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OBJECTIVE To observe the efficacy and safety of ticagrelor combined with Compound xueshuantong capsules in the treatment of unstable angina pectoris. METHODS Totally 120 patients with unstable angina pectoris with deficiency of Qi and Yin combined admitted to Sanmenxia Hospital of Traditional Chinese Medicine from January 2021 to December 2022 were randomly divided into clopidogrel group （group A）， ticagrelor group （group B） and combined medication group （group C）， with 40 patients in each group. In addition to conventional treatment， group A was given clopidogrel orally； group B was given ticagrelor orally； group C was given ticagrelor and Compound xueshuantong capsule orally. After 12 weeks of treatment， the clinical efficacy， frequency of angina attacks， coagulation function indicators， cardiac function indicators， traditional Chinese medicine syndrome efficacy， and the incidence of adverse cardiovascular events and bleeding incidence were evaluated in the 3 groups. RESULTS The total effective rates of group A， group B and group C were 77.5%， 85.0% and 90.0%， respectively. The incidence of adverse cardiovascular events and bleeding events were 7.5%， 7.5% and 5.0% in the respective groups， with no statistically significant difference （P＞0.05）. The frequency of angina attacks， duration of angina attacks and duration of dyspnea were significantly reduced or shortened in all 3 groups after treatment compared to before treatment （P＜0.05）. The frequency of angina attacks in group C was significantly lower than that in groups A and B after treatment （P＜0.05）. The levels of fibrinogen （FBG） and D-dimer in all 3 groups were significantly lower after treatment compared to before treatment （P＜0.05）； group A had significantly higher levels of FBG and D-dimer compared to group B and C （P＜0.05）. The left ventricular end-diastolic diameter and left ventricular end-systolic diameter in all three groups were significantly shorter after treatment， and the left ventricular ejection fraction was significantly higher compared to before treatment （P＜0.05）， but there were no statistically significant differences among those groups （P＞0.05）. The total effective rates of traditional Chinese medicine syndrome efficacy in groups A， B and C were 67.5%， 80.0% and 87.5%， respectively， with group C being significantly higher than group A （P＜0.05）. CONCLUSIONS In addition to conventional treatment， ticagrelor combined with Compound xueguantong capsules can more significantly reduce the frequency of angina attacks in patients with unstable angina pectoris， reduce the levels of FBG and D- dimer， improve traditional Chinese medicine syndrome efficacy， and do not increase the risk of bleeding.
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Background Subways are typical congregate settings and may facilitate aerosol transmission of viruses. However, quantified transmission probability estimates are lacking. Purpose To model spread and diffusion of respiratory aerosols in subways by simulation and calculation of infection probabilities. Methods The internal environment of carriages of Shanghai Metro Line 10 was used to establish a study scene. The movement of tiny particles was simulated using the turbulent model. Trend analysis of infection probabilities and viral quantum doses was conducted in a closed subway carriage scene by a quantum emission-infection probability model. Results Under a typical twelve-vent air conditioning configuration, respiratory droplet aerosols within a subway carriage dispersed rapidly throughout various regions due to airflow, with limited short-term diffusion to other carriages. Concurrently, owing to the uncertainty of airflow patterns, the airflow might circulate and converge within carriages, causing delayed outward dispersion or hindered dispersion of droplet aerosols upon entry into these zones. Passengers boarding the carriage could exacerbate the formation of these zones. When the air conditioning system functioned adequately (air exchange rate=23.21 h−1), the probability of a virus carrier transmitting the virus to other passengers within the same carriage via aerosol transmission was approximately 3.8%. However, in the event of air conditioning system failure (air exchange rate=0.5 h−1), this probability escalated dramatically to 30%. Furthermore, a super-spreader (with virus spreading exceeding 90% of the average) elevated the infection probability to 14.9%. Additionally, due to the complexity of turbulence within the carriage, if local diffusion occurred in 1/2 zones of a carriage, the anticipated infection probability would increase to 8.9%, or during the morning or evening rush hours leading to elevated aerosol concentrations, the infection probability would rise to 4.7%. The subway transmission probability for common coronaviruses diminished to as low as 0.9%. Conclusion Combined computational fluid dynamics and infection probability analysis reveals that in the prevalent twelve-vent air conditioning configurations, despite being a major transportation hub with substantial spatial-temporal overlap, the internal space of subway carriages exhibits a certain level of resistance to virus aerosol transmission owing to built-in ventilation capabilities. However, turbulence and passenger positioning may lead to localized hovering of droplet aerosols, thereby increase the risk of virus transmission. Furthermore, super-spreaders, poor operational status of built-in air conditioning system, and high passenger volume at morning or evening peak hours exert profound effects on virus transmission and infection probability.
