Objective To systematically evaluate the risk of BRCA1 mutation in patients with triplenegative breast cancer (TNBC).Methods Articles about the association between the TNBC and BRCA1 mutation were retrieved from database,such as PubMed,CNKI,Wanfang,VIP and CBM databases.The odds ratio (OR) was used to evaluate the risk of BRCA1 mutation in TNBC compared with non-TNBC.Rev Man 5.2 software was applied to perform the Meta-analysis.Results A total of 23 articles were eligible for the Meta-analysis,including 1 104 patients with TNBC and 4 245 patients with non-TNBC.The pooled OR was 7.67 and 95％ CI(6.24,9.42),and the difference was statistically significant (Z =19.38,P ＜ 0.000 01).In the subgroup analysis about the race,the pooled OR for Asian was 6.67 and 95％ CI (4.98,8.95).The pooled OR for Caucasian was 8.83 and 95％ CI (6.61,11.80).There was statistically significant difference in the pooled OR between the Asian and the Caucasian (Z =14.74,P ＜ 0.000 01).Conclusion The patients with TNBC are 7.67 times more likely to have BRCA1 mutation compared with non-TNBC phenotype.Largesample randomized controlled trials are warranted to demonstrate the detection of BRCA1 mutation can be a conven-tional application in clinical for the patients with TNBC.

Humans ; Optical Imaging

Objective: To explore the psychological status and therapeutic efficacy of peri-operative psychological intervention among patients with oral carcinoma.Method: psychological statuses of 60 patients with oral carcinoma were investigated,and specific peri-operative psychological interventions were performed according to features and initiating factors of their psychological crisis,in order to provide references for the therapy of oral carcinoma.Result: Common psychological crises among patients with oral carcinoma such as anxiety and fear have been dramatically decreased by proper psychological investigation and peri-operative psychological intervention.Conclusion: Psychological investigation contributes to a great improvement of psychological status of patients with oral carcinoma.Therefore,in addition to routine peri-operative medical treatment,an effective psychological investigation is also crucial for patients with oral carcinoma to cure the disease and regain health.

Objective To investigate the effectiveness and feasibility of laparoscopic splenic artery ligation in the treatment of hypersplenism and thrombocytopenia in children. Methods From August 2014 to December 2014, four children with hypersplenism and three children with ITP (idiopathic thrombocytopenic purpura) were treated in our hospital.Laparoscopic splenic artery ligation was performed in all the patients.During the operation, the gastric colon ligament was cut with an ultrasonic knife, and the gastric wall was suspended to expose the pancreas and the spleen.The splenic artery was ligated at the upper edge of pancreas closing to the splenic hilum.The splenic venous branches were dissected and ligated at the splenic hilum by using the Hem-o-lok, which leaded to an area of splenic infarction more than 50%. Results The laparoscopic splenic artery ligation was successfully performed in all the patients, without conversion to open surgery.The operative time was 120-150 min ( mean, 126 min) , and the intraoperative blood loss was 10-20 ml ( mean, 15 ml) .No patient underwent blood transfusion.The length of postoperative hospital stay varied from 4 to 11 days (mean, 6.6 days).The splenic length significantly decreased postoperatively [(13.6 ±2.6) cm vs.(15.1 ±1.7) cm, t=3.199, P=0.049], and so was the splenic thickness [(3.8 ±1.0) cm vs.(4.1 ±0.8) cm, t =3.703, P=0.034].Partial splenic infarction and decreased splenic blood flow were found in the 7 patients by postoperative ultrasound.After surgery, four children suffered from fever, which were 38.8 ℃, 39.0 ℃, 38.6 ℃, and 39.2 ℃, with the duration of fever of 2, 4, 8, and 5 days, respectively.All the patients were followed-up for 6 -10 months (mean, 8.4 months).The complete blood cell count was within normal range. Conclusion The laparoscopic splenic artery ligation is an effective treatment for hypersplenism and thrombocytopenia in children.

