Table of Content

20 June 2020, Volume 20 Issue 03

Previous Issue    Next Issue

Original Articles and Clinical Research

A study on the establishment of the standard for evaluation of gastrointestinal motility in perioperative period

CHEN Zhi-qiang, CAO Li-xing, QIN You, JIANG Zhi, CHEN Qi-cheng.

2020, 20(03):  269-272.  DOI: 10.3969/j.issn.1009-976X.2020.03.001

Asbtract ( )   PDF (1273KB) ( )  

References | Related Articles | Metrics

Objective To establish a scientific evaluation standard for gastrointestinal motility in perioperative period. Methods This approach was to through the application of literature search and research, Delphi method, clinical evaluation method to establish a scientific and standardized evaluation standard of postoperative gastrointestinal motility. First, literature research： search Chinese and English literature databases, determine retrieval strategies, form literature databases, sort out and analyze literature. Second, Delphi method expert consultation： on the basis of literature research, Delphi method was used to conduct peer expert research, select items, and form the first draft of the standard for postoperative gastrointestinal motility evaluation in the perioperative period. The expert group focused on discussing the controversial issues which through five times of expert consultation and research, the final draft of the standard for postoperative gastrointestinal motility evaluation in the perioperative period was formed. Third, clinical evaluation study： evaluate the applicability of the above evaluation criteria in clinical research. Fourth, standard release： it was approved and issued by Guangdong Provincial Bureau of Quality Supervision. Results First, literature research results： the main symptoms of gastrointestinal function recovery in perioperative period were nausea, vomiting, abdominal distention, abdominal pain, diarrhea, exhaust, defecation, etc. Second, the results of Delphi method： after five rounds of national expert questionnaire consultation, the final draft of the standard for postoperative gastrointestinal motility evaluation was formed, and the Objective indicators included exhaust, defecation and bowel sounds; the subjective indicators included abdominal distention, nausea and vomiting; the total score of the standard weighted evaluation was 100 points, good 80~100 points; general 60~79 points; difference 0~59 points. Third, standard release： issued in July 2015 by Guangdong Provincial Bureau of Quality supervision （http：//www.gdqts.gov.cn/zmhd/yjzj/201503/t20150310_ 103772.html. Conclusion In this project, by using literature research, Delphi method and clinical research, a scientific evaluation standard of postoperative gastrointestinal motility in the industry has been established for the first time, which provides a scientific evaluation tool for clinical and research work related to postoperative gastrointestinal function.

Development and validation of prognosis nomogram to predict overall survival in patients with de novo stage Ⅳ breast cancer： a study based on machine learning algorithms

TAN Yu-jie, HE Zi-fan, YU Yun-fang, YAO He-rui

2020, 20(03):  273-279.  DOI: 10.3969/j.issn.1009-976X.2020.03.002

Asbtract ( )   PDF (5199KB) ( )  

References | Related Articles | Metrics

Objective The aim of this study was to construct a prognosis nomogram for patients with de novo stage Ⅳ breast cancer, screening out those who could benefit from locoregional surgery.Methods The clinicopathologic characteristics of 7379 patients with de novo stage Ⅳ breast cancer in SEER database from 1973-2015 were analyzed. Overall survival（OS） was estimated using the Kaplan-Meier method and the log-rank test. Least Absolute Shrinkage and Selector Operation （LASSO） regression analysis were used to screen out the clinicopathologic characteristics which related to the prognosis of patients. The risk score equation was established by multivariate Cox regression analysis and the risk prognosis model was constructed. The predictive accuracy of nomogram was assessed by using operating characteristic curve （ROC） analysis, calculating the area under the curves （AUC）, and concordance index （C-index）. Results Among 7379 patients included in this study, 2703 patients （36.6%） received locoregional surgery and 4676 patients （63.4%） underwent no surgery. LASSO regression analysis screened out 10 clinicopathologic characteristics （age, histologic type, clinical tumor stage, ER status, PR status, HER-2 status, bone metastasis, liver metastasis, lung metastasis, lymph metastasis） which were independent prognosis factors and could be used to constructed risk model for predicting the prognosis of patients. The model predicted well in 1-year and 3-year OS in development cohort （AUCs for 1-, 3-year OS of 0.75, 0.73, respectively） and validation cohort （AUCs for 1-, 3-year OS of 0.72, 0.75, respectively）. C-index of the model was 0.700 （95%CI： 0.69-0.71） and 0.695 （95%CI： 0.67-0.71） respectively in development cohort and validation cohort. According to risk score, patients could divide into low-risk group, medium-risk group, and high-risk group. Kaplan-Meier analyses showed that patients from low-risk and medium-risk group could benefit from locoregional surgery（low-riskgroup： development cohort：HR=0.49, 95%CI：0.42~0.57, P<0.001;validation cohort： HR=0.43, 95%CI： 0.34~0.55, P<0.001; medium-risk group：development cohort： HR=0.75, 95%CI：0.65~0.86, P<0.001; validation cohort：HR=0.72, 95%CI：0.57~0.90, P=0.003）, whereas patients underwent locoregional surgery from high-risk group couldn't improve OS（development cohort： HR=0.65, 95%CI： 0.41~1.02, P=0.06; validation cohort： HR=0.83, 95%CI： 0.41~1.69, P=0.61）. Conclusion The prognosis nomogram of patients with de novo stage Ⅳ breast cancer was constructed based on machine learning algorithms, which could effectively distinguish patients between low-risk group, medium-risk group, and high-risk group. Moreover, locoregional surgery was not recommended for patients from high-risk group （> 360）.

Effect on biological function after XPO1 knockout in pancreatic cancer cell line via CRISPR/Cas9

HUANG Xian-xian, LI Yuan-hua, HUANG Feng-ting, ZHANG Shi-neng, ZHUANG Yan-yan.

2020, 20(03):  280-284.  DOI: 10.3969/j.issn.1009-976X.2020.03.003

Asbtract ( )   PDF (3278KB) ( )  

References | Related Articles | Metrics

Objective To construct an XPO1-knockout pancreatic cancer cell line MIA-Paca2 using CRISPR/Cas9 technology, and to investigatethe effect of XPO1-knockout on cell biological function. Methods The sgRNA-XPO1 plasmid was constructed, packaged into lentivirus-infected MIA-Paca2 cells, and stable transgenic strains of XPO1 knockout were obtained by screening with a suitable concentration of puromycin. DNA sequencing and Western blotting were used to detect the efficiency of XPO1 knockout; Flow cytometry analysis and CCK8 assay were used to detect apoptosis, cell cycle and thehalf inhibitory concentration （IC₅₀） of gemcitabine. Results DNA sequencing showed a frameshift mutation in the gene sequence encoding XPO1 protein. Western blotting showed that the expression of XPO1 protein in the MIA-Paca2 cell line after XPO1 gene knockout was significantly reduced.Flow cytometry analysis and CCK8 assay suggested that apoptosis and the proportion of G2/M cells increased after XPO1 gene knockout, while IC₅₀ on gemcitabine decreased. Conclusion XPO1-knockout MIA-Paca2 was successfully constructed via CRISPR/Cas9. XPO1 knockout can promote apoptosis, induce G2/M phase arrest in the cell cycle, and enhance the chemotherapy sensitivity to gemcitabine.