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This paper summarized clinical experience of treating recurrent subacute thyroiditis based on the theory of internal toxin. It is believed that the core pathogenesis of recurrent subacute thyroiditis is the accumulation of internal toxin. The dysfunction of the spleen in transportation leads to the internal retention of turbidity， which serves as the basis for the formation of toxins. The combination of fire， dampness， and toxins is the key to the disease mechanism. Prolonged accumulation of dampness and turbidity leads to the formation of phlegm， fire， and stasis， and prolonged accumulation of pathogenic factors transforms into secondary toxins. For patients with severe fire， dampness， and toxins， the treatment focuses on dispersing stagnated liver qi， invigorating spleen， and differentiation treatment of fire and water， using a self-designed Chaihu Jiedu Decoction （柴胡解毒饮）. For patients with spleen deficiency and toxin accumulation， the treatment focuses on invigorating the spleen， eliminating turbidity， and cutting off the source of toxins， using a self-designed Shiwei Baizhu Powder （十味白术散）. For patients with yang deficiency and toxin stagnation， detoxification is combined with warming yang， nourishing blood， and supporting toxin expulsion， using a self-designed Heyang Baidu powder （和阳败毒散）.
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Multiple sclerosis is a severe autoimmune inflammatory disease mainly involving the central nervous system. In recent years, the exploration of the mechanism of nerve injury in multiple sclerosis has made great progress. At the same time, disease-modifying therapeutic drugs with different targets are also emerging. Understanding of the mechanisms of nerve injury in multiple sclerosis can help clinicians comprehensively understand the evolution of disease-modifying therapeutic targets of this disorder. Here, the mechanisms of nerve injury in multiple sclerosis and the relationship with the evolution of disease-modifying therapeutic targets are reviewed.
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Objective:To investigate COVID-19 vaccination status and relevant adverse reactions in patients with psoriasis treated with biological agents, and to explore the effect of COVID-19 vaccination on psoriatic lesions.Methods:Clinical data were collected from 572 psoriasis patients aged 18 - 60 years, who were registered in the management system of psoriasis patients treated with biological agents in the University of Hong Kong-Shenzhen Hospital from May 2019 to June 2021. The COVID-19 vaccination status was investigated by telephone interviews, and the vaccination-related information was obtained by fixed healthcare workers during a fixed time period according to a predesigned questionnaire. Measurement data were compared between two groups by using t test, and enumeration data were compared by using chi-square test or Fisher′s exact test. Results:The COVID-19 vaccination coverage rate was 43.13% (226 cases) among the 524 patients who completed the telephone interview, and was significantly lower in the biological agent treatment group (30.79%, 105/341) than in the traditional drug treatment group (66.12%, 121/183; χ2 = 60.60, P < 0.001) . The main reason for not being vaccinated was patients′ fear of vaccine safety (49.66%, 148/298) , followed by doctors′ not recommending (26.51%, 79/298) . In the biological agent treatment group after vaccination, the exacerbation of psoriatic lesions was more common in patients receiving prolonged-interval treatment (42.86%, 6/14) compared with those receiving regular treatment (4.40%, 4/91; Fisher′s exact test, P < 0.001) . Skin lesions were severely aggravated in two patients after COVID-19 vaccination, who ever experienced allergic reactions and whose skin lesions did not completely subside after the treatment with biological agents. Conclusions:The COVID-19 vaccination coverage rate was relatively low in the psoriasis patients treated with biological agents, and no serious adverse reaction was observed after vaccination. Prolonged-interval treatment due to COVID-19 vaccination ran the risk of exacerbation of skin lesions.
