Objective To investigate the safety and efficacy of totally no tube three-port thoracoscopic surgery (TNTT) for thymic tumor via lateral thoracic approach. Methods The clinical data of patients with thymoma admitted to the Department of Thoracic Surgery of the General Hospital of Northern Theater Command from November 2021 to May 2022 were retrospectively analyzed. The patients were divided into a TNTT group and a single utility port video-assisted thoracic surgery (SVATS) group according to different surgical methods. The clinical data were compared between the two groups. Results A total of 111 patients were collected. There were 44 patients in the TNTT group, including 20 males and 24 females, with an average age of 60.11±8.64 years, and 67 patients in the SVATS group, including 30 males and 37 females, with an average age of 62.40±7.92 years. There was no significant difference between the two groups in the baseline data (P>0.05). The postoperative hospital stay and intraoperative blood loss were shorter or less in the TNTT group (P<0.05), and the visual analogue scale score 48 hours after the operation was smaller in the SVATS group (P<0.05). Conclusion TNTT has a good surgical safety, and can shorten postoperative hospital stay, reduce intraoperative blood loss, and has significant advantages in enhanced recovery after surgery, but SVATS can reduce postoperative pain in patients.

Objective To analyze the learning curve of Da Vinci robotic segmentectomy. Methods Cumulative sum analysis (CUSUM) was used to analyze the learning curve of Da Vinci robotic segmentectomy performed by the General Hospital of Northern Theater Command from February 2018 to December 2020. The learning curve was obtained by fitting, and R2 was used to judge the goodness of fitting. The clinical data of patients in different stages of learning curve were compared and analyzed. Results The first 50 patients who received Da Vinci robotic segmentectomy were included, including 24 males and 26 females, with an average age of 61.9±10.6 years. The operation time decreased gradually with the accumulation of operation patients. The goodness of fitting coefficient reached the maximum value when R2=0.907 (P<0.001), CUSUM (n) =0.009×n3−0.953×n2+24.968×n−7.033 (n was the number of patients). The fitting curve achieved vertex crossing when the number of patients reached 17. Based on this, 50 patients were divided into two stages: a learning and improving stage and a mastering stage. There were statistical differences in the operation time, intraoperative blood loss, postoperative drainage volume, number of lymph node dissection, postoperative catheter time, postoperative hospital stay, and postoperative complications between the two stages (P<0.05). Conclusion It shows that the technical competency for assuring feasible perioperative outcomes can be achieved when the cumulative number of surgical patients reaches 17.

OBJECTIVE: To investigate humanistic practice ability of nurses in a general hospital in Hunan Province and analyze the factors affecting their practices to provide evidence for interventions to improve humanistic practice ability of the nurses. METHODS: A total of 1196 nurses were surveyed using a self-designed questionnaire and a nurse humanistic practice ability assessment scale questionnaire for assessment of their abilities for humanistic care practice, psychological adjustment, interpersonal communication, self-management, ethics and legal practice. Univariate and multivariate analyses were performed for analysis of the factors affecting the practice abilities of the nurses. RESULTS: The total score of humanistic practice ability of the 1196 nurses was 105.69±16.45 (the full score of the scale was 130), and the scores of humanistic care practice ability, psychological adjustment ability, interpersonal communication ability, self-management ability, ethics and legal practice ability were 40.95±6.46, 16.41±2.66, 16.41±2.66, 11.32±2.05 and 12.43±2.00, respectively. Univariate analysis and multiple linear regression analysis showed that gender (P=0.033), age (P < 0.001), department (P=0.015), working years (P < 0.001), professional title (P < 0.001), first academic degree (P < 0.001), highest academic degree (P < 0.001), family location (P=0.010), marital status (P=0.023), number of patients to care for (P=0.022), number of children (P=0.001), previous humanities related training (P < 0.001), training times (P < 0.001), and care received from family members (P < 0.001) and colleagues (P < 0.001) were all the factors affecting humanistic practice ability of the nurses. Among these factors, age, working in department of obstetrics and gynecology and emergency department, professional title, humanities training, and care from family and colleagues explained 20.7% of the variance. CONCLUSION The humanistic practice ability of nurses in this general hospital is above the average level, but their self-management ability needs to be improved. Intervention measures should be implemented to improve the nurses' humanistic practice ability including more attentions to the key groups and departments, strengthening the training of humanistic practice ability, and improving the promotion assessment system.
Child ; Female ; Pregnancy ; Humans ; Hospitals, General ; Emergency Service, Hospital ; Multivariate Analysis ; Research Design

