Tạp chí Y Dược học Quân sự

ESTABLISHMENT OF THE 6-SHOGAOL EXTRACTION PROCESS FROM 6-SHOGAOL-ENRICHED GINGER FOR CANCER TREATMENT

Ho Ba Ngoc Minh

Objectives: To optimally extract the potential phytochemical “6-shogaol” from fermented shogaol-enriched ginger. Methods: Extraction process parameters were investigated using 6-shogaol as a marker. Results: The suitable parameters of the 6-shogaol extraction process: Hot extraction using reflux equipment, solvent of 90% ethanol, solvent/herb ratio of 15/1, temperature of 70ºC, duration of 90 minutes, and two-time extraction. The 6-shogaol extraction efficiency was 89.61 ± 0.68%. Conclusion: The optimal process for 6-shogaol extraction from fermented shogaol-enriched ginger has been studied.

EVALUATION OF PTGER4 GENE METHYLATION IN PLASMA FOR LUNG CANCER DETECTION

ThS, BS Phuong Ngoc Anh

Objectives: To evaluate the diagnostic value of PTGER4 (Prostaglandin E Receptor 4) gene methylation in plasma for lung cancer detection compared to healthy controls. Methods: A cross-sectional, case-control study was conducted on 149 non-small cell lung cancer (NSCLC) patients and 100 healthy individuals. Peripheral blood samples were collected for PTGER4 methylation analysis using real-time methylation-specific PCR (MSP). Data were analyzed using SPSS 26.0, including group comparisons, receiver operating characteristic (ROC) analysis, and logistic regression. Results: The PTGER4 methylation positivity rate was significantly higher in lung cancer patients (18.8%) compared to healthy controls (3.0%, p < 0.001). PTGER4 methylation positivity increased the risk of lung cancer by 6.3 times (OR = 6.30; 95%CI: 1.90 - 20.40). The area under the ROC curve (AUC) was 0.58, with a sensitivity of 18.8% and a specificity of 97.0%. Conclusion: PTGER4 gene methylation is a promising biomarker for lung cancer detection. Despite its limited sensitivity, the high specificity suggests its potential as a confirmatory diagnostic tool, particularly when combined with imaging modalities such as low-dose computed tomography (LDCT).

RESULTS OF ALZHEIMER’S DISEASE ANIMAL MODEL INDUCTION BASED ON THE INTRAHIPPOCAMPAL INJECTION OF AMYLOID Β-PEPTIDE (1-42) AT VIETNAM MILITARY MEDICAL UNIVERSITY

Nguyen Ha Hoa

Objectives: To evaluate some behaviors and histological results of the hippocampus in a rat model of Alzheimer's disease (AD). Methods: A longitudinal, descriptive study was conducted on 21 Wistar rats. Intrahippocampal amyloid beta (Aβ) injection was performed, followed by behavioral testing and analysis and hippocampal histological examination. Results: Rats in the AD model showed learning impairment with a reduced average latency time (52.09 ± 10.67s) and reduced latency time on the 5th day (27.08 ± 6.88s) during the learning phase of the Morris water maze (MWM) test. Memory impairment was indicated by a decreased percentage of spontaneous alternations (34.45 ± 7.03%) in the Y-maze test, reduced time spent (14.84 ± 4.61s), and shorter distance traveled (2.26 ± 0.82m) in the target quadrant during the probe trial of the MWM test. Neurodegeneration in the hippocampus was observed, with an increased degeneration score (1.83 ± 0.31). Conclusion: Intrahippocampal Aβ injection is an effective method for inducing the AD model in rats, characterized by learning and memory impairments as well as neurodegeneration in experimental animals.

OPTIMIZATION OF THE FLOW CYTOMETRIC METHOD FOR ANALYZING NK CELL CYTOTOXIC ACTIVITY IN BREAST CANCER

Phung The Hai

Objectives: To establish a protocol for analyzing NK cell cytotoxic activity (NKAc) in breast cancer patients using the flow cytometric technique. Methods: We first optimized the protocol based on the previously published studies, focusing on choosing fluorescent dye concentration, incubation time length, and Effector:Target cell ratio (E:T ratio). Subsequently, we preliminarily applied the established protocol to characterize NKAc in some breast cancer patients and healthy controls. Lastly, we compared the NKAc versus NK cell secretory activity (NKAs) data obtained from the study. Results: The fluorescent dye concentration could be used according to the manufacturer's suggestion (CFSE: 2.5 - 10µM; Zombie NIR: 1:1000 - 1:100 dilution). The co-culture period of effector and target cells and the E:T ratio could be 4 hours and 5:1, respectively. NKAc was reproducible for 1 month. 2/7 breast cancer patients had NKAs < 200 pg/mL and NKAc < 10%. Conclusion: It is feasible to examine NKAc in breast cancer patients via the flow cytometric method established in this study. Further studies are needed to validate the diagnostic and prognostic value of NK cell function tests.

