Objective To evaluate the effect of clinical nursing path on hospital stay and hospitalization expenses of patients with ovarian cyst treated with laparoscopic resection.Methods Meta-analysis was conducted by retrieving the databases of Pubmed, Google,CNKI and Wangfan database.All randomized controlled trials about clinical pathways in patients with ovarian cyst treated with laparoscopic resection were included.RevMan 5.2 was used for statistical analysis.Results Ten papers and 1,002 patients were included.There were statistical differences in hospital stay and hospitalization expenses by meta-analysis.Conclusion The clinical nursing path can reduce hospital stay and hospitalization cost of patients with laparoscopic resection.

Objective:To evaluate the impact of change in the hormone receptor (HR) status on the long-term outcomes of breast cancer patients treated with neoadjuvant chemotherapy (NAC).Methods:There were 215 patients for the HR status of their lesions before and after NAC.After surgery,59 cases were confirmed to have achieved complete remission of pathology,The expression of hormo ne receptors was not consistent in 63 patients before and after neoadjuvant chemotherapy.63 patients were divided into two groups,Group A:39 patients received standard endocrine therapy for 5 years after surgery and chemotherapy;Group B:24 patients were not treated with standard endocrine therapy after surgery and chemotherapy.Conclusions:The 3-year DFS rates were 77.4％ and 54.2％ in Group A and Group B patients,respectively,There was not statistical significancebetween the two groups.The 5-year overall survival rate for Group A patients was higher than that of Group B patients(74.3％ vs 45.8％,P=0.028),The difference was statistically significant.Conclusions:This study revealed that breast cancer patients with HR altered after NAC still benefit from standard endocrine therapy.

Objective To identify high-risk group among gastric cancer patients treated with curative resection and more than D1 dissection, and investigate the indications for proper adjuvant therapy.Methods 297 patients who met the following enrolled criteria were retrospectively analyzed:treated between January 2002 and December 2004, primary gastric or gastroesophageal cancer, underwent curative gastrectomy and more than D1 lymphadenectomy, pathologically staged as T3-4N0-1M0,or TxN2-3M0.The overall survival (OS), disease-free survival (DFS), local-regional recurrence-free survival (LRFS) and distant metastasis-free survival (DMFS) were calculated, and possible prognostic factors were analyzed.Results The median follow-up time was 61 months.The follow-up rate was 92.3%.The 5-year OS, DFS, LRFS and DMFS were 57.9%, 52.2%, 70.6% and 71.7%, respectively.Four independent prognostic variables identified for OS, DFS, LRFS and DMFS using multivariate analysis were Borrmann type (Ⅰ+Ⅱ/Ⅲ+Ⅳ), total number of dissected lymph nodes (>18/≤18), number of positive lymph nodes (0-3/≥4), and 6th AJCC TNM stage (Ⅱ+Ⅲ a/Ⅲ b+ⅣM0)(χ2=3.94-16.34,P<0.05).If one unfavorable prognostic factor was scored as 1, according to the total scores of the four prognostic factors, four risk groups were generated as low (score:0), low-intermediate (score:1), high-intermediate (score:2) and high risk group (score:3 or 4).The 5-year OS, DFS, LRFS and DMFS were 85.7%, 61.0%, 58.6% and 38.6%(χ2=31.20,P<0.01) in low risk group, 85.2%, 61.3%, 48.1% and 31.8%(χ2=31.88,P<0.01) in low-intermediate risk group, 94.4%, 77.8%, 64.4% and 57.2%(χ2=18.36,P<0.01) in high-intermediate risk group and 87.9%, 75.0%, 74.2% and 55.5%(χ2=19.30,P<0.01) in high risk group.Conclusions Even with R0 resection and more than D1 lymphadenectomy, the outcome was poor for gastric cancer patients with two or more unfavorable prognostic factors.Prospective study is warranted to evaluate the efficacy of adjuvant concurrent chemoradiotherapy for this group of patients.

