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Objective:To investigate the effects of low anterior resection syndrome (LARS) on psychological and physical function and quality of life in patients with rectal cancer.Methods:From May 2014 to May 2019, 200 patients were included. LARS scale score was adopted, and the clinical and pathological data were collected. Univariate analysis and multivariate Logistic regression analysis were performed. the European Organization for Research and Treatment of Cancer Quality of Life core questionnaire and psychological distress management screening tool survey were conducted to evaluate the quality of life and psychological state. The incidence of postoperative sexual dysfunction in male patients was analyzed.Results:The incidence of LARS was 43.0%. Multivariate analysis showed that body mass index ≥24 kg/m 2, anastomotic leakage, anastomotic distance ≤5 cm from anal margin, and preoperative radiotherapy were independent risk factors for LARS ( OR=2.123, 15.109, 7.302, 12.682, all P<0.05).The overall health level and the scores of physical function and emotional function in the functional dimension of patients in the severe LARS group were significantly lower than those in the no/mild LARS group ( t=5.788, 8.831, 8.745, all P<0.05). The scores of fatigue and diarrhea were significantly higher than those in the no/mild LARS group ( t=26.280, 49.476, all P<0.05). The psychological distress thermometer score and the scores of communication , emotional and physical problems in the severe LARS group were significantly higher than those in the no/mild LARS group ( t=4.246, 6.563, 5.913, 4.408, all P<0.05). Conclusion:LARS is a common complication after Dixon procedure for rectal cancer. Body mass index ≥24 kg/m 2, anastomotic leakage, anastomotic distance from anal margin ≤5 cm, and preoperative radiotherapy are independent risk factors for LARS.
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Breast cancer is the most common cancer worldwide, and advanced breast cancer with metastases is incurable mainly with currently available therapies. Therefore, it is essential to understand molecular characteristics during the progression of breast carcinogenesis. Here, we report a dataset of whole genomes from the human mammary epithelial cell system derived from a reduction mammoplasty specimen. This system comprises pre-stasis 184D cells, considered normal, and seven cell lines along cancer progression series that are immortalized or additionally acquired anchorage-independent growth. Our analysis of the whole-genome sequencing (WGS) data indicates that those seven cancer progression series cells have somatic mutations whose number ranges from 8,393 to 39,564 (with an average of 30,591) compared to 184D cells. These WGS data and our mutation analysis will provide helpful information to identify driver mutations and elucidate molecular mechanisms for breast carcinogenesis
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Objective: To understand the virulence gene and drug resistance profile of Shigella sonnei outbreak in Huainan city, and conduct pathogenic traceability analysis. Methods: Water samples and feces related to an infectious diarrhea outbreak in Huainan city in August 2020 were collected for multiple pathogen detection. Virulence gene, drug sensitivity, pulse-field gel electrophoresis and whole genome sequencing of Shigella isolates were analyzed respectively. Results: 38 strains of Shigella sonnei were detected in 56 samples of mucilage feces with a positive rate 67.86%, and all serotypes were Shigella sonnei Phase I. Three strains of Shigella sonnei were detected by fluorescence PCR in the Gram-negative (GN) bacterial enrichment solution of terminal water and well water. Virulence genes were ipaH positive (38), ipaH/ial (31) and ipaH/ial/sen positive (1), respectively. The drug resistance spectrum showed that 9 of 14 antibiotics were 100% resistant, and only imipenem, chloramphenicol, ceftazidime and ciprofloxacin were effective drugs. XbaⅠ restriction enzyme map type of 36 isolates was completely consistent, and the ST type analysis of 3 strains was ST152. Whole genome sequencing and analysis verified that the outbreak was caused by a single clonal group of strains, and revealed that the isolates of the outbreak were clustered into a large cluster with 3 Chinese strains and 1 Korean strain in the database, far away from the strains of other countries. Conclusion: The outbreak is caused by a single clone of Shigella sonnei, which are low virulence strains and have multiple drug resistance.