RESEARCH ON CHANGES IN SOME CHARACTERISTICS OF ACTIVATED UMBILICAL CORD BLOOD PLATELET-RICH PLASMA AFTER STORAGE AT NORMAL COLD TEMPERATURE

Thạc sĩ Ngo Minh Duc

Objectives: To evaluate sensory changes, infection, epidermal growth factor (EGF), and vascular endothelial growth factor (VEGF) concentrations in activated umbilical cord blood platelet-rich plasma (PRP) after cold storage at 2 - 6 degrees Celsius (°C). Methods: The study was conducted on 8 umbilical cord blood samples and 8 venous blood samples of adults. Results: EGF concentrations in PRP from umbilical cord blood and adult blood after activation were 115.72 (51.59 - 217.61) pg/mL and 113.04 (69.71 - 155.73) pg/mL (p > 0.05), with VEGF concentration being 193.99 (75.58 - 320.25) pg/mL and 16.12 (11.70 - 49.03) pg/mL, respectively, p < 0.01. After cold storage at 2 - 6°C for 7 days, 10 days, and 14 days, the concentrations of EGF and VEGF in PRP from activated umbilical cord blood showed no difference compared to immediately after activation (p > 0.05). PRP remained clear and yellow, with no signs of infection. Conclusion: PRP from umbilical cord blood has high VEGF concentration, no significant change in appearance, EGF and VEGF concentrations, and sterility after cold storage for 7 - 14 days.

A RARE CASE REPORT: LUNG ADENOCARCINOMA WITH DIFFUSE LESIONS IN A YOUNG MALE PATIENT

Dao Ngoc Bang

The images of diffuse lung involvement are seen in various respiratory diseases, including lung adenocarcinoma (ADC). After ruling out acute infectious causes, lung biopsy is valuable for a definitive diagnosis, with transbronchial biopsy via flexible bronchoscopy being an effective and safe diagnostic approach. However, the widespread lung damage in these patients poses a challenge for transbronchial biopsy. Chemotherapy is often difficult due to the overall poor health of the patient. Targeted therapies, specifically tyrosine kinase inhibitors (TKIs), have shown efficacy in lung cancer treatment.

INITIAL ANALYSIS OF SEVERAL CLINICAL FEATURES AND SPERM CONCENTRATION IN MEN WITH PERICENTRIC INVERSION OF CHROMOSOME 9 FINDING ASSISTED REPRODUCTIVE TREATMENTS

PGS. TS Trinh The Son

Objectives: To evaluate some clinical features and sperm concentration among men with pericentric inversion of chromosome 9, and to find assisted reproductive treatments. Methods: A retrospective, descriptive study was conducted on 36 men with pericentric inversion of chromosome 9 at the Military Institute of Clinical Embryology and Histology, Vietnam Military Medical University, from January 2020 to December 2023. Age, height, weight, and body mass index (BMI) were recorded. Semen analysis was conducted according to World Health Organization (WHO) 2021 guidelines. Results: 36 male patients with pericentric inversion of chromosome 9 were observed, of which the majority had variant 46,XY,inv(9)(p11q13) with a rate of 72.22%. Evaluation of clinical characteristics showed that height, weight, and BMI were all within the normal ranges for men. Semen analysis: 24/36 patients (66.67%) had normal sperm concentration; only 12/36 patients (33.33%) were observed to have a slight decrease in sperm concentration; no cases of severe oligozoospermia or azoospermia were recorded. A case of pericentric inversion of chromosome 9 was recorded as inherited in the family after natural reproduction. Conclusion: In men who found assisted reproductive treatments in our assisted reproductive center and were recorded pericentric inversion of chromosome 9 in the karyotype, age, height, weight, and BMI were all within the normal ranges of Vietnamese people and manifested mild oligozoospermia or normal sperm concentration.

