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Quick Search     Adv Search 2016 Vol. 33, No. 4 Published: 2016-05-26   625 A MetaAnalysis: Application of Fasttrack Surgery Principles in Perioperative Period of Patients Undergoing Hepatectomy for Liver Cancer TANG Shuguang,PENG Chuang,ZHAO Chang,et al 【Objective】To systematically review the clinical efficacy and safety of fasttrack surgery(FTS) in perioperative period of patients undergoing hepatectomy for liver cancer.【Methods】The literature of randomized controlled trials comparing the application of FTS principles and the traditional methods concerning hepatectomy for liver cancer was retrieved, the data collection was limited by November 2015. Test screening, data extraction, quality evaluation and Meta analysis were conducted.【Results】A total of 8 studies with 848 patients were included（416 cases in FTS group and 432 cases in control group）. Compared with conventional group, FTS group had reduced length of hospital stay（MD=-3.24，95% CI=-5.27~-1.21,P<0.01）,length of postoperative hospital stay（MD=-1.46，95% CI=-2.28~-0.63）（P<0.01）,time of first postoperative flatus（SMD=-3.55，95% CI=-4.91~-2.18）（P<0.01）,time of first postoperative defecation（SMD=-1.97，95% CI=-3.39~-0.54）（P<0.01）,and hospitalization expenses（MD=-0.54，95% CI=-0.92~-0.16）（P<0.01）and the levels of serum Creactive protein on the first day after hepatectomy(SMD=-4.87，95% CI=-8.42~-1.32)(P<0.01). There was no statistical difference in the incidence of complications between group CS and group FTS.【Conclusion】FTS can enhance the rehabilitation of patients undergoing hepatectomy. It deserves further investigation and spreading in clinical practice. 2016 Vol. 33 (4): 625-629 [Abstract] ( 248 ) HTML (1 KB)  PDF  (0 KB)  ( 46 ) 630 Effect of Artificial Humeral Head Replacement on Elderly Patients with Complex Proximal Humeral Fractures YUAN Aidong, LI WenRui, LI WenHu 【Objective】To observe and evaluate the shortterm effect of artificial humeral head replacement on elderly patients with complex proximal humeral fractures. 【Methods】Twentyfive elderly patients of complex proximal humeral fractures in our department from January 2010 to July 2014 were collected. According to Neer classification，22 cases of 25 patients were fourpart proximal humerus fracture and 3 cases of 25 were threepart proximal humerus fracture. All patients were treated with artificial femoral head replacement by the same group of operators and imbedded with flank type artificial humeral head prosthesis made by Beijing Chunli Cooperation. All patients were reexamined by Xray 2 months after operation. The Neer scores of the last followup and the occurrence of postoperative complications were recorded. 【Results】Twentyfive patients were followed up for 12~30 months (21.2 ±6.7). The Neer score of artificial joint function was (84.8±2.4). The excellent results were obtained in 7 out of 25, 14 satisfied, 4 unsatisfied. The total satisfaction rate was 84.00%(21/25). The scores of pain、joint functions、movement functions、anatomical reconstructions were (31.8±2.3), (24.1±1.9), (17.4±1.6)，(8.7±0.9) respectively. There occurred superficial wound infection only in 1 case and was healed after antiinfection and local treatment. No prosthesis loosening, dropping or dislocations appeared. 【Conclusion】The shortterm effect of artificial humeral head replacement is satisfied in complex proximal humeral fractures of elderly patients, and its median and longterm effect needs to be identified through further followup. 2016 Vol. 33 (4): 630-636 [Abstract] ( 224 ) HTML (1 KB)  PDF  (0 KB)  ( 26 ) 633 Analysis of Bacterial Pathogenic Factors in Children with Respiratory Tract Infection Before Using Antibiotics in Hunan Province Yasir Bilal, ZHONG Lili, XIE Liangyi,et al 【Objective】To evaluate bacterial distribution characteristics of respiratory tract infection in children in Hunan province before using antibiotics for providing etiology basis for clinical diagnosis and treatment in this region. 【Methods】Children with acute respiratory tract infections who did not use antibiotics in Changsha, Xiangtan, Hunan, Yueyang, Changde, Hengyang, Shaoyang, Chenzhou, and 12 other sentinel units from March 2012 to December 2014 were treated as the objects of study. Nasopharyngeal swab specimens for bacterial culture were collected for bacterial culture, combined with clinical data for statistical analysis. 