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2018 Vol. 41, No. 3
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2018, 41(3): 287-290.
doi: 10.3969/j.issn.1674-4500.2018.03.01
Abstract:
Objective To investigate the effect of n-3 polyunsaturated fatty acids (PUFAs) on bone healing in both Fat-1 transgenic mice and WT mice. Methods To measure the potential role of n-3 PUFAs in fracture regeneration, a femoral fracture model was established in both Fat-1 transgenic mice and WT mice. The bone regeneration of each mice was measured by X-ray, micro-CT and histological assessment at 2, 3, 4 weeks after fixation. Results Histological tests results showed that, compared with WT mice, Fat-1 mice presented significant acceleration of bone regeneration at each time point. Moreover, X-ray and micro-CT analysis exhibited that faster remodeling callus formation were shown in the Fat-1 mice when compared with WT mice. Additionally, histological observation demonstrated that the n-3 PUFAs promoted the endochondral ossification and accelerated the mineralization of the calcified callus in bone regeneration. Conclusion In this study, our results demonstrated that n-3 PUFAs accelerated bone regeneration and fracture healing in mice. These observations suggest that the supplementation of n-3 PUFAs may play a positive role in bone healing.
2018, 41(3): 291-296.
doi: 10.3969/j.issn.1674-4500.2018.03.02
Abstract:
Objective To evaluate the effect of extracorporeal membrane oxygenation aided by color Doppler ultrasonography on the prognosis of respiratory failure patients. Color Doppler ultrasonography was used to measure the cardiac output and the hemodynamic results of ECMO, so as to optimize oxygen supply. Methods 19 severe respiratory failure patients who underwent failure of conventional ventilation therapy were randomly divided into two groups, i.e., observation group (n=10) and control group (n=9). According to hemodynamic parameters of the observation group, indexes including the position of the pipeline and the rotational speed of the centrifugal pump were adjusted, and the blood oxygen pressure of distal radial artery was adjusted to over 90 mmHg; in contrast, the control group received conventional therapy. The workload indicators and prognosis of both groups were compared. Results The ECMO of the observation group was significantly higher than that of the control group in terms of hemodynamic parameters (pulmonary artery wedge pressure and cardiac index) and oxygen dynamics (radial artery oxygen pressure)(P<0.05); besides, blood containing contrast dye in the observation group flows farther after extracorporeal oxygenation than that in the control group(P<0.05). The morphological structure of kidney and liver in the observation group remained normal, while atrophy and swelling of kidney and liver occurred in the control group, the differences were significant(P<0.05). In addition, the total hospitalization time of the observation group was significantly shorter than that of the control group(P<0.05), and the mortality rate of observation group was significantly lower than that of the control group(10%vs 55.6%, χ2=4.550, P<0.05). Conclusion The adjustment of variable indicators, such as ECMO pipeline position and centrifugal pump rotating speed, aided by color Doppler ultrasound, can reduce the occurrence of invalid "small cycle", improve the oxygen supply to tissues and organs, and reduce the incidence rate of acidosis and organ failure, thus shortening hospitalization stay in ICU and decreasing the fatality rate.
2018, 41(3): 297-301.
doi: 10.12122/j.issn.1674-4500.2018.03.03
Abstract:
Ultrasound-guided percutaneous thermal ablation of thyroid nodule is a minimally invasive interventional therapy technique that is safe and effective and can treat various types of thyroid nodules. Its main treatment methods include radiofrequency, microwave, laser ablation and anhydrous ethanol injection, among which radiofrequency ablation is currently the most widely used. Laser ablation is a new minimally invasive treatment method developed in recent years, and there are few reports about its application in the treatment of thyroid nodules. In this thesis, a brief overview of advantages and disadvantages of these methods in the treatment of thyroid nodules was carried out, after which it was concluded that laser ablation was the best treatment for thyroid nodule, thus providing references for future studies.
Ultrasound-guided percutaneous thermal ablation of thyroid nodule is a minimally invasive interventional therapy technique that is safe and effective and can treat various types of thyroid nodules. Its main treatment methods include radiofrequency, microwave, laser ablation and anhydrous ethanol injection, among which radiofrequency ablation is currently the most widely used. Laser ablation is a new minimally invasive treatment method developed in recent years, and there are few reports about its application in the treatment of thyroid nodules. In this thesis, a brief overview of advantages and disadvantages of these methods in the treatment of thyroid nodules was carried out, after which it was concluded that laser ablation was the best treatment for thyroid nodule, thus providing references for future studies.
2018, 41(3): 302-305.
doi: 10.3969/j.issn.1674-4500.2018.03.04
Abstract:
3D bio-printing, a process of converting medical images acquired from clinical data into two-dimensional mode using digital imaging technology, is used for computer-aided design/computer-aided manufacturing software to print and overlay layer by layer. In this bottom-up printing process, biomaterials and living cells are precisely mapped to the target location to achieve sophisticated printing of complex structures. Based on the high flexibility of 3D printing, this high and new technology can be used to repair the problems caused by trauma, tumor or heredity. Therefore, 3D-bioprinting have become a research attraction in recent years. This paper summarized recent research progress of pure biological material in 3D bio-printing and cell-printing, including the characteristics of 3D-biological printing and the way of 3D-biological printing as well as the clinical maxillofacial application and its future development.
3D bio-printing, a process of converting medical images acquired from clinical data into two-dimensional mode using digital imaging technology, is used for computer-aided design/computer-aided manufacturing software to print and overlay layer by layer. In this bottom-up printing process, biomaterials and living cells are precisely mapped to the target location to achieve sophisticated printing of complex structures. Based on the high flexibility of 3D printing, this high and new technology can be used to repair the problems caused by trauma, tumor or heredity. Therefore, 3D-bioprinting have become a research attraction in recent years. This paper summarized recent research progress of pure biological material in 3D bio-printing and cell-printing, including the characteristics of 3D-biological printing and the way of 3D-biological printing as well as the clinical maxillofacial application and its future development.
