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Objective To explore the related factors of hair selenium level in Keshan disease area of Zhangjiakou City, Hebei Province, and to provide reliable data basis for consolidating the elimination of Keshan disease. Methods The association rule (Apriori) analysis was carried out on the survey data of hair selenium level of people in Keshan disease endemic areas and non-endemic areas of Zhangjiakou City from 2018 to 2020. By setting the minimum support and confidence, and combining with the lift ratio, the association relationship between the hair selenium level of people in Keshan disease area and the staple food and vegetables of the residents was analyzed. Results A total of 5 strong association rules were generated. The maximum values of support, confidence and lift ratio were 12.22, 93.33 and 1.17, respectively, and the minimum values were 10.00, 90.91 and 1.14, respectively. The moderate level of selenium in the hair of residents in the disease area was related to the consumption of food purchased from other places and a large quantity of vegetables. Conclusion Association rules provide a reference research method for improving hair selenium nutrition level of residents in Keshan disease area of Zhangjiakou City and establishing a long-term mechanism for Keshan disease prevention and control.
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Objective:To explore the relationship between the ratio of serum creatinine and cystatin C (Creatinine/Cystatin C, Cr/CysC) and the risk of fracture in diabetic patients, and to provide a basis for evaluating the risk of fracture in diabetic patients.Methods:Prospectively selected 216 patients with type 2 diabetes (T2DM) who were treated in our hospital from Apr. 2019 to Apr. 2021. Among them, they were divided into fracture group (56 cases) and non-fracture group (160 cases) according to whether they were combined with fractures.Collected two groups of baseline data, general clinical data, laboratory, imaging data, use sarcosine oxidase method to detect serum creatinine (Cr) content, use immunoturbidimetric method to determine serum cystatin C (CysC) level, and calculate The ratio of the two, After matching the propensity scores for age, gender, body mass index, diabetes course, etc., multi-factor Logistic regression analysis was used to evaluate the influencing factors of fracture risk in diabetic patients, and the restrictive cubic spline was used to evaluate the relationship between Cr/CysC and diabetic fracture risk. Relationship.Results:After the two groups were matched by propensity scores, 42 groups were successfully matched, and there was no statistically significant difference in baseline data after matching ( P>0.05) ; Compared with the fracture group, the AGEs (129.13±37.51) ng/mL andALP (97.50±23.80) U/L in the fracture group were higher than those in the non-fracture group (108.41±29.33) ng/mL, (84.35±25.66) U/L higher; Cr/CysC (0.87±0.15) , limb skeletal muscle mass (19.58±3.99) kg were higher than those in the non-fracture group (0.99±0.21) , (21.81±4.38) kg low ( P<0.05) ;Multivariate logistic regression analysis showed that the skeletal muscle mass of extremities ( OR=0.865, 95% CI0.761~0.985) and Cr/CysC ( OR=0.048, 95% CI0.002~0.933) were protective factors for diabetes complicated with fractures; ALP ( OR=1.023, 95% CI1.002~1.044) , AGEs ( OR=1.022, 95% CI1.006~1.039) risk factors for diabetes and fracture (all P<0.05) ,Restricted cubic spline showed a significant non-linear relationship between Cr/CysC and diabetic fractures ( P<0.05) . Conclusion:Cr/CysC is related to the occurrence of fractures in diabetic patients and can be used as a potential predictor of the occurrence of diabetic fractures.
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Hepatocellular carcinoma (HCC) has the features of high incidence rate, low survival rate, poor treatment outcome, and complex pathogenesis. In recent years, many studies have shown that long non-coding RNA (lncRNA) MALAT1 is upregulated in HCC and can promote the proliferation, invasion, and metastasis of HCC cells, and it can also guide the diagnosis, prognostic evaluation, and treatment of HCC in clinical practice. This article reviews the current status of research on lncRNA MALAT1 in HCC and discusses its expression pattern, mechanism of action, and clinical significance in predicting and monitoring the progression of HCC, so as to gain a deep understanding of the role of lncRNA MALAT1 in the progression of HCC. It is pointed out that lncRNA MALAT1 is expected to become a potential biomarker for the diagnosis and prognostic evaluation of HCC and may be used as a therapeutic target in clinical practice.
