Objective To compare the clinical safety and efficacy of CT-guided hook-wire localization of≤10mm pulmonary ground-glass nodule(GGN)via different path ways before video-assisted thoracoscopic surgery(VATS).Methods The clinical data of a total of 128 patients with 10 mm pulmonary GGN,who received CT-guided hook wire localization before VATS at The Third Hospital of Mianyang of China between July 2018 and March 2023,were retrospectively analyzed.According to the puncturing localization path way mode,the patients were divided into vertical puncturing group(n=88)and non-vertical puncturing group(n=40).The number of puncturing times,the time spent for puncturing localization,the success rate of puncture,the operation time of VATS,and puncture-related complications of the two groups were recorded.Results No statistically significant differences in the gender,age,smoking history,GGN location,puncture position,nodule size,density characteristics of GGN,emphysema,and nodules-pleura distance existed between the two groups(all P＞0.05).Compared with non-vertical puncturing group,in vertical puncturing group the number of puncturing times was smaller,the time spent for localization was shorter,the incidence of pneumothorax was lower,and the operation time of VATS was shorter,the differences in all the above indexes between the two groups were statistically significant(all P＜0.05);and the subgroup analysis of patients whose GGN was overlapped with rib shadow obtained the same results.Binary logistic regression analysis revealed that non-vertical puncturing and the number of puncturing times were the independent risk factors for the occurrence of pneumothorax.Conclusion CT-guided hook-wire localization of≤10mm pulmonary GGN before VATS is clinically safe and effective.Under the condition when the lesion can be localized within the range of 2.0cm and the shadow overlapping of GGN with the rib and blood vessel can be effectively avoided,vertical puncturing path way mode should be preferred,which can effectively reduce the incidence of pneumothorax and shorten the operation time of VATS.

Objective To analyze the clinical efficacy and safety off emoral head replacement(FHR)assisting by the traction table in direct anterior approach(DAA)for the treatment of femur neck fractures in gerontal patients.Methods A retrospective analysis was conducted on 79 elderly patients who under went FHR for femoral neck fractures from March 2019 to July 2020.A total of 42 patients underwent FHR through DAA by using traction table were assigned to the observation group and 37 patients receiving FHR through the PLA to the control group.The perioperative data,follow-up results and complications were compared between the two groups.Results The observation group was significantly superior to the control group in intraoperative blood loss(P<0.05),where as the former was inferior to the latter in preoperative preparation time(P<0.05).There was no significant difference in anesthesia time and operation time between the two groups(P>0.05).The observation group resumed first postoperative standing time,partial-weight bearing walking time and full-weight bearing walk-ing time significantly earlier than control group(P<0.05).Harris score at 1 month after the operation in the observation group were significantly higher than that of the control group(P<0.05),whereas which became not statistical significant between the two groups in 6 months and 1 year(P>0.05).No significant difference was found between the two groups for the incidence of complications(P>0.05).Conclusion DAA-FHR assisting by the traction table for the treatment of femur neck fractures in the elderly was effective and safe,but the preoperative preparation time was longer.

Objective:To investigate the relationship of blood lipid levels with bone mass and fracture risk in elderly patients with type 2 diabetes mellitus (T2DM).Methods:A total of 744 elderly patients with T2DM who were treated in Tangshan Second Hospital from November 2018 to May 2020 were divided into normal bone mass group, low bone mass group and osteoporosis group according to bone mass levels. The total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C) and triglyceride (TG) levels in the three groups were compared, and the relationship between lipid indexes and bone mass was analyzed. The risk of fracture was calculated in the low bone mass group, and the relationship between lipid index and fracture risk was analyzed by linear regression. The blood lipid index between subjects with fracture and without fracture in osteoporosis group was compared, and the relationship between blood lipid index and fracture was analyzed by logistic regression.Results:There were significant differences in gender and age among the three groups (χ 2=38.80, F=4.94, P<0.05). The normal bone mass group had the smallest proportion of women and the youngest average age, while the osteoporosis group had the largest proportion of women and the average age. maximum. The LDL-C level in normal bone mass group was higher than those in the low bone mass group and the osteoporosis group, and LDL-C level in the low bone mass group was higher than that in the osteoporosis group ( F=3.38, P<0.05). In the low bone mass group, the risk of systemic fracture was 3.50% (2.40%, 4.10%) and hip fracture was 0.99% (0.80%, 1.20%). Linear regression showed that LDL-C and TG were positively correlated with the risk of systemic fractures in the low bone mass group (LDL-C: B=0.98, P=0.006;TG: B=0.23, P=0.024);TG was positively correlated with the risk of hip fracture in the low bone mass group ( B=0.16, P=0.002). In the osteoporosis group, the levels of HDL-C and LDL-C were lower in the patients with fractures than those without fractures ( t=3.24, P=0.001; t=2.98, P=0.003). Logistic regression analysis showed that higher HDL-C and LDL-C levels were protection factors for fracture risk in the osteoporosis group ( β=-2.73, P=0.009, OR=0.06, 95 %CI=0.04-0.10; β=-0.15, P=0.033, OR=0.83, 95 %CI=0.74-0.99). Conclusion:The relationship of serum lipid index with bone mass and fracture risk in hospitalized elderly T2DM patients is complicated, it is suggested to set individual blood lipid control targets according to the bone mass of patients.

