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    20 August 2017, Volume 17 Issue 04
    Expression of G0S2 gene in glioma and its biological significance
    XIE Lin, LI Kaishu, LIU Anmin
    2017, 17(04):  381-386.  DOI: 10.3969/j.issn.1009-976X.2017.04.001
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    Objective To analyze the correlation between G0S2G0S2G0/G1 switch 2gene and glioma prognosis and malignancy. Methods The GSE33331 chip was analyzed by bioinformatics technique and the differential expression gene G0S2 was obtained. GO Gene Ontology analysis and survival analysis of G0S2 gene were performed using DAVID and TCGA databaseThe Cancer Genome Atlas. The correlation between G0S2 and glioma level was studied by real-time fluorescence quantitative PCR. Results Bioinformatics analysis showed that G0S2 was the third most significant gene in the chip logFC=-2.53672, P<0.001. The gene was involved in the metabolism of lipids and molecules, and the survival time of glioma patients with high expression of this gene was significantly decreasedChisq=150, P<0.001. In addition, 40 cases of glioma with qPCR results confirmed that G0S2 was differentially expressed in high and low grade gliomas t=3.168, P=0.003. Conclusion The expression level of G0S2 gene is related to the degree of malignancy and prognosis of glioma.

    Application of prophylactic central lymph node dissection in clinically node-negative (cN0) papillary thyroid carcinoma
    LI Yong, LIN Qimou, ZHOU Yi
    2017, 17(04):  386-390.  DOI: 10.3969/j.issn.1009-976X.2017.04.002
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    Objective  To investigate the indications and the extent of prophylactic central lymph node dissection in clinically node-negativecN0papillary thyroid carcinomaPTC. Methods

    A total of 93 cases treated between Mar. 2015 and Dec. 2010 was analyzed retrospectively. The related clinicopathologic factors were analyzed, including sex, age, tumor size, extrathyroidal extension, and multifocal tumor, coexistence of Hashimoto’s thyroiditis. All the cases underwent total/near total thyroidectomy and Ipsilateral central lymph node dissectionIpsiCCD. The removed lymph nodes were sent for frozen section examinationFSE, and at last, the contralateral central lymph node dissection were performed. We compared the Results of FSE and postoperative pathological examination, to evaluate the accuracy of FSE in assessing the nodal status. Results Of these cases, 18 cases were males and 75 females, with a mean age of 41±13.9 years. T1, T2 and T3 diseases accounted for 65, 18 and 10 cases, respectively. The rates of CLN metastasis were 46.2%43/93, and the rates of bilateral CLN metastases were 18.2% 17/93. The analysis showed that sex, age, tumor size, extrathyroidal extension, and multifocal tumor, coexistence of Hashimoto s thyroiditis have no relation with CLN metastases. The FSE had the sensitivity of 86.0%, specificity of 100% and overall accuracy of 93.5% in detecting occult ipsilateral central neck metastases in the unifocal cN0 PTC. Conclusion Ipsilateral CND should be employed for all cN0 PTC. FSE of ipsilateral nodes is accurate in determining nodal status. Routine IpsiCCD plus FSE of the ipsilateral nodes could be used to make the decision of contralateral central lymph node dissection in surgery.

    The expression and prognostic significance of lncRNA MIAT in clear cell renal cell carcinoma
    ZHENG Zaosong, CHEN Haicheng, XIE Wenlian
    2017, 17(04):  391-394.  DOI: 10.3969/j.issn.1009-976X.2017.04.003
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    Objective To explore the expression and prognostic significance of lncRNA MIAT in clear cell renal cell carcinoma, and evaluate its possibility to be a biomarker of clear cell renal cell carcinoma. Methods The expression of MIAT in clear cell renal cell carcinoma and normal tissues were detected by qRT-PCR. The clinical significance and prognostic value of MIAT in clear cell renal cell carcinoma was analyzed using TCGA data. Results The expression of MIAT in clear cell renal cell carcinoma tissues was significantly higher than in normal tissues. The expression of MIAT in renal cancer cells was significantly higher than in HK-2. The expression of MIAT was positively associated with T stage P<0.001 and M stage P=0.03. Meanwhile, patients with higher MIAT expression had a shorter survival time than patients with lower MIAT expression. Conclusion LncRNA MIAT was overexpressed in clear cell renal cell carcinoma tissues and renal cancer cells, and might be a biomarker for clear cell renal cell carcinoma.

    Effect of preemptive analgesia on postoperative cognitive dysfunction in general anesthesia patients undergoing abdominal surgery
    XIANG Mingfang, YANG Han, ZHANG Lizi, LIU Zhiheng, YANG Xinping
    2017, 17(04):  394-399.  DOI: 10.3969/j.issn.1009-976X.2017.04.004
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    Objective To investigate the effects of preemptive analgesia on postoperative cognitive function in patients undergoing general anesthesia. Methods Forty patients who underwent abdominal surgery with the anesthetic duration longer than 3 hours were included in this study. The patients were attibuted to four groups:the total intravenous anesthesia groupTIVA group, n=10, TIVA + preemptive analgesia groupTIVAPA group, n=10, Combined intravenous and inhalative anesthesia CIIA group, n=10and CIIA + preemptive analgesia groupCIIAPA group, n = 10. Cognitive function was assessed at three time points:1 d preoperation, 7 d and 30 d post-operation by several scoring systems including MMSE, TMT, BVMT, HVLT. The levels of serum C-reactive proteinCRPand interleukin-6 IL-6were measured. The pain assessment in all patients were assessed by visual analogue scaleVAS in 24 hours post-operation. The scores of cognitive function, CRP and IL-6 and VAS were compared between the four groups. Results MMSE, BVMT and HVLT scores decreased significantly in the three groups of patients treated with TIVA group, CIIA group and CIIAPA group P<0.05. The most significant decrease in MMSE and BVMT scores was CIIA group. The most significant decrease in HVLT-T score was CIIA group And CIIA PA group. At 7 days post-operation, the HVLT-R score of TIVA group was restored to the level of 1 day before operation. The HVLT-R score of CIIA group was improved by 1 day after operation but still lower than that before operationP<0.05. After 7 days of CIIA group and CIIAPA group, HVLT-T was still lower than that of preoperative dayP<0.05. The VAS scores of TIVAPA group and CIIAPA group were significantly lower than those of TIVA group and CIIA group P<0.05. The levels of serum CRP and IL-6 in CIIA + PA group and TIVAPA group was significantly lower than that in TIVA and CIIA groupsP<0.05. Conclusion The sevoflurane plays a leading role in the occurrence of POCD in the short time after operation. The effect of preemptive analgesia that used NSAIDs drugs Parecoxib sodium and local nerve block on the POCD is very limited.

