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Objective:To systematically evaluate the effects of body mass index (BMI) on the prognosis of patients with diffuse large B-cell lymphoma (DLBCL).Methods:The databases (PubMed, Medline,Web of Science) were searched to identify clinical literatures about the relationship between BMI and the prognosis of DLBCL according to the inclusion and exclusion criteria. RevMan 5.3 software was used to analyze hazard ratio ( HR) and 95% confidence interval (95% CI) of overall survival (OS) and progression-free survival (PFS); the quality of included literatures, publication bias risk and heterogeneity were also evaluated. Results:There were 12 articles included in our research. Meta-analysis result showed that compared with normal weight patients (BMI 18.5-24.9 kg/m 2), the overweight patients (BMI 25.0-29.9 kg/m 2) had longer OS and PFS time, while the differences were not statistically significant (OS: HR=0.93, 95% CI 0.78-1.11, P=0.42; PFS: HR=0.89, 95% CI 0.67-1.20, P=0.45). The under-weight (BMI < 18.5 kg/m 2) (OS: HR=1.97, 95% CI 1.41-2.74, P < 0.01; PFS: HR=1.89, 95% CI 1.19-3.03, P < 0.01) and the obesity (BMI≥30.0 kg/m 2) patients both had shorter OS and PFS time, but the latter had no statistically significant difference (OS: HR=1.15, 95% CI 0.88-1.51, P=0.31; PFS: HR=1.32, 95% CI 0.90-1.94, P=0.15). No publication bias was observed in the symmetric funnel plot analysis. Conclusion:The increased BMI within a certain range is a protective factor for the prognosis of DLBCL patients.
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Objective:To evaluate the clinical effect of percutaneous coablation nucleoplasty (PCNP) in the treatment of discogenic low back pain (DLBP).Methods:From March 2015 to March 2019, the clinical data of 97 single segment DLBP patients with PCNP admitted to orthopaedic department of Beijing Chui Yang Liu hospital were analyzed retrospectively. They were divided into PCNP group ( n=43) and control group ( n=54). The sex proportion, age, medical history, length of hospital stay, follow-up time, operation time, responsibility segment, Pfirrmann classification and complications were recorded. 1 month, 3 months and 6 months after the operation, the routine outpatient reexamination and follow-up were conducted for 6-36 months. The therapeutic effect was evaluated by numeric rating scale (NRS) and Roland-Morris Disability Questionnaire (RMDQ) before, 1 month, 3 months and 6 months after the operation. Measurement data were presented by Mean± SD, t test was used for comparison between groups, and analysis of variance of repeated measurement data was used for comparison of NRS score and RMDQ score before and after treatment. The counting data were expressed by percentage, χ2 test or Fisher precision test was used for comparison between groups, and Mann-Whitney rank sum test was used for comparison between groups of follow-up time and hierarchical grouping data. Statistical software SPSS 20.0 was used to process the data, P< 0.05 was statistically significant. Results:The average operation time of PCNP patients was (36.3±13.2) min (15 to 65 min), and no complications occurred. After treatment, the NRS score and RMDQ score of the two groups decreased significantly( F组内=26.000, P=0.001; F组内=26.000, P=0.001), and the NRS score and RMDQ score of the PCNP group decreased more significantly( F组间=5.666, P=0.024; F组间=4.261, P=0.048), and the NRS score and RMDQ score of the PCNP group decreased more significantly with time ( F交互=26.000, P=0.028; F交互=26.000, P=0.010). Conclusion:PCNP with DLBP patients showed satisfied clinical results in pain relief and improve dysfunction. PCNP is a safe, minimally invasive and effective treatment method, which has a long therapeutic effect and is superior to conservative treatment.