Objective:To investigate changes in autonomic nervous system function in elderly coronary heart disease patients with hypertension.Methods:Clinical data of 186 patients with coronary heart disease(CHD)from January 2017 to January 2021 in our hospital were retrospectively collected.Patients were divided into the CHD group(n=93)and the CHD with hypertension group(n=93)according to whether they had hypertension.All subjects underwent 24-hour dynamic electrocardiogram, and differences in heart rate variability(HRV)were analyzed and compared between the groups.Results:Values from time-domain parameters for HRV included the standard deviation of the normal-to-normal R-R intervals( SDNN)[(77.4±15.1)ms vs.(114.6±25.9)ms, t=11.97, P<0.05], the standard deviation of sequential five-minute R-R interval means( SDANN)[(66.8±14.5)ms vs.(97.4±25.0)ms, t=10.21, P<0.05], the SDNN index[(34.1±11.4)ms vs.(51.9±18.0)ms, t=8.07, P<0.05], the root mean square successive difference( rMSSD)[(26.1±13.9)ms vs.(36.1±27.2)ms, t=3.18, P<0.05], and the percentage of successive normal interbeat intervals greater than 50 milliseconds(PNN50)[(5.0±6.4)% vs.(8.3±11.0)%, t=2.53, P<0.05], and were lower in the CHD with hypertension group than in the CHD group.Values from frequency-domain parameters for HRV included low frequency(LF)[(168.9±202.8)ms vs.(443.6±663.6)ms, t=3.78, P<0.05], high frequency(HF)[(203.3±202.5)ms vs.(499.5±1222.7)ms, t=2.28, P<0.05], and the LF/HF ratio(1.0±0.7 vs.1.3±0.8, t=3.18, P<0.05), and were lower in the CHD with hypertension group than in the CHD group. Conclusions:Impairment of cardiac autonomic nervous system function is more serious in elderly CHD patients with hypertension than in elderly CHD patients.Heart rate variability is a valuable clinical indicator and may be used for treatment targets in evaluating dysfunction of the autonomic nervous system in CHD patients with hypertension.

AIM: To investigate the effects of oridonin on the invasion and migration of hepatocelluar carcinoma cells.METHODS: Human hepatocelluar carcinoma MHCC-97H cells were cultured and treated with 5, 10 or 20 μmol/L oridonin.The migration ability was measured by wound healing assay.The invasion ability was examined by Transwell invasion assay.The adhesion capabilities were evaluated by adhesion assay.The protein levels of LIM kinase-1 (LIMK-1), cofilin and phosphorylated cofilin (p-cofilin) were determined by Western blot.RESULTS: Oridonin inhibited the migration, invasion and adhesion abilities of MHCC-97H cells in a dose-dependent manner (P<0.05).After oridonin treatment, the expression of cofilin had no obvious change, but the protein levels of LIMK-1 and p-cofilin decreased significantly.CONCLUSION: Oridonin inhibits the invasion and migration of MHCC-97H cells.The mechanism may be related with the regulatory effect of oridonin on LIMK-1/cofilin signal transduction pathway.

Objective To study the inhibition effect of miR-106a inhibitor on tumor growth of ovarian cancer xenografts mice. Methods BALB/c mice were selected as experimental animals, ovarian cancer SKOV-3 cells transfected with miR-106a inhibitor and its negative control were inoculated subcutaneously, intratumoral injection of miR-106a inhibitor and its negative control were continued after tumor formation, and they were enrolled as treatment group and model group, respectively. Tumor volume and weight as well as Ki-67 and programmed cell death 4 (PDCD4) expression were determined; miR-106a inhibitor and its negative control as well as miR-106a mimic and its negative control were transfected into SKOV-3 cells, and expression of PDCD4 in cells was determined. Results Tumor tissue volume and weight as well as mRNA expression and protein expression of Ki-67 in treatment group were significantly lower than those in the model group while mRNA expression and protein expression of PDCD4 were significantly higher than those in the model group; transfection of miR-106a mimic could decrease mRNA expression and protein expression of PDCD4 in SKOV-3 cells, and transfection of miR-106a inhibitor could increase mRNA expression and protein expression of PDCD4 in SKOV-3 cells. Conclusions Transfection of miR-106a inhibitor can inhibit the growth of tumor in ovarian cancer xenografts mice through increasing the expression of PDCD4.