    Clinical significances of plasma diamineoxidase,D-lactate and endotoxin activity in critical ill patient with gastrointestinal dysfunction
    HE Zhijie, ZHI Yaowei, HUANG Chaotai, ZHOU Minggen, ZOU Zijun, LI Weichao
    2017, 17(04):  400-403.  DOI: 10.3969/j.issn.1009-976X.2017.04.005
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    Objective To investigate the value of diamineoxidase, D-lactic and endotoxin in critical illness with gastrointestinal dysfunction. Methods  117 patients admitted to ICU were quantitatively detected serum diamineoxidase, D-lactic and endotoxin by using diamineoxidase/lactic/ endotoxin inspection Kit, and calculated the first 24 h Acute Physiology And Chronic Health Evaluation APACHE . The gastrointestinal function of patients was evaluated firstly, and according to whether patients presented gastrointestinal dysfunction, 117 patients were assigned to two group:non-gastrointestinal dysfunction group and gastrointestinal dysfunction group. Results Plasma diamineoxidase level were markedly increased in gastrointestinal dysfunction group16.46±22.60 U/Las compare with non-gastrointestinal dysfunction group6.33 ± 9.55 U/L, P=0.01. Serum D-lactate levels were markedly increased in gastrointestinal dysfunction group24.32 ± 16.49mg/Las compare with non-gastrointestinal dysfunction group11.66±12.36 mg/L, P<0.01. Serum endotoxin levels were higher in gastrointestinal dysfunction group 11.43 ± 9.70U/L than in non-gastrointestinal dysfunction group 9.34 ± 0.17 U/L, P=0.04 Diamineoxidase, D-lactic and endotoxin levels were positively correlated with APACHE II scores:r=0.427, P=0.01, r=0.53, P<0.001, and r=0.451, P<0.001, respectively. Conclusion Diamineoxidase, D-lactic and endotoxin levels were significant increasing in patients with severe gastrointestinal dysfunction and were positively correlated with APACHE and II scores. It suggests the serum diamineoxidase, D-lactic and endotoxin can be used to evaluate gastrointestinal dysfunction as well as the severity in critically ill patients.

    Relationship between serum resistin and gastric cancer-associated cachexia
    ZHAO Lixiang, CHEN Sizeng, WANG Jieshi, YAN Baogong, ZHENG Fangge
    2017, 17(04):  404-406.  DOI: 10.3969/j.issn.1009-976X.2017.04.006
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    Objective To observe the changes of serum resistin level in patients with gastric cancer associated-cachexia and to investigate the relationship between resistin and interleukin-6IL-6. Methods Twenty-three cases of gastric cancer patients with cachexia were assigned to the cachexia group; 23 cases of gastric cancer patients without cachexia were used as the gastric cancer group; and 23 healthy people were taken as normal controls. All the subjects were tested the sex, age, BMI and pathologic stages of cancer. The serum levels of IL-6, resistin were detected by enzyme-linked immunoabsorbent assay ELISA. Results Patients with pathologic stages and were more susceptible to cachexia than those with pathologic stages and in gastric cancerP< 0.05. Compared with control group, the serum resistin level and IL-6 were significantly increased in the cathexia group and gastric cancer groupP<0.05. Along with pathological stage increasing, the serum resistin level were significantly increased. Serum resistin level was positive correlated with IL-6 in the cachexia groupr = 0.512, P = 0.012. Conclusion Along with pathological stage increasing in gastric cancer, the serum levels of resistin and IL-6 were significantly increased. Serum resistin and IL-6 were increased in the cathexia patients. And serum resistin was positively correlated with interleukin-6 in gastric cancer cachexia.

    Research in the function of NDRG2 in inhibiting colon cancer cells proliferation through regulat-ing glycolysis
    SHI Jinglong1, LIN Xiangan2, Lan Qiusheng3, Xu Heyang3
    2017, 17(04):  407-409.  DOI: 10.3969/j.issn.1009-976X.2017.04.007
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    Objective To investigate whether tumor suppressor N-Myc downstream regulated gene 2NDRG2participates in regulating glucose metabolism in colon tumor cells. Methods NDRG2 was stably transfected in colon cancer cells HCT116. Lactate production was measured by lactate assay kits, and glucose consumption was measured by glucose assay kit. Besides, western blot was used to examine the expression of PKMLDHAHK, as the key glycolytic enzymes. Scratch test was used to test tumor cells proliferation. Results HCT116 which transfected with NDRG2 produced less lactate compared with control38.2 ± 3.4 mmol/mL vs 62.1 ± 4.8 mmol/mL, P<0.05, and remaining glucose was more than the control137 ± 3.6 mmol/mL vs 88.2 ± 2.2 mmol/ml, P<0.05. Western blot showed the expression of PKMLDHAHK were less than that in control. Scratch test showed less proliferation of colon tumor cells when above protein were inhibited. Conclusion NDRG2 functions to inhibits glycolysis of colon cancer cells as tumor suppressor gene by repressing the glycolytic enzymes expression, and then inhibits tumor cells proliferation.

    P53 mutation regulate the change of function and expression of KLF5 in the colon cancer cell
    CAO Jiezhi1, LAI Dongming2, WU Heng2, CHU Zonghua2, ZENG Yujie2
    2017, 17(04):  410-414.  DOI: 10.3969/j.issn.1009-976X.2017.04.008
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    Objective  To investigate P53 mutation impact on the function and expression of KLF5 in colon cancer cell. Methods  Take the colon cancer cell lines RKO as the research object, which was both lower KLF5 expression and P53 wild type, chosen from the common colon cancer cells by Western blot and Sanger sequencing. Construct the over-expression/knock-down cell RKO-PCDNA-KLF5 and RKO-PCDNA-shKLF5, RKO-P53R175H-KLF5 and RKO-P53R175H-shKLF5 by the plasmid and verified by Western blot. Transwell assay was used to examine the invasion and metastasis ability. MTS assay was used to examine the proliferation ability. Results In the colon cancer cell lines RKO which was P53 wild type, Transwell assays revealed that the migratory and invasive capacities were inhibited by over-expression of KLF5, as well proliferation ability. And when the KLF5 was silent, the capacities of migratory and invasive, as well as proliferation ability were enhanced obviously. On the contrast with this result, the capacities of migratory, invasive and proliferation in the RKO-P53R175H cell with over-expres-sion KLF5 or silent KLF5 showed the opposite Conclusion. At the same time, the protein level expression of KLF5 in the RKO-P53R175H cell was declined, contrast to the RKO cell with P53 wild type. Conclu-sion In colon cancer cell lines RKO with high expression of P53 mutation, the protein expression of KLF5 levels dropped, and the gene function transformed from a tumor suppressor to the tumor promoter.

