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Objective:To investigate the influencing factors of recurrence after radical resection of middle and low rectal cancer, and to establish a prediction model based on magnetic resonance imaging (MRI) measurement of perirectal fat content and investigate its application value.Methods:The retrospective cohort study was constructed. The clinicopathological data of 254 patients with middle and low rectal cancer who were admitted to Tianjin Union Medical Center from December 2016 to December 2021 were collected. There were 188 males and 66 females, aged (61±9)years. All patients underwent radical resection of rectal cancer and routine pelvic MRI examina-tion. Observation indicators: (1) follow-up and quantitative measurement of perirectal fat content; (2) factors influencing tumor recurrence after radical resection of middle and low rectal cancer; (3) construction and evaluation of the nomogram prediction model of tumor recurrence after radical resection of middle and low rectal cancer. Measurement data with normal distribution were represented as Mean± SD, and measurement data with skewed distribution were represented as M(rang) and M( Q1, Q2). Count data were described as absolute numbers. Univariate and multivariate analyses were conducted using the COX regression model. The rms software package (4.1.3 version) was used to construct the nomogram and calibration curve. The survival software package (4.1.3 version) was used to calculate the C-index. The ggDCA software package (4.1.3 version) was used for decision curve analysis. Results:(1) Follow-up and quantitative measurement of perirectal fat content. All 254 patients were followed up for 41.0(range, 1.0?59.0)months after surgery. During the follow-up period, there were 81 patients undergoing tumor recurrence with the time to tumor recurrence as 15.0(range, 1.0?43.0)months, and there were 173 patients without tumor recurrence. The preoperative rectal mesangial fascia envelope volume, preoperative rectal mesangial fat area, preoperative rectal posterior mesangial thickness were 159.1(68.6,266.5)cm3, 17.0(5.1,34.4)cm2, 1.2(0.4,3.2)cm in the 81 patients with tumor recurrence, and 178.5(100.1,310.1)cm3, 19.8(5.3,40.2)cm2 and 1.6(0.3,3.7)cm in the 173 patients without tumor recurrence. (2) Factors influencing tumor recurrence after radical resection of middle and low rectal cancer. Results of multivariate analysis showed that poorly differentiated tumor, tumor pathological N staging as N1?N2 stage, rectal posterior mesangial thickness ≤1.43 cm, magnetic resonance extra mural vascular invasion, tumor invasion surrounding structures were independent risk factors of tumor recurrence after radical resection of middle and low rectal cancer ( hazard ratio=1.64, 2.20, 3.19, 1.69, 4.20, 95% confidence interval as 1.03?2.61, 1.29?3.74, 1.78?5.71, 1.02?2.81, 2.05?8.63, P<0.05). (3) Construction and evaluation of the nomogram prediction model of tumor recurrence after radical resection of middle and low rectal cancer. Based on the results of multivariate analysis, the tumor differentiation, tumor pathological N staging, rectal posterior mesangial thickness, magnetic resonance extra mural vascular invasion, tumor invasion surrounding structures were included to construct the nomogram predic-tion model of tumor recurrence after radical resection of middle and low rectal cancer. The total score of these index in the nomogram prediction model corresponded to the probability of post-operative tumor recurrence. The C-index of the nomogram was 0.80, indicating that the prediction model with good prediction accuracy. Results of calibration curve showed that the nomogram prediction model with good prediction ability. Results of decision curve showed that the prediction probability threshold range was wide when the nomogram prediction model had obvious net benefit rate, and the model had good clinical practicability. Conclusions:Poorly differentiated tumor, tumor pathological N staging as N1?N2 stage, rectal posterior mesangial thickness ≤1.43 cm, magnetic resonance extra mural vascular invasion, tumor invasion surrounding structures are independent risk factors of tumor recurrence after radical resection of middle and low rectal cancer. Nomogram prediction model based on MRI measurement of perirectal fat content can effectively predict the probability of postoperative tumor recurrence.
