1.Treatment of multi-segmental cervical spondylosis by long or segmented anterior cervical decompression and fixation surgery
Chunyue DUAN ; Jianhuang WU ; Jianzhong HU ; Hongqi ZHANG ; Xiyang WANG
Journal of Central South University(Medical Sciences) 2014;(12):1306-1312
Objective: To investigate the clinical efficacy of two different anterior cervical surgeries in treatment of multi-segmental cervical spondylosis. Methods: A total of 86 patients with multi-segmental cervical spondylosis were treated by anterior cervical surgery procedure. Among them, 62 and 24 cases were involved in three and four gap, respectively. Each patient underwent the surgery of long or segmented anterior cervical decompression and fixation. Preoperative and postoperative cervical curvature change, internal if xation stability, fusion rate and nerve function were evaluated. Results: All patients were successfully completed the operation, segmented surgery showed better cervical lordosis recovery, but there were no significant difference between long and segmented anterior cervical surgery in blood loss and recovery of neurological function (P>0.05). Conclusion: The segmented anterior cervical surgery has advantages in the treatment of multi-segmental cervical spondylosis.
2.Single-incision laparoscopic appendectomy versus conventional laparoscopic appendectomy for adult acute appendicitis:a Meta-analysis for randomized controlled trials
Xuejun KUANG ; Shuangni DUAN ; Jianjun WANG ; Zhao PENG
Journal of Central South University(Medical Sciences) 2014;(12):1299-1305
Objective: To evaluate the efficiency and safety for single-incision laparoscopic appendectomy (SILA) and conventional laparoscopic appendectomy (CLA). Methods: The literature of randomized controlled trials (RCTs) concerning SILA versus CLA was retrieved by searching the electronic databases from the inception date to May 2014. Methodological quality of the included trials was assessed by using the Cochrane Reviewers’ Handbook criteria, and the data were extracted and subjected to Meta-analysis by using RevMan 5.1 analysis sotfware. Results: A total of 1183 patients were ifnally selected atfer the screening. Among them, 582 cases underwent SILA and 601 cases underwent CLA. Meta-analysis results demonstrated that SILA was associated with higher conversion rate (RR=4.38, 95% CI 1.96–9.79,Z=3.59,P=0.0003), longer operative time (RR=4.83, 95% CI 1.57–8.09,Z=2.90,P=0.004), shorter length of hospital stay (WMD=?0.11, 95%CI ?0.21–?0.01,Z=2.02,P=0.04), and better scores for the postoperative appearance of incision (WMD=0.94, 95%CI 0.49–1.40,Z=4.06,P<0.001) compared with CLA; no signiifcant difference was observed in postoperative complications and postoperative pain scores (RR=1.03, 95% CI 0.74–1.45,Z=0.18,P=0.86; WMD=?0.19, 95%CI ?0.59–0.20,Z=0.95,P=0.34) between the 2 groups. Conclusion: For patients under the conditions of the strict selection, SILA is a safe and effective procedure for the treatment of adult acute appendicitis, especially apply to those who care about incision appearance.
3.Effect of puncture-related pain on the quality of life in patients undergoing maintenance hemodialysis through internal arteriovenous fistula
Lina GONG ; Jia LIU ; Jin YAN ; Lufang WANG
Journal of Central South University(Medical Sciences) 2014;(12):1292-1298
Objective: To investigate the effect of puncture-related pain on the quality of life in patients undergoing maintenance hemodialysis through internal arteriovenous if stula. Methods: A total of 180 hemodialysis patients with the arteriovenous ifstula were surveyed by the kidney disease quality of life short form(KDQOL-SF1.3), demographic data questionnaire, visual analogue scale and pain self-effcacy questionnaire. Results: The median score of puncture-related pain was 5 and the score of pain self-efficacy was (31.42±14.59). The quality of life in the patients undergoing maintenance hemodialysis is poor. KDQOL-SF1.3 was (69.45±24.19), SF-36 was (49.82±19.17) and ESRD-targeted was (55.46±18.37). Multivariate analysis demonstrated that the quality of life was positively correlated with the patient gender (β=0.152,P<0.05, OR=1.638, 95% CI 1.241–1.954), working position (β=0.307,P<0.05, OR=2.069, 95% CI 1.206–-3.148), using time of arteriovenous ifstula (β=?0.815, P<0.05, OR=0.223, 95% CI 0.095–0.741), the score of pain (β=-0.017,P<0.05, OR=1.004, 95% CI 0.886–1.431) and pain self-effcacy (β=-0.409,P<0.05, OR=0.803, 95% CI 0.710–0.984). hTere existed negative correlation between the quality of life score and the puncture-related pain score in these patients (r=-0.472,-0.465,-0.381,P<0.01), positive correlation between the quality of life score and the score of pain self-efficacy (r=0.647, 0.203, 0.518,P<0.05), and negative correlation between the puncture-related pain score and the score of pain self-effcacy(r=-0.745,P<0.01). Conclusion: Puncture-related pain is a crucial inlfuential factor on the quality of life in the patients undergoing maintenance hemodialysis through internal arteriovenous ifstula.