    Clinical characteristics of Lynch syndrome-associated colorectal tumorigenesis
    TIAN Lin
    2017, 17(04):  414-416.  DOI: 10.3969/j.issn.1009-976X.2017.04.009
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    Objective  To investigate the clinical features of hereditary nonpolyposis cancer

    HNPCC in Panyu District. The proteins of PMS2, MSH6, MLH1 and MSH2 in tumor tissues were detected by immunohistochemical assay. The detection Results combined with clinical data were analyzed statistically. Methods The clinical and pathological data of 212 patients with colorectal cancer were collected from Panyu District Hospital of Guangzhou. Results In 212 cases of colorectal cancer, 19 cases 8.96%were found MMR protein loss, including MLHl-/PMS2-in 7 cases, MSH2-/MSH6- in 5 cases, MSH6-in 3 cases and PMS2-in 4 cases. The loss of MMR protein in colorectal cancers was associated with the patient’s age and sites of the tumors, not with sex, tumor differentiation and TNM staging. Conclusion The present data revealed that the Lynch syndrome occurred more often in younger patients with the right colon.

    The postoperative abdominal fatigue monitoring based on the combination of subjective sensory fatigue assessment and objective measurement
    CHEN Hongyan, HUANG Liecheng, QIN You
    2017, 17(04):  416-419.  DOI: 10.3969/j.issn.1009-976X.2017.04.010
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    Objective To investigate the postoperative abdominal fatigue monitoring based on the combination of subjective sensory fatigue assessment and objective measurement. Methods VAS and ICFS were used to investigate the patients who underwent four-stage abdominal surgery from September 2016 to February 2017 in Guangdong Provincial Hospital of Chinese Medicine. At the same time, measuring blood samples, superior hand strength and BMI. Comprehensive evaluation Methods which based on the perioperative fatigue rating scale, combination of objective and objective indicators of postoperative fatigue evaluation. Results ICFS combined with CRP, SOD, PA, superior hand strength can be convenient, fast, economical and efficient detection of postoperative fatigue. Conclusion The discriminant function based on the combination of subjective and objective indicators can be used to carry out economic, efficient and objective monitoring of postoperative fatigue, and to minimize the errors caused by subjective judgment.

    The experience of phaseⅠanastomosis in the treatment of left colorectal cancer complicated with acute intestinal obstruction
    WANG Daodu, HE Yongyue, WAN Deyan, SHI Yifeng
    2017, 17(04):  420-422.  DOI: 10.3969/j.issn.1009-976X.2017.04.011
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    Objective To investigate the surgical treatment and outcome of left colon cancer with acute intestinal obstruction. Methods Thirty five patients with left colorectal cancer complicated with acute intestinal obstruction were enrolled in this study. All patients underwent intra-operative lavage and then one-stage anastomosis. Results All patients had a smooth operation procedure, no cases of perioperative death, anastomotic leakage in one case2.9%, and were discharged after treatment with smooth drainage, rinse, and nutrition. The mean hospital stay was 14.59-24days in the patients with left colon cancer and acute obstruction. Three patients developed incision infection or liquefaction 8.6%and healed after dressing. Four cases11.4%were pulmonary infection and recovered by anti-infective therapy. Conclusion Intraoperative colon lavage and one-stage anastomosis is feasible for left colon cancer with acute intestinal obstruction.

    Clinical application of controlled low central venous pressure in laparoscopic hepatectomy
    ZHANG Yuenong, LUO Rong, DENG Jingdan, ZHANG Weiqiang, LIN Weixiong, ZENG Zhiwen, XU Jiwei
    2017, 17(04):  423-431.  DOI: 10.3969/j.issn.1009-976X.2017.04.012
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    Objective  To investigate the feasibility and safety of controlled low central venous pressure (CLCVP) in laparoscopic hepatectomy. Methods Fifty patients underwent elective laparoscopic hepatectomy from January 2016 to May 2017 were attributed to control group (CLCVP) group and conventional central venous pressure (NCVP) group. The patients in CLCVP group were treated with controlled low central venous pressure technique to maintain CVP in 3-5 cmH2O, and keep SAP≥90 mmHg. Those in NCVP group underwent conventional laparoscopic surgery and maintained CVP in 6-12 cmH2O. The cut liver time, intraoperative Bleeding volume, blood transfusion, mean blood transfusion, hemodynamic parameters, postoperative liver and kidney function, with or without gas embolism were observe, recorded and analyzed in two group of patients. Results The cut liver time, intraoperative blood loss, the average blood transfusion in CLCVP group were significantly lower than that in NCVP group, the differences was statistically significant. Serum levels of ALT, AST and TB were significantly increased in the two groups after 1 day, and then gradually decreased, and reached the preoperative level at the 5th day after operation. The levels of ALT, AST and TB in CLCVP group were lower than those in NCVP group at the same time point, the difference was statistically significant. Serum albumin (ALB) levels were significantly decreased on the first day after surgery in two groups, and there were no significant differences between the same time points. There were no significant differences in BUN and Scr levels between the two groups before and after the same time. There was no significant difference in MAP and HR between the two groups at different time points. The white blood cell count of CLCVP group was significantly lower than that of NCVP group at 5 min and at the end of cut liver, and the difference was statistically significant. Conclusion CLCVP can reduce the amount of bleeding, reduce the time of cutting liver and promote the recovery of liver function after laparoscopic hepatectomy.

