Objective To survey the current clinical practice of chronic non-cancer pain (CNCP)management including opioid use in Chinese subgroup report of Current Practices of Cancer and Chronic Non-Cancer Pain Management:A Pan-Asian Study (ACHEON).Methods This questionnaire-based survey included 100 pain physicians and 250 patients experiencing CNCP in the period of September to December in 2013.Results CNCP management training was believed by 40％ of physicians,while 30％ reported adequate pain-relief training on opioid use.Opioids were not considered as the best choice for CNCP management by 65％ of physicians.The majority of location of pain with CNCP was legs/feet (59.2％) and neck (39.2％),arthritis (37.22％),overuse (26.91％),and poor posture (35.56％) were reported as the primary causes of pain.A portion (81.6％) of patients was under treatment,while 66.67％ of patients claimed to be satisfied with their current pain treatment.74.51％ of patients reported that CNCP management was effective pain-relief.Conclusions The Chinese physicians were insufficient cognition of CNCP management on opioid use.The CNCP education and cognition strengthening,CNCP management practice and patient's satisfaction are still necessary for Chinese physicians and patients.

OBJECTIVETo investigate the clinical efficiency of electrocoagulation for the treatment of noninvoluting congenital hemangioma.

METHODSSixteen infants with noninvoluting congenital hemangioma who were admitted to our hospital from January 2011 to June 2013 were included in this study. Color Doppler ultrasound was used to determine the hemangioma location, as well as its size and depth. High frequency electrocoagulation was adopted for the treatment. The output power was set at 10-20 W. The probes were inserted around the tumor or at the surface of the tumor. After switching on for 1-2 seconds, the direction and position of the probe was modulated until covering the whole tumor. After the treatment, the absorption of tumor was about 3-6 months. The efficiency was evaluated during the follow-up.

RESULTSTumor atrophy was obvious after treatment in all patients. The temperature around the tumor mass was decreased, and the aberrant blood signals were decreased under the ultrasonic examination. Complete or partial atrophy were observed. The efficiency was graded as level I, II, III, IV in 0, 2, 9 and 5 patients, respectively. One patient showed local infection due to improper nursing, which was completely relieved after corresponding treatment. No severe adverse events were observed.

CONCLUSIONSHigh-frequency electrocoagulation is effective for treating noninvoluting congenital hemangioma through coagulating the aberrant blood vessels in the tumor, interrupting the vascular endothelial cell, blocking the aberrant blood flow, as well as leading to atrophy and absorption of tumor mass. Besides, no obvious scar is observed after the surgery.

Electrocoagulation ; methods ; Hemangioma ; congenital ; diagnostic imaging ; surgery ; Hemangioma, Capillary ; congenital ; diagnostic imaging ; surgery ; Humans ; Infant ; Skin Neoplasms ; congenital ; diagnostic imaging ; surgery ; Temperature ; Ultrasonography

BACKGROUND:Along with the widespread application of biodegradable materials in the field of medicine and the in-depth research of biomechanics,the drawbacks of traditional medical metal materials are increasingly appearing.In recent years,researchers at home and abroad focus on biodegradable materials that are represented by high molecular polymer to seek new breakthroughs in the field of spinal instability.OBJECTIVE:To investigate biomechanical changes of polylactic acid-polyglycolic acid (PLGA) lumbar interbody fusion cage in the body and discusses its feasibility for treating segmental instability of the spine.METHODS:Forty-two healthy pigs (9 months old) were randomly divided into two groups (n=21),and L4/5 intervertebral disc nucleus pulposus was removed in all animals.In experimental group,PLGA lumbar interbody fusion cage filled with broken bone was implanted;and in control group,autologous bone was implanted.X-ray was performed to observe the fusion of operation segments at 4,12 and 72 weeks postoperatively.Feasibility of fibrous fusion was measured by biomechanical test.Histologically,bone graft fusion at the surgical site and material degradation were detected.RESULTS AND CONCLUSION:(1) Imaging examination:Bone graft fusion in two groups was not visible at 4 weeks after operation.Evidence of increasing fusion was found in the experimental group at 12 weeks after operation;a visible part of the bone bridge was found in the control group,in which there was one case of fusion.Degradation of the fusion cage with one case of fusion in experimental group was found after 72 weeks after operation,and two cases of fusion in the control group.(2) Biomechanical test:There was no difference in the spinal range of motion between the two groups in different states at 4 weeks after operation (P ＞ 0.05).The spinal range values of motion at most of the states at 72 weeks after operation were significantly lower than those at 4 weeks after operation.(3) Cell histology observation:With the passage of time,the materials in the experimental group degraded gradually;new bone grew slowly and then fast,with bone fusion step by step.Fusion results were similar in the two groups.Our experimental findings indicate that the PLGA lumbar fusion cage has good biocompatibility.In addition to the individual state (left flexion),the mechanical properties of the fusion cage are similar to that of autogenous bone,and the fusion cage enables the segmental reconstruction of the pig spine to the maximum extent.

