1 cm. Postoperative pathological findings showed negative cut surface. No hemorrhage or bile leakage were seen after operation. The abdominal drainage tube was indwelled for 3~4 d. The postoperative hospital stay was 3~5 d. Follow-up checkups for 1~20 months (mean, 12.5 months) revealed no tumor recurrence or incision implantation. All the patients survived. Conclusions Laparoscopic regular hepatic left lateral lobectomy can be carried out safely and effectively in clinically selected patients.

Adenocarcinoma ; genetics ; metabolism ; pathology ; Biopsy ; CD56 Antigen ; metabolism ; DNA-Binding Proteins ; metabolism ; Gene Deletion ; Humans ; Keratin-7 ; metabolism ; Lung Neoplasms ; genetics ; metabolism ; pathology ; Male ; Middle Aged ; Receptor, Epidermal Growth Factor ; genetics ; metabolism ; Small Cell Lung Carcinoma ; genetics ; metabolism ; pathology ; Synaptophysin ; metabolism ; Transcription Factors

Objective To explore the pathogen characteristics and related factors of nosocomial infection in adult ICU pa-tients after cardiac surgery, and provide a basis for the rational and standardized use of antibiotics and the control of nosocomial infection.Methods Patients in ICU after adult cardiac surgery from January 2015 to December 2017 were studied.Through the nosocomial infection monitoring and reporting system(HIS and LIS system), data of infected sites, specimens, pathogen and drug-sensitivity results were recorded, and the clinical data were collected and the related factors of nosocomial infection af-ter cardiac surgery were analyzed.Results 213 patients with nosocomial infections were diagnosed , and the nosocomial infec-tion rate was 3.59％.There were 261 cases of nosocomial infection, with a total infection cases rate of 4.39％.232 strains of pathogen were detected.Gram-negative bacteria173 strains(74.57％), klebsiella pneumoniae and acinetobacterbaumannii ac-count for 65(28.07％) and 37(15.95％)strains respectively.35 strains of gram-positive bacteria account for 15.08％, 12 strains of staphylococcus aureus account for 5.17％.24 strains of fungi account for 10.34％, 12 strains of candida albicans(5. 17％) were the most.The resistance rates of klebsiella pneumoniae to amoxicillin/kclavitrate, piperasil/tazobatan, tigacy-cline, tobramycin, and impenan were all<10％.Acinetobacter baumannii show high resistance rate to commonly used antibi-otics other than tigacycline(2.70％).The resistance rates of staphylococcus aureus and staphylococcus epidermis to vancomy-cin and linazolamide were 0.Logistic regression analysis showed that preoperative and postoperative stroke, secondary endotra-cheal intubation, postoperative low cardiac output, postoperative stroke, mechanical ventilation time >48 h, and postoperative ICU stay>72 h were related factors of postoperative nosocomial infection .Conclusion The main pathogen of nosocomial in-fection in ICU after adult cardiac surgery is gram-negative bacteria.Klebsiella pneumoniae, the most common bacteria, has a low resistance rate to antibiotics, while the secondary acinetobacter baumannii has a high resistance rate .According to the fac-tors related to nosocomial infection after cardiac surgery , prevention measures should be formulated .According to the results of pathogen and drug sensitivity, antimicrobial drugs should be selected reasonably so as to postoperative nosocomial infection and the occurrence of drug-resistant strains could be controlled effectively .

Objective To improve the study on chronic obstructive pulmonary disease (COPD) basicknowledge, and the ability of COPD research and design, organization, implementation andmanagement. Methods Clinical research led stu-dents to participate in the COPD, found the problem from clinical,research students went to COPD, literature, grouping the recent 15 years , the discussion of the COPD design experimental study , lipopolysaccharide ( LPS ) rat model of COPDinduced with smoke, explore the love Luo Ning on the treatment of cough with dyspneaeffect COPD and its mech-anism, integration of traditional Chinese and Western medicineknowledge module to the pathogenesis of COPD, as the core of the problem of the cause. Results 5 graduate students completed COPD in the etiology, pathogenesis andmech-anism of Kechuanning love Luo, master and technology related research methods. Conclusion PBL teaching method helps to promote the quality of postgraduate education,PBL teaching was worth to promoted.