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Hepatocellular carcinoma (HCC) is a common malignant tumor that threatens the health of all mankind, and its incidence and mortality rates keep increasing in recent years. Most patients are in the advanced stage at the time of confirmed diagnosis and are unable to undergo potential therapeutic surgery. Transcatheter arterial chemoembolization (TACE) and the anti-angiogenic drug apatinib are two palliative treatments for HCC. At present, apatinib combined with TACE is still a new treatment method for HCC in clinical practice, and there are still controversies over its efficacy and safety, which needs further studies. This article reviews the research advances in apatinib combined with TACE in the treatment of HCC.
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Objective:To assess the effect of stone and urine bacteria culture on the treatment of postoperative infection in percutaneous nephrolithotomy (PCNL).Methods:Between September 2016 and September 2018, 1060 patients with kidney stones treated with first-stage PCNL were included in the study. There were 614 male and 446 female patients, with the mean age (52.4±12.2) years. The mean stone burden was (1 499.6±1 435.3) mm 2. The midstream urine sample and the stone sample were sent for bacterial culture, identification of bacterial strain and antimicrobial susceptibility tests. The results of urine culture (UC), stone culture (SC) and their antimicrobial susceptibility, the details of perioperatively administered antibiotics and postoperative infections were recorded. The relationship between the postoperative infection and the SC was analyzed. Results:In 1 060 patients, 22 bacterial species were identified in UC and 52 bacterial species were identified in SC. The positive rate was higher in SC than in UC[31.8%(337/1 060)vs. 20.9%(222/1 060), P<0.001]. Escherichia coli was the most common bacteria in both UC and SC, but was more prevalent in UC than in SC [52.3%(116/222)vs. 43.6%(147/337), P<0.05]. E. coli cultured from UC and SC had high resistance to ampicillin, cefazolin, ceftriaxone, cefotaxime, levofloxacin, ciprofloxacin (all resistance rate >40%), but were sensitive to meropenem, cefoperazone/sulbactam, piperacillin/tazobactam, and amikacin (all resistance rate <10%). There was no statistical difference in the antibiotic resistance rates of E. coli from the UC and SC (all P >0.05). There were 111 (10.5%) patients who developed fever and 22 (2.1%) who developed urosepsis postoperatively. The incidences of postoperative fever and urosepsis were higher in the patients with positive SC than the patients with negative SC [23.7%(80/337)vs. 4.3%(31/723); 4.2%(14/337)vs. 1.1%(8/723), P<0.05]. Even in patients with negative UC, The incidence of postoperative fever was higher in the group with positive SC than the group with negative SC [17.9%(30/168) vs. 4.2%(28/670), P<0.05]. The incidence of postoperative fever in SC positive patients was lower if they were treated with sensitive antibiotics to the bacteria in stone than those treated with nonsensitive antibiotics [17.5%(22/126) vs. 27.5%(58/211), P<0.05]. Conclusions:The SC had high rate of culture positive, complicated bacterial species and high rate of multi-drug resistant. Positive SC was associated with increased incidence of postoperative infection even if the patients had negative UC. The SC might have a importance clinical value in the treatment of postoperative infection in PCNL.
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Objective To investigate the treatment of urinary tract obstruction after kidney transplantation, and to introduce the novel ‘antegrade percutaneous urinary tract throughout guidance technique’ with guide wire in selected patients. Methods 43 cases of renal transplantation patients due to urinary tract obstruction (ureteral stenosis and hydronephrosis in 24 cases, urinary calculi with or not ureteral stenosis in 19 cases) received endourological treatment. Retrograde pathway was tried firstly, if failed, antegrade pathway was adopted with‘antegrade percutaneous urinary tract throughout guidance technique’, 18 Fr percutaneous tract was established if necessary, endoscopy was needed in antegrade or combine with retrograde pathway. Results Of the 43 patients, 9 (20.9 %) patients were managed directly through the retrograde ureteroscopy, 28 (65.1 %) patients were managed with anterograde percutaneous technique in 18 Fr tract, 6 (14.0 %) patients were treated with ‘antegrade percutaneous urinary tract throughout guidance technique’. Operation time was (72.0 ± 16.0) (45 ~ 95) minutes. Postoperative stone clearance rate of 89.5 % (17/19). Of 32 cases with ureteral stricture, 6 (6/32, 18.8 %) cases were cured after one time of dilation and JJ stent indwelling for 2 months, 18 (56.3%) cases with stable hydronephrosis after 2-3 times of dilation and JJ stent indwelling, 5 cases (15.6 %) needed long-term repeated stent indwelling for drainage, 3 (9.4%) cases required nephrostomy tube drainage. Conclusion Minimally invasive treatment of urinary tract obstruction after renal transplantation is effective. Antegrade percutaneous urinary tract throughout guidance technique provided a powerful guarantee for retrograde operation and avoided the bleeding risk following percutaneous renal surgery, when combined with flexible ureteroscopy, urinary calculi in patients with kidney transplantation can be effectively managed with little trauma.