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Objective:To evaluate the clinical effect of percutaneous endoscopic lumbar discectomy (PELD) in the treatment of complex lumbar disc herniation (LDH).Methods:A retrospective analysis of clinical data of 122 patients with LDH who underwent PELD from October 2015 to June 2019 in department of orthopedics, Beijing Chui Yang Liu Hospital was performed. There were 71 males and 51 females. According to whether lumbar disc herniation was a simple non migrated type, the patients were divided into control group ( n=85) and complex group ( n=37). The age, length of stay, operative approach, operation time, the bleeding volume, operative segments, perioperative complications, and excellent and good rate of 3 months after operation were recorded. Follow-up visit was performed by regular outpatient visit for 3 to 36 months. Before and after surgery, 3 days, 1 month, and 3 months after surgery, the Oswestry disability index (ODI) and modified MacNab criteria were used to evaluate the effect of surgery. The measurement data were expressed as mean±standard deviation ( Mean± SD), and the comparison between groups was performed by ANOVA analysis, the count data were expressed as percentage (%), and the comparison between groups was performed by χ2 test or Fisher test, the rank grouping data were performed by Mann-Whitney U non-parametric test. Results:The age of patients in complex group [(63.0±15.9) years] was older than that in control group [(48.7±16.3 years] ( t=2.289, P=0.030), and the length of stay in complex group [(13.0±6.9) d] was longer than that in control group [(8.2±4.3) d] ( t=2.384, P=0.024). There were no significant differences of the operative approach between the two groups ( χ2=0.420, P=0.517). Compared with the control group [(59.0±25.0) min, (16.3±10.9) mL], the operation time of the complex group [(87.0±29.2) min] was longer ( t=2.737, P=0.011), and the bleeding volume [(63.5±52.5) mL] was more ( t=3.925, P=0.001). There were no significant differences of the operative segments between the two groups ( χ2=0.356, P=0.837). The incidence of operation related complications in the complex group (13.5%, 5/37) was significantly higher than that in the control group (2.4%, 2/85) ( χ2=5.937, P=0.026). There were no significant differences in the excellent and good rate between the two groups at 3 months after operation ( U = 1 398.000, P=0.106). The preoperative ODI score of the complex group [(86.6±8.8) scores] was significantly higher than that in the control group [(76.1±7.7) scores]( t=3.359, P=0.002). The ODI score of the two groups decreased significantly. There were significant differences ( t=18.683, P=0.001) between the preoperative [(76.1±7.7) scores] and 3 d postoperative [(36.6±7.5) scores] in the control group. There were significant differences ( t=7.365, P=0.001) between the 3 d postoperative [(36.6±7.5) scores] and 1 month postoperative [(15.0±10.8) scores] in the control group. There were significant differences ( t=4.524, P=0.001) between the 1 month postoperative [(15.0±10.8) scores] and 3 month postoperative [(10.4±12.7) scores] in the control group. There were significant differences ( t=9.923, P=0.001) between the preoperative [(86.6±8.8) scores] and 3d postoperative [(40.1±11.0) scores] in the complex group. There were significant differences ( t=3.619, P=0.006) between the 3d postoperative [(40.1±11.0) scores] and 1 month postoperative [(18.2±15.1) scores] in the complex group. There were significant differences ( t=5.966, P=0.001) between the 1 month postoperative [(18.2±15.1) scores] and 3 month postoperative [(12.7±14.5) scores] in the complex group. Conclusions:PELD technology can treat complex LDH. Compared with simple non migrated LDH, although the operation time is longer, the amount of intraoperative bleeding is more and the incidence of postoperative complications is higher, there is no difference in ODI scores, excellent and good rate. The clinical effect is similar to that of simple non migrated LDH.
