Objective To explore the psychological status of patients after hand tenolysis and the pertinent nursing countermeasures. Methods 47 patients after hand tenolyais were selected and investigated their psychological status and relevant influencing factors with serf-designed questionnaire and symptom checklist-90(SCL-90). Besides, corresponding psychological nursing were applied. The SCL-90 results of Chinese Norm were adopted to undergo comparison with them and t test was chosen. Results On the first day after operation, the score of the investigation objectives was significantly different compared with that of the Chinese norm. After pertinent mental nursing, their symptoms alleviated, and no significant difference was seen between them. Conclusions There are obvious psychological obstacles in patients after hand tenolysis. The pertinent mental nursing has important effect on rehabilitation training and functional rehabilitation after hand tenolysis.

Objective To investigate the influence of chondrocytes originating from different source on early chondrogenic differentiation of bone marrow mesenchymal stem cells (MSCs) in isolated co-culture system.Methods We applied hanging cell culture system to culture chondrocytes of different origin (osteoarthritis chondrocyte cells,nomal chondrocyte cells,infant chondrocyte cells) and controls.These chondrocytes and MSCs of the same origin were cultured in the common medium in a separated condition,and observed by microscope at 3,6,9,12 day after co culture.Expression levels of aggrecan,collagen type Ⅱ (Col 2),cartilage-specific transcription factor (Sox-9) in MSCs of different origin were determined by Real-time PCR.Results MSCs showed obviously morphological differentiation induced by chondrocytes of different origin at 12 day after coculture as compared with controls.Real-time PCR analysis showed that SOX9 mRNA level was stimulated by 1.7-fold,1.6-fold and 1.2-fold (all P＜0.05) and aggrecan mRNA level was increased by 2.8-fold,2.2-fold and 1.3-fold (all P＜0.05) in infant chondrocytes group,nomal chondrocytes group,osteoarthritis chondrocytes group respectively as compared with controls while COL2 mRNA level had no significant differences among the four groups.Corresponding protein signal level had obvious differences among the four groups,especially in infant chondrocytes as compared with osteoarthritis chondrocytes and nomal chondrocytes.Conclusions Isolated co-culture system may indirectly promote MSCs differentiation to chondrocytes by local micro-environment regulation.Chondrocytes of different origin have different effects on MSCs differentiation,but they could promote MSCs differentiation to chondrocytes.

Objective:To investigate the effects of enteral nutrition on the incidence of treatment complications, results from nutritional indexes and proportions of immune cell subsets in elderly patients with esophageal carcinoma during concurrent chemoradiotherapy.Methods:From January 1, 2020 to December 31, 2020, 108 elderly patients(≥60 years)undergone concurrent chemoradiotherapy for esophageal carcinoma at Quanzhou First Hospital and eligible for inclusion were enrolled in the case-control study.They were randomly divided into the study group(enteral nutrition group)and the control group(normal diet group), with 54 cases in each group.The incidence of complications, results from nutritional indexes and immune cell subsets of the two groups were analyzed according to data type.Results:The incidence of bone marrow suppression(Grade Ⅰ-Ⅱ)in the study group(37.0%)was significantly lower than that in the control group(63.0%)( χ2=7.259, P<0.01). The incidence of bone marrow suppression(Grade Ⅲ-Ⅳ)in the study group(11.1%)was significantly lower than that in the control group(27.8%)( χ2=4.788, P<0.05). The levels of hemoglobin, total serum protein and albumin were(121.36±11.63)g/L, (73.78±7.79)g/L and(40.95±3.52)g/L in the study group and(106.45±10.85)g/L, (63.12±8.35)g/L and(35.54±4.12)g/L in the control group, respectively, after 4 weeks of radiotherapy and chemotherapy( P<0.05). The proportions of CD3+ and CD4+ were(64.15±5.84)% and(48.64±4.28)% in the study group and(59.25±6.27)% and(45.27±4.52)% in the control group, respectively, after 4 weeks of radiotherapy and chemotherapy( P<0.05). The proportion of CD8+ was(26.93±3.63)% in the study group and(30.35±3.36)% in the control group after 4 weeks of radiotherapy and chemotherapy( P<0.05). Conclusions:During concurrent chemoradiotherapy for elderly patients with esophageal carcinoma, enteral nutrition with adjustment based on patient's food intake can reduce patients' nutritional risk and modulate the proportion of immune cell subsets, thus reducing the occurrence of bone marrow suppression.