PHASE ANGLE PREDICTOR OF SARCOPENIA IN PATIENTS WITH STABLE ISCHEMIC HEART DISEASE

TS Nguyen Duy Dong

Objectives: To examine how phase angle (PhA) contributes to sarcopenia and factors influencing sarcopenia in patients with stable ischemic heart disease (SIHD). Methods: A cross-sectional descriptive study was conducted on 52 SIHD patients who were recruited, and relevant data was gathered. Patients were diagnosed with sarcopenia based on the Asian Sarcopenia Working Group 2019 (AWGS 2019) diagnostic criteria. Differences between groups were compared, and statistically significant factors were included in the logistic regression analysis to screen for independent factors affecting sarcopenia. The receiver operating characteristics (ROC) and the area under the curve (AUC) were used to evaluate the predictive value of PhA in sarcopenia. Results: The prevalence of sarcopenia was 36.5% in patients with SIHD. Multivariate logistic regression analysis showed that PhA was an independent factor influencing sarcopenia (OR: 0.078; 95%CI: 0.012 - 0.528; p = 0.009). The AUC of PhA predicting sarcopenia was 0.852, p < 0.001; the best PhA cut-off value for sarcopenia was 5.95° for both sexes (sensitivity and specificity were 0.677 and 0.947, respectively); the PhA cut-off points were 6.05° and 5.25° for men and women, respectively (p < 0.05). Conclusion: PhA is an important determinant of sarcopenia in patients with SIHD. PhA may have an optimistic predictive value for determining sarcopenia in this population.

LIVER BIOCHEMICAL CHANGES IN PATIENTS AFTER DIFFERENTIATED THYROID CANCER SURGERY AND BEFORE RADIOIODINE THERAPY

TS Duong Quang Huy

Objectives: To investigate liver enzyme changes and assess liver function in patients with differentiated thyroid cancer who have undergone surgery and are preparing for radioiodine therapy (131I therapy). Methods: A cross-sectional descriptive study on 163 patients with differentiated thyroid cancer 4 - 6 weeks after surgery at the Military Institute of Radiation Medicine and Oncology from April 2023 to April 2024. Evaluating liver enzymes and liver function at the time of preparing for 131I therapy, compared with a number of paraclinical parameters to find factors related to liver damage. Results: 38.0% of patients had liver damage (increased AST or ALT), of which 35.6% increased AST, and 24.5% increased ALT, mainly mildly increased (40 to < 100 U/L) and a low rate of liver dysfunction (5.5% slight increase in total Bilirubin and 11.0% decrease in Prothrombin ratio). Male gender and decreased FT4 concentration < 1.17 pmol/L were two factors related to liver damage with ORs of 2.56 and 2.74, respectively, p < 0.01. Conclusion: Liver damage is a relatively common phenomenon related to male gender and FT4 levels in patients with thyroid cancer after surgery and being prepared for 131I therapy.

CLINICAL AND PARACLINICAL CHARACTERISTICS OF DENGUE HEMORRHAGIC FEVER DURING PREGNANCY AT MILITARY HOSPITAL 103 IN 2023

Thạc sĩ Nguyen Viet Phuong

Objectives: To describe clinical and paraclinical characteristics of Dengue hemorrhagic fever (DHF) during pregnancy at the Department of Infectious Diseases, Military Hospital 103 in 2023. Methods: A cross-sectional descriptive study was conducted on 162 pregnant patients diagnosed with DHF and treated at the Department of Infectious Diseases during the 2023 epidemic (from January 2023 to December 2023). Results: The average age was 28.92 ± 5.64 years old, and the average gestational age was 18.98 ± 16.75 weeks. Clinical characteristics: Fever was 84.4%; headache and eye socket pain was 76.5%; bleeding gums was 8.6% and abnormal vaginal bleeding was 2.5%; pleural or peritoneal effusion was 7.4%. Paraclinical characteristics: Decreased white blood cell (WBC) (< 4 G/L) was 28.4%, decreased platelet (< 150 G/L) was 69.1%. The first-trimester group had the highest average hematocrit (HCT) (%) and WBC (p < 0.05), and the second-trimester group had the lowest average platelet (p < 0.05) compared to other groups. Blood biochemistry tests showed increased AST (≥ 40 U/L) and ALT (≥ 40 U/L) in 46.7% and 49.3% of cases, respectively. The third-trimester group had the highest average AST and ALT compared to other groups (p < 0.01). Disease severity was classified as DHF with warning signs in 24.7% of cases and severe DHF in 1.8% of cases. The third-trimester group had the highest rate of DHF with warning signs and severe DHF (p < 0.05). Conclusion: Pregnant women with DHF exhibit different clinical and paraclinical characteristics depending on the stage of pregnancy. The third-trimester group experienced more severe liver injury and disease severity compared to the first and second-trimester groups.