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OBJECTIVE@#To evaluate the efficacy of lumbar transforaminal epidural block (LTEB) for treatment of low back pain with radicular pain.@*METHODS@#We retrospectively analyzed the clinical data of 78 patients with low back pain and radicular pain admitted to the Department of Orthopedics of Beijing Chuiyangliu Hospital from March, 2017 to April, 2019. Thirty-three of the patients received treatment with LTEB (LTEB group), and 45 received comprehensive conservative treatment including traction, massage, acupuncture and physiotherapy (control group). The demographic and clinical data of the two groups were compared. The patients were followed up for 3 to 24 months, and numerical rating scale (NRS) and Oswestry disability index (ODI) scores of the patients were evaluated before the treatment and at 2 weeks, 1 month and 3 months after discharge to assess the efficacy of the treatment.@*RESULTS@#The mean operation time of LTEB was 25.7 7.5 min (15-45 min). After the operation, 5 patients developed weakness of the lower limbs but all recovered within 24-72 h. The patients receiving LTEB all showed significantly decreased NRS scores for low back and radicular pain and ODI scores after the operation (@*CONCLUSIONS@#As a minimally invasive approach, LTEB is effective for treatment of low back pain with radicular pain and can produce good short-term effects of pain relief and functional improvement.
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Humans , Injections, Epidural , Low Back Pain/drug therapy , Lumbar Vertebrae , Radiculopathy/drug therapy , Retrospective Studies , Treatment OutcomeABSTRACT
Objective To evaluate the reliability of the TLICS and AO-TLICS scoring system for the thoracolumbar fracture and the effectiveness of the final treatment scheme.Methods The clinical data of 56 adult patients with acute traumatic thoracolumbar fracture diagnosed in Department of Orthopedics,Chui Yang Liu Hospital Affiliated to Tsinghua University from June 2015 to June 2017 were analyzed retrospectively.There were 35 males and 21 females,aged (32.3 ± 9.8) years,with an age range of 21-53 years.Two senior deputy chief orthopaedic physicians retrospective analyzed DR plain films,CT,MRI images and clinical records of thoracolumbar spine by independent blind method.According to TLICS and AO-TLICS scoring system (include injury morphology,neurologic status,posterior ligament complex (PLC) damage or M1 modifier,the severity scores of thoracolumbar fracture were classified and calculated.The score was divided into TLICS score group and AO-TLICS score group,each group of scores was the above 56 patients.Three months later,the two physicians repeated the above analysis process and compared the consistency of the scores between the observer and the observer's own control.The consistency of the two groups was compared,and the accuracy,sensitivity and specificity of the final treatment were compared.Cohen kappa test was used for consistency comparison according to the score and the mean value was taken.Measurement data were expressed as mean ± standard deviation (Mean ± SD),and t test was used for inter-group comparison.Results In the TLICS score group,the Cohen kappa coefficients of the observer's own control in fracture type,neurological status assessment,and PLC injury were 0.810,0.966,and 0.698,respectively,and the total scores were consistent (k=0.727).Cohen kappa coefficients between the observers in fracture morphology,neurological status assessment,and PLC injury were 0.725,0.931,and 0.594,respectively,and the total scores were consistent (k =0.615).In the AO-TLICS score group,the Cohen kappa coefficients of the observer's own control in terms of fracture type,neurological status assessment,and M1 correction factor were 0.760,0.892,and 0.711,respectively,and the total scores were consistent (k =0.666).Cohen kappa coefficients of the observers in terms of fracture type,neurological status assessment and M1 correction factor were 0.707,0.836 and 0.604,respectively,and the total score was consistent (k =0.592).According to the TLICS score,the correct rate of treatment was (84.2 ± 2.8) ％,the sensitivity was (84.1 ±2.1)％,and the specificity was (85.9 ± 6.5)％.According to the AO-TLICS score,the correct rate of treatment was (89.0 ± 2.6) ％,the sensitivity was (88.3 ± 3.5) ％,and the specificity was (89.6 ± 2.4) ％.There was a statistically significant difference in the rate of correct rate (t =2.485,P =0.047).Conclusion The advantage of TLICS score is better consistency in interobservers or intraobservers,but the AO-TLICS score system is more comprehensive,and the choice of treatment plan is more instructive.