Obj ective To explore the influence of edaravone on inflammatory factor of pe-ripheral blood in canine with renal auto-transplantation.Methods 12 weight matched healthy mon-grel dogs were randomly divided into edaravone group (ED group )and normal saline group (PS group),6 dogs in each group.ED group was treated with edaravone by 10 mg/kg intravenous in in-traoperative,postoperative 1,2,3 days,and each for edaravone 10 mg/kg.PS group was treated with the method of using the same volume of saline.The levels of TNF-α,IL-6,IL-8,IL-10 were detected by sampling venous blood before anesthesia (T0 )and after surgery (T1 ),1 days (T2 )and 3 days (T3 )after operation respectively.Results Compared with levels of inflammatory factors of peripheral blood in T0 period,there were no significant differences of concentration in each factor. With increasing of concentration of IL-6,IL-8,TNF-α,IL-10 at T1,T2,T3(P<0.05),the lev-els raised at T1 ,reached a peak at T2 ,slightly down at T3 but still higher than T0 .Levels of TNF-α,IL-6 ,IL-8 in ED group increased in T1 ,T2 ,T3 were significantly less than the PS group (P<0.05).There was no significant difference of IL-10 between two groups (P>0.05).Conclusion Inflammatory factors significantly increase in dogs with renal allograft,and it may be associated with ischemia reperfusion inj ury in renal transplantation.Edaravone can reduce the release of in-flammatory factors,which is also its mechanism of renal protection effect.

Obj ective To explore the influence of edaravone on inflammatory factor of pe-ripheral blood in canine with renal auto-transplantation.Methods 12 weight matched healthy mon-grel dogs were randomly divided into edaravone group (ED group )and normal saline group (PS group),6 dogs in each group.ED group was treated with edaravone by 10 mg/kg intravenous in in-traoperative,postoperative 1,2,3 days,and each for edaravone 10 mg/kg.PS group was treated with the method of using the same volume of saline.The levels of TNF-α,IL-6,IL-8,IL-10 were detected by sampling venous blood before anesthesia (T0 )and after surgery (T1 ),1 days (T2 )and 3 days (T3 )after operation respectively.Results Compared with levels of inflammatory factors of peripheral blood in T0 period,there were no significant differences of concentration in each factor. With increasing of concentration of IL-6,IL-8,TNF-α,IL-10 at T1,T2,T3(P<0.05),the lev-els raised at T1 ,reached a peak at T2 ,slightly down at T3 but still higher than T0 .Levels of TNF-α,IL-6 ,IL-8 in ED group increased in T1 ,T2 ,T3 were significantly less than the PS group (P<0.05).There was no significant difference of IL-10 between two groups (P>0.05).Conclusion Inflammatory factors significantly increase in dogs with renal allograft,and it may be associated with ischemia reperfusion inj ury in renal transplantation.Edaravone can reduce the release of in-flammatory factors,which is also its mechanism of renal protection effect.

ABSTRACT:Objective To summarize nursing experience of 45 complex renal calculi patients treated with invasive percutaneous nephrolithotomy of Cyberwand dual catheters.Methods Oxy-gen-inhaling and electrocardiograph monitoring were given to 45 patients and changes of disease were observed.The indwelling catheters were closely observed and were maintained unobstructed, and the color and property were observed.The related complications such as secondary hemorrhage and urinary irritation were controlled.Results All patients were successfully discharged after re-covery,among whom there was 1 case with postoperative septic shock,3 cases with secondary bleeding,and 3 cases with secondary nephrolithotomy,and all the patients were recovered they were followed after corresponding measures.After 6 ~24 months after operation,42 patients re-turned to normal and 3 cases maintained the former status without residue and relapse of stone. Conclusion Invasive percutaneous nephrolithotomy of Cyberwand dual catheters is safety and effec-tive,and postoperative nursing plays very important role in recovery of patients.

ABSTRACT:Objective To summarize nursing experience of 45 complex renal calculi patients treated with invasive percutaneous nephrolithotomy of Cyberwand dual catheters.Methods Oxy-gen-inhaling and electrocardiograph monitoring were given to 45 patients and changes of disease were observed.The indwelling catheters were closely observed and were maintained unobstructed, and the color and property were observed.The related complications such as secondary hemorrhage and urinary irritation were controlled.Results All patients were successfully discharged after re-covery,among whom there was 1 case with postoperative septic shock,3 cases with secondary bleeding,and 3 cases with secondary nephrolithotomy,and all the patients were recovered they were followed after corresponding measures.After 6 ~24 months after operation,42 patients re-turned to normal and 3 cases maintained the former status without residue and relapse of stone. Conclusion Invasive percutaneous nephrolithotomy of Cyberwand dual catheters is safety and effec-tive,and postoperative nursing plays very important role in recovery of patients.