2018, 41(3): 306-310.
doi: 10.3969/j.issn.1674-4500.2018.03.05
Abstract:
Breast microcalcification (MC) is an important imaging feature of breast cancer. There are two types of MC in the breast tissue; microcalcification type I (calcium oxalate) only occurs in benign lesions, whereas type II (calcium hydroxyapatite) generally in malignant lesions. Over the past few decades, researchers have formulated advanced imaging diagnostic procedures and imaging techniques based on this imaging feature, while the mechanism of its formation is still poorly understood. Hence, this paper attempts to address the molecular mechanism of microcalcification in breast cancer, with focus on how a subpopulation of heterogeneous breast tumor cells attains an osteoblast-like phenotype and activates pathophysiological microcalcification. Also, the regulatory effect of bone morphogenetic proteins, tumor-associated macrophages and epithelial-mesenchymal transition in this pathological calcification of breast has been highlighted.
Breast microcalcification (MC) is an important imaging feature of breast cancer. There are two types of MC in the breast tissue; microcalcification type I (calcium oxalate) only occurs in benign lesions, whereas type II (calcium hydroxyapatite) generally in malignant lesions. Over the past few decades, researchers have formulated advanced imaging diagnostic procedures and imaging techniques based on this imaging feature, while the mechanism of its formation is still poorly understood. Hence, this paper attempts to address the molecular mechanism of microcalcification in breast cancer, with focus on how a subpopulation of heterogeneous breast tumor cells attains an osteoblast-like phenotype and activates pathophysiological microcalcification. Also, the regulatory effect of bone morphogenetic proteins, tumor-associated macrophages and epithelial-mesenchymal transition in this pathological calcification of breast has been highlighted.
2018, 41(3): 311-315.
doi: 10.3969/j.issn.1674-4500.2018.03.06
Abstract:
Due to the high incidence rate of upper limb dysfunction and difficult recovery, stroke can seriously affect the living ability and quality of patients. With the development of virtual reality technology, it has been applied into more and more fields, especially in rehabilitation training. This article mainly reviews the application progress of virtual reality technology in upper limb functional rehabilitation of stroke patients, and claims that virtual reality technology can improve the upper limb function of patients after stroke, such as joint activity and movement accuracy, thus improving upper limb function and life quality.
Due to the high incidence rate of upper limb dysfunction and difficult recovery, stroke can seriously affect the living ability and quality of patients. With the development of virtual reality technology, it has been applied into more and more fields, especially in rehabilitation training. This article mainly reviews the application progress of virtual reality technology in upper limb functional rehabilitation of stroke patients, and claims that virtual reality technology can improve the upper limb function of patients after stroke, such as joint activity and movement accuracy, thus improving upper limb function and life quality.
2018, 41(3): 316-319.
doi: 10.3969/j.issn.1674-4500.2018.03.07
Abstract:
Objective To investigate the characteristics of bone metastasis of triple negative breast cancer (TNBC) with 99mTc-MDP whole-body bone imaging and SPECT/CT bone fusion imaging. Methods Clinical records of 46 untreated patients with confirmed bone metastases of breast cancer by pathology or clinical follow-up were collected. All cases had received 99mTc-MDP whole-body bone imaging before treatment, and SPECT/CT bone fusion imaging was performed on sites of suspected bone metastasis or bone pain of unknown reason. Results A total of 46 patients with 204 lesions were detected. The spine was found to be the most common site for bone metastases (62, 30.39%), followed by ribs (57, 27.94%), thoracic bones (31, 15.20%), pelvic bones (28, d13.73%), craniofacial bones (15, 7.35%) and limb bones (11, 5.39%). No significant differences were found in lesion distribution in the spine, ribs, thoracic bones, pelvic bones, craniofacial bones and limb bones between TNBC and non-TNBC and their bone metastases(X2=0.591, P=0.988). The bone metastasis of TNBC accounted for 28.26% (13/46) of the whole breast cancer bone metastasis. There were 51 bone metastases in 13 cases of TNBC. Totally 90.20% (46/51) of metastatic lesion had high radioactivity concentration, 7.84% (4/51) were mixed lesions, 1.96% (1/51) had low radioactivity concentration, and most of lesions were multiple bone metastases, accounting for 84.26% (11/13). Conclusion 99m Tc-MDP bone imaging and SPECT/CT bone fusion imaging are of great value in the early diagnosis of TNBC. Bone metastasis of TNBC often occurs in the spine, ribs and thoracic bones, and it is mainly caused by multiple and strong radioactivity concentration.
2018, 41(3): 320-323.
doi: 10.3969/j.issn.1674-4500.2018.03.08
Abstract:
Objective To compare the CT imaging findings between focal eosinophilic infiltration (FEI) of liver and hepatic metastases (HMs). Methods A retrospective study including 25 patients with confirmed FEI of liver and 30 patients with confirmed HMs was performed. The lesions’ number, size, distribution, shape, margin, density characteristic, enhancement pattern, and other special features were evaluated. Chi-square test and t –test were used to analyze the differences. Results In all, 136 lesions were detected in 55 cases, including 84 lesions from FEI cases and 52 lesions from HMs cases, and all lesions showed ill-defined margins. Pre-contrast CT images of hepatic FEI demonstrated slightly low attenuation or iso-attenuating, with the size of lesions ranging from 3 to 61 mm. Most lesions (85.7%) were located in subcapsular parenchyma or surrounding the portal vein, and most subcapsular lesions (89.3%) were wedge-shaped or irregular-shaped. Triple-phase enhanced scanning showed progressive enhancement in all lesions, and all the lesions showed the most clearly in the portal vein phase, with portal vein traversal sign in portal vein phase and focal narrowing sign in equilibrium phase detected. However, most of hepatic HMs lesions showed low attenuation on CT pre-contrast images, with size ranging from 8 to 65mm. 67.3% lesions were located in subcapsular parenchyma and partly in the deep hepatic parenchyma, and 82.7% lesions showed inhomogeneous enhancement, with rim enhancement pattern as its feature. 61.5% lesions showed bull eyes signs. Conclusion The clinical and imaging findings of FEI and HMs of liver have certain characteristics. The FEI of liver can be characterized by progressive enhancement, portal vein traversal sign in portal vein phase and focal narrowing sign in equilibrium phase. However, the HMs tends to show clear history of primary lesions and rim enhancement pattern, especially bull eyes signs. These features entertain great significances in differentiating hepatic FEI from HMs.
