Postoperative Recovery Status Research Articles

Efficacy of wound exclusion combined with silicone tube bicanalicular intubation in the treatment of pigmented nevi of the lacrimal punctum

Objective: To investigate the clinical efficacy of wound exclusion combined with silicone tube bicanalicular intubation for treatment of pigmented nevi of the lacrimal punctum. Methods: A retrospective case series analysis was conducted. Clinical data were collected from patients with pigmented nevi of the lacrimal punctum who underwent wound exclusion combined with silicone tube bicanalicular intubation at the Ophthalmology Center of Zhejiang Provincial People's Hospital from April 2020 to February 2023. During the surgery, a linear silicone tube was annularly placed to support the punctum and lacrimal canaliculus under local anesthesia, followed by the pigmented nevus excision under a surgical microscope. The linear silicone tube was removed at 4 to 6 weeks postoperatively. The duration of surgery and postoperative recovery status were recorded and summarized, including the recurrence of the pigmented nevus, epiphora, shape and position of the punctum, medial canthal morphology, and local scar condition. Results: This study included a total of 15 patients, 5 males and 10 females, with an average age of (47.7±13.5) years (range, 19 to 65 years). Two patients had pigmented nevi of the upper punctum, and 13 had pigmented nevi of the lower punctum. All nevi grew around the punctum and were completely excised during the surgery, which lasted (21.8±2.4) minutes on average. By 2 weeks postoperatively, all wounds healed with conjunctivalization, and new punctum openings formed. By 4 to 6 weeks postoperatively, the eyelid margin morphology was almost normal, when the linear silicone tube was removed. The follow-up ranged from 6 months to 2 years. No recurrence of the pigmented nevus was observed during the follow-up. The puncta were well formed without the symptom of epiphora, the medial canthal morphology was basically symmetrical to the healthy side, and the eyelid margin scars were inconspicuous, with a satisfactory appearance. No complications such as punctal occlusion, trichiasis, entropion, and ectropion occurred. Conclusions: For exophytic pigmented nevi of the punctum that do not deeply involve the lacrimal canaliculus, using the wound exclusion combined with silicone tube bicanalicular intubation during the nevus excision may reduce surgical trauma. This simple and feasible method can achieve good therapeutic effects and cosmetic outcomes.

Elevated preoperative plasma D-dimer level is an independent prognostic factor for pediatric patients with Wilms tumor.

Elevated plasma D-dimer levels are an unfavorable prognostic indicator for various tumors. However, its predictive value for prognosis in pediatric patients with Wilms tumor (WT) remains unknown. We aimed to investigate the clinical and prognostic value of preoperative plasma D-dimer levels and other clinicopathological characteristics in patients with favorable histology WT (FHWT). The clinical data of 74 children with FHWT from January 2010 to January 2022 were retrospectively analyzed. The clinicopathologic characteristics, preoperative laboratory parameter results, including D-dimer level, and follow-up data were collected. Based on the postoperative recovery status, the patients were divided into tumor-free survival and disease progression groups. The risk factors affecting disease progression in pediatric patients with WT and the impact of plasma D-dimer levels on overall survival (OS) were evaluated. Over a median follow-up of 33 months (range: 2-145 months), 56 patients survived without progression. Relapses and metastases occurred in 18 patients, of which four survived and 14 died. Higher preoperative plasma D-dimer levels (>0.865) (Odds ratio [OR] = 7.240, 95% confidence interval (CI) = 1.276-33.272, P = 0.011) and tumor rupture (OR = 19.984, 95% CI = 1.182-338.013, P = 0.038) were independent prognostic factors for disease progression. Additionally, patients with elevated D-dimer levels demonstrated a worse 5-year OS than those with low D-dimer levels (Hazard ratio (HR) =4.278, 95% CI = 1.074-17.035, P = 0.039). Elevated D-dimer levels are a prognostic factor for a poorer outcome in pediatric patients with WT and are expected to become a clinical biomarker for predicting the prognosis of WT.

