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Quick Search     Adv Search 2019 Vol. 36, No. 2 Published: 2019-02-28   209 Influential Factors of Cancer-related Fatigue in Patients with Endometrial Cancer after Concurrent Chemoradiotherapy SU Xiao-yu, MENG Li-ping, ZHOU Ju-feng, et al DOI: 10.3969/j.issn.1671-7171.2019.02.001 Objective To investigate the influencing factors of cancer-related fatigue (CRF) on postoperative radiotherapy and chemotherapy in patients with endometrial cancer. Methods A total of 110 patients with postoperative endometrial cancer were enrolled in our hospital from August 2012 to August 2017. All patients received concurrent chemoradiotherapy. Patients were evaluated for fatigue 1 week after surgery according to the Brief Fatigue Inventory (BFI). Also, patients were surveyed regarding age, occupation, family income, education level, marital status, type of medical insurance, and cancer TNM staging via a questionnaire. At the same time, the hospital anxiety and depression scale (HADS) and the social support rating scale (SSRS) were used to evaluate the patients' anxiety, depression and social support. Logistic multiple regression analysis was used to analyze the influencing factors of cancer-related fatigue in patients. Results A total of 110 patients were enrolled and 102 questionnaires were retrieved. The most fatigue score was (6.91±1.54) and the fatigue rate was 97.06 %, which mainly showed level of moderate to severe fatigue. The general data of the patients, as well as the surgical methods, disease stages and other factors were not significantly associated with postoperative CRF. Postoperative cancer-related fatigue score and social support score were negatively correlated with a coefficient of -0.302. In addition, postoperative anxiety and depression were the influencing factors of cancer-induced fatigue. Conclusion The social support status, anxiety and depression of patients with endometrial cancer after concurrent chemoradiotherapy were the influencing factors of cancer-induced fatigue. Enough attention should be paid to them in medical work to reduce the degree of cancer-induced fatigue and reduce the impact on postoperative recovery. 2019 Vol. 36 (2): 209-212 [Abstract] ( 66 ) HTML (1 KB)  PDF  (0 KB)  ( 15 ) 213 Effect of miR-21/FZD6 Axis on Extracellular Matrix Remodeling of Lung Bronchial Epithelial Cells Induced HU Ting, ZHAO Jun, ZHANG Rong-rong, et al DOI: 10.3969/j.issn.1671-7171.2019.02.002 Objective To investigate the function and mechanism of miR-21/FZD6 axis in extracellular matrix (ECM) remodeling of lung bronchial epithelial cells induced by cigarette smoke extracts (CSE). Methods After 16HBE was treated with CSE, the expression of WNT pathway and ECM remodeling related genes were detected, and miRNA, targeting WNT pathway was screened and verified. After interfering with miR-21 expression, the expression of FZD6 was detected by western blot, and the target relationship between miR-21 and FZD6 was verified by double luciferase assay. The function of the pathway in promoting ECM remodeling by CSE were verified by response experiment.Results CSE treatment could inhibit the activity of WNT pathway and the expression of ECM remodeling-related genes; microRNAs screening and cell validation resulted in the expression of microRNAs-21-5p and FZD6; after CSE treatment, the expression of microRNAs-21-5p was up-regulated, while the expression of FZD6 was down-regulated; interfering with microRNAs-21-5p could enhance the expression of FZD6; double luciferase assay showed that microRNAs-21-5p could target FZD6. The results of response experiments showed that si-FZD6 could promote the expression of genes related to ECM remodeling, and that miR-21 inhibitor could inhibit the expression of genes related to ECM remodeling and partly reverse the effect of si-FZD6 on ECM remodeling.Conclusion CSE can induce the expression of microRNA-21-5p in lung bronchial epithelial cells, weaken the expression of FZD6, inhibit the activity of WNT pathway, and accelerate the process of ECM remodeling in lung bronchial epithelial cells. 2019 Vol. 36 (2): 213-216 [Abstract] ( 73 ) HTML (1 KB)  PDF  (0 KB)  ( 13 ) 217 Regulatory Effect of Maizhuni on Rabbit Arthritic Chondrocyte Apoptosis MIAO De-sheng, WANG Yun, CHENG Guo-jie , et al DOI: 10.3969/j.issn.1671-7171.2019.02.003 Objective To explore the regulation effect and mechanism of Maizhuni on the apoptosis of rabbit chondrocytes of arthritis. Methods Apoptosis of arthritic chondrocytes was induced by IL-1beta. Normal serum or low, medium and high dose of Maizhuni serum were added to culture medium to regulate apoptosis of arthritic chondrocytes. Cell viability was measured by MTT assay. Cell apoptosis was detected by flow cytometry using the Annexin V-FITC/PI double staining. The expression level of Fas, FasL, caspase-8, caspase-3, I-FLICE, PARP was analyzed by real time quantitative PCR and western blotting. Results Compared to normal serum mimic group, all doses of maizhuni-treated groups significantly increased the viability of chondrocytes (P<0.001) and significantly reduced early apoptosis of chondrocytes (P<0.05). Meanwhile, maizhuni significantly decreased the expression levels (mRNA and protein) of Fas, FasL, caspase-8 and caspase-3, while increased the expression of I-FLICE and PARP (P<0.001). Conclusion Maizhuni inhibits the apoptosis of rabbit chondrocytes induced by IL-1 beta through mechanism of regulating Fas/FasL signal pathway. 2019 Vol. 36 (2): 217-223 [Abstract] ( 84 ) HTML (1 KB)  PDF  (0 KB)  ( 15 ) 224 Curative Effect of Sural Neurovascular Flap and Medial Plantar Flap on Soft Tissue Defect of Heel YANG Yuan-ming, WANG Xian-cheng, LI Xiao-fang, et al DOI: 10.3969/j.issn.1671-7171.2019.02.005 Objective To analyze the clinical effect of sural neurovascular flap and medial plantar flap in the treatment of soft tissue defect of heel. Methods The clinical data of 42 cases with soft tissue defect of heel were retrospectively analyzed. 25 cases were repaired with medial plantar flap (plantar flap repair group), 17 cases were repaired with sural neurovascular flap (gastrocnemius myocutaneous flap repair group). The repair area of flaps and Fugl-Meyer lower limb motor function score at discharge were compared between the two groups, and the wound healing, survival of flaps and complications were observed.Results The incidence of complications in the plantar flap repair group was 20.0% (5/25), significantly lower than that in the gastrocnemius flap repair group 52.9% (9/17), and the difference was statistically significant (χ2=4.941,P=0.026<0.05). The repair area of plantar skin flap group was (14.05 ±4.46) cm2, which was significantly lower than that of gastrocnemius muscle skin flap group (54.03 ±15.51) cm2 (t=12.229,P=0.00<0.05). Fugl-Meyer lower extremity motor function score was (31.47±1.84) and (30.10±3.23) respectively at discharge, but there was no significant difference between the two groups (t=1.750,P=0.088>0.05). Conclusion Medial plantar flaps and sural neurovascular flaps are ideal methods for repairing soft tissue defect of heel. However, the repair area of medial plantar flaps is limited, so it is necessary to select appropriate flaps according to the specific situation of soft tissue defect of heel in order to achieve better clinical effect.specific conditions of heel soft tissue defect to achieve better clinical effect. 