2018, 41(3): 324-327.
doi: 10.3969/j.issn.1674-4500.2018.03.09
Abstract:
Objective To investigate the clinical significance of transvaginal three-dimensional ultrasonography in the detection of Cesarean scar pregnancy (CSP). Methods 62 cases with CSP and 56 healthy parturient women hospitalized in our hospital from January 2015 to June 2017 were included, and the impact of transvaginal three-dimensional ultrasonography on the detection and prognosis of these cases was retrospectively analyzed. Results Of 62 CSP cases, the ultrasonography of 49 cases showed gestational sac type, located in the scar at the middle and lower part of the uterus; inside the gestational sac of 24 cases, typical yolk sac or fetal buds were visible, pulsation of fetal heart detected in live fetus, low resistance blood signal were showed around the gestational sac and all blood was supplied from the muscle layer of the incision; the ultrasonography of 13 cases showed mass type, located in the scare at the middle and lower part of the uterus, the signals inside which were all low echo or hypoecho and some showed no echo at all, and the surroundings of masses showed rich blood flow, with mainly low resistance blood signal. All 62 patients were securely discharged from hospital, among which 19 cases received conservative treatment, 15 patients were treated with transvaginal CSP lesion resection + uterus neoplasty after unsatisfied recovery from conservative treatment, 28 patients received dilatation and curettage successfully, and no patients received hysterectomy. Conclusion Transvaginal three-dimensional ultrasonography can clearly and accurately show the positional relationship between the gestational sac or clumps and scar, blood flow distribution and uterine muscle wall, etc., and doctors can assess the exact location of gestational sac and uterine scar more accurately with the ultrasonography images. Therefore, it can be considered as the primal method for the early diagnosis of CSP and for the guidance of clinical treatment selection.
2018, 41(3): 328-330.
doi: 10.3969/j.issn.1674-4500.2018.03.10
Abstract:
Objective To investigate the effect of minimally invasive internal fixation by cannulated compression screws on the postoperative recovery of patients with patellar transverse fracture. Methods 74 cases with patellar transverse fracture admitted to our hospital from March 2012 to May 2017 were included and divided into control group and observation group by random number table method, with 37 cases in each group. The control group received K-wire tension band internal fixation, while the observation group received minimally invasive internal fixation by cannulated compression screws assisted by C arm X-ray machine. The recovery condition of knee function and incidence rate of postoperative complications in both groups were compared. Result The postoperative follow-up of six months revealed that the fineness rate of functional recovery of knees of observation group was 91.89%, which was significantly higher than that of control group (72.97%, P<0.05); the incidence rate of postoperative complications, such as postoperative infection, delayed incision healing and fixation loosening, of observation group was significantly lower than that of control group (P<0.05). Conclusion The application of minimally invasive internal fixation by cannulated compression screws in the treatment of patients with patellar transverse fracture has obvious curative effect and enjoys higher patient acceptance rate than K-wire tension band internal fixation for its lower incidence rate of postoperative complications and smaller incision, thus worthy of clinical application and promotion.
2018, 41(3): 331-333.
doi: 10.3969/j.issn.1674-4500.2018.03.11
Abstract:
Objective To explore the effect of trans-abdominal and transvaginal color Doppler ultrasound on the early prenatal diagnosis of alpha-thalassemia major fetus. Methods 153 cases of pregnant women at 12-26 gestational weeks who underwent prenatal examination at our hospital from December 2014 to December 2017 were included. Alpha-thalassemia diagnosis of fetus was carried out on each case via trans-abdominal amniocentesis or puncture of chorionic membrane; in the meantime, trans-abdominal and transvaginal color Doppler ultrasound was applied to examine the fetus. The results of both approaches were compared. Results The detection sensitivity, false positive rate, specificity, and false negative rate of trans-abdominal and transvaginal color Doppler ultrasound for alpha-thalassemia major fetus were 98.96% (95/96), 1.04% (1/96), 92.98% (53/57) and 7.02% (4/57) respectively. Radiographic images displayed clearly the serous cavity effusion, cardiac enlargement and increase of cardiothoracic ratio of the fetus, while other phenomenon, including the increase of nuchal translucency, bowel echo enhancement and thickening placenta, were also detected. Conclusion The application of trans-abdominal and transvaginal color Doppler ultrasound in the early prenatal examination can accurately diagnose alpha-thalassemia major fetus, thus worthy of clinical application.
2018, 41(3): 334-340.
doi: 10.3969/j.issn.1674-4500.2018.03.12
Abstract:
Objective To obtain high-specificity and strong-affinity serum aptamer of lung cancer from lung cancer serum by real-time quantitative PCR and subtractive SELEX technology, with magnetic beads as the screening medium. Methods Using magnetic beads as the carrier and the serum of lung cancer patients as the screening target molecule, aptamers that bind to the sera of lung cancer were screened from the random ssDNA library by SELEX and real-time quantitative PCR. Then the obtained 9th round enriched library was amplified to dsDNA and sent to Sangon Biotech (Shanghai), where the screened library of aptamers went through high-throughput sequencing. Results After four rounds of screening, four aptamers with high specificity of serum were obtained. The sequencing results showed that they were different sequences. Conclusion The specificity of screened aptamer in combination with serum of lung cancer was tested. The results showed that the binding dissociation constants of serum aptamer and lung cancer serum were all within nanomolar level. Seq-2, Seq-3, Seq-6 and Seq-19 can bind to the serum of lung cancer with high specificity, but not with normal human serum. Using the serum of 200 cases of lung cancer and normal human serum of 200 cases, it was showed that the positive detection rate of lung cancers by these four serum aptamers of lung cancers could reach 91% or even higher, thus providing a new method for the early diagnosis of lung cancer.