Dynamic and Static Complementary Balance Theory-Based Functional Exercise Combined With Stepwise Rehabilitation Training Improves Postoperative Hip Function Recovery in Patients Undergoing Total Hip Replacement

To analyze the application value of dynamic and static complementary balance theory-based functional exercise combined with stepwise rehabilitation training in postoperative hip function recovery in patients undergoing total hip replacement (THR). The clinical data of 118 inpatients undergoing THR between June 2022 and June 2023 were retrospectively collected. Among the patients, 57 were given perioperative stepwise rehabilitation training (the control group), and 61 were given a combination of functional exercise based on static and dynamic complementary balance theory and stepwise rehabilitation training during the perioperative period (the combination group). The postoperative recovery status and the incidence of postoperative complications in the two groups were recorded. During postoperative recovery, the patients were assessed for pain with the visual analogue scale (VAS) and for self-efficacy with the Self-Efficacy for Rehabilitation Outcome Scale (SER). Hip function was measured and compared between the two groups at 2 weeks, 4 weeks and 8 weeks after surgery. With regard to the primary outcome indicator, the postoperative length-of-stay was (7.63±1.36) d in the combination group, which was shorter than the (8.22±1.48) d in the control group, and the difference was statistically significant (t=2.257, P=0.026). As for the secondary outcome indicators, no statistically significant difference was observed in the incidence of postoperative complications between the two groups (4.92% vs. 14.04%) (P>0.05). The perioperative VAS scores in the two groups showed an interaction effect according to the repeated measurement variance test (P<0.05). The postoperative VAS scores in both groups declined significantly compared to the preoperative scores (P<0.05), and the VAS score decreased gradually over time after surgery (P<0.05). The VAS scores in the combination group at 7 and 14 days after surgery were lower than those in the control group (P<0.05). At 14 days after surgery, the scores for the coping and the task dimensions and the total score of SER increased in both groups compared with those at 3 days after surgery (P<0.05), with the combination group showing higher scores than the control group did (P<0.05). After surgery, the scores for the dimensions of deformity, pain, function, and joint mobility and the total score of the Harris Hip Scale revealed interaction effects in the two groups according to the repeated measurement variance test (P<0.05), with these scores increasing gradually over time after surgery (P<0.05), and the scores in the combination group were higher at 4 and 8 weeks after surgery compared to those in the control group (P<0.05). The combination of functional exercise based on dynamic and static complementary balance theory and stepwise rehabilitation training shows an advantage over stepwise rehabilitation training alone in enhancing the self-efficacy of THR patients, relieving the postoperative pain, shortening the length-of-stay, and improving the hip function in patients.

Radiological image analysis based on the combined application value of multislice spiral CT and abdominal lavage in patients with acute purulent appendicitis

ObjectiveThe primary objective of this study is to conduct a clinical investigation involving abdominal lavage in patients with acute purulent appendicitis. The study aims to systematically assess the impact of abdominal lavage on complications within one week post-surgery and, in particular, focuses on the application value of multislice spiral CT in confirming these complications. By delving into the effects of different lavage timings on surgical outcomes and postoperative recovery, the study aims to provide scientific evidence for improving the efficacy of surgical treatment for acute purulent appendicitis. MethodsA total of 150 patients diagnosed with purulent appendicitis were selected for this study. They were divided into three groups: one group underwent preoperative abdominal lavage, another group underwent postoperative abdominal lavage , and a third group did not undergo abdominal lavage. The study aimed to compare the therapeutic outcomes among the three groups of patients. Additionally, the efficacy of the treatments was assessed by utilizing multislice spiral CT scans to confirm factors such as the abdominal abscess rate and the maximum diameter of abdominal abscesses one week postoperatively. ResultsThe operative time for patients in the experimental group showed no significant difference compared to the control group. However, postoperative pain scores were significantly lower in the experimental group (p<0.05), and the recovery time for gastrointestinal function was shortened (p<0.05) compared to the control group. The incidence of postoperative complications significantly decreased in the experimental group (p<0.05), while the control group exhibited higher complications. Additionally, the postoperative recovery status of patients in the experimental group was superior to that of the control group. ConclusionPerforming abdominal lavage in cases of purulent appendicitis can significantly alleviate postoperative pain, facilitate the recovery of gastrointestinal function, reduce the incidence of postoperative complications, and enhance overall surgical recovery. Therefore, we recommend using abdominal lavage during laparoscopic appendectomy to improve the surgical outcomes and postoperative recovery quality for patients. However, further large-scale studies are necessary to validate these results.