    The influence of suppressive levothyroxine therapy on bone mineral density in women with differentiated thyroid carcinoma
    ZHOU Yi, LIN Qimou, HUANG Wenjun, LI Yong, YUAN Lin
    2017, 17(04):  428-431.  DOI: 10.3969/j.issn.1009-976X.2017.04.013
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    Objective To investigate the influence of suppressive levothyroxine therapy on bone mineral densityBMD in women with differentiated thyroid carcinoma after thyroidectomy. Methods A total of 46 female patients with differentiated thyroid carcinoma who underwent total or near total thyroidectomy in Jiangmen Central Hospital from 2010 to 2014, were enrolled in this study. Pre-and post-operative BMDT-scoreof lumbarL1-L4and femur were detected and compared in each groups include age, BMI, menopausal status, initial target TSH level and average TSH level. Results Repeated measurement ANOVA showed that T-score of lumbarL1-L4 and femur after suppressive levothyroxine therapy had significantly differencesP<0.05 in each group included group age, menopausal status and initial target TSH level. There was interaction between time effect and group effect in group initial target TSH level and group average TSH level. Conclusion Elder postmenopausal female patients with DTC who underwent long-term suppressive levothyroxine therapy, should be accepted primary prevention against osteoporosis no matter what TSH level they maintain. And also female patients who have lower initial target TSH level≤0.01 mIU/L, should keep on primary prevention against osteoporosis.

    Clinical analysis of lung surgery in 42 cases with multi-drug resistant pulmonary tuberculosis
    JIANG Youding, LIU Zhihui, GAO Jianqi, CHEN Sui, JIANG Tao, LAO Yanping
    2017, 17(04):  432-435.  DOI: 10.3969/j.issn.1009-976X.2017.04.014
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    Objective To analyze the effect of surgical treatment on the patients with multi-drug resistant pulmonary tuberculosis. Methods  A retrospective analysis of the clinical data and follow-up Results were performed on a total of 42 patients with multi-drug resistant pulmonary of tuberculosis in our hospital from January 2009 to June 2016. These 42 patients underwent different surgery procedures, included single lobectomy in 17 cases, multiple lobectomy in 15 cases, Pneumonectomy in 5 cases, completion pneumonectomy in 2 cases and segmentectomy in 2 cases. Results  One patient with single lobectomy and one patient with segmentectomy were lost after one month of follow-up. And 40 patients were followed up for one to 84 months 26 ± 24.8 months. For the rest 40 patients, the treatment success rate, remission rate, failure rate were 80.0%32/40, 7.5%3/40, 12.5%5/40, including 3 death patientsrespectively. They were 16/16, 0 respectively in single lobectomy patients ; 11/15, 2/15, 2/15 respectively in multiple lobectomy patients; 3/5, 1/5, 1/5 respectively in pneumonectomy patients; 2/3, 0, 1/3 respectively in completion pneumonectomy patients; 1/1, 0, 0 respectively in segmentectomy patients. The incidence of complication was 35.0%14/40. The complications included intractable cavity12.5%, 5/40, bronchopleural fistula12.5%, 5/40, pleural infection5.0%, 2/40, pleural active bleeding2.5%, 1/40and incision infection2.5%, 1/40. The complication proportions in the five surgical procedures were 2/16, 8/15, 2/5, 2/3, 0 respectively. Conclusion Surgery is helpful to improve the treatment success rate for patients with multi-drug resistant pulmonary tuberculosis. Single lobectomy should be the preferred surgical procedure for the single lobe lesions. For the multiple lobectomy, surgical complications should be prevented.

    Comparative analysis between uniportal VATS combined with central venous catheter for thoracic drainage and single utility port VATS for spontaneous pneumothorax
    ZHU Lewei, YANG Jie, GU Weiquan, YANG Shengli, YE Jun, WANG Fei
    2017, 17(04):  436-438.  DOI: 10.3969/j.issn.1009-976X.2017.04.015
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    Objective To evaluate the efficacy of uniportal VATS combined with central venous catheter for thoracic drainage and single utility port VATS for spontaneous pneumothorax. Methods Between January 2016 and August 2016, a total of 66 patients with spontaneous pneumothorax who underwent uniportal VATS combined with central venous catheter for thoracic drainage or single utility port VATS were retrospectively reviewed. The 21 patients who underwent uniportal VATS combined with central venous catheter for thoracic drainage were assigned to uniportal group, and the other 45 patients who underwent single utility port VATS served as single utility port group. The surgical Results and complications of two groups were compared. Results The average chest tube drainage time and the degree of pain in the uniportal group were obvious less than that in the single utility port groupP<0.05. There was no signifeant difference in the meam intraoperative blood loss, the mean operative time and postoperative recurrence between the two groups P>0.05. Conclusion These two operation Methods were safe and effective. Uniportal VATS combined with central venous catheter for thoracic drainage is less invasive and painful in the treatment of spontaneous pneumothorax, and deserve to be used widely.

    Clinical observation of dexmedetomidine with different doses combined with sufentanil on patient-controlled intravenous analgesia after lung cancer radical surgery
    LI Quan, SHAO Bing, QIN Tingying, LIU Weihua, ZHANG Yaozhi, HU Ningdong
    2017, 17(04):  439-443.  DOI: 10.3969/j.issn.1009-976X.2017.04.016
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    Objective To investigate the efficacy and safety of dexmedetomidine with different doses combined with sufentanil on patient-controlled intravenous analgesia PCIA after lung cancer radical surgery. Methods Ninety patients with ASA physical status or after lung cancer radical surgery were divided into three groups 30 cases in each group. A group sufentanil plus low-dose dexmedetomidine 0.06 μg?kg-1?h-1; B groupsufentanil + mid-dose dexmedetomidine 0.06 μg?kg-1?h-1;  C groupsufentanil plus high-dose dexmedetomidine 0.06 μg?kg-1 ?h-1. The patients in three groups were given sufentanil 0.04 μg?kg-1?h-1. The VAS pain score, Ramsay sedation score, blood pressure, heart rate, breathing were recorded at 4 h, 8 h, 12 h, 16 h, 24 h and 48 h after surgery. The PCA press times, the satisfaction of patients, the occurrence of adverse reactions such as nausea, vomiting, itching, hypotension, bradycardia, respiratory depression and sedation excessive during the postoperative analgesia were recorded. Results Compared with A group, SBP, DBP and heart rate in B group, C group in all time points decreased with statistically significantP<0.05. Compared with B group, SBP, DBP and heart rate in C group in all time points decreased with statistically significant P<0.05. The postoperative VAS scores in three groups in all time points were less than 4. Group A took the top, followed by Group B, Group C. And the differences are statistically significantP<0.05. Ramsay scores at 4 h, 8 h, 12 h, 16 h, 24 h, Group C took the top, followed by Group B, Group A. And the differences are statistically significantP<0.05. There were no significant differences in PCA press times and the PCA press effective times in three groupsP>0.05. The incidence of adverse effects in the group A and group C were significantly higher than those of group BP<0.05. The satisfaction of patients in the group B was significantly higher than those of group A and group CP<0.05. Conclusion The application of sufentanil0.04 μg?kg-1?h-1combined with mid-dose dexmedetomidine0.08 μg?kg-1?h-1on patient-controlled intravenous analgesia after lung cancer radical surgery can effectively improve analgesia and sedative effects and reduce the adverse reactions, improve the satisfaction of patients.

