ABSTRACT
Objective:To explore the function of temperature difference stimulation oral nursing for the patients with mild to moderate dysphagia after oral cancer operation.Methods:A total of 64 patients with mild to moderate dysphagia after oral cancer surgery admitted to our hospital from January 2019 to June 2021 were selected as the research subjects by convenient sampling method, and divided into control group ( n=32) and observation group ( n=32) according to random number table method. The grouping method was random number table method. The control group was treated with traditional ice-water stimulation rehabilitation training, and the observation group was treated with temperature difference stimulation oral care. The degree of dysphagia, nutritional status, postoperative complications and quality of life were analyzed and compared between the two groups. Results:After the intervention, the degree of dysphagia in the observation group (water swallow test) fromⅠto Ⅳ degree were 2, 11, 13 and 6 cases, while in the control group were 9, 17, 4 and 2 cases, the difference was significant ( Z=-3.41, P<0.05). After the intervention, the serum albumin of the observation group was (38.74 ± 4.87) g/L, which was significantly higher than that of the control group (35.81 ± 5.14) g/L. there was significant difference between the two groups ( t=2.34, P<0.05). After the intervention, the self scores of chewing, swallowing, anxiety, emotion and quality of life in the Chinese version of the University of Washington quality of life scale in the observation group were 70.28 ± 10.39, 68.20 ± 9.43, 72.39 ± 12.28, 65.30 ± 15.33 and 78.05 ± 9.47, which were significantly higher than those in the control group 64.29 ± 9.26, 61.42 ± 12.38, 64.50 ± 10.43, 58.08 ± 11.62 and 72.92 ± 10.40, The difference was statistically significant ( t values were 2.06-2.77, all P<0.05). Conclusions:Oral nursing with temperature difference stimulation can effectively improve the swallowing disorder of patients after oral cancer surgery, reduce the incidence of aspiration and malnutrition, and improve the quality of life of patients.
ABSTRACT
Objective:To evaluate the inflammatory factors effects of early endoscopic therapy for elderly patients with acute biliary pancreatitis (ABP) and its clinical efficacys.Methods:206 elderly patients with ABP admitted from Jan. 2010 to Dec. 2019 were divided into observation group (102 cases) and the control group (104 cases) according to treatment method. The observation group received endoscopic retrograde cholangiopancreatography (ERCP) , endoscopic sphincterotomy (EST) and endoscopic naso-biliary drainage (ENBD) , while the control group received conventional treatment. Clinical symptoms, changes of inflammatory factors, complications and prognosis were observed in each group.Results:CRP, SAA, IL-6, IL-8 and TNF-a after treatment were significantly lowered than those before treatment ( P<0.05) . In addition, the levels of CRP, SAA, IL-6, IL-8 and TNF-a in the observation group were significantly lower than those in the control group ( P<0.05) . The time to abdominal pain extinction, time to fever cessation, hospital stay in observation group were (3.92±1.54) , (3.63±1.41) , and (14.35±2.46) d, significantly less than those in the control group [ (5.81±1.72) , (5.45±2.13) , (19.37±3.12) d, P<0.05]. APACHE Ⅱ score of the observation group was (10.02±2.67) point after treatment, significantly lower than that in the control group [ (12.35±3.62) point, t=4.42, P<0.05]. The incidence of complications in the observation group was 10.78% after treatment, significantly lower than that in the control group [ (24.03%) , χ2=6.27, P< 0.05]. The mortality in the observation group was 1.96%, lower than 4.81% in the control group, with no statistical significance. Conclusion:Early endoscopic therapy is safe and highly effective for elderly patients with ABP, with the advantages of shorter hospital stay, quicker subsided inflammation, and lower incidence of complications.
