1.Mode and effect of cognitive-behavioral therapy for liver transplant recipients waiting for a liver transplant
Jinghan SU ; Shuyan WANG ; Xue LIANG ; Meiling ZHU ; Shan QIAO ; Hongying YIN
Chinese Journal of Tissue Engineering Research 2014;(5):687-692
BACKGROUND:With the development and improvement of liver transplantation technology, patients waiting for or undergoing liver transplantation have continued to increase in number. Due to their fears and concerns about post-transplantation rehabilitation, patients are under physical and mental stress, most of whom are shown to have a variety of mental disorders that affect rehabilitation. At present, mental problems of liver transplant patients are more concentrated in post-transplantation research, while patients waiting for liver transplantation do not get enough mental assessment and intervention.
OBJECTIVE:To investigate the suitable mode of cognitive-behavioral therapy for liver transplant recipients waiting for donor liver and to evaluate the effect to improve patient’s physical and mental state.
METHODS:Twelve liver transplant patients who underwent pre-transplantation assessment were randomly divided into experimental group and control group, each group with six cases. The control group received conventional treatment. The experimental group received cognitive-behavioral therapy in addition to conventional treatment. Self-rating anxiety scale (SAS) and vital signs were measured in the two groups on admission, 1 week and 3 weeks after admission.
RESULTS AND CONCLUSION:The SAS score of the experimental group was lower than that of the control group at 1 and 3 weeks after admission, and SAS score decreased as the intervention extended. The systolic blood pressure of the experimental group was lower than that of the control group at 3 weeks after admission, but there was no significant difference in diastolic blood pressure between two groups. The heart rate of the experimental group was lower than that of the control group at 1 and 3 weeks after admission. The respiratory rate of the experimental group was lower than that of the control group at 3 weeks after admission. Cognitive-behavioral therapy can reduce the level of anxiety and keep vital signs stable with good feasibility and effectiveness in patients waiting for liver transplantation.
2.Multi-slice spiral CT manifestations of perivascular epithelioid cell tumors
Yingling HUANG ; Shuyan SU ; Peifen CHEN
Chinese Journal of Primary Medicine and Pharmacy 2023;30(1):16-20
Objective:To investigate CT manifestations of perivascular epithelioid cell tumors.Methods:The multi-slice spiral CT manifestations in 11 patients with perivascular epithelioid cell tumors which were pathologically confirmed in the First Affiliated Hospital of Shantou University Medical College between October 2012 and August 2021 were retrospectively analyzed.Results:Perivascular epithelioid cell tumors were located in the kidney of eight patients, in the right lobe of the liver of two patients, and in the descending colon of one patient. The largest tumor, approximately 20.0 cm × 26.0 cm × 11.0 cm, was located in the kidney. The smallest tumor, 2.4 cm × 2.6 cm × 3.4 cm, was located in the colon. CT plain scans showed uniform density without bleeding, calcification, or fat in two patients, and non-uniform density with fatty change in two patients. Contrast-enhanced CT images showed non-uniform enhancement in the arterial phase in 10 patients and uniform enhancement in one patient. Contrast-enhanced CT images showed decreased degrees of enhancement of the lesions in 11 patients from the portal venous phase to the delayed phase and dilated and tortuous vascular shadows in 11 patients.Conclusion:The multi-slice spiral CT manifestations of perivascular epithelioid cell tumors are characteristic and the multi-slice spiral CT is of value for the diagnosis of perivascular epithelioid cell tumors.