Objective To investigate the value of three dimensional time-of-flight (3D-TO)F) and three dimensional fast imaging employing steady state acquisition (3D-FIESTA)sequences in evaluation on spatial relationship among trigeminal nerve,facial nerve and peripheral vessels before microvascular decompression(MVD)with 3.0 T MR.Methods Data of MRI of 36 patients with trigeminal neuralgia (TN) and 31 with hemifacial spasm (HFS) before MVD were analyzed retrospectively.The intra-observer agreement for the spatial relationship among trigeminal nerve,facial nerve and adjacent blood vessels were observed.The differences of occurrence rates of neurovascular compression (NVC) of symptomatic side and asymptomatic side in TN and HFS patients were compared.Taking surgical results as the gold standards,the diagnostic efficacy for neurovascular relationships of symptomatic side with 3D-TOF and 3D-FIESTA sequences were calculated.Results The consistency between two observers in assessing relationship of trigeminal nerve,facial nerve and adjacent blood vessels of symptomatic and asymptomatic was good (all Kappa≥0.75,all P＜0.001).In both of TN and HFS patients,the occurrence rates of NVC of symptomatic side were significantly higher than those of asymptomatic side (x2=26.13,20.81,both P＜ 0.001).The accuracy,sensitivity,specificity,positive predictive value and negative predictive value of 3D-TOF and 3D-FIESTA sequences in displaying relationship of trigeminal nerve and vascular was 97.22％ (35/36),97.06％ (33/34),100％ (2/2),100％ (33/33)and 66.67％ (2/3),respectively,of relationship between facial nerve and vascular was 93.55％ (29/31),96.55％ (28/29),50.00％ (1/2),96.55％ (28/29) and 50.00％ (1/2),respectively.Conclusion 3D-TOF and 3D-FIESTA sequences can clearly display the spatial relationship of nerve and adjacent vessels,therefore providing imaging evidences for MVD.

Objective To explore the effect of comfort care on sleep quality of patients after thoracic surgery.Methods A total of 148 patients after thoracic surgery were randomly divided into the observation group (73 cases) and the control group ( 75 cases ) .The observation group received comfort care while the control group was given traditional methods .Sleep quality was compared between two groups before and after the surgery.Results PSQI score after a week was (6.26 ±2.35 ) in the observation group and (10.29 ±3.28 ) in the control group, with statistically significant difference (t=8.572 6,P<0.05).Conclusions Comfort care can improve sleep quality of patients after thoracic surgery , promote their recovery and nursing quality .

Objective To investigate the effect of comfort care on patients ’ anxiety after video-assisted thoracoscope surgery ( VATS) .Methods 148 patients were randomly divided into the control group ( n=75 ) and the observation group ( n=73 ) .The control group performed routine nursing care , while the observation group performed special comfort care .Patients ’ anxiety on 1 day before operation and 7 days after operation were compared between groups .Results Patients’ mean score of anxiety on 1 day before operation was (55.58 ± 12.33).There was no significant difference between groups (χ2 =0.7, P>0.05).For the patients in the observation group, 16.44%had no anxiety, 61.64%had a mild anxiety, 17.81%had a moderate anxiety, and 4.11%had a severe anxiety 7 days after operation.For the patients in the control group , 13.33% had no anxiety, 13.33%had a mild anxiety, 70.67%had a moderate anxiety, and 2.67%had a severe anxiety 7 days after operation.The difference was significant (χ2 =46.88, P <0.05).Conclusions The comfort care intervention can improve the nurse-patient communication and can reduce the degree of anxiety . It also contributes to promoting the postoperative rehabilitation of patients and improving the quality of nursing care .

Objective To investigate the value of MR diffusion tensor imaging(DTI)in assessment of the microstructural changes of the trigeminal nerve,and analyze it's correlation with the degree of vascular compression. Methods Thirty-four patients with trigeminal neuralgia from November 2015 to April 2017 were retrospectively analyzed in this study.And they were treated by microvascular decompression(MVD). There were 11 cases of gradeⅠ,16 cases of gradeⅡand 7 cases of gradeⅢaccording to the severity of the contact between nerves and vessels during the operation. All of them were scanned with three dimensional time-of-flight(3D-TOF)sequences, three dimensional fast imaging employing steady state acquisition(3D-FIESTA)sequences and DTI before undergoing surgical decompression. According to the preoperative MR scans,the trigeminal nerves were divided into the healthy side without neurovascular contact (25 cases) and the healthy side with a neurovascular contact (9 cases).The DTI parameters of the trigeminal nerve,including the anisotropic fraction(FA)and the ADC values were obtained.Comparison of the FA and ADC values of the trigeminal nerve between the different stages of the affected side was performed with single factor analysis of variance, and the paired samples t test was used to compare the difference of FA and ADC values of bilateral trigeminal nerve. The difference of FA and ADC values between the asymptomatic side with or without vascular contact was compared with independent sample t test. Spearman correlation analysis was used to evaluate the correlation between DTI parameters and the degree of compression. Results The FA values of patients with grades Ⅰ,ⅡandⅢwere 0.311±0.009, 0.308±0.007 and 0.299±0.009 respectively,and there was significant difference among different levels(F=5.269,P<0.05).The ADC values of the three grades were(2.298 ± 0.309)×10-3,(2.214 ± 0.175)×10-3and (2.259 ± 0.248)×10-3mm2/s respectively, showing no statistically significant difference(F=0.402,P>0.05). The FA values of bilateral trigeminal nerves in healthy side without neurovascular contact and in healthy side with neurovascular contact were statistically significant (t=-32.528,-25.178,P<0.05). There was significant difference in the ADC value of bilateral trigeminal nerves in the group without neurovascular contact(t=2.162,P<0.05).There was no statistically significant difference in the ADC values of bilateral trigeminal nerves in the healthy side of the neurovascular contact group(P>0.05).There were no statistically significant differences in the FA and ADC values between the two groups on the healthy side of the trigeminal nerve(P>0.05).The FA value was negatively correlated with the degree of vascular compression (r=-0.453,P<0.05),while the ADC value was not correlated with the degree of vascular compression(P>0.05). Conclusion DTI imaging can be used to evaluate the degree of trigeminal nerve injury. More obvious vascular compression leads to lower FA value.

