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@#Objective To study the correlation of preoperative hemoglobin amount with venous thromboembolism (VTE) after surgical treatment of bronchiectasis and the clinical significance. Methods A retrospective study was performed on patients with bronchiectasis who underwent surgical treatment in our center from June 2017 to November 2021. The differences in blood parameters between the VTE patients and non-VTE patients were compared. The relationship between preoperative hemoglobin and VTE was confirmed by quartile grouping and receiver operating characteristic (ROC) curve. Results A total of 122 patients were enrolled, including 50 males and 72 females, with a mean age of 52.52±12.29 years. The overall incidence of VTE after bronchiectasis was 9.02% (11/122). Preoperative hemoglobin amount (OR=0.923, 95%CI 0.870-0.980, P=0.008) and D-dimer amount (OR=1.734, 95%CI 1.087-2.766, P=0.021) were independent influencing factors for VTE after bronchiectasis. The incidence of VTE after bronchiectasis decreased gradually with the increase of preoperative hemoglobin amount. The area under the ROC curve (AUC) of postoperative D-dimer alone was 0.757, whereas the AUC of postoperative D-dimer combined with preoperative hemoglobin amount was 0.878. Conclusion Low preoperative hemoglobin is an independent risk factor for postoperative VTE. Postoperative D-dimer combined with preoperative hemoglobin amount has a better predictive performance compared with postoperative D-dimer alone for postoperative VTE.
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Objective:To observe the clinical effect of prolonged photodynamic therapy (PDT) irradiation time combined with intravitreal injection of ranibizumab in the treatment of circumscribed choroidal hemangioma (CCH).Methods:A retrospective clinical study. From March 2012 to March 2018, 51 eyes of 51 patients diagnosed in Shenzhen Eye Hospital were included in the study. Among the patients, the tumor of 36 eyes were located in macular area, of 15 eyes were located outside macular area (near center or around optic disc). All patients underwent BCVA, color fundus photography, FFA, ocular B-scan ultrasonography and OCT examinations. The BCVA examination was performed using the international standard visual acuity chart, which was converted into logMAR visual acuity. OCT showed 48 eyes with macular serous retinal detachment. of 36 eyes with tumor located in macular area, the logMAR BCVA was 0.05±0.05, the tumor thickness was 4.5± 2.2 mm, the diameter of tumor was 9.7±3.6 mm. Of 15 eyes with tumor located outside macular area, the logMAR BCVA was 0.32±0.15, the tumor thickness was 3.8±1.4 mm, the diameter of tumor was 7.7± 1.9 mm. PDT was performed for all eyes with the irradiation time of 123 s. After 48 h, all patients received intravitreal injections of 0.5 mg ranibizumab (0.05 ml). At 1, 3 and 6 months after treatment, the same equipment and methods before treatment were used for related examination. BCVA, subretinal effusion (SRF), tumor leakage and size changes were observed. BCVA, tumor thickness and diameter before and after treatment were compared by t test. Results:At 6 months after treatment, the tumor was becoming smaller without scar formation. FFA showed that the blood vessels in the tumor were sparse compared with those before treatment, and the fluorescence leakage domain was reduced. OCT showed 43 eyes of macular serous detachment were treated after the combined treatment. The logMAR BCVA were 0.16±0.15 and 0.55±0.21 of the eyes with tumor located in or outside macular area, respectively. The difference of logMAR BCVA between before and after treatment was significant ( t=-2.511, -2.676; P=0.036, 0.040). Both the tumor thickness ( t=3.416, 3.055; P=0.011, 0.028) and diameter ( t=4.385, 4.171; P=0.002, 0.009) of CCH patients were significantly reduced compared with that before treatment. Conclusion:The tumor of CCH can be reduced by prolonged PDT irradiation time combined with intravitreal injection of ranibizumab.
