ABSTRACT
Objective:To investigate the effect of different spray-coagulation time of argon plasma coagulation (APC) injury on the Glisson system primary branche(G1) in the hepatic portal of pigs.Methods:Fifty clean healthy domestic pigs (27 females and 23 males, aged 7 to 14 months) were selected, with the body weighted (100.0±9.5) kg. They were randomly divided into five groups (A, B, C, D, and E), with 10 pigs in each group. G1 models were made and sprayed by APC for 1, 2, 3, 4, and 5 seconds. The damage, maximum damage area, maximum damage depth, and damage of the three branches of the Glisson system (the first branches of the portal vein, intrahepatic bile duct, and hepatic artery) were compared among the groups. The pigs were divided into two groups based on whether the three branches were damaged or not: the three-branch damage group ( n=23) and the control group ( n=27). The maximum damage area and maximum damage depth were compared between the two groups. Results:After the APC spraying, circular or elliptical damage appeared on the surface of the G1, with changes such as yellow-brown color, brown color, charred appearance, and defects. Under the microscope, G1 capsule was found to be deficient, the fibrous tissue beneath the capsule was ruptured, and the structures of small blood vessels and small bile ducts were incomplete. " Burn marks" and damage to the three branches of the Glisson system in G1 were also observed, and the damage was more severe at the center of the spray-coagulation. As the spray-coagulation time increased, the maximum damage area of the G1 model also increased, and the two were positively correlated ( r=0.90, P<0.001). The maximum damage depth was also positively correlated with spray-coagulation time ( r=0.97, P<0.001). The numbers of pigs with damage to the three branches of the Glisson system in Groups A-E were 0, 2, 5, 6, and 10, respectively, and the number of pigs with damage increased with the spray-coagulation time. In the three-branch damage group, the spray-coagulation time, maximum damage area, and maximum damage depth were all higher than those in the control group (without three-branch damage), and the differences were statistically significant (all P<0.05). Conclusion:The degree of damage to G1 caused by APC is positively correlated with the spray-coagulation time, and damage to the three branches of the Glisson system in G1 is related to the maximum damage area, maximum damage depth, and APC spray-coagulation time.
ABSTRACT
Objective:To determine the predictive value of preoperative monocyte-to-lymphocyte ratio(MLR) for prognosis in elderly patients with upper tract urothelial carcinoma (UTUC) after radical nephroureterectomy(RNU).Methods:A retrospective study was performed on 168 elderly patients who underwent RNU in Beijing Hospital between March 2004 to February 2019.Males accounted for 44.6% (75 patients) and females 55.4%(93 patients) of the patients. Median age at the time of surgery was 73(69-78) years, and 110 (65.5%) patients suffered from hydronephrosis. There were 147 cases(87.5%)with single tumor, and 21 cases(12.5%)with multiple tumors, including 75(46.6%) cases in renal pelvis or pelvi-ureteric junction, and 93(53.4%)cases in ureter. Open RNU was performed in 106(63.1%) patients, and laparoscopic method in 62(32.9%) patients. The optimal cutoff value of MLR was set as 0.22 by using the median.χ 2 test, which was used to detect the association between MLR(≤0.22 vs.>0.22) and clinicopathological variables. Survival analyses were performed using the Kaplan-Meier method and were compared using the log-rank test. Additional subgroup analyses(low grade vs. high grade) were performed according to pathological grade. Univariate and multivariate analysis by Cox’s proportional hazards model was used to determine the significance of MLR in respect to OS and PFS. Results:The follow-up period ranged from 19.2 to 86.9 months (median 51.9 months). Next, the cohort was divided into 2 groups , including 77 patients with low MLR(≤0.22) and 91 patients with high MLR(>0.22). High MLR was significantly more frequent in male patients(31.2% vs.56.0%), as well as those undergoing laparoscopic surgery (54.5% vs.70.3%)(All P<0.05). Based on a Cox univariate proportional hazards analysis, male gender( HR=1.793, 95% CI 1.003-3.205, P=0.049), presence of lymph node