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Objective:To evaluate the efficacy of Qinggan Huashi Huoxue Decoction combined with conventional Western medicine in the treatment of alcoholic cirrhosis with spleen deficiency and phlegm stasis syndrome.Methods:Randomized controlled trial. A total of 110 patients from Tangshan Fengrun District Hospital of Traditional Chinese Medicine from March 2020 to March 2022 were selected as observation objects and divided into 2 groups with 55 patients in each group by computer random drawing method. The control group was treated with conventional Western medicine, while the observation group was treated with Qinggan Huashi Huoxue Decoction on the basis of the control group treatment. Both groups were treated for 3 months. The traditional Chinese medicine syndrome score was performed before and after treatment, and the levels of proline peptidase (PLD), type Ⅳ collagen (Ⅳ-C) and type Ⅰ procollagen aminopeptidase (PINP) were detected by phthalaldehyde contrast colorimetry, and the levels of pentamylin 3 (PTX3), protein kinase B (Akt) and B cell activating factor receptor (BAFF-R) were determined by ELISA. Adverse events were recorded and clinical efficacy was evaluated.Results:The total effective rate in the observation group was 92.73% (51/55), while that in the control group was 76.36% (42/55), the difference between the two groups was statistically significant ( χ2=5.64, P=0.018). After treatment, the score and total score of costal pain and fullness, swelling and firmness, anorexia, white and greasy tongue coating in the observation group were significantly lower than those in the control group ( t values were 11.02, 7.36, 7.47, 6.38, 9.37, respectively, P<0.01). After treatment, the levels of serum PLD[(143.28±16.38)U/L vs. (160.69±18.35)U/L, t=5.25], Ⅳ-C[(71.93±8.33)μg/L vs. (83.12±9.91)μg/L, t=6.41], and PINP[(32.36±5.32)ng/L vs. (39.02±5.61)ng/L, t=6.39] in the observation group were significantly lower than those in the control group ( P<0.01); The levels of PTX3[(36.82±4.96)ng/L vs. (42.14±5.83)ng/L, t=5.15], Akt[(69.22±7.94)ng/L vs. (77.24±8.63)ng/L, t=5.07], and BAFF-R[(15.29±3.64)ng/L vs. (19.92±4.15)ng/L, t=6.22] in the observation group were significantly lower than those in the control group ( P<0.01). During the treatment period, the incidence of adverse reactions was 12.73% (7/55) in the observation group and 9.09% (5/55) in the control group, with no statistically significant difference between the two groups ( χ2=0.37, P=0.541). Conclusion:Qinggan Huashi Huoxue Decoction combined with conventional Western medicine therapy can improve the Traditional Chinese Medicine syndrome and the degree of liver fibrosis damage in patients with alcoholic cirrhosis with spleen deficiency and phlegm stasis syndrome, inhibit the expression of serum inflammatory factors, and improve clinical efficacy.
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Objective To establish the implant-mandible model with different design parameters, observe stress distributions on the implant and surrounding bone, and analyze the influence of different design parameters on dental implant of the mandible. Methods Eight implant models were designed based on structural characteristic parameters (implant diameter, thread depth, height of abutment through gingiva, thread shape), and assembly of the mandibular model was performed respectively. The models were applied with static 150 N vertical and oblique 45° loads, so as to analyze peak von Mises stress of the implant and bone tissues and explore the structural parameter variables of implant most sensitive to peak von Mises stress. Results The peak stress of the mandible was larger under inclined load than that under vertical load. Implant diameter was the key factor affecting the peak von Mises stress of cortical bone, while thread depth was the key factor affecting the peak von Mises stress of cancellous bone. The peak von Mises stress was also affected by the height of abutment through gingiva, but the effect was not as significant as thread depth and implant diameter. Thread shape had little effect on the peak von Mises stress of the mandible. Conclusions Different implant design parameters can affect the peak stress of different tissues of the mandible, so it is necessary to carefully consider the selection of implant parameters for personalized implants. This study can provide theoretical guidance for structural parameter design of oral implants and provide references for accurate prediction of oral implants.