2019 Vol. 36 (2): 224-225 [Abstract] ( 76 ) HTML (1 KB)  PDF  (0 KB)  ( 15 ) 226 Effect of Butylphthalide on Renal Interstitial Fibrosis in Rats with Single-side Ureteral Obstruction AN Na, Sun Jian-ping DOI: 10.3969/j.issn.1671-7171.2019.02.004 Objective To observe the effects of butylphthalide(NBP) on the renal interstitial fibrosis in rats with unilateral ureteral obstruction(UUO) and to explore the possible mechanism. Methods A total of 54 clean level male rats were selected to establish the UUO models. These rats were randomly divided into three groups with 18 in each group: group A and B with unilateral ureteral obstruction (left ureteral ligation in close proximity to renal pelvis) and group C without UUO (procedure mimic as control group). Rats in group A received NBP 180 mg/kg/d lavage, while rats in group B received equal dosage saline lavage. Rats in group C were only isolated the ureter with no ligation but give equal saline lavage as well. Rat kidney and blood samples were taken at postoperative d2, d3, and d7, and renal lipid peroxide reaction markers superoxide dismutase (T-SOD) and malondialdehyde (MDA) activities were measured. Results Compared to d2, the levels of T-SOD at postoperative d3 and d7 in group A, group B and group C decreased, while the level of MDA increased (P<0.05). T-SOD level was decreased and MDA level was increased in all three groups at d7 after surgery, if compared to d3 (P<0.05). Compared to group A, the level of T-SOD in group B was decreased, while the level of MDA was increased at postoperative d3 and d7 (P<0.05). Compared with group C, the level of T-SOD was decreased and the level of MDA was increased in group A at postoperative d3 and d7 (P<0.05). The levels of type I collagen protein in group A and group B at postoperative d3 and d7 were significantly higher than those in their matched group at postoperative d2 (P<0.05). Further, the levels of type I collagen protein in group B were greater than those in group A. The postoperative d3 and d7 of group B at postoperative d3 and d7 were higher than those of group A (P<0.05). Type I collagen was expressed in a small amount in group C, and there was no significant difference in the levels of d2, d3, and d7 in group C (P>0.05).Conclusion NBP plays a significant role in the regulation of renal interstitial fibrosis in rats in unilateral ureteral obstruction, which may be related to the regulation of the activity of MDA and T-SOD. 2019 Vol. 36 (2): 226-229 [Abstract] ( 74 ) HTML (1 KB)  PDF  (0 KB)  ( 14 ) 230 Effect of Dexmedetomidine Combined with Comfort Counseling on Restlessness During Recovery from General Anesthesia in Children ZHANG Yuan-ge, MAO Hong-ping DOI: 10.3969/j.issn.1671-7171.2019.02.007 Objective To explore the effect of dexmedetomidine combined with comfort counseling on restlessness during recovery period of general anesthesia in children, and to analyze its clinical application value. Methods One hundred and fifty-four cases of adenoidectomy under general anesthesia in our hospital from March 2016 to June 2018 were selected for prospective control study. The children were divided into dexmedetomidine group, combination group and control group by random number table method, 51 cases in each group. After tracheal intubation, dexmedetomidine group and combination group were given dexmedetomidine pump injection (the control group was pumped with the same amount of saline). The combination group was given comfortable counseling before operation. The changes of physiological state, Ramsay sedation score 1-4 hours after extubation, recovery time, restlessness score and number of restlessness cases were compared among the three groups. The anesthetic effect and safety of different schemes and their effects on restlessness during the recovery period of general anesthesia were analyzed. Results Heart rate (HR) decreased 10 to 60 minutes after awakening in all three groups. HR in the dexmedetomidine group was lower than that in the control group, and HR in the combination group was lower than that in the dexmedetomidine group (P<0.05). Ramsay scores of the three groups at 2~4 hours after extubation were higher than those at 1 hour after extubation. Ramsay scores of the dexmedetomidine group at 1 h, 2 h and 4 h after extubation were higher than those of the control group. Ramsay scores of the combined group at 1 h, 2 h, 3 h and 4 h after extubation were higher than those of the dexmedetomidine group, with statistical significance (P<0.05). The restlessness score of the control group was lower than that of the dexmedetomidine group, and the restlessness score of the dexmedetomidine group was lower than that of the combination group (F=5.879,P=0.000). The incidence of restlessness in the control group was 29.41% (15/51) higher than that in the dexmedetomidine group 15.69% (8/51), and that in the dexmedetomidine group was 3.92% (2/51) higher than that in the combination group (χ2 = 3.015,P=0.013).Conclusion Dexmedetomidine can effectively prevent restlessness during the recovery period of general anesthesia in children without affecting the safety of anesthesia. On this basis, combined comfort counseling can further improve the preventive effect of restlessness. 2019 Vol. 36 (2): 230-232 [Abstract] ( 81 ) HTML (1 KB)  PDF  (0 KB)  ( 12 ) 233 Expression and Significance of SOX-10 and GDNF in Hirschsprung's Disease CHEN Qin-ming, WU Kai, WANG Jian-jun, et al DOI: 10.3969/j.issn.1671-7171.2019.02.006 Objective To investigate the immunohistochemical characteristics of SOX-10 and GDNF in different intestinal tracts of children with Hirschsprung's disease (HD).Methods The clinical data of 30 children with HD from our Hospital were selected. The specimens of dilated segment, transitional segment and narrow segment were taken from the observation group. At the same time, 10 children who underwent colostomy due to anal atresia in the same period were selected as the control group, and routine pathological examination was performed. The expression of SOX-10,GDNF protein in the intestine of the two groups was detected by immunohistochemistry. The relationship between its expression and clinicopathological features was analyzed.Results Among 30 cases of HD, SOX-10 positive cells were not found in 28 cases of narrow segment submucosal and myenteric plexus, but only a little expression was found in 2 cases. In the normal group, the weakly positive, positive or strongly positive ganglia and glial cells were observed in the intestinal canal, HD dilated segment and transitional segment, respectively, but the expression intensity of SOX-10 was also different among the groups. The expression area of SOX-10 nerve plexus in the normal group was larger than that in the transitional group, but the expression of SOX-10 nerve plexus in narrow segment was not clear. The cumulative optical density of SOX-10 positive expression in HD dilated segment, HD transitional segment and HD narrow segment was significantly lower than that in the normal control group (P<0.05). GDNF antibodies were mainly expressed in ganglion cells, nerve fibers and smooth muscle cells. GDNF was positive in ganglion cells and smooth muscle cells, but the expression intensity of ganglion cells was higher than that of smooth muscle cells. Ganglion cells or smooth muscle cells were positive in all specimens, but the expression intensity of GDNF in ganglion cells was stronger than that in smooth muscle cells. In the narrow segment, the positive expression of GDNF was seen in nerve fibers proliferation. The shape of nerve fibers was wavy and the radius of nerve fibers was larger than that of other groups.Conclusions The expression of SOX-10 and GDNF protein in diseased colon of children with HD was significantly lower than that in normal and dilated colon. 