2018, 41(3): 341-345.
doi: 10.3969/j.issn.1674-4500.2018.03.13
Abstract:
Objective To explore the function and mechanism of the high expression of LncRNA in colorectal cancer. Methods ZEB1-AS1 expression in colorectal cancer cells and tissues was detected by qRT-PCR, and the relationship between ZEB1-AS1 expression and the prognosis of patients with colorectal cancer was analyzed. Bioinformatics analysis was used to determine transcriptional factor binding sites of ZEB1-AS1, while dual luciferase reporter gene assay was applied to verify transcriptional factors. The influence of ZEB1-AS1 on the proliferation ability of colorectal cells were studied by MTS assay. Results It was suggested that ZEB1-AS1 was highly expressed in colorectal cancer cells and tissues and it was positively corelated with the poor prognoses of colorectal cancer patients. Bioinformatics analysis combined with dual luciferase reporter gene assay showed that ZEB1-AS1 upregulated by c-Myc could promote its activity and enhance its expression. MTS findings demonstrated that overexpressed ZEB1-AS1 accelerated the proliferation of colorectal cells, while the knocked-down ZEB1-AS1 oppressed the proliferation of colorectal cells. Conclusion c-Myc can upregulate ZEB1-AS1, thus promoting the colorectal cancer progression. Therefore, c-Myc/ZEB1-AS1 axis might be a patient target for colorectal cancer therapy in the future.
2018, 41(3): 346-349.
doi: 10.3969/j.issn.1674-4500.2018.03.14
Abstract:
Objective To investigate the effect of hysterectomy and oophorectomy on the menopausal symptoms of women. Methods 131 women who received hysterectomy and/or oophorectomy in Tongji Hospital and 104 healthy volunteers in menopause were included, and their menopausal symptoms and concentration of serum follicle-stimulating hormone (FSH) were recorded. Results The KMI scores of hysterectomized group, hysterectomized + single oophorectomized group and hysterectomized + bilateral oophorectomized group were significantly higher than that of non-hysterectomized group (P<0.001). The KMI score of the hysterectomized+ bilateral oophorectomized group was markedly higher than that of hysterectomized group (P<0.001). There were no statistically differences between other operation groups. The Ridit test results showed no significant differences in the severity of menopausal symptoms between 4 groups, which was consistent with the comparison results of KMI scores. The statistical results of concentration of serum FSH were as follows: the concentration of serum FSH of three hysterectomized groups were significantly higher than that non-hysterectomized group (P=0.005); that of hysterectomized + bilateral oophorectomized group was higher than that of hysterectomized group (P=0.011) and that of hysterectomized + single oophorectomized group (P<0.001). There were no statistically significant differences in the concentration of serum FSH between hysterectomized group and hysterectomized+ single oophorectomized group. Conclusion We found there was a correlation between postoperative menopausal symptoms and serum FSH value after hysterectomy. Hysterectomy and ovarian resection could accelerate the increase of FSH value and aggravate menopausal symptoms.
2018, 41(3): 350-353.
doi: 10.3969/j.issn.1674-4500.2018.03.15
Abstract:
Objective To investigate the clinical effect of meglumine diatrizoate injection as the wound drainage agent in thyroid surgery. Medthods From May 2016 to May 2017, 60 patients treated with open subtotal thyroidectomy or thyroidectomy plus cervical lymphotomy in the First Affiliated Hospital of Jiamusi University were included and divided into benign group and malignant group according to the rapid pathology report, and each group was further divided into the experimental group (PGD) and the control group (physiological saline group). These groups were further divided, on the basis of resection range, into experimental group A of benign unilateral (n=8), control group B of benign unilateral (n=7), experimental group C of benign bilateral (n=7), control group D of benign bilateral (n=8), experimental group E of malignant unilateral (n=8), control group F of malignant unilateral (n=9), experimental group G of malignant bilateral (n=7), and control group H of malignant bilateral (n=6). For all 30 cases in those experimental groups, a good hemostasis was achieved after the removal of thyroid lesion or lymphadenectomy, and the operative wound was irrigated with 10 mL solution of meglumine diatrizoate injection, after which the drainage was placed. As for the 30 cases of control groups, blood was stopped completely after the completion of major surgical procedures, and the operative wound was irrigated with saline solution and drainage was placed. The drainage flow during the time period of 0-8h, 8-24 h and 24-48 h after the operation was recorded, and the incision was observed to determine the healing effect. Results According collected drainage flow of each group, the drainage flow records of A/B group, C/D group, E/F group, and G/H group were compared. It was observed that the flow rate of experimental groups using meglumine diatrizoate injection as the wound drainage agent was less than that of control groups using saline solution, and the difference was statistically significant (P<0.05). Conclusion The application of meglumine diatrizoate injection as wound drainage agent in thyroid surgery can reduce the postoperative wound flow, thus worthy for extending in clinic.
2018, 41(3): 354-357.
doi: 10.3969/j.issn.1674-4500.2018.03.16
Abstract:
Objective To study the expression of mucin-4 in bladder cancer and its mechanism. Methods A total of 120 cases of bladder cancer admitted to our hospital from January 2015 to December 2016 were selected as experimental group and adjacent tissues 2cm around the tumor were selected as the control group. The relative expression of mucin-4 in bladder cancer and adjacent tissues was analyzed by SYBR green real-time quantitative PCR and western blot test. The relative expression of mucin-4 in bladder cancer carcinoma was analyzed and the relationship between mucin-4 and clinical features was analyzed. Results The relative expression level of mucin-4 in bladder cancer tissues was significantly higher than that in normal bladder tissues (P<0.05). The expression level of mucin-4 was associated with tumor size, lymph node metastasis, and TNM stage of bladder cancer (P<0.05). The expression level of mucin-4 in tumor tissues with diameter greater than 5 cm was higher than that in tumor group with diameter less than 5 cm. The expression level of mucin-4 in bladder transition group was higher than that in bladder transition group without lymph node metastasis. The expression level of mucin-4 in bladder tumor at III + IV stage was significantly higher than that at I + II stage (P<0.05). The expression level of mucin-4 was not related to the age and sex of bladder cancer patients (P>0.05). Mucin-4 overexpression induced the proliferation of bladder cancer cells (T24 cell line) and inhibited apoptosis, while mucin-4 knockout inhibited the proliferation of bladder cancer cells (T24 cell line) and induced apoptosis. It is suggested that mucin-4 can promote the proliferation of bladder cancer cells and inhibit apoptosis. Conclusion Mucin-4 plays an important role in the development and progression of bladder cancer, and its expression level has certain reference value for the severity and prognosis of bladder cancer.