    Safety and efficacy of plasmakinetic enucleation of prostate versus plasmakinetic resection of prostate in treating patients with prostate gland larger than 60 milliliters:a meta-analysis
    YUAN Yaoji LIAO Jianfeng, LIANG Jian, SU Zhengming LI Xun XU Guibin
    2017, 17(04):  444-451.  DOI: 10.3969/j.issn.1009-976X.2017.04.017
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    Objective To evaluate the safety and efficacy of plasmakinetic enucleation of prostate PKEPvs plasmakinetic resection of prostate PKRPin treating benign prostatic hyperplasia BPH which volume was larger than 60 ml. Methods Databases were searched from 2012/01/01 to 2017/03/02 for collecting the randomized controlled trials about PKEP vs PKRP for the treatment of BPH with volume larger than 60 ml, and then selected the literatures using bringing in and ruling out standard, assessing them and extracting data. Meta-analysis was performed by using the RevMan 5.3. Results Compared with PKRP, PKEP had more resection hyperplastic tissueWMD=15.29, 95% CI:9.18, 21.40, P<0.001, shorter operation time WMD=-17.44, 95% CI:-28.69, -6.19, P=0.002, shorter catheter time WMD=-26.51, 95% CI:-36.49, -16.54, P<0.001, less intraoperative bleeding WMD=-77.82, 95% CI:-120.90, -34.74, P=0.0004, but there was no significant difference in the incidence of postoperative complications between PKEP and PKRP. Conclusion  Compared with PKRP for the treatment of BPH which volume is larger than 60 ml, PKEP had more resection hyperplastic tissue, shorter operation time, shorter catheter time, less intraoperative bleeding. But because the original research quality is poor, higher quality, large sample RCT studies are need before clinic promotion.

    Successful management of hypertension in anesthesia of pheochromocytoma via the use of meto-prolol combined with sevoflurane
    LI Li, ZENG Jianfeng, LIU Chunjiao, YANG Yi
    2017, 17(04):  452-455.  DOI: 10.3969/j.issn.1009-976X.2017.04.018
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    Objective To explore the efficiency and risks of β blocker combined with sevoflur-ance in the management of hypertension in pheochromocytoma surgery. Methods Clinical and anaes-thetic data from 3 cases of pheochromocytoma were collected. The patients outcomes were recorded and analyzed including preoperative schedule, intraoperative hemodynamic changes after antihypertensive therapy by metoprolol combined with sevoflurane. Related literatures were reviewed. Results Adrenal adenoma was identified as phaeochromocytoma in 3 cases in our hospital. Laparoscopic adrenalectomy was performed, and phenoxybenzamine was given for preoperative preparation During the surgical exci-sion of the adenoma, severe hypertension occurred; blood pressure were measured as 170/110 mmHg, 160/90 mmHg and 160/90 mmHg respectively in three patients. Along with administration of intravenous metoprolol and deepen of the anesthetic depth, blood pressure gradually diminished to the baseline, no rebound phenomena was observed after withdrawal of medication. No post-operative hypotension was observed after transferred to the ward, and all 3 cases were discharged from hospital on the 6th-8th post-operative day. Conclusion β blocker with deepen anesthetic depth could be used for the management of hypertension in anesthesia of pheochromocytoma, of which the efficiency and safety still need further study.

    Treatment of 26 cases of penile scrotal hypospadias by urethroplasty of Ⅱ flap in situ
    YOU Wanxiang, WANG Wei, QIAN Qi, WANG Zhengqiang, WU Guang, GAO Fangjun, RAN Guangbo, HUA Yelong, QIN Zhimin
    2017, 17(04):  456-458.  DOI: 10.3969/j.issn.1009-976X.2017.04.019
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    Objective To investigate the phase in situ flap for the treatment of urethra shaping penis scrotal type hypospadias clinical curative effect, improve the level of the surgical treatment of patients with congenital hypospadias. Methods Between January 2011 and January 2016, 26 cases of penis scrotal type hypospadias patients take stage I straighten, penis foreskin penile ventral skin flap transfer. Six months after phase in situ flap for the treatment of urethra shaping hypospadias. Results Twenty-six patients with urethral stricture, 2 cases in the law of urethra expansion after urination improvement, 1 cases with anastomotic urinary fistula. Six months after repair success. All cases were followed up for 2 to 3 years, voiding, curative effect is satisfied. Conclusion Flap urethra in situ forming, to ensure the forming urethral blood supply, reduced the anastomotic tension, with a small injury, postoperative edema, the advantages of low incidence of urinary fistula, urethral stricture, which can effectively improve the curative effect.

    Clinical observation of surgical treatment of the first metatarsal base closed comminuted fracture and dislocation
    DENG Haitang, HUANG Shaoxian, CHENG Benqiang, FENG wenjie, SU Xiao’en
    2017, 17(04):  458-460.  DOI: 10.3969/j.issn.1009-976X.2017.04.020
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    Objective To observe the clinical effect of the first metatarsal base closed comminuted fracture and dislocation. Methods Twenty-four patients with the first metatarsal base closed comminuted fracture and dislocation were treated by surgery of reduction and internal fixation in our hospital from October 2012 to December 2015. The clinical data of the patients analyzed respectively. The foot function was evaluated using the standard of American Orthopaedic Foot and Ankle Society. Results All the patients were followed up for one year. Radiographic healing was observed at an overall average of 12.4±2.6. There were no internal fixation loosening, implant screw fracture. AOFAS score was 85.6+6.2 at the final follow-up. Conclusion Open reduction and internal fixation for the treatment of traumatic first metatarsal basal closed comminuted fracture dislocation could result in good functional outcome with simple operation.