Subject(s)
Humans , Disease Outbreaks , Dysentery, Bacillary/microbiology , Shigella , Shigella sonnei/genetics , Water/pharmacologyABSTRACT
Objective:To compare the effect of middle meningeal artery embolization (MMAE) versus conventional therapy for chronic subdural hematoma (CSDH).Methods:Retrospective analysis of 38 patients with 48 CSDHs treated with MMAE from May 2019 to May 2021 was performed. Comparisons were made with a conventional treatment for 126 patients with 126 CSDHs from January 2016 to May 2021. The MMAE and conventional treatment patients were matched by the propensity score matching method, and a total of 25 pairs of patients (31 pairs of CSDHs) were successfully matched. The CSDH recurrence, rescue treatment, radiographic follow-up outcome, clinical improvement and complication between the two groups were compared by t test, χ 2 test or Fisher exact probability methods. Results:The rescue treatment rate in MMAE group was significantly lower than that in conventional treatment group [0 (0/31) vs 19.4% (6/31), P=0.024] and the complete resolution rate at 6 months follow-up in MMAE group was significantly higher than that in conventional treatment group [96.8 (30/31) vs 74.2% (23/31), P=0.026]. In terms of CSDH recurrence, there was a trend of lower recurrence in the MMAE group [3.2%(1/31) vs 22.6% (7/31), P=0.053]. The complete resolution rate at 3 months follow-up was 61.3% (19/31) in MMAE group and 45.2% (14/31) in conventional treatment, clinical improvement rate was 92.0% (23/25) in MMAE group and 88.0% (22/23) in conventional treatment, good outcome rate (mRS≤2) was 92.0% (23/25) in MMAE group and 84.0% (21/25) in conventional treatment, complication rate was 0(0/25) in MMAE group and 4.0% (1/25) in conventional treatment, and there were no significant differences in all above-mentioned parameters ( P>0.05). Conclusions:The MMAE may be considered as a safe and effective treatment for CSDH, and MMAE for CSDH is associated with lower trend of recurrence, lower rescue treatment rate and better radiographic follow-up outcome than conventional therapy.
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Objective:To compare drug-coated balloon (DCB) and standard angioplasty balloon (SAB) in the treatment of postoperative in-stent restenosis (ISR) in patients with arteriosclerosis obliterans (ASO) of the lower extremity.Methods:From Jan 2017 to Dec 2018, 43 ISR patients after percutaneous transluminal angioplasty for ASO of the lower extremity at our hospital were enrolled.Patients were divided into 2 groups with 18 patients treated by DCB and 25 by SAB. The patients were followed up for 6~12 months.Results:There was no significant difference in the incidence of complications between DCB group and SAB group ( P>0.05).Compared with that in SAB group, the plasma level of ET-1 in DCB group was lower while NO was higher at 6, 24 h and 2 weeks after surgery ( P<0.05), there was no significant difference in P-selectin ( P>0.05). The ABI values in both groups increased, and that in DCB group were higher than SAB group at 6 and 12 months after surgery ( P<0.05). The lumen loss in DCB group at 6 and 12 months after surgery was significantly lower ( P<0.05). At 6 and 12 months, the primary patency of target lesions in the DCB group was 100.00% and 88.89%, which was higher than the 72.00% and 52.00% in the SAB group ( P<0.05); the CD-TLR rate in the DCB group was 11.11%, which was lower than 48.00% in the SAB group ( P<0.05). Conclusion:DCB comes with lower postoperative ISR in ASO patients of the lower extremity.
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The mammalian target of rapamycin (mTOR) critically regulates several essential biological functions, such as cell growth, metabolism, survival, and immune response by forming two important complexes, namely, mTOR complex 1 (mTORC1) and complex 2 (mTORC2). mTOR signaling is often dysregulated in cancers and has been considered an attractive cancer therapeutic target. Great efforts have been made to develop efficacious mTOR inhibitors, particularly mTOR kinase inhibitors, which suppress mTORC1 and mTORC2; however, major success has not been achieved. With the strong scientific rationale, the intriguing question is why cancers are insensitive or not responsive to mTOR-targeted cancer therapy in clinics. Beyond early findings on induced activation of PI3K/Akt, MEK/ERK, and Mnk/eIF4E survival signaling pathways that compromise the efficacy of rapalog-based cancer therapy, recent findings on the essential role of GSK3 in mediating cancer cell response to mTOR inhibitors and mTORC1 inhibition-induced upregulation of PD-L1 in cancer cells may provide some explanations. These new findings may also offer us the opportunity to rationally utilize mTOR inhibitors in cancer therapy. Further elucidation of the biology of complicated mTOR networks may bring us the hope to develop effective therapeutic strategies with mTOR inhibitors against cancer.
