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Objective@#To examine the association between secondhand smoke (SHS) exposure in indoor public places and sleep deprivation, so as to provide a reference for strengthening the management of a smoking ban in public places and to promote better sleep in childhood.@*Methods@#Data were obtained from the second follow up survey of the Huantai Childhood Cardiovascular Health Cohort Study, which was conducted from November to December 2021. A total of 1 284 children aged 10-15 years old were included in the study. The participants were assigned to four groups (0, 1-2, 3-4 and ≥5 days) according to the frequency which they were exposed to SHS in indoor public places in the previous 7 days. Multiple linear regression was performed to examine the trend of children s sleep duration with the frequency of SHS exposure. Multivariate Logistic regression was carried out to determine the association between frequency of SHS and sleep deprivation.@*Results@#After adjusting for age, sex, grade, physical activity, intake of fruits/vegetables, intake of soft drinks, screen duration, body mass index (BMI) and blood pressure, the average sleep duration of children who were exposed to SHS for 0, 1-2, 3-4 and ≥5 days in the previous 7 days was 8.48, 8.41, 8.20 and 8.06 h/d , respectively, and the average sleep duration decreased with exposure frequency of SHS ( t=5.96, 5.89, 5.91, P < 0.01 ). The proportion of sleep deprivation among children who were exposed to SHS in public places for 0, 1-2, 3-4 and ≥5 days in the previous 7 days was 40.02%, 43.07%, 54.65% and 63.41%, respectively. Compared to children who were not exposed to SHS in indoor public places in the past 7 days, those exposed for 3-4 days ( OR=1.93, 95%CI =1.19-3.15) or ≥ 5 days ( OR=2.95, 95%CI = 1.76- 4.94) had a significantly increased risk of sleep deprivation ( P <0.05).@*Conclusion@#Children s sleep time decreases with increasing frequency of exposure to SHS, and children who are frequently exposed to SHS are more likely to experience insufficient sleep. Smoking ban management in public places should be strengthened to promote children s sleep health, especially indoor public places.
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Objective@#To examine the association between secondhand smoke exposure (SHS) in indoor public places and carotid intima media thickness (cIMT) in children and adolescents, so as to provide guidance for the prevention of early abnormal vascular architecture.@*Methods@#The data were obtained from the second follow up of the Children Cardiovascular Health Cohort Study conducted from November to December 2021. A total of 1 297 children and adolescents for who completed data relating to sex, age, cIMT, physical examinations, questionnaires variables and blood biochemical indices, were included for analysis. Linear regression analysis was performed to examine trends in the levels of cIMT with exposure to SHS in indoor public places. Multiple linear regression analysis was carried out to assess the association between SHS exposure in indoor public places and cIMT after adjustment for potential covariates.@*Results@#During the previous 7 days, 407 (31.4%) children and adolescents were exposed to SHS in indoor public places for 1-2 days, 86 (6.6%) for 3-4 days, and 82 (6.3%) for ≥5 days. The levels of cIMT in youth increased on different models, with the duration of SHS exposure during the previous 7 days ( t=3.30, 3.05, 2.87, P <0.05). After adjusting for various covariates, the cIMT values of children and adolescents were[0 day:(551.5±29.3) μm, 1-2 days:(554.0±28.6) μm, 3-4 days:(557.0±27.7) μm, ≥5 days:(559.4±27.5) μm]. Compared to those who were not exposed to SHS in indoor public places during the previous 7 days, those exposed for ≥5 days had significantly higher cIMT levels ( β=7.91, 95%CI=1.47-14.34, P <0.05).@*Conclusion@#Among children and adolescents, exposure to SHS in indoor public places remains high and is significantly associated with cIMT. The findings highlight the need for stricter regulation and tobacco control policies to provide healthy smoke free environments for children and adolescents, and to reduce the risk of early abnormal vascular architecture.