Objective: To establish a quantitative model for evaluating the degree of traditional Chinese medicine (TCM) syndromes often seen in patients with coronary heart disease (CHD). Methods: Medical literature concerning clinical investigation of TCM syndromes of CHD was collected and organized, and the "Hall for Workshop of Metasynthetic Engineering" expert symposium method was applied. First, the 100 millimeter scaling was used for combining with scoring on degree of symptoms to establish a quantitative criterion for classification of symptom degree in CHD patients, and the model was established by using comprehensive analytic hierarchy process as the mathematical tool to estimate the weight of the criterion for evaluating qualitative syndromes in various layers by specialists. Then the model was verified in clinical practice and the outcomes were compared with fuzzy evaluation from the specialists. Results: A total of 287 clinical observation forms on CHD cases were collected, and 167 forms were available after excluding any irregular forms. The results showed that basic coincidence rate between the outcomes derived from specialists and those from the model was 68.26% (114/167), and part coincidence rate was 88.62%(148/167). Conclusion: This model, with good rationality and feasibility, has a high coincidence rate with fuzzy evaluation from specialists, and can be promoted in clinical practice. It is a good quantitative model for evaluating the degree of TCM syndromes of CHD.

Objective To investigate the value of time-intensity curve of dynamic contrast enhancement MR imaging in the discrimination of benign and malignancy in musculoskeletal tumors. Methods Ninety patients were examined with fast acquisition with muhiphase enhanced fast GRE series. The TIC of lesions were obtained using slope images in which pixel intensity reflected the slope value. The curves were classified according to their shapes as type Ⅰ , washout enhancement; type Ⅱ, plateau enhancement; type Ⅲ, gradual enhancement. Taking pathological diagnosis as gold standard, the power of the maximal enhancement slope and curve types in discriminating benign and malignant lesions was evaluated by appropriate statistic analysis. Results There were 49 malignant and 44 benign lesions. The distribution of curve types for malignant tumors was type Ⅰ 75.5% ( 37/49), type Ⅱ 24. 5% (12/49). While the numbers for benign tumors was type Ⅰ 59. 1% ( 26/44 ), type Ⅱ 15.9% ( 7/44 ) and type Ⅲ 25.0% ( 11/44 ), respectively. The patterns of curve types in malignant lesions were different from benign lesions significantly ( χ2 = 14. 008, P < 0. 01 ). The slope value in benign lesion was 6. 80 + 3. 35 and that in malignant lesion was 6. 80±2. 71. The difference was not statistically significant( t = 0. 008, P > 0. 05 ). Type Ⅰ and type Ⅱ (excluding lesions with typical benign morphology ) were suggestive of malignant tumors. Type Ⅲ was indicator of a benign lesion. The diagnostic indices for the shape of TIC criterion were: sensitivity 100%, specificity 50%, positive predictive value 78%, negative predictive value 100% and accuracy 82%, respectively. Conclusion Combined with the characteristic of morphology, the TIC improves the power of MR imaging in discriminating benign from malignant musculoskeletal tumors.

Objective To study the teaching effects of using case discussion-analysis method in the teaching course of Nursing Research among nursing students and then put forward suggestions for improving teaching.Methods By way of case discussion-analysis,a part of teaching contents of Nursing Research were taught to the 118 nursing students in 2003 grade.The teaching effect was evaluated by observing the design ability of scientific research,the learning interest,learning attitude,etc.Results The design ability of scientific research,recognition of Nursing Research,learning attitude and learning interest,etc of the students were significantly improved.Conclusions Case discussion-analysis method could effectively excite the interest and the potential of students and then improve the ability of discovering and solving problems.

OBJECTIVETo summarize the vascular and bile duct reconstruction experience in 40 cases of orthotopic liver transplantation in the southwest hepatobiliary surgery hospital.

METHODSThe clinical data of 40 cases of liver transplantation were analyzed retrospectively from Jan. 1999 to Nov. 2001.

RESULTSMortality rate of this group was 15.0%. Complications included: pulmonary infection (18 cases), MOSF (5 cases), intraperitoneal bleeding (4 cases), ARDS (8 cases), thrombus of hepatic artery (1 case), bile leakage (1 case), and cerebral hemorrhage (1 case). The longest survival time was 31 moths (1 case). There were 15 cases whose survival time was more than 1 year.

CONCLUSIONSThe key point of success of liver transplantation relies on excellent vascular and bile duct reconstruction technique.

Adult ; Biliary Tract ; physiopathology ; Blood Vessels ; physiopathology ; Female ; Humans ; Liver Transplantation ; adverse effects ; methods ; mortality ; Male ; Middle Aged ; Postoperative Complications ; mortality ; prevention & control ; Reconstructive Surgical Procedures ; methods ; Survival Rate