2019 Vol. 36 (2): 233-233 [Abstract] ( 87 ) HTML (1 KB)  PDF  (0 KB)  ( 14 ) 234 Effect of Arthroscopic Combined with Rehabilitation Braces on Knee Osteoarthritis and its Effect on the Levels of NO, IL-6, MMP-3 and VEGF WU Yang, ZHANG Bing, JIAO Longbing, et al DOI: 10.3969/j.issn.1671-7171.2019.02.008 Objective To investigate the clinical effect of arthroscopy combined with rehabilitation support in the treatment of knee osteoarthritis (KOA) and its effect on inflammatory factors.Methods Eighty-six cases of KOA from October 2015 to August 2017 were divided into observation group (n=43) and control group (n=43). The control group was treated by arthroscopy alone, while the observation group was treated with rehabilitation support on the basis of the control group. The clinical efficacy and visual analogue score (VAS), Lysholm knee function score, KOA symptom and sign score, serum nitric oxide (NO), interleukin-6 (IL-6) were compared between the two groups before and after treatment. Changes of matrix metalloprotein 3 (MMP-3) and vascular endothelial growth factor (VEGF) levels.Results The total effective rate of the observation group was 90.7% (39/43), which was significantly higher than that of the control group 72.1% (31/43) (χ2=4.914,P=0.048). After treatment, VAS pain score, Lysholm knee function score and KOA symptom and sign score were significantly improved in both groups, and the effect was more obvious in the observation group (P<0.05). After treatment, the levels of serum NO,IL-6,MMP-3 and VEGF in the two groups were significantly lower than those before treatment, and the levels of each index in the observation group were significantly lower than those in the control group (P<0.05).Conclusion Arthroscopy combined with rehabilitation support is effective in the treatment of KOA, which can promote the recovery of knee joint function, relieve pain symptoms, and inhibit the expression of inflammatory factors, which is worth popularizing in clinic. 2019 Vol. 36 (2): 234-236 [Abstract] ( 91 ) HTML (1 KB)  PDF  (0 KB)  ( 18 ) 237 Preventive Effect of Ephedrine and Methoxamine on Spinal Anesthesia-Associated Hypotension in Patients Cesarean Section LIN Li-tian, FAN You-ling, HUANG Fang, et al DOI: 10.3969/j.issn.1671-7171.2019.02.009 Objective To compare the clinical efficacy of ephedrine and methoxamine in the treatment of spinal anesthesia-associated hypotension under cesarean section. Methods A retrospective study was conducted on the clinical data of 60 patients with cesarean section who had hypotension during spinal anesthesia, including group A (n=30, 10 mg ephedrine intravenously) and group B (n=30, 2 mg methoxamine intravenously) according to the treatment plans. The changes of maternal blood pressure (BP), heart rate (HR), fetal umbilical arterial blood gas and adverse reactions were compared. Results There was no significant difference in systolic blood pressure between the two groups 15 minutes before and after anesthesia (P>0.05). The heart rate of group A was significantly higher than that of group B after 6 minutes of anesthesia (P<0.05). The umbilical arterial blood pH, PaO2 and PaCO2 in group A were lower than those in group B, and the difference in pH value between the two groups was significant (P<0.05). The hypotension of group A was lower than that of group B. However, it didn't show statistical significance (P>0.05). The incidence of bradycardia in group A was more than that in group B (P<0.05). Conclusion Both ephedrine and methoxamine can increase spinal anesthesia-associated hypotension under cesarean section with accurate effect. There is no serious adverse reaction in the maternal. Heart rate control by methoxamine is more stable and can be promoted clinically. 2019 Vol. 36 (2): 237-242 [Abstract] ( 90 ) HTML (1 KB)  PDF  (0 KB)  ( 14 ) 243 Effect of Ultrasound-guided Transversus Abdominis Plane Block Combined with Spinal Epidural Anesthesia on Postoperative Analgesia and Levels of Serum CRP and IL-6 in Patients with Lower Abdominal Surgery SHANG Di DOI: 10.3969/j.issn.1671-7171.2019.02.011 Objective To analyze the effect of ultrasound-guided transversus abdominis plane block combined with spinal epidural anesthesia on postoperative analgesia, serum CRP and IL-6 Levels in patients undergoing lower abdominal surgery. Methods A total of 80 patients with lower abdominal surgery who were treated in our hospital from January 2016 to August 2017 were selected as the research objects. All patients (ASAⅠor Ⅱ grade) underwent spinal epidural anesthesia. According to random number table method, patients were divided into two groups with 40 cases in each (n=40): the conventional group received patient-controlled intravenous analgesia (PCIA) and the study group received ultrasound guided transversus abdominis plane block +PCIA. The VAS, Ramsay sedation scores, serum C reactive protein (CRP) and interleukin-6 (IL-6) levels were measured at different times after operation and compared between the two groups. Results The VAS scores at the 2, 6 and 24 h after operation in the study group were significantly lower than those in the conventional group, the differences were statistically significant (P<0.05). There was no significant difference in VAS score between the two groups at 48 h after operation (P>0.05). There were no significant differences in Ramsay sedation score between the two groups at different time points after operation (P>0.05). The serum levels of CRP and IL-6 in the study group were significantly lower than those in the conventional group at 6, 24 and 48 h after operation. The differences were statistically significant (P<0.05). The number of pressing pump and sufentanil in the study group 24 h after operation were significantly lower than those in the conventional group, and the differences were statistically significant (P<0.05). Conclusion Ultrasound-guided transversus abdominis plane block improves the analgesic effect and alleviates inflammatory stress response 24 hours post-operation in patients with lower abdominal surgery. 2019 Vol. 36 (2): 243-245 [Abstract] ( 58 ) HTML (1 KB)  PDF  (0 KB)  ( 16 ) 246 Reduction Surgery on Lung and Endothelial Function among Patients with Chronic Obstructive Pulmonary Disease XUE Xiao-lei, WANG Jun-qi, LI Hai-peng, et al DOI: 10.3969/j.issn.1671-7171.2019.02.010 Objective To investigate the effect of lung volume reduction surgery (LVRS) on pulmonary function and vascular endothelial function in patients with chronic obstructive pulmonary disease (COPD). Methods Sixty-two patients with COPD admitted to our hospital from February 2013 to June 2017 were divided into observation group and control group according to their surgical tolerance , with 31 in each group. LVRS was performed in the observation group after the diagnosis of end-stage COPD, and LVRS was performed in the control group 3 months after the diagnosis of end-stage COPD. Blood pressure, pulmonary function and endothelium dependent diastolic function (FMD) were compared between the two groups on the day of COPD diagnosis and at two time points of 3 months follow-up.Results After 3 months of follow-up diagnosis, the blood pressure and lung residual volume/lung capacity ratio of the control group increased significantly and FMD decreased. The blood pressure value, FEV1 predictive value, FVC predictive value, lung residual gas volume/lung capacity ratio of the observation group were all improved compared with those before LVRS,the improvement was significant (P<0.05), and the improvement of lung function index in the observation group was higher than that in the control group (P<0.05). The observation group underwent LVRS. For every 1% increase in FEV1 or FVC, FMD increased by 0.13% and 0.11%, respectively (P<0.05). Conclusion LVRS in patients with COPD can improve lung function and further improve vascular endothelial function. 