Background The diseases of neuro-ophthalmology are common,which can influence the quality of patients' life seriously.The 39-item National Eye Institute Visual Function Questionnaire (NEI VFQ-39) is an instrument to assess self-reported visual impairment in studies of vision.However,until now,no studies have been performed to specifically assess the vision-related quality of life in persons with diseases of neuro-ophthalmology.Objective To evaluate vision-related quality of life for neuro-ophthalmology inpatients through the NEI VFQ-39,for the better treatment and nursing for them.Methods Ninety-seven neuro-ophthalmology inpatients were scheduled in research from June 1 to September 30,2012,and we collected all the clinical datas and the Chinese version NEI VFQ-39.The NEI VFQ-39 subscale item scores were compared among subgroups divided by monocular or binocular incidence,diseases and best corrected visual acuity(BCVA),and correlation analysis of the NEI VFQ-39 scores and BCVA for better-seeing and worse-seeing eyes was performed.Results The mean age of scheduled patients was (36.6±14.4)years,with no difference in gender.The mean composite score of VFQ-39 was 57.36(46.50,73.38),mental health subscale score was lowest [45.00 (35.00,60.00)].In the four eye diseases groups,except for eye pains,degree of dependence,periphery vision,anterior ischemic optic neuropathy (AION) group had lower scores compared with the other three groups,but there were no statistical significances among the four groups (all at P＞0.05).Except for eye pains,patients with monocular incidence had better scores than those with binocular incidence,with statistical significant significances between them(all at P＜0.05).Patients with BCVA in the better-seeing eye ＞ 20/32 had better scores than the other two groups,compared with the BCVA in the better-seeing eye ＜20/200 group,except for overall health and eye pains,cornpared with the 20/200 ≤ BCVA in the better-seeing eye ＜20/23 group,except for eye pains,social activity and color vision,and the rest subscale scores had significant differences among the three groups(all at P＜0.05).NEI VFQ-39 scores had positive correlations with the BCVA for better-seeing and worse-seeing eyes,and had strong correlations with the BCVA for better-seeing.Conclusions Neuro-ophthalmology diseases have serious influences on patients' visual function and quality of life.The quality of life has direct correlation with BCVA,so improving their visual function is helpful to their quality of life.

Computer tomography scanning was performed in 16 patients with mandibular angle hypertrophy before and after surgery. The imaging data of patients were recorded in three-dimensional reconstruction software (Mimics 10.0), and found the most appropriate surgery plan through simulating different surgical procedures. The geometry character indexes of the face were compared between before and after surgery, and then the results were analyzed. We got intuitive, accurate three-dimensional reconstruction graphs, simulation of surgery procedures, and calculation of difference in the geometry character index of face in all cases. The bone width of mandibular angle shortened (7.69?.89) mm; the soft tissue width of mandibular angle shortened (5.13?.19) mm; the both gonial angle increased (5.68?.43)?and (5.91?.66)? respectively. Applied to actual surgery procedure,the operation time shortened and precision of operation was improved. Results demonstrated that Computer three-dimensional reconstruction and computer simulation techniques is beneficial to reveal the variational regularity of bone and soft tissue, which is a good aided method in stimulation of surgery and choice of surgery plan.

Objective To evaluate the role of postmastectomy radiotherapy in four subgroups of high-risk breast cancer patients, who were grouped by the status of estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor 2 (Her-2). Methods A total of 437 invasive breast cancer patients with T3-4N1 or N2-3 and available immunohistochemistry results of ER, PR and Her-2 were retrospectively analyzed. Patients were classified into 4 subgroups according to hormone receptors (ER or PR, Rec) and Her-2 status:Rec-/Her-2-(triple negative), Rec-/Her-2 +, Rec +/Her-2 + and Rec +/Her-2-. Rec-was defined as ER-and PR-. Rec + was defined as ER + and/or PR +. Her-2 positive was defined as Her-2 + + or Her-2 + + +. End points were isolated locoregional recurrence (LRR), distant metastasis (DM), disease-free survival (DFS) and overall survival (OS). Results The median follow up time was 48 months. Sixty-nine (15. 8%) patients were Rec-/Her-2-, 62 (14. 2%) Rec-/Her-2 +, 89 (20.4%) Rec +/Her-2 + and 217 (49.7%) Rec +/Her-2-. 480(93.4%) patients received chemotherapy and 352(80. 5%) received radiotherapy. Radiotherapy significantly reduced the 5-year LRR rates of all the four subgroups (Rec-/Her-2-: 13.1% vs. 33. 3%, Rec-/Her-2 + :9. 3% vs. 21.2%, Rec + /Her-2 + :9. 7% vs. 47.0%, Rec +/Her-2-:3. 2% vs. 15.4%). Radiotherapy significantly lowered the 5-year DM rates (26. 7% vs. 49.4%, 27.6% vs. 67. 5%, 18.4% vs. 100%) and improved the 5-year DFS rate (66. 7% vs. 33. 3% , 67.7% vs. 33. 3% , 72. 6% vs. 0%) as well as OS (73.9% vs. 25.2% ,69. 8% vs.41.5%, 91.0% vs. 32. 8%) of patients with Rec-/Her-2-, Rec-/Her-2 + and Rec +/Her-2 +. Conclusions In high-risk breast cancer patients, all subgroups of patients grouped by ER, PR and Her-2 status can benefit from postmastectomy radiotherapy.