Effect of minimally invasive strabismus surgery under a microscope on tear film function and ocular surface status in strabismus patients.

To investigate the effects of minimally invasive strabismus surgery (MISS) on tear film function and ocular surface status in patients with strabismus. We respectively analyzed the clinical data from 173 cases of strabismus patients treated at Xi'an First Hospital from September 2021 to March 2024. The patients were classified into a minimally invasive group (n=91, undergoing MISS) and a conventional group (n=82, undergoing traditional strabismus correction) according to their treatment plans. The general data, treatment efficacy, tear film function, ocular surface status, perioperative indicators, pain, and visual recovery were compared between the two groups. Factors affecting the patients' postoperative recovery were further analyzed according to the treatment effects. The clinical efficacy of the minimally invasive group (95.6%) was significantly higher than the conventional group (68.3%). Visual recovery of the minimally invasive group was also significantly better than the conventional group (P<0.05). The minimally invasive group showed superior tear film function and ocular surface health (P<0.05). The visual analog scale (VAS) scores for pain were significantly lower in the minimally invasive group at different postoperative time points (all P<0.05). Intraoperative blood loss was significantly lower in the minimally invasive group (P<0.05), but there was no significant difference in surgical time (P>0.05). Logistics analysis identified the tear secretion basal test (Slt), corneal fluorescein staining score (CFS), and treatment regimen as independent factors influencing postoperative recovery status. MISS effectively improves clinical outcomes in strabismus patients, preserves tear film function and ocular surface health, and promotes visual recovery. The Slt, CFS, and treatment regimen are independent factors affecting postoperative recovery in strabismus patients.

To study the current status of uterine adhesions after fetal residue and the preventive effect of using estrogen and progesterone sequential therapy combined with Foley balloon.

To investigate the current status of uterine adhesions in patients with residual fetus and analyze the preventive effect of estrogen and progesterone sequential therapy combined with Foley balloon. Eighty-six patients with residual fetus were divided into control group and observation group. On the basis of the treatment plan of the control group, the observation group received estrogen and progesterone sequential therapy combined with Floey balloon treatment. Clinical efficacy, postoperative recovery status (abdominal pain duration, vaginal bleeding duration, vaginal bleeding volume, refluid time), the incidence of intrauterine adhesions, uterine hemodynamics (uterine artery systolic maximum blood flow rate [Vmax], end diastolic blood flow rate [Vmin], resistance index [RI]), and the probability of complications were evaluated. Compared with the control group, the observation group achieved higher curative effect (P < .05); the observation group had shorter duration of abdominal pain, vaginal bleeding and refluid time, and lower vaginal bleeding (P < .05); the probability of intrauterine adhesions is lower (P < .05); before treatment, there is little difference in the levels of Vmax, Vmin, RI, and other indicators between the 2 groups (P > .05). After treatment, compared with the control group, the observation group Vmax, Vmin, and other indicators, the level was significantly lower, and the RI level was significantly higher (P < .05); the observation group had a lower probability of complications (P < .05). The likelihood of uterine adhesions after fetal remains is increased. The use of estrogen and progesterone sequential therapy in conjunction with Foley balloon therapy can improve treatment efficacy, improve uterine adhesion prevention, and promote patient recovery after surgery.