Comparative study of the effects of minimally invasive treatment of gallbladder stones and common bile duct stones

LIN Qi-rui, ZHANG Yan-qiang, SONG Xiao-rui, LIU Su, HUANG Dong, ZHOU Wan-bang, YIN Yao-xin, LONG Guang-hui, OU Xi, LIN Ze-wei, LIU Ji-kui, LIU Xiao-ping

2020, 20(03):  285-290.  DOI: 10.3969/j.issn.1009-976X.2020.03.004

Asbtract ( )   PDF (1316KB) ( )  

References | Related Articles | Metrics

Objective To compare the clinical efficacy of three minimally invasive surgical approaches for gallstones and common bile duct,which are laparoscopic common bile duct exploration （LCBDE）+primary closure （PS）+laparoscopic cholecystectomy （LC）,laparoscopic common bile duct exploration+T-tube drainage （TD）+laparoscopic cholecystectomy and endoscopic retrograde cholangiopancreatography （ERCP）+laparoscopic cholecystectomy. Methods Collect clinical data of 229 patients who underwent surgery for common bile duct stones at Peking University Shenzhen Hospital from July 2012 to July 2017, and compare and analyze the three minimally invasive treatments before surgery. Evaluation of the differences in postoperative and hospitalization time and cost between the three surgical methods. Results The three groups of patients were： age, gender, preoperative ALT, preoperative TBil, common bile duct diameter, number of common bile duct stones, and bile The difference in the maximum diameter of the common stones was not statistically significant （P>0.05）; there was no statistical difference in the incidence of postoperative TBil, postoperative analgesia, and postoperative complications among the three groups. Significance （P>0.05）; ERCP+LC group has shorter operation time than LCBDE+PS+LC group and LCBDE+TD+LC group. There is less bleeding during surgery. Postoperative abdominal drainage time and postoperative antibiotic use time are shorter, but the transition High rate, long postoperative fasting time, and slow recovery of ALT; LCBDE+PS+LC group has shorter postoperative hospital stay than ERCP+LC group and LCBDE+TD+LC group; hospitalization costs between the three groups ERCP+LC group> LCBDE+TD+LC group> LCBDE+PS+LC group. Conclusion The ERCP + LC group has the advantages of shorter operation time, less bleeding during the operation, shorter postoperative abdominal drainage time, and shorter antibiotic use time. Disadvantages of long postoperative fasting time： LCBDE+PS+LC group recovers faster than LCBDE+TD+LC group after surgery, with less impact on quality of life, and the incidence of complications does not increase significantly.

The application value of enhanced recovery after surgery in the perioperative period of right hepatectomy

ZHOU Bing, SUN Yong, XIA Yuan.

2020, 20(03):  291-295.  DOI: 10.3969/j.issn.1009-976X.2020.03.005

Asbtract ( )   PDF (1415KB) ( )  

References | Related Articles | Metrics

Objective To explore the clinical value of enhanced recovery after surgery nuring in right hepatectomy. Methods Analysis from August 2017 to August 2019 were right liver resection in our hospital clinical data of 53 patients, according to different perioperative treatment methods, they were divided into the ERAS group and the control group. Preoperative and intraoperative clinical data were compared between the two groups, as well as postoperative hospital stay, anal exhaust recovery time, total hospitalization costs, complications, postoperative recovery quality and CRP. Results The preoperative clinical data of the two groups of patients were comparable without statistically significant difference. There was no significant difference between the two groups in terms of operation time and intraoperative blood loss. There were significant differences between the two groups in terms of anal recovery and exhaust time, postoperative hospitalization time, total hospitalization cost and complications （t=3.728, 9.599, 5.666, χ²=3.865, P values <0.05）. The ERAS group had a higher recovery quality score after surgery than the control group （P<0.05）, and the similar value in the ERAS group had lower values than the latter in terms of CRP （P<0.05）. Conclusion In the perioperative period of right hepatectomy, the accelerated rehabilitation surgery mode can effectively shorten the length of hospital stay, reduce hospitalization costs, postoperative complications and postoperative traumatic stress response, thus promoting rapid recovery of patients.

Effect of liver fibrosis index on survival of patients with primary hepatic cancer after surgical treatment

SUN Zhen-zhi

2020, 20(03):  296-299.  DOI: 10.3969/j.issn.1009-976X.2020.03.006

Asbtract ( )   PDF (1290KB) ( )  

References | Related Articles | Metrics

Objective To investigate the effect of liver fibrosis index （FI） on the survival status of patients with primary liver cancer after surgical treatment. Methods A total of 82 patients with primary liver cancer who underwent liver resection during our hospital from January 2010 to December 2014 were selected as the research subjects. They were divided into high fibrosis groups according to the preoperative blood FI level （FI>5.4, n=45） and low fibrosis group （FI≤5.4, n=37）. Kaplan-Meier method was used to calculate the tumor-free survival rate of the two groups of patients, and the log-rank test was used for comparison. The univariate and multivariate Cox regression analysis was used to analyze the relevant risk factors affecting postoperative recurrence. Results The follow-up results showed that the tumor-free survival rates of all patients at 1, 3, and 5 years were 79.7%, 68.2%, and 32.7%。 The 1-, 3-, and 5-year tumor-free survival rates of the high liver fibrosis group and the low liver fibrosis group were 69.8%, 32.5%, 21.6% and 93.8%, 45.3%, and 45.3%, respectively, and the differences were statistically significant （P<0.05）. Multivariate Cox regression analysis showed that preoperative AFP-L3≥10%, FI>5.4, vascular tumor thrombus and postoperative liver dysfunction were independent risk factors for postoperative recurrence, and the differences were statistically significant （P<0.05）. Conclusion Preoperative FI>5.4 is an independent risk factor for postoperative recurrence in patients with primary liver cancer, and has certain predictive value for the prognosis of patients.

