Objective To investigate the degree of pain for patients with esophageal cancer undergoing surgery, evaluate the influence of pain on life quality, and provide evidence for therapy and nursing. Methods The SF-MPQ and BPI were used to measure the quality and intensity of the pain, and the influence on the life quality. Results Non-manual workers feeled more pain than the manual workers; the degree of the patients' education background positively correlated with PRI emotional score;postoperative pain did not correlated with ages and gender. The more pain, the worse influence on life quality. The pain affected the daily life, emotions, locomotor ability, sleep and enjoyment of life significantly. Conclusions There still existed serious pain in patients with esophageal cancer underwent surgery,and the pain affects the quality of life and postoperative treatment. Nurses should pay close attention to pain management, adopt more accurate evaluation so as to guide the pain control and improve the life quality.

Objective To summarize the clinical experience of thoracic injury.Methods Analyze 778 cases of thoracic injury,including soft tissue injury,rib fracture,hemothorax and pneumothorax,pulmonary contusion,cardiovascular injury,et al.The causes of the injury including traffic accident,injury suffered from the job and dispute,et al.Results 774 cases were cured among all the 778 cases with the recovery rate of 99.35％.There were 5 cases died with the death rate of 0.65％,including 1 case of heart rupture,1 case of large vessle rupture,2 cases of brain combining injury,1 case of spleen combining injury.Conclusion Thoracic injury arise new characteristic in recent years.The main causes of the injury are traffic accident,injury suffered form the job and dispute.Most cases may be cured by rapid treatment.The main causes of death are haemorrage shock due to cardiovascular or spleen rupture and combination of severe brain injury.

Objective To investigate the relationship between serum uric acid (UA) level and abdominal obesity or metabolic syndrome (MS).Methods A total of 875 subjects,with 350 males and 525 females,aged 40-65 years old,were enrolled in this study.The clinical and biochemical data were collected and MRI was used to assess the visceral and subcutaneous adipose tissues.The relationships between UA level and abdominal obesity or MS were analyzed,and the cut-off values of UA for abdominal obesity and MS were determined.Results Raised risks of abdominal obesity (OR =4.35,95％ CI 1.91-9.90 in males; OR =5.44,95％ CI 2.41-12.31 in females) and MS (OR =4.47,95 ％ CI 2.08-9.62 in males; OR =11.62,95％ CI 3.43-39.37 in females) were observed with the increase of UA level.The multiple logistic regression analysis showed that UA was an independent risk factor for hypertriglyceridemia (OR =2.23,95％ CI 1.02-4.87 in males ; OR =3.04,95％ CI 1.49-6.23 in females) in all subjects and for abdominal obesity(OR =3.23,95％ CI 1.32-7.91) and hypertension (OR =2.35,95％ CI 1.37-4.05)in the females.Among the females,the regression line analyzed by simple correlation indicated that the UA level of 244.0 μmol/L was corresponded to the visceral adipose tissue area of 80 cm2.The optimal cut-off point of UA for the diagnosis of MS was 258.8 μmol/L determined by the receiver operating characteristic curve.Conclusions The level of UA is closely correlated with abdominal obesity and MS in the middleaged Chinese.The elevated UA level is an independent risk factor for abdominal obesity and MS in the female.

Objective: Based on the principle of evidence-based nursing, we searched, studied and summarized a nursing pathway for patients who after transverse tibial bone transportation, and explored its effect. Methods: With A set of targeted nursing intervention program, 17 patients with type 2 diabetic foot patients after transverse tibial bone transportation were nursed. After 2 months, the percentage of ulcer decreased, the visual analogue scale and the temperature of foot dorsum were used to evaluate the nursing effect. Results: The average temperature of foot dorsum was (28.49±1.12) ℃, the average visual analogue scale was (4.06±1.40) . And after 2 months, the average temperature of foot dorsum was (29.97± 1.26)℃, the average visual analogue scale was (1.94±1.92), and the area of ulcer in 15 cases (2 cases could not be counted due to toe amputations in treatment) decreased by 25%~100%, with an average of 59%, compared with that before intervention. Conclusions The implementation of evidence-based nursing can provide effective nursing intervention, relieve the pain of patients, and promote the rehabilitation of diabetic foot ulcers after transverse tibial bone transportation.