    Study on conventional cage plate internal fixation in treating multi-level cervical spondylotic myelopathy
    CHEN Zhipeng, HU Xumin#, CEN Shuizhong, GAO Liangbin.
    2017, 17(04):  461-466.  DOI: 10.3969/j.issn.1009-976X.2017.04.021
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    Objective To discuss the clinical outcome of anterior cervical discectomy and fusion ACDFwith internal fixation in treating multi-level cervical spondylotic myelopathy. Methods Thirty-seven cases suffer from multi-level cervical spondylotic myelopathy were treated with anterior cervical decompression and fusion with internal fixation by titanium plate in our hospital from Jan. 2012 to Jan. 2015. The clinical outcomes were evaluated by the parameters including improvement of Japanese Orthopaedic Association JOA score and neck disability index values NDIbefore operation, one months after operation and at the last follow up, measured cervical Cobb Angle CA and Segmental Angle SA on X-ray film. Record operation time, intraoperative blood loss, and the incidence of complications. Bony fusion was verified by X-ray at the final follow-up. Results The patients were followed up for 11 to 30 months. VAS scores were decreased from 6.76±2.02 preoperatively to 3.24±1.53 postoperation and 3.0 ± 0.9 at the final follow-up. JOA scores were increased from 9.71 ± 1.66 preoperatively to 13.26 ± 2.14 postoperation and 15.97 ± 16.79 at the final follow-up. NDI scores were decreased from 30.68 ± 8.46 preoperatively to 6.68 ± 3.85 postoperation and 4.14 ± 1.27 at the final follow up. SA were increased from 8.65°±11.03° preoperatively to 18.65°±8.68° postoperation and 18.26°±8.59° at the final follow up. CA were increased from 12.35° ± 12.86° preoperatively to 21.45° ± 9.92° postoperation and 21.43° ± 9.97° at the final follow up. There were significant improvement for all postoperatively and at the final follow up compared with those preoperatively. There were no significant difference between postoperation and at final follow up for all. Height were increased from 70.44 ± 1.64 mm preoperatively to 76.05±7.98 mm postoperation and 76.05±7.98 mm at the final follow up. There was significant improvement for postoperatively compared with that preoperatively. There were no significant difference between that at final follow up and preoperatively. Bony fusion rate was 94.6%, and one case complicated with nerve root injury, one case had a secondary surgery because of cervical haematoma, three had dysphagia after surgery but was improved after treatment, four cases had adjacent segment degeneration. No complications of internal fixation was found. Conclusion  The clinical outcomes of anterior cervical decompression and fusion with internal fixation in treating MCSM is affirmative, and it makes spinal canal decompression and neurologic symptoms ease and fusion rate increase.

    Application of medical glue in the treatment of lumbar posterior surgical incision
    REN Mingliang, LI Hui, LIU Hu
    2017, 17(04):  467-470.  DOI: 10.3969/j.issn.1009-976X.2017.04.022
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    Objective To investigate the efficacy of surgical glue in treatment of lumbar posterior surgical incision in spine surgery. Methods Two hundred patients with lumbar posterior surgical incision from 2016 Jan to 2017 Mar were chosen from our department of orthopaedics in this study The patients were randomly divided into four groupsA, B, C, D, 50 patients each group, surgical glue treatment groupA, conventional suture treatment group B, metal skin staples treatment group Cand the absorbable intradermal suture treatment groupD. The clinical efficacy was compared among four groups. Results Compared with control groups, the healing of those incisions with surgical glue was better, can achieve more level, beautiful healing effect, however, the incidence of incision infection was significantly higher, and infection only happened in these elderly women who are obese interestingly, could be cured by VSD and debridement and suturing well. There is no significant difference of the incidence of incision infection among the control groups statistically, and in the aesthetical aspect, the absorbable intradermal suture treatment group D was better, metal skin staples treatment group C was middle, the conventional suture treatment groupBwas bad. Conclusion The use of surgical glue was shown to be safe, can achieve more level, beautiful healing effect in treatment of lumbar posterior surgical incision in spine surgery, it has many advantages, such as shortening the period of hospitalization, no need to take out the sutures, improving the patient satisfaction. But the indications should be strictly controlled, sense the surgical glue was unappropriated for the elderly women of physical fitness.

    The safety assessment of intra-articular injection of tranexamic acid on unilateral total knee arthroplasty
    HU Zhigang, WANG Xinliang, CHEN Ming, ZHANG Guangming
    2017, 17(04):  471-473.  DOI: 10.3969/j.issn.1009-976X.2017.04.023
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    Objective To explore the blood loss and the safety of intra-articular injection of tranexamic acid during unilateral total knee arthroplasty. Methods Sixty patients were enrolled from June 2014 to June 2016, and assigned to two groups, observation group and control group. All patients underwent unilateral total knee arthroplasty TKA. In the observation group, had an intra-articular injection of 1 g20 mltranexamic acid and drain clamping for 4 h postoperatively. And in the control group, 20 ml saline was given by intra-articular injection after the surgery and the drain was clamped for 4 hours. Blood loss, drain volume, hidden blood loss and the incidence of deep venous thrombosis between the two groups were recorded. Results Total blood loss, total drainage, cult blood loss were lower in the observation group than that in control groupall P values<0.05. There were no deep venous thrombosis or other complications in either group. Conclusion Immediately postoperative intra-articular retrograde injection of TA and 4 h of drain-clamping effectively reduced blood loss after TKA.

    Analysis of curative effect of early stage mastitis treated by combination of traditional Chinese medicine and modern medicine
    PENG Jianxiong, LIANG Yanfen, CHEN Mengli, ZHONG Xiaodan, YANG Lingling, LIN Zixiong
    2017, 17(04):  474-476.  DOI: 10.3969/j.issn.1009-976X.2017.04.025
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    Objective To study curative effect of the early stage mastitis during lactation patients with treatment by combination of traditional Chinese medicine TCM and modern medicine, and summarize experience. Methods The patients derived from outpatient and inpatient of Guangzhou Maternal and Child Health Hospital of Yuexiu District. 600 patients who diagnosed as the early lactation mastitis from 20 to 35 years were selected including galactostasis period in 300 cases and acute inflammation period in 300 cases according to the severity. The patients in galactostasis period were assigned to 3 groupsn=100 in each group, included Group Abreast massage, sanhuangsan sticking therapy, Group B breast massage, sanhuangsan sticking therapy, acupuncture and Group C observation. Those in acute inflammation period also attributed to Group A1 breast massage, sanhuangsan sticking therapy, Group B1breast massage, sanhuangsan sticking therapy, acupuncture, oral Cefradineand Group C1oral Cefradine. All cases are executed conventional breast suction. The clinical effects were recorded and analyzed. Results The patients of galactostasis peiod, the cure rate in Group A, Group B and Group C were 85%, 95% and 50%, respectively. The patients of acute inflammation period, the cure rate in Group A1, Group B1 and Group C1 were 80%, 88% and 45%. Conclusion  The breast massage, sticking therapy, acupuncture combination of TCM and modern medicine has obvious curative effect on early treatment of acute mastitis, significantly reduce the formation of breast abscess stage and is worthy of promotion.

