Objective To study the effect of adjuvant transcatheter arterial chemoembolization (TACE) on intrahepatic recurrence after curative liver resection for primary hepatocellular carcinoma (PHC).Methods 130 PHC patients who underwent curative liver resection from June 2010 to February 2013 were selected and randomly allocated to the study group (n =67) and the control group (n =63).The study group underwent adjuvant TACE for 1 ～ 4 times,and the control group did not receive any adjuvant therapy.On follow-up for 36 months,the postoperative recurrence rates,tumour free survival time and tumor free survival rates of the two groups were compared.Results At 6 months after surgery,the serum AFP level [(379.8 ±91.7) μg/L vs.(414.5 ±84.3) μg/L] and the IGFBP-2 level [(2 855.3 ±727.5) μg/L vs.(3 259.6 ± 894.1) μg/L] in the study group were significantly lower than the control group (P ＜ 0.05).The 1-year cumulative recurrence rate in the study group (10.4％ vs.28.6％) was significantly lower than the control group (P ＜ 0.05).However,the 2-year and 3-year cumulative recurrence rates were not significantly different between the two groups (P ＞ 0.05).The 3-year cumulative tumor free survival rate of the study group (81.0％ vs.73.2％) was significantly higher than the control group (P ＜ 0.05).Patients in the study group with portal vein tumor thrombus had an 1-year cumulative recurrence rate of (12.8％ vs.31.6％) and a 2-year rate of (28.2％ vs.50.0％).In patients with a preoperative AFP ≥400 μg/L,the 1-year cumulative recurrence rates were (8.8％ vs.30.6％).When the tumor diameter was ≥10 cm,the 1-year,2 year and 3-year cumulative recurrence rates were significantly lower than the control group (P ＜ 0.05,11.8％ vs.46.7％),(35.3％ vs.75.3％) and (47.1％ vs.86.7％),respectively.The recurrence rates in patients who had no cancer thrombus,a preoperative AFP ≤400 μg/L and a tumor diameter ＜ 10 cm were not significantly different between the two groups (P ＞ 0.05).The recurrent rates of patients who underwent TACE 1 time and those who did not receive TACE showed no significant difference (P ＞0.05).In patients who had TACE twice,the 1-year (4.3％ vs.28.6％),2-year (15.2％ vs.41.3％) and 3-year (26.1％ vs.49.2) cumulative recurrence rates were significantly lower than patients who did not receive TACE (P ＜ 0.05).In patients who had TACE for more than three times,the cumulative recurrence rate was similar to patients who had TACE twice (P ＞ 0.05).Conclusions Adjuvant TACE helped to reduce PHC recurrence after curative liver resection during the high-risk period for recurrence.A 1-time TACE did not significantly reduce postoperative recurrence rate,and ≥ 3 times TACE did not significantly improve tumor-free survival rates.Adjuvant TACE and the number of TACE should be reasonably carried out based on the indications and pathological characteristics.

