Channel: Scientific Research http://journal23.magtechjournal.com/Jwk3_gjyyws EN-US http://journal23.magtechjournal.com/Jwk3_gjyyws/EN/1007-1245/current.shtml http://journal23.magtechjournal.com/Jwk3_gjyyws 1007-1245 http://journal23.magtechjournal.com/Jwk3_gjyyws/EN/10.3760/cma.j.issn.1007-1245.2021.06.001 Objective To evaluate the diagnostic value of breast ultrasound, mammography, and MRI for breast ductal carcinoma in situ. Methods Forty cases of breast ductal carcinoma in situ treated in our hospital from June 2015 to June 2018 were retrospectively collected. All 40 patients were examined by ultrasonography, mammography and MRI if necessary. The detection rates of three kinds of image diagnosis methods were observed. Results A total of 36 cases of breast ductal carcinoma in situ were detected by ultrasonography, with the detection rate of 90.00% (36/40); 13 cases of breast ductal carcinoma in situ were detected by mammography, with the detection rate of 61.90% (13/21); 14 cases of breast ductal carcinoma in situ were detected by MRI, with the detection rate of 93.33% (14/15); the difference was statistically significant (P=0.011). When combined the three, the positive rate of diagnosis of breast ductal carcinoma in situ reached to 100.00% (40/40). Conclusion The sensitivity of ultrasonography and mammography in the diagnosis of breast ductal carcinoma in situ is general. The combined application of ultrasound, mammography, and MRI has a high detection rate of breast ductal carcinoma in situ.]]> http://journal23.magtechjournal.com/Jwk3_gjyyws/EN/10.3760/cma.j.issn.1007-1245.2021.06.002 http://journal23.magtechjournal.com/Jwk3_gjyyws/EN/10.3760/cma.j.issn.1007-1245.2021.06.003 http://journal23.magtechjournal.com/Jwk3_gjyyws/EN/10.3760/cma.j.issn.1007-1245.2021.06.004 Objective To evaluate the correlation between interleukin-6 (IL-6) concentration and frailty through meta-analysis. Methods Case-control studies on the relationship between IL-6 and frailty were collected by searching home and aboard databases including PubMed, EMBASE, Cochrane library, CNKI, CBMdisc, Wanfang, VIP. The retrieval time was from the establishment of each database to the analysis of data by Stata15.0 in February 2020. Results Seven qualified case-control studies with 1 644 participants were involved, including 330 frailty patients and 1 314 controls, the IL-6 level in patients with frail was higher (SMD=1.56, 95% CI: 0.81~2.31, P<0.001). The sensitivity analysis results were stable and the Egger's test indicated no significant publication bias (t=1.61, P=0.169). Conclusion High level of interleukin-6 may be a risk factor for frailty, but further study on specific etiological associations need to be done in a larger population in the future.]]> http://journal23.magtechjournal.com/Jwk3_gjyyws/EN/10.3760/cma.j.issn.1007-1245.2021.06.005 Objective To explore the surgical diagnosis and treatment methods and experience of giant anterior superior mediastinal tumors. Methods Through the retrospective analysis of 34 cases of giant anterior superior mediastinal tumors admitted to our hospital from 2013 to 2018, among them 13 cases underwent lateral anterolateral incision + sternal cross-split incision, and 21 cases underwent median thoracotomy. The surgical diagnosis and treatment methods of giant anterior superior mediastinal tumors were discussed. Results Thirty-four cases of giant anterior superior mediastinal tumors were surgically removed: 13 cases underwent lateral anterolateral incision + sternal cross-split incision, there were 12 (92.3%) cases of radical resection and 1 case of palliative resection; 21 cases underwent median thoracotomy, there were 18 (85.7%) cases of radical resection and 3 cases of palliative resection. In 34 cases, there were 3 cases of thymic squamous cell carcinoma, 1 case of highly aggressive B-cell lymphoma-diffuse large B-cell lymphoma, 14 cases of thymoma, 3 cases of sarcoma, 7 cases of mature teratoma, 3 cases of solitary fibrous tumor, 2 cases of seminoma, and 1 case of goiter. The operation time and blood loss of lateral anterolateral incision + sternal cross-split incision group were greater than those of the median thoracotomy group (both P<0.05), there was no statistically significant difference in the maximum tumor diameter between the two groups (P>0.05). However, for giant anterior superior mediastinal tumors those were close to the posterior wall of the sternum with invaded lung tissue, lateral anterolateral incision on the main body of the tumor + sternal cross-split incision could be used as a surgical incision and the surgical field was safer. Conclusion Surgery is the preferred treatment method for giant anterior superior mediastinal tumors. Preoperative enhanced CT has an important reference value for the surgical method and risk assessment, and the choice of surgical incision has an important auxiliary effect on the success of surgery.]]