ObjectiveTo guide fluid management and evaluate the clinical index through monitoring extravascular lung water index(EVLWI) of patients with pulmonary contusion.MethodsThirtyone severe chest trauma patients with pulmonary contusion were selected,performed with central venous catheterization or femoral artery catheterization,and connected to pulse index continuous cardiac output (PICCO).EVLWI after pulmonary contusion were measured by using thermal dilution.The intake and output of patients were recorded in detail,fluid intake was controlled,furosemide was prescribed,and the changes and correlations of oxygenation index,EVLWI and liquid balance difference at different time points were evaluated.ResultsEVLWI after pulmonary contusion at 1st to 7th d after hospitalization was respectively (9.25 ±0.71),(8.98 ±0.61),(8.61 ±0.59),(7.75±0.53),(6.64 ±0.49),(6.22±0.36),(5.59 ±0.39) ml/kg.Comparing with 1st d after hospitalization,EVLWI declined from 3rd d (P ＜ 0.05).Oxygenation index at Ist to 7th d after hospitallzation was respectively( 145.76±23.61 ),( 144.19±20.24),( 146.67±19.25 ),(159.33±15.42),(177.38±14.25),(199.33±19.04),(213.71±18.51) mm Hg(1 mm Hg =0.133 kPa).Comparing with 1st d,oxygenation index from 4th to 7th d had significant difference (P ＜ 0.05 ).The fluid volume at 1st d to 7th d were all negative balance,that of 3rd d to 6th d had significant difference comparing with 1st d [(-431.43±121.17),(-601.43±127.09),(-629.52±140.69),(-320.01 ±93.71) ml vs.(-213.81±63.91 ) ml](P ＜ 0.05 ).Oxygenation index and EVLWI had negative correlation(r =-0.824,P＜0.01).Liquid balance difference and the changes of oxygenation index and EVLWI had no correlation.ConclusionEVLWI effectively monitoring after pulmonary contusion can not only evaluate the changes of pulmonary vascular permeability of patients with pulmonary contusion,but also have important significance to guide fluid management.

Objective To investigate the effect of video-based teaching in the training of nursing operation for newly-contracted nurses. Methods One hundred and twenty one nurses newly recruited in September 2011 to September 2012 were set as the control group, another 128 in October 2012 to October 2013 were set as the experiment group. The former were trained and assessed with traditional training method and the latter were trained for 1 year in video-based teaching methodology. After training, both groups were examined about their operation skills and meanwhile a survey on video-based teaching was conducted. Result After training, the results in operating skills evaluation in the experiment group were significantly better those of the control group (Z=2.82, P<0.05). Conclusion Compared with traditional training method, the video-based teaching can raise the level of nursing operation skills and significantly improve the quality of nursing, thus worthy of popularization and application.

A new phenethanol, (2'R)-4-(2', 3'-dihydroxy-3'-methyl-butanoxy)-phenethanol (1), along with other eleven known benzene derivatives (2-12) were isolated from the roots, stems and leaves of Clausena excavata (Rutaceae). Compounds 3 and 4 are new natural products, and compounds 5-8, 10-12 were isolated from C. excavata for the first time. Their structures were elucidated on the basis of MS, 1D and 2D NMR spectroscopic analyses including HSQC, COSY and HMBC experiments. 1 was tested for its cytotoxicities against A549, HeLa and BGC-823 cancer cell lines, and antimicrobial activities against Candida albicans and Staphylococcus aureus. The results showed that 1 did not exhibit cytotoxic and antimicrobial activities.
Benzene Derivatives ; chemistry ; Candida albicans ; drug effects ; Cell Line, Tumor ; Clausena ; chemistry ; HeLa Cells ; Humans ; Magnetic Resonance Spectroscopy ; Molecular Structure ; Plant Leaves ; chemistry ; Plant Roots ; chemistry ; Plant Stems ; chemistry ; Staphylococcus aureus ; drug effects