Liver cancer is one of the most common cancers in China. In recent years, liver cancer tends to be treated with comprehensive therapies, including surgery, ablation, interventional embolization, radiotherapy, chemotherapy, targeted therapy, immunotherapy, and liver transplantation. At present, the low surgical resectionrate is one of the main factors affecting the prognosis of liver cancer patients. Preoperative neoadjuvant therapy or conversion therapy for liver cancer can maximize the rate of surgical resection and improve the prognosis. With the rapid development of radiotherapy and immunotherapy in the comprehensive treatment of liver cancer, it has been gradually confirmed that the unique effects of preoperative radiotherapy and immune therapy for liver cancer can improve the prognosis of the patients. Therefore, this paper reviewed the research progress in the preoperative radiotherapy and immunotherapy for liver cancer by searching relevant literature and reports at home and abroad.

Objective To analyze the prognosis and its influencing factors for nasopharyngeal carcinoma patients with distant metastasis after radical radiotherapy.Methods Clinical data of 184 cases of nasopharyngeal carcinoma after radical radiotherapy with distant metastases were retrospectively reviewed and the factors affecting prognosis were analyzed.Results The median survival time was 12 months for the whole group, and the 1-, 2-, and 3-year survival rates were 50.6%, 30.7%and 20.9%, respectively.Cox univariate analysis showed that the prognosis of patients with metastasis after radiotherapy was significantly related with The N stage, chemotherapy, time interval between the end of radiotherapy and occurrence of distant metastasis, metastatic sites, chemotherapy after metastasis, cycles of chemotherapy and palliative radiotherapy after metastasis ( P <0.05 ) , but not significantly related with sex, age, T stage, clinical stage, cycles of chemotherapy, radiation technique and radiation dose for initial treatment ( P >0.05 ) . Advanced N stage, no chemotherapy, short time interval between the end of radiotherapy and occurrence of distant metastasis, multiple metastases, no radiotherapy or chemotherapy for metastases were predictive for poor prognosis ( P <0.05).Multivariable analysis indicated that factors including N stage at initial diagnosis, metastatic sites, whether or not chemotherapy was given, the time interval between the end of radiotherapy and the occurrence of distant metastasis were independent factors affecting the prognosis of nasopharyngeal carcinoma patients with distant metastasis after radiotherapy.Conclusions N stage at initial diagnosis, metastatic sites, whether or not chemotherapy was given, the time interval between the end of radiotherapy and the occurrence of distant metastasis are independent factors affecting the prognosis for nasopharyngeal carcinoma patients with distant metastasis after radiotherapy.Systemic chemotherapy and local palliative radiotherapy are the primary treatment for nasopharyngeal carcinoma patients with metastasis.

Objective:To investigate the clinical effect of laparoscopic assisted removal of greater omentum free transplantation combined with skin grafting for the repair of large area refractory wounds.Methods:From June 2013 to June 2018, 18 cases of lower extremity skin and soft tissue defects with multiple bone, joint, tendon and internal plants exposure were admitted to Hanzhong Central Hospital, including 12 males and 6 females, aged from 15 to 50 years old, with an average age of 32.6 years old. The area of skin and soft tissue defect: 30 cm×12 cm-53 cm×21 cm. The operation was divided into two stages. In the first stage, the greater omentum was acquired with the assist of laparoscope and free transplanted to cover the wound. After the greater omentum free transplantation was confirmed to survive, the split-thickness skin graft was applied for wound repair.Postoperative survival of the greater omentum and skin grafting, complications, appearance and function of lower limbs were observed and followed up.Results:The 18 operations were performed successfully, the area of omentum resection was 25 cm×10 cm-35 cm×15 cm, all the greater omentums survived after operation without complications such as intestinal adhesion, volvulus and peritonitis. The area of the skin grafting was 36 cm×8 cm-45 cm×22 cm. 16 cases skin grafting survived completely, 2 cases skin grafting were necrosis just local small area, and scar healed after dressing change. Postoperative follow-up of 6-12 months showed good appearance and function of lower limbs and satisfactory results.Conclusions:For the large area soft tissue defect wound of lower extremity, complicated with multiple deep tissues such as bone, joint and internal materials exposed, the greater omentum free transplantation under laparoscope combined with medium thick skin graft second stage has the advantages of good appearance and function after wound healing, less donor injury and fewer postoperative complications.