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Objective:To investigate the diagnostic value of CT-guided puncture biopsy combined with serum gamma-glutamyltransferase (GGT) and abnormal prothrombin (PIVKA-Ⅱ) in serum alpha-fetoprotein(AFP) negative primary liver cancer (PHC).Methods:Eighty patients with AFP negative PHC treatment in Fuyang Women and Children′s Hospital from January 2018 to March 2021 were selected as AFP negative PHC group, and another 85 patients diagnosed with benign liver tumor during the same period were selected as the control group retrospectively. The patients of the two groups underwent CT-guided biopsy and the levels of GGT and PIVKA-Ⅱ were detected. The single diagnostic value and combined diagnostic value of AFP negative PHC were analyzed by receiver operating characteristic (ROC) curve.Results:Seventy-five of the 80 patients in the AFP negative PHC group were confirmed as liver malignant lesions by biopsy, with a coincidence of 93.75%, and 84 of the 85 patients in the control group were confirmed as liver benign lesions by biopsy, with a coincidence of 98.82%. The levels of AFP, GGT and PIVKA-Ⅱ in AFP negative PHC group were significantly higher than those in the control group: (175.67 ± 39.58) μg/L vs. (18.74 ± 7.42) μg/L, (1 245.37 ± 255.41) U/L vs. (486.63 ± 89.05) U/L, (385.49 ± 30.27) AU/L vs. (25.84 ± 7.66) AU/L, there were statistical differences ( P<0.05). Spearman correlation analysis showed that serum AFP was positively correlated with GGT and PIVKA-Ⅱ ( r = 0.858 and 0.429, P<0.05). The results of ROC curve showed that the area under curve of CT-guided biopsy combined with GGT and PIVKA-Ⅱ in the diagnosis of AFP negative PHC was 0.877, the sensitivity was 91.19%, the specificity was 87.34%. Conclusions:CT-guided biopsy combined with GGT and PIVKA-Ⅱ detection of AFP negative PHC can effectively improve the diagnostic value.
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Objective@#To investigate the correlation between fat mass percentage(FM%), fat mass index(FMI), fat free mass index(FFMI), body mass index (BMI) and physical fitness, and to explore the potential value of body composition index in predicting physical exercise level of children and adolescents.@*Methods@#Data came from 2013 revision of National Students Physical Health Standard of Ministry of Education in Beijing. Body composition of 4 069 children and adolescents aged 6-20 years in Beijing was measured by the BIA(inbody 230). FM, FMI, FFMI and BMI were divided into four groups by quartile method. The differences and trends of the four groups were analyzed by graphpad prism 8.0 software.@*Results@#FM% (20.03±10.39) and FMIS [(4.35± 2.84 )kg/m 2] of oys were significantly lower than those of girls, while FFMI [(14.21±4.95)kg/m 2] and BMI [(20.31±4.27) kg/m 2 ] of boys were significantly higher than those of girls( t =-13.36, -7.66, 11.49, 8.16, P <0.01). In boys, with the increase of FM% and FMI, the performance of 50 m, 1 000 m, standing long jump and pull up showed a downward trend; with the increase of FFMI, the performance of 50 m, standing long jump and pull up had an obvious upward trend. In girls, with the increase of FM% and FMI, the 50 m running time was gradually shortened, and the 800 m running time was gradually increasing; High FFMI was associated with higher performance in 50 m running, while no association was observed between FFMI and 800 m running.Four body composition indicators showed no effects on performance of sitting forward flexion and 1 minute sit up.@*Conclusion@#FM%, FMI, FFMI and BMI have a good predictive effect on physical fitness of children and adolescents. Adolescents with higher FFMI, lower FM% and FMI have better muscle burst strength, muscle endurance, flexibility, aerobic ability and anaerobic ability, especially in boys.
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[Objective] To summarize the academic views and clinical experience of Professor HE Ruoping in the treatment of peri menopausal syndrome by using traditional Chinese medicine. [Method] From the clinical treatment, collecting the clinical information of the teacher, research and discuss the traditional Chinese medicine academic ideas and clinical experience of teacher HE in the treatment of perimenopausal syndrome, to summarize the traditional Chinese medicine of perimenopausal syndrome in dialectical characteristic.And further explain the characteristics of the treatment of teacher HE through case analysis. [Result] Teacher HE thinks that the main pathogenesis of perimenopausal syndrome is the deficiency of kidney Yin, and divides the patients into stagnation of liver-qi type, Qi stagnation and blood stasis, disharmony between heart and kidney, heart and spleen deficiency type, yin-yang deficiency type, a total of five kinds of syndrome types, according to their clinical manifestation.When confronted with such patients, teacher HE often chooses Liuwei Dihuang Pills to tonify kidney-yin and relieve liver for smooth Qi, promoting qi to activate blood, restoring normal coordination between heart and kidney, invigorating heart and spleen, tonify both Yin and Yang, gives patients more grooming solution at the same time to adjust their physical and mental state as a whole, so the patients could receive remarkable effect and avoid the potential risks of hormone replacement therapy.The case in this article has obtained good treatment results. [Conclusion] Teacher HE treats perimenopause syndrome by tonifying kidney-yin and taking accompanied symptoms and signs into account meanwhile, which has significant clinical effect and the value of popularization and application.
