Objective To explore the key points of perioperative nursing patients with planted soft tissue expander after breast cancer surgery.Method The clinical data of 55 patients with planted soft tissue expander after breast cancer surgery were reviewed to summarize the nursing measures.Result Operative process in 55 pattents were succesful,surgery time ranged from 3 to 5 hours.16 of 55 patients developed with complications and all of them were recovered and discharged.Conclusions Perioperative nursing intervention for the patients with planted soft tissue expander after breast cancer surgery can reduce the incidence of complications,improve the life quality and help them build up their confidence in social and family life.

Objective To evaluate the effect of tranexamic acid on the risk of venous thrombosis after operation in patients undergoing revision total hip arthroplasty.Methods Fifty-six ASA physical status Ⅰ or Ⅱ patients of both sexes,aged 35-64 yr,with body mass index of 20-25 kg/m2,scheduled for elective revision total hip arthroplasty,were randomly divided into 2 groups (n =28 each):control group (group C) and tranexamic acid group (group T).After induction of anesthesia,the patients were tracheally intubated and mechanically ventilated.After intubation,tranexamic acid 15 mg/kg was injected intravenously followed by infusion at a rate of 10 mg·kg-1 ·h-1 in group T,while the equal volume of normal saline was given instead of tranexamic acid in group C.Before operation,at the end of operation,and at 6 and 24 h after operation,venous blood samples were obtained for routine blood test and for determination of parameters of coagulation.The intraoperative blood loss and blood salvage,volume of drainage within 24 h after operation and transfusion of allogeneic blood were recorded.The development of venous thrombosis in the lower extremity was recorded with Doppler ultrasound on 7th day after operation.Results Compared with group C,the intraoperative blood loss and blood salvage,volume of drainage within 24 h after operation and transfusion of allogeneic blood were significantly reduced,and hemoglobin and hematocrit were increased at the end of operation and different time points after operation (P ＜ 0.05),and no significant changes were found in activated partial thromboplastin time,prothrombin time and fibrinogen in group T (P ＞ 0.05).The incidence of venous thrombosis in the lower extremity was 18％ and 14％ in C and T groups,respectively,and there was no significant difference between the two groups (P ＞ 0.05).Conclusion Tanexamic acid infused at a rate of 10 mg· kg-1 · h-1 after a loading dose of 15 mg/kg injected during operation dose not increase the risk of venous thrombosis after operation in patients undergoing revision total hip arthroplasty.

Objective To analyze the clinical characteristics,pathology,CT characteristics and targeted therapy of primary retroperitoneal leiomyosarcoma treated at our institution during the past 20 years.Methods A retrospective review was performed among 11 patients of this disease.The main performances were hematuria,abdominal mass and abdominal pain.Non-enhanced CT scanning showed soft tissue density in all cases.Tri-phase enhanced scanning showed reinforcement in different degrees.Pathology results showed tissue necrosis.The pathology featured by routine HE and immumohistochemical staining.Results Surgical treatment was performed in all 11 patients.Postoperative pathology showed that median tumor diameter was 14.40cm.Spindle cell,cellular abnormity and mitotic figures could be seen through light microscope.During follow-up,3 cases recurrenced after 2 months,3 years and 5 years respectively.Conclusions Primary retroperitoneal leiomyosarcoma might have a high fatality rate and high recurrence rate.The clinical and CT features are unapparent.Pathology diagnosis is reliable,surgery is necessary to prolong life and cure disease.