2018, 41(3): 358-360.
doi: 10.3969/j.issn.1674-4500.2018.03.17
Abstract:
Objective To summarize the microsurgical treatment strategy of parasagittal meningioma, so as to reduce operative complications and postoperative recurrence rate. Methods A retrospective analysis of medical data of 25 patients underwent microsurgical excision of parasagittal meningioma with method of sagittal sinus differential attachment in our hospital from January 2016 to June 2017, including their general situation, operation method, effect of surgery and postoperative recovery, was performed. Results According to the Simpson resection standard, among those 25 cases treated with microsurgical excision, 14 cases belonged to Simpson grade I (56.0%), 8 cases Simpson grade II (32.0%), and 3 cases Simpson grade IV (12.0%). The mean follow-up time was 16 months, during which no serious postoperative complications or tumor recurrence occurred. Conclusion Surgical excision of parasagittal meningioma with method of sagittal sinus differential attachment, if strictly adhering to the principle of micro neurosurgery, can keep draining veins and sagittal sinus integral and unblocked, thus reducing operative complications and postoperative recurrence rate.
2018, 41(3): 361-363.
doi: 10.3969/j.issn.1674-4500.2018.03.18
Abstract:
Objective To explore the diagnostic value of coronary CT angiography (CTA) in patients with cardiomyopathy complicated with angina. Methods 36 patients with suspected hypertrophic cardiomyopathy complicated with angina admitted to our hospital from October 2011 to October 2017 were enrolled, with 540 segments of coronary artery in total, and all cases received 64-slice coronary CTA and coronary angiography (CAG). Results of these two examination methods were compared. Results The degree of coronary stenosis showed in CTA and CAG of 384 segments of coronary artery completely matched, with the complete corresponding rate of 71.1%. CTA results demonstrated that the sensitivity of coronary segments with normal or severe stenosis were significantly higher than that of coronary segments with mild or moderate stenosis (P<0.05). However, in terms of positive predictive value, that of coronary segments with mild stenosis was significant lower than that of coronary segments with normal, moderate or severe stenosis (P<0.05). There were no significant differences in the diagnosis rate of non-calcified plaques and mixed plaques (P>0.05). In terms of the diagnosis rate of calcified plaque, that of coronary CTA was significantly higher than that of CAG (P<0.05). Conclusion For patients with hypertrophic cardiomyopathy and angina, coronary CTA can be used to detect the presence of coronary stenosis. Coronary CTA can accurately detect coronary artery lesions, and is safe and fast, thus worthy of clinical application and promotion.
2018, 41(3): 364-367.
doi: 10.3969/j.issn.1674-4500.2018.03.19
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Objective To explore the effect of alprostadil dry emulsion combined with benazepril on the protein level of patients with diabetic nephropathy and its adverse reactions. Methods 66 patients with diabetic nephropathy were randomly divided into the combination group (n=33) and control group (n=33). Control group received routine hypoglycemic agents, antihypertensive treatment, anticoagulation, and Benazepril by oral administration, while combination group was treated with Alprostadil dry emulsion on the base of the treatment routine of control group, and patients were treated for more than one treatment course. Curative effect, 24 h urine protein level, 24 h urinary microalbumin excretive rate (UMER), serum creatinine level, clinical symptom score and incidence rate of adverse reactions during the treatment of two groups were compared, and the relationship between 24 h urine protein levels with the UMER, serum creatinine level and clinical symptom integral score were analyzed. Results Compared with control group, the proportion of marked therapeutic effect and total curative effect rate of combination group were significantly improved, and 24 h urine protein level, UMER, serum creatinine level, clinical symptom score of combination group before treatment and 2 and 4 weeks after treatment were significantly lower (P<0.05). Compared with those before treatment, 24 h urine protein level, UMER, serum creatinine level, clinical symptom score of combination group 2 and 4 weeks after treatment had significantly decreased, and 24 h urine protein level, UMER, serum creatinine level, clinical symptom score of control group 4 weeks after treatment had also declined (P<0.05). During the treatment phase, no significant differences were found in the incidence rate of adverse reactions, including headache, dry cough, nausea, liver and kidney function damage, between two groups (P>0.05). Pearson correlation analysis results showed that 24 h urine protein level of patients with diabetic nephropathy treated with alprostadil combined with benazepril was positively correlated with UMER, serum creatinine level and clinical symptom integral score (r=0.896, 0.842, 0.896,P<0.05). Conclusion Urine protein level of patients with diabetic nephropathy is associated with renal function injury and clinical symptoms. Alprostadil dry emulsion combined with benazepril has good efficacy and is safe, therefore worthy of clinical popularization and application.
2018, 41(3): 368-371.
doi: 10.3969/j.issn.1674-4500.2018.03.20
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Objective To compare therapeutic effects of percutaneous nephrolithotomy (PCNL), minimally invasive percutaneous nephrolithotomy (MPCNL) and flexible ureteroscopy (FURL) for subrenal calyx calculi under 20 mm. Methods 150 patients with subrenal calyx calculi <20 mm were randomly assigned to three groups ( n=50). Patients in different groups received PCNL, MPCNL and FURL respectively, and the operation time, bleeding volume, length of stay, postoperative out-of-bed activity time, visual analogue scale (VAS) scores at the first postoperative day, stone free rates and incidence rate of postoperative complications in each group were recorded and compared. Results Operation time in the PCNL group was the shortest among three groups, and its bleeding volume and ambulation time were significantly lower compared to those in PCNL group (P<0.05). Bleeding volume, length of stay, post-operative out-of-bed activity time and VAS scores on the first postoperative day in FURL group were significantly lower than those in PCNL group and MPCNL group (P<0.05). Instant and final stone free rates were high in PCNL, MPCNL and FURL group, and there were no significant differences among them (P>0.05). The incidence rate of postoperative complication was lower in FURL group than that in PCNL and MPCNL group (P<0.05). Conclusion PCNL, MPCNL and FURL are effective treatments for subrenal calyx calculi under 20 mm. FURL, with shorter recovery time and lower incidence rate of postopertive complications, is less invasive compared to PCNL and MPCNL, thus worthy of clinical application and promotion.