Subject(s)
Glycogen Synthase Kinase 3 , Mechanistic Target of Rapamycin Complex 2 , Neoplasms/drug therapy , Phosphatidylinositol 3-Kinases , Protein Kinase Inhibitors , Proto-Oncogene Proteins c-akt , TOR Serine-Threonine KinasesABSTRACT
Chitinase-3-like-1 (CHI3L1) is known to induce inflammation in the progression of allergic diseases. Previous our studies revealed that 2-({3-[2-(1-cyclohexen-1-yl)ethyl]-6,7-dimethoxy-4-oxo-3,4-dihydro-2-quinazolinyl}sulfanyl)-N-(4-ethylphenyl)butanamide (K284-6111; K284), the CHI3L1 inhibiting compound, has the anti-inflammatory effect on neuroinflammation. In this study, we investigated that K284 treatment could inhibit the development of atopic dermatitis (AD). To identify the effect of K284, we used phthalic anhydride (5% PA)-induced AD animal model and in vitro reconstructed human skin model. We analyzed the expression of AD-related cytokine mediators and NF-κB signaling by Western blotting, ELISA and quantitative real-time PCR. Histological analysis showed that K284 treatment suppressed PA-induced epidermal thickening and infiltration of mast cells.K284 treatment also reduced PA-induced release of inflammatory cytokines. In addition, K284 treatment inhibited the expression of NF-κB activity in PA-treated skin tissues and TNF-α and IFN-γ-treated HaCaT cells. Protein-association network analysis indicated that CHI3L1 is associated with lactoferrin (LTF). LTF was elevated in PA-treated skin tissues and TNF-α and IFN-γ-induced HaCaT cells. However, this expression was reduced by K284 treatment. Knockdown of LTF decreased the expression of inflammatory cytokines in TNF-α and IFN-γ-induced HaCaT cells. Moreover, anti-LTF antibody treatment alleviated AD development in PA-induced AD model. Our data demonstrate that CHI3L1 targeting K284 reduces AD-like skin inflammation and K284 could be a promising therapeutic agent for AD by inhibition of LTF expression.
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Objective To investigate the clinicopathological features,immunohistochemical characteristics,diagnosis,treatment and prognosis of intrathyroid thymic carcinoma.Methods Clinical data of 7 patients with intrathyroid thymic carcinoma were retrospectively reviewed.Histological examination and immunohistochemical staining were performed on the surgically resected tumors.The infection of Epstein-Barr virus(EBV)was detected by EBER in situ hybridization.Results The 7 patients included 5 males and 2 females.The age ranged from 40 to 71 years,with a median of 54 years.The tumors were located in the thyroid gland,with the maximum diameter ranging from 2.2 cm to 6.0 cm and the average maximum diameter of(4.0±1.2)cm.All the patients underwent thyroid gland resection and local lymph node dissection.After operation,all the cases were treated with radiotherapy and five of them additionally received chemotherapy.Six patients were followed up for 10-163 months,all of whom were still alive,including 2 patients with recurrence in situ,1 patient with homolateral cervical lymph node metastasis and the rest with no recurrence or metastasis.CK-pan,P63,CD5 and CD117 were expressed in all the cases,while TTF-1,TG,CT and PAX8 were negative.One case of them expressed SYN and CgA.Ki-67 proliferation index ranged from 10% to 90%.EBER in situ hybridization showed negative results in all 7 cases.Conclusions Intrathyroid thymic carcinoma is a relatively low-grade malignant tumor.The combination of immunohistochemical CD5,CD117 and monoclonal PAX8 is helpful in the diagnosis and differential diagnosis of intrathyroid thymic carcinoma.EBV may not be involved in the development of intrathyroid thymic carcinoma.Thyroid gland resection plus central lymph node dissection is an important treatment measure for intrathyroid thymic carcinoma.For patients with regional lymph node metastasis and obvious peripheral tissue invasion,postoperative radiotherapy with/without chemotherapy can effectively delay the disease progression.
Subject(s)
Child, Preschool , Female , Humans , Male , Epstein-Barr Virus Infections , Herpesvirus 4, Human , Neoplasm Recurrence, Local , Retrospective Studies , Thymoma , Thymus Neoplasms/therapyABSTRACT
Chitinase-3-like-1 (CHI3L1) is known to induce inflammation in the progression of allergic diseases. Previous our studies revealed that 2-({3-[2-(1-cyclohexen-1-yl)ethyl]-6,7-dimethoxy-4-oxo-3,4-dihydro-2-quinazolinyl}sulfanyl)-N-(4-ethylphenyl)butanamide (K284-6111; K284), the CHI3L1 inhibiting compound, has the anti-inflammatory effect on neuroinflammation. In this study, we investigated that K284 treatment could inhibit the development of atopic dermatitis (AD). To identify the effect of K284, we used phthalic anhydride (5% PA)-induced AD animal model and in vitro reconstructed human skin model. We analyzed the expression of AD-related cytokine mediators and NF-κB signaling by Western blotting, ELISA and quantitative real-time PCR. Histological analysis showed that K284 treatment suppressed PA-induced epidermal thickening and infiltration of mast cells.K284 treatment also reduced PA-induced release of inflammatory cytokines. In addition, K284 treatment inhibited the expression of NF-κB activity in PA-treated skin tissues and TNF-α and IFN-γ-treated HaCaT cells. Protein-association network analysis indicated that CHI3L1 is associated with lactoferrin (LTF). LTF was elevated in PA-treated skin tissues and TNF-α and IFN-γ-induced HaCaT cells. However, this expression was reduced by K284 treatment. Knockdown of LTF decreased the expression of inflammatory cytokines in TNF-α and IFN-γ-induced HaCaT cells. Moreover, anti-LTF antibody treatment alleviated AD development in PA-induced AD model. Our data demonstrate that CHI3L1 targeting K284 reduces AD-like skin inflammation and K284 could be a promising therapeutic agent for AD by inhibition of LTF expression.