4.A clinical analysis of 188 cases of pregnancy complicated with critically heart disease
Ming LI ; Qiang YAO ; Aiyun XING
Journal of Central South University(Medical Sciences) 2014;(11):1145-1150
Objective: To investigate the factors that affect the outcome of pregnancies complicated with critically heart disease admitted to obstetric Intensive Care Unit (ICU). Methods: A retrospective study was conducted for 188 pregnant and postpartum patientscomplicated with heart disease who were admitted to the ICU in West China Second University Hospital from July 2009 to March 2013. Results: During the 4 years, there were 619 cases of pregnancy complicated with heart disease hospitalization. Among them, 188 (30.37%) patients complicated with severe heart disease were admitted to the ICU, accounting for 39.17% of the total ICU admission (480); the mean maternal age was (28.45±6.08) years old and the mean gestational time was (36.03±4.19) weeks. 23 (12.23%) patients received regular antenatal care in our hospital. 61 (32.45%) patients never received antenatal care before hospitalization. Among them, 5 patients were dead. hTe ratio for diagnosis of heart disease before pregnancy, during pregnancy and atfer admission were 39.89%, 25.54% and 34.57%, respectively; the most common heart diseases during pregnancy were congenital cardiac disease (80, 42.55%) and rheumatic heart disease (45, 23.94%) followed by arrhythmias (20, 10.64%). The most common complication were pulmonary arterial hypertension (51, 27.13%), arrhythmias (47, 25.00%) and severe heart failure (30, 15.96%); the cardiac function of 164 (87.23%) patients was at stage I–II and 5 (2.66% ) patients died when discharged from hospital. 151 (80.32%) patients received multidisciplinary consultation and 34 (18.09%) used central venous catheterization to control central venous pressure (CVP). 21 (11.17%) patients required mechanical ventilation. 11 (5.85%) patients required emergency life support (cardiopulmonary resuscitation 9 + electric deifbrillation 3). Conclusion: Pregnancy complicated with heart disease is the leading reason for admission to ICU. hTe congenital cardiac disease, rheumatic heart disease and arrhythmias are the main heart diseases during pregnancy. Multidisciplinary cooperation and intensive care are the key measures to improve the outcomes of patients with critically illness. It is very important for reduction of the maternal mortality rate through strengthening preconception care and antenatal care.
5.Effect of chloride ion on corrosion of two commonly used dental alloys
Lei CHEN ; Weidan ZHANG ; Yuanyuan ZHANG
Journal of Central South University(Medical Sciences) 2014;(11):1186-1190
Objective: To investigate the effect of chloride concentration on the corrosion of Co-Cr alloy and pure Ti in a simulated oral environment. Methods: The electrochemical corrosion tests of pure Ti and Co-Cr alloy were carried out in neutral artiifcial saliva solutions with different NaCl concentrations (0.9%, 2.0%, and 3.0%). hTe morphologies of corroded surface for pure Ti and Co-Cr alloy were observed by scanning electron microscope (SEM). Results: hTe changes in the self-corrosion potentials (Ecorr) for pure Ti and Co-Cr alloy in three kinds of artificial saliva solutions was not obvious. However, the self-corrosion current densities (Icorr) of pure Ti were much lower than those of Co-Cr. TheIcorr of Co-Cr alloy increased in a concentration-dependent manner of NaCl, whereas the breakdown potential (Eb) of Co-Cr alloy decreased in a concentration-dependent manner. hTe potential ranged for the breakdown of oxide film (Ev) was shortened in a concentration-dependent manner of NaCl. There was no obviousdifference in theIcorr of pure Ti with different concentrations of NaCl. hTe breakdown potential was not seen according to the polarization curves. Conclusion: In a certain range, the increase of the concentration of Cl- leads to accelerate the corrosion behavior of Co-Cr alloy, but it does not affect pure Ti.
