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Objective:To explore the effect of minimally invasive hematoma puncture and drainage in the treatment of elderly patients with cerebral hemorrhage by using 3D slicer and Sina software to conduct 3D reconstruction and preoperative localization of intracerebral hematoma.Methods:A total of 74 elderly patients with a first-onset intracerebral hematoma aged ≥75 years, having surgical indications and stable vital signs were grouped into 3D slicer plus Sina software localization group(as group A, n=40)or CT localization group(as group B, n=34). Based on the localization, hematoma puncture and drainage were performed after local anesthesia.Preoperative preparation time, hematoma location, puncture success rate, postoperative hematoma clearance rate, postoperative re-bleeding rate and GCS score were statistically analyzed.Glasgow coma scale(GCS)scores were used in predicting the mortality.Results:The preoperative preparation time was significantly shorter in group A than in group B[(5.5±3.4)min vs.(8.5±2.7)min, t=3.337, P=0.001]. The success rate of hematoma puncture and drainage(90.0% and 70.6%, χ2=4.51, P=0.034)and postoperative hematoma clearance rate[(87.5±3.4)% and(80.3±2.7)%, t=10.10, P=0.000]were higher in group A than in group B. There were no significant differences in operative time, the accuracy of hematoma localization, re-bleeding rate and GCS score between the two groups( P>0.05). Conclusions:3D slicer plus Sina software can precisely locate the intracerebral hematoma, and minimally invasive hematoma puncture and drainage of intracerebral hematoma under local anesthesia were safe and effective in the treatment of elderly patients with intracerebral hemorrhage.
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To explore the immunomodulatory effect of adriamycin on 4T1 breast cancer. We used a tandem mass tag-based quantitative proteomic method to detect differential proteins in breast cancer tissues, and multiple bioinformatics databases to analyze the differentially expressed proteins in the proteome. Also, we used enzyme-linked immunosorbent assay to detect the effects of adriamycin on helper T cells 1 and 2 in breast cancer tissues, and flow cytometry to detect CD4+ T cells, CD8+ T cells and regulatory T cells. We discovered the immunomodulatory targets of adriamycin in differential proteins. In total 170 differential proteins were significantly up-regulated, whereas 58 were markedly down-regulated. In addition, 73 proteins were involved in immune regulation. Kyoto encyclopedia of genes and genomes enriched important protein pathways related to cytokines and factor receptors, interleukin 17 pathway and cancer transcriptional regulatory pathways. These pathways and important differential proteins related to immunomodulatory functions were ultimately regulated by adriamycin on CD4+ T cells, CD8+ T cells and regulatory T cells, thereby affecting the prognosis of breast cancer. Moreover, adriamycin significantly increased interleukin 2, CD4+ T and CD8+ T (P<0.01) and markedly reduced regulatory T cells (P<0.05). The function of adriamycin against triple-negative breast cancer was closely related to the immunoregulation process of the differential proteins Ighm, Igkc, S100A8, S100A9 and Tmsb4x. Adriamycin could regulate the content of helper T cells 1 cytokines, CD4+ T and CD8+ T lymphocytes in breast cancer and reduce the number of regulatory T cells to produce immunomodulatory effects.