Timing of stoma closure after necrotizing enterocolitis in neonates

CHU Dong-dong, MAO Jian-xiong, XIAO Dong

2020, 20(03):  300-303.  DOI: 10.3969/j.issn.1009-976X.2020.03.007

Asbtract ( )   PDF (1285KB) ( )  

References | Related Articles | Metrics

Objective Most neonates with necrotizing enterocolitis （NEC） requiring bowel resection and enterostomy. But the optimal timing of ostomy closure is a matter of debate. The purpose of this study was to determine the ideal time for stoma closure in infants with necrotizing enterocolitis. Methods This study retrospectively analyzed the data of infants undergoing necrotic intestinal resection and enterostomy due to NEC from August 2010 to January 2019 in Shenzhen Children's Hospital Neonatal Surgery. For analysis, we define early closure （EC） as 8 weeks （including 8 weeks） after enterostomy, and late closure （LC） as 8 weeks after enterostomy. Results Of the 58 children, 35 were male and 23 were female. The surgical indication was 40 cases of pneumoperitoneum and 18 cases of infections that could not be controlled by conservative treatment, of which 27 cases were early closure （EC） and 31 cases were late closure （LC）. 18 patients in the EC group required ventilator support （66.67%）, while 10 patients in the LC group （32.26%） （P<0.05）. The EC group required longer bowels than the LC group External nutritional support; and the length of hospital stay in the EC group was much longer than that in the LC group. Thirteen patients underwent reoperation for adhesion intestinal obstruction （of which 7 cases, LC group 6 cases）. In the EC group, 4 patients had poor postoperative incision healing, 2 patients died of sepsis, and 1 patients died of short bowel syndrome and severe malnutrition. All patients in the LC group recovered well after surgery and all survived. Conclusion This study suggests that the late stoma closure after NEC enterostomy is significantly better than the early closure.

Effect of video-assisted and beating heart surgical treatment of tricuspid regurgitation late after valve replacement of left heart

LIANG Hua, ZHANG Fei, LUO Yi-xuan

2020, 20(03):  304-306.  DOI: 10.3969/j.issn.1009-976X.2020.03.008

Asbtract ( )   PDF (1261KB) ( )  

References | Related Articles | Metrics

Objective To investigate the outcome of video-assisted and beating heart surgical treatment of severe tricuspid regurgitation late after valve replacement of left heart. Methods Eleven patients with severe tricuspid insufficiency,with the diagnosis conformed by echocardiogram,were treated surgically after left heart valve replacement from February 2009 to February 2018, including 8 mitral valve replacements and 3 double valve replacements. DeVega repair of tricuspid bad been used in 9 patients in the first operation. Results Tricuspid repair was performed in 2 patients,tricuspid replacement was done in 9 patients. The mechanical valves were implanted in 4 patients and biothesis valves in 5 patients.The low cardiac output and multiple organ failure were the causes of death. Two patients died during perioperative period （total hospital mortality was 18%）, both were valve replacement patients in cardioplegia group. Postoperative pericardial drainage volume in beating group were significantly less than those in cardioplegia group （P<0.05）. There were 4 cases of severe low cardiac output syndrome in cardiaplegia group and 1 case in beating group. Echocardiography showed that the right atrium and ventricle were significantly reduced and there was no or mild tricuspid regurgitation in the two groups. There was no significant difference between the two groups. The patients were followed up for 5.1 years （7 months~8 years）. Among the survivors, all patients showed improvement of symptoms,while most patients needed medical therapy. Conclusion The surgical intervention should be earlier before the onset of severe right ventricular failure. Minimally invasive beating heart surgery and proper peri-operative care is the key to successful operation. For end-stage cases, surgical mortality is high, the indication of valve replacement surgery should be cautious, cardiac ultrasound and magnetic resonance detection indicators for the right cardiac system should be actively carried out, and the surgical risk should be comprehensively evaluated.

Effect of overexpression of POLE2 on invasion and migration of non-small cell lung cancer cells

JI Lu-peng, PENG An-ping, ZHANG Yi, LIANG Ting-du

2020, 20(03):  307-310.  DOI: 10.3969/j.issn.1009-976X.2020.03.009

Asbtract ( )   PDF (1498KB) ( )  

References | Related Articles | Metrics

Objective To investigate the effect of POLE2 on the invasion and migration of non-small cell lung cancer （NSCLC） cells. Methods The expression of POLE2 in human NSCLC cells BEAS-2B and A549,human bronchial epithelial cell line SPC-A1 was detected by real-time PCR （qRT-PCR）. The POLE2-overexpression cell was established. The transfection efficiency was verified by qRT PCR and Western blot. Cell counting kit-8 （CCK-8） was used to detect the proliferation of NSCLC cells, Transwell was used to detect the invasion and migration of NSCLC cells, and qRT-PCR was used to detect the expression of MMP9. Results The expression level of POLE2 in human NSCLC cells SPC-A1 and A549 was significantly higher than that of BEAS-2B （P<0.05）. Overexpression of POLE2 promoted the proliferation, invasion and migration of A549 cells, and upregulated the expression of MMP9（P<0.05）. Conclusion Overexpression of POLE2 may promote the invasion and migration of NSCLC cells by up regulating MMP9.

Application of combination femoral nerve with sciatic nerve block in patients undergoing ankle arthroscopic surgery

ZHANG Xue-rong, YANG Xue-ying

2020, 20(03):  311-314.  DOI: 10.3969/j.issn.1009-976X.2020.03.010

Asbtract ( )   PDF (1328KB) ( )  

References | Related Articles | Metrics

Objective To compare the effects of two different anesthesia methods in patients undergoing ankle arthroscopic surgery. Methods Sixty adult patients undergoing ankle arthroscopic surgery in Sun Yat-sen Memorial Hospital from January 2018 to December 2019 were randomly divided into femoral nerve group and lumbar plexus group, with 30 cases in each group. The femoral nerve group received combination of femoral nerve with sciatic nerve block, and the lumbar plexus group received combination of lumbar plexus with sciatic nerve block. The effects of anesthesia and analgesia, the operation time of anesthesia, heart rate and mean blood pressure at different times, complications and adverse reactions of anesthesia were compared between the two groups. Results There were no statistically significant differences between the two groups in the number of patients who used supplementary local anesthetics and anesthetic analgesic drugs during the operation, VAS score at rest or with movement and the number patients who used additional analgesics within 24 hours after the operation. The anesthetic operation time of femoral nerve group was significantly less than that of lumbar plexus group. The heart rate and mean blood pressure of femoral nerve group during anesthetic operation were significantly lower than that of lumbar plexus group. The side effects showed no significant differences between groups. Conclusion There were no significant difference in anesthesia and postoperative analgesia effect between combination femoral nerve with sciatic nerve block and combination lumbar plexus with sciatic nerve block during ankle arthroscopic surgery, however, the former had shorter anesthetic operation time and more stable perioperative vital signs.