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Objective To explore clinical value of serum carcinoembryonic antigen (CEA) rate in early evaluation of imaging tumor efficacy and prognosis of disease control for advanced non-small cell lung cancer (NSCLC) before and after the second course of chemotherapy, and provide the basis for clinical adjustment chemotherapy regimens.Methods Patients in the Third Affiliated Hospital of Sun Yat-sen University were randomly collected in January 2007-September 2014 during the pathological diagnosis of 130 cases for advanced NSCLC, who had an elevated serum CEA level, including pre-chemotherapy and prochemotherapy, were collected.Receiver operating characteristic (ROC) was used to evaluate efficacy of CEA change in evaluation of early disease control (DC).SPSS 18.0 was used to analyze the relationship between CEA change and prognosis.Results After two chemotherapy cycles, the area under the ROC curve was 70.6％.When the cut-point of the change rates of CEA levels was 2.05％ , the Youden index reaches the maximum.Adenocarcinoma group and squamous cell carcinoma patients after 2 courses of CEA change rate evaluation, which area under the ROC curve was 72.0％ (95％ CI :61.4％ ～ 82.5％), and 70.1％ (95％ CI:45.8％ ～94.5％).Survival was analyzed with the Kaplan-Meier method, which showed the change rates of CEA levels were all the influencing factors of progression-free survival (PFS) in patients with advanced NSCLC(P ＜ 0.05).While the change rates of CEA levels were not predictive overall survival (OS) (P =0.715).Conclusions It prompts effective chemotherapy, and patients have the extended PFS, when CEA levels before and after chemotherapy dropped to a certain degree.
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<p><b>OBJECTIVE</b>To observe the effect of N-acetylcysteine (NAC) on intestine injury induced by cardiopulmonary bypass (CPB) in rats.</p><p><b>METHODS</b>Thirty-two rats were randomly divided into sham-operated group, NAC control group, CPB model group, and CPB plus NAC treatment group (n=8). In the latter two groups, the rats were subjected to CPB for 1 h. The rats received intraperitoneal injections of normal saline or NAC (0.5 g/kg) as appropriate for 3 successive days prior to CPB, and those in CPB plus NAC group were given NAC (100 mg/kg) in CPB prime followed by infusion at 20 mgsol;(kg·h) until the cessation of CPB. Intestinal and blood samples were collected 2 h after CPB for pathological analysis and measurement of intestinal concentrations of malondialdehyde (MDA), tumor necrosis factor (TNF)-α, interlukin (IL)-6 and activity of superoxide dismutase (SOD), glutathione (GSH), and glutathione peroxidase (GSH-Px) and serum levels of diamine oxidase (DAO).</p><p><b>RESULTS</b>Evident oxidative stress and pathological damages of the intestines were observed in rats after CPB. NAC treatment obviously alleviated intestinal damages induced by CPB, decreased the levels of intestinal MDA, TNF-α, IL-6 and serum DAO and increased activity of SOD, GSH, and GSH-Px in the intestines.</p><p><b>CONCLUSION</b>Perioperative NAC treatment can alleviate intestinal injury induced by CPB in rats by suppressing oxidative stress and inflammatory response.</p>
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Animals , Rats , Acetylcysteine , Pharmacology , Cardiopulmonary Bypass , Glutathione , Metabolism , Glutathione Peroxidase , Metabolism , Inflammation , Drug Therapy , Interleukin-6 , Metabolism , Intestines , Malondialdehyde , Metabolism , Oxidative Stress , Superoxide Dismutase , Metabolism , Tumor Necrosis Factor-alphaABSTRACT
The purpose of this study is to synthesize nanometer calcium carbonate/poly(L-lactide) composites and evaluate its biocompatibility, and mechanical properties. The nanometer calcium carbonate/poly(L-lactide) composites was prepared by the method of solution mixing and cell culture. Its properties were analyzed using, mechanical tests, MTT assay, transmission electron microscope and scanning electron microscope. It was found that the new kind copolymer had good biocompatibility, nanometer calcium carbonate could enhance the strength of the pure poly (L-lactide) matrix. The nanometer calcium carbonate/poly (L-lactide) composites is a promising bioabsorbable material. It is worth further medical research.