metastasis( HR=6.809, 95% CI 2.124-17.454, P=0.001) and high MLR( HR=2.287, 95% CI 1.259-4.154, P=0.007)were associated with poor OS. Male gender( HR=1.758, 95% CI 1.066-2.902, P=0.027), presence of lymph node metastasis( HR=6.524, 95% CI 2.542-16.748, P<0.001), lymphovascular invasion(LVI) ( HR=2.348, 95% CI 1.139-4.838, P=0.021), high MLR( HR=2.801, 95% CI 1.657-4.735, P<0.001)and PLR( HR=1.663, 95% CI 1.003-2.757, P=0.049) were significantly associated with subsequent PFS. By multivariate analysis, tumor site( HR=2.050, 95% CI 1.079-3.892, P=0.028), lymph node metastasis ( HR=6.641, 95% CI 1.852-23.811, P=0.004) and MLR( HR=2.089, 95% CI 1.062-4.113, P=0.033) were the independent risk factors for OS in elderly patients with UTUC. Tumor side( HR=2.024, 95% CI 1.033-3.965, P=0.040), multifocality ( HR=2.992, 95% CI 1.161-7.713, P=0.023), lymph node metastasis ( HR=6.454, 95% CI 2.026-20.564, P=0.002) and MLR( HR=2.866, 95% CI 1.554-5.284, P=0.001) were associated with PFS.The multivariate analysis of the significant risk factors established a postoperative risk stratification model for OS and PFS. The results showed significant differences among the 3 subgroups of patients with low(0 risk factor), intermediate(1 risk factor), or high risk(2-3 risk factors)(All P<0.05). Conclusion:MLR was an independent risk factor for OS and PFS in elderly patients with UTUC and patients with elevated MLR have worsen prognosis.
ABSTRACT
Hepatocellular carcinoma (HCC) is one of the most common malignant tumors worldwide. At present, hepatectomy is one of the most frequent therapeutic options, whereas the high postoperative recurrence rate severely affects the long-term survival of HCC patients. Therefore, it is urgent to choose appropriate therapeutic regime to treat the recurrence of HCC to improve the long-term survival of HCC patients. Surgical treatment is an efficacious treatment for recurrent HCC, including re-hepatectomy, salvage liver transplantation and radiofrequency ablation. Currently, individualized treatment is recommended for postoperative recurrence of HCC. The selection of treatment should be conducted based on the tumor conditions after the first hepatectomy, the characteristics of recurrent tumors, baseline data of patients and recurrence time, etc., aiming to formulate appropriate treatment regimes for patients. In this article, these surgical regimes were reviewed and compared to explore appropriate surgical schemes for postoperative recurrence of HCC, aiming to provide reference for prolonging the survival of HCC patients.
ABSTRACT
Objective:To explore the clinical efficacy of liver transplantation for Wilson's disease(WD).Methods:From January 1999 to November 2021, clinical data were retrospectively reviewed for 16 recipients with WD undergoing liver transplantation.There were 9 males and 7 females with an age range of 29.5(14~54)years.They were followed up by telephone, outpatient services and hospitalization.The starting point of follow-up was operation date.And recipient death was an endpoint.Postoperative survival, improvement of neuropsychiatric symptom, changes of corneal K-F ring, altered levels of liver function and serum copper-protein at Month 1 post-operation were observed.The follow-up deadline was November 24, 2021.Results:15 recipients underwent classical orthotopic liver transplantation and the other one recipient underwent living-related liver transplantation.No perioperative deaths occurred.All 16 recipients were followed up for 122(6~260)months.The 1-, 5-, and 10-year survival rates were 93.8%、85.2%and 75.8%, respectively.Among 10 recipients with corneal K-F ring positive with varying degrees after operation and was disappeared in 2 recipients at 7 and 11 months.Among 5 recipients with neuropsychiatric manifestation, 4 recipients showed ameliorative neuropsychic symptoms with varying degrees after operation and 1 recipient died.All the levels of liver function and serum copper-protien of all recipients recovered obviously in 1 month and the 1-, 5-, and 10-year post-operation.Conclusions:Classical orthotopic liver transplantation and living-related liver transplantation not only effectively improves copper metabolism of patient with WD and relieves their severe neurological manifestation, but also improves their life and prolongs survival, which is worthy of clinical promotion.