ABSTRACT
Blood-brain barrier (BBB) damage after ischemia significantly influences stroke outcome. Compound LFHP-1c was previously discovered with neuroprotective role in stroke model, but its mechanism of action on protection of BBB disruption after stroke remains unknown. Here, we show that LFHP-1c, as a direct PGAM5 inhibitor, prevented BBB disruption after transient middle cerebral artery occlusion (tMCAO) in rats. Mechanistically, LFHP-1c binding with endothelial PGAM5 not only inhibited the PGAM5 phosphatase activity, but also reduced the interaction of PGAM5 with NRF2, which facilitated nuclear translocation of NRF2 to prevent BBB disruption from ischemia. Furthermore, LFHP-1c administration by targeting PGAM5 shows a trend toward reduced infarct volume, brain edema and neurological deficits in nonhuman primate
ABSTRACT
Objective:To investigate the diagnosis, classification and treatment of pancreatic duct stones (PDS) .Methods:Clinical data and prognosis of 32 patients with PDS treated in our hospital from Jan. 2010 to Dec. 2019 were retrospectively analyzed. The treatment methods were summarized.Results:All 32 cases were diagnosed with PDS by imaging examinations such as B ultrasonography, CT, endoscopic retrograde cholangiopancreatography (ERCP) or magnetic resonance cholangiopancreatography (MRCP) . The diagnosis accuracy was 81.3% (26/32) for B-ultrasound, 86.2% (25/29) for CT, 90.4% (19/21) for MRCP, and 100% (8/8) for ERCP. According to the location of stones and intraoperative exploration, the 32 patients were divided into 3 groups: Type I, 17 patients, the stones were located in the main pancreatic duct; TypeⅡ, 11 patients, the stones were located in both main and branch pancreatic duct; Type Ⅲ, 4 patients, the stones were located in the branch pancreatic duct. Different treatment methods were employed according to the different types. No patient died in the perioperative period. 11 (34.3%) patients had postoperative complications. 3 (9.3%) patients had postoperative residual stones. 32 cases were followed up for a period of 6 to 60 months. The abdominal pain and steatorrhea disappeared or significantly improved postoperatively. 2 patients complicated with pancreatic cancer died 12 to 35 months after operation.Conclusions:The treatment and diagnosis of the PDS still remains complicated. Imaging examinations are the main methods for diagnosis of PDS. The accurate classification and individual treatment are important. Surgery is the most commonly used method for PDS.
ABSTRACT
Objective To investigate the clinical significance of serum miR-187 and miR-143 in the development and diagnosis of gallbladder cancer.Methods 75 serum samples in patients with gallbladder cancer were selected as gallbladder cancer group.75 serum samples in patients with gallbladder benign disease and 45 serum samples in healthy physical examinations at same period were selected as the benign gallbladder disease group and healthy control group.Quantitative RT-PCR was used to detect the serum miR-187 and miR-143 expression in each group,and the expression of those related with the clinicopathological factors,the proliferation and migration of gallbladder cancer cells,and the efficacy in diagnosis of gallbladder cancer was observed.Results The serum miR-187 expression in gallbladder cancer group was significantly higher than that in benign gallbladder disease and healthy control;the serum expression of that in benign gallbladder disease was significantly higher than that in healthy control;after surgery,the expression of that was significantly lower than that before treatment (all P ＜ 0.05).The serum expression of miR-143 in gallbladder cancer group was significantly lower than that in benign gallbladder disease and healthy control;the serum expression of that in benign gallbladder disease was significantly lower than that in healthy control;after surgery the serum expression of that was significantly higher than that before surgery (all P ＜0.05).The serum expression levels of miR-187 and miR-143 in gallbladder cancer were not correlated with gender and age (both P ＞ 0.05),and were significantly correlated with Nevin stage,TNM stage,differentiation and lymphatic metastasis (all P ＜ 0.05).Furthermore,it was confirmed that miR-187 promoted the proliferation and migration of gallbladder cancer cells in vitro,while miR-143 inhibited the proliferation and migration.In the diagnosis of gallbladder,the diagnostic efficacy of miR-187 and miR-143 was significantly better than that of CA199 and CA242 (both P ＜ 0.05).Combined detection could further improve the efficacy in diagnosis of gallbladder cancer.Conclusions miR-187 and miR-143 are involved in the development of gallbladder cancer.Combined detection of serum miR-187 and miR-143 in gallbladder cancer has a high diagnostic efficiency in the diagnosis of gallbladder cancer.