2018, 41(3): 372-375.
doi: 10.3969/j.issn.1674-4500.2018.03.21
Abstract:
Objective To observe the effect of administration mode and time of remifentanil patient-controlled intravenous analgesia on parturient women and fetuses/newborns. Methods Patients were randomly divided into observation group (n=80) and control group (n=45). The observation group received remifentanil intravenous analgesia, while the control group received routine obstetric treatment. The observation group were further divided into four groups randomly, with 20 cases in each group. A1 group was given intermittent patient-controlled intravenous analgesia, A2 group was given continuous infusion combined with intermittent intravenous self-administration, B1 group received analgesia during the incubation period and B2 group during the active period. VAS score, number of PCA compression, oxytocin use, instrumental delivery rate, postpartum hemorrhage at 2h, plasma prolactin concentration, labor complications of postpartum analgesia, postpartum complications and other adverse reactions were observed. Results There was no significant difference in the general clinical data between the groups at admission (P>0.05). There was no statistical difference in Apgar score, labor time, hemorrhage at 2h, neonatal Apgar scores at 1min and 5min, arterial blood gas, respiratory rate, contraction pressure and heart rate between the observation and control groups (P>0.05). Compared with control group, VAS score of observation group was significantly reduced, prolactin concentration was significantly increased, while the number of midwifery, cesarean section cases, and oxytocin use cases were significantly less (P<0.05). The VAS score and PCA compression of A2 group were significantly lower than those of A1 group, and those of B1 group were lower than those of B2 group, with all differences being significant (P<0.05). Prolactin concentrations in group A2 were higher than those in group A1, and those in group B1 were higher than those in group B2. Conclusion Continuous infusion combined with intermittent intravenous self-administration analgesia can perform better analgesic effect during incubation period, promote the secretion of prolactin, and reduce the number of PCA compressions, while producing no obvious adverse effects on parturient women and newborns.
Effect of remifentanil intravenous patient-controlled intravenous analgesia on postpartum depression
2018, 41(3): 376-379.
doi: 10.3969/j.issn.1674-4500.2018.03.22
Abstract:
Objective To study the impact of remifentanil intravenous patient-controlled intravenous analgesia on maternal postpartum depression. Methods 66 full-term primiparas with single head position delivery admitted in the department of obstetrics and gynecology of our hospital during March 2014-March 2017 were included. These cases were divided into remifentanil group (n=22), epidural group (n=22) and control group (n=22) by means of random number table. The remifentanil group were administered intravenous self-controlled analgesia with remifentanil, the epidural group epidural analgesia, while the control group had natural delivery. The general indicators of three groups, including maternal labor, blood loss and neonatal weight, were recorded. The pain index at each time point of delivery was evaluated by visual analogue scale (VAS), the hospital anxiety and depression questionnaire (HAD) was used to assess the prenatal emotional status of these cases and the Edinburgh Postnatal Depression Scale (EPDS) was applied to investigate their postpartum depression. The investigation date of three groups were comparatively analyzed. Results The remifentanil group, epidural group and control group had no significant differences in age, BMI, gestational age, birth course, blood loss and newborn weight (P> 0.05), and the VAS score of both groups after delivery was lower than that at delivery. The VAS score of remifentanil group and epidural group at and after delivery were lower than that of the control group (P<0.05). Compared with epidural group, the VAS score of remifentanil group after delivery was slightly higher with statistically significant results (P<0.05). There were no significant differences in HAD scores and prenatal depression between three groups(P> 0.05). The EPDS score and the incidence of postpartum depression in remifentanil group after delivery were significantly lower than those of control group and epidural group (P<0.05). There was no significant difference in EPDS scores between control group and epidural group(P> 0.05). The incidence of postpartum depression in the epidural group was lower than that of the control group (P<0.05). Conclusion Although the analgesic effect of remifentanil intravenous patient-controlled labor analgesia is poorer than epidural analgesia, it can significantly reduce the occurrence of postpartum depression, thus worthy of administration on pregnant women with prenatal depression tendency.
2018, 41(3): 380-383.
doi: 10.3969/j.issn.1674-4500.2018.03.23
Abstract:
Objective To investigate the correlation between NF-kB and IL-1β, TNF-α, and IL-8 in expressed prostatic secretion (EPS) of patients with prostatitis. Methods A total of 210 patients with prostatitis admitted to the department of urinary surgery in our hospital from January 2016 to January 2018 were included. According to the NIH classification criteria, all cases were divided into three groups, namely type II group (n=65), type III-a group (n=70) and type III-b group (n=75). 50 cases underwent health examination or premarital physical examination were selected as control group. The EPS levels of NF-kB, IL-1β, TNF-α, and IL-8 and the National Institutes of Health (NIH) prostatitis symptom score of these groups were compared. Pearson correlation analysis and logistic regression analysis were performed. Results Compared with the control group, the EPS levels of NF-kB, IL-1β, TNF-α, and IL-8 and the scores of NIH-CPSI of the prostatitis group were significantly higher (P<0.05). Compared with type III-a group and type III-b group, the EPS levels of NF-kB, IL-1β, TNF-α, and IL-8 and the scores of NIH-CPSI in type II group were significantly higher (P<0.05). Compared with type III-b group, the EPS levels of IL-1β, TNF-α, and IL-8 of type III-a group were significantly higher (P<0.05). Pearson correlation analysis indicated that NF-kB, IL-1β, TNF-α and IL-8 were positively correlated with NIH-CPSI score of prostatitis patients (P<0.05), while IL-1β, TNF-α and IL-8 were positively correlated with NF-kB (PP<0.05).Also, multiple regression analysis showed that NF-kB, IL-1β, TNF-α and IL-8 were all related to the prostatitis NIH-CPSI score, which was a risk factor for prostatitis. Conclusion IL-1β, TNF-α, IL-8 and NF-kB play an important role in the occurrence and development of prostatitis, and can be used as the basis for the diagnosis and pathological classification of prostatitis.