CHARACTERISTICS OF MULTIMORBIDITY IN HOSPITALIZED ELDERLY PATIENTS

PGS.TS Tran Ngoc Tuan

Objectives: To evaluate the characteristics of multimorbidity in hospitalized elderly patients and identify factors associated with the length of stay and the number of comorbidities. Methods: A retrospective, cross-sectional study was conducted using 507 medical records of patients aged > 60 years. Descriptive statistics, one-way ANOVA, Pearson correlation analysis, and multiple regression analysis were used to evaluate the associations between age, sex, number of comorbidities, and length of stay. Results: The median age of patients was 73 years, and the sex distribution was relatively balanced (49.3% male, 50.7% female). The median length of stay was 9 days, and the median number of comorbidities was 3. Hypertension was the most common comorbidity (61.9%), followed by chronic lung disease (30.4%) and diabetes (26.4%). Older age and number of comorbidities were associated with longer length of stay. The number of comorbidities was an independent factor affecting the length of hospital stay (OR = 1.63; 95%CI = 1.41 - 1.89). Conclusion: Multimorbidity is common in hospitalized elderly patients, and factors such as advanced age and the number of comorbidities increase the length of hospital stay. Management and medical care should be strengthened to meet the needs of this group of patients.

ASSESSMENT OF ANXIETY DISORDER USING THE DASS-21 AND RELATED FACTORS IN MAINTENANCE HEMODIALYSIS PATIENTS

Pham Ngoc Thao

Objectives: To describe the characteristics of anxiety disorders using the DASS-21 (depression - anxiety - stress scale-21) and some related factors in patients with maintenance hemodialysis at Military Hospital 103. Methods: A cross-sectional descriptive study was conducted on 60 patients with maintenance hemodialysis treated at the Department of Nephrology - Hemodialysis, Military Hospital 103, from August 2023 to May 2024. Patients' anxiety disorders were evaluated using the DASS-21. The Spearman correlation analysis and Mann-Whitney U test were used to analyze the data. Results: The rate of patients with anxiety disorders was 35.0%. The anxiety disorder score was negatively and significantly correlated with age. The group with the hemodialysis duration of more than 24 months showed significantly higher anxiety scores than the group with the hemodialysis duration of less than 12 months. Conclusion: The rate of anxiety disorders was high among end-stage renal disease patients with maintenance hemodialysis. Age and hemodialysis duration were factors related to anxiety symptoms in patients with maintenance hemodialysis.

DEPRESSIVE SYMPTOMS AND GERIATRIC CHARACTERISTICS IN DEMENTIA PATIENTS AT NATIONAL GERIATRIC HOSPITAL

Tran Viet Luc

Objectives: To determine the prevalence of depression symptoms and geriatric characteristics of dementia patients. Methods: A cross-sectional study was conducted on 87 dementia patients ≥ 60 years old at the Outpatient Department, National Geriatric Hospital. Data were collected using designed tools, including general information, Health-related Quality of Life (HRQoL), Instrumental Activities of Daily Living (IADLs), Activities of Daily Living (ADLs), Pittsburgh Sleep Quality Index (PSQI), Mini Nutrition Assessment Short Form (MNA-SF). Depressive symptoms were diagnosed by the Patient Health Questionnaire 9 (PHQ-9). Results: A total number of 87 patients were recruited for the study. The mean age was 76.84 years old. Moderate dementia had the highest rate with 43.7%. The remaining levels of mild dementia and severe dementia were 34.5% and 20.7%, respectively. The prevalence of having depressive symptoms was 43.7%. The symptom that occurred the most on all days was "Trouble falling or staying asleep or sleeping too much" at 32.2%. Low quality of life accounted for the highest number of 38 people (43.7%). Conclusion: The prevalence of having depressive symptoms in dementia patients was respectively high at 43.7%. Early screening for depressive symptoms of dementia patients is essential and should be considered for application in comprehensive geriatric assessment.

QUALITY OF LIFE AMONG ELDERLY PATIENTS WITH HEART FAILURE AT THONG NHAT HOSPITAL IN 2023

Thạc sĩ Nguyen Thi Thao Suong

Objectives: To evaluate the quality of life (QoL) among elderly patients with heart failure (HF) treated at Thong Nhat Hospital in 2023. Methods: A cross-sectional descriptive study was conducted to assess the QoL of 300 elderly inpatients (≥ 60 years old) diagnosed with HF from January 1, 2023 to December 31, 2023. Data were collected using the SF-36 and Kansas City Cardiomyopathy Questionnaire (KCCQ) tools. Results: 55.33% of patients reported moderate-to-poor overall health, with a mean physical health score of 23.51 ± 19.61 (62% poor, 27.33% moderate-to-poor). Mental health scores were comparatively higher, averaging 57.84 ± 10.84, with 67.67% reporting moderate-to-good outcomes. Marital status, education level, disease duration, and comorbidities (atrial fibrillation) significantly influenced the maintenance of a good QoL. Conclusion: Maintaining a good QoL among elderly HF patients was predominantly moderate-to-poor, especially concerning physical health. Factors such as marital status, educational attainment, duration of illness, and comorbidities were significant determinants of maintaining a good QoL.

