10.3969/j.issn.1008-9691.2013.03.009

Objective To investigate the effect of preoperative and postoperative inspiratory muscle training(IMT) on cardiopulmonary function and quality of life for patients undergoing esophagectomy.Methods Sixty patients who had received esophagectomy for esophageal cancer were randomly divided into an observation group (n =30) and a control group (n =30).All of the subjects were given conventional treatment (including preoperative health education,abdominal respiration training,pursed lip respiration training and expectoration training).On this basis,the patients in the treatment group were advised to do deep respiratory training using a breathing training device,four times a day,lasting 20 minutes each time,for 10 days (including five days before and five days after the operation).Respiratory muscle strength,blood gases,six minute walk test (6MWT) distances and Borg dyspnea scores were measured on admission,on the day prior to the operation and on the 1st,3rd and 5th day after the operation.And also on admission and on the 5th day after the operation their pulmonary function was tested,and their psychological status and quality of life were evaluated using the hospital anxiety and depression scale (HADS) and the Nottingham health profile (NHP) respectively.Results There was no significant difference in any index between the two groups on admission(P ＞ 0.05).Everyone's respiratory function and exercise capacity were sharply decreased,and Borg dyspnea score increased on the first postoperative day,and then gradually and significantly improved in both groups compared to that on admission(P ＜ 0.05).On the fifth postoperative day,the maximal inspiratory pressure of 67.41 ± 14.53 mmH2O,maximal ventilatory volume of 79.83 ± 5.37 L,6MWT of 427.19 ± 46.52 m,Borg score of 1.45 ± 0.48 points,postoperative anxiety score of 8.14 ±2.80 points,NHP total (128.91 ± 25.12 points),NHP pain score (24.66 ± 10.12 points),NHP sleeping score (25.18 ± 9.75 points),and NHP physical activity scores (22.81 ± 10.72 points) were significantly more improved in the observation group than those in the control group(P ＜ 0.05).Conclusion Preoperative and postoperative inspiratory muscle training can significantly reduce postoperative anxiety symptoms,improve postoperative cardiopulmonary function and the quality of life during perioperative period.Such therapy deserves further clinical research.

This study was aimed to investigate the efficacy ofTong-Bu San-Sheng(TBSS) Decoction to reduce the toxicity and side effects of chemotherapy, as well as prolong progression-free survival (PFS) for advanced lung squamous carcinoma patients who received chemotherapy. A total of 83 lung squamous carcinoma cases were divided into two groups by patients’ wishes. The control group contained 41 cases were treated by the chemotherapy of gemcitabine plus cisplatin (GP). The trial group contained 42 cases were treated by chemotherapy plus Chinese herbal medicine TBSS decoction. The toxicity and side effects of chemotherapy, as well as short-term outcome were evaluated. PFS of patient was recorded. The results showed that there were no differences on granulocytopenia (P = 0.115) or short-term outcome (P = 0.081) for patients of both groups after chemotherapy. The percentages of nausea, vomiting and thrombocytopenia in the trial group were lower than that in the control group (P = 0.037,P = 0.040). The PFS of patients in the trail group were prolonged compared to patients in the control group (4.31 ± 0.24 VS 3.78 ± 0.16 month;P = 0.043). It was concluded that Chinese herbal medicine TBSS decoction cannot reduce granulocytopenia caused by chemotherapy, or improve the tumor response rate (RR) of short-term outcome. However, it can prolong PFS, relieve nausea, vomiting and thrombocytopenia during chemotherapy.