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Objective:To compare the effects of high progesterone induced ovulation (PPOs) and antagonist on the outcome of in vitro fertilization embryo transfer (IVF-ET) in patients with poor ovarian response (POR) .Methods:208 POR patients who underwent IVF-ET in our hospital were selected as the research objects, and were randomly divided into observation group and control group according to the random number table method, with 104 cases in each. The observation group were treated with PPOs regimen,while the control group were treated with antagonist regimen.The daily hormone levels of human chorionic gonadotropin (hCG) [follicle stimulating hormone (FSH) , luteinizing hormone (LH) , progesterone (P) , estradiol (E2) ], pregnancy outcome [total amount of gonadotropin (GN) , days of GN administration, number of oocytes retrieved, number of transferred embryos, cycle cancellation rate, oocyte maturation rate] and pregnancy outcomes were compared between the two groups (endometrial thickness on trigger day, number of transferred embryos, implantation rate, pregnancy rate, clinical pregnancy rate, abortion rate, live yield) .Results:The serum LH level in the observation group was significantly lower than that in the control group ( P<0.05) , and there was no difference in HCG hormone levels (FSH, P, E2) between the two groups after treatment ( P>0.05) . The total amount of Gn medication, Gn medication days, and oocyte maturation rate of the observation group after treatment were significantly higher than those of the control group, and the cycle cancellation rate was significantly lower than that of the control group ( P<0.05) ; The number of transferred embryos, embryo implantation rate, and live birth rate in the observation group after treatment were significantly higher than those in the control group, while the abortion rate was significantly lower than that in the control group ( P<0.05) ; There was no significant difference in the endometrial thickness and clinical pregnancy rate on trigger days between the two groups ( P>0.05) . Conclusions:Compared with the antagonist regimen, the PPOS regimen has a more obvious clinical effect in treatment of POR patients. It simplifies the process of ovulation stimulation and enhances the sensitivity of the ovaries to ovulation stimulation drugs. It is safe, convenient, economical and feasible, and is worthy of clinical promotion.
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When this paper was first published the following ethical statement was omitted in error: This study was approved by the Ethics Committee of AAALAC (NO. 001488) and carried out in strict accordance with the recommendations in the Guide for the Care and Use of Laboratory Animals of Tianjin Institute of Pharmaceutical Research. The authors would like to apologise for any inconvenience caused. DOI of original article: https://doi.org/10.1016/j.chmed.2018.12.002
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PURPOSE: The aim of the present study was to evaluate the efficacy and safety of the electromagnetic-type low-intensity extracorporeal shock wave therapy (Li-ESWT) in patients with erectile dysfunction (ED).MATERIALS AND METHODS: The randomized, sham-controlled, double-blind prospective study was performed at two referral hospitals. Participants were randomized in a 1:1 ratio to receive sham or Li-ESWT for 6 weeks. ED was evaluated at screening and at 4 and 7 weeks after treatment. Participants were asked to complete the international index of erectile function-erectile function (IIEF-EF) domain questionnaire, erection hardness scale (EHS), and sexual encounter profile questionnaire (SEPQ 2 and 3). The development of complications was investigated.RESULTS: Eighty-one of 96 patients completed the study. The median change in the IIEF-EF score in the Li-ESWT and sham groups was 5.1 and −2.2 (p<0.001), respectively, at the 7-week follow-up; 47.4% (18/38) patients had EHS <3, of which 77.8% (14/18) showed significant improvement in virtue of Li-ESWT treatment (p=0.001). A significant improvement was observed in the percentage of “Yes” responses to SEPQ 2 and 3 in the Li-ESWT group vs. sham group from baseline to 7-week follow-up (91.3% vs. 69.4%; p=0.008 and 50.0% vs. 14.3%; p=0.002, respectively). No patients reported pain or other adverse events during treatment or follow-up.CONCLUSIONS: Thus, Li-ESWT could have a role in improving erectile function. Furthermore, it is safe. We believe that Li-ESWT is an attractive new treatment modality for patients with ED.