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Objective:To identify the risk factors for adverse cardiac events after thoracic surgery in the patients with coronary heart disease.Methods:Perioperative data of patients with coronary heart disease who underwent elective thoracic surgery and had undergone coronary CT angiography before surgery from January 2020 to June 2022 were retrospectively collected. The number and stenosis score of coronary artery were obtained from preoperative coronary artery CT angiography. The patients were divided into cardiac adverse event group and non-cardiac adverse event group according to the occurrence of cardiac adverse events after thoracic surgery from the end of surgery to discharge. Multivariate logistic regression analysis was used to identify the risk factors for adverse cardiac events after thoracic surgery in the patients with coronary heart disease.Results:A total of 786 patients were finally enrolled, and the incidence of cardiac adverse events was 19.6% after thoracic surgery in the patients with coronary heart disease. The results of logistic regression analysis showed that age, preoperative arrhythmia, preoperative coronary stenosis score >7, coronary stent implantation, intraoperative infusion volume, intraoperative red blood cell infusion were risk factors for adverse cardiac events after thoracic surgery in the patients with coronary heart disease ( P<0.05). Conclusions:Age, preoperative arrhythmia, preoperative coronary stenosis score>7, coronary stent implantation, intraoperative infusion volume, intraoperative red blood cell infusion are risk factors for cardiac adverse events after thoracic surgery in the patients with coronary heart disease.
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Objective:To analyze the apply effect of radiofrequency ablation assisted associating liver partition and portal vein ligation for staged hepatectomy (RALPPS) in liver cancer patients with insufficient future liver remnant (FLR).Methods:The data of 29 patients who underwent RALPPS in the First Affiliated Hospital of the Army Military Medical University from June 2014 to July 2020 were analyzed, including 25 males and 4 females, aged (46.6±9.9) years. The patients were divided into the second stage group (completed the second stage operation, n=18) and the first stage group (completed only the first stage operation, n=11) according to whether they had successfully completed the second stage operation. FLR, percentage of FLR in standard liver volume (percentage of FLR), growth rate of FLR, liver function after operation, operation time and radiofrequency ablation time of first stage operation, surgical complications were compared between the two groups. Results:The percentage of FLR before the first stage operation was (30.0±7.0)% in 29 patients, and the second stage operation was completed in 18 patients (62.1%). After the first stage operation, the aspartate aminotransferase and alanine aminotransferase in the second stage group were 519.0 (362.9, 696.0) U/L and 391.8 (297.2, 591.1) U/L, which were better than those of the first stage group 931.0 (711.7, 1131.9) U/L and 851.3 (426.6, 888.0) U/L (both P<0.05). There was no significant difference between the two groups in FLR and percentage of FLR before the first stage operation, duration time, amount of bleeding and time of radiofrequency ablation of the first stage operation (all P>0.05). In the second stage group, the interval between two operations was (21.6±6.7) days, the FLR before the second stage operation was (623.2±101.8) cm 3, the FLR percentage was (49.0±7.0)%, and the FLR growth rate was (19.0±5.0)%. In the first stage group, there were 11 patients (100.0%) who developed complication after first stage operation, induding 7 patients (63.6%) with complication above Clavien-Dindo grade Ⅲb. In the second stage group, 18 patients (100.0%) developed complication after the first stage operation. There were no complication above grade Ⅲb. The causes of 11 patients who did not completed secondary surgery included poor liver function and insufficient FLR in 4 patients, tumor progression in 6 patients, and death in 1 patient. Conclusion:RALPPS is a therapeutic option for liver cancer patients with insufficient FLR, and the therapeutic effect is reasonable.
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The research on the training program of medical education postgraduates will help to cultivate medical education talents with professional knowledge and ability, so as to further promote the specialization and sustainable development of medical education. In the practice of educational research, under the guidance of personnel training objectives, a relatively complete theoretical curriculum system has been set up around students' ideological and political quality, scientific research ability, theoretical and practical knowledge learning and application. In addition, the practical courses of postgraduate training have been rationally designed, and the evaluation methods of the effects have been planned scientifically and reasonably. Through the research, we can make the postgraduate training work of medical education has rules to follow, which plays a key role in improving the quality of education and training.