A CASE REPORT: HER2-TARGETED THERAPY IN COLORECTAL CANCER

Thạc sĩ Dao Thi Thu Trang

Colorectal cancer (CRC) is a malignant tumor arising from the inner lining of the colon or rectum and is the third most common cancer and the third leading cause of cancer-related deaths in the United States. Human epidermal growth factor receptor 2 (HER2)geneoverexpressed or amplified CRC has shown treatment responses with HER2-targeted therapies. This article reports two cases of heavily pretreated metastatic CRC (mCRC) with HER2 overexpression who achieved a remarkable clinical response to trastuzumab plus pertuzumab.

PREVALENCE AND ASSOCIATED FACTORS OF SARCOPENIA IN LUNG CANCER PATIENTS UNDERGOING CHEMOTHERAPY: A CROSS-SECTIONAL STUDY AT A TERTIARY HOSPITAL IN VIETNAM

TS Pham Duc Minh

Objectives: To evaluate the prevalence of sarcopenia and its associated factors in lung cancer patients undergoing chemotherapy at a tertiary hospital in Vietnam. Methods: A cross-sectional descriptive study was conducted on 89 lung cancer patients. Sarcopenia was assessed using the Asian Working Group for Sarcopenia (AWGS) 2019 criteria, including measurements of handgrip strength (HGS), appendicular skeletal muscle mass (ASM), and physical performance. Logistic regression analysis identified factors associated with sarcopenia. Results:The mean age of participants was 62.6 ± 9.8 years; 78.7% were male. The prevalence of sarcopenia was 39.3%, with 40.4% of patients having reduced ASM. Malnutrition (Body mass index (BMI) < 18.5) was found in 15.7% of patients. Logistic regression analysis revealed significant associations between sarcopenia and male gender (OR = 8.19), lower hemoglobin levels (OR = 0.96), and increased lymphocyte counts (OR = 1.05). Patients with normal BMI (18.5 - 23) and high BMI (≥ 23) had lower odds of sarcopenia compared to those with BMI < 18.5. Conclusion: Sarcopenia is prevalent among lung cancer patients undergoing chemotherapy. Male gender, low BMI, low HGB, and high lymphocyte counts are associated with increased sarcopenia risk in lung cancer patients, whereas normal to high BMI offers protective effects.

THE EFFECTIVENESS OF LASER ACUPUNCTURE COMBINED WITH ACUPRESSURE MASSAGE IN PATIENTS SUFFERING FROM LOW BACK PAIN DUE TO SPONDYLOSIS

TS Nguyen Thanh Ha Tuan

Objectives: To evaluate the effectiveness of laser acupuncture (LA) combined with acupressure massage in treating low back pain, focusing on pain intensity, functional disability, and lumbar range of motion. Methods: An uncontrolled, randomized, clinical trial was conducted to compare the effectiveness before and after treatment in 30 volunteered patients aged ≥ 38 diagnosed with low back pain due to spondylosis, regardless of gender or occupation, at the Traditional Medicine Department, Military Hospital 103. Results: Combining the LA method with acupressure massage showed good effectiveness, with a success rate of 96.7%. The pain level, according to the Visual Analogue Scale (VAS), improved significantly after 14 days of treatment, decreasing from an average of 5.4 ± 1.886 to 1.17 ± 1.234 (p < 0.05). The lumbar spine expansion and daily activity limitation measured by the Oswestry Disability Index (ODI) significantly improved. Conclusion: The treating method using LA combined with acupressure massage has been proven to be an efficient adjunct therapy in treating low back pain due to spondylosis.

PREVALENCE AND ASSOCIATED FACTORS OF VERTEBRAL COMPRESSION FRACTURE AMONG OLDER WOMEN WITH OSTEOPOROSIS

Ths.BS. Truong Tri Khoa

Objectives: To investigate the prevalence and associated factors of vertebral compression fracture (VCF) in older women with osteoporosis. Methods: A cross-sectional study was conducted on 279 older women with osteoporosis at the Rheumatology and Neurosurgery Department and Rheumatology Clinic, University Medical Center, from August 2022 to May 2023. Results: 102/279 older women (36.6%) had at least one vertebral fracture, and more than 50% of participants were symptomatic. In the adjusted logistic regression, physical activity (OR: 0.44; 95%CI: 0.20 - 0.94; p = 0.038), osteoarthritis (OR: 0.24; 95%CI: 0.12 - 0.48; p < 0.001), frailty (OR: 7.41; 95%CI: 3.45 - 16.73; p < 0.001), falls (OR: 3.86; 95%CI: 1.68 - 9.32; p = 0.002), T-score at femoral neck (OR: 0.63; 95%CI: 0.41 - 0.92; p = 0.002) were associated with vertebral fracture. Conclusion: The prevalence of VCF was quite high among older women with osteoporosis, highlighting a disease burden in this population. Physical activity, osteoarthritis, and higher T-score at the femoral neck decreased the odds of VCF, while frailty and falls increased the odds of VCF.