2019 Vol. 36 (2): 246-249 [Abstract] ( 64 ) HTML (1 KB)  PDF  (0 KB)  ( 21 ) 250 Analysis of Correlation between Serum lncRNA H19 Ex-pression and Postoperative Chemotherapy Effect in Patients with Colorectal Cancer DENG Ling-hui, JIN Jian-hua, LU Wen-bin, et al DOI: 10.3969/j.issn.1671-7171.2019.02.013 Objective To investigate the correlation between the expression of serum long-chain non-coding RNA (lncRNA) H19 and prognosis in patients with colorectal cancer.Methods Eighty-six patients with colorectal cancer who underwent radical operation and adjuvant chemotherapy in our hospital from January 2013 to December 2015 were selected as the study subjects (observation group). 90 volunteers who underwent physical examination in our hospital during the same period were selected as the control group. The expression level of lncRNA H19 in serum of the two groups was detected by qRT-PCR, and the correlation between the expression level of lncRNA H19 in serum of the observation group and the effect of chemotherapy was analyzed. Results The results of qRT-PCR showed that the level of serum lncRNA H19 in the observation group was (1.63±0.35) significantly higher than that in the control group (1.00 ± 0.11), and the difference was statistically significant (t = 16.259,P<0.01). The critical value 2.03 was set as the median level of serum lncRNA H19 expression in the observation group, and the patients were divided into two groups: high expression group and low expression group, 43 cases in each group. The maximum diameter, low differentiation, lymph node metastasis, invasion of serosa, the proportion of stage Ⅲ~Ⅳ and preoperative CEA level in the high expression group were significantly higher than those in the low expression group (P<0.05). There was no significant difference in the incidence of gastrointestinal discomfort, bone marrow sup-pression, liver and kidney dysfunction, neurotoxicity and mucositis between the high and low expression groups after chemotherapy (P>0.05). The median total survival time (OS) and progression-free survival (PFS) in the high-expression group were 33.6 months and 22.9 months respectively, which were significantly lower than those in the low-expression group (55.8 months and 43.3 months), with statistical significance (P<0.05).Conclusion The survival of patients with high expression of serum lncRNA H19 in colorectal cancer is poor, and the sensitivity of post-operative chemotherapy is lower, but there is no significant correlation with chemotherapy tolerance. 2019 Vol. 36 (2): 250-252 [Abstract] ( 76 ) HTML (1 KB)  PDF  (0 KB)  ( 14 ) 253 Multi Factor Analysis and Electroencephalogram of Epileptic Seizures in Stroke Patients XU Dong-mei DOI: 10.3969/j.issn.1671-7171.2019.02.012 Objective To analyze the risk factors of post-stroke epilepsy and the electroencephalogram (EEG) of the patients. Methods A total of 1,396 stroke patients admitted to our hospital from September 2011 to September 2017 were selected as the study subjects, and 951 stroke patients were included in the study. According to whether epilepsy occurs after stroke, they were divided into epilepsy seizure group and non-epilepsy seizure group. The risk factors of epileptic seizures after stroke were analyzed and the EEG manifestations of the patients were observed. Results In this study, the incidence of epileptic seizures after stroke was 5.68%, of which early-onset epilepsy accounted for 55.56%, late-onset epilepsy accounted for 44.44%. Disseminated abnormalities in EEG and localized abnormalities were found in 25.93% and 48.15% of patients with epileptic seizures after stroke. Multivariate regression analysis showed that the location, extent, hyperhomocysteinemia and NIHSS score (≥25) were independent risk factors for epileptic seizures after stroke.Conclusion Patients with stroke in the cortex, large extent of lesions, hyperhomocysteinemia, and NIHSS score ≥25 should be highly alert to seizures. 2019 Vol. 36 (2): 253-253 [Abstract] ( 69 ) HTML (1 KB)  PDF  (0 KB)  ( 17 ) 254 Application Value of NovaSure Impedance-controlled Endometrial Ablation in Treatment of Refractory Abnormal Uterine Bleeding LI Xue-ying, LU Yan, Cui Cao-mei, et al DOI: 10.3969/j.issn.1671-7171.2019.02.014 Objective To explore the value of NovaSuer impedance controlled endometrial ablation system in the treatment of refractory abnormal uterine bleeding (AUB). Methods A total of 68 patients with refractory AUB were treated with NovaSure impedance controlled endometrial ablation. General surgery procedure, complications curative effect and follow-up results were recorded. Results The surgery was successfully completed in all 68 cases. The NovaSure treatment time was 28~120 (mean 61.90±19.73) s. The intraoperative bleeding was less than 10 mL with no serious complications occurred during the operation. At postoperative 1 month, 3 months, 6 months, 12 months and 24 months, the effective rates of menstrual improvement were 100%(68/68),100%(68/68),98.53%(67/68),98.53%(67/68) and 97.30%(36/37), respectively. The rates of amenorrhea were 63.23%(43/68),63.23%(43/68),63.23%(43/68) ,63.23%(43/68) and 59.45%(22/37), respectively. At 3 months after operation, the postoperative hemoglobin was (103.12±7.74 g/L) ,which was higher than the preoperative hemoglobin (92.70±8.26 g/L). The difference was statistically significant (P<0.05). Conclusion NovaSure is safe and effective for the treatment of AUB. Surgery can even be performed in an outpatient clinic. NovaSure is especially suitable for refractory AUB patients with conservative treatment failure and severe medical diseases who cannot tolerant drugs and hysterectomy. 2019 Vol. 36 (2): 254-260 [Abstract] ( 79 ) HTML (1 KB)  PDF  (0 KB)  ( 14 ) 261 Nasal Endoscopic Approach and Applied Anatomy of the Paraspinal Midline Skull Base ZHUO Mu-gai, LU Yong-tian DOI: 10.3969/j.issn.1671-7171.2019.02.016 Objective To study the approach and applied anatomy of the paranasal endoscopic cranioscopial endoscopic surgery. Methods Sixty adult nasal and skull base CT scans were reconstructed by interactive medical image control software. The related skull base structures could be measured on the three-dimensional reconstructed model. 20 wet skull specimens were dissected on the midline skull base under nasal endoscopy. Combined with nasal-maxillary sinus approach, the important anatomical structures of the paramedian skull base, such as the infratemporal fossa, pterygopalatine fossa and the important nerve vessels, muscles and bony anatomical landmarks of the nasopharynx, were studied. Results The distances from the inner margin of jugular foramen, the posterior end of pterygoid canal, the inner margin of external carotid canal and the inner margin of ruptured foramen to the median line were (28.67±1.50) mm, (13.2±1.37) mm, (28.99±1.73) mm, (11.59±0.96) mm, respectively; the distances from the superior anterior nasal spine to the ruptured foramen were (72.68±2.43) mm); the distance from the midpoint of the posterior margin of vomerula to the rupture hole was (13.71±1.14) mm. Conclusion Anatomy research on the pterygopalatine fossa, infratemporal fossa, nasopharyngeal eustachian tube area and other paramedian skull base under nasal endoscopy combined with nasal cavity-maxillary sinus approach has a broader visual space and surgical space, is a better surgical method worthy of promotion in clinical treatment. 