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Objective@#To investigate the association between mutation of PLCB1, the downstream gene of KISS1/GPR54 pathway, and the risk of central precocious puberty (CPP) in Chinese Han girls.@*Methods@#Totally 169 pairs of CPP girls on their first visit to hospital and age-matched controls (± 3 months) were recruited. The genotypes of rs6140544, rs11476922, rs3761170 and rs2235613 were determined and the effect of loci variations on CPP was investigated.@*Results@#After adjusting for confounding factors (BMI, maternal age at menarche, maternal age at birth, and time for bed), rs2235613 variation was significantly negative associated with CPP in recessive models(OR=0.46，95%CI=0.24-0.91), and mutation in rs3761170 increased the risk of CPP in dominant models (OR=1.99，95%CI=1.01-3.93).@*Conclusion@#The study suggests that mutation in rs3761170 increases the risk of CPP and rs2235613 variation may have a protective effect on the risk of CPP.
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Objective To investigate the multimodal imaging characteristics of central serous chorioretinopathy (CSC) converted to polypoidal choroidal vasculopathy (PCV) and pachychoroidal neovascularization(PNV).Methods A retrospective case series study was adopted.The clinical data of 91 eyes from 79 patients with CSC who received treatment from June 2009 to September 2017 in Shenzhen Eye Hospital were analyzed.Color fundus photography,fundus fluorescein angiography (FFA),spectral domain optical coherence tomography (SD-OCT) and indocyanine angiography (ICGA) were performed in the patients.The eyes with recurrence or maintained serous retinal pigment epithelium (RPE) after treatment were examined once more.Results In 91 eyes,11 eyes of 9 patients converted to PNV.Late stage of FFA showed multifocal hyperfluorecnece in macular area.ICGA showed plaque hyperflurorescence overlying dilated choroidal vessel.OCT revealed irregular flap shallow RPE detachment with retinal neurosensory detachment.OCTA revealed mass-like enlarged choroidal vessel between RPE and Bruch membrane.Nine eyes of 7 patients with CSC converted to PCV,and late stage of FFA showed serous-hemorrhage pigment epithelium detachment(PED) and multifocal enlargement hyperfluorecnece.ICGA showed branch vessels network (BVN) with small polyps.OCT revealed PED like thumb with double-layer sign and retinal neurosensory detachment.OCTA en-face revealed BVN with small polyps at choroidal capillaries layer.The baselines BCVA of PCV and PNV (LogMAR) was 0.282±0.220 and 0.413±0.190,respectively with a significant difference between them (t =0.037,P ＜ 0.05).Subfoveal choroidal thickness (SFCT) of CSC,PCV and PNV patients was (373.61 ±65.11),(296.22 ±30.24) and (328.63 ±76.18) μm,with siginificant differences among them (F =3.48,both at P＜0.05).SFCT of PNV patients was thicker than that of PCV patients,with a significant difference between the two groups (t =2.91,P＜0.05).Conclusions Chronic or recurrence CSC is probably to develop to PNV,and the PNV with serous or hemorrhage PED is probably to switch to PCV.Multimodal imaging examination is helpful to the diagnosis of PNV and PCV.
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The risk of perioperative venous thromboembolism (VTE) is pretty high in thoracic cancer patients. Perioperative VTE influences the recovery of patients after operation and quality of life in the future, even seriously leading to death. To strengthen the knowledge and attention of thoracic surgeons on perioperative VTE in thoracic cancer patients, China National Research Collaborative Group on VTE in Thoracic Surgery released the edition of VTE prophalaxis in thoracic cancer patients: Chinese experts consensus in 2018. This article is to interpret the diagnostic value and risk prediction value of D-dimer in VTE in detail, and briefly introduce the role of other biomarkers in VTE of tumor patients. The consensus interpretation aims to deepen the understanding of thoracic surgeons on the clinical significance of D-dimer in VTE.