Objective:To observe the efficacy of traditional Qigong exercise combined with Tuina(Chinese therapeutic massage)manipulations in treating lower cervical disc herniation(CDH).Methods:A total of 120 CDH patients who met the inclusion criteria were randomly divided into an observation group and a control group,with 60 cases in each group.Patients in both groups were given the same Tuina manipulations.In addition,patients in the observation group practiced traditional Qigong exercise,and those in the control group did conventional neck exercise.After 8 weeks of treatment,the efficacy of the two groups was observed.Follow-up was conducted 3 months after the end of the treatment to record any recurrence.Results:The total effective rate of the observation group was higher than that of the control group(P＜0.05).The improvement in symptom scores was more significant in the observation group than in the control group(P＜0.05).There was inter-group statistical significance in comparing the cross-sectional area and fatty infiltration of certain cervical muscles(P＜0.05).In addition,the recurrence rate in the observation group was lower than that in the control group(P＜0.05).Conclusion:On the basis of the same Tuina manipulation treatment,the efficacy of traditional Qigong exercise in treating CDH is superior to that of conventional neck exercise,with more significant improvements in pain and quality of life and a lower recurrence rate.

OBJECTIVE To investigate the management situation of cross infection in outpatient service of stomatology in hospital and clinic in Zhanjiang city and conduct effective measure to control hospital infection.METHODS In our investigation,we selected 105 hospitals and private clinics to inspect their management situation of cross (infection) via dental(instrument).RESULTS The management in the hospitals of the city was quite qualified but the some private dental clinics were terrible.The main problems were as follows: no effective disinfection for dental instrument and the bad environment in procedure room,especially the worse sterilization situation of the dental handpieces.Most of the doctors in private clinics were short of knowledge in the sterilization for dental(instruments.) CONCLUSIONS There is no time to delay for the health administration department to normalize the management of the private dental clinics.It is essential to train the medical staffs,and implement measures for dental instrument disinfection management in private dental clinics.

Objective:To evaluate the change of sleep-wake rhythm after extracorporeal circulation (ECC) in New Zealand rabbits,and to explore the role of clock genes in sleep-wake rhythm disorder by ECC.Methods:A total of 54 New Zealand rabbits were randomly divided into 3 groups:a normal group (Group N),a sham group (Group S) and a model group (Group ECC).Electrocorticogram (ECOG),electroophthalmogram (EOG) and electromyogram (EMG) were respectively recorded by multipurpose EEG recorder,and the sleep-wake rhythm was also recorded.The mRNA and protein expressions of period1 (Per1) and cryptochrome1 (Cry1) were detected by semiquantitative reverse transcriptase PCR (RT-PCR) and Western blot in pineal gland of rabbits.The differences between the 3 groups were compared.Results:1) Compared with the Group N and Group S at 24,48 h respectively,the total amount of sleep (TAS),light time,slow wave sleep (SWS) in the Group ECC at 24,48 h were significantly reduced (all P＜0.05),and the proportion of light sleep increased (all P＜0.05),the proportion of SWS decreased (all P＜0.05);2) Compared with the Group N and Group S,the expression of Per1 mRNA in the Group ECC at 24,48 h and Cry1 mRNA at 24 h significantly increased (all P＜0.05);3) Compared with the Group N and Group S,the expression of Perl protein in the Group ECC at 48 h and Cry1 protein at 24 h significantly increased (all P＜0.05);4) In the Group ECC,the sleepwake rhythm disorder and clock genes expression were ameliorated at 72 h after surgery.Conclusion:ECC can cause sleep-wake rhythm disorder in New Zealand rabbits,which may be related to the abnormal expression of Per1 and Cry1,and their transcription proteins.