2019 Vol. 36 (2): 261-263 [Abstract] ( 67 ) HTML (1 KB)  PDF  (0 KB)  ( 14 ) 264 Effects of Continuous 4C Nursing on Self-Management, Cardiovascular Events and Social Function of Patients Undergoing Percutaneous Coronary Intervention ZHAO Ying, LIU Gui-hua, ZHANG Mei DOI: 10.3969/j.issn.1671-7171.2019.02.015 Objective To explore the effects of continuous 4C nursing on self-management ability, cardiovascular events and social function of patients undergoing percutaneous coronary intervention (PCI).Methods A total of 112 patients treated with PCI in our hospital from April 2015 to April 2017 were selected and divided into the control group and the observation group according to random number table method. Patients in the control group received routine nursing, while those in the observation group received continuous 4C nursing. Self-management ability, cardiovascular events, social function, quality of life and nursing satisfaction of the two groups were observed. Results The scores of partnership, emotional management, problem solving, self-care, and the total score in the observation group were significantly higher than those in the control group (P<0.05). The total incidence of cardiovascular events in the observation group was 8.93%, which was significantly lower than 28.57% in the control group (P<0.05). The score of social disability screening schedule (SDSS) in the observation group was significantly lower than that in the control group (P<0.05). The scores of various items of quality of life in the observation group were significantly higher than those in the control group (P<0.05). The nursing satisfaction of the observation group was 96.43%, which was higher than 76.79% of the control group (P<0.05). Conclusion Continuous 4C nursing can significantly improve the self-management ability and social function of patients with PCI, reduce the incidence of cardiovascular events, improve the quality of life, and result in high nursing satisfaction. 2019 Vol. 36 (2): 264-264 [Abstract] ( 70 ) HTML (1 KB)  PDF  (0 KB)  ( 16 ) 265 Efficacy of Sodium Cantharidin Combined with TP Themotherapy on Advanced Non-small Cell Lung Cancer and Influence on Tumor Angiogenesis WANG Da-zhong DOI: 10.3969/j.issn.1671-7171.2019.02.017 Objective To investigate the therapeutic effect of sodium cantharidate vitamin B6 combined with paclitaxel and cisplatin chemotherapy (TP) on advanced non-small cell lung cancer (NSCLC) and its influence on tumor markers and angiogenesis.Methods A total of 76 cases of advanced NSCLC patients was randomly divided into two group (n=38) . Patients in the control group were treated with TP chemotherapy only while those in the observation group were treated with sodium cantharidin combined with TP chemotherapy. Patients in both groups completed 2 courses of treatment. The short-term efficacy, serum contents of tumor markers and angiogenesis markers were compared between two groups. Results After 2 courses of treatment, the effective rate (RR) and disease control rate (DCR) in the observation group were higher than those in the control group (P<0.05) and the serum tumor markers Cyfra21-1, (CEA), carbohydrate antigen125 (CA125) and angiogenesis indicators of vascular endothelial growth factor (VEGF), angiopoietin-2 (Ang-2), matrix metalloproteinase-9 were lower than the control group (P<0.05). Conclusion Sodium hyaluronate vitamin 6 combined with TP chemotherapy can improve the treatment effect in patients with advanced NSCLC and reduce angiogenesis activity. 2019 Vol. 36 (2): 265-270 [Abstract] ( 67 ) HTML (1 KB)  PDF  (0 KB)  ( 15 ) 271 Effects of Different Dialysis Modes Combined with Low Molecular Weight Heparin on Hemodynamics and Cerebral Hemorrhage in Patients with End Stage Renal Disease WU Sheng-kai, ZENG Bin DOI: 10.3969/j.issn.1671-7171.2019.02.019 Objective To explore the effects of different dialysis modes combined with low molecular weight heparin on hemodynamics and cerebral hemorrhage in patients with end-stage renal disease (ESRD). Methods According to the different dialysis modes, a total of 96 patients with ESRD were divided into the intermittent dialysis group (group A,n=48) and the continuous dialysis group (group B,n=48).The changes of cardiac function, hemodynamic parameters and related factors, and the occurrence of adverse events during treatment were compared between the two groups. Results There were no significant differences in mean blood pressure, cardiac output, cardiac index, stroke volume, stroke index and intracranial pressure between the two groups before treatment (P>0.05). Compared to before treatment, the variation of stroke volume in group A was higher than that in group B (P<0.05). After dialysis, the level of endothelin-1 (ET-1) in group B was significantly higher than that in group A (P<0.05). There were no significant differences in interleukin-6 (IL-6), thiobarbituric acid reactant (TBARS) and B-type natriuretic peptide(BNP) between the two groups(P>0.05). No significant differences were shown in the incidence of cerebral hemorrhage, cerebral infarction and severe infection between the two groups (P>0.05). Conclusion Intermittent and continuous hemodialysis combined with low molecular weight heparin have no significant difference in hemodynamics and cerebral hemorrhage in patients with ESRD, so it can be flexibly selected according to the specific situation in clinic. 2019 Vol. 36 (2): 271-272 [Abstract] ( 72 ) HTML (1 KB)  PDF  (0 KB)  ( 18 ) 273 Clinical Analysis of Perioperative Bleeding in Patients with Scar Uterus Complicated with Central Placenta Previa ZOU Hong-xia, BAI Shu-fang, ZHANG Juan-juan, et al DOI: 10.3969/j.issn.1671-7171.2019.02.018 Objective To investigate the incidence of prenatal, intraoperative and postoperative bleeding and severe complications in patients with scar uterus complicated with central placenta previa. Methods A total of 135 patients with single-fetal scar uterus and central placenta previa who met the inclusion criteria during the period from March 2017 to February 2018 were enrolled. According to the adhesion of placenta and uterus during operation, they were divided into the placenta adhesion group (n=30), placenta implantation group (n=51) and normal group ( neither adhesion nor implantation, n=54). The perioperative bleeding, complications and treatment measures of the three groups were analyzed and recorded. Results There was no significant difference in antepartum bleeding rate between the three groups (χ2=0.22,P=0.90). The bleeding rate, perioperative bleeding rate and hysterectomy rate in the three groups were statistically different (F/χ2=72.05, 42.45, 54.64,P<0.01). The amount of intra-operation bleeding and perioperative bleeding in the placenta implantation group were significantly higher than those in the placental adhesion group and the normal group (t=6.22, 10.53, 4.50, 8.66,P<0.01). The amount of intra-operation bleeding and perioperative bleeding in the placenta adhesion group were higher than those in the normal group (t=4.81, 3.46, P<0.01). The rate of hysterectomy in the placenta-implanted group was significantly higher than that in the placenta-adhesive group and the normal group. There was no significant