OBJECTIVES: To investigate the clinical treatment outcomes and the changes of the outcomes over time in extremely preterm twins in Guangdong Province, China. METHODS: A retrospective analysis was performed for 269 pairs of extremely preterm twins with a gestational age of <28 weeks who were admitted to the department of neonatology in 26 grade A tertiary hospitals in Guangdong Province from January 2008 to December 2017. According to the admission time, they were divided into two groups: 2008-2012 and 2013-2017. Besides, each pair of twins was divided into the heavier infant and the lighter infant subgroups according to birth weight. The perinatal data of mothers and hospitalization data of neonates were collected. The survival rate of twins and the incidence rate of complications were compared between the 2008-2012 and 2013-2017 groups. RESULTS: Compared with the 2008-2012 group, the 2013-2017 group (both the heavier infant and lighter infant subgroups) had lower incidence rates of severe asphyxia and smaller head circumference at birth (P<0.05). The mortality rates of both of the twins, the heavier infant of the twins, and the lighter infant of the twins were lower in the 2013-2017 group compared with the 2008-2012 group (P<0.05). Compared with the 2008-2012 group, the 2013-2017 group (both the heavier infant and lighter infant subgroups) had lower incidence rates of pulmonary hemorrhage, patent ductus arteriosus (PDA), periventricular-intraventricular hemorrhage (P-IVH), and neonatal respiratory distress syndrome (NRDS) and a higher incidence rate of bronchopulmonary dysplasia (P<0.05). CONCLUSIONS There is a significant increase in the survival rate over time in extremely preterm twins with a gestational age of <28 weeks in the 26 grade A tertiary hospitals in Guangdong Province. The incidences of severe asphyxia, pulmonary hemorrhage, PDA, P-IVH, and NRDS decrease in both the heavier and lighter infants of the twins, but the incidence of bronchopulmonary dysplasia increases. With the improvement of diagnosis and treatment, the multidisciplinary collaboration between different fields of fetal medicine including prenatal diagnosis, obstetrics, and neonatology is needed in the future to jointly develop management strategies for twin pregnancy.
Bronchopulmonary Dysplasia/epidemiology* ; Female ; Gestational Age ; Humans ; Infant ; Infant, Extremely Premature ; Infant, Newborn ; Pregnancy ; Respiratory Distress Syndrome, Newborn/epidemiology* ; Retrospective Studies ; Treatment Outcome

Objective　MicroRNAs are differentially expressed in colorectal cancer tumor tissues and adjacent normal tissues, which play an important role in the development of colorectal cancer. This study aims to investigate the expression of microRNA-7-5p in colorectal cancer patients and its influence on the proliferation and apoptosis of colon cancer cell CaCo2.　Methods　The high-throughput microarray was used to screen differentially expressed microRNAs, and real-time quantitative PCR (RT-PCR) was used to detect the expression of microRNA-7-5p in 10 cases of colorectal cancer patients and corresponding adjacent normal tissues. Western blot was performed to detect the expression of intestinal trefoil factor (TFF3) in different tissues and CaCo2 cells after transfection with microRNA-7-5p. The expression of TFF3 in different tissues and CaCo2 cells transfected with microRNA-7-5p was detected. TUNEL combined with flow cytometry was used to detect the apoptosis of CaCo2 cells after transfection. The CCK-8 assay was used to detect the proliferation of CaCo2 cells after transfection.　Results　The relative expression of MicroRNA-7-5p in colorectal cancer tissue was 0.409 ± 0.095, which was significantly lower than that of normal tissue adjacent to cancer (1.000 ± 0.014), and the difference was statistically significant (P <0.01). The relative expression of TFF3 in colorectal cancer tissues was significantly higher than that in normal adjacent tissues (P <0.01). The relative expression of TFF3 in CaCo2 cells decreased in the overexpressed microRNA-7-5p of the control group (0.729 ± 0.041). The proliferation ability (0.930 ± 0.007) was significantly lower in the blank control group (0.990 ± 0.005) (P <0.01), and it could increase the proportion of early apoptotic cells (50.700 ± 0.989) and late apoptotic cells (40.525 ± 0.515).　Conclusion　MicroRNA-7-5p is lowly expressed in colorectal cancer and is associated with the occurrence and development of colorectal cancer. Up-regulated microRNA-7-5p inhibits the proliferation of colon cancer cell CaCo2 and promotes its apoptosis.

