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知情同意教育对未成年女性尖锐湿疣患者的影响

目的评价知情同意教育和常规健康教育对未成年女性尖锐湿疣患者的影响。 方法选取2010年11月－2012年11月在门诊接受治疗的未成年女性尖锐湿疣患者62例，按就诊先后排序，单数作为对照组（31例），进行常规健康教育，双数作为观察组（31例），进行知情同意教育。 结果观察组患者6个月内均按时复诊，对照组患者21 d内按时复诊，21 d后至6个月内仅16例（51.6%）复诊。观察组和对照组患者治疗的有效率（93.5%，90.3%）、近期复发率（6.5%，9.6%）差异无统计学意义（P＞0.05），治愈率（74.2%，48.4%）、远期复发率（19.4%，41.9%）差异均有统计学意义（P＜0.05）。观察组治愈率明显增高，远期复发率相对较低。 结论有目的、有计划和系统的知情同意教育在提高未成年女性尖锐湿疣患者的治愈率和降低远期复发率方面优于常规健康教育。

全胸腔镜下支气管袖式成形肺癌切除术患者的护理体会

目的总结全胸腔镜下支气管袖式成形肺癌切除术患者的围手术期护理经验，提出护理体会。 方法回顾并总结2010年12月-2012年7月11例全胸腔镜下支气管袖式成形肺癌切除术患者的围手术期护理措施，并观察术后并发症发生情况。 结果1例因支气管胸膜瘘于术后49 d因呼吸道出血死亡，其余10例均顺利出院，且随访3个月均未发现吻合口狭窄。 结论正确的护理干预、医护一体化的围手术期管理，可减少术后并发症的发生，促进患者术后恢复。

姜黄素抗肿瘤机制研究进展

Laparoscopic Cholecystectomy on Porcelain Gallbladder in 13 Cases

Objective　To investigate the possibility of laparoscopic cholecystectomy （LC） on porcelain gallbladder. Methods　Twenty-four cases of porcelain gallbladder， who were operated in China Medical University， including 13 LC cases， from 2006 to 2008 were retrospectively reviewed. Results　Of 24 porcelain gallbladder cases (0.48%) in 4964 cholecystectomy patients， calcification of gallbladder in 87.50%(21/24) patients was diagnosed by ultrasonography. Of 13 patients who were cured by LC, one suffered from postoperative leak bile, no metastasis were found by following up 12 or 14 months in two gallbladder carcinoma cases. Conclusion　There’s specificity of ultrasonographic image in porcelain gallbladder, in which LC is safe to be performed and routine frozen pathology during operation is necessary.

胸外科危急值报告分析及护理对策的应用

目的分析胸外科常见危急值的种类及原因，探讨其护理对策。 方法收集2013年1月－12月四川大学华西医院胸外科报告的所有危急值，结合患者的临床资料进行分析，针对形成原因探讨相应的护理对策，并完善危急值的管理制度。 结果危急值报告共93例次涉及82例患者，其中7例患者多次出现危急值，出现2例次危急值4例，出现3例次危急值2例，出现4例次危急值1例。排除4例次假性危急值后，其余89例次危急值发生情况：血钾异常（＞6.0或＜3.0 mmol/L）72例次（80.90%），血糖异常（＞18.0或＜2.8 mmol/L）11例次（12.36%），血培养阳性3例次（3.37），人类免疫缺陷病毒阳性2例次（2.25%），凝血功能异常1例次（1.12%）。 结论胸外科常见的危急值与术后应激状态及电解质失衡有关，提供针对性的护理对策，落实危急值报告规范，对保证术后患者的安全和康复有重要意义。

Reliability and Validity of SF-36 Scale for Evaluating Quality of Life of Thoracic Surgery Patients

ObjectiveTo investigate the reliability and validity of Short-Form 36 Health Survey Scale (SF-36) for evaluating quality of life (QOL) of thoracic surgery patients in a specific regional medical center,and improve care and nursing plan for these patients. MethodsNinety-five patients who were admitted in Department of Thoracic Surgery of West China Hospital from March to May 2012 were enrolled in this study. Ninety-four patients finished a valid questionnaire study including 68 male and 26 female patients with their average age of 62.0±13.0 years. Preoperative diagnosis was squamous cell lung cancer in 8 patients,lung adenocarcinoma in 6 patients,small cell lung cancer in 1 patient,esophageal cancer in 12 patients and undefined lung mass in 67 patients. Postoperative diagnosis was squamous cell lung cancer in 39 patients, lung adenocarcinoma in 28 patients,small cell lung cancer in 8 patients,esophageal cancer in 12 patients,pulmonary tuberculosis in 3 patients and inflammatory pseudo-tumor in 4 patients. Chinese edition of SF-36 was used to evaluate patients' QOL. Cronbach's coefficients (α) and split-half reliability were used to assess its reliability. Its validity was assessed through factor analysis. ResultsCronbach's coefficients (α) of SF-36 were as followed:Physical Functioning (PF) 0.721,Role-Physical (RP) 0.859,General Health (GH) 0.721,Vitality (VT) 0.899,Social Functioning (SF) 0.852,Role-Emotional (RE) 0.872,and Mental Health (MH) 0.598. Split-half reliability of each part was PF 0.725,RP 0.784,GH 0.758,VT 0.749,SF 0.745,RE 0.740,and MH 0.426. Nine principal components were extracted by factor analysis and generally reflected the 8 dimensions of SF-36,which was correspondent to the SF-36 structure. ConclusionSF-36 scale can be used to measure QOL of thoracic surgery patients with good reliability and validity.

