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ObjectiveTo study the effect on quality of life and the bone turnover markers of Buzhong Yiqitang in the treatment of senile osteoporotic vertebral compression fracture （OVCF， syndrome of Qi deficiency in spleen and stomach） after operation based on ''spleen governing muscle''. MethodA total of 135 senile patients with OVCF treated by percutaneous kyphoplasty in Rizhao Hospital of Traditional Chinese Medicine from January 2020 to January 2021 were enrolled in this study. They were randomly assigned to two groups on the basis of block randomization at a ratio of 2∶1 （90 cases in the observation group and 45 cases in the control group）. Both groups were administrated with calcitriol capsules （0.5 μg·d-1） and caltrate D （1 200 mg·d-1） for basic treatment of osteoporosis. The observation group was additionally treated with Buzhong Yiqitang. Bone mineral density （BMD）， procollagen type Ⅰ N-terminal propeptide （PINP）， osteocalcin （OST）， β cross-linked C-telopeptide of type 1 collagen （β-CTx）， appendicular skeletal muscle mass index （ASMI）， and quadriceps muscle strength were compared between the two groups before and 6， 12 months after treatment. Additionally， traditional Chinese medicine （TCM） symptom score and visual analogue score （VAS） before and 3， 6 months after treatment， as well as quality of life questionnaire of the European Foundation for osteoporosis （QUALEFFO） score before and 3， 6， 12 months after treatment， were compared between the two groups. ResultA total of 85 patients in the observation group and 41 patients in the control group were followed up. The general curative effect of the observation group was better than that of the control group （χ2=10.503， P<0.05）. Specifically， the observation group had higher PINP， BMD， ASMI， and quadriceps muscle strength but lower β-CTx， TCM symptom score， VAS， and QUALEFFO score than the control group （P<0.05， P<0.01）. No adverse reactions related to Buzhong Yiqitang were observed. ConclusionBuzhong Yiqitang can regulate bone metabolism indexes， promote osteogenesis， increase bone density， enhance skeleton appendiculare and quadriceps muscle strength， relieve clinical symptoms， and improve quality of life in patients with senile OVCF （syndrome of Qi deficiency in spleen and stomach）， being worthy of promotion in clinical application.
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Objective:To investigate the expression level of TRPM7 in breast cancer tissues and adjacent carcinoma tissues and to analyze its clinicalpathological characteristics.Methods:The expressions of TRPM7 in 87 breast cancer and 47 adjacent tissues were detected by immunohistochemistry, and then the relationship between expression and clinicopathological characteristics was analyzed.Results:The positive rate of TRPM7 in breast cancer tissues was 66.7%, significantly higher than that in para-cancer tissues (10.6%) ( P<0.001) . Meanwhile, TRPM7 expression was much higher in those with tumor diameter≥2 cm ( P=0.023) , TNM stage III ( P=0.001) and lymph node metastasis ( P=0.015) . The expression of TRPM7 has nothing to do with patients’ age ( P=0.455) or histological grade ( P=0.577) . Conclusions:High expression of TRPM7 is associated with the development of breast cancer. TRPM7 may become a potential biological indicator to monitor the prognosis of breast cancer in the future.
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Objective To investigate the clinical pathological characteristics and the prognosis of the invasive micropapillary carcinoma (IMPC) of breast cancer.Methods The clinical pathological characteristics of 47 IMPC patients treated in the Second Hospital of Jilin University from Jan.2010 to Dec.2016 were retrospectively analyzed.A long term survival has been followed.Results 47 IMPC patients were all female.The median age was 56(34-76) years old.The median diameter of the tumor was 1.9(0.8-7.0) cm.The rate of axillary lymph node metastasis was 66.7％ (30/44),the median number of axillary lymph node metastasis was 9.5 (1-55),and the metastasis number of 1 to 3 accounted for 43.3％ (13/30),the metastasis number of 4 to 9 accounted for 6.7％ (2/30),and the metastasis number more than 10 accounted for 50％ (15/30).The lymphatic invasion rate was 40.2％(39/97),and the skin and (or) the nipple invasion rate was 15.6％(7/45).The positive rate of ER,PR,HER2,E-Cadherin was 95.7％(44/46),91.3％(42/46),10.5％(4/38),100％(40/40),respectively.The tumor cell growth index marked by Ki-67 was 1％-80％,and 78.3％ patients' tumor cell growth index marked by Ki-67 were more than 20％.Conclusions IMPC is a relatively rare special type of breast cancer,which typically occurs at middle-aged and old female.The expression of ER,PR,E-Cadherin is high and the expression of HER2 is low.It has strong ability and high positive rate of lymph node metastasis,lymphatic invasion,and poor prognosis.