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Purpose@#Bone destruction and pain caused by cancer is one of the most devastating complications of cancer patients with bone metastases, and it seriously affects the quality of patients’ life. Extracellular matrix metalloproteinase inducer (EMMPRIN) is a cell adhesion molecule with increased expression in a variety of tumors. This study focused to clarify the specific function of EMMPRIN in bone metastasis of breast cancer. @*Materials and Methods@#Adenovirus with shRNA-EMMPRIN was transfected into MRMT-1 rat breast carcinoma cells, and the MRMT-1 cells with different expression levels of EMMPRIN were implanted into the bone marrow cavity of rat tibia. Next, the effect of down-regulation of EMMPRIN was evaluated as follows: bone damage was detected by X-ray radiological and tartrate-resistant acid phosphatase staining; the tumor burden was evaluated by hematoxylin and eosin staining; the test of pain-related behaviors was assessed used the bilateral paw withdrawal mechanical threshold; and the levels of secretory factors in tumor conditioned medium were determined by using enzyme-linked immunosorbent assay. @*Results@#We found that down-regulation of EMMPRIN in tumor cells can simultaneously reduce tumor burden, relieve cancer-induced bone destruction and pain. @*Conclusion@# @*Materials and Methods@#EMMPRIN is expected to be a therapeutic target for relieving bone metastasis of breast cancer and alleviating cancerinduced bone destruction and pain. The method of targeting EMMPRIN may be a promising strategy for the treatment of cancer in the future.
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Purpose@#Bone destruction and pain caused by cancer is one of the most devastating complications of cancer patients with bone metastases, and it seriously affects the quality of patients’ life. Extracellular matrix metalloproteinase inducer (EMMPRIN) is a cell adhesion molecule with increased expression in a variety of tumors. This study focused to clarify the specific function of EMMPRIN in bone metastasis of breast cancer. @*Materials and Methods@#Adenovirus with shRNA-EMMPRIN was transfected into MRMT-1 rat breast carcinoma cells, and the MRMT-1 cells with different expression levels of EMMPRIN were implanted into the bone marrow cavity of rat tibia. Next, the effect of down-regulation of EMMPRIN was evaluated as follows: bone damage was detected by X-ray radiological and tartrate-resistant acid phosphatase staining; the tumor burden was evaluated by hematoxylin and eosin staining; the test of pain-related behaviors was assessed used the bilateral paw withdrawal mechanical threshold; and the levels of secretory factors in tumor conditioned medium were determined by using enzyme-linked immunosorbent assay. @*Results@#We found that down-regulation of EMMPRIN in tumor cells can simultaneously reduce tumor burden, relieve cancer-induced bone destruction and pain. @*Conclusion@# @*Materials and Methods@#EMMPRIN is expected to be a therapeutic target for relieving bone metastasis of breast cancer and alleviating cancerinduced bone destruction and pain. The method of targeting EMMPRIN may be a promising strategy for the treatment of cancer in the future.
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Objective:To determine the potency of remimazolam in inhibiting ventilatory function during sedation in the patients undergoing internal jugular vein puncture.Methods:American Society of Anesthesiologists physical status Ⅰ or Ⅱ patients of either sex, aged 18-64 yr, with body mass index<30 kg/m 2, undergoing elective internal jugular vein puncture under local anesthesia, were enrolled in this study.Remimazolam was intravenously injected, and the dose was determined by up-and-down sequential allocation.The initial dose was 0.07 mg/kg and was increased/decreased in the next patient depending on whether the patients showed inhibition of ventilatory function, and the ratio between the 2 successive doses was 1.2.The criterion for inhibition of ventilatory function was defined as Integrated Pulmonary Index < 5.The median effective dose (ED 50) and 95% confidence interval of remimazolam in inhibiting ventilatory function were calculated by Dixon-Massey method. Results:Thirty-six patients were enrolled in this study.The ED 50 (95% confidence interval) was 0.106 (0.097-0.115) mg/kg. Conclusion:The ED 50 of remimazolam in inhibiting ventilatory function during sedation in internal jugular vein puncture is 0.106 mg/kg.
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As one of the three major nutrients, dietary lipids provide energy and nutrition for human. The quantity and quality of dietary lipids affect the composition of gut microbiota, which consequently may affect the host metabolic health. Development of disease animal models is an important approach to study the relationship between gut microbiota and human metabolic health. In this review, we discussed the types of dietary lipids, and summarized how dietary lipids affect the composition of gut microbiota and regulate the metabolic health of animal models. The clarification of potential underlying mechanisms will shed lights on future research in other live systems including human.