【Results】Among 886 nasopharyngeal swab specimens from children with respiratory tract infection, 188 (21.22%) cases had positive bacterial culture. Streptococcus pneumoniae (8.24%)、Moraxella catarrhalis (3.05%)、Haemophilusinfluenzae (2.60%) were most common. Among different age groups, bacteria detection rate in the ≤ 6 months group was higher than in the other 4 groups; there were statistically significant differences.There was also statistically significant differences in the rate of bacteria detection among different seasons; the highest rate being in spring and lowest being in summer. The sample inspection time had a certain effect on the bacterial culture positivity rate, but the difference was not statistically significant. 【Conclusion】The most common bacterial pathogen of respiratory tract infections in Hunan province children are Streptococcus pneumoniae, Moraxella catarrhalis, and Haemophilusinfluenzae, in that order. The detection rate of bacterial pathogens varies amongst different ages and seasons. Sample inspection time on the bacterial detection rate had no significant effect. 2016 Vol. 33 (4): 633-636 [Abstract] ( 185 ) HTML (1 KB)  PDF  (0 KB)  ( 37 ) 637 Longterm Efficacy of Surgeryonly and Adjuvant Chemotherapy for Resectable Pancreatic Cancer：A Systematic Review and MetaAnalysis LI Wenwen,YAN Han,CAO Bangwei 【Objective】To systematically review the the longterm efficacy of adjuvant chemotherapy for resectable pancreatic cancer. 【Methods】Databases including MEDLINE, EBM, CBM and ASCO meeting abstracts were electronically searched for relevant randomized controlled trails (RCTs) by using the key words "pancreatic carcinoma"、"pancreatic cancer"、" pancreatic adenocarcinoma "、"adjuvant"、and "chemotherapy" in both Chinese and English. The qualities of the included studies were evaluated according to the Jadad scale and the stata 12.0 software were used for system evaluation.【Results】 A total of 9 studies were adopted, and the total number of cases was 1057. The results of a systematic review showed that survival rate after 1 year, 2 years and 3 years is higher with adjuvant chemotherapy after surgery than surgeryonly, of which adjuvant chemotherapy containing gemcitabine achieved the same benefits. For overall survival (OS), adjuvant chemotherapy after surgery is superior to surgeryonly, of which gemcitabine containing adjuvant chemotherapy also increased OS. 【Conclusion】 Compared with surgeryonly, adjuvant chemotherapy after surgery could significantly prolong survival. 2016 Vol. 33 (4): 637-641 [Abstract] ( 162 ) HTML (1 KB)  PDF  (0 KB)  ( 39 ) 641 Analysis of the Prognosis for Comprehensive Treatment of Limb Salvage for Lower Extremity Osteosarcoma in the Elderly HU Yong,PENG Dan，TANG Chao 【Objective】To investigate the effect of limb salvage surgery on the survival rate, recurrence rate, and survival time of elderly patients with lower extremity osteosarcoma. 【Methods】One hundred elderly patients with lower extremity osteosarcoma were selected as research objects. According to the patient's specific condition and their wishes, patients were divided into two groups with fifty cases in each group. The control group was underwent conventional amputation treatment, while the observation group underwent comprehensive limbsalvage therapy. The survival rate, tumor recurrence rate, and survival time of the two groups were compared at 6 months, 12 months, and 18 months after operation. 【Results】There was no statistically significant difference in postoperative survival and tumor recurrence between the two groups after 6 months and 12 months (P>0.05), but the postoperative survival of the observation group after 18 months was significantly higher than that of the control group, while the recurrence rate was significantly lower than that of the control group (P<0.05). Survival time of the two groups showed significantly statistical differences, and survival time of the observation group was significantly higher than that of control group (P<0.05). 【Conclusion】Compared with the conventional amputation treatment, comprehensive limbsalvage increased survival rate and reduced recurrence after 18 months . This prolonged survival in patients has significant meaning. 