OBJECTIVE: To study the effect of functional chewing training (FuCT) on masticatory function, the severity of tongue thrust, and the severity and frequency of drooling in children with cerebral palsy. METHODS: A prospective study was performed for 48 children who were diagnosed with oral motor dysfunction from January 2019 to January 2020, and they were randomly divided into an FuCT group and an oral motor training group, with 24 children in each group. Both groups received FuCT or oral motor training for 12 weeks, and then they were evaluated in terms of the changes in the masticatory function, the severity of tongue thrust, and the severity and frequency of drooling. RESULTS: There were no significant differences between the two groups in the masticatory function, the severity of tongue thrust, and the severity and frequency of drooling before treatment (P>0.05). After the 12-week training, the FuCT group showed significant improvements in the masticatory function and the severity of tongue thrust and drooling (P<0.05), but with no improvement in the frequency of drooling (P>0.05), while the oral motor training group had no improvements in the masticatory function, the severity of tongue thrust, and the severity and frequency of drooling (P>0.05). After the 12-week training, the FuCT group had more significantly improvements in the severity of tongue thrust and the severity and frequency of drooling than the oral motor training group (P<0.05). CONCLUSIONS FuCT can effectively improve the masticatory function, the severity of tongue thrust, and the severity and frequency of drooling in children with cerebral palsy.
Cerebral Palsy ; Child ; Humans ; Mastication ; Prospective Studies ; Sialorrhea

Background/Aims: To determine the value of salivary pepsin in discriminating sub-types of gastroesophageal reflux disease (GERD) and GERD-related disorders. Methods: Overall, 322 patients with different sub-types of GERD and 45 healthy controls (HC) were studied. All patients took Gastroesophageal Reflux Disease Questionnaire (GerdQ) and underwent endoscopy and 24-hour esophageal pH monitoring and manometry. Salivary pepsin concentration (SPC) was detected by using colloidal gold double-antibody immunological sandwich assay. Oral esomeprazole treatment was administrated in the patients with non-erosive reflux disease (NERD) and extra-esophageal symptoms (EES). Results: Compared to HC, patients with erosive esophagitis, NERD, EES, EES plus typical GERD symptoms, or Barrett’s esophagus had a higher prevalence of saliva and SPC (all P < 0.001). There was no significant difference in the positive rate for pepsin in patients with functional heartburn or GERD with anxiety and depression, compared to HC. After esomeprazole treatment, the positive rate and SPC were significantly reduced in NERD (both P < 0.001) and in EES (P = 0.001 and P = 0.002, respectively). Of the 64 NERD patients, 71.9% (n = 46) were positive for salivary pepsin, which was significantly higher than the rate (43.8%, n = 28) of pathological acid reflux as detected by 24-hour esophageal pH monitoring (P = 0.002). Conclusions Salivary pepsin has an important significance for the diagnosis of GERD and GERD-related disorders. Salivary pepsin and 24-hour esophageal pH monitoring may complement with each other to improve the diagnostic efficiency.

