ObjectiveTo explore the value of fluorescence tracer technique in sentinel lymph node (SLN) orientation of cN0 papillary thyroid cancer. MethodsThe total clinical data of 40 cT1-3N0M0 thyroid cancer patients admitted from January 2015 to January 2016 in our hospital were collected, and the SLN with indocyanine green (ICG) as fluorescent trace agent were observed and detected, and the effect of ICG detecting SLN and the guide role of SLNB on the dissection of the central area of neck lymph nodes by intraoperative frozen biopsy pathology and postoperative paraffin pathology were analyzed. ResultsA total of 40 thyroid cancer patients were treated by SLNB and then conducted by the dissection of the central area of neck lymph nodes, and 37 cases detected SLN, so the detection rate was 92.5% (37/40). And a total of 98 SLNs were detected, 1-5 for each case, average of 2.65/case. Intraoperative frozen pathological detected 28 cases of patients with metastases in SLN, and 9 patients without metastasis, including 1 case with postoperative pathology detecting micrometastasis in SLN and other 8 cases without metastasis in the central area of neck lymph nodes. Three cases who were not detected the SLN showed no metastases in final postoperative paraffin pathology. The SLNB of ICG fluorescent tracer was with a sensitivity of 96.6% (28/29), false-negative rate of 3.45% (1/29). ConclusionThe fluorescent tracer technique can guide the dissection of the central of neck lymph node of cN0 thyroid cancer patients accurately with a high detection rate and advantages of high sensitivity in detecting the SLN of thyroid cancer.
ObjectiveTo investigate the needs for health education in chronic hepatitis B patients, in order to provide a theoretical basis for taking pertinent nursing intervention. MethodsBetween July and December 2011, self-made questionnaires on the needs for health education were used to investigate 70 in-patients with chronic hepatitis B. Meanwhile, factors associated with the needs of health education such as age, education, and the course of the disease were also analyzed. ResultsThe differences in the needs of health education were statistically significant among patients with different cultures, ages, and courses of disease (P<0.01). The needs of health education were correlated with culture, age and courses of disease. ConclusionThere are some deficiencies in the health education for chronic hepatitis B patients. In clinical practice, health education should be multidimensional and continuous based on the age, education degree and the course of the disease.
This paper presents a surgical optical navigation system with non-invasive, real-time, and positioning characteristics for open surgical procedure. The design was based on the principle of near-infrared fluorescence molecular imaging. The in vivo fluorescence excitation technology, multi-channel spectral camera technology and image fusion software technology were used. Visible and near-infrared light ring LED excitation source, multi-channel band pass filters, spectral camera 2 CCD optical sensor technology and computer systems were integrated, and, as a result, a new surgical optical navigation system was successfully developed. When the near-infrared fluorescence was injected, the system could display anatomical images of the tissue surface and near-infrared fluorescent functional images of surgical field simultaneously. The system can identify the lymphatic vessels, lymph node, tumor edge which doctor cannot find out with naked eye intra-operatively. Our research will guide effectively the surgeon to remove the tumor tissue to improve significantly the success rate of surgery. The technologies have obtained a national patent, with patent No. ZI.2011 1 0292374.1.
ObjectiveTo compare the effectiveness between open reduction and closed reduction of pediatric subtrochanteric fractures using elastic stable intramedullary nailing (ESIN). MethodsBetween January 2010 and January 2014, 22 children with subtrochanteric fractures were treated by ESIN internal fixation combined with hip cast fixation, and the clinical data were retrospectively reviewed. Closed reduction was used in 12 cases (group A) and miniopen reduction in 10 cases (group B). There was no significant difference in gender, age, sides, fracture causes, type of fracture, complications, and time from injury to operation between 2 groups (P>0.05). The operation time, intraoperative blood loss, fracture healing time, and complications were recorded and compared between 2 groups, the limb function was evaluated according to the Flynn et al. outcome score. ResultsThe intraoperative blood loss of group A was significantly less than that of group B, but the operation time of group A was significantly longer than that of group B (P<0.05). All the patients were followed up 12-36 months (mean, 14.9 months). There was no major complications in the other patients of both groups except 1 patient having delayed wound healing in group B. There was no significant difference in fracture healing time between 2 groups (t=-1.006, P=0.327). Inverted angle of 10° and shortened limb of 1.8 cm were observed in 1 case of group A, and sagittal plane angle of 15° and shortened limb of 2 cm in 1 case of group B. There was no abnormal walking and function of hip and knee activity at last follow-up. According to the Flynn et al. outcome score, the results were excellent in 8 cases and good in 4 cases in group A, and were excellent in 6 cases and good in 4 cases in group B, showing no significant difference between 2 groups (χ2=0.041, P=0.956). ConclusionBoth closed and open fracture reduction using ESIN have satisfactory outcomes for treating pediatric subtrochanteric fractures. A mini-open reduction should be selected intraoperatively if closed reduction proves to be difficult.
ObjectiveTo quantitate expression of microRNA-21 (miRNA-21) in gastric cancer of different tumor stages and discuss its clinical value. Method The relative expressions of miRNA-21 were quantitated in the cancer tissues, corresponding normal gastric tissues adjacent to gastric cancer, and serums of 50 gastric cancer patients received opera-tion and confirmed gastric cancer by pathology and the serums of nongastric cancer patients in Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine and its Chongming Branch from January 2015 to January 2016 by real time quantitative PCR. ResultsThe relative expression level of miRNA-21 in the gastric cancer tissues was significantly higher than that in the normal gastric tissues adjacent to gastric cancer. Among the TNM stageⅠ, Ⅱ, Ⅲ of gastric cancer patients, the relative expression levels of miRNA-21 in the cancer tissues were 2.17 (1.48-2.90), 4.08 (2.30-4.86), 8.64 (5.82-18.20), respectively and the differences among these three stages were statistically significant (P<0.05). The relative expression level of the serum miRNA-21 in the gastric cancer patients was significantly higher than that in the nongastric cancer patients, which in the serums for stageⅠ, Ⅱ, and Ⅲpatients were 31.00 (24.60-37.15), 39.10 (28.90-39.80), 44.15 (38.95-56.68), respectively and the differences among three stages were statistically significant (P<0.05). The relative expression level of miRNA-21 in the serums and cancer tissues had a positive correlation (r=0.86, P<0.05). ConclusionMiRNA-21 appears to have a potential association with TNM stage of gastric cancer, which cautiously suggests that it might be a potential indicator for prediction of preoperative TNM stage of gastric cancer.