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Objective To analyze stress distributions on mandible bone and periodontal ligaments during acceleration of orthodontic tooth movement by mechanical vibration, and investigate the mechanism of static-vibration coupled loading to accelerate orthodontic tooth movement. MethodsThe finite element model including tooth, periodontal ligament, cancellous bone and cortical bone was established by Mimics，SolidWorks，Geomagic and ANSYS Workbench software. Conventional static orthodontic force and low-magnitude high-frequency mechanical vibration loads were applied to the finite element model for dynamic analysis. ResultsThe compression and tension zones of alveolar bone and periodontal tissues were identified based on Y-normal stress distribution of alveolar bone and periodontal tissues, which was periodic with the same frequency as the applied low-magnitude high-frequency vibration. The von Mises stress of alveolar bone and periodontal tissues also showed periodic changes, but the compression and tension zones of alveolar bone and periodontal tissues could not be identified based on von Mises stress distribution of alveolar bone and periodontal tissues. Conclusions In the field of orthodontics, Y-normal stress is a reasonable mechanical stimulus, and static-vibration coupled loading is an effective method for accelerating orthodontic treatment. The research findings can provide guidance for low-magnitude high-frequency mechanical vibration to accelerate orthodontic tooth movement.
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Objective:To transfer the interleukin 37 (IL-37) gene to cervical cancer Hela cells,and to explore the killing effect of IL-37 on the HeLa cells and its enhancement in the chemotherapy sensitivity of HeLa cells.Methods:The pIRES2-EGFP (NC group) and pIRES2-EGFP/IL-37 (IL-37 group) plasmids were transfected into the HeLa cells.Q-PCR and Western blotting methods were used to detect the expression levels of IL-37 mRNA and protein.The activities of HeLa cells in NC group,IL-37 group,DDP group and IL-37+DDP group were detected by CCK8 method,and the inhibitory rates of cells were calculated.The gene expressions of signal transducer and activator of transcription 3 (STAT3) and Cyclin D1 were detected by RT-PCR method.Results:Compared with NC group,the expression levels of IL-37 mRNA and protein in IL-37 group were significantly increased (P＜0.01).The activities of HeLa cells in DDP (5-15 mg · L-1) groups were inhibited after administration for 24-72 h (P＜ 0.01);the inhibitory rates in IL-37 + DDP group were higher than those in DDP group within 48 h after administration (P＜0.05).Compared with IL-37 group,the inhibitory rates in IL-37+DDP group was increased with 96 h after administration (P＜0.05).Compared with NC group,the expression levels of STAT3 and Cyclin D1 mRNA in IL-37 group were significantly decreased (P＜0.01).Conclusion:The over-expression of IL-37 can inhibit the proliferation of cervical cancer cells and enhance the effect of DDP on the chemotherapy of cervical cancer cells which may be related to the down-regulation of the expressions of STAT3 and Cyclin D1 by IL-37.
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Objective:To transfer the interleukin 37 (IL-37) gene to cervical cancer Hela cells,and to explore the killing effect of IL-37 on the HeLa cells and its enhancement in the chemotherapy sensitivity of HeLa cells.Methods:The pIRES2-EGFP (NC group) and pIRES2-EGFP/IL-37 (IL-37 group) plasmids were transfected into the HeLa cells.Q-PCR and Western blotting methods were used to detect the expression levels of IL-37 mRNA and protein.The activities of HeLa cells in NC group,IL-37 group,DDP group and IL-37+DDP group were detected by CCK8 method,and the inhibitory rates of cells were calculated.The gene expressions of signal transducer and activator of transcription 3 (STAT3) and Cyclin D1 were detected by RT-PCR method.Results:Compared with NC group,the expression levels of IL-37 mRNA and protein in IL-37 group were significantly increased (P＜0.01).The activities of HeLa cells in DDP (5-15 mg · L-1) groups were inhibited after administration for 24-72 h (P＜ 0.01);the inhibitory rates in IL-37 + DDP group were higher than those in DDP group within 48 h after administration (P＜0.05).Compared with IL-37 group,the inhibitory rates in IL-37+DDP group was increased with 96 h after administration (P＜0.05).Compared with NC group,the expression levels of STAT3 and Cyclin D1 mRNA in IL-37 group were significantly decreased (P＜0.01).Conclusion:The over-expression of IL-37 can inhibit the proliferation of cervical cancer cells and enhance the effect of DDP on the chemotherapy of cervical cancer cells which may be related to the down-regulation of the expressions of STAT3 and Cyclin D1 by IL-37.