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Animals , Humans , Dietary Fats , Gastrointestinal MicrobiomeABSTRACT
Objective:To analyze the risk factors for cardio-cerebrovascular disease(CCVD)in adults aged 45 years and over, so as to provide the basis for formulating intervention and control measures of risk factors and improving the prognosis.Methods:In-service and retired employees of Tianjin First Central Hospital who underwent health examinations from September 2016 to August 2017 were enrolled in this cross-sectional study.A total of 4815 subjects aged 45 years and over were included, and they were divided into the CCVD group(n=947)and the control group(n=3868)according to previous history of myocardial infarction or coronary stent implantation, cerebral hemorrhage and cerebral infarction.Meanwhile, subjects were divided into the 45-59 years old group(n=2123), the 60-74 years old group(n=1434)and the 75-84 years old group(n=1258). Fasting blood glucose(FBG), glycated hemoglobin(HbA1c), blood lipids, blood pressure(BP)and body mass index(BMI)were measured and recorded.Risk factors for CCVD were analyzed by logistic regression analysis.Results:A total of 4 815 valid samples were obtained.There were statistically significant differences in BMI, BP, FBG, HbA1c, triglyceride and high-density lipoprotein cholesterol(HDL-C)between the CCVD group and the control group( P<0.05).60-74 years old( OR=1.67, 95% CI: 1.37-2.02, P<0.01), 75-84 years old( OR=2.95, 95% CI: 2.42-3.61, P<0.01), emaciation( OR=1.44, 95% CI: 1.21-2.26, P<0.05), overweight( OR=1.24, 95% CI: 1.04-1.48, P<0.05)and obesity( OR=1.49, 95% CI: 1.17-1.91, P<0.01)were risk factors for CCVD.The risk of CCVD was higher in diabetes mellitus patients with poor blood glucose control than in subjects without diabetes mellitus( OR=1.74, 95% CI: 1.42-2.14, P<0.01). With the increase of hypertension grade, the risk of coronary heart disease(CHD)was also increased( OR=1.50, 1.78 and 2.96, respectively). Compared with subjects without hypertension, hypertensive patients with target blood pressure control had a higher risk for CHD( OR=1.92, 95% CI: 1.46-2.54, P<0.01). Gender, smoking history, dyslipidemia and fatty liver were not correlated with CCVD in people aged 45 years and above. Conclusions:The prevention and treatment of CCVD should be focused on proper body weight maintenance, BP control, FBG adjustment and comprehensive management of complications in people aged 45 years and above.
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BACKGROUND: Osteochondritis dissecans of the knee in adults may lead to local instability of articular cartilage and subchondral bone. If it is not treated in time, it will have a secondary impact on articular cartilage, and the probability of osteoarthritis of knee joint is significantly increased. At present, there is no clear treatment plan. OBJECTIVE: To investigate the clinical effect of knee arthroscopy combined with Herbert bidirectional compression screw internal fixation for osteochondritis dissecans of the knee. METHODS: Adult patients who met the diagnostic criteria of osteochondritis dissecans of the knee from June 2014 to September 2018 were retrospectively analyzed, and those with other knee joint diseases were excluded. There were 43 patients treated, including 25 males and 18 females. All patients were treated with knee arthroscopy combined with Herbert two-way compression screw internal fixation. All patients were adults, aged 18-53 years, with an average age of (29.00±4.62) years. All patients had unilateral knee joint disease, including 19 cases of the left limb and 24 cases of the right limb. Before treatment and at final follow-up, knee motion range was compared. Visual analogue scale score was used to evaluate knee pain. Knee Lysholm score was used to evaluate knee function. RESULTS AND CONCLUSION: (1) Of the 43 patients, 35 completed the follow-up time of more than 1 year, and the follow-up time was 12-20 months, with an average of (14.0±2.5) months. None of the patients had related complications. (2) Knee joint pain and function improved significantly in all patients after surgery. The mean knee motion range before operation was (109.57±12.45)°, and (126.39±13.73)° at the final follow-up (t=-56.72, P <0.001). Visual analogue scale score was (5.53±1.47) before surgery and (0.79±1.35) (t=-137.51, P < 0.001) after surgery. Mean Lysholm score was (58.27±10.51) before surgery, and (89.36±5.43) postoperatively (t=-163.65, P < 0.001). (3) Knee arthroscopy combined with Herbert’s two-way compression screw internal fixation for adult osteochondritis dissecans of knee has reliable fixation and small surgical trauma, which can significantly improve knee function, and the clinical effect is satisfactory.