PREVALENCE OF DEPRESSION IN ELDERLY PATIENTS FOLLOWING ACUTE CORONARY SYNDROME AT DISCHARGE FROM THONG NHAT HOSPITAL

Vo Tran Minh Ngoc

Objectives: To estimate the frequency of depression among older adults with acute coronary syndrome (ACS) and identify relevant factors that are associated with depression at the time of discharge. Methods: A cross-sectional descriptive study was conducted on 117 elderly patients with ACS who were discharged from Thong Nhat Hospital between March 2024 and June 2024. Depression was assessed using the 30-item Geriatric Depression Scale (GDS-30), with a total score of ≥ 10 indicating the presence of depression. Results: The prevalence of depression at discharge among elderly ACS patients was 15.4% (95%CI: 8.7% - 22.0%). In the multivariate regression analysis, female gender, illiteracy, high-risk CCI, experiencing two or more stressful life events, and low perceived social support were significantly associated with a higher prevalence of depression. Conclusion: The prevalence of depressive symptoms at the time of discharge among elderly patients recovering from ACS was 15.4%. Early detection of depression is crucial, particularly in patients who are female, have illiteracy, present with multimorbidity, particularly type 2 diabetes mellitus, experience stressful life events, and have low perceived social support.

PREVALENCE AND CHARACTERISTICS OF NON-ALCOHOLIC FATTY LIVER DISEASE IN PATIENTS WITH FATTY LIVER DIAGNOSED BY ULTRASOUND

Tran Thi Khanh Tuong

Objectives: To determine the prevalence and characteristics of non-alcoholic fatty liver disease (NAFLD), including steatosis and fibrosis, in patients with fatty liver detected by ultrasound. Methods: A cross-sectional study was conducted on 303 patients diagnosed with fatty liver by ultrasound at People’s Hospital 115 from August 2019 to October 2020. Steatosis and fibrosis were assessed using FibroScan, employing the controlled attenuation parameter (CAP) and liver stiffness measurements (LSM). Statistical analysis was performed using SPSS version 22.0. Results: The prevalence of NAFLD in patients with fatty liver detected by ultrasound and assessed by FibroScan using CAP probe was 66%. Among patients with fatty liver on ultrasound who have NAFLD, the distribution of liver fat levels was as follows: S1 = 20.5%; S2 = 27%; S3 = 52.5%. The stages of liver fibrosis were: F0 - F1 at 74.5%; significant fibrosis at 25.5%, advanced fibrosis at 11%, and cirrhosis at 6%. NAFLD patients exhibited higher body mass index (BMI), waist circumference, cholesterol, triglyceride, type 2 diabetes mellitus (T2DM), and obesity rates compared to those without NAFLD. Conclusion: The study underscores the high prevalence of NAFLD in patients with fatty liver detected by ultrasound, with the highest proportion of patients in stage S3, while 25.5% of the cases are classified as significant fibrosis, which indicates a considerable level of liver damage.

COMPARISON OF FUNCTIONAL OUTCOMES BETWEEN ADJUSTABLE- AND FIXED-LOOP DEVICES FOR FEMORAL FIXATION IN ARTHROSCOPIC ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION

Vu Anh Dung

Objectives: To compare outcomes of anterior cruciate ligament reconstruction (ACLR) with adjustable- and fixed-loop devices. Methods: A retrospective, observational study was conducted on 92 patients who underwent ACLR with the ﬁxation of a hamstring graft with the fixed- and adjustable-loop suspensory devices on the femoral side from December 2021 to December 2023. Knee function was evaluated using the Lysholm score, Lachman test, and Pivot-shift test, both preoperatively and at the one-year postoperative follow-up. Results: One year postoperatively, the Lysholm score averaged 90.62 ± 4.167 in the adjustable-loop group, with 83.1% of cases achieving good grades. In comparison, the fixed-loop group had a mean score of 90.15 ± 4.704, with 77.8% of cases obtaining good grades. However, no significant statistical difference was found between the two groups (p > 0.05). A negative pivot shift test was confirmed in 60 cases (92.3%) from the adjustable-loop group and 24 cases (88.9%) from the fixed-loop group (p = 0.5). No cases of infection, graft failure, or flexion limitation were recorded. Conclusion: There were no notable differences in graft laxity and functional outcomes between the fixed- and adjustable-loop devices for femoral fixation in arthroscopic ACLR.