To investigate monoterpenes and sesquiterpenes of the stems and leaves of Clausena excavata, an AcOEt fraction of the methanol extract was subjected on column chromatographies including silica gel and RP-18, as well as preparative HPLC. The structures of compounds isolated were identified on the basis of spectroscopic data as excamonoterpene (1), (6R, 9S)-9, 10-dihydroxy-4-megastigmen-3-one (2), (3R, 6R, 7E) -3-hydroxy-4, 7-megastigmadien-9-one (3), (3S) -3-hydroxy-7, 8-dihydro-beta-ionone (4), (3S, 5R, 6S) -3-hydroxy-5,6-epoxy-beta-ionone (5), (6R, 9R) -9-hydroxy-4-megastigmen-3-one (6), (3S, SR) -dihydroxy-6, 7-megstigmadien-9-one(7), (-)-loliolide(8), caryolane-1, 9alpha-diol(9) and 2, 6-dihydroxyhumula-3 (12), 7 (13), 9(E)-triene (10), were isolated from the stems and leaves of C. excavata. Compound 1 is a new monoterpene, named as excamonoterpene. Compounds 2-10 were isolated from this plant for the first time.
Chromatography, High Pressure Liquid ; methods ; Clausena ; chemistry ; Magnetic Resonance Spectroscopy ; Methanol ; chemistry ; Molecular Structure ; Monoterpenes ; analysis ; chemistry ; Plant Leaves ; chemistry ; Plant Stems ; chemistry ; Sesquiterpenes ; analysis ; chemistry ; Spectrometry, Mass, Electrospray Ionization

Objective:To investigate the effect of peer support education on family function of breast cancer patients with breast reconstruction.Methods:Totally 146 patients who received surgical treatment in the department of plastic surgery for breast cancer from June 2017 to June 2019 were randomly divided into the experimental group and the control group by the method of random number table, 73 cases each. The control group received routine education. Patients in the observation group received regular education and peer support education. The intervention time was from admission to 6 months after discharge, and the control group received routine nursing care. Quality of life questionnaire was used to evaluate the quality of life of the patients at six months after operation, family care index questionnaire was used to evaluate the family function of the patients, and comprehend social support scale was used to evaluate the level of social support, then various indicators of the two groups of patients were compared.Results:6 months after operation, the scores of quality of life function and symptom dimension of the intervention group were 6.43±1.54. 5.83±1.47, while control group were 6.02±1.59; 6.39±1.63. There were statistically significant differences between the two groups ( t values were 4.30, 5.01, P < 0.05); family care scores of the two groups were compared, the intervention group was 8.78±2.04. The control group was 8.43±2.05. There were statistically significant differences between the two groups ( t value was 2.02, P < 0.05); the comprehension support score of the two groups was compared, and that of the intervention group was 62.24±14.81. The control group was 55.74±13.58. There were statistically significant differences between the two groups ( t value was 4.26, P < 0.05). Conclusion:Peer support education can improve the quality of life and family care of breast cancer patients with breast reconstruction.

Animals ; Chlorine Compounds ; toxicity ; Dose-Response Relationship, Drug ; Female ; Lung ; drug effects ; metabolism ; RNA, Messenger ; genetics ; Rats ; Rats, Sprague-Dawley ; Transforming Growth Factor beta1 ; biosynthesis ; genetics ; Tumor Necrosis Factor-alpha ; biosynthesis ; genetics

Objective To observe the outcome of free TAAP flap in the reconstruction of defect after oral tumor radical resection.Methods From June,2010 to April,2015,12 patients with oral tumor underwent radical resection,including 4 cases of gingival carcinoma,3 cases of tongue carcinoma and 5 case of buccal cancer.The cause ranged from 2 to 12 months.The radical resection left defects with size ranged from 4.5 cm×3.5 cm to 6.0 cm× 4.5 cm which were reconstructed by free TAAP flaps with size ranged from 7.0 cm×4.0 cm to 12.0 cm×8.0 cm.The length of TAAP flap was (6.5±0.6) cm.The width of flap was (4.3±0.5) cm.And the thickness of flap was (1.1±0.3)cm.The length of pedicle was(8.4±0.2) cm.All the arteries of TAAP were anastomosed with superior thyroid arteries,while the venae comitans were anastomosed with superior thyroid venae or internal jugular venae.Results The perforators existed consistently.All 12 flaps survived uneventfully.The donor sites were closed directly in all cases.All patients were followed up for 14-38 months with satisfied esthetic and functional results in reconstructed tongue.No local recurrence happened.The shoulder function was not affected.Conclusion The TAAP flap has consistent blood supply,good color match and texture,while leaving minimal morbidity at donor site,is an ideal choice for buccal tumor reconstruction.