difference in the rate of hysterectomy between the placenta-adhesive group and the normal group (P<0.05). There were 32 cases of hysterectomy in placenta implantation group, which was significantly higher than 2 cases in placenta adhesion group and 2 cases in the normal group (χ2=22.14, 39.10,P<0.01). The other patients used suture, uterine contraction, abdominal aortic balloon block and other symptomatic treatment to stop bleeding and preserve the uterus. In the placenta-implanted group, 1 case of pregnant women had an intraoperative blood loss of 6000 mL with cardiac arrest. After active rescue and symptomatic treatment, the mother and baby in this case were saved and discharged. In the placenta-implantation group, 15 patients underwent abdominal aortic balloon block whose lower abdominal aorta was blocked by balloon filling during operation. Of the 15 patients, 8 underwent hysterectomy and 7 underwent conservative treatment. The mean amount of bleeding was 1142.86 mL while the mean amount of bleeding in patients without abdominal aortic balloon block was 2100 mL. The volume of bleeding in patients with abdominal aortic balloon obstruction decreased significantly (Z=3.58,P=0.03). Conclusion Patients with scar uterus complicated with central placenta previa have the characteristics of high placenta implantation rate and large amount of bleeding. The abdominal aorta balloon obstruction can effectively reduce the intra-operation and perioperative bleeding. 2019 Vol. 36 (2): 273-276 [Abstract] ( 58 ) HTML (1 KB)  PDF  (0 KB)  ( 15 ) 274 Effect of Gefitinib on Tumor Markers of Stage IV Non-small Cell Lung Cancer Chemotherapy PAN Xin-yan, LI Zhi-min DOI: 10.3969/j.issn.1671-7171.2019.02.020 Objective To investigate the effect of gefitinib in the treatment of stage IV non-small cell lung cancer (NSCLC). Methods A total of 72 patients with stage IV NSCLC in our hospital were divided into the observation group (n=34) and the control group (n=38). Patients in the control group were treated with cisplatin plus pimitrex, while patients in the observation group were given cisplatin plus gefitinib. The therapeutic effects and tumor marker changes in the two groups were compared. Results The short-term curative effect of the observation group was significantly better than that of the control group (P<0.05), which of clinical effective rates were 91.18% and 81.58%, respectively; The rates of bone marrow suppression and diarrhea in the observation group were significantly higher than those in the control group (P<0.05);After treatment, the paracancerous antigen (CEA), cytokeratin fragment 21-1 (CYFRA21-1) and squamous cell carcinoma antigen (SCCA) in the observation group were (30.03±11.02) g/L, (25.58±6.22)g/L and (25.50±5.44) g/L,respectively, which were significantly lower than those of the control group (P<0.05).The median progression-free survival time and overall survival in the observation group were 9 months and 13 months, respectively, which were significantly longer than those in the control group (5 months and 9 months, respectively) (P<0.05). Conclusion Gefitinib has good clinical efficacy in the treatment of stage Ⅳ non-small cell lung cancer patients, which can significantly reduce CEA, CYFRA21-1 and SCCA levels. It is worthy of clinical use. 2019 Vol. 36 (2): 274-287 [Abstract] ( 69 ) HTML (1 KB)  PDF  (0 KB)  ( 15 ) 277 Clinical Study on the Effect of the Polymorphism of CACNA1C on Geriatric Hypertension Treatment with Nifedipine WU Wei, PENG Qianwen DOI: 10.3969/j.issn.1671-7171.2019.02.021 Objective To observe the effect of the polymorphism of CACNA1C on geriatric hypertension treatment with nifedipine. Methods CACNA1C genotyping (rs2222732,rs2239050,rs2239128 locus) was performed in 96 elderly patients with hypertension. Nifedipine 20 mg/d was given for 5 weeks. Fasting venous blood was collected before and after treatment. Fasting blood glucose(FPG), blood urea nitrogen(BUN), creatinine (Cr), systolic blood pressure (SBP), diastolic blood pressure (DBP) and body mass index (BMI) were measured. Results There was no significant difference in SBP, DBP, BMI,serum FPG, BUN, Cr level of between patients with different genotypes (rs2222732, rs2239050, rs2239128 locus) before and after treatment (P>0.05).The decrease of SBP,DBP in TT patients with rs2222732 locus was significantly higher than that in patients with TG, GG genotype before and after treatment (P<0.05).The decrease of SBP,DBP in rs2239050 genotype patients before and after treatment was significantly higher than that in GC, CC type patients (P<0.05).There was no significant difference in the decrease of SBP,DBP between groups before and after treatment in CT,TT, CC patients with rs2239128 locus (P>0.05).Conclusion The polymorphisms of rs2222732 and rs2239050 locus of CACNA1C gene have great influence on the antihypertensive effect of nifedipine. 2019 Vol. 36 (2): 277-281 [Abstract] ( 65 ) HTML (1 KB)  PDF  (0 KB)  ( 18 ) 282 Effect of Target-directed Liquid Therapy Guided by Stroke Volume Variability on Digestive System in Patients Undergoing Colorectal Cancer Surgery ZHANG Lei, SUN Li, HUANG Yi DOI: 10.3969/j.issn.1671-7171.2019.02.023 Objective To investigate the effect of target-directed liquid therapy guided by stroke volume variability on the clinical efficacy and digestive system in patients with colorectal cancer surgery. Methods A total of 142 patients with colorectal cancer who underwent surgery in our hospital were divided into two groups. Patients in the control group received a goal-directed fluid therapy guided by central venous oxygen saturation, and patients in the observation group received target-directed fluid therapy guided by stroke volume variability. The total fluid volume, surgery procedure, gastrin, motilin and complications were compared between the two groups. Results The total fluid volume of the observation group was smaller than that of the control group. The postoperative feeding time, exhaust time and hospitalization time were shorter than the control group, and the difference between the two groups was significant (P<0.05). The gastrin level of the observation group was higher and the motilin level was lower than that of the control group, and the duration of bloating and the recovery time of bowel sounds were shorter as well (P<0.05). The incidence of complications was 14.08% (10 cases out of 71 patients) in the observation group and 32.39% (23 out of 71 cases) in the control group. The difference between the two groups was statistically significant (P<0.05). Conclusion Target-directed fluid therapy guided by stroke volume variability for patients with colorectal cancer surgery can speed up postoperative recovery, improve the recovery of digestive system, and help reduce clinical complications. 