Objective To analyze CT manifestations of chest wall Askin tumor and to illustrate its CT diagnostic and differentially diagnostic key points.Methods Eleven cases of chest wall Askin tumors were pathologically confirmed in our hospital between May 2006 and November 2014.Of them,10 cases were children and adolescents,and 9 cases had chest pain as the first symptom.All patients received plain CT scan,while 7 cases received contrast enhanced scan.CT signs of this group were retrospectively analyzed,including the location,quantity,shape,size,density,adjacent tissue invasion and distant metastasis of the tumors.Results CT examination showed a single oval mass on the chest wall in all 11 cases.The tumor was located completely within the thoracic cavity in 10 cases,while a tumor's main part was within thoracic cavity.Nine tumors had long diameters of more than 9 cm.All the tumors were heterogeneous without calcification,wherein 10 cases showed necrosis and cystic degeneration.On contrast enhanced scan,7 cases showed heterogeneously mild to moderate enhancement.All tumors invaded adjacent tissues,including 7 cases of bone damage of a single rib,and 7 cases of pleural involvement,wherein 6 cases had pleural effusion.No remote metastases were found in this group.Conclusions CT manifestations of Askin tumors of chest wall have some characteristics,and familiarity with these manifestations is conducive to diagnosis and differential diagnosis of this disease.

Objective To explore the methodology of skin flap muscle flap (double flaps) and and effect of the double flaps on eyelid bag blepharoplasty.Methods Through lower eyelid incision,skin flap and muscle flap were formed,orbicularis muscle and orbital septum separated between the skin and flaps,direct access to the inferior orbital rim depression.Arcuate edge of the orbicularis muscle was fully stripped and released,especially the orbicularis muscle at the inferior orbital rim periosteal surface.The orbital fat was released,sutured below the inferior orbital rim periosteal surface.The orbicularis muscle flap was designed,lift and fixed to enhance midface to achieve the rejuvenation effect in the lower eyelid region.Results The 36 patients treated had no hematoma and flinch in the lower eyelid.Within 3 to 18 months follow-up,there were no ectropion,and facial nerve damage and other complications.Conclusions Double-flap is a feasible method as it can effectively enhance midface rejuvenation and correct eyelid bags deformity.

The purpose of this paper is to achieve a measurement of temperature prediction for artificial heart without sensor, for which the research briefly describes the application of back propagation neural network as well as the optimized, by genetic algorithm, BP network. Owing to the limit of environment after the artificial heart implanted, detectable parameters out of body are taken advantage of to predict the working temperature of the pump. Lastly, contrast is made to demonstrate the prediction result between BP neural network and genetically optimized BP network, by which indicates that the probability is 1.84% with the margin of error more than 1%.
Heart, Artificial ; Neural Networks (Computer) ; Temperature

This paper built the mathematical model of a centrifugal blood pump, which was designed by ourselves, combined it with that of the human cardiovascular system and simulated the coupling system using Matlab. Then we set up the experiment platform, linked the blood pump to mock human cardiovascular system in case of three-stage heart failure, and measured aortic pressure and flow under different speed. The comparison between experiment results and simulation results not only indicates the coupling model is correct and the blood pump works well, but also shows that with the increase of blood pump speed, the pulsation of aortic pressure and flow will be reduced, this situation will affect the structure and function of blood vessels.
Cardiovascular System ; Heart-Assist Devices ; Hemodynamics ; Humans ; Models, Theoretical