Comparison of the Efficacy of Indwelling Gastric Tubes in Preoperative and Postoperative Patients With Oral and Maxillofacial Malignancies.

PURPOSE: To explore the optimal plan for the timing of indwelling gastric tube placement in oral and maxillofacial malignant tumor patients. DESIGN: A prospective randomized controlled trial. METHODS: 80 patients with oral and maxillofacial tumor were selected, and 40 patients were Pre-operative group. The remaining 40 patients were the control group, called Postoperative group. The body weight and hospital stay of the two groups were observed before and after surgery. Blood samples were taken before surgery and 1, 3 and 7 days after surgery to detect hemoglobin and plasma albumin. FINDINGS: The number of postoperative hospitalization days in the pre-operative group was significantly lower than that in the post-operative group; postoperative hemoglobin and plasma albumins were lower in both groups compared with the preoperative level. CONCLUSIONS: Preoperative nasogastric tube ensured early postoperative administration of gastrointestinal nutrition, promoted postoperative plasma albumin recovery, and shortened the days of hospitalization.

Clinical Study of Clopidogrel Combined with Huoxue Tongluo Prescription in Improving Transient Ischemic Attack and the Effect on MMP-9, Hcy, and CRP.

Background: This study aimed to explore the clinical study of clopidogrel combined with Huoxue Tongluo prescription in improving transient ischemic attack (TIA) and the effect on MMP-9, Hcy, and CRP. Methods: A total of 84 patients with TIA admitted to our hospital from December 2019 to February 2021 were selected. The patients were divided into the control group (42 cases: not treated with Huoxue Tongluo prescription) and study group (42 cases: treatment with Huoxue Tongluo prescription). The clinical efficacy, adverse reactions, the levels of blood pressure and lipid, blood rheology and cerebral hemodynamics, neurological function-related indicators, MMP-9, Hcy, and CRP of the two groups were compared. Results: The total effective rate in the study group was higher than the control group. Compared with before treatment, the levels of SBP and DBP in both groups decreased memorably after treatment, and those in the study group decreased more particularly than the control group. The levels of LDL, HDL, TC, and TG in the study group were significantly better than those in the control group. The plasma viscosity, whole blood high shear viscosity, whole blood low shear viscosity, and hematocrit of patients in the study group were lower than those in the control group, and the maximum blood flow velocity, minimum blood flow velocity, average blood flow velocity, and average blood flow were higher than those in the control group. The levels of NSE, MBP, and S100ß in the study group were more memorably lower than those in the control group. After treatment, the levels of MMP-9, Hcy, and CRP in the study group were significantly lower than those in the control group. There was no obvious difference in the incidence of adverse reactions between the study group and control group. Conclusion: Clopidogrel combined with Huoxue Tongluo prescription can significantly improve the therapeutic effect and reduce the levels of MMP-9, Hcy, and CRP in patients with TIA.

To Analyze the Application Value of Perioperative Nursing Care in Patients with Resected Brain Tumor Accompanied with Epileptic Symptoms under Cortical Electrocorticography Monitoring.