ABSTRACT
Objective:To investigate the effect of maximal androgen blockade(MAB)therapy on serum calcium, phosphorus and other metabolic indices in elderly patients with prostate cancer.Methods:Clinicopathological data of prostate cancer patients treated with MAB in our department from January 2010 to December 2018 were retrospectively analyzed.All patients underwent prostate biopsy for definitive diagnosis.Detailed data on patient's age, body mass index(BMI), previous medical history, treatment plan and peripheral blood indicators before and after endocrine treatment, such as blood calcium, phosphorus, hemoglobin, fasting blood glucose, triglycerides and cholesterol, were collected.Results:Patients had a mean age of(75.5±5.8)years and a mean BMI of(24.6±3.2)kg/m 2.Blood calcium levels exhibited a downward trend after MAB treatment compared pre-treatment[(2.12±0.44)mmol/L vs.(2.17±0.31)mmol/L, t=0.82, P=0.42], but had no significant difference.Serum phosphorus concentrations were higher and the calcium-phosphorus ratio was lower after MAB treatment than before treatment[(1.02±0.26)mmol/L vs.(1.17±0.34)mmol/L, 2.10±0.28 vs.1.88±0.60, t=-4.12 and 3.56, P<0.01]. After MAB treatment, blood fasting glucose[(6.50±1.55)mmol/L vs.(5.34±1.04)mmol/L, t=-7.82, P<0.01], triglycerides[(1.66±1.32)mmol/L vs.(1.22±0.59)mmol/L, t=-3.38, P<0.01]and cholesterol[(4.70±1.08)mmol/L vs.(4.16±0.90)mmol/L, t=-4.72, P<0.01]were elevated, while hemoglobin concentrations[(122.11±20.43)g/L vs.(130.78±23.98)g/L, t=3.98, P<0.01]were decreased compared with pre-treatment levels. Conclusions:MAB therapy can cause varying degrees of metabolic abnormalities in calcium and phosphorus metabolism, hemoglobin concentrations, blood glucose and lipid levels in elderly prostate cancer patients.The above indicators should be closely monitored during treatment, and treatment-related complications should be proactively prevented.
ABSTRACT
Objective:To analyze the clinical features and reflectance confocal microscopy (RCM) characteristics of vulvar lichen sclerosus (VLS).Methods:RCM examination was carried out in 34 patients who were preliminarily diagnosed as VLS in People's Hospital of Xinjiang Uygur Autonomous Region from January 2018 to June 2019, the results of the various indicators were recorded, and then a histopathological examination was performed at the same site.The RCM image characteristics were analyzed against histopathological manifestations, after that the results were compared and calculated the consistency rate of these image features.Results:The RCM image features of 28 patients with VLS were as follows: the thickness of spinous layer of lesion was thinner than that of surrounding normal skin (epidermis atrophy) in 21 cases (75%); hyper reflectance in basal layer was decreased in 21 cases (75%); In 16 (57.14%)cases, the basal cell ring was absent at the junction of the epidermis, the boundary was blurred, and the infiltration of mononuclear cells and scattered round like large cells in the superficial dermis (liquefaction and degeneration of basal cells); 28 cases (100%) had increased refractive index of superficial dermis (collagen homogenization). The coincidence rates with histopathological examination were 89.29%, 92.86%, 85.71% and 100%, respectively. The sensitivity and specificity of the increase of refractive index in the superficial dermis were the highest, reaching 96.53% and 62.35%. The highest specificity was 92.82% in the presence of epidermal atrophy and the increase of refractive index of superficial dermis.Conclusions:The RCM images of VLS were highly consistent with the histopathological examination.It also has high sensitivity and specificity.Combined with clinical manifestations, it can provide effective help for the diagnosis of vulvar lichen sclerosus and the judgment of therapeutic efficacy.