2016 Vol. 33 (4): 641-643 [Abstract] ( 134 ) HTML (1 KB)  PDF  (0 KB)  ( 51 ) 644 Protective Effects of Ulinastatin Combined with Continuous Blood Purification on Myocardial Injury in Patients with Severe Sepsis ZHAO Lina,YAN Haibing,NIU Kechao,et al 【Objective】To investigate the protective effects of Ulinastatin combined with continuous blood purification on myocardial injury in patients with severe sepsis. 【Method】The 160 cases of severe sepsis patients with myocardial injury were randomly divided into four groups. The C group (control group), U group (Ulinastatin group), CBP group (continuous blood purification group), and A group (Ulinastatin combined with continuous blood purification group). Tumor necrosis factor α(TNFα), interleukin6 (IL6), superoxide dismutase (SOD), malondialdehyde (MDA), arterial blood lactate (LAC), creatine kinase MB(CKMB), lactate dehydrogenase (LDH), troponin I (cTnI), brain natriuretic peptide (BNP), and APACHE Ⅱ scores were measured before treatment and five days after treatment. Cardiac complications of 5 days to 28 days after treatment and the prognosis after 28 days were all recorded. 【Results】All scores showed no significant difference before treatment (P＞0.05). Compared with group C after treatment, LAC and MDA of Group U, and SOD of Group CBP had no significant change (P＞0.05). INFα, LAC, MDA, IL6, CKMB, LDH, BNP, cTnI, and APACHE Ⅱ scores in group A were significantly decreased (P＜0.01） but SOD in group A was significantly higher (P＜0.01）. Compared with Group C, heart failure in Group U, and myocardial infarction in Group CBP were not significantly different (P＞0.05). Heart failure, myocardial infarction, and 28d mortality rates in Group A were significantly decreased (P＜0.01）.【Conclusion】 Ulinastatin combined with continuous blood purification can significantly reduce myocardial injury in patients with severe sepsis and improve both the prognosis of patients and production rate of deposit. 2016 Vol. 33 (4): 644-649 [Abstract] ( 138 ) HTML (1 KB)  PDF  (0 KB)  ( 41 ) 647 Effects of Kang Fu Yan Capsule Combined with Dan Hong Injection on Inflammatory Factors in Patients with Chronic Pelvic Inflammatory Disease JU Xiuli 【Objective】To study the effect of Kang Fu Yan capsule combined with Dan Hong Injection on inflammatory factors in patients with chronic pelvic inflammatory disease. 【Methods】The 160 cases of chronic pelvic inflammatory disease were randomly divided into two groups with 80 cases in each group. The control group received conventional western medicine treatment with the plus Kang Fu Yan capsule, (3 capsulesper time with twice a day for 8 days; another course was given after a resting period of 10 days). The observation group, upon the basis of the control group, also used an intravenous 20 ml Dan Hong injection +500 ml 5% glucose injection daily for 8 days, and after a resting period of 10 days, another course of treatment was given. Before and after treatment, by enzyme linked immunoassay, the detection of C reactive protein (CRP), tumor necrosis factor (TNF alpha), proinflammatory cytokines IL6, and antiinflammatory inflammatory cytokine IL4 levels were all detected and analyzed. 【Results】After two courses of treatment, the overall curative effect of observation group and the control group were 96.3% (77/80) and 85% (68/80), respectively. The former was better than the latter (χ2=12.335,P<0.05). After treatment, the two groups' TCM syndrome integrals and local signs improved, and the observation group was better than the control group (P<0.05). TNF, CRP, and IL6 factors were significantly lower than before treatment, whereas IL4 increased (P<0.05). The observation group was significantly higher than the control group (P<0.05). 【Conclusion】Kang Fu Yan capsule combined with Dan Hong injection can give full treatment to the antiinflammatory and invigorate the circulation of blood, regulate the level of inflammatory factor, balance proinflammatory cytokines and antiinflammatory cytokines levels, and effectively control chronic pelvic inflammation levels. 2016 Vol. 33 (4): 647-649 [Abstract] ( 175 ) HTML (1 KB)  PDF  (0 KB)  ( 38 ) 650 Clinic Differences in Premedication of anesthesia of Oral Midazolamor and of Intranasal Dexmedetomidine in Children Undergoing Selective Congenital Heart Surgery BAI Jie,HUANG Yue,BIAN Yong,et al 【Objectives】 To investigate the clinic effects and differences of premedication of anesthesia of oral midazolamor and of intranasal dexmedetomidine in children undergoing selective congenital heart surgery. 