OBJECTIVE: To explore the application value of perioperative nursing for patients with brain tumors with epilepsy symptoms under the cortical electrocorticography (EEG) monitoring. METHODS: A total of 86 patients with brain tumor complicated with epilepsy admitted to the department of brain surgery of our hospital from January 2018 to December 2019 were selected as the research objects, and all underwent resection under cortical EEG monitoring. According to different nursing methods, they were divided into the control group and observation group, each with 43 cases. The control group was given perioperative basic nursing, and the observation group was given perioperative comprehensive nursing. The EEG image of the patient during the operation was observed by a portable EEG monitor. Anxiety and depression were assessed by self-rating anxiety scale (SAS) and self-rating depression scale (SDS) scores. The self-made satisfaction questionnaire was used to investigate the nursing satisfaction. A visual analogue (VAS) score is used to assess pain degree. A multiparameter monitor was used to detect the patient's heart rate (HR), systolic blood pressure (SBP), and diastolic blood pressure (DBP). The quality of life was assessed by the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-30). The complication rate and recurrence rate were also counted. RESULTS: Eighty-six patients with epileptic brain tumor developed spikes in 35 cases, including 7 meningiomas, 22 gliomas, and 6 cholesteatomas; 27 cases of sharp waves, including 14 meningiomas, 12 gliomas, and 1 case of cholesteatomas; and 24 cases of complex wave, including 9 cases of meningioma, 13 cases of glioma, and 2 cases of cholesteatoma. There was no significant difference in the scores of SAS, SDS, VAS, HR, SBP, DBP, and quality of life between the two groups at T0. The VAS score increased at T1 and T2, and the increase in the control group was greater than that in the observation group. At T3 and T4, the SAS, SDS, and VAS scores of the two groups decreased, and the observation group decreased more than the control group. HR, SBP, and DBP of the two groups showed an upward trend at T1 and T2, and the increase in the control group was more significant than that in the observation group. At T3, the three indicators of the two groups decreased, and the observation group decreased more significantly than the control group. At T4, the scores of all indicators of the quality of life of the two groups increased, and the observation group increased more significantly than the control group. The nursing satisfaction of the observation group was higher than that of the control group. The complication rate and recurrence rate in the observation group were decreased compared with the control group. CONCLUSION: Perioperative comprehensive nursing intervention for patients with epileptic brain tumor undergoing resection under cortical EEG monitoring can reduce or even eliminate the recurrence rate of epilepsy, reduce the patient's pain and stress response, and improve the patient's quality of life. It can also reduce the occurrence of complications, improve nursing satisfaction, thereby improving patient compliance, and has a high clinical application value.

Distribution of HPV 16 E6 gene variants in screening women and its associations with cervical lesions progression.

The aim of this study is to investigate distribution of human papillomavirus (HPV) 16 variants in screening healthy women and the potential association between HPV 16 variants and progression of cervical lesions. For this study a total of 2000 healthy women in Tianjin urban area and 212 patients who were HPV 16 positive and underwent colposcopy were analyzed for HPV 16 variants by pyrosequencing. The results show that the HPV 16 was the most prevalent genotype in Tianjin healthy women and five HPV 16 variant types were detected. The HPV 16 variants were determined by sequencing parital E6 region and the detected variants were European prototype E-T350 (E-p), E-G350, E-C109 G, Asian (As) and Asian-American (AA), among which the E-p variant was the most prevalent (82.76%) followed by As variant. Interestingly, in patients with suspected cervical lesions the most prevalent variant was As variant (54.9%) by increasing significance with severity of cervical diseases (OR 4.337; 95% CI 1.248-15.067; P = 0.021), and followed by HPV 16 E-p variant while E-G350 variant only appeared in HSIL and cervical cancer. Our results show that HPV 16 E-p variant was more prevalent than As in Tianjin healthy screening women while As variant was the most frequently type in HSIL and cervical cancer. It is suggested that the mutation of HPV 16 Asian variants, comparing with HPV 16 E-p variants, might contribute to the transformation from HPV 16 persistent infection to cervical cancer.

Decisions, decisions: how program diversity influences residency program choice.

BACKGROUND: Recent studies suggest that students' feelings of fit with a residency program substantially influence students' ranking of the program. As diversity issues become increasingly focal concerns, we investigate how perception of gender and racial diversity of a program influences students' rankings of the program. We focus on students pursuing surgical specialties and ask whether diversity concerns are more prominent among applicants to surgical programs than among applicants to nonsurgical programs. STUDY DESIGN: We invited all interviewees at all residency programs at the Stanford University School of Medicine to participate in our study in the spring of 2009. Nineteen residency programs, amounting to 1,657 residency interviewees, participated. Sixty-eight percent (n = 1,132) responded to the survey. RESULTS: Women and under-represented minority applicants differ in their assessments from male and non-under-represented minority applicants because women applying to surgical programs and under-represented minority students are less likely than others to perceive their prospective programs as diverse. However, perceived program diversity is an important factor that positively influences the program ranking decision for women and minorities pursuing surgical training. CONCLUSIONS: Surgical training programs that promote gender and racial diversity will likely be more successful in attracting women and minority students because women and minorities are especially sensitive to program diversity in both their perceptions and rankings of programs. Promoting women and minorities within programs and connecting women and minority applicants to outreach programs and mentors is pertinent to the recruitment of these traditionally under-represented groups to surgical programs.