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Objective To investigate the risk factors of anastomotic leakage after radical gastrectomy for gastric cancer and establish a risk prediction scoring model for postoperative anastomotic leakage.Methods The retrospective case-control study was conducted.The clinicopathological data of 1 757 patients who underwent radical gastrectomy for gastric cancer in the First People's Hospital of Yibin from February 2000 to December 2017 were collected.There were 1 207 males and 550 females,aged (59± 11) years,with a range from 48 to 70 years.Observation indicators:(1) follow-up situations;(2) risk factors analysis of anastomotic leakage after radical gastrectomy for gastric cancer;(3) establishment of risk prediction scoring model and verification;(4) risk prediction scores and probability of anastomotic leakage in patients with different scores.Follow-up using outpatient examination and telephone interview to detect anastomotic leakage after radical gastrectomy and reoperation or death caused by anastomotic leakage up to June 2018.Measurement data with normal distribution were represented as Mean±SD.Count data were described as absolute number.The univariate analysis and multivariate analysis were performed using the chi-square test and Logistic regression model respectively.The discrimination and fitting degree of the model were detected by the Hosmer-Lemeshow test and receiver operating characteristic (ROC) curve.Results (1) Follow-up situations:800 of 1 757 patients were followed up at 1 week,1 month,3 months and 6 months after discharge.During the follow-up,75 had anastomotic leakage,60 of which recovered after conservative treatment,9 recovered after reoperation,6 died of complications including septic shock and cardiac and respiratory failure.(2) Risk factors analysis of anastomotic leakage after radical gastrectomy for gastric cancer:results of univariate analysis showed that patients with diabetes,preoperative pulmonary insufficiency,preoperative level of albumin and volume of intraoperative blood loss were related factors affecting anastomotic leakage after radical gastrectomy for gastric cancer (x2=5.604,4.975,18.563,35.688,P＜0.05).Results of multivariate analysis showed that patients with diabetes,preoperative pulmonary insufficiency,preoperative level of albumin ＜ 30 g/L and volume of intraoperative blood loss ＞ 400 mL were independent risk factors affecting anastomotic leakage after radical gastrectomy for gastric cancer (odds ratio=2.337,1.946,3.478,4.357,95％ confidence interval:1.136-4.804,1.022-3.705,1.871-6.464,2.678-7.090,P＜0.05).(3) Establishment of risk prediction scoring model and verification.Risk prediction equation was established according to the multivariate Logistic regression results:P =1/1 +exp (4.092-0.666 * X1-0.849 * X2-1.246 * X3-1.472 * X4).The fitting degree of the model was detected by the Hosmer-Lemeshow test (P=0.287).The discrimination of the model was detected by the ROC curve,with the area under curve as 0.734 (95％ confidence interval:0.689-0.834,P=0.002).(4) Risk prediction scores and probability of anastomotic leakage in patients with different scores:the risk prediction scores of anastomotic leakage after radical gastrectomy for gastric cancer were 1,1,2,2 in patients with diabetes,preoperative pulmonary insufficiency,preoperative level of albumin ＜ 30 g/L and volume of intraoperative blood loss ＞400 mL,respectively.The incidence of anastomotic leakage of patients with risk prediction scores of 0,1,2,3,4,5,6 was 1.6％,3.2％,5.9％,10.1％,19.3％,31.8％ and 47.6％,respectively.The incidence of anastomotic leakage was 13.7％ of patients with score ≥3 and 3.5％ of patients with score ＜ 3.Conclusions Patients with diabetes,preoperative pulmonary insufficiency,preoperative level of albumin ＜ 30 g/L and volume of intraoperative blood loss ＞ 400 mL are independent risk factors affecting anastomotic leakage after radical gastrectomy for gastric cancer.Establishment of a risk prediction scoring model for anastomotic leakage after radical gastrectomy for gastric cancer can effectively identify high-risk patients with anastomotic leakage after radical gastrectomy.
