Medicine
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To investigate the clinical efficacy of laparoscopic choledocholithotomy with one-stage suture. The clinical data of 68 patients who underwent laparoscopic choledocholithotomy in our hospital from January 2015 to December 2021 were retrospectively analyzed. Among them, 29 patients underwent laparoscopic primary closure (PC group) and 39 underwent T-tube drainage (T-tube group). ⋯ The average operation time, postoperative bowel function recovery time, postoperative pain index, hospitalization time and expenses in PC group were significantly shorter or lower than those in T-tube group (P < .05) and the patient satisfaction in PC group was significantly higher than that in T-tube group (P < .05). In addition, the intraoperative blood loss and the incidence of surgical complications were similar between the 2 groups (P > .05). After laparoscopic common bile duct exploration, primary suture of common bile duct is a safe and effective treatment method, but the incidence of bile leakage is high, and clinical indications for surgery should be strictly controlled.
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Observational Study
Predictive factors of the presence of pulmonary embolism in patients with interstitial lung disease: Observational study.
In patients with interstitial lung disease (ILD), the risk of pulmonary embolism (PE) is increased; however, distinguishing between PE and ILD exacerbation can be difficult. Therefore, this study investigated the usefulness of the Wells criteria and revised Geneva score and predictive factors for diagnosing PE in ILD patients with worsening respiratory symptoms. We retrospectively collected the data of 65 patients with ILD who underwent computed tomography pulmonary angiography at Fukujuji Hospital and Kyorin University Faculty of Medicine from January 2018 to March 2023, including 18 patients in the PE group and 47 patients in the non-PE group, and the data were compared between the 2 groups. ⋯ Patients in the PE group showed higher D-dimer, total protein (TP), and globulin levels than those in the non-PE group (D-dimer median 24.5 µg/mL [range 3.0-79.3] vs 9.3 µg/mL [range 0.5-80.8], P = .016; TP median 7.2 g/dL [range 5.1-8.7] vs 6.4 g/dL [range 5.0-8.2], P = .002; globulin median 3.8 g/dL [range 2.6-5.5] vs 3.2 g/dL [range 3.0-5.3], P = .041). Using cutoff values of TP ≥ 7.0 g/dL and D-dimer ≥ 11.8 µg/mL, the odds ratios for predicting PE were 10.5 and 4.90, respectively. This study demonstrates that high TP and D-dimer levels are useful indicators for predicting PE in ILD patients with worsening respiratory symptoms, while the Wells score and revised Geneva score are not reliable in diagnosing PE.
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The prevalence of metabolic dysfunction-associated steatotic liver disease (MASLD) is increasing at an alarming rate. Elevated liver enzymes are a primary reason to refer patients for further testing. However, liver enzymes within the normal range do not exclude the presence of MASLD. ⋯ The prevalence of MASLD in middle-aged men and women with overweight and liver enzymes within the normal range is over 40%. LFS showed the highest accuracy to detect MASLD, but, overall, biomarker scores performed relatively poor. The presence of metabolic syndrome was the prime predictor of MASLD.
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Observational Study
Impact of evidence-based nursing on postoperative psychological state, quality of life, and function of affected limbs in breast cancer patients: An observational study.
To analyze the effect of evidence-based nursing on postoperative psychological state, quality of life, and function of affected limbs in breast cancer (BC) patients. This study is a retrospective analysis. The clinical data of 122 BC patients in our hospital were selected and divided into evidence-based group and routine group according to different nursing programs. ⋯ After intervention, range of motion of the upper limbs increased significantly between the 2 groups, which was much higher in evidence-based group, exhibiting statistical significance (P < .05). The scores of quality of life (role, emotion, body, cognition and society dimension) in evidence-based group were higher than those in conventional group, exhibiting statistically significant difference (P < .05). Evidence-based nursing can develop more targeted nursing measures according to patients' problems, thus effectively promoting the recovery of upper limb function of BC patients after surgery.
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Secondary injury of the anterior cruciate ligament (ACL) is a common concern after anterior cruciate ligament (ACL) reconstruction, and identification of morphological risk factors is essential to prevent these injuries. We hypothesized that abnormal femoral trochlea morphology is associated with secondary ACL injuries after reconstruction. This study aimed to investigate the relationship between femoral trochlear morphology and secondary ACL injuries after reconstruction. ⋯ This study demonstrated a significant correlation between abnormal femoral trochlear morphological characteristics and secondary ACL injuries after reconstruction. Decreased MCH, TSD, and MTI along with increased TSA are associated with a higher risk of secondary ACL injury. These data could thus help identify individuals susceptible to secondary ACL injuries after reconstruction.