Totally thoracoscopic surgery is a branch of minimally invasive cardiac surgeries, and its operational indicators are expanding with the development of the medical and imaging devices compared with median sternotomy and other minimally invasive cardiac surgeries (such as thoracoscope-assisted small incision surgery and robotic surgery). The learning curve is significantly shortened through the professional technique training. Totally thoracoscopic cardiac surgery has many advantages, such as minor trauma, few serious complications, fast recovery, high patient acceptance and being suitable to our country's current situation. Therefore it will be one main direction of minimally invasive cardiac surgery. This article mainly introduced the current status of totally thoracoscopic technology in the field of cardiac surgery in China.
Objective To explore the mental health status of college students in the Xining region. Methods A total of 1 875 college students were surveyed by the Symptom Checklist-90 (SCL-90) and the Eysenck Personality Questionnaire (EPQ).Results Out of the 1 875 college students, 21.5% had at least one item scoring more than 3. Compared with the normal samples, college students scored significantly higher on SCL-90 indicating that the students had worse mental health. Significant differences were noted in the dimensions of EPQ between college students and the normal samples. The total score of SCL-90 was found to be significantly related to four factors, namely neuroticism, family economic status, school and nationality. Conclusion The mental health status of college students in Xining region is lower than that of the normal population, and factors of neuroticism, family economic status, school and nationality are related to their mental health.
ObjectiveUsing Quality in prognosis studies (QUIPS) analysis, this paper systematically reviewed the factors influencing the poor outcome of children with convulsive status epilepticus (CSE).MethodsTo longitudinal cohort studies on the prognostic evaluation of CSE mortality and mobidity in children.The retrieval time was from January 2008 to November 2019, and three system reviewers PUBMED, EMBASE, COCHRANE and other databases were used to search for literatures related carried out literature extraction and quality evaluation. According to the QUIPS analysis method, the included literatures were scored, the quality grade was divided, and the analysis variables of medium/high quality literatures with statistical significance were selected to draw a conclusion.ResultsQUIPS analysis was used to assess the literature quality, 17 medium/high quality literatures were included, and the factors with statistical significance (P<0.05) mentioned at least twice or more in≥2 medium/high quality literatures were selected, which were considered as important risk factors affecting prognosis.These factors include: etiology, age, duration of convulsion, refractory CSE, neuroimaging abnormalities.ConclusionFive risk factors indicating poor outcome of CSE in children were summarized. Due to the heterogeneity of various literature studies, Meta-analysis has not been completed, so it has certain limitations.
Background Hepatitis B is one of the major infectious diseases of mankind, and up to now, there is no effective way to handle it. Recent clinical trials have shown the potential advantages of Kurorinone an extract of Chinese herb, in treament of chronic HBV infection. Objectives Systermically review the safety and efficacy of Kurorinone in treatment of chronic HBV infection. Search strategy With the searching terms including Kurorinone, its products’ name, hepatitis B and chronic carrier status, the trials registers of the Cochrane Hepato- Biliary Group, the Cochrane Complementary Medicine Field, and the central database of the Cochrane Library as well as MEDILINE, EMBASE and Chinese Biomedical CD Database were searched from their date of inception onward. 20 Chinese medical journals and relevant academic conference proceedings have been searched by hand. The reference lists of identified documents were checked as the complementary search. Inclusion Criteria All RCTs that tested Kurorinone for chronic HBV infection were included in this review. Method of the review According the demand of Cochrane systematic review, selection of trial for inclusion, assessment of methodological quality, data extraction and data syntheses would be conducted for each included trial.
Total hip arthroplasty is an end-stage treatment for hip diseases such as hip osteoarthritis and osteonecrosis of the femoral head. Traditional surgery models are still mostly used in China, and related day surgery models abroad have shown that day surgery for total hip arthroplasty is as safe and feasible as traditional pattern without increase in complications and readmission. It can also shorten the length of hospitalization for patients, reduce hospitalization costs, thereby speeding up bed turnover and increasing the utilization of medical resources. This article reviews the patient admission, perioperative management, anesthesia and surgical techniques, post-discharge rehabilitation and nursing care of patients undergoing day surgery for total hip arthroplasty, and aims to providea reference for the development of day surgery for total hip arthroplasty in China.
ObjectiveTo analyze the quality of life (QOL) and psychological status among patients having undergone cardiac resynchronization therapy (CRT).
MethodsA total of 42 patients underwent CRT in our hospital during January 2011 to January 2014. All the patients were studied by MOS SF-36 scale and symptom checklist-90 (SCL-90) on overall QOL and psychological QOL, respectively. Another 42 healthy people in matched control group were also tested.
ResultsThe QOL of patients after CRT was significantly lower than that of healthy subjects (P<0.05). The psychological status score, which was obtained by the examination of SCL-90, was significantly higher in patients after CRT than in the healthy population (P<0.05). The length of the disease course and leveling exercise tolerance are the influence factors for the QOL and psychological status in patients undergoing CRT. Gender does not make any difference between the two groups.
ConclusionThe QOL of patients having undergone CRT is significantly lower than that of healthy people, and the psychological status score is higher. Medical staff need to pay attention to the mental illness (such as depression, anxiety and panic) of patients after CRT, especially in patients with long course of disease, and patients who fail to improve exercise tolerance or who are mateless. Psychological interventions can further improve the QOL of patients.
