Objective To discuss the perioperative nursing care of patients who is going to receive interventional therapy for hepatic artery stenosis after liver transplantation and to provide useful reference for reducing surgery-related complication and for improving the prognosis of patients. Methods Based on the patient's condition and operative requirement,we provided effective nursing care for 20 patients who were admitted to receive the interventional therapy for hepatic artery stenosis after liver transplantation. The nursing care included preoperative preparation,postoperative nursing and medical guidance at the time of discharge. Results Interventional therapy was successfully performed in all 20 cases,and no hemorrhagic tendency or acute thrombosis occurred. Marked symptomatic improvement was obtained in all patients. Conclusion The interventional therapy is an effective treatment for hepatic artery stenosis after liver transplantation. Intensive perioperative nursing care can well prevent the occurrence of surgery-related complications and can surely improve the therapeutic results.

In order to explore the effects of printing and dyeing wastewater untreated and treated by bacterial biotechnological method on the specific immune response of Carassius auratus, the tested fish were preimmunized intraperitoneally with Aeromonas hydrophila vaccine then were separately placed into control clean water,untreated printing and dyeing wastewater (dilution ratio 13%,pH=7) and treated water 5 fish of every group were killed on the day 2,4,6,8,10,14,18,25,35 th to detect their immune indexes The results indicated that total leucocytic numbers of blood and serum lysozyme level in fish of clean water and treated water increased rapidly and reached their peaks on the day 8th and 6th respectively after vaccination,then reduced to baseline and maintatined for a period of time Leucocytic numbers in fish in untreated wastewater group decreased on day 2nd then increased gradully to normal,serum lysozyme level in this group had decreasing tendency and was lower than the other 2 groups from beginning to end However titer of anti A hydrophila antibody in serum of untreated water group was only lower than that of treated water group on the day 6th when it appeared After this antibody titers of these 3 groups had no significant defference It indicated that printing and dyeing wastewater inhibited immune response of Carassius auratus ,but water treated by bacterial biotechnological method had no this kind of toxic effect

Objective To compare the concordance among RECIST, EASL and modified RECIST criteria for the evaluation of tumor response after transarterial chemoembolization of primary liver cancer.Methods Fifty patients with primary liver cancer underwent 2 TACE cycles separated by 30-40 days.Triphasic helical CT or MRI scans were performed at baseline, at 4 weeks after TACE procedure, and 2 independent radiologists evaluated tumor response according to above-mentioned three different criteria. Chisquare test was used to compare the response rate, and kappa coefficients were used to evaluate the coherence. Results When tumor responses were evaluated using the RECIST-EASL and modified RECIST criteria, the numbers of the patients achieved complete response, partial response, stable disease,progressive disease were 0, 10, 30, 10; 6,21,14,9; 6,21,13,10 respectively. The objective response rates for three different criteria were 20%, 54%, 54% respectively ( P ＜ 0. 01 ). Kappa coefficients between RECIST and EASL, between RECIST and modified RECIST, between EASL and modified RECIST were 0. 382, 0. 170, and 0. 857 (P = 0. 000). Conclusions RECIST criteria underestimates the extent of tumor response after TACE in primary liver cancer. Both EASL and modified RECIST criteria appear to agree with each other in determining treatment response. Furthermore, the modified RECIST is more convenient in clinical practice compared with EASL criteria.

Objective To discuss the change of cellular immune and humoral immune function in children patients with Henoch-Schonlein purpura(HSP)and to investigate its clinical significance.Methods The expression levels of T lymphocyte CD3 + ,CD3 +CD4 + ,CD3 + CD8 + ,CD3 + CD4 + CD8 + ,B lymphocyte CD3 - CD19 + and NK lymphocyte CD3 - CD16 + CD56 + in periphetal blood of 156 patients with HSP was detected by flow cytometry.The level of immunioglobins(IgG,IgA,IgM)and complement(C3,C4)of serum were evaluated by nephelometry immunoassay.The level of immunioglobin IgE was measured by immunochemiluminometric assays and compared with 25 healthy controls.Results Compared with control group,the ratio of CD4 +/CD8 + and the contents of CD3 + ,CD4 + cells in HSP patients were decreased significantly(P <0.01),while the content of CD19 + was significantly increased (P <0.01).The content of CD16 + CD56 + was decreased(P <0.05 ),while the content of CD3 + CD4 + CD8 + was increased(P <0.05),the content of CD8 + had no obvious change(P >0.01).The level of IgA and IgE were increased significantly(P <0.01).The level of IgG and C3 were increased (P <0.05),The level of IgM and C4 had no obvious change(P >0.05).Conclusion The cellular immune and humoral immune function in children with HSP are in disorder.To detect lymphocyte subsets,immunioglobin and com-plement will be of important significance to understand the immune function from the perspective of the cellular immune and humor-al immune to explore the pathogenic mechanisms and to assist diagnosis and patient′s prognosis.