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OBJECTIVE@#To assess the association of single nucleotide polymorphisms (SNPs) of STK39 gene with response to hydrochlorothiazide among ethnic Han Chinese patients with essential hypertension.@*METHODS@#In total 118 patients with essential hypertension were recruited. All participants had received six weeks of treatment with hydrochlorothiazide 25 mg daily. Blood pressure (BP) and heart rate (HR) were measurement every 2 weeks. Genotypes of STK39 rs3754777 and rs6749447 were determined using a SNaPshot technique.@*RESULTS@#A significant difference was found in ΔSBP between individuals with rs3754777 CC, CT and TT and those with rs3754777 CC and CT-TT (P0.05). Relative risk analysis showed that STK39 rs3754777 was significantly associated with BP response to hydrochlorothiazide (OR=0.416, 95%CI=0.189-0.918, P<0.05).@*CONCLUSION@#Polymorphisms of STK39 rs3754777 may be associated with BP response to hydrochlorothiazide among ethnic Han Chinese with essential hypertension.
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Humans , Asian People , Essential Hypertension , Genotype , Hydrochlorothiazide , Polymorphism, Single Nucleotide , Protein Serine-Threonine Kinases , GeneticsABSTRACT
Chromochloris zofingiensis represents an industrially relevant and unique green alga, given its capability of synthesizing triacylglycerol (TAG) and astaxanthin simultaneously for storage in lipid droplets (LDs). To further decipher lipid metabolism, the nitrogen deprivation (ND)-induced LDs from C. zofingiensis were isolated, purified, and subjected to proteomic analysis. Intriguingly, many C. zofingiensis LD proteins had no orthologs present in LD proteome of the model alga Chlamydomonas reinhardtii. Seven novel LD proteins (i.e., two functionally unknown proteins, two caleosins, two lipases, and one l-gulonolactone oxidase) and the major LD protein (MLDP), which were all transcriptionally up-regulated by ND, were selected for further investigation. Heterologous expression in yeast demonstrated that all tested LD proteins were localized to LDs and all except the two functionally unknown proteins enabled yeast to produce more TAG. MLDP could restore the phenotype of mldp mutant strain and enhance TAG synthesis in wild-type strain of C. reinhardtii. Although MLDP and caleosins had a comparable abundance in LDs, they responded distinctly to ND at the transcriptional level. The two lipases, instead of functioning as TAG lipases, likely recycled polar lipids to support TAG synthesis. For the first time, we reported that l-gulonolactone oxidase was abundant in LDs and facilitated TAG accumulation. Moreover, we also proposed a novel working model for C. zofingiensis LDs. Taken together, our work unravels the unique characteristics of C. zofingiensis LDs and provides insights into algal LD biogenesis and TAG synthesis, which would facilitate genetic engineering of this alga for TAG improvement.
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Objective@#To study and analyze the risk factors of deep Venous Thrombosis of Lower limbs in patients with Orthopaedic bed rest.@*Methods@#273 cases of patients with bed rest who were treated by Orthopaedic operation from November 2015 to March 2016 and from November 2016 to March 2017 in our hospital were.collected and divided into 2 groups according to whether there were deep venous thrombosis after operation, and A group had 232 patients who did not have deep venous thrombosis of lower limbs after Operation. B Group had 41 patients who had deep venous thrombosis of lower limbs after Operation. The two groups of patients were treated with orthopedic treatment, the researchers recorded the basic data of two groups of patients, and analyzed the risk factors of lower extremity deep venous thrombosis in patients with orthopedic Bed rest.