ABSTRACT
Objective:To explore the possible role of endoplasmic reticulum aminopeptidase 1 (ERAP1), tumor necrosis factor-α receptor Ⅰ (TNFR-Ⅰ), tumor necrosis factor-α receptor Ⅱ (TNFR-Ⅱ) in the pathogenesis of psoriasis vulgaris.Methods:15 cases of normal skin and 20 cases of psoriasis vulgaris in Xinjiang Uygur Autonomous Region People's hospital were enrolled. Immunohistochemical staining techniques were used to detect the expression of ERAP1, TNFR-Ⅰ, TNFR-Ⅱ protein in the two groups. Statistical analysis was then performed to compare the difference in expression between the two groups.Results:⑴ In normal skin , ERAP1 is mainly expressed in the basal layer of the epidermis. In the psoriatic vulgaris lesions, ERAP1 was diffusely positive. The expression of ERAP1 in the psoriatic lesions was stronger than that of normal tissues, with stastically significant difference ( Z=-4.170, P<0.05). ⑵ TNFR-Ⅰ is diffusedly expressed in the normal skin tissues. However, in the epidermis of psoriatic lesions, the expression of TNFR-Ⅰ in the spinous layer was stronger than that of the basal layer (χ 2=17.740, P<0.05). ⑶ In the normal skin, TNFR-Ⅱ was not expressed; in the psoriatic lesions, TNFR-Ⅱ was diffusely expressed in the basal cell layer and acanthosis of the epidermis in varying degrees, and the difference between normal and psoriatic skin was statistically significant (χ 2=17.500, P<0.001). ⑷ The expression of ERAP1 in the epidermis of psoriasis vulgaris was negatively correlated with TNFR-Ⅰ ( rs=-0.662, P=0.001). There was no significant correlation between ERAP1 and TNFR-Ⅱ ( rs=0.343, P=0.139). Conclusions:ERAP1, TNFR-Ⅰ, and TNFR-Ⅱ may play important roles in the pathogenesis of psoriasis vulgaris. They may interact with each other to regulate the proliferation and apoptosis of keratinocyte in order to maintain the abnormal proliferation and benign proliferation of psoriasis vulgaris epidermis.
ABSTRACT
Objective@#To investigate the effect of H-uvulopalatopharyngoplasty(H-UPPP) combined with tongue base radiofrequency ablation in the treatment of obstructive sleep apnea hypopnea syndrome(OSAHS).@*Methods@#Sixty-two patients with moderate or severe OSAHS, whose obstructive plane located in the oropharynx and tongue base were divided into two groups two groups according to the patient′s independent choice under the condition of fully informed before the operation. The control group of 30 cases underwent H-UPPP, while the experimental group of 32 patients underwent improved H-UPPP and tongue base radiofrequency. The clinical efficacy between the two groups was compared.@*Results@#There was no significant difference between the two groups before operation. After the operation, the total effective rate of the experimental group was 71.9%, significantly higher than that of the control group (46.7%, χ2=4.09, P<0.05), the difference was statistically significant. After operation, in the control group, AHI was (19.4±8.1)/h, LSaO2 was 0.767±0.052. In the experimental group, AHI was (17.8±7.8)/h, LSaO2 was 0.790±0.059. There was significant difference in both groups before and after surgery (P<0.001), with statistical significance. In the experimental group, after operation, the minimum diameter of oropharyngeal cavity was (10.6±2.4) mm, there was obvious increase compared with the diameter of oropharyngeal cavity (9.9±2.2) mm before operation, the difference was statistically significant (t=2.64, P<0.05). In the control group, after operation, the minimum diameter of oropharyngeal cavity was(10.0±2.4) mm, there was no obvious increase compared with the diameter of oropharyngeal cavity (9.9±2.5) mm before operation, the difference was not statistically significant (P>0.05). Compared between control group and experimental group, the differences of AHI, LSaO2, the minimum anteroposterior diameter of oropharyngeal cavity before and after operation were not statistically significant (P>0.05).@*Conclusion@#The effect of same time H-UPPP and radiofrequency ablation surgery is definitive.
ABSTRACT
Objective To investigate the feasibility of liver transplantation in the treatment of inoperable hilar cholangiocarcinoma. Methods The clinical data for 3 patients with unresectable hilar cholangiocarcinoma who underwent liver transplantation in the Department of Hepatobiliary Surgery of Fuzhou General Hospital of People's Liberation Army from January 2006 to December 2012 were retrospectively analyzed. The patients were followed up by phone, outpatient service, and hospitalization. The starting point of the follow-up was the operation date. The patients death was the end point. The clinical and pathological features, postoperative survival, tumor recurrence, and prognostic factors were observed. The follow-up deadline was December 2017. Results All 3 patients underwent classical orthotopic liver transplantation using retrograde perfusion through inferior vena cava and no perioperative deaths occurred. All 3 patients were followed up for 10 to 132 months. During the follow-up period, of 1 patient who died of tumor recurrence, the pathological TNM stage was T4a N1 M0, and both had Union for International Cancer Control stage Ⅳa, and the tumor-free survival time was 3 months, and the survival time was12 months. Of 1 patient who died of other causes, the pathological TNM stage was T3N1 M0, and both had Union for International Cancer Control stage Ⅲ, and the tumor-free survival time was 12 months, and the survival time was12 months. One case as of the end of follow-up, the patient has survived for 132 months, the pathological TNM staging was T2a NOM0, and both had Union for International Cancer Control stage Ⅱ. Conclusions Lymph node positive and high pathological TNM stage were poor prognosis factor for hilar cholangiocarcinoma who underwent liver transplantation. Patients with early hilar cholangiocarcinoma who don't have lymph node metastasis are expected to benefit from liver transplantation.