3.A clinical study on the central lymph node metastasis of papillary thyroid carcinoma in cN0 T1/T2
Shuyan ZHAO ; Ruochuan CHENG ; Yunhai MA ; Yanjun SU ; Bin LIU ; Tianyun WEN ; Jun QIAN
Chinese Journal of Endocrine Surgery 2019;13(4):283-288
Objective To probe the reasonable range of central lymph node dissections(CLNs)for papillary thyroid carcinoma (PTC) in cN0 T1/T2 by analyzing the metastasis regulations of PTC in cN0 T1/T2.Methods Data of 891 PTC patients in cN0T1/T2 cases according to the research criterion from Oct.2013 to Sep.2017 were analyzed.All the patients were under the treatment of the same group of surgeons in Department of Thyroid Surgery of the First Affiliated Hospital of the Kunming Medical University and had undergone operation of bilateral total resection of thyroid gland and central lymph node.The clinical and pathological data were collected.Univariate and multivariate analysis were used to investigate the risk factors of central neck lymph node metastasis and high volume central neck lymph node metastasis.Results ①Univariate analysis showed that gender (P=0.002),age(P=0.002),multiform(P=0.000),nodular goiter(P=0.000)and with Hashimoto's(P=0.031)had significant influence in prevalence of CLN node metastasis.Gender(P=0.010)and tumor size(P=0.000)showed significant influence in prevalence of high volume CNL node metastasis.In multivariate analysis,age (OR=0.962,OR=2.856)and nodular goiter(OR=0.969,OR=3.012)showed the independent risk factor of CNL node metastasis and high volume CNL node metastasis.②The numbers of lesion in unilateral lesion were not correlated with IpsiCLNs and Cont-CLNs metastasis (P=0.347,P=0.653).The tumor diameter was correlated with Ipsi-CLNs and ContCLNs metastasis (P=0.010,P=0.000).The tumor diameter of bilateral multifocal carcinoma was correlated with LN-prRLN-CLNs metastasis (P=0.019).The tumor diameter of left and right unilateral single focal lesion was not correlated with LN-prRLN-CLNs metastasis(P=0.684,P=0.072).Conclusions According to the study,it is recommended that the PTC in cN0 T1/T2 should routinely undergo preventive central lymph nodes dissection in the case of technical support:①Preventive overall CLND is recommended for unilateral non-microscopic carcinoma and bilateral multiform carcinoma,especially in those older than 55.②For patients with unilateral single or multifocal microscopic carcinoma,only ipsilateral central lymph nodes dissection can be considered.③ Generally,routine dissection is not necessary for the lymph nodes of the right recurrent laryngeal nerve in the central region of the neck.However,for bilateral non-small cancers and right non-small cancers,LN-prRLN-CLNs dissection is recommended.
4.Clinical and imaging analysis on meningiomas initially manifesting as intracranial hemorrhage in 19 cases
Ruibin HUANG ; Shuyan SU ; Huanpeng WANG ; Ruyao ZHUANG ; Yuan LIU
Chinese Journal of Primary Medicine and Pharmacy 2022;29(12):1783-1788
Objective:To investigate the main clinical characteristics, imaging features, diagnosis, and treatment of meningiomas initially manifesting as spontaneous intracranial hemorrhage.Methods:The clinical characteristics, imaging features, treatment, and follow-up data of 19 patients with meningiomas initially manifesting as spontaneous intracranial hemorrhage who received treatment in The First Affiliated Hospital of Shantou University Medical College from January 2011 to December 2020 were retrospectively analyzed.Results:Among the 19 patients, there were 6 males and 13 females, with an average age of (53 ± 14) years. The onset manifestations were sudden and severe headache and vomiting in 6 cases, progressive coma in 4 cases, and hemiplegia in 9 cases. Among the 19 patients, 15 patients showed irregular tumor shape and mixed hyperintense signal in CT, and 4 patients showed a homogeneous hyperintense signal. Eighteen patients showed peritumoral edema. Three patients showed intratumoral calcification. One patient showed an intratumoral fluid level. Fourteen patients showed isointense to hypointense signals on T1WI images and isointense to hyperintense signals on T 2WI images. Five patients showed mixed isointense and hyperintense signals on T 1WI images and mixed hypointense and hyperintense signals on T 2WI images. Heterogeneous enhancement was found in 18 patients, intratumoral cystic necrosis was found in 15 patients, and the meningeal tail sign was found in 16 patients. Preoperative imaging misdiagnosis occurred in 4 patients. Before surgery, all patients underwent surgery to resect the tumor and remove the hematoma. No patients died because of surgery. After surgery, muscle strength was improved compared with that before surgery. The average follow-up time was (46.5 ± 28.4) months. Tumor recurrence occurred in two patients. The Karnofsky Performance Scale score at the last follow-up, at discharge, and before surgery was (73.7 ± 3.4) points, (61.1 ± 5.5) points, and (49.5 ± 5.6) points, respectively ( F = 21.06, P < 0.01). The Karnofsky Performance Scale score at the last follow-up was significantly increased compared with that at discharge and before surgery ( F = 13.13, P < 0.01). Conclusion:Spontaneous hemorrhagic meningioma is rare and has a sudden onset. It is easily misdiagnosed before surgery. Skull CT, skull CT angiography, and enhanced magnetic resonance imaging examination in combination can increase the preoperative diagnosis rate. Early surgical resection of tumors and removal of hematoma can acquire good clinical efficacy.
