Objective To explore the pattern of cervical nodal metastasis and the clinical significance of total thyroidectomy plus functional neck lymphadenectomy in papillary thyroid carcinoma patients. Methods Clinical and pathological data of 172 patients with papillary thyroid cancer who underwent total thyroidectomy plus functional neck lymph node dissection at Jinan Military General Hospital were retrospectively reviewed, including patient demographics, extent of surgery, parathyroid hormone level,recurrence, tumor pathology, such as tumor size, multifocality, capsular invasion, vascular invasion,extrathyroidal extension, and lymph node status. Results Of the 172 functional neck dissection patients (47 ambilateral), the incidence of lymphonodus metastasis in regions Ⅵ, Ⅳ and Ⅲ was 96. 3% ,78. 5%and 62.1% respectively. Rate of nodal metastasis was higher in patients with extracapsular invasion than in patients with no invasion ( P ＜ 0. 05 ). Serum parathyroid hormone levels significantly decreased immediately postoperatively in total thyroidectomy plus functional neck dissection and remained low for several weeks thereafter ( P ＜ 0. 01 ). The 5-, 10- and 15-year survival rate was ( 98. 83 ± 0. 82) %, (98. 23 ± 1.02 ) % and (96. 42 ± 1.43 )%, respectively. Conclusions Therapeutic neck lymph node dissection for papillary thyroid cancer is recommended for cervical nodal metastasis patients. Total thyroidectomy plus functional neck dissection is important in the treatment of papillary thyroid cancer.

OBJECTIVETo study the effect and safety of the Chinese-made inflatable penile prosthesis in the treatment of erectile dysfunction (ED).

METHODSAccording to the anatomy and physiology of Chinese men, an inflatable penile prosthesis was developed in China, consisting of an innovated pump, a reservoir, and a pair of penile cylinders, which were connected by tubes to form a complete system. It was authorized to be used clinically by State Food and Drug Administration (SFDA). Forty-five cases of organic ED were selected for penile prosthesis implantation. Penoscrotal approach was used to implant the cylinders into the corpus cavernosum, the pump into the scrotum and the reservoir into the prevesical space.

RESULTSSurgical problems and mechanical failures were not found in the subjects. Post-operative complications occurred in 3 cases (6.6%), but did not affect the intercourse. Satisfactory intercourses were achieved 10-12 months later and the intercourse duration averaged about (20 +/- 6) min.

CONCLUSIONThe Chinese-developed inflatable penile prosthesis was safe and effective for patients with ED, with low rate of mechanical failures. Its long term effect has yet to be further studied.

Adult ; Erectile Dysfunction ; surgery ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Penile Implantation ; Penile Prosthesis ; Prosthesis Design

Objective To know the levels of antibodies against influenza A virus subtypes H1 and H3 of population in Shanghai during 2009, and the detection of antibodies against avian influenza virus subtypes H5 and H9 in population which contacts with avian. Methods The serological survey of the antibodies against influenza A viruses subtypes H1, H3, H5 and H9 in 356 close contacts with avian (professional population) and 332 general subjects (general population) at various age groups were carried out using hemagglutinin inhibit (HI) test. Results The positive rates of antibodies against influenza virus A/Brisbane/59/2007 (H1N1) in general population and professional population were 82.8% (275/332) and 73.9% (263/356), respectively; those of A/Brisbane/10/2007 (H3N2)were 50.6% (168/332) and 54.8% (195/356), respectively. The positive rate of antibodies against influenza virus A/Brisbane/59/2007 (H1N1 )was significantly higher than that of influenza A viruses subtype H3, which was consistent with etiological survey of influenza virus in Shanghai during 2008.The positive rates of antibodies against influenza A virus subtype H5 in professional population and general population were 4.2% (15/356) and 0.3% (1/332), respectively; those of influenza A virus subtype H9 were 34.6% (123/356) and 2.4% (8/332), respectively. The positive rates of antibodies against influenza virus A/Brisbane/59/2007 (H1N1 ) and A/Brisbane/10/2007 (H3N2) in age groups of 6 months-5 years and ≥60 years were lower than other age groups. Conclusions The immune protective response against seasonal influenza A subtype H1 and H3 of population in Shanghai is high,while those of children and the elders were low. The levels of antibodies against influenza A viruses subtype H5 and H9 in professinal population present obviously ascending trend, which indicates that the etiological and serological survey of influenza virus in this population should be enhanced.