> http://journal23.magtechjournal.com/Jwk3_gjyyws/EN/10.3760/cma.j.issn.1007-1245.2021.06.006 Objective To evaluate the efficacy and safety of popliteal sciatic nerve block (PSNB) in multi-modal analgesia after Hallux Valgus surgery. Methods Forty-nine patients who underwent unilateral or bilateral Hallux Valgus surgery under intraspinal anesthesia from September 2014 to March 2020 were retrospective analyzed. The PSNB group (n=14) underwent postoperative ultrasound guided PSNB with 15 ml of 0.5% ropivacaine, and oral analgesics (paracetamol, tramadol, and celecoxib); the Oral group (n=35) only received aforementioned oral analgesics for pain control. The postoperative 6 h and 24 h rest/active pain NRS scores, the incidence of moderate to severe pain within postoperative 24 h, the requirement of rescue opioid analgesics, side effects, and patients' subjective satisfaction rating were observed and compared between the two groups. Results The median of postoperative 6 h rest NRS score in the PSNB group and the Oral group were 2.0 and 3.0 (P<0.05); the median of postoperative 24 h rest/active pain NRS scores were 0.0/1.5 and 1.0/3.0, the incidences of moderate to severe pain within postoperative 24 h were 14.3% (2/14) and 22.9% (8/35), the incidences of remedial opioid analgesics were 7.1% (1/14) and 2.9% (1/35), there were no statistically significant differences in the above mentioned indices (all P>0.05). No side effect was found in the PSNB group, there was a case of post-dural puncture headache in the Oral group, and the subjective satisfaction rate was 100% in both groups. Conclusion Adding PSNB to multi-modal analgesia management strategy for Hallux Valgus surgery may improve short term postoperative pain control, but has no impact on the need of rescue analgesics after surgery.]]> http://journal23.magtechjournal.com/Jwk3_gjyyws/EN/10.3760/cma.j.issn.1007-1245.2021.06.007 Objective To investigate the effectiveness and safety of ultrasound-guided erector spinae plane block (ESPB) combined with oxycodone patient controlled intravenous analgesia (PCIA) for postoperative analgesia in patients undergoing laparoscopic cholecystectomy (LC). Methods A total of 58 patients underwent laparoscopic cholecystectomy under general anesthesia, including 22 males and 36 females, with ASA I or II, they were randomly divided into two groups: single ESPB combined with PCIA group (group EP) and simple PCIA group (Group P). Patients in the group EP received ultrasound-guided ESPB before induction of anesthesia. Both groups were evaluated according to the numerical rating scale (NRS). When the NRS score was ≥4 points, oxycodone titration was administered intravenously until the NRS score was <4 points and then PCIA was used. Postoperative oxycodone titration; NRS scores before titration, at the end of titration, 1 h, 4 h, 8 h, 12 h, 16 h, 24 h later at rest and cough; the dose of oxycodone within 0~4 h, 4~8 h, 8~12 h, 12~16 h, and 16~24 h after surgery; the number of effective press of analgesic pump within 0~4 h, 4~8 h, 8~12 h, 12~16 h, and 16~24 h after surgery; the number of postoperative remedial analgesia and postoperative adverse reactions in the two groups were recorded. Results The postoperative titrated oxycodone dosage and the PCIA oxycodone dosage with 0~4 h and 4~8 h after surgery of the group EP were significantly less than those of the group P [0.0 (1.0, 2.0) mg vs.2.0 (0.0, 4.0) mg, 0.4 (0.4, 1.4) mg vs.0.4 (0.4, 1.4) mg, 0.4 (0.4, 0.4) mg vs.0.4 (1.4, 2.4) mg] (all P<0.05). The NRS scores at 1 hour after surgery at rest and cough in the group EP were significantly lower than those in the group P [(1.38±0.86) points vs.(1.92±0.83) points, (1.93±0.80) points vs.(2.50±0.59) points] (both P<0.05); the NRS scores at 4 hours after surgery at rest and cough in the group EP were significantly lower than those in the group P [(1.21±0.68) points vs.(1.71±0.69) points, (1.90±0.62) points vs.(2.29±0.69) points] (both P<0.05); the NRS scores at 8 hours after surgery at rest and cough in the group EP were significantly lower than those in the group P [(1.41±0.73) points vs.(2.00±0.59) points, (1.66±0.67) points vs.(2.21±0.83) points] (both P<0.01). The number of effective press of analgesic pump within 0~4 h and 4~8 h after surgery in the group EP were significantly lower than those in the group P [0.4 (0.4, 1.4) times vs.1.4 (0.4, 3.1) times, 0.4 (0.4, 0.4) times vs.1.4 (0.4, 2.4) times] (both P<0.05). Conclusion Ultrasound-guided ESPB can significantly reduce the PCIA dosage of oxycodone after LC, which is a safe and effective way of analgesia.]]> http://journal23.magtechjournal.com/Jwk3_gjyyws/EN/10.3760/cma.j.issn.1007-1245.2021.06.008 Objective To explore the application value of H2H management model in improving self-efficacy and mood state of leukemia patients. Methods A total of 68 patients with leukemia admitted to our hospital from June 1, 2019 to April 30, 2020 were divided into observation group and control group with the random number table method with 34 cases in each group. The control group was given routine nursing management, oral education for patients, such as drug guidance, regular review, nutrition, hygiene, complications protection and so on. The observation group was given H2H management on the basis of routine nursing. Before and after 4 weeks of intervention, the self-efficacy and mood state of the two groups were evaluated by GSES and POMS-SF respectively, the differences were compared and analyzed. Results There were no statistically significant differences in self-efficacy and mood state scores between the two groups before intervention (all P>0.05). After 4 weeks of intervention, the self-efficacy score of the observation group was (32.41±3.58), significantly higher than that of the control group [(23.47±3.10)]; the total score and scores of six dimensions of mood state in the observation group were significantly lower than those in the control group, the total score of mood state in the observation group was (65.00±5.34), significantly lower than that of the control group [(98.24±6.70)], with statistically significant differences between the two groups (all P<0.05). Conclusion The implementation of H2H management model can effectively improve the self-efficacy and mood state of leukemia patients.]]