皮肤色素失禁症合并双眼视网膜病变一例

Research progress of clinical therapy for concha-type microtia

ObjectiveTo summarize the current progress of clinical therapy for concha-type microtia.MethodsThe domestic and overseas literature about the treatment of concha-type microtia was reviewed and the contents of operative timing, operation selection, and complications were analyzed.ResultsThe unified therapeutic schedule of the concha-type microtia has not yet been determined due to its complicated various therapeutic methods and unknown etiology. The operation methods commonly used in clinic are partial ear reconstruction with autologous costal cartilage framework and free composite tissue transplantation. The timing of the partial ear reconstruction depends on the development of costal cartilage and children’s psychological healthy. The timing of free composite tissue transplantation depends on the severity. It is recommended to perform the operation at about 10 years old for mild patients. For moderate patients, ear cartilage stretching should be performed at 1-2 years old and free composite tissue transplantation would be performed at about 10 years old. The complications of partial ear reconstruction with autologous costal cartilage framework for concha-type microtia mainly include framework exposure, deformation, infection, cartilage absorption, and skin necrosis. The complications of free composite tissue transplantation have not been reported.ConclusionEtiology and elaborated classifications with individualized treatment are the future research directions.

Predictive value of preoperative pulmonary function test indexes for postoperative pneumonia in patients undergoing upper gastrointestinal surgery

ObjectiveTo analyze the relationship between preoperative pulmonary function indexes and postoperative pneumonia (POP) in patients undergoing upper gastrointestinal surgery.MethodsThe clinical data of 303 patients who underwent lung function examination and upper gastrointestinal surgery in West China Hospital, Sichuan University from September 2020 to January 2021 were prospectively collected and analyzed. There were 217 males and 86 females, with an average age of 61.61±10.42 years. Pulmonary function was evaluated from four aspects including ventilatory function, pulmonary volume, diffusion function and airway resistance. Relevant pulmonary function indicators were displayed as the percentage of actual measured value to predicted value (%pred). The outcome index was pneumonia within 30 days after the surgery. Logistic regression was used to analyze the relationship between preoperative pulmonary function indicators and POP.ResultsA total of 196 patients with gastric cancer and 107 patients with esophageal cancer were included, and the incidence of POP in patients undergoing upper gastrointestinal surgery was 26.7% (81/303). Patients with preoperative low peak expiratory flow (PEF%pred) had a 3.094 times higher risk of developing POP than those with normal PEF%pred [OR=3.094, 95%CI (1.362, 7.032), P=0.007]. The incidence of POP had no correlation with the other preoperative indicators.ConclusionPreoperative PEF%pred may be an important indicator for predicting the occurrence of POP in patients undergoing upper gastrointestinal surgery.

Computer-aided prediction and molecular mechanism investigation of active components in compound Kushen injection inhibiting p21-activated kinase 1

Targeting p21-activated kinase 1 (PAK1) is a novel strategy for pancreatic cancer treatment. Compound Kushen injection contains many anti-pancreatic cancer components, but the specific targets are unknown. In this study, 14α-hydroxymatrine, an active component of Kushen injection, was found to possess high binding free energy with the allosteric site of PAK1 by molecular docking based virtual screening. Molecular dynamics simulations suggested that 14α-hydroxymatrine caused the α1 and α2 helices of the allosteric site of PAK1 to extend outward to form a deep allosteric regulatory pocket. Meanwhile, 14α-hydroxymatrine induced the β-folding region at the adenosine triphosphate (ATP)-binding pocket of PAK1 to close inward, resulting in the ATP-binding pocket in a “semi-closed” state which caused the inactivation of PAK1. After removal of 14α-hydroxymatrine, PAK1 showed a tendency to change from the inactive conformation to the active conformation. We supposed that 14α-hydroxymatrine of compound Kushen injection might be a reversible allosteric inhibitor of PAK1. This study used modern technologies and methods to study the active components of traditional Chinese medicine, which laid a foundation for the development and utilization of natural products and the search for new treatments for pancreatic cancer.