Objective:To prepare and optimize the formula of metoclopramide orally disintegrating tablets, and investigate the in vitro drug dissolution behavior. Methods:The formula was optimized by full-factorial experiment design, the ratio of mannotil to micro-crystalline cellulose ( X1 ) and the amount of disintegrating agent ( X2 ,%) were selected as the independent variables, and the friabili-ty ( Y1 ,%) , disintegration time ( Y2 , s) and metoclopramide dissolution ( Y3 ,%) were used as the dependent variables. The release rate of metoclopramide orally disintegrating tablets in different dissolution media was studied. Results:The optimum formula of meto-clopramide orally disintegrating tablets was as follows:the ratio of mannotil to microcrystalline cellulose was 2. 5∶ 1, and the amount of disintegrating agent was 6. 5%. The dissolution of metoclopramide orally disintegrating tablets in the different dissolution media was o-ver 80%. Conclusion:The formula design is reasonable, the preparation process is feasible and the quality can be controlled.

Objective:To investigate the clinical value of gadolinium ethoxybenzyl diethy-lanetriaminepentaacetic acid (Gd-EOB-DTPA) enhanced magnetic resonance imaging (MRI) in the preoperative diagnosis of macrotrabecular-massive hepatocellular carcinoma (MTM-HCC).Methods:The diagnostic test was conducted. The clinicopathological data of 150 HCC patients who were admitted to the First Affiliated Hospital of Army Medical University from January 2019 to December 2020 were collected. There were 116 males and 34 females, aged (53±10)years. There were 38 MTM-HCC patients and 112 non-macrotrabecular-massive hepatocellular carcinoma (nMTM-HCC) patients. All patients received Gd-EOB-DTPA enhanced MRI examination. Observation indicators: (1) clinicopathological features of MTM-HCC and nMTM-HCC; (2) imaging features of MTM-HCC and nMTM-HCC; (3) imaging features for diagnosis of MTM-HCC. The normality test of continuous data was analyzed by the Kolmogorov-Smirnov test. Measurement data with normal distribution and homoscedasticity were represented as Mean± SD, and comparison between groups was analyzed using the independent sample t test. Measurement data with skewed distribution were represented as M( P25, P75), and comparison between groups was analyzed using Mann-Whitney U test. Count data were described as absolute numbers, and comparison between groups was analyzed using the chi-square test. Multivariate analysis was conducted using the Logistic regression model. The receiver operating characteristic (ROC) curve was used to evaluate diagnostic value of indicators, and Delong test was used for comparison. Results:(1) Clinicopathological features of MTM-HCC and nMTM-HCC: the alpha-fetoprotein and cases with microvascular invasion were 329 μg/L(20 μg/L,1 034 μg/L) and 24 for MTM-HCC patients, versus 25 μg/L(8 μg/L,200 μg/L) and 31 for nMTM-HCC patients, showing significant differences between the two groups ( Z=-3.306, χ2=15.380, P<0.05). (2) Imaging features of MTM-HCC and nMTM-HCC: cases with regular morphology of tumor, intra-tumoral fat, arterial phase peritumoral enhancement, complete capsule, intratumoral necrosis or ischemia, peritumoral hypointense at hepatobiliary phase (HBP) were 6, 4, 20, 5, 28, 17 for MTM-HCC patients, versus 44, 40, 21, 43, 26, 11 for nMTM-HCC patients, showing significant differences between the two groups ( χ2=7.049, 8.684, 16.399, 8.303, 31.368, 22.783, P<0.05). (3) Imaging features for diagnosis of MTM-HCC. ① Results of multivariate analysis showed that intratumoral fat, intratumoral necrosis or ischemia were independent predictors for MTM-HCC ( hazard ratio=4.033,0.215, 95% confidence interval as 1.196-13.603, 0.079-0.588, P<0.05). ② Diagnostic efficacy: the arear under ROC curve, sensitivity and specificity of intratumoral fat combined with intratumoral necrosis or ischemia for diagnosis of MTM-HCC were 0.799(95% confidence interval as 0.718-0.880, P<0.05), 73.7%, 76.8%. The above indicators of intratumoral fat for diagnosis of MTM-HCC were 0.626(95% confidence interval as 0.530-0.721, P<0.05), 89.5%, 35.7%. The above indicators of intratumoral necrosis or ischemia for diagnosis of MTM-HCC were 0.752(95% confidence interval as 0.659-0.845, P<0.05), 73.7%, 76.8%. There were significant differences in the diagnostic efficacy between the intratumoral fat combined with intratumoral necrosis or ischemia and single intratumoral fat, between the intratumoral fat combined with intratumoral necrosis or ischemia and single intratumoral necrosis or ischemia, respectively ( P<0.05). Conclusions:Intratumoral fat, intratumoral necrosis or ischemia on Gd-EOB-DTPA MRI are independent predictors for MTM-HCC. The two combined features has higher diagnostic efficacy. Gd-EOB-DTPA MRI can be used for pre-operative diagnosis of MTM-HCC.