Objective: To study the efficacy, safety and long-term outcomes of integrated strategy of bortezomib-based induction regimens followed by autologous hematopoietic stem cell (ASCT) and maintenance therapy in Chinese multiple myeloma (MM) patients. Methods: 200 MM patients receiving integrated strategy of bortezomib--based induction regimens followed by ASCT and maintenance therapy were retrospectively and prospectively analyzed from December 1. 2006 to April 30. 2018. Results: The complete remission rates (CR) and better than very good partial remission rates (VGPR) after induction therapy, transplantation and maintenance therapy were respectively 31% and 75.5%, 51.8% and 87.7%,73.6% and 93.4%. There was no difference between 4 cycles and more than 5 cycles induction chemotherapy. The negative rate of MRD detection by flow cytometry was 17.6% and 38.2% respectively after induction and 3 months after transplantation. The negative rate of MRD gradually increased during the maintenance therapy. The success rate of high dose CTX combined with G-CSF mobilization was 95.5% and transplantation related mortality (TRM) was zero. The median time to progress (TTP) was 75.3 months and the median overall survival (OS) was 99.5 months. TTP of patients obtaining CR and negative MRD after induction were longer that those of no CR and positive MRD. TTP and OS of patients receiving triple-drug induction and ASCT in early stage were longer than those of double-drug induction and ASCT in late stage. LDH≥240 U/L, high risk cytogenetics, ISS II+III stage and HBsAg positive were prognostic factors at diagnosis. However, only MRD and high risk cytogenetics were independent prognostic factors after transplantation and maintenance therapy. The clinical characteristics of patients of TTP ≥6 years were listed below: light-chain type M protein, ISS I stage, normal level of hemoglobin and platelet, normal LDH, HBsAg negative, chromosome 17p-negative, good response and sustained good response. Conclusions: Integrated strategy of bortezomib-based induction regimens followed by ASCT and maintenance therapy can significantly improve the short-term and long-term efficacy. The prognostic factors of TTP in different disease stages were different. Response to treatment, especially MRD, played a more important role in prognostic factors.
Antineoplastic Combined Chemotherapy Protocols ; Bortezomib/therapeutic use* ; Follow-Up Studies ; Hematopoietic Stem Cell Transplantation ; Humans ; Induction Chemotherapy ; Multiple Myeloma/therapy* ; Retrospective Studies ; Stem Cell Transplantation ; Transplantation, Autologous ; Treatment Outcome

Metabolomics is an omics subject which studies on the metabolic network of organism and the intrinsic metabolic change of entirety with the aim of clarifying the mechanism of medicinal effect and pathogenesis of disease, is similar to the whole concept theory of Chinese medicine. The mectabolomics technology helps to promote the modern process of traditional Chinese medicine. This article illustrated the application research on the concept of metabolomics, the syndrome of Chinese medicine, quality and components of traditional Chinese medicine, traditional Chinese medicine compounds and so on, explored the problems on the current research and the prospect meanwhile.

Objective To study the difference effects of enriching blood function of different medicinal parts in Angelica on the hemolytic blood deficiency in rats.Methods Wistar rats were randomly divided into 6 groups:blank group,model group,positive control group,Angelica group,Angelica body group,Angelica tail group.The hemolytic blood deficiency rats was established by acetyl phenylhydrazine hydrochloride.Rats in normal and model groups were orally administered with saline,while rats in positive control group were orally treated with Lvjiaobuxue granule at the dose of 3.60 g · kg-1.Water decoction of Angelica,Angelica body and Angelica tail groups were orally at the dose of 10.8g · kg-1.All the drugs were administered to rats for consecutive 12 d.The contents of red blood cell (RBC),hematocrit (HCT),hemoglobin (HGB),platelet (PLT),mean corpuscular volume (MCV),mean corpuscular hemoglobin(MCH) and mean corpuscular hemoglobin concentration(MCHC) were detected by hematology analyzer.While liver index (LI),thymus index (TI),spleen index (SI),reticulocyte (RC),and marrow karyocyte were calculated.After collecting thighbone,marrow cell cycle was detected by flow cytometry method flow cytometry.Results With the treatment of Angelica and Angelica body water decoction,the whole blood contents of RBC,HGB,HCT,PLT,MCHC were (6.05 ±0.22),(6.12 ±0.12) 1012/L;(155.80 ±4.89)％,(154.40 ±5.19)％;(53.79±1.88),(53.27 ± 1.57) g · L-1;(68.21 ± 5.63),(67.53 ± 5.11) 1010/L;(289.70 ± 3.94),(289.91 ± 8.41)g · L-1,respectively in each group,which were obviously higher than that of model group (P ＜ 0.05,P ＜ 0.01).The contents of MCH,MCV in Angelica and Angelica body groups were (25.75 ± 0.44),(25.23 ± 1.09) pg;(88.88 ± 1.67),(87.01 ±2.72) fl,which were lower than that of model group(all P ＜0.05).After used by Angelica tail,the contents of RBC,HGB,HCT were (5.69 ± 0.40) 1012/L,(123.10 ± 3.70) ％,(51.41 ± 2.03) g · L-1,which were higher than that of model group (all P ＜ 0.05).Conclusion Angelica and Angelica body,in which has same enrichment blood effect has effect of enriching blood on the hemolytic blood deficiency rats,and Angelic tail has weaker effect of enriching blood.