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Objective:To assess the prognostic value of modified Charlson comorbidity index (mCCI) combined with serum albumin for long-term prognosis in peritoneal dialysis (PD) patients.Methods:From January 1, 2007 to June 30, 2015, patients who started PD in Nanjing Drum Tower Hospital were enrolled in this retrospective cohort study. Clinical data including gender, age, underlying diseases, laboratory examination and prognosis were collected. The mCCI at the beginning of PD was calculated. Whether the duration of PD exceeded 5 years was used as an indicator to evaluate the prognosis. The patients were divided into≥5 years group and<5 years group according to the duration of PD, and the data were compared between the two groups. Cox regression model was constructed to analyze the influencing factors of all-cause death in PD patients. Multivariate logistic regression model and receiver operating characteristic (ROC) curve were used to analyze the predictive value of mCCI and serum albumin levels on whether patients could maintain long-term PD.Results:Of the 183 patients included [males 106(57.9%), females 77(42.1%); (53.35±16.50) years old; 162 cases (88.5%) with hypertension, 55 cases (30.1%) with diabetes], 97 cases had PD duration for ≥5 years and 86 cases less than 5 years. The overall 5-year technical survival rate was 65.1%. At the beginning of PD, compared with the dialysis age≥5 years group, the patients in the dialysis age less than 5 years group had older age, higher mCCI, lower serum albumin level, and higher C-reactive protein (CRP) level (all P<0.05), but there were no significant differences in gender, education level, electrolyte, mean arterial pressure, high densitv lipoprotein (HDL), low-density lipoprotein (LDL) and PD adequacy index between the two groups (all P>0.05). Multivariate logistic regression analysis showed that increased age ( OR=1.022, 95% CI 1.000-1.043, P=0.046), increased mCCI ( OR=1.620, 95% CI 1.300-2.018, P<0.001) and decreased serum albumin ( OR=0.807, 95% CI 0.730-0.893, P<0.001) were independent predictors for the duration of PD<5 years. ROC curve analysis showed that the area under ROC curves ( AUC) of mCCI, serum albumin level and combined prediction probability of the two for the duration of PD<5 years were 0.647(95% CI 0.568-0.727), 0.655(95% CI 0.577-0.734), and 0.767(95% CI 0.700-0.835), respectively, indicating that the accuracy of combined parameters to predict survival outcome was higher than that of any single parameter. Multivariate Cox analysis showed that increased age ( HR=1.073, 95% CI 1.046-1.100, P<0.001), increased mCCI ( HR=1.198, 95% CI 1.044-1.375, P=0.010) and decreased serum albumin ( HR=0.904, 95% CI 0.843-0.969, P=0.004) were independent influencing factors for all-cause death in PD patients. Conclusions:Old age, high mCCI and low serum albumin level are influencing factors for dialysis age<5 years and all-cause death in PD patients. mCCI combined with serum albumin level can improve the accuracy of predicting the long-term dialysis in PD patients.
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Objective:To observe the effects of Shenma Yizhi prescription（SMYZ）on learning and memory， inflammatory factors and oxidative stress related indexes of rats with chronic cerebral ischemia inducing vascular dementia caused by bilateral common carotid artery ligation. Method:The chronic cerebral ischemia model of SPF grade SD rats was prepared by bilateral common carotid artery ligation. After successful surgery， the rats with cognitive impairment were randomly divided into 5 groups，model， donepezil（0.45 mg·kg-1）， SMYZ-low， medium and high dose（2.97，5.94，11.88 g·kg-1）， with 10 rats in each group， and 10 rats in sham operation group were established. Intragastric administration were given for 8 weeks respectively then followed Morris water maze test. The pathomorphological changes of hippocampus CA1 were observed. The serum levels of acetylcholine(Ach)and acetylcholinesterase (AChE)were detected， and the levels of inflammatory cytokines interleukin-1β (IL-1β) and tumor necrosis factor-α (TNF-α) in the serum of rats were detected. The contents of glutathione (GSH)， malondialdehyde (MDA)， superoxide dismutase (SOD) and glutathione peroxidase reductase (GSH-Px) were observed. Result:Compared with sham operation group， the escape latency increased significantly in the model group， and the frequency of platform search， the frequency of crossing the original platform and the percentage of swimming time in the original platform quadrant decreased significantly （P<0.05，P<0.01）. The contents of Ach and the contents of GSH and GSH-Px were significantly decreased （P<0.05，P<0.01）. The contents of AChE， IL-1β and TNF-α and the contents of MDA were significantly increased （P<0.05，P<0.01）. Compared with model group， the escape latency of rats in the in the low， medium and high dose groups of SMYZ prescription was significantly reduced （P<0.05，P<0.01）.The frequency of looking for a platform， the frequency of crossing the original platform and the percentage of swimming time in the original platform quadrant of the rats in the low， medium and high dose groups of SMYZ prescription increased significantly （P<0.05，P<0.01）. The content of AChE in high dose group were significantly reduced（P<0.01）， and the content of Ach in high dose group were significantly increased（P<0.05）， the rat serum IL-1β， TNF-α levels and MDA content were significantly reduced（P<0.05，P<0.01）. The GSH， SOD and GSH-Px levels were significantly increased （P<0.05，P<0.01）. Conclusion:SMYZ can improve the learning and memory ability of rats with vascular cognitive disorder caused by chronic cerebral ischemia caused by ligation of bilateral common carotid artery， bilateral common carotid artery ligation， improve the pathological morphology of hippocampal tissue， inhibit inflammatory response， improve cholinergic level and oxidative stress state.