Repair of soft tissue defect of dorsal foot in adults using uperficial circumflex iliac artery perforator superthin flaps

FU Bing-jin, YANG Jia-lin, DENG Ming-ming, DU Rui, SUN Guang-chao, YIN Gang

2020, 20(03):  315-318.  DOI: 10.3969/j.issn.1009-976X.2020.03.013

Asbtract ( )   PDF (2535KB) ( )  

References | Related Articles | Metrics

Objective To analyze the clinical effect of uperficial circumflex iliac artery perforator superthin flaps in repair of soft tissue defect of dorsal foot in adults. Methods The clinical data of 19 cases of soft tissue defect of dorsal foot with bone or tendon exposure from 2014 to 2017 in the Affiliated Hospital of Binzhou Medical College were analyzed retrospectively,the soft tissue defect was repaired by uperficial circumflex iliac artery perforator superthin flap, primary or secondary defect repair,and the donor area was sutured directly. Results All the patients were followed up for an average of 1~5 years, and the soft tissue defect of dorsal foot was repaired effectively. 3 cases had local necrosis of 0.5~1 cm flap edge. After the necrosis boundary was cleared, the flap healed well through suturing again. 1 case had blood stasis under the flap, swelling of the flap, but the flap survived through intermittent suture removal, removal of congestion and full drainage. 1 case presented with arterial crisis, which emergency operation was performed. The embolus with a length of about 0.5 cm was found by exploration. The embolus was removed and the artery was anastomosed again, and the flap survived well.The skin flap was beautiful in appearance, soft in texture and suitable in thickness. At the last follow-up, the AOFAS ankle posterior foot score was （91.02 ± 1.74）, the function was excellent in 14 cases （74%）, good in 4 cases （21%）. The excellent and good rate of AOFAS was 95%, and the function of affected limb recovered well. Conclusion The uperficial circumflex iliac artery perforator superthin flap can be used to repair the soft tissue defect of dorsal foot in adults. The skin flap is beautiful in appearance, soft in texture and suitable in thickness, which can achieve good clinical effect.

The expression of FOS-like antigen 1 in head and neck squamous cell carcinoma and its clinical significance

GAO Xiao-lin, XIU Xia, QIU Ping-ping, ZHANG DU-he-yi, XIE Shu-le, LIN Zhao-yu

2020, 20(03):  319-323.  DOI: 10.3969/j.issn.1009-976X.2020.03.012

Asbtract ( )   PDF (2383KB) ( )  

References | Related Articles | Metrics

Objective To detect the expression of FOS-like antigen 1 （FOSL1） in head and neck squamous cell carcinoma （HNSC） and to investigate the correlation between its expression and the clinical data or prognosis of HNSC patients. Methods The expression of FOSL1 in 98 HNSC patients and the adjacent normal tissues were predicted by UALCAN microarray database. The expression of FOSL1 in head and neck squamous cell carcinoma tissues and normal tissues was further detected by immunohistochemistry （IHC）. The relationship between the FOSL1 expression and clinical characteristics was analyzed bytest, and Kaplan-Meier methods were used to analysis the correlation between FOSL1 protein and HNSC patients' survival. Results UALCAN database and IHC assays showed that the expression of FOSL1 protein in HNSC was significantly higher than that in normal tissues （P<0.05）. The expression of FOSL1 protein was closely correlated with tumor size, lymph node metastasis, pathological grading and HPV status （P<0.05）. Survival analysis showed that the survival rate of FOSL1 high expression group was significantly lower than that of FOSL1 low expression group （P<0.05）. Conclusion FOSL1 is involved in the development and progression of HNSC, and may be useful in evaluating the prognosis.

Effect of Zero profile anterior cervical interbody fusion cage in treating of the single segmental cervical spondylotic myelopathy

FU Chao-hua, JIANG Xiong-jian, QIN Ying, LAO Yong-bin, XIANG Shan-shan, CHEN Zhong-xian

2020, 20(03):  324-327.  DOI: 10.3969/j.issn.1009-976X.2020.03.013

Asbtract ( )   PDF (2412KB) ( )  

References | Related Articles | Metrics

Objective To observe the clinical effect of Zero profile anterior cervical interbody fusion in treating of the single segmental cervical spondylotic myelopathy （CSM） and analyze the operative characteristics. Methods Twenty-three patients with single segmental CSM were treated by Zero profile anterior cervical interbody fusion. Clinical outcome according to VSA and JOA scoring system,Dysphagia, lordosis angle of cervical spine and intervertebral space angle and height on radiographs were recorded preoperatively and postoperatively. Results All patients were followed up for an average of 12 months. The average cervical and limb VAS score decreased from 3.2±1.5, 6.5±1.6 preoperatively to 2.8±1.6, 1.2±0.7 at the final follow-up; the average JOA score increased from 9.4±1.9 preoperatively to14.8±1.9 at the final follow-up. The good to excellent rate was 100%. The intervertebral height and Cobbs angle in the immediate postoperative and the last follow-up were significantly increased compared to preoperation. Conclusion Zero profile ACDF in treating of the single segmental CSM is a good technique which can effectively maintain the physiological vertebral lordosis and intervertebral height, provide long time stability and achieve satisfactory clinical results with less injury.

Comparison of effect of morphine periarticular multimodal drug injection and intrathecal injection on pain and join function after total knee arthroplasty

LIU Ming-ming, XU Zhi-qiang, LI Guo-jian

2020, 20(03):  328-332.  DOI: 10.3969/j.issn.1009-976X.2020.03.014

Asbtract ( )   PDF (1297KB) ( )  

References | Related Articles | Metrics

Objective To compare the effect of morphine periarticular multimodal drug injection （PMDI） and intrathecal injection on pain and join function after total knee arthroplasty （TKA）. Methods 153 received TKA patients were retrospectively analyzed and assigned to the control group, PMDI group and intrathecal injection group （n=51）. Patients in the control group received regular spinal anesthesia and PMDI. Patients in the PMDI group received morphine 10 mg PMDI, and patients in the intrathecal injection group received morphine 0.1 mg intrathecal injection. Patients' visual analog scale （VAS） pain scores, tramadol usage, first using tramadol time, range of active knee flexion, vomiting times, usage of anti-nausea drugs were recorded postoperatively. Results VAS pain scores were significantly lower in the PMDI group and the intrathecal injection group than those in the control group in postoperative 6, 12 and 24 h （P<0.05）, and they were significantly lower in the intrathecal injection group than those in the PMDI group （P<0.05）. Tramadol usages were significantly lower in the PMDI group and the intrathecal injection group than those in the control group in postoperative 12 and 24 h （P<0.05）, and they were significantly lower in the intrathecal injection group than those in the PMDI group （P<0.05）. The first using tramadol time was significantly lower in the PMDI group and the intrathecal injection group than that in the control group （P<0.05）, and it was significantly lower in the intrathecal injection group than that in the PMDI group （P<0.05）. The ranges of active knee flexion were significantly larger in the PMDI group and the intrathecal injection group than those in the control group in postoperative 12 and 24 h （P<0.05）, and they were significantly larger in the intrathecal injection group than those in the PMDI group （P<0.05）. Vomiting times and usages of anti-nausea drugs were significantly more than those in the control group in postoperative 12, 24 and 48 h （P<0.05）, and they were significantly more in the PMDI group than those in the intrathecal injection group （P<0.05）. Conclusion Morphine PMDI and Ⅱ are both effective analgesic methods, and morphine Ⅱ is more effective in relieving postoperative pain and increasing knee function than morphine PMDI. However, morphine PMDI and Ⅱ both could increase the incidence rate of vomiting after TKA, which needs more attention from doctors.