ABSTRACT
Objective To evaluate diagnosis and treatment outcomes about suprascapular neuropathy with massive rotator cuff tear.Methods Fifty patients with massive rotator cuff tear underwent arthroscopic surgery from January 2011 to June 2014.The mean age was 51.50± 11.50 years with average disease duration 4.60±6.70 months.Preoperative fat infiltration Goutallier grade was 3 cases in grade 0,18 in grade 1,18 in grade 2,9 in grade 3 and 2 in grade 4.Based on medical history,physical examination and electromyogram,six cases were diagnosed with Neuropathy.Compression of scapular transverse ligament and ganglion notch cyst were not founded before and during rotator cuff repairing.Only neurotrophic drugs were admitted after arthroscopy.The clinical outcomes (range of motion,muscle strength in flexion and in rotation,electromyogram,Constant-Murley score,ASES score and VAS) and MRI results were collected.The differences between suprascapular neuropathy and normal group were compared at pre-operation and 2 years after operation.Results There was no complication like axillary nerve injury,infection and instability during the 27.90±6.70 months follow-up.All patients of Goutallier grade 4 (2/2) and partial patients of grade 3(4/9) showed delayed conduction with suprascapular neuropathy.The muscle strength in flexion and bodyside external/internal rotation improved.The VAS decreased from 7.70±2.50 to 1.20± 1.80 (t=14.670,P=0.000),and ASES score improved from 45.80±9.50 to 92.50±6.30 (t=-18.450,P=0.000).Furthermore,Constant-Murley score improved from 41.40±8.70 to 90.20±4.70 (t=-20.790,P=0.000).Compared with the normal group,the patients with suprascapular neuropathy showed higher pain and worse functional score preoperatively (P＜0.05).At 2 years after operation,the normal and neuropathy group showed similar pain and function scores (P＞0.05).Conclusion The incidence of suprascapular neuropathy is 12％ (6/50) in patients with massive rotator cuff tear.The preoperative function is worse in patients with neuropathy.Diagnosis for suprascapular neuropathy with massive rotator cuff tear can be based on the pain in posterior superior scapular region,severe infraspinatus muscular atrophy,MRI and EMG.Reversal of suprascapular neuropathy is founded with good curative effects after neurotrophic therapy during short-term follow-up.Arthroscopic release is not needed for patients without suprascapular nerve entrapment.
ABSTRACT
Objective To investigate the biliary complications and recovery of liver function after liver transplantation from citizen's deceased donors (DCD) versus standard criteria donors (SCD).Method The clinical data of 269 patients who underwent orthotopic liver transplantation from January 2009 to December 2016 at the Fuzhou General Hospital were collected.197 livers were from SCD and 72 from DCD.Propensity score matching (PSM) was used to compare the biliary complications and recovery of liver function after liver transplantation in the two groups.Results PSM matched 61 pairs of patients.There were 10 (16.4％) and 8 (13.1％) biliary complications in the DCD and the SCD groups,respectively,with no significant difference between them (P ＞ 0.05).The recovery of liver function was significantly delayed in the DCD group when compared with the SCD group.The levels of ALT,AST,GGT and AKP in the DCD group were significant different on the postoperative first,third,fifth,seventh and fourteenth day (P ＜ 0.05).At 30 days after surgery,there was no significant difference in liver function between the two groups.Conclusions Liver grafts from DCD had a significant impact on the recovery of liver function.When compared with the SCD group,the DCD group recovered significantly slower in liver function.There was no significant increase in the incidence of biliary complications.