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Objective:To explore the relationship between cerebral hemorrhagic transformation (HT) and angiographic early venous filling (EVF) following mechanical thrombectomy for acute ischemic stroke.Methods:A retrospective imaging analysis was performed in the consecutive patients treated from January 2015 to November 2018 for acute anterior circulation large vessel occlusion using mechanical thrombectomy on the Affiliated Hospital of Yangzhou University. The demography, vascular risk factors and other clinical data of the patients were also collected. According to the experimental study of European Cooperative Acute Stroke Study Ⅱ (ECASS Ⅱ), the modified classification of HT after mechanical thrombectomy was divided into HT negative, HT-Ⅰ type and HT-Ⅱ type. The differences in EVF, clinical and demographic characteristics were compared. Multivariate logistic regression analysis was used to identify the independent risk factors for HT and clinical outcome. Diagnostic test characteristics of EVF for HT-Ⅱ type were determined using a receiver operating characteristic curve (ROC) analysis.Results:A total of 98 patients with acute ischemic stroke who received mechanical thrombectomy were enrolled, including HT negative in 48 cases (49.0%, 48/98), HT-Ⅰ in 40 cases (40.8%, 40/98) and HT-Ⅱ in 10 cases (10.2%, 10/98). Significant differences were noted in age, and incidence of atrial fibrillation, EVF and poor outcomes among three groups ( P<0.05). Multivariate logistic regression analysis showed that EVF [odds ratio (OR) 5.960, 95%CI 1.750-8.960, P=0.001] and atrial fibrillation (OR 3.485, 95%CI 1.962-18.986, P=0.028) were risk factors for the occurrence of HT-Ⅱ after mechanical thrombectomy. No risk factor for HT-Ⅰ was noted. Baseline National Institute of Health Stroke Scale (NIHSS) score (OR 1.162, 95%CI 1.021-1.345, P=0.038), EVF (OR 5.358, 95%CI 1.665-13.653, P=0.006) and HT-Ⅱ (OR 1.326, 95%CI 1.226-2.038, P=0.032) were independent risk factors for poor outcomes. And the sensitivity and specificity of EVF in prediction for HT-Ⅱ were 80.0% and 86.4% respectively, with the area under the ROC curve of 0.832. Conclusion:Presence of EVF after mechanical thrombectomy may be the predictor for HT-Ⅱ, which indicates the poor clinical outcomes for acute ischemic stroke patients.
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Objective:To analyze the safety and effectiveness of application of modified double-lumen microcatheter in the measurement of fractional flow reserve(FFR) in coronary bifurcation lesions.Methods:Total of 28 patients with coronary bifurcation lesions in two centers were divided into two groups:conventional technique group(CON) and novel technique group(NOV). The fluoroscopy time, contrast dye usage and FFR-related complications of the two groups were analyzed retrospectively.Results:There were 16 cases in CON group and 12 cases in NOV group. The median time required fluoroscopy in NOV group was significantly less than that in CON group; additionally, lesser amounts of contrast dye were used in NOV group (both P<0.05). The NOV group procedures were successfully accomplished in all cases without complications, such as damage of the pressure sensor, SB spasm or dissection. However, The CON group failed in three patients, including two who experienced coronary artery spasms( P>0.05). Conclusions:Limited experience suggests that the application of modified double-lumen microcatheter in the jailed SB FFR measurement after MV stenting is a safe and technically feasible approach.