Objective To understand and summarize the clinicopathological characteristics and differential diagnosis of lymphoepithelial sialadenitis(LESA)-like thymic hyperplasia.Methods The clinicopathological data of patients with LESA-like thymic hyperplasia diagnosed in our hospital from October 1,2019 to September 1,2023 were collected,and the related literatures on their epidemiological characteristics,clinicopathological features,treatments and prognosis were reviewed.Results There were 2 female patients with LESA-like thymic hyperplasia included,at an onset age of 51 and 52 years,respectively.Imaging examination revealed an anterior mediastinal mass in both patients,with the largest diameter of 7.5 and 12.0 cm,respectively.Microscopic morphology and immunophenotype analysis showed there were florid lymphoid follicles with germinal centers.Reticular or nested thymic epithelial,thymic corpuscles and lymphoepithelial lesions without dysplasia were seen in the interfollicular areas as well.Focal cystic changes,cholesterol crystals and the formation of cholesterol granuloma were observed.Our results were similar to the pathological morphology and immunohistochemical phenotype of 46 cases with LESA-like thymic hyperplasia reported in the literature.They had favorable prognosis,except 5 patients progressed to lymphoma.Conclusion LESA-like thymic hyperplasia is a benign disease with unique morphological characteristics and of favorable prognosis.But rare patients can progress to lymphoma,therefore regular and close follow-up is still required.

Objective:To explore the effects of professional nurse led multidisciplinary care team in extended nursing outside hospital among elderly diabetic patients.Methods:From January 2018 to December 2018, we selected 102 elderly patients with type 2 diabetes of Endocrinology Department in the First Affiliated Hospital of Zhengzhou University as subjects by convenience sampling. All of patients were randomly divided into control group and observation group, 51 cases in each group. Control group implemented the routine model management, while observation group carried out the professional nurse led multidisciplinary care team model management; the extended nursing outside hospital lasted for 6 months. We compared the fasting blood glucose (FBG) , glycosylated hemoglobin, readmission rate and the complication incidence between two groups.Results:After 6 months intervention, the FBG of control group was lower than that before intervention with a statistical difference ( P<0.05) ; there was no statistical difference in the glycosylated hemoglobin of control group before and after intervention ( P>0.05) . After 6 months intervention, the FBG and glycosylated hemoglobin of observation group were lower than those before intervention, and lower than those of control group with statistical differences ( P<0.05) . The readmission rate of observation group within 6 months was 15.69% (8/51) lower than that [37.25% (19/51) ]of control group with a statistical difference (χ 2=6.095, P=0.014) . The complication incidence of observation group within 6 months was 7.84% (4/51) lower than that [35.29% (18/51) ]of control group with a statistical difference (χ 2=11.359, P=0.001) . Conclusions:Extended nursing outside hospital with the professional nurse led multidisciplinary care team model can effectively improve the FBG and glycosylated hemoglobin of elderly diabetic patients, reduce the readmission rate and complication incidence which is worthy of clinical generalization.

Background: Obesity is an independent risk factor for gastroesophageal reflux disease (GERD), but the mechanism remains unclear. There are few studies focusing on the effectiveness of standard dose proton pump inhibitor (PPI) in treating obese GERD patients. Aims: To investigate the effect of obesity on esophageal motility and acid reflux in GERD patients and the efficacy of standard dose PPI in treating obese GERD patients. Methods: Patients who were initially diagnosed as GERD and met the inclusion criteria from January 2017 to October 2021 at Anhui Provincial Hospital were included in this study. The results of esophageal high-resolution manometry and 24 h esophageal pH-impedance monitoring before PPI treatment in patients with normal body mass index (BMI) and obesity (BMI≥28.0 kg/m