseases and operations enables the hospitals to generate accurate and timely data statistical analysis. Therefore, SPSS is worth of further popularization and application.
2016, 39(4): 451-452.
doi: 10.3969/j.issn.1674-4500.2016.04.30
Abstract:
2016, 39(4): 453-454.
doi: 10.3969/j.issn.1674-4500.2016.04.31
Abstract:
ObjectiveTo investigate the clinical features of pulmonary complicated with hepatic epithlioid hemangioendothelioma(EHE), improve the cognition. MethodsTwo cases of pulmonary complicated with hepatic epithlioid hemangioendothelioma cases were reported, the clinical features of the disease were analyzed by combining with the relevant literature. ResultsEHE was a rare tumor of low grade malignant tumor, which was extremely rare in the liver and lung, and was easily misdiagnosed as metastatic tumor. ConclusionThe clinical manifestations of EHE in the liver and lung are not specific, the liver EHE imaging has certain characteristics, and pathology is still the only means of diagnosis of EHE.
2016, 39(4): 535-355.
doi: 10.3969/j.issn.1674-4500.2016.04.03
Abstract:
Objective To study the diagnostic value of ultrasound examination in the digestive tract perforation． MethodsWe jastive analysis with the X-ray examination results and the operative results. Results Among 65 cases, there were 10 cases of gastric perforation, 39 cases of duodenal perforation, 14 cases of appendiceal perforation and 1 cases of small intestinal rupture caused by trauma. 58 cases of digestive tract perforation were found by preoperative ultrasonography and the coincidence rate was 90.6%. And we were found 41 cases of free intraperitoneal air(64%), 54 cases of free peritoneal fluid or loculated fluid(84%), 23 cases of the gathered omentum (gathered) and 21 cases were found the site of perforation(32.8%). X-ray examination found 44 cases of free intraperitoneal air and the diagnosis coincidence rate was 68.7%. It was no statistically significant difference with ultrasonography. Conclusion The X-ray and the ultrasound examination all can be found free intraperitoneal air, but the ultrasound can also be found peritoneal effusion and local retinal aggregation. The ultrasound examination had higher detection rate for the digestive tract perforation and had great clinical practical value.