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Objective@#To explore the effect of simulated family ward in training and management of illiterate rural peritoneal dialysis catheter patients.@*Methods@#Between January 2013 and December 2013 in our department, 80 patients with peritoneal dialysis catheter rural illiteracy as the research object, using the random number table method, the patients can be divided into the experimental group and control group, 40 cases of control group accepted traditional way standard training, the experimental group adopted simulation training family ward as the carrier, two groups of patients were carried out by the same pd specialist nurse training, the control group patients take traditional 7 days training courses for training, the experimental group according to the characteristics of the illiterate patients, an interactive learning mode of explanation-demonstration-imitation-case analysis-feedback and so on was established in the simulated family ward based on real objects and pictures. The training lasted for 5-7 days.After 12 months of observation, the changes of peritonitis and outlet infection cases, edema, blood pressure, outpatient follow-up compliance and laboratory examination indexes in the two groups were statistically analyzed.@*Results@#There were 5 cases of peritonitis, 2 cases of exit infection and 27 cases of edema in the experimental group, and 13 cases, 10 cases and 34 cases in the control group, respectively. The difference between the two groups was statistically significant (χ2=4.126, 5.847, Z=2.382, all P<0.05).The systolic blood pressure and diastolic blood pressure in the experimental group were (131± 13) and (86± 9) mmHg, respectively, and those in the control group were (140±15) and (92±11) mmHg, respectively. The differences between the two groups were statistically significant (t=2.789 and 2.595, all P<0.05). Compliance of outpatient follow-up was good in 33 cases in the experimental group and 27 cases in the control group, and the difference between the two groups was statistically significant (χ2=4.551, P<0.05).@*Conclusions@#The education and training of rural illiterate patients with peritoneal dialysis catheterization in simulated family wards has mobilized the patients' participation, improved their cognitive level, and improved their treatment compliance, thus effectively improving the patients' peritoneal dialysis effect and quality of life.
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Objective To explore the effect of simulated family ward in training and management of illiterate rural peritoneal dialysis catheter patients. Methods Between January 2013 and December 2013 in our department, 80 patients with peritoneal dialysis catheter rural illiteracy as the research object, using the random number table method, the patients can be divided into the experimental group and control group, 40 cases of control group accepted traditional way standard training, the experimental group adopted simulation training family ward as the carrier, two groups of patients were carried out by the same pd specialist nurse training, the control group patients take traditional 7 days training courses for training, the experimental group according to the characteristics of the illiterate patients, an interactive learning mode of explanation-demonstration-imitation-case analysis-feedback and so on was established in the simulated family ward based on real objects and pictures. The training lasted for 5-7 days.After 12 months of observation, the changes of peritonitis and outlet infection cases, edema, blood pressure, outpatient follow-up compliance and laboratory examination indexes in the two groups were statistically analyzed. Results There were 5 cases of peritonitis, 2 cases of exit infection and 27 cases of edema in the experimental group, and 13 cases, 10 cases and 34 cases in the control group, respectively. The difference between the two groups was statistically significant (χ2=4.126, 5.847, Z =2.382, all P<0.05).The systolic blood pressure and diastolic blood pressure in the experimental group were (131± 13) and (86± 9) mmHg, respectively, and those in the control group were (140 ± 15) and (92 ± 11) mmHg, respectively. The differences between the two groups were statistically significant (t=2.789 and 2.595, all P<0.05). Compliance of outpatient follow-up was good in 33 cases in the experimental group and 27 cases in the control group, and the difference between the two groups was statistically significant (χ2=4.551, P<0.05). Conclusions The education and training of rural illiterate patients with peritoneal dialysis catheterization in simulated family wards has mobilized the patients' participation, improved their cognitive level, and improved their treatment compliance, thus effectively improving the patients' peritoneal dialysis effect and quality of life.
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Objective To investigate the effect of miRNA -1 00 on the proliferation of human leukemia cells HL -60,and to explore the mechanism of this action.Methods The bioinformatics software and database were applied to predict and analyze target genes of miRNA -1 00.The vector contained the target gene 3′UTR portion cloned into a luciferase reporter construct.A luciferase reporter assay was performed following co -transfection of small molecular miRNA -1 00 mimics and target gene wild -type or mutant plasmid into HEK -293T cells.HL -60 cells were trans-fected with miRNA -1 00 mimics or anti -miRNA -1 00.After transfection,Western blot was applied to validate the expression of carboxy -terminal domain small phosphatase -like protein (CTDSPL),and the viability of HL -60 was measured by using cell counting kit (CCK -8)assay at 24 h,48 h,72 h,96 h.Results Online software predicted that CTDSPL was likely to be the target gene of miRNA -1 00.Dual luciferase reporter gene assay system showed that miRNA -1 00 could significantly suppress the activity of reporter gene containing CTDSPL 3′-UTR which decreased by about 57.1 %(P =0.000 7).Western blot showed that the expression of CTDSPL was increased after being trans-fected with miRNA -1 00 antisense oligonucleotides and decreased after being transfected with miRNA -1 00 mimics.At the same time,the growth rate of cells treated with miRNA -1 00 mimics or CTDSPL miRNA -1 00 was increased com-pared with that in control by CCK -8 test (P <0.05 ).Conclusions CTDSPL is a downstream target gene of miRNA -1 00.miRNA -1 00 can promote leukemia cell proliferation by inhibiting the expression of CTDSPL.