Exploring the scope of 4sb and 12a lymph node dissection for cT2-4 lower third gastric cancer: Study protocol for a prospective cohort trial.

BackgroundCurrently, the extent of 4sb and 12a lymph node dissection is not clear and is based on the personal understanding of the surgeon. It may result in damage to the splenic artery and portal vein, leading to surgical complications. Therefore, this study aims to explore the scope of 4sb and 12a lymph node dissection in cT2-4 lower third gastric cancer.MethodsThis is an ongoing prospective cohort trial. The total sample size required for the trial (March 2022 to February 2025) is approximately 524 patients. The participants are divided into the experimental (4sb first branch and 12a anterior lymphadenectomy) or control groups (traditional 4sb and 12a lymphadenectomy). Electronic data capture systems will be used to collect demographic, laboratory test, auxiliary examination, operation, postoperative condition, postoperative pathology, and follow-up data. The primary outcome is the 12a lymph node metastatic rate. Secondary outcomes include the pathology (consisting of the 4sb lymph node metastatic rate, the number of 4sb lymph nodes dissected, the number of 12a lymph nodes dissected and tumor pathological staging), a safety evaluation index (consisting of complications and mortality ≤30 days after surgery), an efficacy evaluation (consisting of operation data and postoperative recovery status), and follow-up data (consisting of 3-year or 5-year disease-free survival and overall survival).DiscussionBy exploring the scope of 4sb and 12a lymph node dissection on the premise of ensuring radical cure of the tumor, the operation is simplified, the operation time is shortened, the damage of important blood vessels is reduced, the intraoperative and postoperative complications are reduced, and the patient recovers as soon as possible. Our study is a prospective exploration of the pathology, safety, efficacy, and prognosis of the new and traditional methods of 4sb and 12a lymph node dissection.Trial registrationChinese Clinical Trial Registry, ChiCTR2200057698 (registration date: March 15, 2022).

Effect of Entropy Index-Targeted Dextromeetomidine on Postoperative Neurocognitive Function in Elderly Patients with Gastrointestinal Tumors

Objective: To investigate the effect of entropy index targeted monitoring combined with dexmedetomidine infusion on cognitive function after thoracic and abdominal surgery in elderly patients. Methods: 60 elderly patients undergoing abdominal surgery in our hospital on October ~2017 and October 2019 were selected, ASAⅡ~ grade III, and the random digital table method was divided into 3 groups ,20 cases in each group. entropy index monitoring combined with dexmedetomidine group (D1 group), entropy index monitoring combined with dexmedetomidine group (D2 group) and dexmedetomidine monitoring combined with saline group (D0 group). All patients were subjected to sequential rapid induction of endotracheal intubation general anesthesia. D1, D2, the group was injected with 0.5μg/kg dexmedetomidine hydrochloride intravenously in the first 15 min of induction, followed by a 0.3μg•kg-1•h-1, 0.6μg•kg-1•h-1 maintenance pump until 30 minutes before the end of operation, respectively. The D0 group was injected with the same amount of saline intravenously before induction, and then maintained with the same amount of saline. D1 and D2 groups were calibrated at 40~60. preoperative (T1), tracheal intubation immediate (T2),30 min after operation (T3) and extubation immediate (T4) M after operation were compared in 3 groups AP (mmhg), hr (sub/ min), blood oxygen saturation (SpO2) and intraoperative anesthetic dosage, vasoactive drug use, and postoperative recovery status; simple intelligent mental state examination scale (MMSE) test was completed 1 day before ,1 day after ,3 days after and 7 days after operation to record the incidence of perioperative neurocognitive disorders (PND). To detect the necrosis factor-α(TNF-α) and C-reactive protein (CRP) of the above-mentioned concurrent serum tumors; Results Compared with D0 group, the MAP of D1 group and D2 group decreased significantly and the HR slowed down significantly (P&lt;0.05), The MAP, HR of T3, T4 in D2 group was significantly decreased compared with that in the D1 group (P&lt;0.05), but the difference was not significant at all time points (0.05);The respiratory recovery time (min), dialling time (min) and restoring directional force time (min) were significantly shortened compared with the D0 group and the D2 group, and the consumption of propofol and sufentanil during the operation was significantly decreased. Compared with the D2 group, the use of vasoactive drugs in the D1 group was significantly decreased (P&lt;0.05). The TNF-α, CRP of patients in the first day and the third day were higher than those in the first day of operation, but the TNF-α, CRP of D1 group and D2 group were lower than those in the D0 group (0.05). The MMSE scores of l days and 3 days after operation in D1 and D2 groups were higher than those in D0 groups. Significantly decreased (P&lt;0.05), and there was no significant difference between the groups 7 days after operation (P&gt;0.05): Conclusion entropy index targeted monitoring combined with dexmedetomidine infusion (0.3μg/kg/h) in the elderly patients during surgery can improve the intraoperative and postoperative hemodynamic stability, can improve the perioperative neurocognitive disorders of patients, worthy of clinical promotion.