ABSTRACT
Objective To observe the efficacy of endoscopic retrograde cholangiopancreatography (ER-CP) and laparotomy in treatment of acute gallstone cholangitis and their impact on the levels of serum amyloid A (SAA),C-reactive protein (CRP) and endothelin-1 (ET-1).Methods 80 patients with acute gallstone cholangitis,from Jan.2013 to Dec.2016,were divided into observation group(35 cases) and the control group (45 cases)according to the surgical procedure.The observation group received ERCP,and the control group were performed with open cholecystectomy,common bile duct extraction and T-tube placement.The operation time,blood loss,gastrointestinal function recovery time,hospital stay,and the success rate of stone removal,and the levels of SAA,and changes in CRP and ET-1 before and after treatment were observed in each group.Results Compared with the control group,the observation group had shorter operative time [(76.43±9.82)min vs (69.28±7.53) min,P=0.000],less blood loss[(1 1.73±2.83)ml vs (78.41±3.28) ml,P=0.000],shorter gastrointestinal function recovery time [(29.53±3.27) h vs (78.33±8.43) h,P=0.000],and shorter hospital stay [(5.73±1.32)d vs (8.54±1.62) d,P=0.000],while the success rate of stone removal was not significantly different between the two groups (97.14％ vs 95.56％,P＞0.01).Before treatment,the levels of SAA,CRP and ET-1 had no significant difference between the two groups(P＞0.05).The levels of SAA,CRP and ET-1 in the two groups after treatment were significantly lower than those before treatment (P＜0.01),while the levels decreased more in the observation group compared with that in the control group (P＜0.01).Conclusions The endoscopic therapy and laparotomy in treatment of acute cholangitis stones have both achieved good efficacy.Compared ith laparotomy,ERCP has faster recovery,shorter hospital stay,and quicker subsided inflammation.
ABSTRACT
Objective To compare the operative results of removing large olfactory groove meningiomas(diameter≥3 cm)using either a unilat?eral or bilateral subfrontal approach ,and to determine whether there is an advantage in the unilateral approach. Methods Sixty?nine cases of large olfactory groove meningioma,treated in our department,by either a unilateral or bilateral subfrontal approach microsurgery were retrospec?tively reviewed. Removal grading,post?operative complications,and other clinical indices were evaluated. Results Total resection(Simpson Ⅰ or Ⅱ)was achieved in all the cases. There were lesser complications with use of the unilateral subfrontal approach. Conclusion Patients with ol?factory groove meningioma have a good prognosis when a unilateral subfrontal approach is used for surgery.
ABSTRACT
Objective To investigate the efficacy of micro?surgery for the treatment of medulla oblongata cavernomas. Methods A retrospective analysis was conducted on the clinical data of 21 patients with cavernous hemangioma who received micro?surgical treatment. Of the 21 patients, 13 were men and 8 women,aged 22 to 63 years. The preoperative Karnofsky performance status(KPS)score was 76.5 ± 10.2. The main clinical manifestations included sensory disorder and difficulty swallowing etc. According to the location of the lesions ,the posterior transchoroidal fissure approach was employed for 16 patients;far?lateral approach,5 patients. Electrophysiological monitoring and nervous system navigation were supple?mentarily adopted in both types of surgery. Further ,KPS scoring was conducted to evaluate the patients 'quality of life. Results The medulla cav?ernous hemangioma was excised in all cases. For 17 patients with primary neurological disorders ,their symptoms were alleviated or resolved;4 pa?tients had severe symptoms and 8 presented with new clinical symptoms. A follow?up visit was conducted 8 to 97 months post?surgery(average 47.6 months). All patients were found capable of caring for themselves in daily life and performing simple or normal learning and working activities without recurrence or bleeding. The mean postoperative KPS score was 83.7 ± 15.5. Conclusion Patients with medulla cavernous hemangioma bleeding or severe symptoms should actively seek surgical treatment. Repeated bleeding is the absolute indication for surgery. Surgical skills ,elec?trophysiological monitoring,and nervous system navigation can reduce nervous system damage and protect the brainstem. The patient's quality of life is expected to significantly improve after surgery.