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Animals , Female , Humans , Mice , Breast Neoplasms/drug therapy , CD4-Positive T-Lymphocytes , CD8-Positive T-Lymphocytes , Disease Models, Animal , Doxorubicin/pharmacology , ProteomicsABSTRACT
Objective:To explore the effect of continuous obstetric-pediatric cooperative nursing on anxiety, depression and the parenting sense of competence in NICU premature mothers.Methods:Totally 140 mothers of NICU preterm infants in hospital from January 2018 to December 2018 were selected and randomly divided into the control group and intervention group according to the method of random number table, and each group 70 cases. The control group received the routine nursing mode in obstetrics and paediatrics and the intervention group received the continuous obstetric-pediatric cooperative nursing based on routine nursing. To compare the anxiety level, depression level, the score of parenting sense of competence, hospitalization days of preterm infants, the outpatient rate and the readmission rate of preterm infants within 1 months of discharge between two groups.Results:The levels of anxiety and depression of the mothers of premature infants in the intervention group during hospitalization ,1 week after discharge and 1 month after discharge were (43.17±6.89), (8.96±2.67), (34.65±6.87), (7.65±1.92), (34.97±6.06), (6.29±1.54) points, lower than control group (47.03±8.06), (10.97±3.34), (45.44±7.72), (9.43±2.61), (41.46±7.26), (8.28±2.23) points, the differences between the two groups showed statistical significance ( t value was 2.331-6.097, P<0.05). The two dimensions of parenting efficacy and parenting satisfaction were (31.47±4.97), (43.38±4.21) points, which were higher than (25.91±5.42), (39.43±5.91) points of the control group, there were significant statistical differences among the two groups ( t value was -6.314 and -4.528, P<0.01). The hospitalization days of premature infants, outpatient and readmission rate within 1 month of discharge were (13.25±3.27) days, 8.57% (6/70), 2.86% (2/70), which were shorter or lower than (15.59±2.79) days, 24.29% (17/70), 12.86% (9/70) in the control group, the differences were statistically significant ( t value was 2.909, χ2 values were 6.295, 4.834, P<0.05). There were significant statistical differences among interaction effect, time effect and intergroup effect ( F values were 4.921-99.310, P<0.05). Conclusion:Obstetrical-pediatric cooperative nursing can effectively to lower the anxiety and depression level of preterm mothers, improve the parental competence, promote the mental health of preterm mothers, and ultimately shorten hospital days and decrease the rate of outpatient and readmission of premature infants, which is conducive to preterm infants′ rehabilitation.
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OBJECTIVE: To investigate the effects of Xuesaitong for injection on microembolic signal (MES) and blood lipid of patients with middle cerebral artery (MCA) atherosclerotic stenosis complicated with MES positive transient ischemic attack (TIA). METHODS: A total of 98 patients with MCA atherosclerotic stenosis complicated with MES positive TIA in the Affiliated Hospital of Chengdu University of TCM during May 2015-May 2016 were divided into routine group and Xuesaitong group according to random numble table, with 49 cases in each group. Routine group received routine treatment. Xuesaitong group was additionally given Xuesaitong for injection (lyophilized) 400 mg intravenously, once a day, for consecutive 15 d, on the basis of routine treatment. The distribution of MES classification and the number of MES were observed in 2 groups before treatment, 15 d after treatment and 3rd and 6th month after treatment. The levels of TG, TC, LDL were observed before treatment and 15 d after treatment. The occurrence of ischemia event and ADR were recorded. RESULTS: Fifteen days after treatment, the distribution of MES classification in 2 groups was significantly better than before treatment; Xuesaitong group was significantly better than routine group, with statistical significance (P＜0. 05). At 3rd and 6th month after treatment, the distribution of MES classification in Xuesaitong group was significantly better than routine group; 6th month after treatment was significantly better than 3rd month after treatment, with statistical significance (P＜0. 05). Fifteen days and the 3rd, 6th month after treatment, the number of MES in 2 groups were significantly lower than before treatment and decreased as time; Xuesaitong group was significantly lower than routine group, with statistical significance (P＜0. 05). Fifteen days after treatment, TG and TC levels of 2 groups were significantly lower than before treatment; Xuesaitong group was significantly lower than routine group, with statistical significance (P＜0. 05); there was no statistical significance in the level of LDL before and after treatment (P＞0. 05). The incidence of ischemic events in routine group at 6th month after treatment was significantly higher than 3rd month after treatment, and the incidence of ischemic events in Xuesaitong group at 3rd and 6th month after treatment was significantly lower than routine group, with statistical significance (P＜0. 05). At 6th month after treatment, the incidence of ADR in 2 groups was significantly lower than 3rd month, with statistical significance (P＜0. 05). CONCLUSIONS: Based on routine treatment, Xuesaitong for injection can reduce the number of MES, reduce the incidence of ischemia events and further improve the level of blood lipid in patients with MCA atherosclerotic stenosis complicated with MES positive TIA without increasing the occurrence of ADR.