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BACKGROUND:Mechanotransduction is an issue of concern in the study on the relationship between stress and growth. Mechano-growth factor (MGF) holds stress sensitivity, and exerts similar effect with stress in bone metabolism regulation. OBJECTIVE: To explore the mechanotransduction during bone remodeling, and investigate the relationship between stress and growth at molecular level. METHODS: The governing equations about the relationship between MGF and mechanical stimulation, regulation of MGF on osteoblasts and osteoclasts, regulation of MGF on RANK-RANKL-OPG signaling axis were established, and then the MGF-mediated bone reconstruction model was established to simulate the bone remodeling process under mechanical stimulation. RESULTS AND CONCLUSION:Under the condition of disuse, there was a decrease in osteoblasts/osteoclasts ratio, bone mass and bone volume fraction, and bone resorption was more than bone formation. Under the condition of overload, there was an increase in osteoblasts/osteoclasts ratio, bone mass and bone volume fraction, and bone formation was more than bone resorption. The simulation results were in accordance with Frost mechanostat theory. These findings show that the mechanobiological model of bone remodeling based on MGF can simulate the bone remodeling process under mechanical stimuli, and achieve mechanotransduction.
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Objective To evaluate the accuracy of stroke volume variation (SVV) in monitoring the changes in blood volume during laparoscopic surgery.Methods Forty ASA physical status Ⅰ or Ⅱ patients of both sexes,aged 40-64 yr,with body mass index ranged from 20 to 25 kg/m2,scheduled for elective laparoscopic surgery under general anesthesia,were studied.After induction of general anesthesia,baseline registrations of variables were obtained.After establishing pneumoperitoneum,6％ hydroxyethyl starch (HES 130/0.4) 500 ml was infused over 30 min.Before pneumoperitoneum (T1),at 5 min after pneumoperitoneum (T2),immediately before volume expansion (T3) and at 3 min after volume expansion (T4),cardiac output (CO),cardiac index (CI),SV,stroke volume index (SVI) and SVV were monitored and recorded.The changing rate of CI (△CI) was calculated.The criterion for effective volume expansion was △CI ≥ 15％.The ROC curve for SVV in determining the volume expansion responsiveness was plotted,and the diagnostic threshold was determined.The area under the curve and 95％ confidence interval were calculated.Results SVV was significantly lower at T2 than at T1.CO,CI,SV and SVI were significantly higher,and SVV was lower at T4 than at T3.The results of ROC curve analysis showed that a 9.2％ SVV threshold discriminated between responders and non-responders with a sensitivity of 61％ and a specificity of 50％,and the area under the curve (95％ confidence interval) was 0.567 (0.378-0.757).Conclusion SVV is not a suitable index in monitoring the changes in blood volume during laparoscopic surgery.
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Objective To evaluate the effect of obesity on the potency of propofol for sedation.Methods Sixty patients of both sexes, aged 35-55 yr, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ , scheduled for elective operation under general anesthesia, were enrolled in the study.The patients were divided into 2 groups (n=30 each) according to the body mass index (BMI) : normal body weight (BMI ＜ 25 kg/m2) group (group C) and obesity (BMI 30-40 kg/m2) group (group O).No patients received premedication.Propofol was given by target-controlled infusion.The initial target plasma concentration of propofol was set at 1.2 μg/ml.After the target concentration was steadily maintained for 30 s, it was increased in 0.3 μg/ml increment until the patients lost consciousness (OAA/S score =1).The target plasma concentration of propofol was recorded during each period.The median effective concentration (EC50) and 95％ confidence interval of propofol for loss of consciousness was calculated using probit analysis.Results The EC50 and 95％ confidence interval of propofol for loss of consciousness were 3.82 (3.73-3.90) and 3.29 (3.20-3.37) μg/ml in group C and group O, respectively.Compared with group C, the EC50 was significantly decreased in group O (P＜0.05).Conclusion Obesity can enhance the potency of propofol for sedation.