> http://journal23.magtechjournal.com/Jwk3_gjyyws/EN/10.3760/cma.j.issn.1007-1245.2021.06.009 Objective To explore the effect of painting therapy in the treatment of tension type headache (TTH). Methods A total of 113 female patients with TTH from November 2016 to June 2018 in Boya Women's College of Lianyungang were randomly divided into observation group and control group. The control group was given routine treatment (relieving pain, regulating emotion, improving sleep, and so on), and the observation group was given painting therapy (free painting) on the basis of the control group. Visual analogue scale (VAS) was used to evaluate the degree of headache of the patients, Hamilton anxiety scale (HAMA) and Hamilton depression scale (HAMD) were used to evaluate the mental state of the patients. The patients were followed up for 90 days after admission. Results Follow-up on the 90th day showed that the HAMA and HAMD scores of the observation group were (5.88±2.31) points, (6.48±2.76) points respectively, and those of the control group were (6.91±2.67) points, (7.72±3.11) points respectively, with statistically significant differences (both P<0.05); the VAS score of the observation group was (1.23±0.63) points, which was significantly lower than that of the control group [(1.60±0.88) points] (P<0.05); the frequency of headache attack in the observation group was (5.50±2.61) times, which was significantly lower than that of the control group [(6.67±2.85) times] (P<0.05); the proportion of taking analgesics in the observation group was significantly lower than that in the control group [5.4%(3/56) vs 17.9%(10/57)] (P=0.042). Compared with the control group, the proportion of anti-anxiety and depression drugs used in the observation group decreased on the 60th and 90th days, and there was statistically significant difference between the two groups on the 90th day (P<0.05). Conclusion Combined painting therapy can relieve the degree of headache, reduce the frequency of headache attacks, alleviate anxiety and depression symptoms in patients with tension type headache.]]> http://journal23.magtechjournal.com/Jwk3_gjyyws/EN/10.3760/cma.j.issn.1007-1245.2021.06.010 Objective To explore the relationship between self-management level and quality of life in maintenance hemodialysis patients. Methods A total of 95 patients with maintenance hemodialysis who were admitted to our hospital from January 2019 to December 2019 were selected. Hemodialysis patient self-management scale and health survey summary table were used to evaluate the self-management level and quality of life of the patients, and their correlation was analyzed. Results Ninety-five patients had a low self-management level with a total score of (52.18±7.36). The scores of each dimension from low to high were emotional processing, partnership, problem solving, and self-care. The scores of physiological function, physical pain, physiological function, energy, social function, emotional function, mental health, overall health, and the total score of 95 patients were lower than the domestic norm, with statistically significant differences (all P<0.001). According to the results of Spearman analysis, the self-management behavior of patients was significantly positively correlated with quality of life (P<0.05). Conclusion Maintenance hemodialysis patients have a low self-management level and poor quality of life. Self-management level and quality of life are positively correlated.]]> http://journal23.magtechjournal.com/Jwk3_gjyyws/EN/10.3760/cma.j.issn.1007-1245.2021.06.011 Objective To investigate the prevalence of hepatitis E virus (HEV) infection among Qingdao blood donors. Methods Blood samples were collected from donors in Qingdao from january 2015 to December 2016, included 773 eligible blood donors, and then tested for HEV related serological parameters (anti-HEV IgG, anti-HEV IgM, HEV Ag), compared with blood donors with elevated ALT (839 cases). Results The results of serum markers of HEV infection in 773 qualified blood donors showed anti-HEV IgG positive in 100 cases (12.94%), anti-HEV IgM positive in 6 cases (0.78%), no HEV Ag positive. The rate of anti-HEV IgG positive of the low age group was significantly lower than that of over 40 years old group (all P<0.01). There was no statistically significant difference in the rate of anti-HEV IgG, IgM positive between eligible blood donors and blood donors with elevated ALT (all P>0.05). HEV IgM reactive specimens were further detected for HEV RNA, all negative results. Conclusion The infection rate of HEV is lower among blood donors in Qingdao area. After the blood donors screened by ALT, the potential risk of transmission of HEV by blood transfusion is low.]]>