Objective To explore the risk factors of postoperative activities of daily living in elderly patients after hip fracture. Methods By convenience sampling,from October 2013 to June 2015,150 elderly patients having undergone surgery after hip fracture were selected,with data of 141 cases finally collected. Gender,age,underlying diseases,surgical procedures,postoperative complications,ambulation time,whether walking with aids,family caregivers and reexamination conditions were recorded for evaluation of the patients about their activities of daily living half a year after the surgery. Mean comparison and chi-square test were used for univariate analysis about the above factors and Logistic regression analysis was used to identify possible risk factors. Results It was shown in univariate analysis that recovery of postoperative activities of daily living was influenced by age,surgical procedures,postoperative complications,ambulation time,walking aids,etc. (P< 0.05);it was shown in multivariate logistic regression that age (OR=1.065,95%CI:1.010-1.124, P=0.020),surgical procedures (OR=2.900,95%CI:1.200-7.008,P=0.018),postoperative complications (OR=6.366,95%CI:2.592-15.632,P< 0.001),ambulation time (OR=2.684,95%CI:1.133-6.359,P=0.025) and walking aids (OR=5.796,95%CI:1.542-21.780,P=0.009) were risk factors of postoperative daily living ability in elderly patients after hip fracture. Conclusions Old age,developing internal fixation surgery after incision,postoperative complications, walking more than 3 months after operation or walking without aids affect postoperative activities of daily living in elderly patients after hip fracture,thus affecting their quality of life, which makes it necessary for nursing staff to focus on risk factors for positive prevention and intervention.

Objective To explore the effect of modified anal injection on preventing fecal incontinence caused by glycerol enema and reliving constipation in elderly orthopedic patients. Methods A total of 78 aged patients with constipation was selected and divided into experimental group (38 cases, modified anal injection enema method) and control group (40 cases, traditional enema anus method) according to the random numbertable method. And then, we compared the situation of fecal incontinence and relieving constipation. Results In the control group, there were 10 patients with fecal incontinence, while there was no case of fecal incontinence in the experimental group, it was statistically significant between them (P<0. 01). After using the enema, there were 14 ineffective cases in the control group and 5 ineffective cases in the experimental group, and the differences were statistically significant between the two groups (P <0. 05). The effect in the experimental group was better than that in the control group. Conclusions Modified anal injection enema can prevent fecal incontinence caused by enema and relieve constipation in elderly orthopedic patients.

Objective? To explore the application effect of self-help lower limb functional exercise shoes in elderly patients after total knee arthroplasty(TKA). Methods? A total of 58 patients with knee osteoarthritis who underwent TKA in the Second Affiliated Hospital of Wenzhou Medical University from September of 2017 to September 2018 were selected and randomly divided into the control group(n=28) and observation group(n=30). Routine functional exercise method was adopted in the control group while self-help lower limb functional exercise shoes were applied in the observation group. The time needed to master the functional exercise instruction, compliance with the functional exercise and knee joints activity post-operation in the two groups were compared. Results? The time needed to master the functional exercise instruction in the observation group was (4.3±1.5)min, shorter than the control group with statistical significance (t=4.87, P＜ 0.01). In the observation group there were 27 patients who had high compliance with the functional exercise, while 15 patients in the control group had high compliance, the difference was statistically significant (χ2=9.62,P＜0.05). Three months after operation, the knee joint activity of the observation group was better than that of the control group (115.3±11.3)°, the difference was statistically significant (t=2.45, P＜0.05). Conclusions? The use of self-help lower limb functional exercise can help the elderly TKA patients to master the functional exercise method faster, improve their compliance with postoperative functional exercise, improve postoperative rehabilitation exercise effects and promote early recovery of the affected limb functional.