@*Results@#In group B, patient ratio of age greater than 65 years old, with a body mass index (BMI) of more than 25 kg/m2, with chronic diseases, bed rest for more than 5 days after operation, triglyceride index ≥ 1.7 mmol/L D-dimer ≥ 500 μgP/L, operating time over 4 h were 54.10% (23/41), 58.54% (24/41), 75.61% (31/41), 60.98% (25/41), 58.50% (24/41), 63.41% (26 /41), 48.78% (20/41), respectively.In group A, patient ratio of age greater than 65 years old, with a body mass index (BMI) of more than 25 kg/m2, with chronic diseases, bed rest for more than 5 days after operation, triglyceride index ≥ 1.7 mmol/L D-dimer ≥ 500ugP/L, operating time over 4 h were 24.14%(56/232), 23.28% (54/232), 13.36% (31/232), 23.28% (54/232), 21.12% (49/232), 10.78% (25/232), 9.91% (23/232), respectively, The difference between the two groups was statistically significant (χ2=3.602~11.623, all P < 0.05); Related risk factors for deep venous thrombosis in lower limbs logistic regression analysis showed that age greater than 65 years old, with a body mass index (BMI) of more than 25 kg/m2, with chronic diseases, bed rest for more than 5 days after operation, triglyceride index ≥ 1.7 mmol/L D-dimer ≥ 500 μg/L, operating time over 4 h were the related risk factors for deep venous thrombosis in patients with bed rest after operation.@*Conclusion@#the risk factors for deep venous thrombosis of lower limbs in the elderly patients with bed rest after orthopedic operation are mainly age greater than 65 years old, with a body mass index (BMI) of more than 25 kg/m2, with chronic diseases (such as hypertension, diabetes, etc.), bed rest for more than 5 days after operation, triglyceride index ≥ 1.7 mmol/L D-dimer ≥ 500 μg/L, operating time over 4 h, nursing staff should carry out nursing intervention according to the risk factors related to deep venous thrombosis of lower limbs to avoid the formation of deep vein thrombosis of lower limbs as far as possible.
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Objective To evaluate the clinical efficacy of radical surgery combined with irradiation in the treatment of rectal cancer and its effect on the angiogenesis and survival rate.Methods A total of 200 colorectal cancer patients admitted to Zhengzhou Central Hospital from March,2014 to March,2015 were recruited and divided into the observation group (n=105) and control group (n=95) by using random number table method.In the control group,radical surgery was performed,and radical surgery combined with irradiation was conducted in the observation group.The clinical efficacy,the serum levels of vascular endothelial growth factor-C (VEGF-C) and prostaglandin E2(PGE2) were statistically compared between the control and observation groups.The changes of the microvascular morphology and microvessel density (MVD) in the rectal cancer tissues were observed and recorded.The 3-year survival rate was calculated during postoperative follow-up.Results After corresponding treatment,the clinical overall response rate was 86.67％ in the observation group,and 70.53％ in the control group (P＞0.05).The 2-year survival rate did not significantly differ between two groups (P＞0.05).The 3-year survival rate in the observation group was significantly higher than that in the control group (P＜0.05).After treatment,the serum levels of VEGF-C and PGE2 were significantly improved in two groups (both P＜0.05).In the observation group,the serum levels of VEGF-C and PGE2 were significantly lower compared with those in the control group (both P＜0.05).The microvessel morphology in the cancer tissues remarkably differed between two groups.The microvessel diameter did not significantly differ,whereas the lumen diameter in the observation group was significantly smaller than that in the control group.The MVD in the observation group was 12.25±3.35,significantly lower than 28.14± 17.26 in the control group (P＜0.05).Conclusion Radical surgery combined with irradiation is an efficacious treatment of rectal cancer,which can effectively improve the serum levels of VEGF-C and PGE2,decrease the MVD,reduce the lumen diameter in the cancer tissues,lower the angiogenesis in rectal cancer and enhance the survival rate,which deserves widespread application in clinical practice.