Objective: To investigate the contents of radionuclide ¹³⁷Cs in seafood from coastal areas of Zhejiang province, and to estimate the annual committed effective dose to population in different regions from ingestion of ¹³⁷Cs in seafood. Methods: Three representative monitoring areas were set on the coastaline of Zhejiang province, and the locally popular seafoods were selected as monitoring objectives. The contents of radionuclide ¹³⁷Cs were detected using HPGe γ spectrometry. The committed effective doses were estimated based on monitoring results and consumption data on seafoods in Zhejiang. Results: The detection ratio of ¹³⁷Cs in seafood produced on coastal areas of Zhejiang province was estimated to be 35.3% (36/102). Specific activity detected ranged from 0.004 to 0.140 Bq/(kg, Wet). Committed effective doses from ingestion of ¹³⁷Cs in one year to the population in island region, coastal region and inland region were 3.03×10^-5, 1.63×10^-5, 3.38×10^-6 mSv, respectively, far lower than the world committed effective dose resulting from internal exposure. Conclusions At present, the content level of ¹³⁷Cs in seafood produced on the coastal areas of Zhejiang province is much lower than the national standard limit, and the dose burden to the population is very minor with no health impact to the population.

Objective    In this study, three-dimensional printed (3DP) titanium implants were used for skeletal reconstructions after wide excision of chest wall. 3DP titanium implants were expected to provide a valid option with perfect anatomic fitting and personalized design in chest wall reconstruction. Methods    There were 13 patients [mean age of 46 (24-78) years with 9 males and 4 females] who underwent adequate radical wide excision for tumors and chest wall reconstruction using 3DP titanium implants. Surgical data including patient demographic characteristics, perioperative clinical data and data from 1-year follow-up were collected and analyzed. Results    Six patients of rib tumors, six patients of sternal tumors and one patient of sternal pyogenic osteomyelitis were finally selected for the study. The chest wall defect area was 221.0±206.0 cm2. All patients were able to maintain the integrity of the chest wall after surgery, and no abnormal breathing was found, achieving personalized and anatomical repair. Thirteen patients were successfully discharged from the hospital. Two patients developed pneumonia in the perioperative period. During the follow-up period in the first year after surgery, no implant related adverse reaction was observed, including implant rupture, implant shift, rejection reaction and allergies. One patient had wound ulcer after chemotherapy. Three patients had tumor recurrence, with the recurrence rate of 25.0%. Two patients died of tumor recurrence, with a mortality rate of 16.7%. Conclusion    3DP titanium implant is a safe and effective material for chest wall reconstruction. 

Objective    To explore the safety and effectiveness of a precise marking method based on body surface mesh and three-dimensional (3D) image reconstruction. Methods    We retrospectively analyzed the clinical data of 22 patients in our hospital from October 2018 to October 2019. There were 13 males and 9 females aged 58.5 (37-72) years. All patients underwent a precise marking of pulmonary nodules based on body surface mesh and 3D image reconstruction. Then, video-assisted thoracoscopic surgery (VATS) was performed to resect the nodules. The clinical data, including positioning success rate and operation time were analyzed. Results    A total of 22 small pulmonary nodules were removed. The average diameter of small nodules was 12±3 mm, and the average distance from the visceral pleura was 17±6 mm. The localization success rate was 86.4%. The operation time was 110±43 min, and there was no surgery-related complication. Conclusion    The method of marking pulmonary nodules based on body surface mesh and 3D image reconstruction is a safe and reliable technology, which reduces the risk of hemopneumothorax caused by CT-guided lung puncture.

Phyllanthi Fructus is a highly unique medicine and food homologous item, which exhibits distinctive flavor, notable nutritional value, and abundant pharmacological activity. It has enormous potential in the creation of health products and pharmaceuticals. However, due to the unique laws of quality formation and transfer of Phyllanthi Fructus, its appearance, shape, chemical compositions, nutrients, and sensory flavors are frequently greatly influenced by botanical resources, the processing and storage conditions. As a result, the current quality evaluation model is difficult to meet the needs of Phyllanthi Fructus as a medicine and food homologous item in the development of diversified products. This paper constructs the hierarchical utilization mode of Phyllanthi Fructus based on its unique quality formation and transmission laws, explores the quality evaluation model for food-oriented use and medicinal-oriented use, respectively, and systematically describes the quality evaluation idea under diversified application scenarios. This paper aims to serve as a reference for the construction of a quality evaluation model suitable for the medicine and food homologous item of Phyllanthi Fructus.