In the present paper, the contribution of the largest principal component and the number of principal component needed for accumulative contribution 95% are selected as indices of electroencephalogram (EEG) in mental fatigue state in order to investigate the relationship between these parameters and mental fatigue. The experimental results showed that the contribution of the largest principal component of EEG signals increased in the prefrontal, frontal and central areas, while the number of principal component needed for accumulative contribution decreased by 95% with the increasing mental fatigue level. The parameters of singular system of EEG signals can be regarded as useful features for the estimation of mental fatigue and have larger application value in the study of mental fatigue.
ObjectiveTo analyze the clinical effective of differentiated thyroid cancer and approach the correct treatment methods for it. MethodThe clinical and postoperative follow-up data of 137 patients with differentiated thy-roid cancer treated in this hospital from 2002 to 2012 were analyzed retrospectively. ResultsOne hundred and thirty-seven patients accepted individualization surgery, conventionalⅥregion lymph node dissection, and postoperative com-prehensive therapy.The rate of lymph node metastasis was 53.28%(73/137).Ⅵregion lymph node was confirmed to be positive by pathology which performedⅡ+Ⅲ+Ⅳregion lymph node dissection, the rate of lymph node metastasis was 41.10%(30/73).Multivariate analysis showed that penetrate capsule, pathologic type, and TNM stage were the independent risk factors for lymph nodes metastasis (P < 0.05).No death occurred perioperative period.The temporary hoarseness was found in 4 cases (2.92%), short-term hypocalcemia in 11 cases (8.03%).During postoperative average 6.5 years of follow-up, there were 5 cases (3.65%) of local recurrence, 11 cases (8.03%) of cervical lymph node meta-stasis, 3 cases (2.19%) of distant metastasis including 1 case of bone metastasis and 2 cases of pulmonary metastasis, and 16 cases (11.68%) of reoperation. ConclusionIndividualized surgical options, conventionalⅥregion lymph node dissection, and close follow-up management could reduce the postoperative complications and guarantee the treatment effect of differentiated thyroid cancer.
ObjectiveTo investigate the expression of ubiquitin-specific protease 9X (USP9X) in pancreatic cancer, and to evaluate the correlation of USP9X with the survival of patients with pancreatic cancer. MethodThe expression of USP9X was detected in 55 pieces of surgically resected primary pancreatic cancer tissues and adjacent nontumorous pancreatic tissues by streptavidin-perosidase immunohistochemical method. ResultsThe rate of USP9X high expression in the 55 pieces of the primary pancreatic cancer tissues was 58.2% (32/55), which in the adjacent nontumorous pancreatic tissues was zero. The expression of USP9X was not correlated with the gender, age, tumor position, or tumor size (P > 0.05), while which was significantly correlated with the differentiation degree, lymph node metastasis, or TNM stage (P < 0.05). By using Cox proportional hazard model, the multivariable analysis revealed that the differentiation degree, lymph node metastasis, and USP9X expression were the independent risk factors. Survival of the patient with USP9X high expression was significantly shorter than that with USP9X low expression (P < 0.05), and there was the same result in the patients with stageⅡ, with lymph node negative, or intermediate differentiation degree (P < 0.05). ConclusionThe results indicate that USP9X might play an important role in the pathogenesis and prognosis of pancreatic cancer.
ObjectiveTo present the safety and efficiency of laparoscopic Nissen fundoplication for hiatal hernia in elderly patients. MethodsClinical data of 35 elderly patients with hiatal hernia who underwent laparoscopic Nissen fundoplication in The Affiliated Hospital of Xuzhou Medical College between August 2013 and March 2014 was retrospectively analyzed. ResultsAll patients underwent laparoscopic Nissen fundoplication. The operation time was 72-minute in average (65-105 minutes) and intraoperative blood loss was 30 mL in average (10-120 mL). The mean value of postoperative hospital stay was 5-day (3-23 days). Patients' stomachs and esophagus were restored to normal position after surgery. No complication was noted except 2 patients had mild gastroesophageal reflux after operation, and 1 patient suffered from transient dysphagia after operation, all the symptoms subsided after conservative treatment. Afterwards, 33 of them achieved follow-up for 6 to 12 months (mean of 8.5 months), the other 2 patients were lost to follow-up. During the follow-up period, a questionnaire regarding to the criteria for Reflux Diagnostic Questionnaire (RDQ) score were conducted in the 33 patients, and the results showed that the symptoms including acid reflux, heartburn, chest pain, cough, dyspnea, lump sensation in the pharynx, and hoarseness were improved significantly in 6 months after operation (P<0.05), and no recurrence was found during the follow-up period. ConclusionLaparoscopic Nissen fundoplication is a safe operation for elderly patients with hiatal hernia, and it can achieve good clinical result.
ObjectiveWe aimed to further investigate the feasibility of using small bore chest tubes or even without chest tube insertion after da Vinci robot-assisted thoracic surgery. MethodsWe retrospectively analyzed initial 70 patients between September 12, 2014 and March 30, 2015 as a control group at the department of thoracic surgery, the First Affiliated Hospital of Zhejiang University, and proposed four schemes. There are 31 males and 39 females with mean age of 57.1±9.8 (ranged from 30-80 years). We applied those four schemes for the last 30 patients as an experimental group. There are 12 males and 18 females with mean age of 58.8±8.1 (ranged 42-73 years). ResultsThe days in hospital after surgery ranged 2-25 days and there was no severe complication. After the surgery, the pain scores of the trial group are lower than that of the control group. And the schemes 1 and schemes 2 of trial group reduced significantly than the control group (P<0.05). There is no significant difference of the rate of the complication caused by poor drainage between the trial group and the control group (P>0.05). But the pain score after surgery is lower than that of the control group (P<0.05). ConclusionOptimizing thoracic drainage strategy after da Vinci robot-assisted thoracic surgery is safe, possible and helpful to relieve postoperative pain.