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Objective To investigate the expression change of RACK1 ,Src and Bcl‐2 in gastric carcinoma tissue and adjacent carcinomatous tissue .Methods Eighty specimens of gastric carcinoma and adjacent carcinomatous tissues in our hospital from Au‐gust 1 ,2011 to February 1 ,2014 were collected .The immunohistochemistry staining and Western blotting methods were adopted to detect the expression of RACK1 ,Src and Bcl‐2 protein in gastric carcinoma and adjacent carcinomatous tissues ,and their correlation was analyzed and performed the statistical analysis by combining with the clinicopathological data .Results The immunohistochem‐istry staining and Western blotting detection displayed that the expression positive rate and expression level of RACK 1 in gastric carcinoma tissue were obviously lower than those in the adjacent carcinomatous tissue ,while the expression positive rate and ex‐pression level of Src and Bcl‐2 in gastric carcinoma tissue were obviously higher than those in the adjacent carcinomatous tissue ,the differences were statistically significant (P0 .05) .Conclusion The expression of RACK1 in gastric carcinoma tissue is significantly decreased ,while the expres‐sions of Src and Bcl‐2 are increased .
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Objective To evaluate the clinical outcome in the treatment of humerus shaft comminuted fractures using limited open reduction and internal fixation combined with an external fixator.Methods Data of 80 patients with comminuted humerus shaft fractures treated from January 2005 to January 2013 were analysed retrospectively.All the patients underwent limited open reduction and internal fixation combined with an external fixator (treatment group) and open reduction and plate fixation (control group) according to the random number table.In the treatment group,there were 40 patients (28 males,12 females),at mean age of 33.5 years (range,21-54 years),with causes of injury including traffic accidents in five patients,falls in nine,crashes in seven and others in six.There were seven patients with open fractures and 33 with closed fractures.In the control group,there were 40 patients (25 males,15 females),at mean age of 32.9 years (range,19-55 years),with causes of injury including traffic accidents in 16 patients,tumbling in seven,crush in seven and others in ten.There were eight patients with open fractures and 32 with closed fractures.The operation time,intraoperative blood loss,bone union time and complications in both groups were recorded.Clinical efficacy was evaluated using the Stewart and Hundley standard.Results Mean follow-up was 19 months (range,15-24 months).Treatment and control groups showed significant differences in operation time [(55.5 ± 10.3) minutes vs.(120.5 ± 15.3) minutes],intraoperative blood loss [(120.4 ± 20.7) ml vs.(245.4 ± 26.7) ml] and bone union time [(11.6 ± 1.3) weeks vs.(14.9 ± 2.3) weeks] (P ＜ 0.05).Rate of incision infection was 8％ (3/40) in treatment group and 10％ (4/40) in control group (P ＞ 0.05).In treatment group the results were excellent in 31 patients and good in nine.In control group the results were excellent in 27 patients,good in nine,fair in one and poor in three.One patient with radial nerve injury after a second surgery for implant removal and two patients with osteomyelitis or bone nonunion were noted in control group.Conclusion Limited open reduction and internal fixation in combination with an external fixator is associated with small trauma,easy operation,short operation time,few bleeding,rigid fixation,early functional exercises and reduced bone nonunion for treatment of comminuted humerus shaft fractures,which exhibits great clinical value.
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Objective To evaluate the methodological performance of the new enzymatic method for detecting glycated hemo-globin(HbAIc)and its influencing factors.Methods HbAIc was detected by the enzymatic method.The precision,anti-interfer-ence,recovery rate,accuracy and the influence of pre-processing(anti-coagulation,preservation,centrifugation)on the detection re-sults were evaluated,its correlation with HPLC and the bias degree were analyzed.Results The within-run coefficients of variation (CVs)for high,middle and low value QC samples in the enzymatic assay were 1.04%,1.26% and 1.37% respectively and the be-tween-run CVs were 1.83%,2.24% and 2.64%,respectively;the enzymatic method showed the linear correlation with HPLC(r=0.996,P 0.05);the sample was centrifuged at 500,1 000 r/min(R=15 cm)for different time(1,2,5,10 min)and at 2 000 r/min for 1 min,their detection results had statistical differences compared with the sample centrifuged=3 000 r/min for 5 min (P <0.05).Conclusion The precision,anti-interference,accuracy and linearity range of the enzymatic method all conform to the clinical requirement.Compared with the conventional method,its correlation is good with small deviation,which can entirely satisfy the demand of the HbAIc detection in clinic.