6.Application of improved flushing method in anastomotic leakage after low anterior resection for rectal cancer
Lei REN ; Chunfeng LIU ; Yejiang ZHOU
Journal of Central South University(Medical Sciences) 2014;(11):1177-1180
Objective: To investigate clinical effect of improved flushing method applied in anastomotic leakage (AL) atfer low anterior resection for rectal cancer. Methods: We performed a retrospective study to analyze the therapeutic effect for 39 AL from 438 patients who received Dixon surgery in the Affliated Hospital of Luzhou Medical College. Among them, 23 patients received the traditional lfushing method (the traditional group) and 16 received the improved lfushing method (the improved group). Results: hTe rate of AL was 8.9% (39/438). All patients were cured with non-operative treatment. hTe cleanliness degree of the surrounding skin of drainage tube in the improved group was higher than that in the traditional group. hTe duration of average hospitalization and extubation of drainage tube was shorter in the improved group than that in the traditional group (P<0.05). Conclusion: Compared with the traditional methods, the improved one is better for the ALpatients. Both the patients themselves or their family members can chose it. hTe improved lfushing method is worth to be spread in clinic.
7.Clinical study on chemotherapy of lobaplatin combined with docetaxel in patients with relapsed ovarian cancer
Journal of Central South University(Medical Sciences) 2014;(11):1131-1136
Objective: To evaluate the efficacy and safety of lobaplatin combined with docetaxel in the treatment of the recurrent ovarian carcinoma. Methods: We collected 31 patients who diagnosed as recurrent ovarian carcinoma according to the histopathology or cytology from Tumor Hospital of Hunan Province from January 2011 to January 2013. The patients received cisplatin-based chemotherapy or carboplatin-based chemotherapy before the combined chemotherapy of docetaxel and lobaplatin. For patients with the recurrence, they received a treatment at a dose of 80 mg/m2 for docetaxel on day 1 and a dose of 30 mg/m2 for lobaplatin on day 2, which lasted for 21 days as a treatment cycle. hTe patients received 6-cycletreatment at most. Results: A total of 153 cycles of chemotherapy were given to 31 patients, with a median of 4 (2–6) cycles. Three patients showed complete response, 11 partial response, 2 stable disease, and 15 progressive disease. hTe objective response rate (ORR) was 45.16% (95% CI, 26.61%–63.72%), and the disease control rate (DCR) was 51.63% (95% CI, 32.98%–70.25%). The median progression-free survival was 7 months (95% CI, 4.27–9.73 months). For the toxic and side effects among the 31 patients, the numbers of the grade 3, grade 2, and grade 1 leukopenia were 1, 8, and 13, respectively. Meanwhile, 18 were grade 1–2 neutropenia, 17 grade 1–2 anemia, and 2 grade 1 thrombocytopenia. At the same time, alimentary canal reaction followed by nausea and vomiting was relatively modest and could be controlled. hTe serious damage of hepatic-renal function was not found. Conclusion: The chemotherapy of lobaplatin combined with docetaxel is effective on recurrent and refractory ovarian cancer with low side effects, which has advantages over the second-line chemotherapy protocols.
8.Model of multiple seasonal autoregressive integrated moving average model and its application in prediction of the hand-foot-mouth disease incidence in Changsha
Ting TAN ; Lizhang CHEN ; Fuqiang LIU
Journal of Central South University(Medical Sciences) 2014;(11):1170-1176
Objective: To establish multiple seasonal autoregressive integrated moving average model (ARIMA) according to the hand-foot-mouth disease incidence in Changsha, and to explore the feasibility of the multiple seasonal ARIMA in predicting the hand-foot-mouth disease incidence. Methods: EVIEWS 6.0 was used to establish multiple seasonal ARIMA according to the hand-foot-mouth disease incidence from May 2008 to August 2013 in Changsha, and the data of the hand-foot-mouth disease incidence from September 2013 to February 2014 were served as the examinedsamples of the multiple seasonal ARIMA, then the errors were compared between the forecasted incidence and the real value. Finally, the incidence of hand-foot-mouth disease from March 2014 to August 2014 was predicted by the model. Results: Atfer the data sequence was handled by smooth sequence, model identiifcation and model diagnosis, the multiple seasonal ARIMA (1, 0, 1)×(0, 1, 1)12 was established. The R2 value of the model iftting degree was 0.81, the root mean square prediction error was 8.29 and the mean absolute error was 5.83. Conclusion: hTe multiple seasonal ARIMA is a good prediction model, and the iftting degree is good. It can provide reference for the prevention and control work in hand-foot-mouth disease.