    Application of silver ion dressing combined with vacuum sealing drainage in the treatment of diabetic foot ulcer
    LI Hongmei, JIN Wensheng, FU Qirui, GUO Yanyan
    2017, 17(04):  477-480.  DOI: 10.3969/j.issn.1009-976X.2017.04.024
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    Objective To explore the safety profile and efficacy of silver ion dressing combined with vacuum sealing drainage in the treatment of diabetic foot ulcer. Methods Totally 110 cases with diabetic foot ulcer in our hospital from December 2014 to December 2016 were randomized into observation group 55 cases and control group 55 cases. The observation group were treated with silver ion dressing combined with vacuum sealing drainage, while the control group were treated with conventional debridement combined with Vaseline gauze. Compared with the wound healing, dressing time, hospitalization time, VAS score and clinical efficacy. Results The appeared time of fresh granulation tissue, wound healing time, dressing change times and hospitalization time of the observation group were significantly less than the control group6.74±1.86 vs 10.55±1.73 d, 33.04±5.82 vs 42.29±4.77 d, 8.87±2.85 vs 20.29±3.06 times, 15.38±5.51 vs 22.08±4.85 d, all P values<0.05, the wound reduced area of the observation group was significantly higher than that of control group48.83 ± 7.37 vs 34.49 ± 6.94%, P<0.05. The VAS score of observation group and control group after treatment was significantly lower than those before treatment2.71±1.39 vs 5.44±1.58, 4.13±1.44 vs 5.51±1.49, all P values<0.05. The VAS score of observation group after treatment was significantly lower than the control group 2.71 ± 1.39 vs 4.13 ± 1.44, P<0.05. The effective rate of observation group was significantly higher than the control group 90.91% vs 66.45%, P<0.05. Conclusion Silver ion dressing combined with vacuum sealing drainage can effectively cure diabetic foot ulcer, promote the rehabilitation of patients, which is worthy of clinical application.

    Clinical observation of compound polyethylene glycol electrolyte powder for preoperative intestinal preparation in patients with mixed hemorrhoid
    ZHONG Xiongdong
    2017, 17(04):  481-483.  DOI: 10.3969/j.issn.1009-976X.2017.04.026
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    Objective  To observe the efficiency of polyethylene glycol electrolyte powder and mannitol injection in patients with mixed hemorrhoid according to their preoperative and postoperative outcomes summarize experience. Methods Between January 2017 and June 2017, 32 patients as the trial group took polyethylene glycol electrolyte powder and 32 patients as the control group took mannitol for intestinal preparation in People’s Hospital of Zhuhai. The first defecation time, the postoperative anal exhaust time, and the rate of adverse event were recorded. Results The time of the first defecation was 2.31±0.54 h in the trial group, and 4.04+0.55 h in the control groupP<0.001; the postoperative anal exhaust time was 17.03 ± 1.60 h, and 20.19 ± 1.38 h in the control groupP<0.001; the rate of adverse event was 3.1% in the trial group, and 25.0% in the control groupP=0.031. Conclusion The preparation of polyethylene glycol electrolyte powder for mixed hemorrhoid patients has good bowel preparation effect, and can effectively promote the recovery of intestinal function with less side effects, which is worthy of clinical recommendation.

    Effece of microwave treatment combined with traditional Chinese medicine and Interleukin II on improving the quality of life of patients with anal condyloma acuminatum
    WANG Yong, LIU Shuiping, ZHONG Jiantao, YAO Jinwang, DENG Qun, HUANG Weixaing, YANG Liu’e
    2017, 17(04):  484-486.  DOI: 10.3969/j.issn.1009-976X.2017.04.027
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    Objective To observe the effect of microwave combined with western medicine and Western medicine treatment on anal condyloma acuminatum CA and the quality of life of patients. Methods Sixty-two patients with anal condyloma acuminatum were assigned to observation group n=31 and control group n=31. The patients of observation group received microwave autery, subcutaneous injection of interleukin 2 500 000 U and homemade external application of Chinese Medicine. Those of control group underwent microwave autery and subcutaneous injection of interleukin 2 500 000 U DLQI scores were used to observe the effect and influencing factors in CA patients before and after treatment, and were statistically analyzed. Results DLQI scores before treatment were not statistically significant between the observation group and the control group all P values more than 0.05. Both in observation group and in control group, there were statistical differences between before and after treatment, moreover, there were statistical differences between two groups in the Results after treatment all P values less than 0.05. Conclusion Microwave therapy combined with Chinese and Western medicine treatment can significantly improve the quality of life of patients with anal CA.

    Follicular dendritic cell sarcoma complicated with paraneoplastic pemphigus:a case report and literature review
    ZHANG Ketao, SU Zheng, LIU Jianping, YANG Shanglinlin, LIU Jianping
    2017, 17(04):  487-490.  DOI: 10.3969/j.issn.1009-976X.2017.04.0228
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    Objective  to report one case of follicular dendritic cell sarcoma complicated with paraneoplastic pemphigus clinical manifestations and clinical treatment, so as to improve the understanding of the diseases clinical manifestations, to avoid misdiagnosis and missed diagnosis. Methods The clinical data including the manifestation and surgical treatment in one case of follicular dendritic cell sarcoma complicated with paraneoplastic pemphigus was introduced and analyzed, and the present related documents was review. Results Pathological findings showed the tumor arised from follicular dendritic cell sarcoma outside the lymph node, and the tumor cell boundary was unclear and had obvious atypia and mitosis. Because of the high malignancy of the tumor, the patient s condition deteriorated gradually. Conclusion For localized lesions, surgical resection is the preferred treatment for Follicular dendritic cell sarcoma complicated with paraneoplastic pemphigus. But surgery alone has a high local recurrence rate, consolidation radiotherapy can reduce the local recurrence rate of patients with surgery and extend its disease-free survival. For patients with systemic diffuse FDCS (multiple lymphadenopathy), there is a huge mass or surgery can not cure patients, the need for effective combination chemotherapy.