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Objective To investigate the risk factors and clinical manifestations of placental abruption, and to analyze the causes of missed diagnosis and misdiagnosis. Methods A retrospective analysis was conducted in 135584 women who delivered in Women′s Hospital, School of Medicine, Zhejiang University from January 2005 to December 2015. The diagnosis of placental abruption was made in 1212 cases. According to the consistency of prenatal and postnatal diagnosis, they were divided into 3 groups.(1) The diagnosis was consistent prenatally and postnatally in 715 cases(58.99%,715/1212) as the diagnosis group.(2)In 312 cases (25.74%,312/1212), the diagnosis was made after birth as the missed diagnosis group.(3)In 185 cases (15.26%,185/1212), the diagnosis was made prenatally but excluded after birth as the misdiagnosis group. The disease classification was made, and the risk factors, clinical manifestations, lab results, the time of termination and perinatal outcomes were recorded in the 3 groups. The reasons of missed diagnosis and misdiagnosis were analyzed. Results (1) In the 1212 cases, the diagnosis of placental abruption was confirmed in 1027 cases, with the incidence of 0.76%(1027/135584). The rate of missed diagnosis was 30.38%(312/1027), and the rate of misdiagnosis was 0.14%(185/134557). (2) There were significant differences in the degree of placental abruption among the 3 groups (P＜0.05). (3)Significant differences were found among the 3 groups regarding the ratio of hypertensive disorders, trauma, induced labor and advanced maternal age (all P＜0.05). (4) There were statistically significant differences among the 3 groups regarding the incidence of vaginal bleeding, persistent abdominal pain and uterine tenderness, bloody amniotic fluid, increased uterine tension and stillbirth (all P＜0.05). (5) There was no significant difference in the rate of abnormal fetal heart rate mornitoring among the 3 groups (P=0.22). The differences were statistically significant among the 3 groups when regarding the incidence of abnormal ultrasound finding and abnormal blood coagulation (P＜0.01), with the highest incidence of abnormal ultrasound in the diagnosis group (68.1%) and the highest incidence of abnormal coagulation in the misdiagnosis group (24.9%). (6)There was statistically significant difference among the 3 groups when comparing the ratio of termination of pregnancy within 24 hours (P=0.01). (7) There were statistically significant differences among the 3 groups when the ratios of postpartum hemorrhage, DIC, neonatal asphyxia and perinatal death were compared (all P＜0.05). The highest incidence of postpartum hemorrhage was in the diagnosis group (17.9%) and the lowest was in the misdiagnosis group (5.4%). The highest incidence of DIC was in the diagnosis group (3.9%) and the lowest was in the misdiagnosis group (0). The highest incidence of neonatal asphyxia was in the diagnosis group (30.6%) and the lowest was in the misdiagnosis group (7.6%). And for perinatal death, the highest incidence was in the diagnosis group (12.6%), the lowest was in the misdiagnosis group (2.2%). Conclusions Placental abruption could be misdiagnosed when depending on risk factors, such as trauma. And it could be missed diagnosis during the induction of labor. Uterine contraction, abnormal fetal heart rate mornitoring, abnormal ultrasound and abnormal coagulation function are important in the diagnosis of placental abruption.
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Objective To explore the dynamic changes of D-dimers during pregnancy and early puerperium (within 3 days postpartum). Methods A retrospective study was performed among 8 367 healthy women who had term singleton delivery in Women′s Hospital, School of Medicine, Zhejiang University from January 2007 to December 2014. D-dimers concentrations during pregnancy and early puerprium of all the cases were collected. Data of 21 065 D-dimers tests were assigned to 5 groups according to the time of sampling, including early pregnancy (≤12 gestation weeks), middle pregnancy (12-28 gestation weeks), late pregnancy (>28 gestation weeks), 1 postpartum (within 48 hours postpartum) and 2 postpartum (48-72 hours postpartum). The D-dimers concentrations in different groups were compared. The effect of delivery mode on D-dimers of early pureperium was analyzed. The correlation between D-dimers and the thromboembolic disease was also explored. In this study, Student′s t-test and Wilcoxon rank sum test were used for statistical analysis. D-dimers concentration≤0.5 mg/L was used as the normal range. Results (1) D-dimers concentrations during pregnancy were higher than the non-pregnant women (P<0.01), but there was no statistical difference between early pregnancy and late pregnancy (P=0.820). D-dimers concentration in the 1 postpartum group was higher than that of early pregnancy group or late pregnancy group (P<0.01). But in the 2 postpartum group, it was lower than early pregnancy, late pregnancy and 1 postpartum groups. (2)D-dimers in cesarean section cases was significantly higher than in vaginal delivery cases in each period of pregnancy and early pueprium.(3)The 95%CI of D-dimers in early pregnancy, late pregnancy, 48 hours after vaginal delivery, 48-72 hours after vaginal delivery, ≤48 hours after cesarean section, 48-72 hours after cesarean section were 0.58-8.28, 0.47-11.52, 1.04-9.59, 0.87-5.22, 1.07-11.58 and 1.00-6.23 mg/L, respectively.(4)In 6 cases with thromboembolic disease, D-dimers was 6.89-19.89 mg/L, with the mean value of 13.66 mg/L. It was significantly higher than normal range. In 3 cases, all after cesarean section, with lower extremity vein thrombosis within 48 hours postpartum, the D-dimers concentrations, 9.77, 8.65 and 6.89 mg/L respectively, were in the 95%CI of the study population after cesarean section. Conclusions D-dimers concentration of 0.5 mg/L is not suitable for venous thromboembolism screening during pregnancy. D-dimers concentration in pregnancy and early puerprium is higher than non-pregnancy. It increases in the very early period postpartum and decreases with time. D-dimers should not be a routine screening test to exclude thromboembolic disease in pregnant women without high risk factors and clinical manifestation of thromboembolic disease.