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Objective We attempted to investigate optic radiation (OR) injury and visual field mean defect (MD) in patients with hypertensive putaminal hemorrhage by using diffusion tensor imaging (DTI). Methods Thirty-three first onset of patients with hypertensive putaminal hemorrhage and 30 normal healthy control subjects were recruited. DTI data were acquired between 3 and 5 days as well as 3 months after onset. DTI-Studio software was used to reconstruct the OR and examine the degree of OR injury (typeⅠ, Ⅱ, and type Ⅲ). Fractional anisotropies (FA) and apparent diffusion coefficient (ADC)values of the ORs were measured. Statistical analysis was performed to calculate hematoma volume, MD,OR-FA and ADC values by using SPSS 17.0 software. Results FA and ADC values of ORs were not significantly different between the two hemispheres in normal control groups (student t-test, P>0.05). Compared with MD values in control group, the visual field was significantly impaired in patients group (P<0.01). FA and ADC values of ORs were significantly different between two hemispheres in patient group (student t-test, P<0.01). There was no correlation of hematoma volume with OR-FA nor with ADC values nor with MD values (P>0.05). The MD values were correlated with OR-FA and ADC values after onset(P<0.05). MD, FA and ADC values of ORs in the affected hemisphere of the patient group were significantly different for the three OR types between 3 and 5 days as well as 3 months after onset (P<0.01). Conclusion DTI can examine the three-dimensional relationship between hematoma and OR, reflect the changes of OR morphology and predict the degree of visual-field defects.
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Objectives To conduct grading comparison for the damage degree of pyramidal tracts after procedure in patients with unilateral hypertensive putamen hemorrhage via transsylvian-transinsular (TS-TI) approach and transcortical transtemporal (TC-TF) approach using magnetic resonance diffusion tensor imaging (DTI) and to evaluate the postoperative recovery of the patients according to the quality criteria of the activities of daily living (ADL),and to identify the advantages and disadvantages of both surgical approaches.Methods Sixty-three consecutive patients with first onset of unilateral hypertensive basal ganglia putamen hemorrhage admitted to Department of Neumlsurgery in Affiliated Hospital of Southwest Medical University of Traditional Chinese Medicine were enrolled prospectively.The volume of hematoma at admission was 26-45 ml.They were randomly divided into group A and group B by random number table.The patients in group A (n =31) were treated via the TS-TI approach,and those of group B (n =32) were treated via the TC-TT approach.The operator was the same surgeon.The patients of rebleeding were excluded (4 in group A,7 in group B),and 52 patients were actually included,including 27 in group A and 25 in group B.The DTI examinations were perforrned 5 to 8 d after procedure.The image data were processed by PHILIPS Extended MR Workspace 2.6.3.4 (EMW 2.6.3.4) software.The bilateral pyramidal tracts were reconstructed,the damage degree of pyramidal tract and its relationship with hematoma and surgical approach were observe respectively.The ADL quality criteria were used to evaluate the recovery at 3 months after procedure.The SPSS 17.0 software was used to conduct rank sum test for the pyramidal tract injury grade after procedure in both groups.The number of rebleeding in the operation areas and the ADL quality criteria evaluation were tested by Chi-squared test.Results There was no significant difference in the postoperative rebleeding rate between group A (12.9％,4/31) and group B (21.9％,7/32) (x2 =0.367,P =0.545).The postoperative pyramidal tract damage degree of group A was better than that of group B.There was significant difference (U =180.00,P =0.004).The comparison of ADL quality evaluation in both groups after procedure showed that the good prognosis rate (81.5％,22/27) of group A after procedure was better than that of group B (56.0％,14/25).There was significant difference (x2 =3.957,P =0.047).Conclusions The three-dimensional relationship between the hematoma lesions and the pyramidal tracts was observed by DTI,the damage degree of the pyramidal tracts were identified.The TS-TI approach was superior to the TC-TF approach in the postoperative damage degree of pyramidal tract and the quality of ADL for the treatment of hypertensive putamen hemorrhage.