2018, 41(3): 384-387.
doi: 10.3969/j.issn.1674-4500.2018.03.24
Abstract:
Objective To investigate the effect of non-steroidal anti-inflammatory drugs (NSAIDs) on postoperative healing of patients with clavicle fracture, and to provide basis for clinical medication. Methods 120 patients with clavicle fracture were randomly divided into experimental group and control group, with 60 cases in each group. Patients in experimental group took celecoxib orally 200 mg bid for 7 days after operation, while the control group was not given any NSAIDs or opioid analgesics. The VAS score was used to evaluate the postoperative pain in two groups, and adverse reactions were recorded. The X-ray was used to evaluate the postoperative healing of fracture sites at 4, 8 and 12 weeks after operation respectively. Results After the treatment of celecoxib, the VAS score in experimental group was significantly decreased than that in control group (4.08±1.05vs 8.07±0.84, P<0.05), and the scores of periosteal reaction at 4, 8 and 12 weeks were significantly higher than those in the control group (scores of periosteal reaction at 4, 8 and 12 weeks in experimental group: 1.15±0.33, 2.02±0.34, 2.60±0.49,P<0.05), while the incidence of callus, score of fracture healing and skeletal shape were significantly lower than those of the control group (P<0.05). Conclusion Celecoxib, a nonsteroidal anti-inflammatory drug, has an adverse effect on the healing of clavicular fractures.
2018, 41(3): 388-391.
doi: 10.3969/j.issn.1674-4500.2018.03.25
Abstract:
Objective To investigate the clinical features of mycoplasma pneumonia in children and to analyze factors that affect the severity of the disease, so as to provide the basis for the early diagnosis and evaluation of mycoplasma pneumonia. Methods The clinical data of 156 children with mycoplasma pneumonia admitted to our hospital from March 2014 to March 2016 were included. According to the severity of mycoplasma pneumonia in children, these cases were divided into severe group (n=62) and mild group (n=94). Relevant analysis of these data was performed. Results Of the 156 cases with mycoplasma pneumonia, the youngest was 2 months old and the eldest was 14 years old; among 142 cases with fever, the main symptoms were irregular heat and remittent fever, among which high fever and over-high fever were most common. The course of fever of 103 cases was 1 to 7 days, and that of 39 cases was 8 to 14 days; there were 106 cases with cough, mostly paroxysmal cough and dry cough, 98 cases with fine rales, and the chest X-ray findings of 148 cases showed chest inflammation. Significant differences in ESR, IL-6, CRP and PCT were found between severe group and mild group (P<0.05). ESR, IL-6, CRP and PCT were all independent risk factors for the exacerbation of mycoplasma pneumonia in children. Conclusions The main manifestations of mycoplasma pneumonia in children are fever and cough, and excessive inflammation might occur. The increase of ESR, IL-6, CRP and PCT are all risk factors for the exacerbation of mycoplasma pneumonia, thus able to be used for clinical prevention and treatment.
2018, 41(3): 392-394.
doi: 10.3969/j.issn.1674-4500.2018.03.26
Abstract:
Objective To evaluate the clinical efficacy of montelukast in the treatment of children with secretory otitis media (SOM). Methods 100 children with confirmed SOM admitted to our hospital from March 2013 to March 2014 were included. They were randomly divided into control group and treatment group, with 50 cases in each group. While both groups received intravenous infusion of cefoperazone twice a day, the treatment group also received additional oral administration of montelukast once a day before sleep. Clinical symptoms and the duration that signs and symptoms disappeared were compared. Results The signs and symptoms, including earache, invagination of swelled tympanic membrane and exudate in the middle ear cavity, disappeared sooner in the treatment group than that in the control group, and the treatment group exhibited a shorter hearing recovery time than that of the control group. The effective rates of the treatment and control group were 98% and 82% respectively, which showed a significant difference (P<0.01). The degrees of family member satisfaction after treatment for the treatment and control group were 100% and 84% respectively (P<0.05). Conclusion The curative effect of montelukast in the treatment of children with secretory otitis media is obvious with no adverse reactions, thus worthy to be recommended for clinical applications.
2018, 41(3): 395-397.
doi: 10.3969/j.issn.1674-4500.2018.03.27
Abstract:
Objective To compare the clinical effect of two types of operation in the treatment of high myopia combined with cataract. Methods 90 cases (90 eyes) admitted to our hospital from January 2016 to December 2017 were included and divided into modified group (treated with modified operation; n=45) and traditional group (treated with traditional operation; n=45) via the random number table method. Postoperative visual acuity (count in <0.1), corneal endothelial cell count and postoperative complications of both groups were observed. Results Compared with traditional group, the corneal endothelial cells in patients from modified group recovered faster (t=2.011, 2.433, P<0.05) and they underwent less postoperative complications (x2=6.450, P<0.05). No significant differences were found in postoperative visual acuity between two groups (x2=1.323, 0.445, P>0.05). Conclusion Under the condition of this clinical treatment, the modified operation is more satisfactory in treating patients with high myopia combined with cataract.
2018, 41(3): 398-401.
doi: 10.3969/j.issn.1674-4500.2018.03.28
Abstract:
Objective To compare the clinical characteristics of elderly and non-elderly community-acquired pneumonia (CAP) patients. Methods A total of 292 cases of CAP hospitalized in the Affiliated Hospital of Guilin Medical University from April 2014 to April 2017 were included. Their medical readings logged into the electronic medical record system of the department of respiratory medicine were collected, among which those general items, including length of hospital stay, initial symptoms at admission, sputum culture result, antibiotic use, clinical and laboratory data, were statistically analyzed via clinical epidemiological investigation methods. Results The age range, average age, average hospitalization time and bacterial culture rate of these 292 CAP cases were 14-89 years old, (49.10±19.4) years old, (9.11±3.23) d, and 11.64% respectively. The differences of the underlying comorbidity, sputum culture, NEUT, PCT and ESR between two groups were significant(P<0.05),while no significant differences were found in length of hospital stay, CRP, and initial symptoms at admission. No significant differences were found in the use of B amides, quinolones and macrolides between two groups, while the use of forest amides differed significantly between two groups. Conclusion CAP patients in the elderly group tend to be complicated with underlying diseases. The PCT sensitivity and positive rate of sputum culture in the elderly group were higher than that in the non-elderly group, while the positive rate of pathogen detection in the elderly group was lower than that in the non-elderly group.