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<p><b>OBJECTIVE</b>To investigate the expression of miR-181a in bone marrow (BM) samples of pediatric acute lymphoblastic leukemia (ALL) and explore the mechanism of miR-181a on ALL cell line CCRF-CEM and drug resistance cell line CEM-C1.</p><p><b>METHODS</b>BM samples were obtained from 18 patients where matched samples at initial diagnosis and first BM relapse or complete remission were available. BM samples and cord blood samples (normal controls) were used to confirm the differential expression of miRNA-181a by quantitative real-time polymerase chain reaction (qRT-PCR). The expressions of miR-181a in both CCRF-CEM and its mutidrug-resistant counterpart CEM-C1 cells were also detected. Then, CCK-8 assay was performed to quantify the effects of miR-181a on CEM-C1 and CCRF-CEM cells growth and viability.</p><p><b>RESULTS</b>Up-regulated miR-181a with higher fold changes in both initial diagnosis (4.84 ± 2.71, 7.58 ± 2.50) and relapsed samples (6.53 ± 2.20) compared to normal controls (1.41 ± 0.53) (P=0.017, 0.000, 0.001, respectively) were observed, whereas the miR-181a expression in the samples of CR (1.35 ± 0.35) compared to normal control showed no significant difference (P=0.863). The miR-181a expression level was higher in CEM-C1 cells (-4.39 ± 0.08) than of in CCRF-CEM cells (-2.32 ± 0.03) (P=0.000). CCK-8 assay revealed that suppression of miR-181a in CEM-C1 cells by transfecting the specific inhibitor of miR-181a led to significantly higher cellular proliferation inhibition rate than negative control cells (P<0.05), IC50 were 30.61 ng/ml and 2 255.00 ng/ml with RI as 73.67. While increased miR-181a in CCRF-CEM cells led to significantly lower CPIR than negative control cells (P<0.01), IC50 were 126.60 ng/ml and 1.34 ng/ml with RI as 94.26.</p><p><b>CONCLUSION</b>Upregulation of miR-181a might play an important role in the development of drug resistance in CEM-C1 cells, and knockdown of miR-181a could sensitize CEM-C1 cells to camptothecin; Meanwhile increased expression of miR-181a could promote CCRF-CEM drug resistance. These results suggested that suppression of miR-181a expression might provide a promising therapeutic in drug resistance of leukaemia.</p>
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Child , Humans , MicroRNAs , Precursor Cell Lymphoblastic Leukemia-Lymphoma , Real-Time Polymerase Chain Reaction , Up-RegulationABSTRACT
Objective To validate the therapeutic effect of acupuncture stage treatment on facial spasm and seek a better method for treating this disease. Method One hundred and forty patients were randomly allocated to stage treatment (50 cases), acupuncture (50 cases) and Western medicine (40 cases) groups. In the stage treatment group, treatment was divided into early, middle and late stages according to the patients’ duration of disease. Each stage provided acupuncture point injection of different medicine plus warm needling. The acupuncture group received conventional acupuncture with 1 hour retention of needles and the Western medicine group, oral administration of carbamazepine tablets, 0.2 g 3 times a day. After the completion of treatment course, a six-month follow-up was performed to determine no relapse or aggravation in the three groups and the therapeutic effects were evaluated using Cohen and Albert spasm grading criteria.Result The complete resolution rate was 56% (28/50) in the stage treatment group, 14.0% (7/50) in the acupuncture group and 20.0% (8/40) in Western medicine group. The complete resolution rate was significantly higher in the stage treatment group than in the acupuncture and Western medicine groups (P<0.05). The total efficacy rate was 100.0% (50/50) in the stage treatment group, 70.0% (35/50) in the acupuncture group and 60.0% (24/40) in the Western medicine group. The total efficacy rate was significantly higher in the stage treatment group than in the acupuncture and Western medicine groups (P<0.05).Conclusion Stage treatment has a marked effect on facial spasm.