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Objective@#To investigate the drug resistance pattern and drug resistance genotypes of Salmonella. spp isolated from fecal specimens and anal swabs of diarrhea cases in Anhui Province.@*Methods@#The 149 strains of Salmonella.spp isolated from feces and anal swabs of diarrhea cases in Anhui Province from April to October 2017 were selected. The serotypes of Salmonella.spp were identified by slide agglutination. The susceptibility of all strains to 14 antibiotics were determined by micro-broth dilution method. Sixty of the cephalosporin-resistant antibiotics were selected. The β-lactamase encoding genes blaTEM, blaSHV, blaOXA-1, blaOXA-2, blaPER, blaCMY, blaCTX-M, and colistin resistance genes mcr-1 and mcr-2 were performed using the multi-PCR method.@*Results@#Of the 149 diarrhea cases, the median (P25, P75) of the age was 5.0 (1.1, 38.5). The 92 of them were male and 54.4% were children. Of the 149 strains of Salmonella.spp, 105 strains had different degrees of resistance to 13 antibiotics other than imipenem. The resistance rate of ampicillin was 55.0% (82/149), which was the highest. 53.0% strains (79 strains) were multidrug resistant, main of which were Salmonella typhimurium and Salmonella enteritidis. A total of 53 resistance patterns were detected, and 10 strains were resistant to ampicillin-ampicillin/sulbactam-tetracycline-chloramphenicol-cefazolin-trimethoprim/sulfamethoxazole, which was the most common resistance pattern. Among the 60 cephalosporin resistant strains, 45 strains carried blaTEM-1, 6 of which also carried blaCTX-M-14 and 3 of which also carried blaCTX-M-65. All the 32 strains carried only blaTEM-1 show resistance to ampicillin and 31 of them show resistance to cefazolin. There were 2 strains showing negative results of gene detection. mcr-1 was detected in a multidrug resistant strain.@*Conclusion@#The resistance of Salmonella.spp to ampicillin shows a serious situation in this region, and there were a number of multidrug resistant strains. The blaTEM-1 was the major drug resistance gene detected in this research. Detection of the mcr-1 suggests the emergence of surveillance to colistin resistance of Salmonella.spp in this area.
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Objective@#To observe the effect of ulinastatin combined with glutamine on early hemodynamics in patients with severe burns.@*Methods@#Thirty-two patients with severe burns who met the inclusion criteria and hospitalized in the Affiliated Huaihai Hospital of Xuzhou Medical University from January 2016 to December 2018 were selected for conducting a prospective randomized controlled trial. According to the random number table, the patients were divided into conventional treatment group (4 males and 4 females), ulinastatin group (5 males and 3 females), glutamine group (5 males and 3 females), and ulinastatin+ glutamine group (4 males and 4 females), with ages of (36±8), (34±8), (35±9), and (38±13) years in turn. From post injury day 2, patients in the 4 groups were given nutritional support of equal nitrogen and equal calories, of which protein was 2.0 g/kg daily. In addition, patients in the ulinastatin group received intravenous injection of 100 kU ulinastatin every 8 hours for 7 consecutive days; 0.3 g/kg of protein given to patients in the glutamine group was provided by alanine glutamine for 7 consecutive days; patients in the ulinastatin+ glutamine group received corresponding treatments of both ulinastatin group and glutamine group. With the help of pulse contour cardiac output (PiCCO) monitoring technology, the cardiac index, stroke volume index (SVI), global end-diastolic volume index (GEDI), systemic vascular resistance index (SVRI), extravascular lung water index (EVLWI), pulmonary vascular permeability index (PVPI) of patients in each group were measured on treatment day (TD) 1, 3, and 7. Data were processed with Fisher′s exact probability method, one-way analysis of variance, analysis of variance for repeated measurement, and Bonferroni method.@*Results@#The cardiac index was low and the SVI value was lower than the normal value on TD 1 in patients of the 4 groups, without statistically significant differences between any two groups (P>0.05), and then they were all gradually increased. On TD 3 and 7, compared with those of the conventional treatment group, the cardiac index and SVI of patients in the other three groups were all increased, and the cardiac index and SVI of patients in the ulinastatin+ glutamine group were significantly increased (P<0.05 or P<0.01). On TD 1, the GEDI of patients in the conventional treatment group, ulinastatin group, glutamine group, and ulinastatin+ glutamine group were at normal low levels, which were (659±58), (661±79), (659±88), and (653±71) mL/m2 respectively, without statistically significant differences between any two groups (P>0.05), and then they all gradually increased. On TD 3 and 7, compared with (684±82) and (742±46) mL/m2 of the conventional treatment group, the GEDI of patients in the ulinastatin group, glutamine group, and ulinastatin+ glutamine group were all elevated, which were (732±53) and (777±33), (725±58) and (783±49), (813±65) and (849±27) mL/m2 respectively, and the GEDI of patients in the ulinastatin+ glutamine group was significantly increased (P<0.05). The SVRI of patients in the four groups were all at high levels on TD 1, without statistically significant differences between any two groups (P>0.05), and