    Neurofibromatosis type Ⅰ complicated with massive retroperitoneal mass:one case report
    LI Songqing, DONG Gaohong, ZHANG Yi
    2017, 17(04):  491-497.  DOI: 10.3969/j.issn.1009-976X.2017.04.029
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    Type I neurofibromatosisNF-1with retroperitoneal massive tumor is rare in clinical practice, and there are rare cases of the retroperitoneal massive tumor complicated with a low grade malignant schwannoma. This paper reports a case of retroperitoneal hyperplasia of NF-1, who presented the multiple subcutaneous nodules and was found right posterior inferior vena cava mass by CT imaging and diagnoses as neurocutaneous syndromesuch as neurofibromatosis type I. The operation proved that retroperitoneal mass was neurofibroma accompanied with local malignant change. The patient was followed up three months and recovered well.

    The research progress of early diagnosis in developmental hip dysplasia
    LI Qianchun1, JIANG Zhongchao2
    2017, 17(04):  494-497.  DOI: 10.3969/j.issn.1009-976X.2017.04.030
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    Developmental hip dysplasiaDDHis a common hip disease in infants and children. The early diagnosis of DDH is very important. Previously, the basis of the diagnosis of DDH was from physical examination and AP roentgenograms. The diagnostic rate of physical examination is very low. And the conventional X-ray provides limited information, because the hip of infant is build up with vast cartilage, which nonvisualized in X-ray. Numerous infants and children were misdiagnosed or missed diagnosis. In recent years, more and more scholars both here and abroad pay attention to these facts. It is ultrasonic examination widely used, that effectively improve the diagnostic accuracy. Freshly, the research and application of MRI is developing in the diagnosis of DDH. In this article we reviewed the research progress and using value about physical examination and imaging findings on DDH.

    Effect and nursing care of PPDO thread for counteracting the descent and laxity of the face
    ZHANG Ting, RAO Xiangting, PAN Xiaokang, WU Biying
    2017, 17(04):  498-503.  DOI: 10.3969/j.issn.1009-976X.2017.04.031
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    Objective To observe the effect of PPDO thread adopted to counteract the descent and laxity of the face, as well as summarizing the nursing experience. Methods The clinical data of 28 patients who received the operation from October 2016 to April 2017 were collected from our department. Perioperative regular nursing, skin nursing, psychological assistance and health education, as well as postoperative follow-up were provided for the patients. The perioperative nursing experience of PPDO thread lifting surgery were summarized. Results All the cases were successful with no serious complications occurring. All the patients were satisfied with the effect of the operation and their mental states were stable. Conclusion It is helpful to prevent complications and improve the satisfaction of the operation by intensive nursing.

    Effect of nursing interventions combined with electrical acupuncture on the treatment for community female stress urinary incontinence
    YANG Suhua1, ZHANG Lihua2, CHEN Jing2, JING Linlin2
    2017, 17(04):  500-503.  DOI: 10.3969/j.issn.1009-976X.2017.04.032
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    Objective  To study the effect of nursing interventions combined with electrical acupuncture on the treatment for community female stress urinary incontinence. Methods  Thirty-six patients were assigned to the observation group18 casesand the control group18 cases. Electrical acupuncture was implemented in control group while patients in observation group received nursing interventions combined with electrical acupuncture for 6 weeks. The therapeutic effects between these two groups were evaluated after treatment. Results  Thirty-five patients completed in the 6-week treatment program. In both of the groups, there were significant improvements in 1-hour pad test urine loss and total-score of quality of lifeQOL. There were significant differences between these two groups in 1-hour pad test urine loss and total-score of QOLP<0.001. Conclusion Compared with electrical acupuncture, treatment of nursing interventions combined with electrical acupuncture on SUI demonstrated significant effect in improving urine loss and QOL.

    Critical special care reduce early rebleeding after aneurysmal subarachnoid hemorrhage
    LIANG Miaodan, ZHAO Lihua, LEI Linfang
    2017, 17(04):  504-505.  DOI: 10.3969/j.issn.1009-976X.2017.04.033
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    Objective To analyze the effect of critical special care in preventing and reducing the rebleeding after aneurysmal subarachnoid hemorrhage. Methods Retrospective analysis of 96 patients with aneurysmal subarachnoid hemorrhage received critical special care from January 2012 to December 2015. Results Of 96 cases, ten patients signed out of the hospital, 30 patients received operation within 6 h after onset while other patients within 72 h. A total 14 patients got worse, and 6 of them underwent rebleeding. Conclusions Early critical special care can reduce rebleeding after aneurysmal subarachnoid hemorrhage.

    Analysis on the effect of mindfulness-based stress reduction on occupational stress of hospital nurses
    LI Xiao, ZHOU Meixiang, ZENG Xiong
    2017, 17(04):  506-508.  DOI: 10.3969/j.issn.1009-976X.2017.04.034
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    Objective  To observe the effect of mindfulness-based stress reduction on occupational stress of inpatient nurses. Methods Sixty inpatient nurses were attributed to intervention group and control group 30 cases/each group. The intervention group performed mindfulness based stress reduction therapy, and the control group met regularly on a weekly basis without any intervention. The occupational stress were evaluated in two groups of nurses were before and 4 weeks after intervention respectively. Results After 8 weeks, the emotional exhaustion of the nurses in the intervention group decreased, the score of personality was decreased, the score of personal achievement was increased, and the detection rate of nurses occupational stress was significantly reduced. The difference between the above indicators and the control group were statistically significant. Conclusion The use of mindfulness based stress reduction therapy can alleviate the occupational stress of hospital nurses to a certain extent.

    Nursing strategies for ascending aortic arch replacement combined with descending aortic arch stent“elephant trunk”implantation during deep hypothermic circulatory arrest
    CHEN Shuhong, QIU Yihong, LIANG Min, CHEN Zhaolun, HU Lixuan, LI Ying
    2017, 17(04):  509.  DOI: 10.3969/j.issn.1009-976X.2017.04.035
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    Objective To report the nursing procedure and experience for ascending aortic arch replacement combined with descending aortic arch stent “elephant trunk”implantation during deep hypothermic circulatory arrest. Methods Between May 2013 and December 2016, 38 patients admitted to our hospital for acute type A dissection underwent ascending aortic arch replacement combined with descending aortic arch stent“elephant trunk”implantation during deep hypothermic circulatory arrest. Results The cardiac surgery were successfully accomplished in 38 out of 38 cases, and the patients were followed up for 2 to 27 months to assess the effects of the nursing procedure on Stanford A type aortic dissection surgery during deep hypothermic circulatory arrest. All 38 patients were in good general condition in the period of followed up. Conclusion In Stanford type A aortic dissection patients with ascending aortic arch replacement combined with descending aortic arch stent “elephant trunk” implantation, there were net benefits in the strengthen of nursing management that, at 2 to 27 months of follow up, help reduce the risk of clinical outcomes.