Objective To analyze the trend of death level and the probability of premature death caused by chronic obstructive pulmonary disease (COPD) in Jinshan District of Shanghai from 1980 to 2020, and to provide reference for the formulation of prevention and control measures of COPD. Methods The death cases of COPD in Jinshan District from 1980 to 2020 were collected through the death cause registration information system. The crude mortality, standardized mortality, age group mortality, early death probability and annual change percentage in different periods were calculated. Results From 1980 to 2020, the crude mortality of COPD in Jinshan District was 154.38/100 000, and the standardized mortality was 82.66/100,000. In the past 41 years, the standardized mortality of COPD showed a downward trend in males and females (APC=-1.79%, -2.52%, P<0.001). In the same period, the mortality of COPD in subjects aged 30-69 years old and subjects aged 70 years old and above also decreased (APC=-8.79%, -4.79%, P<0.001), and the probability of premature death caused by COPD showed a downward trend in males and females (APC=-9.61%, -10.71%, P<0.001). Conclusion The mortality rate and the probability of premature death of COPD in Jinshan District have decreased in the past 41 years. However, COPD is still one of the major chronic diseases that pose a serious threat to the health of residents in Jinshan District. Comprehensive prevention and treatment measures should be taken to reduce the mortality and the probability of premature death of COPD.

ObjectiveTo understand the infection characteristics of multidrug-resistant organisms (MDROs) in hospitalized patients in a tertiary sentinel hospital in Shanghai, so as to provide an evidence for the development of targeted prevention and control measures. MethodsData of MDROs strains and corresponding medical records of some hospitalized patients in a hospital in Shanghai from 2021 to 2023 were collected, together with an analysis of the basic information, clinical treatment, underlying diseases and sources of sample collection. ResultsA total of 134 strains of MDROs isolated from hospitalized patients in this hospital were collected from 2021 to 2023 , including 63 strains of methicillin-resistant Staphylococcus aureus (MRSA), 57 strains of carbapenem-resistant Acinetobacter baumannii (CRAB), and 14 strains of carbapenem-resistant Klebsiella pneumoniae (CRKP). Of the 134 strains, 30 strains were found in 2021, 47 strains in 2022 and 57 strains in 2023. The male-to-female ratio of patients was 2.05∶1, with the highest percentage (70.90%) in the age group of 60‒<90 years. The primary diagnosis was mainly respiratory disease, with lung and respiratory tract as the cheif infection sites. There was no statistically significant difference in the distribution of strains between different genders and infection sites (P>0.05). However, the differences in the distribution of strains between different ages and primary diagnosis were statistically significant (P<0.05). Patients who were admitted to the intensive care unit (ICU), had urinary tract intubation, were not artery or vein intubated, were not on a ventilator, were not using immunosuppresants or hormones, and were not applying radiotherapy or chemotherapy were in the majority. There was no statistically significant difference in the distribution of strains for whether received radiotherapy or chemotherapy or not (P>0.05), while the differences in the distribution of strains with ICU admission history, urinary tract intubation, artery or vein intubation, ventilator use, and immunosuppresants or hormones use or not were statistically significant (all P<0.05). The type of specimen was mainly sputum, the hospitalized ward was mainly comprehensive ICU, the sampling time was mainly in the first quarter throughout the year, the number of underlying diseases was mainly between 1 to 2 kinds, the application of antibiotics ≥4 kinds, and those who didn’t receive any surgery recently accounted for the most. There were statistically significant differences in the distribution of strains between different specimen types, wards occupied and history of ICU stay (P<0.05), but no statistically significant difference in the distribution of strains between different sampling times, number of underlying diseases and types of antibiotics applied (P>0.05). ConclusionThe situation of prevention and control on MDROs in this hospital is still serious. Focus should be placed on high-risk factors’ and infection monitoring and preventive measures should be strengthened to reduce the incidence rate of MDROs infection.