【Methods】Two hundreds children scheduled for selective congenital heart surgery were randomly assigned to one of four groups. Group M0.5 and group M0.75 received 0.5 mg/kg or 0.75 mg/kg of oral midazolam syrup, respectively. Group D1 and group D2 received 1μg/kg or 2μg/kg of intranasal dexmedetomidine, respectively. HR, RR, PETCO2, SpO2 and Ramsay scores were recorded every 5 minutes after induction. 【Results】 The Ramsay scores of children in Groups D1 and D2 were significantly higher than those of children in Groups M0.5 and M0.75 from 10 min. after administration to induction. SpO2 in the four groups increased after administration (P=0.03,P<0.01), but showed no significant differences in levels among the four groups. Compared to a baseline, RR at 20 min. after drug administration increased significantly in both groups M0.5 and M0.75. At the same time, PETCO2 in group D2 increased significantly. However, PETCO2 in all groups remained normal.【Conclusions】By monitoring vital signs, dexmedetomidine or midazolam premedication can be safely used in children with congenital heart disease. However, dexmedetomidine 2μg/kg administered by intranasal should be used cautiously because of its influence on HR and PETCO2. 2016 Vol. 33 (4): 650-653 [Abstract] ( 149 ) HTML (1 KB)  PDF  (0 KB)  ( 42 ) 654 5,7Dimethoxyflavone Inhibits the Properties of Human Pancreatic Cancer Stem Cells in Pancreatic Cancer Line PANC1 in Vitro ZENG Deyu,YING Xianli,YANG Jianfeng,et al 【Objective】To examine the effects of 5,7Dimethoxyflavone (DMF) on the properties of human pancreatic cancer stem cell. 【Methods】Human pancreatic cancer PANC1 cell lines were cultured in vitro to generate mammospheres and then detect phenotypes by flow cytometry. The Scratch method was used to contrast cell migration and movement ability after the influence of different concentrations of DMF on the pancreatic cancer stem cells in vitro. Western blot analysis was used to compare of surface marker CD133, CD44, ALDH1, Bmil, Ecad, and Ncad protein expression levels of human PANC1 pancreatic cancer stem cells after different concentrations of DMF interaction.【Results】DMF in a concentration dependent scenario decreased the sphereforming and migration ability of human PANC1 pancreatic cancer stem cells in vitro. Stem cell marker CD133, CD44, ALDH1, Bmi1, and Ncad protein expression levels were decreased by DMF in a concentration dependent manner, but Ecad protein level increased. 【Conclusion】DMF in a concentration dependent manner significantly inhibited in human PANC1 pancreatic cancer stem cell selfrenewal, cell migration, stem cell markers CD133、 CD44、 ALDH1、 Bmi1 protein expression ，but Ncadherin protein expression increased. 2016 Vol. 33 (4): 654-657 [Abstract] ( 146 ) HTML (1 KB)  PDF  (0 KB)  ( 38 ) 658 A Preliminary Study on the Practice of Clinical Pharmacy Service Mode in Children with Asthma LI Zhicun,QIN Youfa,WENG Haojie,et al 【Objective】To explore the effects of clinical pharmacy service mode in children with asthma. 【Methods】84 cases of children with asthma were randomly divided into a control group and an observation group by the random number table method, with 42 cases in each group. Patients in the control group received with routine treatment, while patients in the observation group were guided by the clinical pharmacy service mode. The clinical curative effect, adverse drug reactions, medication compliance, incidence of asthma attack after intervention, treatment status, and pulmonary function indexes before and after intervention were compared between the two groups. 【Results】After 6 months of intervention, the effective rate and rate of good compliance in the observation group (92.9%, 73.8%) were significantly higher than those of the control group (69.0%, 31.0%), (P<0.05). The incidence rate of adverse drug reactions in the observation group (7.1%) was significantly lower than that of the control group (23.8%), (P<0.05). The differences in times of asthma attack ［(1.0±0.8) vs (2.5± 1.6) times］, times of emergency ［(1.0±0.7) vs (2.4±1.5) times］, and hospitalization times ［(0.2±0.2) vs (1.0±0.6) times］ between the two group in 6 months were statistically significant (P<0.05). After 6 months of intervention, FEV1% and PEF% in the observation group ［(82.6±4.4), (81.5±5.5)］ were significantly higher than those in the control group ［(78.7±5.6), (76.3±5.3)］, (P<0.05). 