CLINICAL OUTCOMES OF TRANSURETHRAL THULIUM LASER ENUCLEATION OF THE PROSTATE IN THE MANAGEMENT OF BENIGN PROSTATIC HYPERPLASIA

Tran Hoai Nam

Objectives: To evaluate the safety and efficacy of Thulium laser enucleation of the prostate (ThuLEP) as a treatment for benign prostatic hyperplasia (BPH), with a focus on clinical, functional, and anatomical outcomes. Methods: A prospective, cross-sectional study was conducted on 92 patients diagnosed with BPH at Military Hospital 175 from September 2023 to December 2024. Data were collected on preoperative and postoperative clinical symptoms (IPSS score), urinary function (Qmax and PVR), anatomical outcomes, and quality of life (QoL). Comparative analyses were performed, and results were benchmarked against international literature. Results:A total of 92 patients diagnosed with BPH, with an average prostate volume of 72.48mL, were included in the study. The average surgery duration was 84.5 minutes, and hemoglobin dropped by 1.1 g/dL postoperatively. The mean IPSS improved significantly from 28.7 preoperatively to 1.3 at six months postoperatively. Qmax increased from 2.7 mL/s to 23.1 mL/s, and prostate volume decreased by more than 50% on average. At six months, 94.2% of patients achieved excellent treatment outcomes, with no severe complications observed. Additionally, patients reported substantial improvements in QoL, with mean QoL scores dropping from 5.8 preoperatively to 0.1. Conclusion: ThuLEP demonstrates safety and efficacy in managing BPH, offering significant symptom relief, functional improvements, and favorable anatomical outcomes.

A CASE REPORT: CARCINOMA AFTER TRAUMATIC BRAIN INJURY CAUSED BY INCENDIARY WEAPONS

Tiến sĩ Nguyen Xuan Phuong

Carcinoma in patients with traumatic brain injury having retained metal foreign bodies does not commonly exist. Complications of local cancer by traumatic brain injury, having retained metal foreign bodies can occasionally occur. Changes mainly appear at the wound due to chronic inflammation and cell hyperplasia, which leads to cancer. The clinical case the authors introduce is a patient participating in the Resistance War for National Salvation who was shot by artillery pieces in the right temporal. The patient was admitted to the hospital and had experienced surgery to remove a tumor from the right temporal. The histopathology of the tumor was carcinoma. After surgery, the patient was awake, the incision recovered well, and the patient could live normally.

PROSEAL LARYNGEAL MASK AIRWAY VERSUS CLASSIC LARYNGEAL MASK AIRWAY FOR AIRWAY MANAGEMENT IN BURN NECROSIS AND SKIN GRAFTING SURGERY

TS Vo Van Hien

Objectives: To compare the efficiency of the classic laryngeal mask airway (c-LMA) and the proseal laryngeal mask airway (p-LMA) in patients with indications for burn necrosis and skin grafting surgery. Methods: A clinical descriptive, randomized comparison study was conducted on 60 patients divided into two groups: p-LMA (30 patients) and c-LMA (30 patients) were anesthetized with p-LMA and c-LMA, respectively. Accessing and comparing the ease of placement, respiratory function, and hemodynamic response, and the degree of airway injury after surgery between two groups. Results: 100% patients were successfully inserted laryngeal mask airway (LMA) with insertion time of 22.14 seconds and 20.56 seconds, respectively (p > 0.05); oropharyngeal leak pressure (OLP) was 28.56 cmH2O (p-LMA) and 19.66 cmH2O (c-LMA) (p < 0.05); hemodynamic and respiratory function during surgery were maintained in normal range and there was no difference between the two groups (p > 0.05), and no airway complications related to insertion technique (sore throat, hoarseness, or blood staining) were found in either group. Conclusion: Both LMAs are useful for managing airways in burn necrosis and skin grafting procedures. Both kinds of masks are simple to put on, do not significantly alter hemodynamic response or respiratory function, and patients recover safely from LMA placement without any problems.