Feasibility of transumbilical single-incision laparoscopic-assisted appendectomy and enhanced recovery after surgery in acute appendicitis

CHEN Liu-xiang, TENG Fan-wu, CHEN Xiao-feng

2020, 20(03):  333-337.  DOI: 10.3969/j.issn.1009-976X.2020.03.015

Asbtract ( )   PDF (1316KB) ( )  

References | Related Articles | Metrics

Objective Transumbilical single-incision laparoscopic-assisted appendectomy （TSLAA） was a surgical technique that used a combined intra- and extracorporeal method for acute appendicitis. The aim of this study was to compare the clinical outcome and safety between TSLAA and traditional laparoscopic appendectomy （LA）. Methods Patients with acute appendicitis between January 2017 and October 2019 who underwent laparoscopic appendectomy and received perioperative enhanced recovery after surgery （ERAS） protocal were analyzed retrospectively. All the enrolled patients were divided into two groups according to different surgical methods： TSLAA （47 cases） and LA （92 cases）. The perioperative parameters were compared between two groups. Results TSLAA group and LA group was comparable in terms of preoperative general information and cases in TSLAA group had lower BMI and shorter duration of abdominal pain. No differences were found in operation time and intraoperative blood loss between two goups. Only one case in TSLAA group was converse to LA. A better pain control and satisfaction score during hospitalization were noticed in TSLAA group. Postoperative recovery of gastrointestinal functions were similar between two groups. The incidences of overall complication tended to be lower in TSLAA group, however no statistical differences were found between two groups. Moreover, patients in the TSLAA group had intraoperative cost （5863.4 yuan） and perioperative expenses （6354.3 yuan）. Conclusion TSLAA was a safe and feasible technique and it may be a useful more minimally invasive alternative to acute appendicitis

The effect of Ulinastatin on the concentration of SOD and MDA in patients undergoing supratentorial tumor resection

LIU Shi-le, ZHOU Cui-yun, YUAN You-hong, LUO Cheng-lei, CHEN Han-wen, TANG Shu-yi, XING Zu-min

2020, 20(03):  338-340.  DOI: 10.3969/j.issn.1009-976X.2020.03.016

Asbtract ( )   PDF (1265KB) ( )  

References | Related Articles | Metrics

Objective To observe the concentration of superoxide dismutase （SOD）, malondialdehyde （MDA） in patients undergoing supratentorial tumor resection with Ulinastatin treatment. Methods 24 patients with supratentorial tumor resection,aged between 18 and 55 yeas old, ASAⅠorⅡ, were randomly divided into the control group （group A, n=12） and Ulinastatin groups （group U, n=12）. Patients in Group U received Ulinastatin （2 kU/kg） at the beginning of the surgery, with the continuous dose of 1 kU·kg^-1·h^-1 till the end of the operation. Group A received equivalent volume of saline solution as the vehilcle control. Blood samples were taken from the artery and jugular venous bulb before induction of anesthesia （T₁）, skin incision （T₂）,1 h after dura openning （T₃）, at the closure of dura （T₄）, at the end of operation （T₅）and 24 h after operation （T₆） to analysis the concentration of superoxide dismutase （SOD） andmalondialdehyde （MDA）. The concentration of superoxide dismutase （SOD）, malondialdehyde （MDA） were determined by improved hydroxylamine hydrochloride method and TAB fluorescence method. Results The concentration of serum MDA were more dramatic rise at T₃-T₆ than at T₁ in both groups. The concentration of serum SOD were more dramatic decline at T₃-T₆ than at T₁ in both groups. The concentration of SOD and MDA increasd and decreased significantly at T₃-T₆ in group U than that in group A （P<0.001）. Conclusion Ulinastatin can improve the concentration of serum SOD and decrease MDA during surgery, which indicates the alleviating for the brain injury during supratentorial tumor resection.

Anesthesia management of Beckwith-Wiedemann syndrome：a case report and review of literatures

YANG Shu-ting, PENG Yu-xuan, DU Su-juan, YE Xi-jiu.

2020, 20(03):  341-345.  DOI: 10.3969/j.issn.1009-976X.2020.03.017

Asbtract ( )   PDF (1799KB) ( )  

References | Related Articles | Metrics

Objective To investigate the anesthesia management of Beckwith-Wiedemann syndrome. Methods The anesthesia management of a child with Beckwith-Wiedemann syndrome was retrospectively analyzed,and the related literatures were reviewed. Results After sufficient preoperative systemic evaluation,knowing the patient's history and confirming the risks such as difficult airway and hypoglycaemia, an intravenous induction and intubation were succeed and the operation was successfully completed under combined intravenous and inhalation anesthesia. The patient recovered well after operation. Conclusion Difficult airway caused by macroglossia and hypoglycaemia are the main problems in BWS anesthesia management. Anesthesiologists should fully understand these problems and make appropriate preoperative evaluation of BWS patients so as to formulate appropriate anesthesia management plan.

Observation of the effect of low-dose dexmedetomidine combined with propofol titration induction during transvaginal oocyte retrieval

LI Ling, LIU Guo-dong, YU Chun-yu, OUYANG Hui-wang, WU Jian, CAI Hong-mei

2020, 20(03):  346-349.  DOI: 10.3969/j.issn.1009-976X.2020.03.018

Asbtract ( )   PDF (1323KB) ( )  

References | Related Articles | Metrics

Objective To observe the effect of dexmedetomidine combined with propofol titration induction on the safety and comfort of patients undergoing transvaginal oocyte retrieval. Methods 100 patients undergoing transvaginal oocyte retrieval from May 2019 to October 2019 in Foshan Maternal and Child Health Hospital were randomized into group D （dexmedetomidine combined with propofol group） and group C （propofol group） according to the Random-number Table, with 50 cases in each group. That the MOSS/A reach 0 was used as the end point dring titration induction. The mean arterial pressure （MAP）, heart rate （HR）, pulse oxygen saturation （SpO₂） were compared between the two groups at different time points. Propofol dosage, patient satisfaction and adverse reactions were recorded. Results Propofol dosage in group D is lower than that in group C （P<0.05）. The frequency of respiratory depression, body movement during operation and postoperative abdominal pain in group D were significantly lower than those in group C （P<0.05）. There was no statistically significant in propofol-induced injection pain and comfort scores between the two group （P>0.05）. The incidence of bradycardia and hypotension in the two groups was not statistically significant （P>0.05）. Conclusion Compared with propofol alone, dexmedetomidine combined with propofol can reduce the dosage of propofol and the incidence of respiratory depression,body movement during operation and postoperative abdominal pain, so it is safer to be used during transvaginal oocyte retrieval.