then they all gradually decreased. On TD 3 and 7, compared with those of the conventional treatment group, the SVRI of patients in the other three groups were all increased, and the SVRI in the ulinastatin+ glutamine group was significantly increased (P<0.05). On TD 1, the EVLWI of patients in the conventional treatment group, ulinastatin group, glutamine group, and ulinastatin+ glutamine group were all in the normal range, which were (6.6±0.6), (6.3±0.4), (6.5±0.4), and (6.6±0.6) mL/kg respectively, without statistically significant differences between any two groups (P>0.05), and then they all showed the increasing trend. On TD 3 and 7, compared with (7.1±0.9) and (7.9±0.5) mL/kg of the conventional treatment group, the EVLWI of patients in the ulinastatin group, glutamine group, and ulinastatin+ glutamine group were all decreased, which were (6.2±0.6) and (7.1±0.4), (6.3±1.0) and (7.2±0.9), (5.8±0.7) and (6.7±0.6) mL/kg respectively, and the EVLWI of patients in the ulinastatin+ glutamine group was significantly decreased (P<0.05). On TD 1, the PVPI of patients in the four groups were all in the normal range, without statistically significant differences between any two groups (P>0.05), and then they all gradually decreased. On TD 3 and 7, compared with those of the conventional treatment group, the PVPI of patients in the other three groups were all decreased, and the PVPI in the ulinastatin+ glutamine group was significantly decreased (P<0.05).@*Conclusions@#Ulinastatin combined with glutamine can increase the cardiac index, SVI, GEDI, and SVRI and reduce the EVLWI and PVPI in treating patients with severe burns, thereby increasing early cardiac output after injury, promoting tissue and organ perfusion, and reducing pulmonary edema, resulting in significant improvement in early hemodynamics of patients with severe burns.
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Objective@#To explore the relationship between cerebral hemorrhagic transformation (HT) and angiographic early venous filling (EVF) following mechanical thrombectomy for acute ischemic stroke.@*Methods@#A retrospective imaging analysis was performed in the consecutive patients treated from January 2015 to November 2018 for acute anterior circulation large vessel occlusion using mechanical thrombectomy on the Affiliated Hospital of Yangzhou University. The demography, vascular risk factors and other clinical data of the patients were also collected. According to the experimental study of European Cooperative Acute Stroke Study Ⅱ (ECASS Ⅱ), the modified classification of HT after mechanical thrombectomy was divided into HT negative, HT-Ⅰ type and HT-Ⅱ type. The differences in EVF, clinical and demographic characteristics were compared. Multivariate logistic regression analysis was used to identify the independent risk factors for HT and clinical outcome. Diagnostic test characteristics of EVF for HT-Ⅱ type were determined using a receiver operating characteristic curve (ROC) analysis.@*Results@#A total of 98 patients with acute ischemic stroke who received mechanical thrombectomy were enrolled, including HT negative in 48 cases (49.0%, 48/98), HT-Ⅰ in 40 cases (40.8%, 40/98) and HT-Ⅱ in 10 cases (10.2%, 10/98). Significant differences were noted in age, and incidence of atrial fibrillation, EVF and poor outcomes among three groups (P<0.05). Multivariate logistic regression analysis showed that EVF [odds ratio (OR) 5.960, 95%CI 1.750-8.960, P=0.001] and atrial fibrillation (OR 3.485, 95%CI 1.962-18.986, P=0.028) were risk factors for the occurrence of HT-Ⅱ after mechanical thrombectomy. No risk factor for HT-Ⅰ was noted. Baseline National Institute of Health Stroke Scale (NIHSS) score (OR 1.162, 95%CI 1.021-1.345, P=0.038), EVF (OR 5.358, 95%CI 1.665-13.653, P=0.006) and HT-Ⅱ (OR 1.326, 95%CI 1.226-2.038, P=0.032) were independent risk factors for poor outcomes. And the sensitivity and specificity of EVF in prediction for HT-Ⅱ were 80.0% and 86.4% respectively, with the area under the ROC curve of 0.832.@*Conclusion@#Presence of EVF after mechanical thrombectomy may be the predictor for HT-Ⅱ, which indicates the poor clinical outcomes for acute ischemic stroke patients.
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To prospectively evaluate the correlation between intravoxel incoherent motion (IVIM)-derived parameters and CT perfusion parameters as well as the pathological grade in insulinoma. A total of 55 patients with suspected insulinoma undergoing IVIM and CT perfusion scans were prospectively enrolled. The images were post-processed to obtain IVIM parameters including apparent diffusion coefficient (ADC),diffusion (D),perfusion correlated diffusion (D*),and f,and CT perfusion parameters including blood flow (BF),blood volume (BV),and permeability (PM). The pathological specimens were stained to obtain pathological parameters including the grading,ki-67 index,and the mitotic count. The IVIM derived parameters of normal pancreas including head,body,and tail as well as that of the pancreatic insulinoma were compared. The correlation between IVIM parameters and CT perfusion parameters as well as the pathological parameters was analyzed. ADC and D values of pancreatic tail were significantly lower than those of the pancreatic head and neck (all 0.05). IVIM parameters differ at different anatomical parts of normal pancreas. IVIM parameters can distinguish normal pancreatic parenchyma from insulinoma. The ADC value is weakly correlated with BF.