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Objective To investigate surgical outcomes of treatment of pilon fractures of Ruedi -Allgower types Ⅱ and Ⅲ by raft screws fixation combined with bone grafting.Methods 21 patients with pilon fractures of Ruedi -Allgower types II and Ⅲ received surgery were selected.They were 15 men and 6 women,23 to 68 years of age(average 38.2 years).16 cases were closed and 5 cases open.12 cases were type II and 9 cases type III.Intervals between injury and operation ranged from 7 to 14 days,with 8.5 days on average.All of them were treated with raft screws fixation by plate type L combined with bone grafting.Results All cases were followed up for an average of 12 months(range from 8 to 30 months).Fractures healed from 16 to 24 weeks,with 18.2 weeks on average.According to the Burwell -Charnley radiological criteria,anatomical reduction was achieved in 17 cases,and fair reduction in 4.According to the Mazur clinical criteria,ankle functions were rated as excellent in 8 cases,good in 10 cases,fair in 2 cases and poor in 1 case.The rate of excellent and good was 85.7%.Conclusion Raft screws fixation combined with bone grafting are effective for the pilon fractures of Ruedi -Allgower types II and Ⅲ,preventing articular surface collapse and leading to anatomic reduction,and has stable fixation and early functional rehabilitation.
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Objective To evaluate the clinical outcome of artificial cervical disc arthroplasty combined with anchoring cervical intervertebral fusion cage (ACIFC) in the treatment of multilevel cervical disc herniation. Methods From October 2011 to September 2013, 0.26 patients with multilevel cervical disc herniation underwent artificial cervical disc arthroplasty combined with ACIFC, there were 10 male and 16 female with age from 32 to 60 years (mean 46.8 years). Two segment were involved in 15 patients, three segment were involved in 11 patients. Neck disability index (NDI) and Japanese Orthopaedic Association (JOA) score were used to evaluate neurofunctional recovery preoperatively and postoperatively. The postoperative stabilization and the range of motion (ROM) of implanted disc and the fusion of cage were observed on dynamic radiograph. Results The average operation time and amount of bleeding were (95±15) min and (100±20) ml respectively. The average postoperative follow-up was 15 months(range 6-20 months). At the end of follow up,the scores of JOA was increased and the scores of NDI was decreased:(9.08±1.72) scores vs. (14.88±1.37) scores, (40.31±4.97) scores vs. (25.23±4.10) scores,there had significant differences (P0.05). Solid fusion was achieved in all levels brought by cage.There was no cage subsidence or displacement. All artificial cervical disc achieved definite stabilization, no intraoperative and postoperative complication was noted. Conclusions Artificial cervical disc arthroplasty combined with ACIFC provides a feasible way for the treatment of multilevel cervical disc herniation. The definite stabilization and maintained ROM can reduce the fusion segments and avoid the increased stress of adjacent segment which can ensure a good preliminary clinical outcome.