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Objective To investigate the frequency of JAK2 V617F mutation and JAK2 V617F mutation allele burden in patients with essential thrombocythemia (ET), and explore the relationship between mutation and hematological parameters and coagulation function. Methods The clinical and laboratory parameters of 90 ET patients were analyzed. JAK2 V617F mutation was detected by AS-PCR and the mutation allele burden of JAK2 V617F was detected by qPCR. The correlation between mutation frequency and mutation burden of JAK2 V617F and blood laboratory parameters were investigated in ET. Results JAK2 V617F mutation was found in 50 patients (55.6 %). RBC [(4.67±0.89)×109/L vs (4.04±0.99)×109/L, P =0.003], WBC (11.64±5.20)×109/L vs (9.11±4.11)×109/L, P = 0.014], HCT (0.41±0.07) vs (0.36±0.07), P =0.005) in the JAK2 V617F mutated group were higher than those in the wild-type group. PT in mutated patients was longer than that in wild-type group [(13.18±1.63) s vs (12.02±1.24) s, P = 0.000]. The JAK2 V617F mutation allele burden was (29.91 ±18.63) %. No significant correlation was found between JAK2 V617F mutation allele burden and hematological parameters such as WBC, RBC and Plt (all P>0.05), but the JAK2 V617F mutation allele burden had a significant correlation with FDP (r = 0.456, P = 0.001). Conclusions JAK2 V617F mutation occurs in significant percentage patients with ET. Detection of JAK2 V617F mutation allele burden at diagnosis may play an important role in the early prevention of vascular events.
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OBJECTIVE:To systematically review the efficacy and safety of Deproteinised calf blood serum injection in the treatment of cerebral infarction,and to provide evidence-based reference for clinical treatment.METHODS:Retrieved from Co-chrane Library,EMBase,Medline,CBM,CJFD,VIP and Wanfan database,randomized controlled trials(RCT)about theeffica-cy and safety ofDeproteinised calf blood serum injection(test group)based on basic treatment(control group)in the treatment of cerebral infarction were collected.Meta-analysis was performed by using Rev Man 5.2 software after data extraction and quality eval-uation with Cochrane system evaluation manual 5.1.0.RESULTS:A total of 18 RCTs were included,involving 2 111 patients.Re-sults of Meta-analysis showed the total effective rate [OR=3.30,95%CI(2.48,4.39),P<0.001],National Institutes of Health Stroke Scale (NIHSS) score[MD=-1.47,95%CI(-2.06,-0.88),P<0.001] and activities of daily living(ADL) score[MD=9.09,95%CI(6.46,11.72),P<0.001] in test group were significantly better than control group,there were significant differences be-tween the 2 groups;and there was no obvious adverse reactions during treatment. CONCLUSIONS:Both efficacy and safety of De-proteinised calf blood serum injectionin the treatment of cerebral infarction are good.
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Objective To explore clinical characteristics and diagnosis of aggressive natural killercell leukemia (ANKL),and evaluate the value of flow cytometry (FCM) in diagnosing it.Methods A case of ANKL was reported and literatures were reviewed.Results The patient presented with persistent high fever,progressive pancytopenia and hepatosplenomegaly.The untypical cells could be seen by morphology.By FCM,NK cells consisted 83.3 ％ of total lymphocytes in bone marrow and immunophenotypes were CD34-,CD2+,CD7+,CD3-,CyCD3+,CD5-,CD16+,CD56+,CD30-,CD4-,CD8-,CD117-,CD11c,CD19-,CD45++,SSC+-++.T-cell receptor (TCR) and IgH gene rearrangement were negative and chromosome was normal.The patient was diagonised ANKL eventually.Conclusions ANKL is a quite rare disease with highly aggressive,poor prognosis and could be misdiagnosed easily.FCM combined with morphology is a convenient,handy,practicable and less invasive device for the diagnosis,and can be a preferred detection technique in some cases.
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A molecularly imprinted polymer (MIP) for the selective solid phase extraction of imidacloprid, imidaclothiz, thiacloprid was synthesized by polymerization for 24 h using thiacloprid as template. Dynamic adsorption and selective adsorption test showed that the MIP could quickly adsorb the imidacloprid, imidaclothiz, thiacloprid, with good selectivity for targets. The maximum static adsorption capacity of MIP was 31. 7, 36. 7 and 45. 3 mg / g, respectively. A molecularly imprinted solid phase extraction (MIP-SPE) was developed to separate, clean up and enrich the thiacloprid, imidacloprid and imidaclothiz residue in paddy water, soil, rice, tomato, cucumber. The average recoveries were 80. 2% -98. 8% , with relative standard deviation of 1. 4% -4. 5% . The MIP-SPE was used to analyses the real samples, the result was satisfied.