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Objective@#To investigate the spatial relationship between intraparotid facial nerve and parotid ducts in different types of parotid neoplasms with 3D improved motion-sensitized driven-equilibrium pulse (3D-iMSDE) MR neurography, and to guide the operation plan.@*Methods@#By means of prospective research methods, the sequences of 3D-iMSDE and 3D-T2-fast field echo (3D-T2-FFE) were obtained in 30 healthy volunteers and 40 patients with parotid gland tumors, respectively. All patients with parotid mass were found by physical examination, by maxillofacial surgeons or by ultrasonography or other imaging examinations. Facial nerve trunk with its first branches and parotid ducts were evaluated independently on images of iMSDE and T2-FFE sequence for volunteers. The signal intensity ratio (SIR) of both facial nerve and parotid ducts were compared respectively in two sequences The relationship between intraparotid facial nerve and parotid ducts with the lesion were analyzed on images of iMSDE and T2-FFE sequences for 40 patients. The results were compared with intra-operative anatomy and post-operative pathological findings.Wilcoxon symbolic rank test, t test and chi-square test were used@*Results@#The image scores of intra-parotid facial nerve and parotid ducts in iMSDE sequence were higher than that of T2-FFE sequence in all 30 healthy volunteers. The difference was statistically significant (Z=-6.197,P<0.05). Both the facial nerve and parotid duct on images of iMSDE sequence had higher SIR than that of T2-FFE. The differences were statistically significant (t=10.772,11.586, respectively;P<0.05). Forty patients with parotid gland tumors had a total of 41 lesions. Compared with the intraoperative anatomy, the accuracy of iMSDE and T2-FFE sequences in showing the relationship between the facial nerve and its primary branches with the mass were 36/41 (87.8%), and 22/41 (53.7%) respectively, and the accuracy of the two sequences in showing the relationship between the dominant duct of the parotid gland and the mass were 38/41 (92.7%) and 30/41 (73.2%), respectively.The accuracy rate in showing the relationship between facial nerve and its primary branch and the mass on images of iMSDE sequence were higher than that of T2-FFE sequence, and also in showing the relationship of parotid duct and the mass. The statistical differences were significant (χ2=9.725, 5.513;P<0.05,respectively). In the iMSDE sequence, the relationship between the facial nerve and its first branches (temporofacial and cervicofacial division) with the tumor was correctly demonstrated in 36 cases. 38 cases of parotid ducts were satisfactorily displayed on image of iMSDE sequence.@*Conclusions@#The 3D-iMSDE MRN sequence can correctly show the relationship between intraparotid facial nerve and parotid duct and the parotid gland neoplasms.
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OBJECTIVE: To analyze the factors influencing postpyloric placement of spiral nasoenteral feeding tube(NET) in neurocritical care patients and establish a visualized prediction model. METHODS: Patients in Neurological Intensive Care Unit(NICU)who undertook postpyloric placement of NET after receiving prokinetics from Apr 2012 to Mar 2018 were included for retrospective analysis. The patients were divided into the success and failure group base on whether the tube tip entered into duodenum(or beyond)or not confirmed by bedside X-ray 24 hours later. The baseline data, APACHE Ⅱ score(acute physiology and chronic health evaluation Ⅱ), AGI grade(acute gastrointestinal injury), therapeutic measures and agents administered were recorded. Univariate and multivariate Logistic regression analysis was used to identify the potential factors affecting the postpyloric placement of NET. Based on those factors, a predicting model was established and visualized into an easy-to-use nomogram. RESULTS: A total of 241 patients including146 male and 95 female were enrolled for the study, with an median age of 58 years, median APACHEⅡscore of 20, median AGI of Ⅰ.The placement succeeded in 119(49.4%) of 241 patients. Logistic regression analysis demonstrated that APACHE Ⅱ score, sedatives and analgesics, vasopressors and AGI grade were among the influencing factors. A prediction model with a ROC-AUC of 0.8002 were established and visualized into a nomogram. CONCLUSION: APACHE Ⅱ score, sedatives and analgesics, vasopressors and AGI grade are the factors influencing success of postpyloric NET placement in neurocritical care patients, which incorporate a predicting model that can be visualized into a nomogram. The nomogram provided intensivists an easy-to-use decision support tool in NET placements.