Objective: To compare the efficacy of Tuina (Chinese therapeutic massage) plus physical agents and physical agents alone for lateral collateral ligament injury of ankle in gymnasts, and to explore the feasibility of Tuina for injury intervention in competitive athletes.Methods: A total of 64 gymnasts with types Ⅰ-Ⅱ lateral collateral ligament injury of ankle were selected and divided into a control group and an observation group according to a full analysis set based on the intention-to-treat principle, with 32 cases in each group. Patients in the control group received ultrasound and microwave treatment, while those in the observation group received additional Tuina manipulations. The efficacy was evaluated by total effective rate, visual analog scale (VAS) score, and American Orthopedic Foot and Ankle Society ankle-hindfoot scale (AOFAS-AHS) score. Results: The total effective rate was 96.9％ in the observation group and 90.6％ in the control group. There was no statistical difference in the total effective rate between the two groups (P>0.05). The markedly effective rate was 75.0％ in the observation group and 46.9％ in the control group. The markedly effective rate in the observation group was higher than that in the control group (P<0.05). After treatment, the VAS scores of both groups showed a downward trend, and there were statistical differences between different treatment time points in the same group (P<0.05). After one and three months of treatment, the VAS scores of the observation group were lower than those of the control group (P<0.05). There were statistical differences in the AOFAS-AHS score before and after treatment within the same group (P<0.05). After one month of treatment, there was no statistical difference in the AOFAS-AHS score between the two groups (P>0.05). After three months of treatment, the AOFAS-AHS score in the observation group was higher than that in the control group, indicating statistical significance (P<0.05). There was an interaction between time and group (P<0.05). Conclusion: Tuina plus physical agents can improve the symptoms of lateral collateral ligament injury of ankle in gymnasts. This combined treatment is superior to physical agents alone in relieving pain and improving joint functions. Therefore, Tuina plus physical agents can be used as a treatment for lateral collateral ligament injury of ankle in gymnasts.

Objective To evaluate the effect of ulinastatin on the expression of metabotropic glutamate receptor Ⅱ ( mGluRⅡ) during cerebral ischemia-reperfusion ( I∕R) in rats. Methods Forty-eight male Sprague-Dawley rats, aged 6-8 weeks, weighing 230-280 g, were divided into 3 groups ( n=16 each) by a random number table method: sham operation group (S group), cerebral I∕R group (I∕R group) and ulinastatin group ( U group) . The model of cerebral I∕R injury was established by occluding the right middle cerebral artery using a nylon thread with a rounded tip inserted into internal carotid artery and advanced cranially until resistance was met. Middle cerebral artery occlusion was maintained for 2 h followed by 24-h reperfusion. Ulinastatin 100000 U∕kg was injected via the tail vein immediately after onset of reperfusion in group U. The neurological deficit score ( NDS) was assessed after 24 h of reperfusion. The rats were then sacrificed, and brain tissues were obtained for determination of brain infarction ( by TTC staining) , expression of IκB-α in cerebral ischemic penumbra ( by Western blot) and expression of mGluRⅡ in cerebral ischemic penumbra ( by immunofluorescent staining) . The percentage of cerebral infarct vol-ume was calculated. Results Compared with S group, the NDS and percentage of cerebral infarct volume were significantly increased, the expression of mGluRⅡ in cerebral ischemic penumbra was up-regulated, and the expression of IκB-α in cerebral ischemic penumbra was down-regulated in I∕R and U groups ( P<0. 05). Compared with I∕R group, the NDS and percentage of cerebral infarct volume were significantly de-creased, the expression of mGluRⅡ in cerebral ischemic penumbra was down-regulated, and the expres-sion of IκB-α in cerebral ischemic penumbra was up-regulated in U group ( P<0. 05) . Conclusion The mechanism by which ulinastatin mitigates cerebral I∕R injury may be related to inhibiting the expression of mGluR Ⅱ in cerebral ischemic penumbra of rats.