2019 Vol. 36 (2): 282-283 [Abstract] ( 62 ) HTML (1 KB)  PDF  (0 KB)  ( 14 ) 284 Analysis of Correlation between Cognitive Function and Levels of IL-6, hs-CRP, Hcy and Cys C in Patients with Senile Dementia GUO Min, JIN Di, WANG Pei-fu, et al DOI: 10.3969/j.issn.1671-7171.2019.02.022 Objective This aim was to investigate the relationship between cognitive function and serum levels of interleukin-6 (IL-6), high-sensitivity C-reactive protein (hs-CRP), homocysteine (Hcy) and Cys C in patients with senile dementia (Alzheimer's disease). Methods A total of 106 patients with senile dementia admitted to our hospital from June 2014 to October 2017 were selected in the study. According to MMSE score, patients were divided into two groups: Alzheimer's disease (AD,n=59) and mild cognitive impairment (MCI, n=47). Meanwhile, 40 healthy subjects with matched health and education status in the same period were selected as the control group. Logistic regression analysis was used to analyze the relationship between the risk of dementia and serum indexes. Results The levels of Hcy and hs-CRP were AD group > MCI group > the control group (P<0.05). Cys C level order was AD group < MCI group < the control group (P<0.05). The level of IL-6 seemed to show AD group > MCI group > the control group. However, the differences were not statistically significant (P<0.05). The serum levels of IL-6, hs-CRP, Hcy and Cys C in AD patients were not significantly correlated with MMSE scores (P>0.05). The prevalence of AD is associated with levels of low folate, high hs-CRP and high Hcy. Conclusion The results show that there is no significant correlation between cognitive function and serum levels of IL-6, hs-CRP, Hcy and Cys C in patients with Alzheimer's disease. Low folate, high Hcy levels and high hs-CRP levels may increase the risk of AD by some mechanism. Cys C may be protective factors of cognitive impairment in AD. 2019 Vol. 36 (2): 284-284 [Abstract] ( 67 ) HTML (1 KB)  PDF  (0 KB)  ( 16 ) 285 Observation on the Curative Effect of Small Tidal Volume Ventilation Combined with Pulmonary Reexpansion in the Treatment of ARDS DENG Mei-yao, CHENG Lian-fang DOI: 10.3969/j.issn.1671-7171.2019.02.024 Objective To explore the clinical effect of small tidal volume (VT) ventilation combined with pulmonary resuscitation in the treatment of acute respiratory distress syndrome (ARDS).Methods Thirty-one ARDS patients treated in our hospital from January 2013 to July 2015 were selected. VT (VT= 6 mL/kg, frequency 15~20 times/minute, respiratory ratio=1∶2) ventilation combined with positive end-expiratory pressure increment was used to treat pulmonary reexpansion. The changes of blood gas, mechanical ventilation and adverse reactions before and after 30 minutes of pulmonary reexpansion were compared. Results There was no significant difference in pH value, PaCO2 level, PEEP and tidal volume between pre-and post-pulmonary reexpansion patients (P>0.05). After pulmonary reexpansion, the arterial partial pressure of oxygen (PaCO2) and oxygenation index (OI) increased significantly, and the inhaled oxygen concentration (FiO2) decreased significantly (P<0.05), compared with pre-pulmonary reexpansion patients (P<0.05). After reopening, the plateau pressure was significantly reduced, and the static lung compliance was significantly improved, which was significantly different from that before reopening (P<0.05). No adverse reactions occurred after reopening. Conclusion VT ventilation combined with pulmonary resuscitation in the treatment of ARDS patients can significantly improve PaCO2 and OI, reduce FiO2 levels, thus effectively improve the patient's hypoxemia. 2019 Vol. 36 (2): 285-290 [Abstract] ( 63 ) HTML (1 KB)  PDF  (0 KB)  ( 16 ) 288 Effect of Free and Traditional Postures of Primipara during the Second Stage of Painless Labor on Pregnancy Outcomes WANG Wen-yi, CUI Lei, LIU Zhi-hui DOI: 10.3969/j.issn.1671-7171.2019.02.025 Objective To investigate the effect of free posture and traditional position of primipara during the second stage of painless labor on pregnancy outcomes. Methods A total of 120 primiparas were randomly divided into the free group and the traditional group, with 60 cases in each group. The prenatal intervention of the two groups was the same, and they were given spinal anesthesia of painless labor. When entering the second stage of labor, the traditional group adopted the traditional supine before delivery while the free group adopted free position. Comparisons were made between the two groups in terms of labor process, pregnancy outcome, complications, postpartum subjective pain and sense of delivery control. Results The second stage of labor in the free group was significantly shorter than that in the traditional group (P<0.05), and the incidence of abnormal fetal heart rate in the second stage of labor was significantly lower than that in the traditional group. The improvement time of abnormal fetal heart rate was significantly shorter than that in the traditional group (P<0.05). The natural delivery rate of primipara in the free group was significantly higher than that in the traditional group, and the transit cesarean section rate was significantly lower than that in the traditional group (P<0.05). Compared to the traditional group, the incidences of lateral perineal excision, postpartum discomfort, tension urinary incontinence and neonatal asphyxia were significantly lower in the free group (P<0.05). The pain visual analogue scale (VAS) score of subjective delivery in the free group was significantly lower than that in the traditional group, and the parturition control (LAS) score was significantly higher than that in the traditional group (P<0.05). Conclusion Compared to the traditional position, the free posture during the second stage of primipara painless labor can shorten the labor time, improve the rate of natural delivery and reduce maternal and neonatal complications. Thus, it can further reduce labor pain and improve parturition control. 2019 Vol. 36 (2): 288-311 [Abstract] ( 69 ) HTML (1 KB)  PDF  (0 KB)  ( 15 ) 291 Analysis of Long-term Survival Status of Patients with Small Hepatocellular carcinoma Treated by Minimally Invasive Surgery WU Zhen-yang, MA Ben, WANG Da-wei DOI: 10.3969/j.issn.1671-7171.2019.02.026 Objective To study the long term survival of patients with small hepatocellular carcinoma after minimally invasive surgery.Methods The clinical data of 115 patients with small hepatocellular carcinoma in our hospital were analyzed retrospectively, of which 43 cases were treated by laparotomy (open group) and 72 cases of minimally invasive surgery (minimally invasive group). The post-operative recovery of the two groups was observed, and the post-tumor recurrence and the long-term survival rate were observed.Results The incidence of complications in the minimally invasive group 5.56%(4/72)was significantly lower than that in the open group 16.28% (7/43). The difference was statistically significant (χ2=4.693,P=0.016＜0.05), and the incidence of complications in the minimally invasive group was significantly lower than that in the open group (P<0.05). The hospitalization time in minimally invasive group was shorter than that in open group (P<0.05). There was no significant difference in the disease-free survival rate and the overall survival rate between the two groups at 1 year, 3 years and 5 years after operation by Kaplan-Meier plot and Log-rank method during follow-up (P>0.05), and there was no significant difference between the two groups (P>0.05). Conclusion The incidence of complications after minimally invasive surgery for small hepatocellular carcinoma is lower than that of open surgery, and the tumor-free survival rate and overall survival rate within 5 years are consistent with that of open operation. Minimally invasive surgery is a safe and effective method for the treatment of small hepatocellular carcinoma. 