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Objective To evaluate the efficacy and safety of retrograde flexible ureteroscopic lithotripsy ( RFUL) with holmium:YAG laser for the treatment of renal stones with a large series.Methods The data of 466 patients who underwent RFUL with holmium:YAG laser for the treatment of kidney stones between January 2013 and December 2013 were collected.The maximum diameter of stone was 23 ±16 mm.The stone free rate, complications, retreatment rate were evaluated.Results Out of the 466 patients, the mean operative time and postoperative hospital stay were 33.5 ±18.8 min and 2.3 ±2.0 d.The stone free rate was 67.6% ( 315/466 ) after single procedure, which increased to 69.5% ( 324/466 ) via re-treatments after 3 months.The retreatment rate was 4.3%(20/466), with a total of 493 RFUL procedures performed and 1.06 times per patient.There were 67 (14.4%) cases undergoing complications.Five cases had false passage of ureter orifice causing slight ureteral wall injuries.Steinstrasse occurred in 9 cases, ureteral perforation in 3 cases and perirenal hematoma in 1 case.Overall postoperative fever rate was 10.7%(50/466) with urosepsis in 16 cases (3.4%).When the stone size was≤10, 11-20, 21-30, 31-40, and >40 mm, the stone free rates after a single procedure were 97.0% ( 65/67 ) , 84.2% ( 160/190 ) , 63.1%(70/111), 29.2%(14/48), 12.0%(6/50) (P<0.001), and the postoperative fever rates were 1.5%(1/67), 9.5%(18/190), 13.5% (15/111), 14.6% (7/48), 18.0% (9/50), respectively. The postoperative fever rates were 19.3%(27/140) and 7.1%(23/326) (P<0.001) in the patient with positive and negative preoperative urine leukocyte, and 22.0% ( 22/100 ) and 7.7% ( 28/366 ) ( P <0.001) in patients with positive and negative preoperative urine culture.Conclusions RFUL with holmium:YAG laser is a safe and effective treatment for kidney stones.The postoperative fever rate would increase and stone free rate would reduce with the increased stone size.
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Objective To study the effects of COX-2 selective inhibitor celecoxib on the apoptosis of acute promyelocytic leuke-mia NB4 cell line,and to investigate its apoptosis mechanisms.Methods The expression of COX-2 mRNA in different cell lines was detected by reverse transcript polymerase chain reaction(RT-PCR).After treatment of NB4 with different doses of celecoxib,the in-hibition of NB4 growth was assayed by MTT,and the DNA fragmentation was examined by the DNA ladder test.The level of Bcl-2 protein expression was assayed by the flow cytometry.Results As compared with the no-medication treatment group,the DNA ladder fragments became more and more obvious after the treatment by different doses of celecoxib.The expression rates of Bcl-2 protein in the different doses of celecoxib groups (25,50,100 μmol/L)were (71.69 ±1.65 )%,(34.51 ±2.53)% and (29.28 ± 2.38)% respectively,compared with the Bcl-2 protein expression rate (85.34±2.89%)in the blank control group,the expression rate of Bcl-2 protein in different doses of celecoxib groups(50,100 μmol/L )was significantly decreased(P <0.05 ).Conclusion Celecoxib as COX-2 selective inhibitor could evidently induce the apoptosis of NB4 cells by down-regulating the expression of Bcl-2 protein in NB4 cells.
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Objective To evaluate the clinical application of open reduction and internal fixation and bone grafting on treatment of pilon fractures of tibia.Methods Forty cases with Pilon fractures of Ⅱ,Ⅲ tibia who underwent open reduction and intemalfixation and bone grafting treatment were selected as our subjects.Those 40 cases were performed follow-up for 8.0-60.0 months,and average was 31.5 months.The ankle joint symptoms and functional Mazur scoring system were used to evaluate the function of ankle joint.Results Of the 40 patients,15 cases were with excellent ankle function,and 19 cases were good,4 cases were poor and 2 cases were worse.The excellent and good rate was 85％ (34/40).Conclusion Open reduction and internal fixation and bone grafting is proved as the effective treatment on Ⅱ,Ⅲ tibia pilon fractures.