ABSTRACT
Objective To conclude the diagnostic and therapeutic experience for acute mesenter ic ischemia(AMI).Methods Clinical data of 102 AMI patients were analyzed retrospectively.The curative effect of conservative management,endovascular treatment and open surgery were evaluated.All patients were treated with anticoagulation,vasodilator,thrombolysis after the diagnosis was made.17 cases were relieved by simple medical therapy.The other 85 patients had no obvious effect within 48 hours after conservative treatment.Of the 63 cases undergone endovascular treatment,58 were relieved.Among other 7 unrelieved cases,2 of them gave up treatment and 5 patients were turned to open surgery.The left 22 cases were converted to open surgery directly.Results Of all 102 cases,92 patients were relieved completely,5 patients were turned to chronic intestinal dysfunction.3 patients died in hospital and 2 patients lost follow-up.Conclusion AMI is a potentially fatal vascular emergency.Early diagnosis by CTA and revascularization of intestine without delay is the pivotal management.Endovascular treatment is the preferred therapeutic options.
ABSTRACT
One hundred and forty-two patients on maintenance hemodialysis were enrolled in the study.According to the guideline of American Society of Echocardiography 97 patients (68.3％) were classified as pulmonary artery hypertension [PAH,pulmonary artery systolic pressure (PASP) ＞ 35 mmHg (1 mmHg =0.133 kPa)] and 45 patients (31.7％) as non-PAH (PASP ≤ 35 mmHg).High sensitivity Creactive protein (hs-CRP) and tumor necrosis factor-α (TNF-α) were measured by automatic analyzer and enzyme linked immunosorbent assay (ELISA),respectively.There were significant differences in CRP and TNF-α levels between PAH and non-PAH patients (P ＜ 0.05).Multivariate linear regression showed that TNF-α and interdialytic weight gain were positively correlated with PAH and left ventricular ejection fraction was negatively correlated with PAH (P ＜ 0.01).In the multivariate Cox proportional hazards models,PAH and TNF-α level were independently associated with higher risk for all-cause death (HR =1.06,95％ CI:1.03-1.09 and HR =1.31,95％ CI:1.17-1.46,respectively).In Kaplan-Meier survival analysis,the risk of all-cause mortality increased in parallel with PASP.The risk of death in patients with PASP ＞45 mmHg was higher than that in patients with PASP ≤45 mmHg (log-rank test:x2 =6.58,P =0.010),the risk was 2.82-fold (HR =2.82,95％ CI:1.38-5.77,P =0.004).
ABSTRACT
Objective To investigate the mid-term outcome of high tibia osteotomy (HTO) combined with tibial tuberosity limited rotation in the treatment of disorder of patellofemoral joint with knee varus.Methods HTO was performed in all 42 patients.The lower limb alignment,lateral femoral tibial angle,medial proximal tibial angle,Q angle and TF-TG were measured before and after operation.All the patients with disorder of patellofemoral joint were divided into three types based on preoperative patellar trajectory and TF-TG.According to different types we chose the limided rotation of distal tibia through adjustment of tibial tubercle location to improve patellar track.Type Ⅰ in 10 cases and type Ⅱ in 12 cases only accepted HTO,type Ⅲ in 20 cases accepted HTO and tibial tubercle rotation.The rotation angle was determined according to preoperative imaging results and foot forward angle.Before and after operation patellar tilt angle,patellofemoral angle and lateral patellar angle were measured.Results 42 patients were followed up for more than 5 years,an average of 72.20± 12.60 months (60-88 months).No nerve damage,infection and bone nonunion occurred.The patellar tilt angle was improved from 12.45°±3.76° to 6.98°± 1.78° 5 years after operation.The patellofemoral angle was improved from 12.51°±4.71° to-4.70°±2.57° 5 years after operation,and the lateral patellar angle was improved from 1.50°±4.90° to 7.80°±3.10°.Preoperative lateral femoral tibial angle was improved from 182.45°±2.20° to postoperative 174.60° ±3.50°,medial proximal tibial angle was improved from preoperative 78.75°± 3.50° to postoperative 93.25°±1.95°.The Lysholm score was improved from preoperative 53.10±5.60 to 92.70±5.50.The preoperative IKDC subjective score was improved from 47.50±6.40 to 91.30±6.90.The Kujala score was 62.40±8.70 before operation and 87.30±4.10 5 years after operation.Visual analogue score (VAS) was 7.50±2.45 before operation and 1.50±0.90 5 years after operation.The short and mid-term follow-up,knee patellar trajectory and lower limb alignment was good,postoperative symptoms was satisfactory and acceptable.Conclusion HTO combined with limited rotation of the tibial tubercle could improve patellar trajectory and lower limb alignment to relieve pain,and has satisfactory mid-term outcome in the disorder of patellofemoral joint with knee yarus patients.