Objective: To observe the efficacy of herbal cake-partitioned moxibustion for lumbar disc herniation (LDH) due to kidney deficiency and blood stasis and observe the influence of this method on lumbar functions and inflammatory factors in patients with this condition. Methods: A total of 120 LDH patients who met the inclusion criteria were randomly divided into three groups, including a herbal cake-partitioned moxibustion group, a flour cake-partitioned moxibustion group, and a Western medication group, with 40 patients in each group. The patients in the Western medication group were treated with diflunisal tablets, 0.5 g per dose, 2 doses a day. Those in the herbal cake-partitioned moxibustion group were treated with additional herbal cake-partitioned moxibustion group at Back-Shu Points and Jiaji (EX-B2) Points once a day. Those in the flour cake-partitioned moxibustion group were treated with the same methods as in the herbal cake-partitioned moxibustion group, except that the herbal cake was replaced by a flour cake. All the patients were treated for 10 d. After treatment, the scores of the visual analog scale (VAS) and Japanese Orthopaedic Association (JOA) and the changes of the interleukin (IL)-6, tumor necrosis factor (TNF)-α, and substance P (SP) levels were observed, and the efficacy was evaluated. Results: After treatment, the VAS score and the levels of IL-6, TNF-α, and SP were lower than those before treatment, and the JOA score was higher than that before treatment in the three groups, indicating intra-group statistical significance (P<0.05). The VAS score and the levels of IL-6, TNF-α, and SP of the herbal cake-partitioned moxibustion group were lower than those of the flour cake-partitioned moxibustion group and the Western medication group, while the JOA score of the herbal cake-partitioned moxibustion group was higher than that of the other two groups, indicating inter-group statistical significance (P<0.05). The total effective rate of the herbal cake-partitioned moxibustion group was 92.5％, higher than that of the flour cake-partitioned moxibustion group (80.0％) and the Western medication group (72.5％), indicating inter-group statistical significance (P<0.05). Conclusion: On the basis of Western oral medication, additional herbal cake-partitioned moxibustion can alleviate the pain and improve the lumbar functions in patients with LDH due to kidney deficiency and blood stasis. The efficacy of the integrated method is better than that of either flour cake-partitioned moxibustion or Western medication alone, which may be related to the reduction of serum inflammatory factors.