Objective To analyze the feasibility of totally no tube (TNT) in da Vinci robotic mediastinal mass surgery and its significance for fast track surgery. Methods A total of 79 patients receiving robotic mediastinal TNT surgery in the General Hospital of Shenyang Military Command from January 2016 to December 2017 were enrolled as a TNT group; 35 patients receiving robotic mediastinal surgery in General Hospital of Shenyang Military Command from January 2014 to December 2017 and 54 patients receiving thoracoscopic mediastinal surgery during the same period were enrolled as a non-TNT group and a video-assisted thoracoscopic surgery (VATS) group. The muscle relaxation and tracheal intubation/laryngeal masking time, operation time, intraoperative blood loss, postoperative ICU stay, postoperative hospital stay, postoperative visual analogue scale (VAS), hospitalization costs and postoperative complications and other related indicators were retrospectively analyzed among the three groups. Results Surgeries were successfully completed in 168 patients with no transfer to thoracotomy, serious complications (postoperative complications in 9 patients) or death during the perioperative period. All patients were discharged. Compared with the non-TNT group, the TNT group had significantly less muscle relaxation-tracheal intubation/laryngeal masking time, operation time, intraoperative blood loss, VAS pain score, ICU stay, postoperative hospital stay (P<0.01); there was no significant difference in the total cost of hospitalization between the two groups (P>0.05). Between the non-TNT group and the VATS group, there was no significant difference in time of muscle relaxation and tracheal intubation, operation time and ICU stay (P>0.05). The non-TNT group was superior to the VATS group in terms of intraoperative blood loss, VAS pain scores on the following day after operation, chest drainage volume 1-3 days postoperatively, postoperative catheterization time and postoperative hospital stay (P<0.05); but the cost of hospitalization in the non-TNT group was significantly higher (P=0.000). Conclusion The da Vinci robot is safe and feasible for the treatment of mediastinal masses. At the same time, TNT is also safe and reliable on the basis of robotic surgery which has many advantages such as better comfort, less pain, ICU stay and hospital stay as well as faster recovery.

BACKGROUND: Da Vinci Surgical System is one of the greatest inventions of the 20th century, which represents the development direction of the precise minimally invasive surgical techniques, the aim of this study was to comparing the short-term outcomes between da Vinci robot-assisted lobectomy and video-assisted thoracic surgery (VATS) lobectomy for non-small cell lung cancer. METHODS: 45 pairs of non-small cell lung cancer patients underwent pulmonary lobectomy with da Vinci Robotic assisted thoracoscopic (RATS) and VATS approach during the same period from January 2014 to January 2017. The operative time, estimated blood loss (EBL), total number and total groups of dissected lymph nodes, postoperative duration of drainage, the first day volume of drainage, total volume of drainage were compared. RESULTS: No perioperative death and convertion to thoracotomy occured in both groups. There were significant difference between RATS group and VATS group in EBL [(50.30±32.33) mL vs (208.60±132.63) mL], the first day volume of drainage [(275.00±145.42) mL vs (347.60±125.80) mL], the dissected total number [(22.67±9.67) vs (15.51±5.41)] and total team [(6.31±1.43) vs (4.91±1.04)] of lymph node. There were no significant difference in other outcomes. CONCLUSIONS RATS is safe and effective and took better short-outcomes than VATS in non-small cell lung cancer.
Adult ; Aged ; Carcinoma, Non-Small-Cell Lung ; surgery ; Case-Control Studies ; Female ; Humans ; Lung Neoplasms ; surgery ; Lymph Node Excision ; Lymph Nodes ; surgery ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures ; Operative Time ; Retrospective Studies ; Robotics ; methods ; Thoracic Surgery, Video-Assisted ; instrumentation ; methods ; Thoracoscopy ; instrumentation ; methods