BRCA1/2 gene mutation is correlated with tumor mutation burden in breast invasive ductal carcinoma

LIAO Jianwei, WU Wei, LI Xiao-juan, XIAO Xiao-qin, JIANG Yuan-lin, PENG Xiao-fang, OUYANG Neng-tai

2020, 20(03):  350-354.  DOI: 10.3969/j.issn.1009-976X.2020.03.019

Asbtract ( )   PDF (1480KB) ( )  

References | Related Articles | Metrics

Objective To provide reference for uncovering biomarkers for immunotherapy,we investigated the correlation between multiple gene mutationswith tumor mutation burden （TMB） in invasive ductal carcinoma of breast. Methods 32 cases were grouped by ER, PR and HER2 status using immunohistochemistry. Then target capture sequencing was applied to analyze gene variants including somatic variant, germline variant, microsatellite instability and tumor mutation burden. Results Four cases are triple negative, four cases are HER2 positive alone, and other 24 cases are hormone receptor positive types （including Luminal A and B）. The two most common mutations are loss-of-function mutation of TP53 and gain-of-function mutation of PIK3CA, with incidence rates 84.4% and 50.0%, respectively. No MSI-H cases are found. There are 18 cases with TMB value greater than or equal to 5. Only 6 cases are found BRCA1/2 mutated. TMB is not correlated to receptor classification, TP53 mutation or PIK3CA mutation, but is related to BRCA1/2 mutation. TMB of BRCA1/2 mutated cases is 11.9±9.73, while that of cases without BRCA1/2 mutation is 5.62±3.67. Higher TMB is found in cases with BRCA1/2 gene mutations. Conclusion The invasive ductal carcinoma of breast with BRCA1/2 has higher TMB.

Anti-tumor effects of RNA interference silencing on the FasL expression of gastric cancer cells

HE Mao-qin, TAN Xiao-xing, Ahetibieke, MA Bo, LI Jian-hui

2020, 20(03):  355-359.  DOI: 10.3969/j.issn.1009-976X.2020.03.020

Asbtract ( )   PDF (2647KB) ( )  

References | Related Articles | Metrics

Objective To verify the FasL expression of gastric cancer cells that induces tumor-specific CD8⁺CTL apoptosis mediates the immune evasion and prove RNA interference silences the FasL expression of gastric cancer cells can enhance antitumor function by increasing the number of tumor-specific lymphocytes. Methods Targeted FasL shRNA was design and screened to transfect gastric cancer cells by using liposome to silence the FasL expression. The experimental group（transfect targeted plasmid）, negative group and （transfect idler plasmid）blank group（without transfect） were set up,and then observing the effects of gastric cancer cells on inducing tumor-specific CTL apoptosis and antitumor function in the cell co-culture system with tumor-specific CD8⁺CTL. The FasL expression in gastric cancer cells was detected by flow cytometry. And the results of co-culture with gastric cancer cells and tumor-specific CD8⁺CTL were determined by MTT method. Results In the experimental group, those gastric cancer cells transfected by FasL-siRNA expressed a lower level of FasL which was significant in statistics compared with blank group. Compared with negative group and blank group, there existed more lymphocytes in the experimental group （differences between groups were significant in statistics, P<0.05）. Conclusion In the present study, Using RNA interference reduced the FasL expression of gastric cancer cells that enhanced the function of lymphocytes killing cancer cells.

Safety of laparoscopic colorectal surgery in patients with peritoneal dialysis

SONG Shun-xin, ZHANG Jian-wen

2020, 20(03):  360-362.  DOI: 10.3969/j.issn.1009-976X.2020.03.021

Asbtract ( )   PDF (1258KB) ( )  

References | Related Articles | Metrics

Objective To explore the safety of laparoscopic colorectal surgery in patients with peritoneal dialysis （PD）. Methods Retrospective analysis a total of 310 patients underwent laparoscopic colorectal surgery for colorectal cancer at of Chenzhou NO.1 people's hospitalduring June 2016 to December 2018. Among them, four had PD when they underwent surgery. We retrospectively investigated the clinical characteristics of these four cases. Results All patients were treated with laparoscopiccolorectal surgery successfully.The time of operation was from 180 min to 240 min．The patients were discharged 10~15 days following the operation,no serious complications. Conclusion Our study suggests that laparoscopic colorectal surgeries in patients with PD may be safety and reliably. Future studies should aim to better standardize the perioperative management of PD during laparoscopic colorectal surgery.

Experience in the application of Enhanced Recovery After Surgery after laparoscopic gastrectomy

BAI Ying-wei, YANG Lin-hai, ZHANG Huai-bo

2020, 20(03):  363-366.  DOI: 10.3969/j.issn.1009-976X.2020.03.022

Asbtract ( )   PDF (1273KB) ( )  

References | Related Articles | Metrics

Objective To explore the application and experience of Enhanced Recovery After Surgery after laparoscopic gastrectomy. Methods The clinical data of 23 patients （ERAS group） who underwent laparoscopic gastrectomy for gastric cancer from February 2018 to October 2019 were collected and retrospectively analyzed. In addition, 23 patients with gastric cancer were selected as the controls （routine group）. Laparoscopic D2 radical gastrectomy combined with complete mesocolic excision was performed in all patients. ERAS protocol was implemented by referring to the previous literature. Results Compared with the routine group, the postoperative hospital stay in ERAS group was shorter （7.8±1.3 days and 6.7±1.4 days respectively）; the early postoperative food intake in ERAS group was earlier （2.9±0.7）days than that in routine group （3.5±0.8 days）; the defecation time in ERAs group was shorter （3.1±0.7）day than that in routine group （3.6 ± 0.8 days）. There were also significant differences in activity time （2.6±0.9 day in ERAS group and 3.1±1.0 days in routine group） between the two groups. There was no significant difference in the incidence of complications between Era Group and routine group （P=0.437）. Conclusion ERAS protocol has the characteristics of quick postoperative recovery, but the author realized that the application of ERAS protocol is mainly based on the experience of surgeons during and after the operation, which is related to the personalized treatment of patients.