ABSTRACT
Objective To review the phenylalanine(Phe) and thyrotropin(TSH) results of national external quality assessment(EQA)in neonatal screening laboratory for 7 years,evaluate qualitity control level and summarize the problems in the screening measurement.Methods The Phe and TSH values in dried blood spot specimens on filter paper distributed by national center for clinical laboratory were measured by fluorometrie method and time-resolved fluorescence immunoassay respectively.The Phe and TSH EQA results from 2010 to 2016 year were analyzed.Results Five specimens were distributed by EQA organizer each time,and 3 times each year.(1) In the 105 specimens of 21 batches,the bias ranges of Phe and TSH measurement were wide and their average values were 2.21% and 0.98% respectively.(2) Quantitative results analysis :Six quantitative results of Phe measurement and two quantitative results of TSH measurement were out of aunty control(bias ≥30% or ≤-30%),accounting for 5.71%(6/105)and 1.9%(2/105) respectively.(3)Qualitative results analysis:The Phe and TSH qualitative analysis of specimens conformed to the expected results(100%).The result of every batch was up to 80%.Conclusion It is useful to evaluate the measurement competence,find out the problems in the Phe and TSH measurement in neonatal screening laboratory and resolve them in time.Consequently,it is useful to improve the quality of measurement,reduce the error and ensure the accuracy of results.
ABSTRACT
Objective To conclude the diagnostic and therapeutic experience for acute mesenter ic ischemia(AMI).Methods Clinical data of 102 AMI patients were analyzed retrospectively.The curative effect of conservative management,endovascular treatment and open surgery were evaluated.All patients were treated with anticoagulation,vasodilator,thrombolysis after the diagnosis was made.17 cases were relieved by simple medical therapy.The other 85 patients had no obvious effect within 48 hours after conservative treatment.Of the 63 cases undergone endovascular treatment,58 were relieved.Among other 7 unrelieved cases,2 of them gave up treatment and 5 patients were turned to open surgery.The left 22 cases were converted to open surgery directly.Results Of all 102 cases,92 patients were relieved completely,5 patients were turned to chronic intestinal dysfunction.3 patients died in hospital and 2 patients lost follow-up.Conclusion AMI is a potentially fatal vascular emergency.Early diagnosis by CTA and revascularization of intestine without delay is the pivotal management.Endovascular treatment is the preferred therapeutic options.
ABSTRACT
Objective To evaluate the application value of confocal laser scanning microscopy(CLSM)in the differentiation between seborrheic keratosis and Bowen′s disease. Methods CLSM was used to observe typical skin lesions in 88 patients clinically diagnosed with seborrheic keratosis and 18 patients clinically diagnosed with Bowen′s disease. Then, tissue specimens were resected from these lesions and subjected to histopathological examination. Results CLSM imaging of seborrheic keratosis lesions showed gyrus?like structures and keratin?filled inclusion cysts in the epidermis with trabecula?like extension of rete ridges in all the 88 cases, basal cells arranged in a cordike or radial pattern in 9 cases, and bright reflective structures in the basal layer and dermis in 6 cases. CLSM imaging of Bowen′s disease lesions revealed disorderly arrangement of large, irregularly shaped atypical cells in some areas in the middle and lower epidermis, and infiltration of scattered mononuclear cells in the superficial dermis. Conclusion CLSM images of seborrheic keratosis are different from those of Bowen′s disease, and CLSM may be helpful for their differential diagnosis.