ABSTRACT
Objective To evaluate the efficacy and safety of the bundles of treatment protocol for patients with acute brain injury (ABI) complicated by acute lung injury (ALl)/acute respiratory distress syndrome (ARDS).Methods A total of 83 patients with acute brain injury complicated by ALI/ARDS were randomly divided into experimental group (n =41) and control group (n =42).The control group was treated with the routine bundle protocol while the experimental group was treated with an intensive bundle protocolin addition to the routine bundle protocol.The data was collected,and the effectiveness and safety of the two bundles of treatment protocol were evaluated.Results The results of heart rate (HR),SpO2,and PO2/FiO2 in the two groups showed significant differences before and after treatment.The improvement of PO2/FiO2 in the experimental group occurred earlier and was more significant compared tothe control group,24 hours after treatment.The mechanical ventilation time,ICU stay time,and total hospitalization time for the experimental group were significantly different (P ＜ 0.05) from the control group.The 28-day mortality and morbidity of ventilator-associated pneumonia showed no significant difference (P ＞ 0.05) between the two groups.Conclusion The treatment of acute brain injury complicated by ALI/ARDS by the two bundles of treatment protocol is effective.Compared to the conventional treatment bundles,the intensive treatment bundles can significantly improve oxygenation,and shorten the mechanical ventilation time required,as well as ICU and total hospital stay.
ABSTRACT
Objective To learn the correlation between thyroid function and arteriosclerosis in elderly popu-lation,and to provide research data for early clinical intervention.Methods 7 1 elderly patients with hypothyroidism were selected as A group,76 elderly patients with subclinical hypothyroidism were selected as B group,70 healthy elderly cases were selected as C group.Triiodothyronine (FT3 ),tetraiodothyronine (FT4 ),thyrotrophin (TSH ), triglyceride (TG),total cholesterol (TC ),low density lipoprotein cholesterol (LDL -C ),high density lipoprotein cholesterol (HDL-C),C reactive protein (CRP)levels of the three groups were detected.Carotid artery intima media thickness (CIMT)was examined by color Doppler ultrasonography.Results FT4 levels of A group,B group were (5.25 ±4.17)pmol/L,(10.74 ±5.02)pmol/L respectively,which were lower than (18.53 ±6.38)pmol/L of C group.TSH levels of A group,B group were (16.45 ±6.96)mU/L,(6.25 ±3.84)mU/L respectively,which were higher than (3.37 ±1.13)mU/L of C group (t=14.650,8.232,15.522,6.037,all P<0.05).FT4 level of A group was lower than that of B group,TSH level of A group was higher than B group (t=7.185,11.097,P<0.05).TC, LDL-C levels of A group,B group were (5.96 ±1.01)mmol/L,(4.15 ±1.69)mmol/L,(5.64 ±0.94)mmol/L, (3.64 ±1.17)mmol/L respectively,which were higher than those of C group [(5.17 ±1.12)mmol/L,(3.20 ± 1.06)mmol/L](t=4.400,2.754,3.992,2.374,all P<0.05).TC,LDL-C levels of A group were higher than B group (t=1.990,2.139,all P<0.05).CIMT,CRP levels of A group,B group were (0.90 ±0.23)mm,(6.20 ± 1.31)mg/L,(0.79 ±0.17)mm,(4.55 ±1.05)mg/L respectively,which were higher than those of C group [(0.68 ±0.11)mm,(3.12 ±0.88)mg/L](t=7.229,4.599,16.364,8.878,all P<0.05).CIMT,CRP levels of A group were higher than B group (t=3.312,8.453,all P<0.05 ).CIMT and TSH,LDL -C,CRP levels were positively correlated (r=0.789,0.647,0.583,all P<0.05),CIMT and FT4 levels were negatively correlated (r=-0.636,P<0.05 ).Conclusion Hypothyroidism,subclinical hypothyroidism are associated with atherosclerosis in elderly population,and elderly patients with hypothyroidism,subclinical hypothyroidism are at high risk of atherosclerosis.