Objective To review our single institutional 10-year experience in complex chest wall reconstruction and identify a working algorithm based on our retrospective analysis.Methods A retrospective analysis of 87 patients who underwent chest wallreconstruction in our department from January 2005 to December 2015.Fifty female patients and 37 male patients who underwent the above procedure were reviewed retrospectively.The median age of the patients is 52.3 years (24-75years).Histologic diagnosis including squamous-cell carcinoma (n =10),soft tissue sarcoma(n =22),chondrosarcomas(n =13) and metastasis from breast cancer(n =42).Type of skeletal defect including partial ribs/sternum defects in 19 cases,soft tissue defects alone in 33 cases,complicated composite chest wall defects involving multiple layers(soft tissue,ribs/sternum,and intrathoracic organs) in 35 cases.Sole methylmethacrylate/polypropylene mesh was used for small sized rib defects in 26cases.Methylmethacrylate/polypropylene mesh sandwich prostheses was used in 28 cases with extensive skeletal reconstruction after partial sternectomy and rib resection.The chest wall defects were repaired with pedicled internal mammary artery perforator flap(3 cases),pedicled deep superior epigastric artery perforator flap(4 cases),pedicled pectoralis major flap(8 cases),free anterolateral thigh perforator flap(9 cases),free deep inferior epigastric artery perforator flap(17 cases),pedicled lateral thoracic flap(5 cases),pedicled latissimus dorsi flap(17 cases),pedicled rectus abdominis flap(15 cases),free deep inferior epigastric artery perforator flap combined with pedicled rectus abdominis flap (4 cases),pedicled bipaddled latissimus dorsi flap(5 cases).11 cases with extensive full-thickness defects of the chest wall,the skeletal reconstruction was achieved with prosthetic sandwich and then covered with the omental flap,further free flaps were harvested for skin and soft tissue repairing.Results 1 case with pedicled rectus abdominis flap partial necrosis was noted,free anterolateral thigh flap was used for repairmen after further revision.1 case with edicled bipaddled latissimus dorsi flap,necrosis of the distal 1/4 part of one paddle was noted,healed with dressing therapy,no secondary skin grafting was required.Postoperative venous congestion occurred in 2 cases with deep inferior epigastric artery flap transplantation,in which both skin flaps exhibited venous crisis within 24 h after surgery.The reexploration procedures were successful in both cases and the flaps survived totally.All other flaps survived.The mean follow-up was 31 months,ranged from 9 to 72 months.No tumour extirpation was noted,functional and appearance results were satisfied.Conclusion According to the size and location of chest wall defect,different pedicled and free flaps should be chosen to achieve optimal outcome.Free flaps are efficient for large complex chest defects reconstruction.

Objective: To investigate the application of free medial thigh chimeric myocutaneous perforator flap in the reconstruction of tongue defect after radical resection of tongue carcinoma. Methods: From June 2013 to November 2015, 17 cases with tongue carcinoma underwent radical resection and tongue and mouth floor defects after surgery were reconstructed with medial thigh chimeric myocutaneous perforator flaps at the same stage. These 17 cases included tongue carcinoma on lingual margin (n=9), ventral tongue (n=7) and mouth floor (n=1). Appearance and functional results were evaluated with follow-up. Results: Medial thigh chimeric myocutaneous perforator flap was (9.0±0.3) cm in length, (4.5±0.3) cm in width , and (1.8±0.4) cm in thickness. The length of pedicle was (7.4±0.6) cm. All of the 17 flaps survived uneventfully, and the donor sites were closed directly in all cases. All patients were followed up for 10-28 months with satisfied esthetic and functional results in reconstructed tongue. Aside from linear scar in the donor sites, the functions of thighs were not affected. No local recurrence occurred. Conclusion The free medial thigh chimeric myocutaneous perforator flap is an ideal choice to reconstruct the tongue and mouth floor defect after radical resection of tongue carcinoma.

OBJECTIVETo evaluate the application of shear wave elastography (SWE) combined with transition zone biopsy in the detection of prostate cancer (PCa).

METHODSA total of 489 patients with suspected PCa underwent transrectal ultrasonography (TRUS) and SWE-guided prostatic biopsy. We evaluated the role of SWE combined with transition zone biopsy in promoting the detection rate in comparison with the results of biopsy pathology.

RESULTSThe pathological results confirmed 221 malignant and 268 benign cases. Based on systematic biopsy, SWE combined with transition zone biopsy achieved a detection rate of 45. 19% , significantly higher than that of systematic biopsy alone (33.13%) (P < 0.05). The diagnostic sensitivity, specificity, and accuracy of SWE were significantly better than those of TRUS (P < 0.05). The mean elasticity (Emean) of SWE was remarkably higher for malignant than for benign lesions ([40.1 ± 9.5] vs [21.6 ± 8.3] kPa, P < 0.05). With 28.5 kPa as the threshold of the Emean value, the area under the ROC curve was 0. 899, and the diagnostic sensitivity and specificity were 88.71% and 86.23%, respectively.

CONCLUSIONSWE combined with transition zone biopsy could significantly improve the detection rate of prostate cancer.

Elasticity Imaging Techniques ; methods ; Humans ; Image-Guided Biopsy ; methods ; Male ; Prostate ; pathology ; Prostatic Neoplasms ; diagnosis ; diagnostic imaging ; pathology ; ROC Curve ; Sensitivity and Specificity