【Conclusion】The implementation of clinical pharmacy service mode can significantly improve medication compliance, reduce the incidence of adverse drug reactions, promote good control of asthma and improve the pulmonary function. 2016 Vol. 33 (4): 658-660 [Abstract] ( 130 ) HTML (1 KB)  PDF  (0 KB)  ( 33 ) 661 Expression and Analysis of IL2 and IL12 in Local Tissues of Patients with Perianal Abscess ZHOU Kailiang,WU Shimin,ZOU Xianjun,et al 【Objective】To analyze the changes of Interleukin2 and Interleukin12 in local tissues of patients with perianal abscess and to explore its possible role in the pathogenesis of the disease.【Methods】78 cases of perianal abscess patients admitted to our hospital were selected. Tissues about 0.2 cm×0.2 cm×0.1 cm around abscess wall edge was taken during the operation, and a little anal surrounding normal tissue as control group. The levels of IL2 and IL12 were detected by enzymelinked immunosorbent method in the peripheral tissues of the anus.【Results】The levels of IL12 and IL2 in the perianal abscess tissue group were significantly higher than those in the control group, the difference between the two groups was statistically significant (P<0.05); There was no significant correlation between IL2 levels and IL12 levels in the perianal abscess tissue group (r=0.138, =0.552,P>0.05).【Conclusion】IL2 and IL12 secretion abnormalities appeared in the local tissues of patients with perianal abscess, which suggests they may be involved in the pathogenesis of perianal abscess. 2016 Vol. 33 (4): 661-666 [Abstract] ( 113 ) HTML (1 KB)  PDF  (0 KB)  ( 35 ) 663 Comparison of the Clinical Curative Effects of Anatomic Locking Plate Internal Fixation and Conservative Treatment in Elderly Patients with C Type Distal Radius Fractures LIU Dexin 【Objective】To compare the clinical curative effects of anatomic locking plate internal fixation and conservative treatment in elderly patients with C type distal radius fractures.【Methods】Fifty elderly patients with C type distal radius fractures who were treated in our treatment group between March 2012 and March 2014 were selected. According to different treatment methods, the patients were divided into open reduction with volar locking plate internal fixation group (group A) and close manipulative reduction with macromolecule plaster immobilization conservative treatment group (group B). Through imaging data, the recovery of indexes of distal radius fractures was compared; The wrist pain degree was evaluated by visual analogue scale (VAS); The recovery of wrist function was evaluated by modified GartlangdWerlery scoring system and PatientRated Wrist Evaluation (PRWE). 【Results】After surgery, the recovery of distal radius indexes such as palmar tilt, ulnar inclination, radial shortening length and degree of articular surface collapse were significantly improved (P<0.05). At the end of followup, the values of group A were better than those of group B (P<0.05); VAS score of group A was lower than that of group B (P<0.05), the difference was statistically significant (P<0.05); The excellent and good rate of GartlangdWerlery score in group A was 88.5%, which was much better than that of group B 75.0% (P<0.05); The PRWE score of group A was lower than that of group B, the difference was statistically significant (P<0.05). 【Conclusion】 Both of the two regimens can effectively treat elderly patients with C type distal radius fractures. However, open reduction with anatomic locking plate internal fixation can better restore and maintain distal radius palmar tilt, ulnar inclination, height of processus styloideus radii and flatness of articular surface, reduce radial shortening length, so that the wrist joint function can recover better. It also can effectively reduce joint pain and symptoms of traumatic arthritis in the affected wrist. It is a more effective treatment for the disease. However, when choosing clinical treatment methods, the patient's condition and patient's must be taken into consideration. 2016 Vol. 33 (4): 663-666 [Abstract] ( 124 ) HTML (1 KB)  PDF  (0 KB)  ( 38 )

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