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Objective To evaluate the efficacy and advantages of the technique by combined PCNL and retrograde intrarenal surgery (RIRS) in a second stage to treat the complex renal stones in solitary kidney cases.Methods PCNL most with a single 18-24 F tract was performed first and RIRS was carried out at a second stage in solitary kidneys of 21 patients,of which congenital in 14.3％ (3 cases),contralateral nephrectomy in 42.8％ (9 cases),and functional solitry kidneys in 42.8％ (9 cases).Of the 21 patients,the average age was 45 years with 15 males and 6 females.The stones were 8 multiple,6 partial staghorn,and 7 complete staghorn with a mean size of 4.6 (3.8-6.8) cm.Results Of the 21 PCNL cases,a single tract,double,triple tracts were established in 18 (85.7％),2 (9.5％),1 (4.8％) cases,respectively.Mean operation time of PCNL was 95 (45-175) min.After 1 day of PCNL,all case had residual stones with a mean size of 1.9 (1.0-3.5) cm.Two case occurred fever after PCNL and one case presented bleeding resolved by selective renal artery embolization.The mean operation time of RIRS was 72 (35-95) min.Stone-free rate after RIRS was 85.7％ (18/21).The final stone free rate increased to 95.2％ (20/21) after one case received a second-look PCNL and two cases accepted ESWL.Two cases occurred fever and steinstrasses after RIRS resolved by rigid ureteroscopy.At the 3 months follow-up,renal function became stable,improved and worse in 71.4％ (n=15),23.8％ (n=5),and 4.8％ (n=l) of patients.Conclusions PCNL combined with RIRS could be an effective and safe option for complex stones in solitary kidneys with less bleeding,reduced tracts,minor complications and good renal function preservation.
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Objective To compare the efficiency between mini-percutaneous nephrolithotomy (MPCNL) and extracorporeal shock wave lithotripsy (ESWL) for monotherapy of renal calculi in infants less than 3 years.Methods Forty-six infants were treated with either SWL (22 infants) or MPCNL monotherapy (24 infants).The mean age was (22.6 ± 8.7) months vs (23.5 ± 6.6) months and the stone size was (21.4 ± 3.5) mm vs (21.7 ± 1.7) mm,and there were no significant difference.Results For MPCNL,mean operating time was (76.2 ± 23.4) min and mean hospital stay was (14.13 ± 5.8) d.The stone-free rates were 84.0％ (21/25) after first session and 96.0％ (24/25) after second-look procedure.Postoperative fever happened in 4 (16.0％) cases.Hemoglobin drop was (8.5 ± 4.4) g/L and no one needed blood transfusion.For ESWL,the stone-free rate were 31.8％ (7/22) after first session and 86.3％ (19/22) after second session for 11 infants (50.0％).Mean hospital stay was (6.6 ± 2.3) d and 10 cases (45.5％)had complications.Hemoglobin drop was (10.6 ± 12.7) g/L.MPCNL was lower than ESWL in complications rate and re-treatment rate,and the stone-free rate was higher,but the hospital stay and operation time was longer (P ＜ 0.05).GFR revealed improve or stable after operation in both groups.Conclusions For a higher success rate,lower complication rate and re-treatment rate,MPCNL was an effective option for the management of relatively larger stones in children (even in infants).
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Objective To study far femoral malignant bone tumor salvage limb treatment with allogeneic heterotopic half-joint transplantation and the use of GSH nail Methods Eleven cases with far femoral malignant bone tumor were administered tumor resection,transplanted with allogeneic heterotoeic bone half-joint,and fixed with GSH nail Results Nine out of the 11 cases were followed up.None of them had infection,rejection or heterotopic bone fracture.All of them can move with walking after 6 months.The effects of surgery was rated as excellent for 3 cases,fine for 4 cases andbad for 2 cases according to Mankin's rating criteria.Conclusion Salvage limb treatment for bone tumor can improve patients' quality of life.Allogeneic heterotopic bone,with rich source and acceptable joint surface,is a good graft for the treatment of bone defect after bone tumor resection.
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Objective To investigate the therapeutic effect of Sky Bone Expander System in the treatment of osteoporotic vertebral body compression fractures in the elderly.MethodsTwenty-five cases (26 vertabrals)with osteoporotic vertebral body compression fractures were treated by Sky Bone Expander System.ResultsAll the 25 cases completed the surgery successfully,with an average operation duration of 35 min (range:30 -60 min).We injected 2.7 -4.5 ml bone cement to each vertebrae with an average of 3.5 ml.No blood vessels and nerves damage or other complications were found.The height of vertebral was restored.ConclusionSky Bone Expander System could effectively treat osteoporotic vertebral body compression fractures in the elderly.The height of vertebral could rebound and kyphosis could be improved.Furthermore,Sky Bone Expander System could relieve pain and reduce the leakage of bone cement