Effect of the Addition of Human Milk Fortifier to Breast Milk on the Early Recovery of Infants After Congenital Cardiac Surgery

Objective: This article studied the effect of breast milk supplemented with human milk fortifier (HMF) on the early recovery of infants after congenital cardiac surgery.Methods: Infants undergoing congenital cardiac surgery were randomly divided into an intervention group (n = 27) and a control group (n = 27). Infants in the intervention group received HMF, and those in the control group were exclusively breastfed. The nutritional indicators at discharge, the postoperative recovery status, and nutritional-related complications were recorded.Results: Compared with the control group at the time of discharge, the weight and albumin and prealbumin levels of the intervention group were significantly increased (P < 0.05). The length of hospital stay of the intervention group was significantly reduced compared with that of the control group (P < 0.05). Although the length of ICU stay for the intervention group was shorter than that of the control group, the difference was not significant (P > 0.05). No significant difference in the incidence of postoperative nutrition-related complications was noted between the two groups (P > 0.05).Conclusion: Compared with breastfeeding alone, with HMF can improve postoperative weight gains, reduce the length of stay, and promote infants' early recovery after congenital cardiac surgery.

Comparison of the effect of double-mirror combined with gallbladder removal and laparoscopic cholecystectomy for gallbladder stones

Objective To compare the effect of double-mirror combined with gallbladder removal and laparoscopic cholecystectomy for gallstones. Methods From January 2016 to December 2017, 120 patients with gallstones in the Department of Hepatobiliary Surgery of Dongyang People's Hospital were enrolled.The patients were divided into laparoscopic group (n=60) and double-mirror group (n=60) according to the random number table method.Laparoscopic cholecystectomy was performed in the laparoscopic group, and double-mirror (laparoscopic and choledochoscopy) combined with gallstone removal was performed in the double-mirror group.The surgical results of the two procedures were analyzed.Surgical index, postoperative recovery status, postoperative complications and recurrence rate of one year after surgery were observed. Results The success rate of surgery in both two groups was 100.0%.The operation time of the double-mirror group [(48.2±5.3)min] was significantly longer than that of the laparoscopic group [(41.2±5.8)min](t=6.901, P 0.05). The total incidence rate of postoperative complications in the double-mirror group was 3.3%, which was significantly lower than 15.0% in the laparoscopic group (χ2=4.904, P=0.027). In the double-mirror group, the recurrence rate of calculi was 1.7% in 1 year after surgery, which in the laparoscopic group was 0, there was no statistically significant difference between the two groups (χ2=1.008, P=0.315). Conclusion Double-mirror combined with gallbladder stone removal and laparoscopic cholecystectomy can achieve good stone removal effect, the short-term efficacy is similar to long-term efficacy, laparoscopic cholecystectomy has shorter operation time.Double-mirror combined with gallstone removal has advantages in postoperative recovery and lower complications. Key words: Cholecystolithiasis; Biliary tract surgical procedures; Cholecystectomy, laparoscopic; Hemorrhage; Recurrence; Postoperative complications; Length of stay