Analysis of risk factor between asymptomatic carotid intraplaque hemorrhage and cerebral infarction and death after coronary stent implantation

LI Wan-chun, GAO Yan-sheng

2020, 20(03):  367-370.  DOI: 10.3969/j.issn.1009-976X.2020.03.023

Asbtract ( )   PDF (1279KB) ( )  

References | Related Articles | Metrics

Objective To investigate risk factors for postoperative ipsilateral cerebral infarction and all-cause mortality after coronary stent implantation in patients with asymptomatic carotid artery stenosis （ACS）. Methods 110 patients with carotid stenosis of 50% or more were included in the study. The relationship including carotid intraplaque hemorrhage （IPH）, ipsilateral cerebral infarction and all-cause mortality was analyzed retrospectively. Results Sixteen cases of IPH occurred in 110 ACS patients（14.5%）. Six cases of IPH （37.5%） and 6 cases （6.4%） encountered ipsilateral infarction and all-cause mortality, respectively. Multivariate Cox regression analysis showed that IPH was a predictor of ipsilateral cerebral infarction （HR：18.47,95%CI： 5.14~76.08,P<0.001）and all-cause mortality and all-cause mortality （HR：4.26, 95%CI： 1.48~11.76, P=0.016）. Conclusion In patients with ACS undergoing coronary stent implantation, IPH is associated with a high risk of postoperative cerebral infarction and all-cause mortality.

Efficacy of locking compression plate systemfor treatment of senile patients with proximal humerus fractures

CHEN Jun-ping, WANG Guo-shou, TAN Wei-yuan

2020, 20(03):  371-375.  DOI: 10.3969/j.issn.1009-976X.2020.03.024

Asbtract ( )   PDF (1895KB) ( )  

References | Related Articles | Metrics

Objective To summarize the clinical effect of locking compression plate fixation in senile patients with proximal humerus fractures. Methods The clinical data of 49 elderly fracture patients admitted to the Fifth Affiliated Hospital （Zhuhai） of Zunyi Medical University from September 2016 to June 2019 were analyzed retrospectively. A total of 49 patients were included in this study, in whom 32 under went proximal humeral locking plate fixation and 17 will receive conservative treatment. The therapeutic effect, postoperative pain, postoperative swelling and functional recovery of shoulder joint were compared between the two groups. Results The effective rate of locking plate fixation group was （90.6%） and that of conservative treatment group was （82.4%）, the difference between the two groups was statistically significant （P<0.05）. VAS score of locking plate fixation group was lower than that of conservative group （P<0.05）, but there was no statistically significant difference between the two groups in the degree of postoperative swelling recovery （P>0.05）. Neer classification score, DASH score and CMS score of locking plate fixation group showed the recovery of shoulder function was better than that of the conservative group （P<0.05） at six-month follow-up. The complications in the locking plate fixation group were higher than those in the conservative group, but the difference was not statistically significant （P>0.05）. Conclusion Locking plate fixation has a good clinical effect in the treatment of proximal humeral fracture in the elderly, but different patients should choose operation or conservative treatment according to the specific situation.

Perioperative blood transfusion is associated with post-operative infectious complications in patients underwent emergency surgery

XIE Jian-zhu, XIAO Fan, CHANG Rui-ming

2020, 20(03):  376-380.  DOI: 10.3969/j.issn.1009-976X.2020.03.025

Asbtract ( )   PDF (1320KB) ( )  

References | Related Articles | Metrics

Objective To analyze the relationship between perioperative blood transfusion and postoperative infection in emergency patients. Methods The data of emergency surgery from 2011 to 2015 were collected, including baseline data, perioperative clinical and laboratory record and complications. Blood transfusion was defined as any transfusion event from admission to discharge. The main records were postoperative infectious events, including incision and surgical site infection, wound rupture, urinary tract infection, pneumonia, septicemia and septic shock; the secondary records included hospital stay, unplanned tracheal intubation, ventilator use for more than 48 hours, acute renal failure, any thromboembolism event and accidental reoperation exploration. Results Of the 3153 emergency surgery, 242 （7.7%） received perioperative blood transfusion. The patients who received blood transfusion were older than those who did not receive blood transfusion. The BMI of the blood transfusion group was lower than that of the non-blood transfusion group. ASA classification of the blood transfusion patients was lower than that of the non-blood transfusion group at levels 3 and 4. The operation time and hospitalization time of the blood transfusion patients were longer than that of the non-blood transfusion group. The risk of thromboembolism complications of the blood transfusion patients, such as pulmonary embolism, deep vein thrombosis and respiratory dysfunction, was increased, and the patients with blood transfusion were more likely to have unplanned tracheal intubation. There were 594 postoperative infection events （18.83%） occurred, in which the infection rate of blood transfusion patients accounted for 39.7% （96/242） in blood transfusion patients. There were significant differences in the history of chronic diseases such as diabetes, COPD, chronic heart disease and hypertension. Patients with weight loss more than 10%, higher ASA score,contaminated surgical wounds, corticosteroids user, and hemorrhagic disease were also more likely to infect. In addition, there were significant differences in hypoproteinemia and hematocrit, and the infection rate of open surgery was higher than that of laparoscopic surgery. Conclusion Transfusion in emergency patients is associated with an increased risk of postoperative infectious complications.

The experience of diagnosis and treatment process of four patients with pulmonary sequestration and literature review

GUO Quan-wei, YAN Jun, ZHONG Cheng-hua, KUANG Jun, MO Yi-jun, TAN Jian-feng, LI Dong-fang, ZHANG Jian-hua

2020, 20(03):  381-385.  DOI: 10.3969/j.issn.1009-976X.2020.03.026

Asbtract ( )   PDF (2576KB) ( )  

References | Related Articles | Metrics

Objective To explore the diagnosis and treatment strategies of pulmonary sequestration. Methods Four patients with pulmonary sequestration were admitted from July 2017 to June 2019 in our hospital. Three patients underwent video-assisted thoracic surgery, and one patient underwent interventional surgery by vascular plug. The diagnosis and treatment process and clinical data were retrospectively analyzed, and the experience was summarized. Results All four patients were treated. One patient received interventional surgery by vascular plug and recovered smoothly. One patient received video-assisted thoracic lobectomy and recovered smoothly. Two patients received video-assisted thoracic sequestration lobectomy, and one patient recovered well. Unfortunately, one patient suffered video-assisted thoracic surgery once more time for active thoracic bleeding, and the patient finally recovered. A review of chest spiral computed tomography angiography at 3 months after surgery revealed that these abnormal lung lobes and blood supply arteries disappeared in three patients who underwent video-assisted thoracic sequestration lobectomy or lobectomy, and the abnormal blood vessels was completely blocked by vascular plug after interventional surgery in one patient. There was no blood supply to the distal end of the embolized blood vessel, and the congestion of the lung tissue of pulmonary sequestration was significantly better than before. Four patients were followed up for 7-31 months without recurrence. In terms of operation time, intraoperative blood loss, postoperative pain, volume of closed chest drainage, postoperative complications, length of stay, and hospitalization costs, interventional embolization were all superior to video-assisted thoracic surgery in pulmonary sequestration. Conclusion Video-assisted thoracic surgery is the main treatment for pulmonary sequestration at present. Interventional embolization is also a safe, effective, and minimally invasive treatment for pulmonary sequestration, especially for those who have hemoptysis as the main symptom, abnormal blood coagulation function, and severe illness.