Objective To investigate whether the laparoscopic portoenterostomy is superior to open surgery in the treatment of biliary atresia.Methods A total of 26 children with type Ⅲ biliary atresia underwent laparoscopic portoenterostomy from August 2003 to September 2005(Laparoscopic Group).The operation was performed under 4-port laparoscopy.The hepatic portal was fully exposed and mobilized and the gallbladder was removed.The cut end of the duct was widened by incising along the anterior wall of the hepatic duct following the excision of the narrow segment.By using intraoperative bile duct endoscopy,the optimal level of resection of the common hepatic duct was determined without endangering the orifices of the hepatic ducts or leaving any redundant duct.The Roux-en-Y jejunal loop was fashioned extracorporeally by exteriorizing the jejunum for 40 cm in length distally through the umbilical incision and passed up retrocolically followed by an end-to-side hepaticojejunostomy.They were compared with other group of 34 children,with the same age range and diagnosis,who underwent open portoenterostomy(Open Group) in the same period,in respect of the operative time,the blood loss,the liver functions,complications,the length of hospital stay,the hospitalization expenditure,and the short-term outcomes. Results As compared with the Open Group,the Laparoscopic Group presented a less blood loss(15.4?5.0 ml vs 33.8?19.4 ml;t=-4.709,P=0.000) and a higher hospitalization expenditure(19 153.9?619.5 yuan vs 15 116.7?898.4 yuan;(t=19.607),P=0.000).There were no significant differences between the two groups in the operative time and the length of hospital stay.The serum levels of total bilirubin,direct bilirubin,ALT,and AST were deceased more significantly in the Laparoscopic Group than in the Open Group.Complications happened in 1 case in the Laparoscopic Group(incisional hernia) and in 4 cases in the Open Group(1 case of acute hepatic failure,1 case of incision rupture,and 2 cases of wound infection),the incidence of complications being not significant(?~2=0.395,P=0.530).Follow-up observations at 4 postoperative month found the jaundice had subsided in 13 cases in the Laparoscopic Group(50%) and in 18 cases in the Open Group(53%). Conclusions Laparoscopic portoenterostomy is a minimally invasive,safe,and effective procedure for the treatment of pediatric biliary atresia.

Objective To explore the categories and precautions of complications after laparoscopic total cyst excision with Roux-en-Y hepatoenterostomy for congenital choledochal cyst in children. Methods Laparoscopic cyst excision with Roux-en-Y hepatoenterostomy was performed in 66 cases of congenital choledochal cyst from July 2001 to June 2006. Their median age was 3.8 years (range, 2 months ~ 28 years). The choledochal cyst was classified as cystic type in 61 cases, with a diameter ranged 2.5~18 cm, and fusiform type in 5 cases, with a diameter ranged 1.2~2.2 cm. Nine cases were associated with hepatic ductal stenosis; they underwent a laparoscopic excision of the cyst with a ductoplasty. Results The laparoscopic operation was successfully completed in all the 66 patients, with a mean operation time of 3.8 h (2.6~9.5 h) and a mean hospital stay of 4.5 d (3~8 d). Early complications included 2 cases of bile leakage (spontaneous recovery in 1 case, and an open surgery required in 1 case because of obstructed drainage, with anastomotic leakage identified and re-anastomosis performed during the operation), 1 case of hyperkalemia (10.8 mmol/L at 7 h after operation, resulting in heart failure and cardiopulmonary resuscitation, and died of renal failure on the 3rd postoperative day), and 2 cases of stress ulcer (spontaneously relieved). There were no infections of the abdominal cavity or the wound. Long-term complications included 1 case of intestinal obstruction (open exploration showed intestinal adhesion and necrosis, and an enterectomy with enteroanastomosis was given). No anastomotic stenosis and postoperative cholangitis were encountered.Follow-up observations for 6~56 months (median, 21 months) were conducted in 65 survived cases, B-ultrasonography found no bilestone, and liver functions were in normal limits. Conclusions Laparoscopic total cyst excision with Roux-en-Y hepatoenterostomy is a complicated operation with high risks. Some complications are similar to those after conventional operations, such as bile leakage, stress ulcer, and intestinal obstruction. Hyperkalemia is perhaps the most serious one, which maybe related to carbon dioxide pneumoperitoneum. It is essential to monitoring hyperkalemia in postoperative period.