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Objective To discuss the correlation between plasma homocysteine (Hcy) and diabetes and pre-diabetes.Methods Participants included 115 patients with diabetes,150 patients with abnormal glucose tolerance diagnosis for pre-diabetes and 131 cases without blood glucose abnormalities crowd as control.All the basic informations of the subjects were recorded detailedly.Multiple factors regression analysis was completed.Results Development of diabetes single factor correlation analysis result showed that history of hypertension,hyperlipidemia,body mass index (BMI) ≥ 24 kg/m2,high Hcy were positively correlated with development of diabetes,and life rules was negatively correlated with development of diabetes (P ＜ 0.05 or ＜ 0.01).Development of diabetes multiple factors correlation analysis result showed that history of hypertension,hyperlipidemia,BMI ≥ 24 kg/m2,high Hcy were the independent risk factor for development of diabetes (P ＜ 0.05).Development of pre-diabetes single factor correlation analysis result showed that hyperlipidemia,BMI ≥24 kg/m2,high Hcy were correlated with development of pre-diabetes (P ＜ 0.01).Development of pre-diabetes multiple factors correlation analysis result showed that hyperlipidemia,BMI ≥ 24kg/m2,high Hcy were the independent risk factor for development of pre-diabetes (P ＜ 0.05).Conclusions Plasma Hcy is intimate correlated with diabetes and pre-diabetes,and it is an independent risk factor for development of them.In clinical work,the patients with high Hcy need to give the necessary intervention.
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Objective To observe the effect of salvia lignstrazine combined with methylcobalamin in treatment of type 2 diabetic peripheral neuropathy.Methods From May 2010 to May 2011,112 cases of type 2 diabetic peripheral neuropathy patients were classified into two groups by random digits table,control group of 56 cases were treated with methylcobalamin and observation group of 56 cases were treated with salvia lignstrazine combined with methylcobalamin.The clinical effects,motor nerve conduction velocity (MNCV) and sensory nerve conduction velocity (SNCV) of common peroneal nerve and tibial nerve between two groups were compared.Results The total effective rate in observation group was 87.5％(49/56),which was significantly higher than that in control group [ 57.1％( 32/56 ) ] (P ＜ 0.05 ).After treatment,the levels of MNCV and SNCV of common peroneal nerve and tibial nerve were (47.89 ± 6.93 ),(49.12 ± 5.54) m/s and (43.69 ± 4.97 ),(42.35 ± 5.14) m/s in observation group,which were significantly increased compared with those before treatment,while the levels of MNCV and SNCV of common peroneal nerve and tibial nerve were (41.15 ± 4.36),(39.89 ± 3.67 ) m/s and (37.57 ± 3.08),(36.56 ± 2.81 ) m/s in control group,which had no significant difference compared with those before treatment (P ＞ 0.05 ).Moreover,the levels of MNCV and SNCV of common peroneal nerve and tibial nerve in observation group were significantly higher than those in control group (P＜ 0.05).Conclusion Salvia ligustrazine combined with methylcobalamin in treatment of type 2 diabetic peripheral neuropathy can enhance the clinical effects,and improve neurological status,and can be applied in clinic.
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Objective To observe the effect of PI3K/AKT signal passageway on renal tubulointerstitial fibrogenesis of UUO rats.Methods Thirty Sprague Dawley rats were divided into two groups,the sham-operated group and the uuo model group.The model group's left ureter was dissociated to be obstructed.The sham-operated group was dissociated left ureter only without obstruction.Five rats of each group were killed respectively at 5,10,15(days after) surgery.Histological changes of renal tubular interstitium was observed by HE and Masson staining.Immunohistochemistry was performed on left renal tubular interstitium for AKT1,phospho-AKT1,TGF-?1 in renal(tubulointerstitum) at each time point.Results AKT1,phospho-AKT1and TGF-?1 were faintly stained in the sham-operated kidneys.Immunostaining of AKT1,phospho-AKT1 and TGF-?1 in renal tubulointerstitium increased(progressively) starting from 5 to 15 days after UUO(vs sham-operated group,P