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Objective:To analyze whether medical insurance and environment protective behaviors could alleviate the influence of environmental pollutions on individual health status.Methods:Using the data of CGSS(2010) to conduct the empirical analysis based on Logit model.Results:Residents' choice on medical insurance and environment protective behaviors could alleviate the damage of environmental pollutions on health.Compared with the young and middle-aged,the elderly effectively alleviated the damage brought by environment pollutions through participating medical insurance.Compared with the low-educated individuals the high-educated inviduals' choices for environment protective behavior could effec tively release the damages brought by environmental pollutions.Conclusion:The government should advocate environmental protective behaviors,provide full coverage of medical insurances to let individuals alleviate the damages of environmental pollutions by their rational choice.More emphasis should be paid to the damage of environmental pollutions on the elderly group and individuals with lower education.
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<p><b>OBJECTIVE</b>To investigate the clinical value of three-dimensional (3D) laparoscopic cholecystectomy in the treatment of complicated gallstone disease.</p><p><b>METHODS</b>From March 2014 to March 2015, 46 patients underwent cholecystectomy for complicated gallstone disease under 3D laparoscopy (3D group) and 43 received 2D laparoscopic cholecystectomy (2D group). The surgical data including the operative time, intraoperative blood loss, the rate of conversion to open laparotomy, recovery time of postoperative bowel motion and hospital stay were compared between the 2 groups.</p><p><b>RESULTS</b>Laparoscopic cholecystectomy was successfully completed in 43 patients in 3D group and in 39 patients in 2D group, and the rates of conversion to open laparotomy were similar between the two groups (P>0.05). The median operation time was significantly shorter in 3D group than in 2D group (50.5∓15.2 vs 65.4∓18.1 min, P<0.05), and the median volume of intraoperative blood loss was significantly smaller in 3D group (34.1∓13.6 vs 44.5∓22.3 mL, P>0.05). No significant differences were found in the recovery time of postoperative bowel motion and postoperative hospital stays between the two groups (P>0.05).</p><p><b>CONCLUSION</b>3D laparoscopy, which provides three-dimensional vision with a good sense of depth to allow precise surgical manipulation, can shorten the operation time and reduce the rate of conversion to open laparotomy for patients undergoing 3D laparoscopic cholecystectomy for complicated gallstone disease.</p>
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Humans , Blood Loss, Surgical , Cholecystectomy, Laparoscopic , Methods , Gallstones , General Surgery , Imaging, Three-Dimensional , Length of Stay , Operative TimeABSTRACT
Objective To study the clinical value of color Doppler ultrasound in carotid endarterectomy ( CEA) .Methods Forty-five patients with CEA were examined and analyzed by TCD and CDFI.The position, range,character,diameter,stenosis rate were measured by CDFI and collateral flow by TCD before CEA.The intraop-erative CDFI was applied to confirm the flow and the flaps in carotid artery.TCD monitoring of middle cerebral blood flow in CEA to assess whether use shunt technique and cerebral hyper-perfusion.CDFI was applied to assess patency and intimal hyperplasia of carotid artery.Results Seventeen low echo plaques,twelve high echo plaques and sixteen hypoechogenicity echo plaques in forty-five patients with internal carotid stenosis were found by color Doppler ultra-sound.Blood flow volume increased significantly in the ispilateal internal carotid arteries and middle cerebral arteris after operation.Carotid artery restenosis was not found by color Doppler ultrasound after CEA.Conclusion Applica-tion of color Doppler in CEA is valuable in the diagnosis of internal carotid stenosis,intraoperative monitoring and in the evaluation of effect.