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Objective To compare the cerebral oxygenation in the patients undergoing gynecological laparoscopic surgery under sevoflurane-versus propofol-based anesthesia.Methods Fifty adult patients,aged 18-56 yr,weighing 55-72 kg,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,with hemoglobin≥ 110 g/L,undergoing elective gynecological laparoscopic surgery under general anesthesia,were equally and randomly divided into sevoflurane group (group S) and propofol group (group P) using a random number table.Anesthesia was induced with iv midazolam 0.04 mg/kg,sufentanil 1.5-2.0 μg/kg,rocuronium 0.9 mg/kg,and propofol 1.5-2.0 mg/kg.Anesthesia was maintained with inhalation of sevoflurane (2.0％-2.6％) in group S,or with target-controlled infusion of propofol (plasma concentration 2.5-4.0 μg/ml) in group P.The concentrations of sevoflurane and propofol were adjusted to maintain bispectral index value at 40-50.In both groups,remifentanil was given by targetcontrolled infusion (target plasma concentration 2 ng/ml),and vecuronium 0.06-0.08 mg/kg was injected intermittently to maintain muscle relaxation.The regional cerebral oxygen saturation (rSO2) was recorded after induction and at 10 min before pneumoperitoneum (T1),at 10 min of pneumoperitoneum in the Trendelenburg position (T2),and at 10 min after the end of pneumoperitoneum (T3).The occurrence of cerebral oxygen desaturation was recorded during surgery.Results The rSO2 was significantly higher at T2,3 in group S than in group P (P＜0.05).Compared with the value at T1,no significant change was found in rSO2 at T2,3 in group S (P＞0.05),and the rSO2 was significantly decreased at T2,3 in group P (P＜0.05).The incidence of cerebral oxygen desaturation was 12％ in group P,and cerebral oxygen desaturation was not detected in group S.Conclusion Sevoflurane-based anesthesia produces no effect on rSO2,however,propofol-based anesthesia can decrease rSO2 in the patients undergoing gynecological laparoscopic surgery,and sevoflurane-based anesthesia is more suitable for gynecological laparoscopic surgery.
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ThevolatilecompositionsofDuchesneaindicawerestudiedbyheadspacesolid-phase microextraction ( HS-SPME ) , soxhlet extraction ( SE ) , ultrasonic assistant extraction ( UAE ) and steam distillation ( SD) coupled with gas chromatography-mass spectrometry ( GC-MS) . The experimental parameters of HS-SPME, including fiber type, extraction temperature, extraction time and desorption time were investigated. 47, 32, 16 and 16 compounds were identified by HS-SPME, SD, SE and UAE extracting methods, respectively. 66 compounds were obtained in total, among which 47 compounds were first reported in Duchesnea indica. The experimental results showed that terpenoids were the most abundant compositions in HS-SPME and SD, but acids accounted for 61. 44% and 69. 54% of the total content obtained by SE and UAE.
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Objective To construct and identify the Eukaryotic expression vector of RNAi hTRET. Methods The hRERT interference sequence was synthesized by artificial way and was directed cloning to the Eukaryotic expression vector pSilencer 3.1 H1 neo,and was identified by pcr,enzyme cutting,sequencing,determining its concentration and purity. Results We construct the Eukaryotic expression vector of RNAi hTRET successfully. Conclusion Construction of Eukaryotic expression vector of RNAi hTRET established foundation for biological effectiveness of telomere and telomerase in cancer cells.