Objective:To explore the diagnostic value of synthetic magnetic resonance imaging (syMRI) quantitative parameters for benign and malignant breast lesions.Methods:From September 2018 to March 2019, a total of 43 cases of breast lesions which were confirmed by surgery and pathology in Cancer Hospital, Chinese Academy of Medical Sciences were enrolled in this study. All patients underwent syMRI sequence scans before and after enhancement except for conventional T2WI, DWI, and enhancement scans. GE AW4.7 workstation was used to generate syMRI parameter maps (T1, T2, proton density mappings), and ITK-SNAP software was used to delineate the volume of interest. The T1, T2, PD values before and after dynamic contrast enhanced (DCE) were obtained, and the change values of each parameter were calculated. Meanwhile, the apparent diffusion coefficient (ADC) and time intensity curve (TIC) of the lesions were measured. The differences of each parameter value were compared between benign and malignant breast lesions, and the receiver operating characteristic (ROC) curve was used to analyze the diagnostic performance of each parameter.Results:Among the 43 enrolled cases, 13 were benign and 30 were malignant. Among the syMRI parameters, the pre-enhancement parameters including T1pre (median 1 663.07 ms), T2pre (median 103.33 ms), post-enhancement parameters ΔT1 (median 1 022.68 ms) and ΔT2 (median 27.67 ms) of benign group, significantly higher than those of the malignant group (the medians were 1 141.74, 92.53, 664.95, and 16.19 ms, respectively, P<0.05). The ADC value of the benign group (median 1.66×10 -3mm 2/s) was significantly higher than that of the malignant group (median 1.00×10 -3mm 2/s, P<0.05). The benign group included 6 cases of TIC curve type Ⅰ, 5 cases of type Ⅱ, and 2 cases of type Ⅲ. The malignant group included 2 cases of TIC curve type Ⅰ, 17 cases of type Ⅱ, and 11 cases of type Ⅲ. The difference between the two groups was statistically significant ( P<0.05). The area under the ROC curve (AUC) of T1pre before DCE was 0.869, higher than 0.806 of ADC and 0.697 of TIC. When the best cut-off value of 1 282.94 ms was chosen, the sensitivity and specificity of diagnosis were 76.9% and 93.3%, respectively. The combination of T1pre and T2pre can further improve the diagnostic performance (AUC=0.908). Conclusions:Among the syMRI quantitative parameters, T1pre, T2pre, ΔT1 and ΔT2 have good value for the differential diagnosis of benign and malignant breast lesions. T1pre has the best diagnostic performance, and the combination of T1pre and T2pre can further improve the diagnostic performance.

Objective:To explore the diagnostic value of synthetic magnetic resonance imaging (syMRI) quantitative parameters for benign and malignant breast lesions.Methods:From September 2018 to March 2019, a total of 43 cases of breast lesions which were confirmed by surgery and pathology in Cancer Hospital, Chinese Academy of Medical Sciences were enrolled in this study. All patients underwent syMRI sequence scans before and after enhancement except for conventional T2WI, DWI, and enhancement scans. GE AW4.7 workstation was used to generate syMRI parameter maps (T1, T2, proton density mappings), and ITK-SNAP software was used to delineate the volume of interest. The T1, T2, PD values before and after dynamic contrast enhanced (DCE) were obtained, and the change values of each parameter were calculated. Meanwhile, the apparent diffusion coefficient (ADC) and time intensity curve (TIC) of the lesions were measured. The differences of each parameter value were compared between benign and malignant breast lesions, and the receiver operating characteristic (ROC) curve was used to analyze the diagnostic performance of each parameter.Results:Among the 43 enrolled cases, 13 were benign and 30 were malignant. Among the syMRI parameters, the pre-enhancement parameters including T1pre (median 1 663.07 ms), T2pre (median 103.33 ms), post-enhancement parameters ΔT1 (median 1 022.68 ms) and ΔT2 (median 27.67 ms) of benign group, significantly higher than those of the malignant group (the medians were 1 141.74, 92.53, 664.95, and 16.19 ms, respectively, P<0.05). The ADC value of the benign group (median 1.66×10 -3mm 2/s) was significantly higher than that of the malignant group (median 1.00×10 -3mm 2/s, P<0.05). The benign group included 6 cases of TIC curve type Ⅰ, 5 cases of type Ⅱ, and 2 cases of type Ⅲ. The malignant group included 2 cases of TIC curve type Ⅰ, 17 cases of type Ⅱ, and 11 cases of type Ⅲ. The difference between the two groups was statistically significant ( P<0.05). The area under the ROC curve (AUC) of T1pre before DCE was 0.869, higher than 0.806 of ADC and 0.697 of TIC. When the best cut-off value of 1 282.94 ms was chosen, the sensitivity and specificity of diagnosis were 76.9% and 93.3%, respectively. The combination of T1pre and T2pre can further improve the diagnostic performance (AUC=0.908). Conclusions:Among the syMRI quantitative parameters, T1pre, T2pre, ΔT1 and ΔT2 have good value for the differential diagnosis of benign and malignant breast lesions. T1pre has the best diagnostic performance, and the combination of T1pre and T2pre can further improve the diagnostic performance.