Objective:To explore the effect of different doses of lidocaine on recovery quality of patients with iodine-deficiency goiter after general anesthesia resection.Methods:Using a prospective design, 108 patients who underwent iodine-deficiency goiter resection in Yantai Yeda Hospital from April 2018 to April 2020 were selected as the research subjects. The patients were divided into control group (normal saline), lidocaine group A (1 mg/kg) and lidocaine group B (2 mg/kg) by random number table method, 36 cases in each group. The corresponding dose of lidocaine or the equivalent dose of normal saline was pumped into the vein after anesthesia induction and intubation for 30 minutes. The changes in the diastolic blood pressure (DBP), systolic blood pressure (SBP) and blood glucose (GLU) levels of the three groups were observed before administration, immediately after the operation, immediately after opening the eyes, immediately after extubation, and 10 minutes after extubation; at the same time, arousal and restlessness score (RS), sedation score (Ramsay), visual analogue score (VAS) and adverse reactions(coughing, nausea and vomiting, respiratory depression) occurrence were recorded.Results:At the moment of eye opening, immediately after extubation and 10 minutes after extubation, DBP (mmHg: 77.26 ± 4.85, 73.45 ± 4.37, 70.94 ± 4.45, 83.53 ± 6.19, 77.86 ± 5.33, 74.14 ± 5.20, 73.86 ± 5.73, 68.41 ± 5.16, 63.09 ± 5.24), SBP (mmHg: 129.17 ± 6.54, 121.25 ± 6.07, 116.24 ± 5.86, 137.48 ± 6.62, 129.53 ± 6.38, 123.07 ± 6.25, 125.65 ± 6.13, 117.48 ± 6.09, 108.17 ± 6.04), GLU level (mmol/L: 5.83 ± 0.36, 5.37 ± 0.29, 5.12 ± 0.26, 6.69 ± 0.34, 5.84 ± 0.30, 5.57 ± 0.27, 5.61 ± 0.32, 5.25 ± 0.31, 4.97 ± 0.28) of lidocaine group A and lidocaine group B were significantly lower than those of control group, the difference were statistically significant ( F=17.520, 25.755, 36.034, 41.028, 45.525, 74.330, 10.397, 49.756, 52.348, P < 0.05); among them, the DBP, SBP and GLU levels of lidocaine group A and lidocaine group B were lower than those of control group, and lidocaine group B was lower than lidocaine group A ( P < 0.05). The RS and VAS of lidocaine group A and lidocaine group B were significantly lower than those of control group, and Ramsay was higher than that of control group ( P < 0.05); and the RS and VAS of lidocaine group B were lower than those of lidocaine group A, the Ramsay was higher than that of lidocaine group A ( P < 0.05). The incidence of coughing, nausea and vomiting in lidocaine group A and lidocaine group B were lower than those in the control group ( P < 0.05); and there was no respiratory depression in the three groups. Conclusions:Thrity minutes after induction of anesthesia, continuous pumping of 2 mg/kg lidocaine can maintain blood pressure and GLU of patients undergoing general anesthesia for iodine-deficiency goiter, and effectively reduce restlessness, pain and adverse reactions during the recovery period. It is a satisfactory dose for thyroid surgery patients to wake up and comfortably.

OBJECTIVE:To prepare compound zinc sulfate oral solution and establish its quality control method. METHODS: The oral solution was prepared with zinc sulfate and lysine hydrochloride as chief components. The content of lysine hydrochloride was determined by coordination titration and uv spectrophotometry, respectively, and the stability of the preparation was investigated. RESULTS: The oral solution was colorless or yellowish, with its identification and test results all in conformity with the related stipulation stated in Chinese Pharmacopeia(2005 edition). The average content of zinc sulfate labeled in the sample stood at 101%. The linear range of lysine hydrochloride was 3.2～9.6 ?g?mL-1(r=0.999 9) and its average recovery rate was 99.75%(RSD=0.27%, n=6). The preparation was stable within 6 months storing under room temperature. CONCLUSION: This preparative technology of compound zinc sulfate oral solution is simple and feasible, and the quality of which is stable and controllable.

Objective The nursing staff's output and journals distribution of core scientific journals papers were analyzed, providing evaluation data and a decisive basis for scientific research management. Methods A retrospective analysis was performed to the publication of core journals papers of nursing staff in 2013-2015 based on the publication from different nursing positions , the ranking of published nursing papers from different departments and different journals by using analysis method of bibliometric. Results About 1550 nursing papers were published , of which the number of authors whose paper was published in core journals was 216 , the number of papers published in core journals was 378, and 38 authors published more than 3 papers (17.6%). The core journals papers published rate in different position was statistically significant (P<0.01). The papers published journals were concentrated in nursing class. Dominated the first 3 places in the list of core journals paper number of departments were department of nursing , cancer center and operation room, respectively. Conclusion In order to improve the nursing scientific research level of nursing staff, it is necessary to establish a theoretical system of scientific knowledge training , formulate a long-term effective mechanism in paper management , focus on scientific research talent introduction and training and mobilize the nursing research enthusiasm of nursing staff.