In recent years, transcatheter aortic valve replacement (TAVR) has developed rapidly in China, and the number and quality of operations have increased significantly. TAVR has become an important treatment strategy for patients with severe aortic stenosis and regurgitation following surgical aortic valve replacement. Prosthesis-patient mismatch (PPM) is one of the main complications after TAVR, but the incidence of TAVR-related PPM is significantly lower than surgical aortic valve replacement. Most studies believe that PPM has no significant effect on the clinical prognosis of most patients after TAVR, and only increases postoperative mortality in a specific population. This article will review the incidence, influencing factors, impact on clinical prognosis and related coping strategies of PPM after TAVR.
Objective To investigate the effect of FLEEOX regiment on nutritional status of advanced gastric cancer patients after neoadjuvant chemotherapy. Methods Forty-eight cases of advanced gastric cancer patients from December 2010 to October 2011 in this hospital were included into. The indexes of body composition and the blood related nutritional indicators before and after neoadjuvant chemotherapy were determined. Results After neoadjuvant chemotherapy，the body weight，intracellular fluid，body mass index，protein，body fat，body cell mass，and arm circumference mildly decreased；extracellular fluid，body water content，inorganic salts，bone mineral content，non-fat group，skeletal muscle，and arm muscle circumference mildly increased，but the differences were not statistically significant （P＞0.05）. The blood albumin，prealbumin，total protein，transferrin，and lymphocytes decreased at different degrees down，but the differences were not statistically significant （P＞0.05）. Conclusion Patients have no obvious changes in nutritional status during chemotherapy of FLEEOX regiment.
Objective
To evaluate the influence of resection status, pathological type, pathological stage and postoperative adjuvant therapy on prognosis of surgically treated thymic carcinoma.
Methods
In this retrospective study, 56 patients with surgically treated thymic carcinoma in the Department of Thoracic Surgery, Peking Union Medical College Hospital from January 2005 to December 2015 were enrolled. There were 30 males and 26 females aged 52.1±11.5 years ranging from 22 to 81 years. The survival curve was performed by Kaplan-Meier method. The prognostic factors affecting overall survival (OS) and disease-free survival (DFS) were analyzed by one-way analysis of variance (ANOVA).
Results
R0 resection was performed in 37 patients (67.9%), and other resections in 19 (32.1%); 13 patients suffered thymic carcinoma with Masaoka stage Ⅰ-Ⅱ, 26 Ⅲ, and 17 Ⅳ. Low-grade thymic carcinoma was found in 42 patients, and high-grade in 14. Postoperative radiotherapy, chemotherapy and chemoradiotherapy were performed on 17, 12 and 18 patients respectively and 9 patients were untreated. Forty-one patients was followed up for 1 to 10 years, and the follow-up rate was 73%. The 1-, 3- and 5-year OS rates were 93%, 74% and 61%, respectively. Resection status and pathological stage affected OS. Postoperative radiotherapy after R0 resection affected DFS, but did not affect OS.
Conclusion
Most patients with thymic carcinoma after surgery can survive for a long period, and R0 resection is the most important prognostic factor of thymic carcinoma. Postoperative radiotherapy after R0 resection in patients with Masaoka stage Ⅱ-Ⅲ is recommended.
Objectives Retrospective analysis of the Tibetan convulsive status epilepticus (CSE) for the aetiology, prognosis and its influencing factors in Tibet area. Methods Through electronic patient record, making “epilepsy”, “status epilepticus ”, “epileptic seizure” as keywords, convulsive status epilepticus patients in the People’s Hospital of Tibet Autonomous Region hospitalized from January 2015 to December 2020 were retrospectively observed, gathering their clinical data and aided examinations furthermore, and the prognoses were returned by telephone, meanwhile the functional status of those patients was assessed by the modified rankin scale. and the causes differ in gender, age, out-of-hospital antiepileptic treatment, family history of epilepsy and history of epilepsy were analyzed. The prognostic factors were analyzed by logistic regression. Results A total of 2 254 hospitalized patients with epilepsy were retrieved, including 331 CSE patients aged 14~84 years, 219 males and 112 females. There were 36 lost calls, 62 CSE deaths (21.01%), and 4 adverse outcomes (non-death)(1.7%).There were statistically significant differences in etiology of CSE in different ages and history of epilepsy (P<0.05), but there were no statistically significant differences in gender, out-of-hospital antiepileptic treatment, progression of refractory status epilepticus and family history of epilepsy. Cerebrovascular disease was the main cause of CSE in people aged 45 and over (54 cases), while the main cause of CSE in people aged under 45 was unknown (104 cases).Among the patients with previous history of epilepsy, the highest proportion was unknown cause [117 cases (48.8%)]; Among patients without a history of epilepsy, cerebrovascular disease [34 cases (37.4)] was the most common cause of CSE. Multivariate logistic regression analysis of prognostic factors of CSE showed that gender, age, GCS and electrolyte disorder had statistically significant effects on the death of CSE patients (P<0.05), while altitude and their duration and other factors had no statistically significant effects on the death of CSE patients (P>0.05). ConclusionsCerebrovascular disease is the leading cause of CSE in people aged 45 and over. Male, advanced age, low GCS score at discharge, and electrolyte disorder were risk factors.