A case report of severe water poisoning during hysteroscopy surgery and review of literature

GUO Wei-bing, MENG Ke, YE Xi-jiu, CAO Bing-bing

2020, 20(03):  386-388.  DOI: 10.3969/j.issn.1009-976X.2020.03.027

Asbtract ( )   PDF (1262KB) ( )  

References | Related Articles | Metrics

Hysteroscopic surgery is a common type of minimally invasive gynecological surgery, which has been widely used in hospitals of China. Although hysteroscopy has little trauma and short surgery time, many complications may occur during the operation. Water poisoning is one of the complications of hysteroscopic surgery, which is life-threatening and need to be treated timely. Here, we report a case of severe water poisoning during hysteroscopic surgery, and explore its pathogenesis, management principles and preventive measures after reviewing the literature. Anesthesiologists should be able to grasp the relevant knowledge of complications during hysteroscopic surgery, and ensure patients safety and operation smoothly, which have a great significant effect on patients' prognosis and outcome.

Case Report

Preoperative CT and intraoperative exploration confirmed a case of secondary cocoon

ZHANG Long, HUANG He, GUO Jian-qiang, JIANG Xiao

2020, 20(03):  389-391.  DOI: 10.3969/j.issn.1009-976X.2020.03.028

Asbtract ( )   PDF (1667KB) ( )  

References | Related Articles | Metrics

Abdominal cocoon （AC） is a rare peritoneal disease related to the autoimmune system. It is usually caused by an abnormal cocoon-shaped fibrous film covering the whole abdomen or part of the small intestine and other organs, causing acute and chronic intestinal obstruction symptom. At present, its etiology and pathogenesis are not completely clear, and the misdiagnosis rate of the first diagnosis is high, which is often accidentally found during surgery. Usually increase related knowledge reserves, carefully read CT before surgery can predict the possibility of AC, keep vigilant and carefully explore during surgery to avoid misdiagnosis and missed diagnosis of AC.

Review

Advances in the effects of deep brain stimulation on axial symptoms of Parkinson's disease

LI Hai-tao, YU Yang, WANG Yue, CHENH Yuan-yuan, YANG He-chao, LIANG Si-quan

2020, 20(03):  394-398.  DOI: 10.3969/j.issn.1009-976X.2020.03.030

Asbtract ( )   PDF (1305KB) ( )  

References | Related Articles | Metrics

Parkinson's disease（PD） is characterized by a combination of motor symptoms （bradykinesia, rest tremor,rigidity etc.） and non-motor symptoms（depression, anxiety etc.）. As the PD progresses, paitents may exhibit axial symptoms（including postural instability, balance disorder and gait disability）. Currently,both medication therapy and non-medication therapy make great progress in relieving the motor symptoms of PD. Therapy of deep brain stimulation on axial symptoms becomes one of the research hotspots. However,its effects remain controversial due to the complexity of the mechanism. In this paper, we summarize the development of researches on the effect of DBS on axial symptoms and provide reference for related studies.

Clinical application of oncoplastic surgery in breast cancer

OUYANG Bin, ZHANG Le-hong

2020, 20(03):  399-403.  DOI: 10.3969/j.issn.1009-976X.2020.03.031

Asbtract ( )   PDF (2156KB) ( )  

References | Related Articles | Metrics

Breast-conserving surgery combined with radiotherapy has become the standard treatment for early breast cancer. In recent years, breast cancer has become younger. Young patients have higher requirements for the aesthetic effect of postoperative breast cancer. Therefore, breast cancer oncoplastic surgery has become increasingly popular. Volume displacement technology is relatively simple and practical, suitable for patients with small tumors, and small trauma can bring satisfactory cosmetic results; volume replacement technology is suitable for patients with large skin and breast tissue defects after tumor resection. More difficult.Summarize the common oncoplastic surgery and its progress.

Advances in research on anti-tumor mechanism of dihydromyricetin

LI Zuo-biao, JIANG Lian-gui, LI Ming-yi

2020, 20(03):  404-406.  DOI: 10.3969/j.issn.1009-976X.2020.03.032

Asbtract ( )   PDF (1267KB) ( )  

References | Related Articles | Metrics

Dihydromyricetin （DHM） is a polyphenolic hydroxy dihydroflavanols extracted from the stem and leaf of vine tea.Current pharmacology studies have shown that its anti-tumor effects can significantly inhibit the development of lung cancer, liver cancer, stomach cancer and other cells and induce their apoptosis. Existing studies have shown that the anti-tumor mechanisms of DHM mainly include inhibition of tumor cell cycle, intervention of mitochondrial pathways and regulation of tumor-related signaling pathways.

Surgical Nursing

Analysis of the influence of PDCA cycle management based on nursing sensitive indexes on the prevention and control of nosocomial infection in the operating room

CHEEN Xue-mei, GUO Lv-ping, OU Gao-wen

2020, 20(03):  407-410.  DOI: 10.3969/j.issn.1009-976X.2020.03.033

Asbtract ( )   PDF (1291KB) ( )  

References | Related Articles | Metrics

Objective To analyze the effect of PDCA circulation management with nursing sensitive indexes on the prevention and control of nosocomial infection in operating room. Methods From October 2017 to September 2019, 164 surgical patients were selected and divided into two groups according to different nursing modes. The control group （79 cases） used Plato analysis method to control the quality of hospital infection in operating room. The observation group （85 cases） analyzed the nursing sensitive indicators to control infection. Combined with PDCA circulation management mode, repeated circulation analysis and improvement effect were evaluated. A total of 3 operating room nurses participated in the study process.The detection rate of pathogenic bacteria, infection rate of incision and disinfection effect of operating room were compared between the two groups. Results The sterilization qualification rates of hand, material surface and environmental sanitation disinfection of medical staff in the observation group were 92.94%, 95.29% and 80.0%, respectively,while 82.28%, 84.81% and 62.03% in the control group respectively, the observation group was significantly higher than the control group, the difference was statistically significant （P < 0.05）; in the observation group, the detection rate of Gram-positive and negative bacteria and the infection rate of incision were 4.71%, 10.59%, and 2.35%, the control group was 24.05%, 31.65%, 10.13%, and the observation group was significantly lower than the control group （P<0.05）. Conclusion PDCA circulation management with nursing sensitive index can effectively prevent and control the risk of nosocomial infection