Aged ; Carcinoma, Hepatocellular ; diagnostic imaging ; pathology ; surgery ; Hepatectomy ; methods ; Humans ; Liver Neoplasms ; diagnostic imaging ; pathology ; surgery ; Male ; Middle Aged ; Tomography, X-Ray Computed

OBJECTIVETo investigate the clinical experiment of cortical screw in the treatment of tibiofibular syndesmosis separation together with ankle fractures.

METHODSFrom March 2008 to May 2012,42 patients with tibiofibular syndesmosis separation were treated with cortical screw, including 20 cases in the left and 24 cases in the right. All the patients had closed injury. According to Lauge-Hansen classification, there were 18 cases of supination-external rotation, in which 4 patients with injuries belong to type II, 8 patients with injuries belong to type III, 6 patients with injuries belong to type IV; 14 cases of pronation-external rotation, in which 6 patients with injuries belong to type III, 8 patients with injuries belong to type IV; and 12 cases of pronation-abduction, in which 4 patients with injuries belong to type II, 8 patients with injuries belong to type III. According to injury of ankle, 4 patients had injuries in one ankle, 28 patients had injuries in 2 ankles, and 12 patients had injuries in 3 ankles. All the patients were diagnosised definitely in sight of medical history, checking-up, iconography. The clinical effects were evaluated based on Baird-Jackson score and activity degree of ankle.

RESULTSAll the patient were followed up, and the duration ranged from 11 to 23 months, with an average of 15.7 months. No postoperative wound infection, nonunion, and tibiofibular syndesmosis separation again and other complications occurred. Postoperative Baird-Jackson score exhibited 91.56 ± 6.26 (75 to 99), and 26 patients got an excellent result, 10 good, 6 poor and 2 bad. One patient had nail broken after operation,and got good function after removing broken nail without external fixation. Other 1 patient had osteoarthritis to 1 degree, and got better result with the treatment of physical therapy and intra-articular injection.

CONCLUSIONCortex screw is the effective treatment for tibiofibular syndesmosis separation. Clear diagnosis, delicate operation and postoperative reasonable functional exercise are primary factor of prognosis.

Adult ; Ankle Fractures ; surgery ; Ankle Joint ; surgery ; Bone Screws ; Female ; Fracture Fixation, Internal ; Humans ; Male ; Middle Aged ; Treatment Outcome

Objective To investigate the prevalence of serum Anti-sperm antibodies(AsAb) in group of prepubertal boys with cryptor-chidism before and after surgery,and explore whether it may be influenced by testicular location,orchiopexy,unilateral or bilateral cryptorchi-dism and deferens and(or) epididymis abnormality.Methods Serum AsAb was examined in 50 prepubertal boys with cryptorchidism and 50 boys with oblique inguinal hernia before and 6 months after surgery.Fifty boys who were normal were served as controls.IgG and IgM AsAb were determined by the immunodotting method.Results The preoperative and post-orchiopexy serum AsAb positive rates in cryptorchid boys were significantly higher than the preoperative and post-high ligation of hernial sac ones respectively in boys with oblique inguinal hernia(Pa0.05).Conclusion Cryptorchidism may induce an autoimmune response against sperm antigen in prepuberty independent of testicular location,orchiopexy,unilateral or bilateral cryptorchidism and deferens and(or) epididymis abnormality.