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To study the effect of recombinant human growth hormone [rhGH] therapy on carbohydrate, lipid and protein metabolisms of Turner syndrome [TS]. Total 45 patients with TS admitted between Jul. 2008 and Jun. 2011 were involved in this study. All patients received the clinical evaluation of body fat, plasma lipids, proteins and oral glucose tolerance test [OGTT] before and after rhGH therapy. Our results indicated a significant decrease of body fat [FAT%] from 23.56 +/- 4.21 to 18.71 +/- 2.23 but no obvious change on the level of fat mass [FM] [p > 0.05] was observed after rhGH therapy. We also detected significant changes on plasma high-density lipoprotein cholesterol [HDL-C] from [1.65 +/- 0.58 mmol/L] to [2.20 +/- 0.65 mmol/L] and low-density lipoprotein cholesterol [LDH-C] from [2.55 +/- 0.55 mmol/L] to [2.10 +/- 0.54 mmol/L] after rhGH exposure. However, no statistical significance was detected on the level of plasma triglyceride [TG], cholesterol [CHO]. Interestingly, the levels of plasma retinol binding protein [RbP] [32.55 +/- 4.28mg/L], transferrin [TRF] [2.95 +/- 0.40 mg/L], serum albumin [PRE] [250.00 +/- 45.50 mg/L] and albumin [propagated] [33.58 +/- 4.25 mg/L] were significantly increased. When it goes to the oral glucose tolerance test [OGTT] test, there were 10 impaired glucose tolerance [IGT] cases among all patients before and after rhGH therapy. No significant change was observed on homeostasis model assessment- insulin resistance [HOMA-IR] level during rhGH intervention. Abnormal lipid and protein metabolisms of the children with TS can be improved with rhGH therapy for 6 months
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Objective To investigate the effect of carbon dioxide ( CO2 ) pneumoperitoneum on the neuromuscular block of cisatracurium in patients undergoing laparoscopic operation.Methods Sixty ASA Ⅰ or Ⅱ patients,aged 35-60 yr,with body mass index of 18-24 kg/m2,scheduled for elective hysterectomy,were randomly divided into 2 groups ( n =30 each ):pneumoperitoneum group ( group P) and control group ( group C ).Each group was further divided into 2 subgroups according to the use of the antagonist of neuromuscular block ( n =15 each):no neostigmine group ( group P0 or C0 ) and neostigmine group (group P1 or C1 ).Anesthesia was induced with fentanyl,propofol and cisatracurium and maintained with target-controlled infusion of propofol and remifentanil.Tracheal intubation was performed and the patients were mechanically ventilated.Neuromuscular function was monitored by TOF-Watch SX accelerography (Organon Co.,Organon).A train of four (TOF) stimulation of the ulnar nerve was used.When T,returned to 5％ of control height after CO2 pneumoperitoneum was established,cisatracurium 0.05 mg/kg was injected intravenously in group P.When T1 returned to 25％ of control height after the end of operation,neostigmine was injected intravenously in groups P1 andC1.The clinical duration and recovery index were recorded after CO2 pneumoperitoneum was established.Arterial blood samples were obtained immediately before induction,at 30 and 60 min of pneumoperitoneum,and at the end of operation for blood gas analysis.Results The clinical duration and recovery index were significantly longer in group P0 than in group C0,and in group P1 than in group C1 ( P ＜ 0.05).Compared with group C0,the pH value was significantly decreased and PaCO2 was significantly increased at 30 and 60 min of pneumoperitoneum,and at the end of operation in group P0 ( P ＜ 0.05).Compared with group C1,the pH value was significantly decreased and PaCO2 was significantly increased at 30 and 60 min of pneumoperitoneum,and at the end of operation in group P1 ( P ＜ 0.05).Conclusion CO2 pneumoperitoneum can strengthen the neuromuscular block induced by cisatracurium and prolong the recovery time following antangonism by neostigmine administration in patients undergoing laparoscopic operation.