ABSTRACT
PURPOSE: Allergic rhinitis (AR) is an inflammatory disorder of the upper airway. Exosomes or extracellular vesicles are nanosized vesicles of endosomal origin released from inflammatory and epithelial cells that have been implicated in allergic diseases. In this study, we characterized the microRNA (miRNA) content of exosomes in AR. METHODS: Extracellular vesicles were isolated from nasal mucus from healthy control subjects (n=10) and patients with severe AR (n=10). Vesicle RNA was analyzed by using a TaqMan microRNA assays Human Panel-Early Access kit (Applied Biosystems, Foster City, CA, USA) containing probes for 366 human miRNAs, and selected findings were validated with quantitative RT-PCR. Target prediction and pathway analysis for the differentially expressed miRNAs were performed using DIANA-mirPath. RESULTS: Twenty-one vesicle miRNAs were up-regulated and 14 miRNAs were under-regulated significantly (P<0.05) in nasal mucus from AR patients when compared to healthy controls. Bioinformatic analysis by DIANA-mirPath demonstrated that 32 KEGG biological processes were significantly enriched (P<0.05, FDR corrected) among differentially expressed vesicle miRNA signatures. Among them, the B-cell receptor signaling pathway (P=3.709E-09), the natural killer cell-mediated cytotoxicity (P=8.466E-05), the T-cell receptor signaling pathway (P=0.00075), the RIG-I-like receptor signaling pathway (P=0.00127), the Wnt signaling pathway (P=0.00130), endocytosis (P=0.00440), and salivary secretion (P=0.04660) were the most prominent pathways enriched in quantiles with differential vesicle miRNA patterns. Furthermore, miR-30-5p, miR-199b-3p, miR-874, miR-28-3p, miR-203, and miR-875-5p, involved in B-cell receptor and salivary secretion signaling pathways, were selected for validation using independent samples from 44 AR patients and 20 healthy controls. MiR-30-5p and miR-199b-3p were significantly increased in extracellular vesicles from nasal mucus when compared to healthy controls, while miR-874 and miR-28-3p were significantly down-regulated. In addition, miRNA-203 was significantly increased in AR patients, while miRNA-875-5p was found to be significantly decreased in AR patients. CONCLUSIONS: This study demonstrated that vesicle miRNA may be a regulator for the development of AR.
Subject(s)
Humans , B-Lymphocytes , Biological Phenomena , Endocytosis , Epithelial Cells , Exosomes , MicroRNAs , Mucus , Receptors, Antigen, T-Cell , Rhinitis , RNA , Wnt Signaling PathwayABSTRACT
Objective To investigate pulmonary embolism (PE) clinical characteristics, the first clinical symptoms, and risk factors.Methods Incidence trends, clinical manifestations, etiology and inducing factors of 459 PE cases were analyzed retrospectively.Results For women the two peak period of PE incidence are 20-25 years of age and 60-70 years of age, for men are 20-30 years and 60-70 years;For both men and women PE incidence is peaked at 40-65 years of age.Circular distribution statistics showed the peak incidence of PE falls from November 30 through April 4, roughly in seasons of winter and spring.Dyspnea, chest distress, were among the most common symptoms (64.04％).Pulmonary infarction trilogy accounted for only 8.50％.Surgery, trauma, fracture were the primary causes for PE (44.88％), with tumor accounting for 13.0％.The veins affected by DVT are plexus venosus leg muscle, femora popliteal vein, iliac veins, tibial and peroneal veins.Conclusions The incidence of PE has obvious central tendency of age, season.Clinical symptoms are varied and non-specific.Surgery, trauma and fractures are the primary cause of PE, tumor is an independent risk factor for PE.
ABSTRACT
Objective To explore the correlation between the enhancement pattern of hepatocellular carcinoma (HCC) on contrast-enhanced ultrasound (CEUS) and its tumor differentiation on histopathology. Methods HCC lesions (n=259) from 224 patients were retrospectively evaluated with CEUS and histopathological examination. CEUS was performed with SonoVue. The characteristics of blood perfusion and parameters of the time-intensity curve (TIC) were analyzed by ACQ soft?ware. Histopathological diagnoses were decided base on Edmonson grading system. Results Pathologic grading of HCC was not related to the arrival time(P>0.05);The washing-out time point and the enhancement time point and peak time point all appeared earlier in poorly differentiated HCC group, than those in moderately differentiated HCC group than those in well differentiated HCC group(P<0.01);The enhancement time point and the expurgation time point are shorter in poorly differ?entiated HCC group than those in moderately differentiated HCC group than those in well differentiated HCC group. All dif?ferences were with statistical significance. The mode of arterial perfusion in early stage was divided into 3 types:spider web type, radiative type and mixed type. The well differentiated HCC group mainly presented as radiative type ( 28/49, 47.14%). But the most of poorly differentiated HCC group mainly present as spider web type(88/127, 69.29%). The mix type was more common in moderately differentiated HCC group(49/83, 59.03%). Conclusion CEUS show different features of TIC pa?rameters and blood perfusion in different pathological stages of HCC lesions so it can serve as a method to assess the biologi?cal behavior of hepatocellular carcinoma.