Objective To observe the treatment outcome of using reversed island flap based on cutaneous branch of dorsal metacarpal artery for middle-and-distal finger soft tissue defect.Methods From May,2015 to March,2017,21 cases of middle-and-distal finger soft tissue defect were treated with reversed island flaps based on cutaneous branch of dorsal metacarpal artery which were designed on the dorsal hand pedicled by dorsal metacarpal artery.The flap was then elevated and rotated at the point where digital common artery was anastomosed with the terminal branch of the dorsal metacarpal artery.The cutaneous nerve included in the flap was anastomosed with the terminal branch of digital nerve to restore sensation and the donor site was covered directly.Regular followed-up was performed after operation.Results Except 1 case was suffered with distal 1/3 skin flap necrosis,flaps were well developed.Postoperative follow-up period was 3 to 12 months.All these flaps recovered with satisfying appearance and quality,excellent sensation with grade S3 to S4 and 5 to 8 mm of two-point discrimination.Range of motion(ROM)of the metacarpalphangeal and interphalangeal joint of the injured fingers was good.The excellent and good rate was 95.2％.Conclusion Reversed island flap based on dorsal cutaneous branch of dorsal metacarpal artery transfer is an ideal method for repairing middle-and-distal finger soft tissue defect.The surgery is simple.Reliable blood supply and sensation can be achieved without sacrificing the primary artery and nerve.There is minor donor site damage and very few complications.

Objective: To investigate the effect of O-Z flap for the reconstruction of round-or elliptical-shaped defects following the scalp tumor removal. Methods: The resection of the scalp tumor resulted in a round or elliptical-shaped defect. Intraoperative frozen section identified pathological diagnosis, while also ensured margin being tumor-free. Based on the size and location of the defect, the mobility of the surrounding scalp and hair distribution, two local flaps were designed in opposite directions on each side of the defect. The two flaps were rotated to close the defect in an O-Z fashion. Results: From April 2016 to November 2017, 6 patients underwent defect reconstruction using the scalp O-Z flap. The etiologies included basal cell carcinoma (n=2), squamous cell carcinoma (n=2), and trichilemoma and epidermoid cyst (n=2). The defect size ranged from 3.0cm×3.5cm to 5.0cm×6.0cm. Necrosis on the distal of the flap had occurred in 1 patient. It was taken approximately 6% of the flap size, and healed after conservative management. Other flaps survived without any complications. After 3 to 12 months follow-up, the appearance of the sclap was satisfactory and tumor recurrence was not noticed. Conclusions The O-Z flap technique can be considered as an alternative for the medium-sized defect reconstruction of the scalp. The postoperative outcome of scalp was satisfactory, without disrupted hair orientation.

Objective:To investigate the expression of circ0008234 and miR-1205 in breast cancer and the oncology characteristics of CT.Methods:40 patients with breast cancer were collected as observational objects from Jan.2018 to Dec.2018 and 40 patients without breast cancer were selected as the control group. The expression levels of circ0008234 and miR-1205 of all patients were estimated by quantitative real-time polymerase chain reaction. Bioinformatics was used for the predictions of circ0008234 target miRNA. A dual-luciferase reporter assay was used to confirm the interaction between circ0008234 and miR-1205. All patients of the observation group were examined by multi-slice CT. CT images were analyzed through observing tumor size, shape, calcification area, lymph node metastasis and margin. The correlation between CT signs and the expression of circ0008234 and miR-1205 was further analyzed.Results:The levels of circ0008234 of observation group were significantly higher than those of the control group (2.23±0.86, 1.07±0.37, P=0.00) , but the expression levels of miR-1205 were lower than the control group (0.76±0.29, 1.04±0.29, P=0.00) . In the observation group, there were no significant differences in the expression of circ0008234 and miR-1205 among patients with different tumor marginal morphology and micro calcifications. However the expression of circ0008234 in patients with regular lump form were significantly higher than those in patients with inregular form (2.52±0.88, 1.91±0.74, P=0.025) , and the expression of miR-1205 were lower than those in patients with inregular form (0.66±0.30, 0.86±0.25, P=0.025) . In the observation group, the expression of circ0008234 in patients with mass diameter≥2 cm were significantly higher than those in patients with mass diameter<2 cm (2.59±0.95, 1.69±0.17, P=0.001) , but the expression of miR-1205 were lower than those in patients with mass diameter<2 cm (0.65±0.21, 0.92±0.33, P=0.003) . In the observation group, the expression of circ0008234 in patients with lymph node metastasis were higher than those without lymph node metastasis (2.55±1.09, 1.94±0.44, P=0.022) , but the expression of miR-1205 in patients with lymph node metastasis were lower than those without lymph node metastasis (0.65±0.26, 0.85±0.30, P=0.027) . miR-1205 was verified as a direct target of circ0008234 by luciferase assay. circ0008234 could negatively regulate the expression of miR-1205. Conclusion:There is a correlation between CT imaging signs and the expression of circ0008234 and miR-1205 in patients with breast cancer, which can provide more reference for the judgment of malignant degree and prognosis of patients with breast cancer.