Objective:To investigate the imaging features of pancreatic hypervascular tumors in computed tomography (CT) and magnetic resonance imaging (MRI) examinations.Methods:The retrospective and descriptive study was conducted. The clinicopathological data of 53 patients with pancreatic hypervascular tumors who were admitted to two medical centers, including 32 cases in the Affiliated Hospital of Medical School, Ningbo University and 21 cases in the First Affiliated Hospital of Naval Medical University, from March 2007 to February 2021 were collected. There were 21 males and 32 females, aged (48±23)years. Of the 53 patients, there were 19 cases with pancreatic neuroendocrine tumor (PNET), 9 cases with pancreatic metastasis from renal cell carcinoma (PRCC), 8 cases with solid pseudopapillary tumors of pancreas (SPTP), 7 cases with intrapancreatic accessory spleen (IPAS), 6 cases with serous cystadenoma of pancreas (SCP) and 4 cases with aneurysms. All the 53 patients underwent CT and MRI. Observation indicators: (1) imaging feature of PNET; (2) imaging feature of PRCC; (3) imaging feature of SPTP; (4) imaging feature of IPAS; (5) imaging feature of SCP; (6) imaging feature of aneurysms. Measurement data with normal distribution were represented as Mean±SD, and measurement data with skewed distribution were represented as M(range). Count data were described as absolute numbers. Results:(1) Imaging feature of PNET: of the 19 cases with PNET, there were 1 case with Von Hippel-Lindau disease (VHLD), 8 cases with multiple endocrine neoplasia type 1 (MEN1) and 10 cases with neuroendocrine tumor (NET). Of the 19 cases, 16 cases had single tumor and 3 cases had 2 tumors, 9 cases had tumor located at head of pancreas and 10 cases had tumor located at body and tail of pancreas. Morphology of tumors in the 19 cases were mostly round or elliptical, with some shallow lobes and clear boundary. There were 4 cases with cluster-like calcifications in the center of tumors and 15 cases with no cluster-like calcification in the center of tumors. The tumor diameter of 19 cases was (26.7±10.3)mm. Of the 19 cases, 1 case underwent pancreatic atrophy and segmental expansion of the main pancreatic duct and 18 cases underwent no pancreatic atrophy or segmental expansion of the main pancreatic duct, 2 cases underwent dilated bile ducts and 17 cases underwent no dilated bile ducts. The enhance-ment mode of imaging examination of PNET was wash in and wash out. (2) Imaging feature of PRCC: Of the 9 cases with PRCC, 2 cases had single tumor and 7 cases had multiple tumors. Of the 2 cases with single tumor, 1 case had tumor located at neck of pancreas and 1 case had tumor located at body and tail of pancreas. All the 7 cases with multiple tumors had tumor located at head, neck, body and tail of pancreas. Morphology of tumors in the 9 cases were round or quasi-circular, with clear boundary. The tumor diameter were (18.0±5.0)mm of the 2 cases with single tumor and 2.0-50.0 mm of the 7 cases with multiple tumors, respectively. Of the 9 cases, 2 cases underwent pancreatic ducts dilatation and 7 cases underwent no pancreatic ducts dilatation. The enhancement mode of imaging examination of PRCC was wash in and wash out. (3) Imaging feature of SPTP: all 8 cases with SPTP had single tumor, including 4 cases with tumor located at head of pancreas and 4 cases with tumor located at body and tail of pancreas. Morphology of tumors in the 8 cases were lobulated with clear boundary. Of the 8 cases, there were 2 cases with no calcifications of tumors and 6 cases with calcification of tumors, 2 cases with no cystic necrosis of tumors and 6 cases with cystic necrosis of tumors, 3 cases with no bleeding in the tumors and 5 cases with bleeding in the tumors. The tumor diameter of 8 cases was (51.6±11.8)mm. All the 8 cases were negative for pancreatic ducts dilatation, but the adjacent organs were compressed and moved. The enhancement mode of imaging examination of SPTP was asymptotic enhancement. (4) Imaging feature of IPAS: all the 7 cases with IPAS had single tumor located at tail of pancreas. Morphology of tumors in the 7 cases were round or quasi-circular shape with clear boundary. Of the 7 cases, 1 case with solid-cystic and uneven density tumor was epidermoid cyst in the accessory spleen of the tail of the pancreas, and 6 cases had solid and uniform density tumors. The tumor diameter of 7 cases was (25.5±8.5)mm. All the 7 cases were negative for pancreatic ducts dilatation and the surrounding structures of pancreatic ducts were clear. The enhancement mode of imaging examination of IPAS was asymptotic enhancement. (5) Imaging feature of SCP: all 6 cases with SCP had single tumor, including 1 case with tumor located at neck of pancreas and 5 cases with tumor located at body and tail of pancreas. Morphology of tumors in the 6 cases were round or quasi-circular, with clear boundary. Of the 6 cases, 2 cases had cystic tumors and 4 cases had solid tumors. The tumor diameter of 6 cases was (35.5±15.4)mm. Of the 6 cases, 2 cases were positive for pancreatic ducts dilatation and 4 cases were negative for pancreatic ducts dilatation. The enhancement mode of imaging examination of SCP was wash in and wash out. (6) Imaging feature of aneurysms: all the 4 cases with aneurysms had single tumor, including 1 case with tumor located at body of pancreas and 3 cases with tumor located at tail of pancreas. One case with tumor located at body of pancreas was superior duodenal aneurysm and 3 cases with tumor located at tail of pancreas were splenic aneurysms. Morphology of tumors in the 4 cases were round, with clear boundary. Of the 4 cases, 1 case was negative for tumor marginal calcification and 3 cases were positive for tumor marginal calcification. The tumor diameter of 4 cases was (11.3±2.5)mm. All the 4 cases were negative for pancreatic ducts dilatation. The enhance-ment mode of imaging examination of aneurysms was wash in and wash out.Conclusions:The imaging features of pancreatic hypervascular tumors in CT and MRI examinations show diversity. The enhancement mode of imaging examination of PNET, PRCC, SCP and aneurysms is wash in and wash out. The enhancement mode of imaging examination of SPTP and IPAS is asymptotic enhancement.