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Objective To discuss the diagnostic value of N-terminal-pro-brain natriuretic peptide (NT-proBNP) for patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) complicated with left heart failure. Methods Patients with medical history of AECOPD, or are diagnosed as AECOPD from March 2014 to February 2015 were involved in the study. Based on echocardiography and clinic characteristics , the patients were divided into left heart failure group (group A) and non-left heart failure group (group B). Related factors of elevated NT-proBNP in AECOPD and the diagnostic value of NT-proBNP for patients with AECOPD complicated with left heart failure were analyzed , and exclusive and diagnostic cutoff were worked out. Results In this study , 109 AECOPD patients were collected , including 21 patients in group A and 88 patients in group B. Multivariate linear regression analysis indicated NT-proBNP was positively associated with PCT (β=0.180,P = 0.011) and PAP(β = 0.333,P = 0.000), and negatively with LVEF(β = -0.511,P = 0.000)and the area under the ROC curve(AUC) was 0.959 (95% confidence interval:0.915-1.002,P = 0.000). The exclusive cutoff was 794.6 pg/mL(sensitivity:90.5%,specificity:92%), and the diagnostic cutoff 1 618 pg/mL(sensitivity:85.7%,specificity: 97.7%). Conclusions NT-proBNP can help to diagnose whether AECPOD patients are complicated with left heart failure. Besides left heart dysfunction and the state of systemic inflammation , pulmonary hypertension may be the reasons for the elevated NT-proBNP in AECOPD patients.
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Objective To identify allergens in portunus trituberculatus responsible for atopic dermatitis (AD) in children.Methods Totally,145 child outpatients with AD were enrolled in this study from September 2013 to July 2014,and underwent the skin prick test (SPT) with crab proteins or crab-specific IgE determination assay.Then,the children with positive SPT or elevated IgE levels underwent an oral challenge with portunus trituberculatus.Serum samples were collected from 33 children with a positive oral food challenge (test group) and from 30 health check-up child examinees (control group).Total proteins were extracted from fresh portunus trituberculatus.Sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE) and Western blot were conducted to identify the protein fragments of portunus trituberculatus responsible for AD among these children.Results The SDS-PAGE of crude protein extracts from portunus trituberculatus yielded 11 protein bands with relative molecular masses of 94 000,70 000,58 000,49 000,36 000,34 000,32 000,27 000,21 000,19 000 and 17 000 respectively.Of the 11 protein bands,only 4 with relative molecular masses of 70 000,58 000,49 000 and 36 000 respectively reacted with sera from the patients by Western blot,with the reaction rate being 93.9％,45.4％,39.4％ and 100％ respectively.None of these protein bands reacted with sera from the control group by Western blot.There were significant differences between the test group and control group in the reaction rates of the four proteins with relative molecular masses of 70 000,58 000,49 000 and 36 000 respectively to sera (x2 =55.483,17.898,14.891,63.000,all P ＜ 0.05).Conclusion The two proteins with relative molecular masses of 70 000 and 36 000 respectively are major allergens in portunus trituberculatus responsible for AD among children.
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BACKGROUND:Due to complex etiology, manifestations, symptoms, development and outcomes, there is no article about the detailed introduction of condylar resorption in China. OBJECTIVE:To analyze the etiology, pathogenesis, clinical manifestations, diagnosis and treatment of condylar resorption, thereby providing a theoretical basis for clinical treatment of condylar resorption. METHODS:An online computer-based retrieval of PubMed database and CNKI database between January 1990 and January 2014 was performed by the first author. The keywords were “temporomandibular joint, condylar resorption, pathogenesis, diagnosis, treatment” in English and Chinese, respectively. Finaly 38 literatures on the etiology, clinical presentation, diagnosis and treatment of condylar resorption were included. RESULTS AND CONCLUSION: Condylar resorption was subdivided into secondary condylar resorption and primary condylar resorption. Secondary condylar resorption has clear risk factors, including condylar fractures, orthognathic surgery, connective tissue or autoimmune diseases and rheumatoid arthritis. Primary condylar resorption may be associated with lowered serum estradiol concentration. Condylar resorption can be diagnosed by imaging studies combined with clinical manifestations and disease history. Condylar resorption treatment measures mainly include medications, splint treatment, occlusal reconstruction, orthognathic surgery, rib-cartilage transplantation and total joint replacement surgery, in conjunction with orthodontic treatment. Currently, its complex etiology and pathogenesis has not been fuly elucidated, and we need to conduct further studies.
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To improve physician-patient morality accomplishment is the basic project for construct a harmonious society,a harmonious physician-patient relationship,and a harmonious hospital,thus is of great realistic significance and value.The improvement of physician-patient morality accomplishment contributes to the construction of a harmonious society,while a harmonious society also lays a solid foundation for the improvement of physician-patient morality accomplishment.Thus the two depend on,contribute and interact with each other.