ABSTRACT
Objective To investigate the clinical curative effect of α-lipoic acid combined with lipid microsphere alprostadil in treating elderly early diabetic kidney disease .Methods One hundred and sixty-four cases of early diabetic kidney disease treated in this hospital from January 2014 to January 2016 were selected and randomly divided into the experimental group and the control group according to the random number table method ,82 cases in each group .The control group was given lipid microsphere alpros-tadil ,while on this basis the experimental group was added with α-lipoic acid .The various biochemical indexes ,clinical efficacy and subcutaneous bruising ,fundus event occurrence were compared between the two groups .Results The levels of U-RBP and NAG after treatment in the two groups were significantly decreased compared with before treatment ,the difference was statistically sig-nificant (P<0 .05) .Although other indicators such as serum Scr ,BUN ,CysC andβ2-MG had different degrees of decline ,but the difference was not statistically significant (P>0 .05) .The effective rate in the experimental group was 91 .46% ,which was signifi-cantly higher than 78 .05% in the control group ,the difference was statistically significant (P<0 .05) .Subcutaneous bruising and fundus events in the experiment group had the increasing trend ,but the difference between the two groups had no statistical signifi-cance (P>0 .05) .Conclusion α-lipoic acid combined with lipid microsphere alprostadil in treating elderly early diabetic kidney dis-ease can better improve glomerular and renal tubular function .
ABSTRACT
<p><b>OBJECTIVE</b>To retrospectively explore the effectiveness of surgical intervention model for repairing the tuberculosis wound with sinus tract.</p><p><b>METHODS</b>Forty-three patients with tuberculosis wound with sinus tract who met the inclusion criteria were admitted to the 309th Hospital of PLA from January 2010 to October 2015. These patients were divided into test group (n=38) and control group (n=5) according to the different treatment and patient's consent. Patients in test group were treated as follows. Firstly, antituberculosis drugs were taken orally for at least 3 weeks, and the wounds were accurately assessed using magnetic resonance imaging combined with 3-dimensional reconstruction software. Then sinus tract and its surrounding devitalized tissue were completely excised, and vacuum sealing drainage (VSD) treatment with negative pressure value of -26.6 kPa was performed for 1 to 2 weeks (dressing change was performed per 7 days). Lastly, the wounds were covered through direct suture or grafting skin or flap. Patients in control group were firstly given antituberculosis drugs orally for at least 3 weeks, and then they were treated with routine dressing change in outpatient service every 3 days. After the former therapy, patients in both groups were given antituberculosis drugs by oral administration for at least 6 months and were followed up for 6 to 36 months. Detection of Bacillus tuberculosis, Acid-fast bacilli, and tuberculosis granuloma, wound healing time, and relapse of tuberculosis wound in patients of both groups were recorded. The rates of single sinus tract, two sinus tracts, and more than or equal to 3 sinus tracts of patients in test group were recorded. Data were processed with Fisher's exact test and Wilcoxon rank-sum test.</p><p><b>RESULTS</b>Bacillus tuberculosis was respectively detected in wounds of 5 patients in test group and 2 patients in control group. Acid-fast bacilli were positively expressed in wounds of 8 patients in test group and 3 patients in control group. A typical tuberculosis granuloma phenomenon was observed in the wounds of 27 patients in test group and 4 patients in control group. These differences in above-mentioned 3 indexes between two groups were not statistically significant (with P values respectively 0.238 4, 0.154 4, 1.000 0). The median of wound healing time of patients in test group was 19.6 d, which was significantly shorter than that in control group (94.4 d, χ(2)=12.986 0, P=0.000 3). There were 2 and 1 patients with recurrent tuberculosis wound in test group and control group respectively, without statistically significant difference (P=0.363 0). Among patients in test group, the rate of single sinus tract was 23.7%(9/38), the rate of two sinus tracts was 28.9%(11/38), and the rate of more than or equal to 3 sinus tracts was 47.4% (18/38).</p><p><b>CONCLUSIONS</b>Repairing the tuberculosis wound with sinus tract in surgical intervention model of antituberculosis therapy+ accurate wound assessment+ debridement+ VSD treatment+ surgical repair is beneficial to making the optimal operation plan under the premise of knowing location of sinus tract, which can reduce surgical risk.</p>
Subject(s)
Humans , Debridement , Magnetic Resonance Imaging , Negative-Pressure Wound Therapy , Paranasal Sinuses , Pathology , General Surgery , Retrospective Studies , Skin Transplantation , Surgical Flaps , Treatment Outcome , Tuberculosis , Drug Therapy , General Surgery , Wound HealingABSTRACT
Objective To investigate the expressions and clinical significances of MUC1-mRNA and CK20-mRNA in peripheral blood of esophageal cancer patients.Methods MUC1-mRNA and CK20-mRNA were detected in 53 patients with esophageal cancer,10 patients with esophageal benign tumor and 20 healthy volunteers by RT-PCR technique.Results The expressions of MUC1-mRNA,CK20-mRNA and combining group were 35.85 % (19/53),49.06 % (26/53) and 62.26 % (36/53) in peripheral blood of 53 esophageal cancer patients.In control group,there was no expression of MUC1-mRNA and CK20-mRNA in peripheral blood of 10 patients with benign esophageal disease and 20 healthy volunteers.The positive rate increased by combining test(x2 =11.0228,P ＜0.05).Conclusion MUC1-mRNA and CK20-mRNA might be specific and sensitive markers to detect circulating tumor cells in peripheral blood and their expressions are closely related to TNM stages of the esophageal cancer patients.The combining test might be of high value of the diagnosis of micrometastasis.
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Objective To establish reverse transcriptase-polymerase chain reaction(RT-PCR) with primers specific for CEA gene and CK20 gene to detect circulating tumor cells in peripheral blood of esophageal cancer pa-tients,and try to find the relationship between the mRNA expression and micrometastasis. Methods The expressions of CEA,CK20 were analyzed by RT-PCR in 53 cases of esophageal tumor tissue and in peripheral blood,compared with 10 patients with benign esophageal disease and 20 healthy volunteers. Results The expressions of CEA-mRNA, CK20-mRNA were 96.23% (51/53), 100% ( 53/53 ) in 53 esophageal tumor tissue and were 52.83% (28/53), 49.06% (26/53) in peripheral blood of 53 esophageal cancer patients. In control group,there was only one expression of CEA-mRNA in peripheral blood of 10 patients with benign esophageal disease,as well as in 20 healthy volunteers. There was no expression of CK20-mRNA in peripheral blood of 10 patients with benign esophageal disease and 20 healthy volunteers. Conclusion CEA-mRNA, CK20-mRNA might be specific and sensitive markers to detect circu-lating tumor cells in peripheral blood and their expression was closely related to TNM stages of the esophageal cancer patients.