Subject(s)
Humans , Diffusion Magnetic Resonance Imaging , Insulinoma , Diagnostic Imaging , Motion , Pancreatic Neoplasms , Diagnostic Imaging , Reproducibility of Results , Tomography, X-Ray ComputedABSTRACT
To investigate the drug resistance pattern and drug resistance genotypes of Salmonella. spp isolated from fecal specimens and anal swabs of diarrhea cases in Anhui Province. The 149 strains of Salmonella.spp isolated from feces and anal swabs of diarrhea cases in Anhui Province from April to October 2017 were selected. The serotypes of Salmonella.spp were identified by slide agglutination. The susceptibility of all strains to 14 antibiotics were determined by micro-broth dilution method. Sixty of the cephalosporin-resistant antibiotics were selected. The β-lactamase encoding genes , , (1), (2), , , , and colistin resistance genes 1 and 2 were performed using the multi-PCR method. Of the 149 diarrhea cases, the median ((25), (75)) of the age was 5.0 (1.1, 38.5). The 92 of them were male and 54.4% were children. Of the 149 strains of Salmonella.spp, 105 strains had different degrees of resistance to 13 antibiotics other than imipenem. The resistance rate of ampicillin was 55.0% (82/149), which was the highest. 53.0% strains (79 strains) were multidrug resistant, main of which were Salmonella typhimurium and Salmonella enteritidis. A total of 53 resistance patterns were detected, and 10 strains were resistant to ampicillin-ampicillin/sulbactam-tetracycline-chloramphenicol-cefazolin-trimethoprim/sulfamethoxazole, which was the most common resistance pattern. Among the 60 cephalosporin resistant strains, 45 strains carried (1), 6 of which also carried (14) and 3 of which also carried (65). All the 32 strains carried only (1) show resistance to ampicillin and 31 of them show resistance to cefazolin. There were 2 strains showing negative results of gene detection. 1 was detected in a multidrug resistant strain. The resistance of Salmonella.spp to ampicillin shows a serious situation in this region, and there were a number of multidrug resistant strains. The (1) was the major drug resistance gene detected in this research. Detection of the 1 suggests the emergence of surveillance to colistin resistance of Salmonella.spp in this area.
ABSTRACT
BACKGROUND@# Stent failure is more likely in the lipid rich and thrombus laden culprit lesions underlying ST-segment elevation myocardial infarction (STEMI). This study assessed the effectiveness of post-dilatation in primary percutaneous coronary intervention (pPCI) for acute STEMI.@*METHODS@# The multi-center POST-STEMI trial enrolled 41 consecutive STEMI patients with symptom onset <12 hours undergoing manual thrombus aspiration and Promus Element stent implantation. Patients were randomly assigned to control group (n=20) or post-dilatation group (n=21) in which a non-compliant balloon was inflated to >16 atm pressure. Strut apposition and coverage were evaluated by optical coherence tomography (OCT) after intracoronary verapamil administration via thrombus aspiration catheter, post pPCI and at 7-month follow-up. The primary endpoint was rate of incomplete strut apposition (ISA) at 7 months after pPCI.@*RESULTS@# There were similar baseline characteristics except for stent length (21.9 [SD 6.5] mm vs. 26.0 [SD 5.8] mm, respectively, P=0.03). In post-dilatation vs. control group, ISA rate was lower (2.5% vs. 4.5%, P=0.04) immediately after pPCI without affecting final TIMI flow 3 rate (95.2% vs. 95.0%, P>0.05) or corrected TIMI frame counts (22.6±9.4 vs. 22.0±9.7, P>0.05); and at 7-month follow-up (0.7% vs. 1.8%, P<0.0001), the primary study endpoint, with similar strut coverage (98.5% vs. 98.4%, P=0.63) and 1-year rate of major adverse cardiovascular events (MACE).@*CONCLUSION@# In STEMI patients, post-dilatation after stent implantation and thrombus aspiration improved strut apposition up to 7 months without affecting coronary blood flow or 1-year MACE rate. Larger and longer term studies are warranted to further assess safety (ClinicalTrials.gov identifi er: NCT02121223).