EVALUATION OF GASTRIC CONDUIT PERFUSION RESULTS BASED ON REAL-TIME INDOCYANINE GREEN FLOW SIGNAL IN THORACOSCOPIC SURGERY FOR ESOPHAGEAL CANCER

Nguyen Van Tiep

Objectives: To evaluate gastric conduit perfusion (GCP) images based on indocyanine green (ICG) flow signal timing in thoracoscopic surgery for esophageal cancer (EsC). Methods: A cross-sectional descriptive study was conducted on 70 patients who were applied ICG to evaluate GCP during thoracoscopic surgery to treat EsC at 108 Military Central Hospital and Military Hospital 103 from June 2022 to June 2024. Results: The mean age was 59.0 ± 7.9 (32 - 71) years old; 100% were male. The anastomotic leak rate was 7.1%, with a mean gastric conduit (GC) width of 5.1 ± 0.2cm. Through ICG imaging, 17 patients with missing GC were detected. The average ischemic GC length was 2.7 ± 0.6cm. The time of appearance of the ICG signal in segments (B-C) and segments (A-D) of the anastomotic leak group was longer than that of the group without anastomotic leak (p < 0.05). Multivariable logistic regression analysis found that the greater the rate of ischemic GC, the higher the anastomotic leak rate (OR = 59.27; 95%CI= 1.25 - 2802.03; p = 0.04). Conclusion: Evaluation of GCP images based on ICG flow signal timing is feasible, safe, and objective. ICG current signal timing helps detect the location of the poorly perfused GC and select the appropriate location to create the anastomosis with a low anastomotic leak rate.

A CASE REPORT: METHODS TO ALLEVIATE REPERFUSION SYNDROME IN AMPUTATED ARM REPLANTATION

Tiến sĩ Vu Huu Trung

Limb replantation has been performed for decades and is being clinically applied more prevalently. Reperfusion syndrome crucially affects the outcome of the replantation and sometimes poses a life-threatening risk to patients, especially in cases with major surgeries like arm amputations. The following report presents methods to mitigate the syndrome in amputated arm replantation.

RESULTS OF BILIARY DILATION AND STONE REMOVAL VIA FLEXIBLE CHOLANGIOSCOPY FOR THE TREATMENT OF PRIMARY BILIARY STRICTURES AND STONES AT MILITARY HOSPITAL 103

Do Son Hai

Objectives: To evaluate the results of biliary dilation and stone removal via flexible cholangioscopy for the treatment of primary biliary strictures (BS) and stones. Methods: A prospective, descriptive, uncontrolled study was conducted on 62 patients with primary BS and stones treated by biliary dilation and stone removal via flexible cholangioscopy at Abdominal Surgery Centre, Military Hospital 103, from July 2021 to July 2024. Results: The mean age was 60.1 ± 14.1; the female/male ratio was 1.69/1. 75.8% of patients had a history of biliary stones. Most patients had multiple stones (79%), including choledocholithiasis and hepatolithiasis. BS were mostly in one location (90.3%), intrahepatic strictures (88.7%), and were all benign. The mean length and diameter of the strictures were 3.96 ± 2.9mm and 3.6 ± 0.7mm, respectively. Surgical methods were choledochotomy with intraoperative cholangioscopy (90.3%) and percutaneous cholangioscopy (9.7%). Stone removal was performed using baskets, electrohydraulic, and/or laser lithotripsy. BS was performed using balloon dilation; then, biliary-cutaneous stents were placed in 64.5% of cases at risk of recoil. Intraoperative complications accounted for 16.1%; postoperative complications accounted for 12.9%. The rate of stone clearance and successful stricture dilation after surgery was 83.9% and 87.1%. Rechecked at 1 month, 3 months, and 6 months after operation, the ratio of recurrent stones and BS was 0%, 0%, 5.8% and 1.9%, 7.4%, 11.1%, respectively. Conclusion: Stone removal and stricture dilation by flexible cholangioscopy is a safe and effective method for treating primary BS and stones.

OUTCOMES OF LONG-STEM CEMENTLESS HEMIARTHROPLASTY FOR UNSTABLE INTERTROCHANTERIC FEMORAL FRACTURES IN GERIATRIC PATIENTS: A TWO-YEAR FOLLOW-UP STUDY

TS Pham Ngoc Thang

Objectives: To assess the clinical outcomes of primary long-stem cementless bipolar hip arthroplasty as a treatment option for unstable intertrochanteric femoral fractures in geriatric patients. Methods: A retrospective study was conducted on 67 elderly patients aged > 70 years old with unstable intertrochanteric femoral fractures. Clinical outcomes were assessed based on the duration of walking without support, length of hospital stay, mortality rate, Harris Hip scores (HHS), and postoperative complications. Results: The mean age of patients was 84.34 ± 6.67. Fracture types included 43 cases of A2.2, 19 cases of A2.3, and 5 cases of A3.1. The mean follow-up duration was 27.89 ± 10.24 months. The mean duration of hospitalization was 15.37 ± 5.09 days. Median HHS at the last follow-up was 81.61 ± 7.06. Postoperative complications were four cases of pulmonary infection and one case of postoperative dislocation. During follow-up, the postoperative mortality rate was 5.97%. Conclusions: Primary cementless bipolar hemiarthroplasty is a secure and effective choice for the treatment of intertrochanteric femoral fracture in the elderly.