5.Practice of online teaching method of combining CBL and RadiAnt DICOM Viewer for undergraduate medical students in radiology department
Ruibin HUANG ; Shuyan SU ; Liujiang CHEN ; Xiaoli CHEN ; Xiaohuan YANG ; Yuan LIU
Chinese Journal of Medical Education Research 2023;22(9):1356-1360
Clinical undergraduates generally have the following problems during their radiology internship: short internship period, low motivation, teachers using traditional teaching mode, and insufficient hardware and software facilities for image reading. In this study, RadiAnt DICOM Viewer and case-based learning (CBL) model were applied in online practice teaching for clinical undergraduates in the radiology department, which achieved good results. The results showed that the clinical undergraduates had a pass rate of 91.18% (124/136) in the image reading quiz and a mean score of (85.71±10.99) in the in-class quiz, with a pass rate of 91.91% (125/136). The satisfaction survey showed that 84.56% (115/136) of the students were more satisfied with the application of RadiAnt DICOM Viewer in image reading teaching; 80.88% (110/136) of the students expressed more interest in radiology after this training course; 90.44% (123/136) of the students thought that online practice teaching of radiology is feasible.
7.Pollution status and distribution characteristics of indoor air bacteria in subway stations and compartments in a city of Central South China
Shuyan CHENG ; Zhuojia GUI ; Liqin SU ; Guozhong TIAN ; Tanxi GE ; Jiao LUO ; Ranqi SHAO ; Feng LI ; Weihao XI ; Chunliang ZHOU ; Wei PENG ; Minlan PENG ; Min YANG ; Bike ZHANG ; Xianliang WANG ; Xiaoyuan YAO
Journal of Environmental and Occupational Medicine 2024;41(7):801-806
Background Bacteria are the most diverse and widely sourced microorganisms in the indoor air of subway stations, where pathogenic bacteria can spread through the air, leading to increased health risks. Objective To understand the status and distribution characteristics of indoor air bacterial pollution in subway stations and compartments in a city of Central South China, and to provide a scientific basis for formulating intervention measures to address indoor air bacteria pollution in subways. Methods Three subway stations and the compartments of trains parking there in a city in Central South China were selected according to passenger flow for synchronous air sampling and monitoring. Temperature, humidity, wind speed, carbon dioxide (CO2), fine particulate matter (PM2.5), and inhalable particulate matter (PM10) were measured by direct reading method. In accordance with the requirements of Examination methods for public places-Part 3: Airborne microorganisms (GB/T 18204.3-2013), air samples were collected at a flow rate of 28.3 L·min−1, and total bacterial count was estimated. Bacterial microbial species were identified with a mass spectrometer and pathogenic bacteria were distinguished from non-pathogenic bacteria according to the Catalogue of pathogenic microorganisms transmitted to human beings issued by National Health Commission. Kruskal-Wallis H test was used to compare the subway hygiene indicators in different regions and time periods, and Bonferroni test was used for pairwise comparison. Spearman correlation test was used to evaluate the correlation between CO2 concentration and total bacterial count. Results The pass rates were 100.0% for airborne total bacteria count, PM2.5, and PM10 in the subway stations and train compartments, 94.4% for temperature and wind speed, 98.6% for CO2, but 0% for humidity. The overall median (P25, P75) total bacteria count was 177 (138,262) CFU·m−3. Specifically, the total bacteria count was higher in station halls than in platforms, and higher during morning peak hours than during evening peak hours (P<0.05). A total of 874 strains and 82 species were identified by automatic microbial mass spectrometry. The results of identification were all over 9 points, and the predominant bacteria in the air were Micrococcus luteus (52.2%) and Staphylococcus hominis (9.8%). Three pathogens, Acinetobacter baumannii (0.3%), Corynebacterium striatum (0.1%), and Staphylococcus epidermidis bacilli (2.2%) were detected in 23 samples (2.6%), and the associated locations were mainly distributed in train compartments during evening rush hours. Conclusion The total bacteria count in indoor air varies by monitoring sites of subway stations and time periods, and there is a risk of opportunistic bacterial infection. Attention should be paid to cleaning and disinfection during peak passenger flow hours in all areas.