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<p><b>OBJECTIVE</b>To study the clinical efficacy of three dimensional visualization technique assisted hepatectomy for the treatment of primary liver cancer.</p><p><b>METHODS</b>A total of 108 primary liver cancer patients who had been admitted to Zhujiang Hospital of Southern Medical University from September 2013 to December 2014 were assigned to three dimensional visualization technique assisted hepatectomy group (n = 55) and routine hepatectomy group (n = 53) according to different methods of hepatectomy. The observed variable in two groups as fellow: the operative time, intraoperative blood loss, intraoperative blood transfusion, the change of postoperative liver function and biochemical indicators in 1, 3, 5 days, postoperative complication. The patients were followed up via-return visit or telephone.A student's t test was used to compare continuous parametric variables, and the Mann-Whitney U test was used to compare non-parametric or discrete variables, as appropriate. Categorical data were compared using the Chi-square test or Fisher's exact test.</p><p><b>RESULTS</b>In 3D group and routine hepatectomy group, the patients' intraoperative blood transfusion volume were 300 ml (200-600 ml) and 400 ml (300-700 ml) (χ² = -2.609, P = 0.009) respectively, intraoperative blood loss volume were 400 ml (250-600 ml) and 550 ml (400-800 ml) (χ² = -2.277, P = 0.023), the operative time were (247 ± 57) min and (262 ± 53) min (χ² = -1.787, P = 0.074), the deterioration of the mainly liver function indicators peak in routine hepatectomy group were higher than that in 3D group (P < 0.05). The ALT, AST, TBIL in 3D group were lower than that in routine group on postoperative day 1, 3, 5, respectively (χ² = -5.740- -0.692, all P < 0.05). The ALB in 3D group was higher than that in routine group on postoperative day 3, 5 ((33.0 ± 5.6) g/L vs. (31.2 ± 4.1) g/L, (36.7 ± 4.4) g/L vs. (34.7 ± 4.2) g/L) (t = 1.922-2.573, both P < 0.05). In 3D group and routine hepatectomy group, the incidence of postoperative complications were 10.9% and 30.1% (χ² = 6.185, P = 0.013), the length of postoperative hospital day were (12.6 ± 3.6) days and (14.4 ± 3.5) days (χ² = -3.384, P = 0.031), the positive rate of resection margin were 0 and 9.4% respectively (Fisher test: P = 0.026), the 1-year tumor recurrence rate were 22.2% and 37.5% (P > 0.05), 1-year survival rate was 82.2% and 77.5% (P > 0.05). No perioperative mortality was occured in the two groups.</p><p><b>CONCLUSION</b>Three dimensional visualization technique assisted hepatectomy for the treatment of primary liver cancer could reduce surgical injury, lower the rate of postoperative complications, improve the safety and the efficacy of the operation and achieve a good prognosis.</p>
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Humans , Blood Loss, Surgical , Blood Transfusion , Chi-Square Distribution , Hepatectomy , Methods , Imaging, Three-Dimensional , Liver Neoplasms , General Surgery , Neoplasm Recurrence, Local , Operative Time , Postoperative Complications , Survival RateABSTRACT
<p><b>OBJECTIVE</b>To compare the applied value of the pressure aggravation test and breath aggravation test in the diagnosis of early acute appendicitis.</p><p><b>METHODS</b>A total of 101 cases with epigastralgia, middle or upper abdomen pain, disease duration within 6 hours undergoing pressure aggravation test and breath aggravation test respectively in our hospital between October 2010 and December 2012 were prospectively enrolled. By comparing with the postoperative pathological diagnosis (early acute appendicitis and other abdominal pain), the sensitivity and specificity of these two tests were calculated. Through analyzing the receiver operating characteristic (ROC) curve, the diagnostic value of early acute appendicitis was evaluated.</p><p><b>RESULTS</b>Fifty-two cases of early acute appendicitis and 49 cases of other abdominal pain were diagnosed by postoperative pathologic results. The sensitivity and specificity of the pressure aggravation test were 87.5% and 72.1% and of the breath aggravation test were 53.8% and 83.7% respectively. The area under the ROC curve of the pressure aggravation test was 0.786 (95% CI: 0.693-0.878), similar to that of the breath aggravation test (0.688, 95% CI: 0.583-0.792).</p><p><b>CONCLUSION</b>The pressure aggravation test has higher value to diagnose early acute appendicitis, while the breath aggravation test has better specificity.</p>
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Humans , Abdominal Pain , Acute Disease , Appendicitis , Diagnosis , Breath Tests , Pressure , ROC Curve , Sensitivity and SpecificityABSTRACT
Objective To analyze the direct and indirect effects of influencing factors on suicide ideation among college students based on the structural equation model. Methods 1505 college students were investigated with ASLEC, Simplified Coping Style Questionnaire, SSRS, QSA and BDI. Results Incidence rate of college students' suicidal ideations during the past year was 6.67%. The goodness of fit for the structural equation model was satisfactory and 3 major indices( x2/df = 2.23, GFI = 0. 982, RMSEA = 0. 029 ) had met corresponding requirements. The depression was directly influencing factor on suicide ideation, while four factors including passive coping style, social support, positive coping style and suicide attitude, had indirect impacts. Negative life event not only directly affected suicide ideation, but also had indirect effects. According to the percentages of their contribution, the risk factors were ranked as follows:depression (41.08%), negativity life event (35.35%) and passive coping style (6.05%). Similarly, the top protective factor was: social support ( 11.94% ), followed by positive coping style (4.94%) and suicide attitude (0.63%). Conclusion Depression is an important risk factor of suicide,and has a direct impact. So, not only strengthen the mental health of college students, but also train students to face up the difficulties with a positive style, and make the college students get social supports sufficiently.