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Objective To study and analyze the risk factors of deep Venous Thrombosis of Lower limbs in patients with Orthopaedic bed rest. Methods 273 cases of patients with bed rest who were treated by Orthopaedic operation from November 2015 to March 2016 and from November 2016 to March 2017 in our hospital were.collected and divided into 2 groups according to whether there were deep venous thrombosis after operation, and A group had 232 patients who did not have deep venous thrombosis of lower limbs after Operation. B Group had 41 patients who had deep venous thrombosis of lower limbs after Operation. The two groups of patients were treated with orthopedic treatment, the researchers recorded the basic data of two groups of patients, and analyzed the risk factors of lower extremity deep venous thrombosis in patients with orthopedic Bed rest. Results In group B, patient ratio of age greater than 65 years old, with a body mass index (BMI) of more than 25 kg/m2, with chronic diseases, bed rest for more than 5 days after operation, triglyceride index≥1.7 mmol/L D-dimer≥500 μgP/L, operating time over 4 h were 54.10% (23/41), 58.54% (24/41), 75.61% (31/41), 60.98% (25/41), 58.50% (24/41), 63.41% (26/41), 48.78% (20/41), respectively.In group A, patient ratio of age greater than 65 years old, with a body mass index (BMI) of more than 25 kg/ m2, with chronic diseases, bed rest for more than 5 days after operation, triglyceride index≥1.7 mmol/L D-dimer≥500ugP/L, operating time over 4 h were 24.14%(56/232), 23.28%(54/232), 13.36%(31/232), 23.28%(54/232), 21.12%(49/232), 10.78%(25/232), 9.91%(23/232), respectively, The difference between the two groups was statistically significant (χ2=3.602～11.623, all P < 0.05); Related risk factors for deep venous thrombosis in lower limbs logistic regression analysis showed that age greater than 65 years old, with a body mass index (BMI) of more than 25 kg/ m2, with chronic diseases, bed rest for more than 5 days after operation, triglyceride index ≥ 1.7 mmol/ L D-dimer ≥ 500 μg/L, operating time over 4 h were the related risk factors for deep venous thrombosis in patients with bed rest after operation. Conclusion the risk factors for deep venous thrombosis of lower limbs in the elderly patients with bed rest after orthopedic operation are mainly age greater than 65 years old, with a body mass index (BMI) of more than 25 kg/m2, with chronic diseases (such as hypertension, diabetes, etc.), bed rest for more than 5 days after operation, triglyceride index≥1.7 mmol/L D-dimer≥500 μg/L, operating time over 4 h, nursing staff should carry out nursing intervention according to the risk factors related to deep venous thrombosis of lower limbs to avoid the formation of deep vein thrombosis of lower limbs as far as possible.
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Objective@#To investigate the relationship between UGT1A1*6, UGT1A1*28, UGT1A1*60 and UGT1A1*93 polymorphisms and irinotecan-induced severe adverse reactions(grade 3-4 delayed diarrhea and neutropenia) in Chinese cancer patients.@*Methods@#A total of 141 cancer patients treated with irinotecan were enrolled in this study. Peripheral venous blood was collected and genomic DNA was extracted. The genetic polymorphisms of UGT1A1*6, UGT1A1*28, UGT1A1*60 and UGT1A1*93 were analyzed by PCR and direct sequencing. The adverse reactions during chemotherapy were observed and recorded. The incidence of severe adverse reactions was compared among patients with different genotypes.@*Results@#Among 141 patients, the cases with UGT1A1*6 GG, GA and AA genotypes were 71, 54 and 16, while those with UGT1A1*28 TA6/6, TA6/7 and TA7/7 genotypes were 105, 33 and 3, respectively. The cases with UGT1A1*60 AA, AC and CC genotypes were 52, 80 and 9, while those with UGT1A1*93 GG, GA and AA genotypes were 105, 32 and 4, respectively. The patients with grade 3-4 delayed diarrhea and neutropenia were 23 and 56, respectively. Multivariate logistic regression analysis showed that UGT1A1*6 and UGT1A1*60 genetic polymorphisms were independent factors influencing the occurrence of grade 3-4 delayed diarrhea. The risk of grade 3-4 delayed diarrhea in homozygous AA carriers of UGT1A1*6 increased 3.79 times compared with that in wild-type GG carriers (95%CI: 1.35-10.67). Moreover, the risk of grade 3-4 delayed diarrhea in homozygous CC carriers of UGT1A1*60 was 20.42 times compared with that in wild-type AA carriers (95%CI: 3.52-118.33). In addition, UGT1A1*28 genetic polymorphism was an independent factor of the occurrence of grade 3-4 neutropenia. The patients with homozygous TA7/7 carriers of UGT1A1*28 had an 1.61 times higher risk of grade 3-4 neutropenia compared with those with wild-type TA6/6 carriers (95%CI: 1.44-12.65). There was no correlation between UGT1A1*93 genetic polymorphism and severe adverse reactions caused by irinotecan.@*Conclusion@#The cancer patients who carried UGT1A1*6, UGT1A1*28 and UGT1A1*60 gene polymorphisms have high risk of severe adverse events caused by irinotecan-based chemotherapy.