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A probe into the management of outpatient medical records written by rural doctors:Such a record is indispensible for technical appraisal of medical accidents; yet writing of such a record might involve illegal medical practice or go beyond the scope of practice.It is recommended to normalize the behavior of rural doctors in their writing of outpatient medical records,stipulating that the Basic Regulations on Medical Records do not apply to rural doctors at present.It is also recommended that separate regulations for rural doctors be formulated,along with a promotional period before these regulations are in practice.An alternative would be clarifying that Article 28 of the Regulations of Medical Malpractice Settlement do not apply to rural doctors.
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Secretome includes all the gene products secreted by a cell. The development of proteomicbased approaches and genome-based computational prediction technology have gradually revealed secretome plays an important role in pathogen infection recently. Secretome facilitates pathogen to proliferate and invade the host by inhibiting the host's immune system, resisting acidic PH conditions, snatching nutrition and so on.Identification of pathogenic secretome helps discovering new drug targets and biomarkers, and supporting the diagnosis and treatment.
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Objective To explore ureaplasma urealyticum (UU) infection of recurrent candida vaginitis (RVVC) and bacterial vaginosis(BV) ,and their clinical characteristics. Methods The vaginal discharge of 81 patients with RVVC and BV were taken for detection of UU. Results The positive rate of UU was 59.3% (48/81). There were significant differences between the patients with UU infection and those without UU infection (P>0.05 ). Conclusion RV VC is correlated with alteration of vaginal milieu internae, dysbacteria and infection of varied pathogen. The comprehensive treatment should be considered according to different pathogen.
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Abstract The processs of female Osteoporosis and its prevention by Physical activity were simulated using anisotropic bone remodelling model with mechanostat combining with finite element method. The results show that bone mass declines slowly at the beginning, bone loss accelerates in postmenopause and bone mass declines 25. 84%-28.63% at the age of 60 and 38.50%-40.44% at the age of 80. Bone mass increases 3.05%-10.26% by an increase of 10%-20% in physical activity. The above results are consistent with clinical observations,which proves that declination of mechanical usage is the primary factor leading to osteoporosis, menopause quickens the process of female osteoporosis, physical activity can decelerate it.
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Aged , Female , Humans , Middle Aged , Biomechanical Phenomena , Bone Remodeling , Computer Simulation , Exercise , Physiology , Models, Biological , Osteoporosis, PostmenopausalABSTRACT
<p><b>OBJECTIVE</b>To study the prevalence of cerebral palsy (here in after referred to CP) in children aged 1 - 6 in Guangxi, China, and its epidemiologic characteristics and relevant risk factors.</p><p><b>METHODS</b>Investigations on the prevalence and etiology of CP in children at ages of 1 - 6 were conducted in Nanning, Hengxian and Qinzhou of Guangxi from June to December in 1998, with a cluster sampling.</p><p><b>RESULTS</b>Totally, 150 806 children aged 1 - 6 were investigated in Nanning, Hengxian and Qinzhou of Guangxi, with 89 418 boys and 61 388 girls. Among them, 193 children were diagnosed as CP, with a prevalence rate of 1.28 per thousand, higher in boys (136 cases, 1.52 per thousand ) than in girls (57 cases, 0.93 per thousand ), with statistical significance (chi(2) = 9.536 7, P = 0.02). Logistic regression analysis showed that risk factors for CP were children who could not cry after birth (neonatal asphyxia), Apgar score less than eight, delivery at lower level of maternity hospital, number of mother's gravidity, no prenatal checks for mothers, and taking antipyretics and preserved food with salt during pregnancy.</p><p><b>CONCLUSIONS</b>Prevalence of CP in children of Guangxi was at a lower level in comparison with that in other areas at home and abroad, which, maybe, was related with the lower neonatal survival and higher infant mortality.</p>
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Child , Child, Preschool , Female , Humans , Infant , Male , Pregnancy , Cerebral Palsy , Classification , Epidemiology , China , Epidemiology , Logistic Models , Pregnancy Trimesters , Prevalence , Risk FactorsABSTRACT
0.05), but were highly significant at doses of 100 ?mol/L or above (P