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Apoptosis of cancer cells between the gastric and intestinal-type human gastric carcinoma were compared in terms of the expression of oncogene MDM2 and CD68, the histological types, the infiltration depth, and lymph node metastasis. Terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end-labeling (TUNEL) assay was employed to stain apoptotic cells. Histochemical method(AB-PAS) was applied to stain mucus that is neutral or acidic in nature. Immunohistochemical method (SABC) was used to detect expression of MDM2 and CD6. The results showed that the mean apoptosis index (AI) of total 48 cases was 8.60+/-2.60. AI in the 30 intestinal type cases was significantly higher than that in the 18 gastric type cases (t=4.67, P0.05). But in the gastric type cases, a significant difference existed (t=5.87, P<0.01). A significant difference in lymph node metastasis ratio was found between the two gastric carcinoma types (chi2=4.48, P<0.05). The CD68 expression ratio in the 30 intestinal type cases was much lower than that in the 18 gastric type cases (t=4.29, P<0.01). AI of 25 MDM2-positive cases was much lower than that of the 23 MDM2-negative cases (t=7.80, P<0.01). CD68 positive ratio in the 25 MDM2-negative cases was much lower than that in the 23 negative cases. The difference was statistically significant (t=10.90, P<0.01). Except for few cells scattering within the cancer nest, most CD68 positive cells infiltrated in the interstitium around the cancer tissue. In the high-AI cases, CD68-positive cells increased. And the CD68-positive cells decreased in low-AI cases (r=0.96, P<0.01). Logistic regression analysis suggested that among the control variables, only AI was a statistically significant factor in the regression model (chi2=9.64, P<0.01). We concluded that (1) the spontaneous apoptosis index in gastric-type cases of gastric carcinoma was significantly lower than that in intestinal type cases; (2) AI in the two types was influenced by the expression of MDM2 and lymph node metastasis, but no visible connection was found between AI and the infiltration depth or histological types; (3) in the intestinal type cases, AI and the CD68-positive cells increased in MDM2-negative cases.