2019 Vol. 36 (2): 291-293 [Abstract] ( 63 ) HTML (1 KB)  PDF  (0 KB)  ( 16 ) 294 Effect of Health Education of Health Promotion Model on Health Behavior and Blood Glucose Control of Patients with Gestational Diabetes Mellitus YUAN Jing DOI: 10.3969/j.issn.1671-7171.2019.02.027 Objective To explore the effect of health education promotion model on health behavior and blood sugar control of patients with gestational diabetes mellitus (GDM).Methods One hundred patients with GDM who visited our hospital from July 2015 to June 2017 were randomly divided into observation group and control group with 50 cases in each group. The control group was given GDM routine health education, while the observation group was given HPM health education. After 8 weeks of intervention, health behavior compliance, blood sugar control and pregnancy outcome were compared between the two groups. Results After 8 weeks of intervention, the compliance rates of diet control, moderate exercise, body mass management, blood sugar monitoring, regular review and attending lectures in the observation group were significantly better than those in the control group (P<0.05); the levels of fasting blood glucose (FPG), 2-hour postprandial blood glucose (2hPG) were significantly lower than those in the control group (P<0.05); the incidence rates of polyhydramnios, premature delivery, puerperal infection and neonatal hypoglycemia were significantly lower than those in the control group (P<0.05).Conclusion HPM health education can promote the healthy behavior of GDM patients, help to improve the effect of blood sugar control and improve pregnancy outcomes. 2019 Vol. 36 (2): 294-296 [Abstract] ( 64 ) HTML (1 KB)  PDF  (0 KB)  ( 14 ) 297 Clinical Efficacy and Safety of Laparoscopic and Open Surgery for Appendicitis in Pregnancy LI Teng-fang, LI Quan, Gu Jun DOI: 10.3969/j.issn.1671-7171.2019.02.028 Objective To compare the clinical efficacy and safety of laparoscopic and open surgery in the treatment of appendicitis in pregnancy. Methods A retrospective analysis was made of 56 cases of appendicitis complicating pregnancy treated in our hospital from January 2014 to January 2017. According to the surgical methods, 32 cases were divided into laparoscopic surgery (minimally invasive group) and 24 cases were treated by open surgery (control group). The operation time, blood loss, hospitalization time, hospitalization expenses, surgical complications, serum C-reactive protein (CRP), tumor necrosis factor-α(TNF-α), white blood cell (WBC) levels and pregnancy outcomes were compared between the two groups. Results The bleeding volume and hospitalization time in the minimally invasive group were significantly less than those in the control group, and the hospitalization expenses were significantly higher than those in the control group, with statistical significance (P<0.05), but there was no significant difference in the operation time between the two groups (P>0.05); there was no significant difference in the levels of serum CRP, TNF-αand WBC in the peripheral blood between the two groups before operation (P>0.05). The levels of CRP, TNF-αand WBC in peripheral blood in minimally invasive group were significantly lower than those in control group at D1 and D3 after operation (P<0.05). The complication rate in minimally invasive group was 6.25%, significantly lower than that in control group (29.17%,P<0.05). There was no significant difference in gestational weeks, birth weight, 1 minute and 5 minute Apgar scores between the two groups during follow-up until the end of delivery (P>0.05).Conclusion Laparoscopic minimally invasive surgery in the treatment of appendicitis during pregnancy has obvious curative effect and high safety, which is worthy of clinical application. 2019 Vol. 36 (2): 297-299 [Abstract] ( 86 ) HTML (1 KB)  PDF  (0 KB)  ( 14 ) 300 Retrospective analysis on 291 cases of Radionuclide Bone Imaging in Breast Cancer ZHANG Sen, Chen Qiang, Liu Ling DOI: 10.3969/j.issn.1671-7171.2019.02.029 Objective To investigate the relative factors of bone metastasis in breast cancer. Methods The clinical data of 291 breast cancer patients from July 2013 to June 2017 were analyzed retrospectively. The single factor analysis was applied to the collected clinical factors, and then the meaningful items were analyzed by Logistic regression. Results Bone metastasis was found in 53 of 291 patients (18. 2%), 3 of them lack Ⅰ~Ⅳ stage, N stage, 2 cases lack T stage, 3 negative, lymph node metastasis, not included in the table analysis. The results showed that clinical stage, T stage, N stage, size of primary tumor and lymph node metastasis might be correlated with bone metastasis of breast cancer (P<0.05). Five variables with statistical difference were analyzed by Logistic regression analysis. The results showed that clinical stage was a risk factor for bone metastasis of breast cancer (P<0.05). Bone metastasis occurred within 5 years after diagnosis. Axial bone was the most common metastatic site, but bone metastasis of limbs was not uncommon.Conclusion Clinical staging is an independent risk factor for bone metastasis in breast cancer. The metastatic site of breast cancer is mainly axial bone, but metastasis to extremities is not uncommon. 2019 Vol. 36 (2): 300-302 [Abstract] ( 49 ) HTML (1 KB)  PDF  (0 KB)  ( 14 ) 303 Influence of Axillary Lymph Node Extranodal Metastasis on Survival status of Elderly Patients with Breast Cancer WANG Kuang, LI Gui-mei DOI: 10.3969/j.issn.1671-7171.2019.02.030 Objective To investigate the impact of axillary lymph node metastasis on the survival of elderly women with breast cancer. Methods The clinical and pathological data of 106 elderly patients with primary invasive breast cancer admitted to our hospital from October 2014 to October 2016 were retrospectively analyzed. The tumor size, estrogen receptor (ER) and progesterone receptor (PR) status, histological differentiation, positive number of lymph node metastasis, number of lymph node metastasis at level Ⅰ~Ⅱ, axillary lymph node metastasis and recurrence-free survival rate (RFS) were analyzed. ) Prognostic correlations such as overall survival rate (OS) were also discussed. Kaplan-Meier survival analysis was used to analyze the differences of RFS and OS between patients with simple axillary lymph node metastasis and those with extranodal axillary lymph node metastasis.Results Univariate analysis showed that the size of tumor, the number of positive lymph node metastasis and the number of lymph node metastasis at Ⅰ~Ⅱ level had significant effect on the extranodal metastasis of axillary lymph node (P<0.05). Cox multivariate analysis showed that the number of lymph node metastasis at the level of Ⅰ~Ⅱ had statistical significance. The size of tumor, the number of lymph node positive metastasis, the rate of lymph node metastasis and axillary lymph node metastasis were the risk factors of RFS,OS, the difference was statistically significant (P<0 05). The survival analysis of Kaplan-Meier showed that there was no significant difference between the two groups (P<0 05). In patients with axillary lymph node alone, RFS was 73.68% (42 / 57), OS, 91.22%(52/57). The RFS in patients with axillary lymph node metastasis with axillary lymph node extranodal metastasis was 32.65% (16 / 49), OS 44.80%( 22 / 49), which was lower than that in patients with simple axillary lymph node metastasis. Log-Rank test was performed on the patients with axillary lymph node metastasis and extranodal metastasis. The difference was statistically significant (P<0.05).Conclusion Tumor size, positive lymph node, number of lymph node metastasis, rate of lymph node metastasis and axillary lymph node metastasis can be used as risk factors of RFS,OS in elderly patients with breast cancer. 2019 Vol. 36 (2): 303-305 [Abstract] ( 74 ) HTML (1 KB)  PDF  (0 KB)  ( 14 )

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