2018, 41(3): 402-405.
doi: 10.3969/j.issn.1674-4500.2018.03.29
Abstract:
Objective To investigate the mental state of mucosa contact point headache patients with Hamilton anxiety scale (HAMA) and to conduct a preliminary study on the treatment plan. Method Thirty-two patients with mucosa contact point headache treated in our hospital from January 2011 to December 2017 and thirty-two healthy volunteers were included, and their mental state was evaluated by HAMA. Results The HAMA results of 32 cases with mucosa contact point headache and 32 volunteers were 6.875±5.072 and 2.625±1.845 respectively. Significant differences in various anxiety features were found (F=17.286, P=0.000): anxiety (F=0.580, P=0.036), scare (F=30.393, P=0.000), cardiorascular system symptoms (F=15.808, P=0.000), respiratory system symptoms (F=15.036, P=0.000),gastrointestinal symptoms (F=31.598, P=0.000), and interview performance (F=24.785, P=0.000). Conclusions Patients with mucosa contact point headache are significantly more anxious than healthy people; therefore, a comprehensive diagnosis and treat scheme should be formulated for these patients and surgical treatment should be chosen carefully.
2018, 41(3): 406-408.
doi: 10.3969/j.issn.1674-4500.2018.03.30
Abstract:
Objective To investigate the clinical efficacy of two different hepatic vascular occlusion techniques in surgery for hepatic cystic echinococcosis. Methods 42 patients with hepatic cystic echinococcosis undergoing surgical intervention in recent 2 years were included in a retrospective analysis. 24 cases received surgeries with Pringle maneuver (Pringle group) and the other 18 cases underwent surgeries with hemi-hepatic vascular occlusion (non-Pringle group). The operation time, vascular occlusion time, intraoperative blood loss, postoperative liver function and postoperative complications were recorded and compared between two groups. Results Compared with Pringle group, non-Pringle group manifested significantly less intraoperative blood loss and better postoperative liver function (P<0.05). No significant differences were found in the operation time, blood inflow occlusion time or postoperative complications between the two groups (P>0.05). Conclusion Appropriate hepatic vascular occlusion has significant value in surgical treatment of hepatic cystic echinococcosis, and the choice of the optimal vascular occlusion method should be made based on the patient's condition, intraoperative findings and the condition of the local medical facilities.
2018, 41(3): 409-412.
doi: 10.3969/j.issn.1674-4500.2018.03.31
Abstract:
Objective To explore the clinical effect of PDCA cycle management in the treatment of benign thyroid nodules by microwave ablation. Methods 65 patients with thyroid nodules admitted to our hospital from January 2015 to January 2016 were selected as the treatment group and were treated with microwave ablation; other 65 patients with benign thyroid nodules confirmed by postoperative pathology were included to the traditional operation group and were treated by traditional surgery before January 2015.The PDCA cycle was performed in the microwave ablation group, while not implemented in the traditional operation group. After 6 months of postoperative follow-up, the patients’ satisfaction with postoperative treatment and incidence rate of complications were systematically analyzed. Result The ablation rate, incidence rate of complications, and patients’ satisfaction rate during the six-month follow-up of the microwave ablation group were 95.38%, 7.77% and 98.5% respectively, while the rate of complete resection, incidence rate of complications and patients’ satisfaction rate during the six-month follow-up of the traditional operation group were 85.54%, 16.6%, and 81.5%. Conclusion PDCA cycle management can improve the postoperative satisfaction of patients with benign thyroid nodules after microwave ablation treatment, and reduce the incidence rate of benign nodule complications and improve nursing satisfaction.
2018, 41(3): 413-416.
doi: 10.3969/j.issn.1674-4500.2018.03.32
Abstract:
Objective To investigate the clinical effect of comprehensive nursing intervention on children with functional dyspepsia. Methods A total of 100 children with functional dyspepsia were randomly divided into control group and observation group. The control group received routine nursing intervention, while the observation group was given comprehensive nursing intervention. The treatment effect, compliance, amelioration of anxiety and depression, and improvement of quality of life of the two groups were compared. Results The total effective rate of observation group was significantly higher than that of control group (98.00% and 80.00% respectively, P<0.05). The SAS score and SDS score of the two groups after intervention were significantly lower than those before the intervention. SAS and SDS score of the observation group were significantly lower than those of the control group (P<0.05). The scale of taking prescribed medication, avoiding inducing factors, making emergency treatment during dyspepsia attack and regular follow-up compliance of observation group were significantly higher than those of control group (P<0.05). The SF-36 scores of the two groups after intervention were significantly higher than those before the intervention, and the SF-36 score of observation group was significantly higher than that of control group (P<0.05). Conclusion The comprehensive nursing intervention can improve the clinical efficacy in the treatment of children with functional dyspepsia, improve adverse psychological state, and enhance treatment compliance and quality of life, thus worthy of clinical application.
2018, 41(3): 417-419.
doi: 10.3969/j.issn.1674-4500.2018.03.33
Abstract:
Objective To explore the therapeutic effect of local cryotherapy in relieving postoperative pain after lumbar spinal fusion. Methods 150 patients underwent lumbar spinal fusion were included and randomly divided into control group and experimental group (n=75). In the experimental group, an ice bag was placed at the surgical site of patients and removed after 20 min, which was repeated every 8 h within the postoperative 48 h. Patients in the control group received the same postoperative treatment except cryotherapy. Preoperative and postoperative visual analog scales (VAS) scores at 1, 2, 4, 8, 16, 24, 36 and 48 h were recorded. Meanwhile, postoperative morphine consumption at 6, 12, 24 and 48 h were recorded. Likert scale was used to evaluate patients’ satisfaction with postoperative analgesia at 48 h. Results Postoperative VAS scores in the experimental group at 1, 2, 4, 8, 16, 24, 36 and 48 h were significantly lower than those in the control group (P<0.05). Postoperative morphine consumption between 0 and 6 h, 6 and 12 h, 12 and 24 h, 24 and 48 h, total morphine consumption at 48 h were significantly lower in the experimental group than those in the control group (P<0.05). Likert scale score at postoperative 48 h was significantly higher in the experimental group than that in the control group (P<0.05). Conclusion Local cryotherapy could relieve postoperative pain after lumbar spinal fusion, reduce postoperative consumptions of opioid analgesics and enhance patients’ satisfaction with postoperative analgesia, thus worthy of clinical application and promotion.