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This study was aimed to observe clinical efficacy of Bushen Huoxue Kaiqiao (BSHXKQ) treatment of diabetes-induced vascular mild cognitive impairment . A total of 30 cases of diabetes-induced vascular mild cognitive impairment were randomly divided into the treatment group ( 15 cases ) and the control group ( 15 cas-es). The treatment group received free-fried BSHXKQ prescription (Cistanche 10 g, Shichangpu 5 g, Sanqi 2 . 5 g ) for treatment 3 times a day , and in combination of 30 mg of nimodipine , 3 times a day . In the con-trol group , 30 mg of nimodipine was orally administrated 3 times a day . The treatment was continued for 6 months. Clinical Dementia Rating (CDR), Activity of Daily Living Scale (ADL), Montreal Cognitive Assessment Beijing Edition ( MoCA ) and TCM Syndrome Score were used in the evaluation before and after the treatment . The results showed that the rate of progress was in both groups after treatment . In the treatment group , the rate was 86 . 70%, and in the control group the rate was 33 . 33%. The total effective rate in the treatment group was superior to the control group ( P < 0 . 05 ) . There were statistical significances in the MoCa Scale , ADL Scale and TCM Syndrome Score before and after treatment in each group ( P < 0 . 05 ) . The treatment ef-fect in the treatment group was superior to the control group ( P < 0 . 05 ) . There was no statistical significance in the incidence of adverse events in both groups . It was concluded that the effect of BSHXKQ prescription in the treatment of diabetes-induced vascular mild cognitive impairment was superior to nimodipine in improving activities of daily living , cognitive function , degree of dementia and TCM syndrome score . There was no differ-ence in the incidence of adverse events compared with nimodipine .
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ObjectiveTo explore clinical characteristics and diagnosis of patients with granulocytic sarcoma (GS),and to evaluate the value of FCM in diagnosing it.MethodsClinical data of one patient with GS was reviewed and related literature was reviewed. ResultsThe patient was diagnosed as AML-M2,chromosomal karyotype was 46.XY, t (8;21)(q22;q22)and the AML/ETO gene was positive. Systemic chemotherapy with daunorubicin plus cytarabine was given and complete remission was received. Then a nodular in medial angle of right eye was found. Result of CT indicated the possibility of leukemia infiltration.Needle aspiration cytology was conducted and many blast cells were found by microscope.CD34+ CD117+ CD13+ CD33+CD45dim SSC+ can be found by FCM. The cytology was complete remission and minimal residual disease was negative. Finally diagnosis was GS, relapse of AML. After a systemic chemotherapy with large dose of cytarabine plus teniposide (cytarabine 6.0 g/d, d1-3;teniposide 50 mg/d, d1-3), the mass could not be touched and the follow-up was continued.Conclusion Although relapse of AML often occurs in the testicle or the central nervous system,it pay attention to the possibility of relapse of AML presenting as GS.Fine needle aspiration cytology(FNAC)combined with FCM can provide an convenient, handy, practicable and less invasive way of the diagnosis and can be a preferred detection technique.
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Objective To study the significance of morphologic, immunophenotype, cytogenetic features, molecular biology (MICM) and prognosis of t (8;21) acute myeloid leukemia (AML) patients.Methods Morphological, FAB subtypes, flow cytometric immunophenotyping, G-binding technique and RTPCR were performed in 70 AML patients with t (8;21) and AML1-ETO fusion transcripts as compared with normal karyotype 70 AML patients. Results In 70 AML patients with t(8;21), 1 case of M1, 64 cases of M2, 3cases of M4 and 2 cases of ambiguity AL according to FAB classification. The CD13, CD33, CD34 and CD117expression were higher, meanwhile CD19 was positive in 40 %, CD15 was 11%, CD11b was 10 % and CD7 was 7 %. Cytogenetically, 50 % cases had additional chromosomal abnormalities, and main associated recurrent additional abnormalities were loss of a sex chromosome, 9q- and hyperdiploid. AML1/ETO fusion gene transcripts were detected in all 70 AML patients with t(8;21) by RT-PCR. CR rate of t(8;21) AML with CD19were 72 %, t(8;21) AML with CD19 and CD7 were 0; in normal karyotype AML were 31%. Conclusion The t(8;21) is the characteristic chromosome abnormality of M2. In the t(8;21), CD19, CD34 and CD117 expression are high, while CD7 are low. These antigen expression in t(8;21) AML closely correlated with karyotype. CD19 is a marker of good prognosis, but CD7 is a marker of low CR.