EMG Signal Processing and Application Based on Empirical Mode Decomposition

With the development of rehabilitation medicine and kinematics, the study of Electromyographic (EMG) signal come into people’s sight. The information obtained from the surface EMG signals can not only reflect the motion state of muscles and joints, but also judge people's motion type, which is one of the important indexes in the study of human body. Based on the EMG as the research object with the detailed analysis to understand the EMG of time domain, frequency domain and SNR, etc. The study of EMG signal denoising and feature extraction is of great value and significance in the field of medical diagnosis. Such as using sEMG signals to assess muscle status and determine postoperative recovery status. Empirical Mode Decomposition (EMD) based on hilbert-huang is a time frequency analysis method for non-linear and non-stationary signals like EMG signals, which has unique advantages and broad prospects in signal analysis and processing. In this paper, we used EMD to decompose signal which contain multiple frequency component into a series of inherent modal parameters, and then combine the method of EMD decomposition and wavelet transform to carry out denoising processing and feature extraction for EMG signals, which can effectively weaken the noise of surface EMG signals and reflect the essential characteristics of the original signal, and classify the damage of EMG signals by analyzing the characteristic values.

Application effect of straight leg raising intervention in rehabilitation of patients after transforaminal endoscopic discectomy

Objective To explore the effects of straight leg raising intervention in the rehabilitation of patients after transforaminal endoscopic discectomy (TED). Methods Totally 69 patients suffering from single level lumbar intervertebral disc herniation and received the treatment of transforaminal endoscopic discectomy from January 2015 to March 2016 were selected and randomly divided into the intervention group (n=39) and the routine group (n=30). Patients in the intervention group received regularly postoperative straight leg raising intervention, while patients in the routine group received routine health education and nursing. Lumbar function score of Japanese Orthopaedic Association (JOA) and Oswestry Disability Index questionnaire (ODI) were used to assess patients′ postoperative recovery status, and we compared the waist and limb visual analog scale score (VAS) score of patients between two groups by using SPSS 21.0 software for statistical analysis. Results There was no significant difference in the waist VAS score of patients in two groups during follow-up (P>0.05); the limb VAS scores in the intervention group at 1 week and 1 month after surgery were (1.79±2.01) and (1.38±0.90), which were significantly lower than that in the routine group (t=2.173, 2.015; P 0.05). At 1 week and 1 month after surgery, the ODI scores were (21.71±2.24) and (18.31±1.99) in the intervention group, which was lower than that in the routine group (t=2.425, 2.388; P<0.05); the JOA scores in the intervention group were (22.71±2.01) and (22.30±1.85), which were higher than that in the routine group (t=2.326, 2.104; P<0.05). Conclusions The application of straight leg raising intervention after TED can improve the process of pain relief and functional rehabilitation in early nursing, which could contribute to the nursing efficacy after orthopaedic nerve root decompression. Key words: Hospital, orthopaedics; Rehabilitation; Straight leg raise; Transforaminal endoscopic; Discectomy

Clinical Suspicion of Abdominal Paragonimiasis was Confirmed after Emergency Laparotomy Together with Unfolding of Coexisting Endometriosis

The present study reports a human case of paragonimiasis which coexisted with endometriosis, leiomyoma and salpingitis in Nigeria. A 28-year-old woman from the Igbo ethnic group presented with acute colicky abdominal symptoms at a hinterland Missionary Hospital. Therefore, emergency laparotomy was carried out. This revealed uterine fibroids and dense lesions between the pelvic organs. There were nodules attached to the mesenteric border of the ileum. Biopsy from several sites was performed. The individually labeled samples were received at a Reference Pathology Laboratory where paragonimiasis, endometriosis, leiomyomata and salpingitis were diagnosed. The patient’s immediate post-operative recovery status was uneventful until she was lost to follow up.