Objective To investigate the efficacy and safety of laparoscopic repair in children with congenital esophageal hiatal hernia. Methods From September 2001 to December 2008,seven children with congenital esophageal hiatal hernia,including 4 boys and 3 girls,were treated by laparoscopic repair and Nissen's fundoplication in our hospital. One of them received laparoscopic pyloroplasty in the meanwhile because of delayed gastric emptying (confirmed by preoperative gastrointestinal angiography); one child underwent laparoscopic high ligation due to right oblique inguinal hernia; spleneolus was found in one patient,no further treatment was carried out. Results The procedures were completed in all of the patients without conversion to open surgery. The mean operation time was 94.2 min (75-150 min) in this series,and the average blood loss was 5 ml (2-10 ml). No patient received blood transfusion after the surgery. The children began to intake milk or regular diet in 24-48 hours after the operation. They were discharged from hospital in a mean of 4.5 days (ranged from 3 to 7 days). Then,the children were followed up for 6 to 20 months (mean,12.6 months). One of the patients suffered from vomiting on the 10th day after the operation,1 patient showed recurrence in 1 year postoperation and then was cured by a second operation. The other five patients were healthy during the follow-up. Conclusions Laparoscopic repair of congenital esophageal hiatal hernia is a safe,effective,and minimally invasive procedure. It is feasible for patients complicated with other diseases. The indications for the surgery must be strictly selected.

To study the effect of different storage conditions and storage time on herb quality of Lonicera macranthoides, different packaging materials including vacuum plastic bags, plastic bags, woven bags, sealed with endometrial bags, paper bags, sack bags were selected for the study under different storage conditions including room temperature, 5 degrees C refrigerator, low temperature of - 20 degrees C refrigerator and desiccator. Twenty-four batches of samples were used for the study, and active ingredients were determined. The experimental results showed that the ingredients in each storage group changed with the storage time, storage conditions (storage environment, packaging). Under the same storage time, the storage environment (temperature, humidity) had effect on the stability of herb quality. Low temperature had less effect on herb quality. The effect of packaging on herb quality was as following: plastic vacuum packaging > woven with endometrial sealed packaging > plastic bag > woven bag > sack bags > paper bags. Under the same storage conditions, with the increase of storage time, caffeic acid content increased slowly, and other five ingredients content decreased gradually. Storage time affected significantly on the intrinsic quality (chemical composition) and appearance of herb. It is suggested that low temperature (5 degrees C), dark and sealed storage are suitable for storage of L. macranthoides herb, the storage time should be not more than 24 months.
Desiccation ; Drug Packaging ; Drug Storage ; methods ; Drugs, Chinese Herbal ; chemistry ; Lonicera ; chemistry ; Organic Chemicals ; analysis ; Quality Control ; Time Factors

Objective To study the effect of papaverine on vasospasm caused by PICC intubation with B-mode ultrasonography. Method Three mg papaverine were injected into the median cubital vein for at least 2 minutes in 15 patients with vasospasm. Results The vasospasm in the 15 patients was relieved 36~270 s seconds after injection. The followed intubation was all successful. There was no abnormality in their liver function and heart rate, or abnormal bleeding, or other serious complications. Conclusion Papaverine can relieve vasospasm caused by PICC intubation, so it can allow another intubation. It also can avoid delayed intubation reduce patients′pain and cost and reduce psychological pressure of the nursing practitioner.

Objective:To explore the function of risk management in outpatient blood collection work under the conditions of informationization. Method:This paper retrospectively reviewed the nursing risk management in out-patient blood collection work from January 2014 to January 2015 in our hospital, analyzed the causes of risk in out-patient blood collection work, evaluated the possible adverse outcomes, and put forward the measures to prevent and control risks. Results:Through the nursing risk management, the nurses′ risk prevention consciousness was enhanced, as well, both nurse and patient satisfaction was improved. Conclusion:Application of risk management in outpatient blood collection work could improve the quality of nursing, conform to the ethical requirements of guaranteeing patient safety, and effectively reduce the incidence of medical risks and accident.