9.Geographical distribution of left ventricular Tei index based on principal component analysis
Jinhui XU ; Miao GE ; Jinwei HE ; Ranyin XUE ; Shaofang YANG ; Jilin JIANG
Journal of Central South University(Medical Sciences) 2014;(11):1163-1169
Objective: To provide a scientific standard of left ventricular Tei index for healthy people from various region of China, and to lay a reliable foundation for the evaluation of left ventricular diastolic and systolic function. Methods: The correlation and principal component analysis were used to explore the left ventricular Tei index, which based on the data of 3 562 samples from 50 regions of China by means of literature retrieval. hTe nine geographical factors were longitude(X1), latitude(X2), altitude(X3), annual sunshine hours (X4), the annual average temperature (X5), annual average relative humidity (X6), annual precipitation (X7), annual temperature range (X8) and annual average wind speed (X9). ArcGIS sotfware was applied to calculate the spatial distribution regularities of letf ventricular Tei index. Results: hTere is a signiifcant correlation between the healthy people’s letf ventricular Tei index and geographical factors, and the correlationcoeffcients were 0.107 (r1), 0.301 (r2), 0.029 (r3), 0.277 (r4),?0.256(r5),?0.289(r6),?0.320(r7), 0.310 (r8) and 0.117 (r9), respectively. A linear equation between the Tei index and the geographical factor was obtained by regression analysis based on the three extracting principal components. hTe geographical distribution tendency chart for healthy people’s letf Tei index was iftted out by the ArcGIS spatial interpolation analysis. Conclusion: hTe geographical distribution for letf ventricular Tei index in China follows certain pattern. hTe reference value in North is higher than that in South, while the value in East is higher than that in West.
10.Relationship between FAT10 expression and biological behaviors in infitrating ductal carcinoma of breast
Journal of Central South University(Medical Sciences) 2014;(11):1125-1130
Objective: To study the relationship between FAT10 expression and biological behaviors in inif trating ductal carcinoma of breast. Methods: The expressions of diubiquitin (FAT10), estrogen receptor (ER), progesterone receptor (PR) and c-erbB2 in 50 cases of inif trating ductal carcinoma of breast were detected by immunohistochemistry. Western blot was used to detect FAT10 expression in MB-MDA-435, MB-MDA-435-transfected with FAT10 siRNA expression plasmid, MCF-7 and MCF-7-transfected with FAT10 expression plasmid, respectively. Transwell was used to detect invasion capability of MB-MDA-435, MB-MDA-435-transfected with FAT10 siRNA expression plasmid, MCF-7 and MCF-7-transfected with FAT10 expression plasmid. Results: hTe expression intensity of FAT10 was signiifcantly correlated to patho-grading, lymph nodes metastasis, distant metastasis and TNM staging (P<0.01), but not to age of patients and tumor sizes in iniftrating ductal carcinoma of breast (P>0.05). hTe expression intensity of FAT10 in receptor- negative group was obviously stronger than that in receptor- positive group (P<0.01). hTe expression intensity of FAT10 in triple-negative breast cancer was signiifcantly stronger than that in non- triple-negative breast cancer (P<0.01). hTe survival rate of patients with FAT10 positive expression was significantly lower than negative ones (P<0.05). Western blot results showed that FAT10 intensity in MB-MDA-435 significantly higher than that in MCF-7. Up-regulation expression of FAT10 could obviously increase the invasion capability of MCF-7, and down-regulation of FAT10 could signiifcantly decrease the invasion capability of MB-MDA-435 (P<0.01). Conclusion: FAT10 might increase the invasion capability of breast cancer cells by direct or indirect ways, and play an important role in invasion and metastasis of breast cancer. FAT10 might be an independent index for evaluation of breast cancer prognosis, and a potential target for breast cancer therapy, especially for triple-negative breast cancer.