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Apoptosis of cancer cells between the gastric and intestinal-type human gastric carcinoma were compared in terms of the expression of oncogene MDM2 and CD68, the histological types, the infiltration depth, and lymph node metastasis. Terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end-labeling (TUNEL) assay was employed to stain apoptotic cells.Histochemical method(AB-PAS) was applied to stain mucus that is neutral or acidic in nature. Immunohistochemical method (SABC) was used to detect expression of MDM2 and CD6. The results showed that the mean apoptosis index (AI) of total 48 cases was 8.60±2.60. AI in the 30 intestinal type cases was significantly higher than that in the 18 gastric type cases (t=4.67, P＜0.01). In the 30intestinal type cases, the spontaneous apoptosis index of MDM2 negative cases was significantly higher than that of the positive cases (t=7.16, P＜0.01). And in the 18 gastric type cases, the same result was found. (t=11.39, P＜0.01). The MDM2 positive ratio in gastric type cases was higher than that in intestinal type cases (x2=4.68, P＜0.05). There is no significant difference in AI between cases of lymph node metastasis and non-metastasis cases in intestinal type cases (t=0.26, P＞0.05). But in the gastric type cases, a significant difference existed (t=5.87, P＜0.01). A significant difference in lymph node metastasis ratio was found between the two gastric carcinoma types (x2=4.48, P＜0.05).The CD68 expression ratio in the 30 intestinal type cases was much lower than that in the 18 gastric type cases (t=4.29, P＜0.01). AI of 25 MDM2-positive cases was much lower than that of the 23MDM2-negative cases (t=7.80, P＜0.01). CD68 positive ratio in the 25 MDM2-negative cases was much lower than that in the 23 negative cases. The difference was statistically significant (t=10.90,P＜0.01). Except for few cells scattering within the cancer nest, most CD68 positive cells infiltrated in the interstitium around the cancer tissue. In the high-AI cases, CD68-positive cells increased. And the CD68-positive cells decreased in low-AI cases (r=0.96, P＜0.01). Logistic regression analysis suggested that among the control variables, only AI was a statistically significant factor in the regression model (x2=9.64, P＜0.01). We concluded that (1) the spontaneous apoptosis index in gastric-type cases of gastric carcinoma was significantly lower than that in intestinal type cases; (2) AI in the two types was influenced by the expression of MDM2 and lymph node metastasis, but no visible connection was found between AI and the infiltration depth or histological types; (3) in the intestinal type cases,AI and the CD68-positive cells increased in MDM2-negative cases.
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Objective In order to explore the possibility of autologous transplantation of olfactory mucosa for spinal cord repair,the changes of autologous olfactory mucosa being transplanted into spinal cord and the effect of promoting axon regeneration in adult rats were investigated. Methods Forty male adult rats were divided into two groups randomly:olfactory mucosa transplantation and control groups.Olfactory mucosa (1*!mm+2) was taken from the posterior region of nasal septum,and this graft was transplanted into the posterior funiculus of cervical 1 segment of spinal cord and destructed the corticospinal tract(2*!mm?1
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0.05), higher than those in the nighttime (t=3.63,3.16;P
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Objective To observe the B-scan ultrasonic characteristics of the posterior vitreous detachment (PVD) and the relationship between the PVD and retina. Design Retrospective case series. Participants 991 cases (1107 eyes) with PVD. Methods The results of B-scan ultrasonography were retrospectively in PVD patients and according to the adhesion between the posterior vitreous cortex (PVC) and eyeball wall, complete PVD and incomplete PVD were divided. Main Outcome Measures The ratio of types and characteristics of PVD. Results 710 eyes(64.1%)were diagnosed as complete PVD, in which 69 eyes(17.3%)accompanied with peripheral ruptured detachment of retina, and 16 eyes(23.0%)PVC adhered with lid of peripheral retina hole. 397 eyes(35.9%)were diagnosed as incomplete PVD, in which 159 eyes(40.0%)as partly PVD, and 76 eyes(47.7%)concomitanted with PVC proliferation and vitreous incompletely splitting. 121 eyes(30.5%)PVC were adhered with the macula, and 117 eye(29.5%)with the optic disc. Conclusions Ultrasonography can be applied to diagnose PVD precisely,which can provide credible morphologic evidence for the clinic.
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Objective To investigate the technical methods for culturing and purifying the olfactory ensheathing cells(OECs) from the adult canine and human olfactory epithclium.To establish a basis for future studying the transplantation of peripheral(OECs) to repair the spinal cord injury in human. Methods Purifying the OECs from the olfactory epithelium of adult canine and man according to their different attachment time with other types of cells.Culturing for 25 days,observed at 6d,10d and 25d,and immunostained with NGFRp75 antibody to identify the OECs. Results The number of cultured olfactory epithelium OECs from both adult canine and man were increased much more after 10 days of culture,and its sharp showed to be bi-polar or tripe-polar and are immunopositive to NGFRp75 antibody.The in vitro OECs of canine grew better than that in man's in the present conditions.Conclusion\ The method of different attachment time seems available in purifying olfactory ensheathing cells from both the adult canine and man olfactory epithelium.