Objective To study HBeAg change in patients infected hepatitis B virus(HBV) with pre-C signal enzyme cleavage site mutation. Methods Mutation in pre-C signal enzyme cleavage site was detected by PCR-RFLP. The PreC/C gene with mutation was amplified by PCR and was cloned to EB viral eukarotic expression vector. Then transfect the vector with wild type or mutant PreC/C gene to HepG2 cell. SEAP reporter system was used to monitor the efficiency of transfection. HBeAg and its precursor in the supernatant and HepG2 cell were detected by ELISA and Western blot. Results HBeAg was positive in the supernatant of wild type and negative control in T1862 vaniant by ELISA. In HepG2 cell transfected with wild type, three proteins were detected by Western blot, they were HBeAg(17 000) and two HBeAg precursor(22 000 and 25 000). And in HepG2 cell transfected T1862 vaniant, only two HBeAg precursor was detected. The precursor in cells transfected withT1862 vaniant were significantly stronger than cells transfected with wild type. Conclusion Mutation in pre-C signal enzyme cleavage site may affect the decoration of HBeAg, which may cause great of HBeAg precursor locating in cells and lead to HBeAg negative in serum of patients infected with HBV.

Objective To investigate the correlation between aneurysmal subarachnoid hDepartment of Neurosurgery,Xi Dian Group Hospital,Xi'an 710077,Chinaemorrhage (aSAH) and myocardial dysfunction (MD).Methods Totally 96 cases of aSAH patients meeting the criterion were chosen,and the correlations of electrocardiograph (ECG),and ultrasonic cardiogram (UCG)with delayed cerebral ischemia (DCI),death and poor outcome and death were analyzed.Results Of the 93 cases of aSAH patients meeting the criterion,DCI rate was 59.2％,death rate was 19.4％,and poor outcome rate was 21.5％.With multivariable Poisson regression analysis,the results showed that wall motion score index (WMSI) ＞ 1.1 was correlated with death and poor outcome,mid-ventricular wall motion abnormality (WMAs) was correlated with death,and apical WMAs was correlated with DCI.Conclusions Myocardial dysfunction is significantly related to outcome of aSAH.Thus,this study may provide a reference for prognosis assessment and treatment of aSAH.

[ABSTRACT]AIM:ToexploretheeffectofretinoidXreceptor(RXR)agonistbexarotene(Bex)andvitaminD receptor (VDR) agonist calcitriol (Cal) on the expression of nuclear factor-kappa B (NF-κB) and the development of atherosclerosis in streptozotocin-induced diabetic apolipoprotein E knockout ( STZ-ApoE-/-) mice.METHODS: Male mice were treated for 12 weeks as follows:(1) C57+vehicle;(2) ApoE-/-+vehicle;(3) STZ-ApoE-/-+vehicle;(4) STZ-ApoE-/-+Bex (10 mg· kg-1· d-1);(5) STZ-ApoE-/-+Cal (10 μg/kg, twice a week);(6) STZ-ApoE-/-+Bex (10 mg· kg-1· d-1) +Cal (10 μg/kg, twice a week).Intraperitoneal injection of STZ was performed to establish the diabetic animal model .Western blotting and immunohistochemical method was used to detect NF-κB level in the thorac-ic aorta.Plaque area in the thoracic aorta was measured using HE staining .RESULTS:Compared with the C57 mice, the fasting blood glucose in the ApoE-/-mice was not remarkably changed .The levels of total cholesterol ( TC) and low-densi-ty lipoprotein ( LDL) were greatly increased .The fasting blood glucose and lipid levels in STZ-ApoE-/-group were much higher than those in ApoE-/-group.Compared with STZ-ApoE-/-group, the fasting blood glucose and lipid levels in Bex group and Cal group were not significantly changed .Compared with the C57 mice, the protein expression of NF-κB in the ApoE-/-mice and the STZ-ApoE-/-mice was remarkably increased .Compared with STZ-ApoE-/-group, the levels of NF-κB in Bex group, Cal group and combination group were greatly decreased .Compared with STZ-ApoE-/-group, the thoracic artery plaque areas in Bex group and Cal group were inhibited (both P<0.05).Compared with Bex group, the plaque area of the thoracic artery in combination group was significantly decreased (P<0.05).CONCLUSION:Bexaro-tene or calcitriol decreases the development of atherosclerosis in streptozotocin -induced diabetic ApoE-/-mice.Bexarotene combined with calcitriol affords greater protection than monotherapy .The mechanism may be involved in down-regulating the expression of NF-κB.