Objective:To evaluate the clinical outcome of transplantation of metatarsophalangeal and proximal interphalangeal joint of the second toe with toe preservation for repair of traumatic digital arthritis.Methods:From February, 2016 to June, 2018, nine cases with traumatic digital arthritis were treated, including 7 males and 2 females aged from 19 to 46 (average 26.7) years. Three cases had index finger and 6 middle fingers injuried. Four cases had arthritis in metacarpophalangeal joint (MP) and 5 in proximal interphalangeal joint (PIP). All cases with digital arthritis were secondary to trauma. The involved digital joints were reconstructed by transplanting the MP or PIP of the second toes. At the same time, the affected joints (7 cases) or autologous iliac bone grafts (2 cases) were used to repair the bone defects to retain the length of toes. The donor site were closed directly. The appearance and healing of fractures of the fingers and toes, range of motion (ROM) of the transplanted digital joint, healing of the donor site, foot function and complications were observed.Results:All 9 grafted joints survived. In 1 case, the bone defect in the donor site was fixed with iliac bone graft and mini-plate. The wound did not heal at 1 week after operation, which was considered as a rejection of internal fixator. The wound healed smoothly after having the plate removed and replaced it with a cross-fixation by Kirschner pins. Duration of postoperative followed-up was 6-30 (mean 16.3) months. Primary postoperative healing was achieved in all cases. The bone healing time in the hand was 7 to 10 (mean 8.3) weeks. The appearance and function was satisfactory. The postoperative range of motion (ROM) in the transferred MP was 50°-75°(mean 65.3°), and ROM of PIP was 10°-80°(mean 61.5°). According to the evaluation standard of upper limb function set up by the Society of Hand Surgery of Chinese Medical Association, excellent in 5 cases, good in 3 cases and fair in 1 case, with an overall satisfaction of 88.9%. The bone healing time in the foot was 9 to 12 (mean 10.2) weeks. All cases presented with good appearance of the toe without obvious affect to walking and running. For the ilium, there was only an inconspicuous linear scar without any discomfort in the donor iliac area of 2 cases.Conclusion:Transfering of MP and PIP of the second toe with toe preservation can restore the anatomy structure and function of the digital joint. Meantime, the use of autogenous iliac bone graft to replace the donor site defect may retain the length of the toe and minimizes the injury to the donor site.

Chronic atrophic gastritis (CAG) and gastric intestinal metaplasia (GIM) significantly increase the risk of gastric cancer. Blocking the development of CAG and GIM would help to decrease the incidence of gastric cancer. It was revealed that eradication of Helicobacter pylori could reverse gastric mucosa atrophy. Recent studies reported that GIM could be reversed to a certain extent. Clinical studies demonstrated that Lamb′s tripe extract and vitamin B12 capsule exhibited significant reversal effects on GIM. The present study systemically reviewed the diagnosis and treatment of CAG and clinical application of Lamb′s tripe extract and vitamin B12 capsule, and established the specialist instruction that would guide the reversal treatment of CAG and GIM.

Chronic atrophic gastritis (CAG) and gastric intestinal metaplasia (GIM) significantly increase the risk of gastric cancer. Blocking the development of CAG and GIM would help to decrease the incidence of gastric cancer. It was revealed that eradication of Helicobacter pylori could reverse gastric mucosa atrophy. Recent studies reported that GIM could also be reversed to a certain extent. Clinical studies demonstrated that Lamb’s tripe extract and vitamin B12 capsule exhibited significant reversal effect on GIM. The present study systemically reviewed the diagnosis and treatment of CAG and clinical application of Lamb’s tripe extract and vitamin B12 capsule, and established the specialist instruction that would guide the reversal treatment of CAG and GIM.