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Objective To explore the expressions of c-Met and c-Src in non-small cell lung cancer (NSCLC), and its relationship with clinical pathological characters and prognosis. Methods The c-Met and c-Src expressions were detected by immunohistochemistry in 88 patients with NSCLC from April 2011 to January 2013. The relationship between the expressions of c-Met and c-Src and clinical pathological features and prognosis were analyzed. Results The c-Met and c-Src were all significantly expressed in NSCLC tissues, and no expression showed in interstitial and normal lung tissues. The expressions of c-Met and c-Src in patients with NSCLC were associated with sex, differentiation, pathology type, T staging and TNM staging (P<0.05 or <0.01); and the expression of c-Met was associated with lymph node metastasis (P<0.01). The expressions of c-Met and c-Src in patients with NSCLC were not associated with age, and the expression of c-Src was not associated with lymph node metastasis (P>0.05). Pearson correlation analysis result showed that the expressions of c-Met and c-Src in lung cancer tissues was positive correlation (r=0.662, P<0.01). Kaplan-Meier survival curve analysis result showed that the disease free survival time (DFS) and overall survival time (OS) in c-Met high expression patients (51 cases) were significantly shorter than those in c-Met low expression patients (37 cases): (18.08 ± 1.34) months vs. (23.76 ± 1.79) months and (33.63 ± 1.95) months vs. (42.24 ± 2.68) months, the DFS and OS in c-Src high expression patients (25 cases) were significantly shorter than those in c-Src low expression patients (63 cases): (16.96 ± 2.56) months vs. (21.86 ± 1.15) months and (27.84 ± 2.89) months vs. (40.98 ± 1.81) months, the DFS and OS in both c-Met and c-Src high expression patients (25 cases) were significantly shorter than those in both c-Met and c-Src low expression patients (37 cases): (16.96 ± 2.56) months vs. (23.76 ± 1.79) months and (27.84 ± 2.89) months vs. (42.24 ± 2.68) months, and there were statistical differences (P<0.05). Cox multiplicity result showed that T staging (RR=2.174, 95％CI 1.354 to 3.490, P=0.001) and high expressions of c-Met and c-Src (RR=1.447, 95％CI 1.114 to 1.880, P=0.006) were the independent risk factors of DFS in patients with NSCLC;pathology type (RR=0.610, 95％CI 0.377 to 0.986, P=0.044), T staging (RR=2.215, 95％CI 1.357 to 3.616, P=0.001) and high expressions of c-Met and c-Src (RR=1.979, 95％CI 1.455 to 2.692, P = 0.000) were the independent risk factors of OS in patients with NSCLC. Conclusions The c-Met and c-Src are involved in the development of NSCLC and affect the prognosis of patients with NSCLC.
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Objective To explore the source of human infection H9N2 avian influenza virus (AIV). Methods Environmental AIV nucleic acid monitoring was conducted for live poultry markets in Changsha city from 2014 to 2015, and data of human infection H9N2 subtype AIV cases worldwide were collected. Phylogenetic trees of hemagglutinin(HA), neuraminidase(NA)and non-structural protein(NS)genes from human infection H9N2 subtype AIV, the live poultry markets environmental H9N2 subtype AIV and partial avian H9N2 subtype AIV were constructed using the MEGA 6.06 software, respectively. Results In 2014-2015, H9 subtype AIV had the highest nucleic acid positive rate (44.76%) in the live poultry markets environment of Changsha city, and the pollution was serious. A total of 27 cases of human infection with H9N2 subtype AIV had been reported worldwide, and most of these patients recovered after treatments.Epidemiological survey showed that 59.26% (16/27) of cases had a clear history of exposure to poultry or live poultry markets. The phylogenetic trees of HA, NA and NS genes showed that the human infection H9N2 subtype AIV isolates isolated from Hunan and Guangdong were closely related to the H9N2 subtype AIV isolated from the live poultry markets environment in Hunan and Guangdong provinces from 2013 to 2016. The nucleotide similarity was as high as 97%-99%. Conclusion Live poultry market is one of the sources of human infection with H9N2 influenza virus.
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OBJECTIVE@#To investigate clinical efficacy of dual plate internal fixation triceps through approach for the treatment of type C3 fracture of distal radius.@*METHODS@#Totally 21 patients with type C3 fracture of distal radius were retrospectively analyzed from December 2011 to June 2017. Among them, including 13 males and 8 females, aged from 15 to 68 years old with an average of (40.7±3.4) years old. The time from injury to operation ranged from 3 to days with an average of (5.0±1.2)days. Fracture healing and postoperative complications were observed, Mayo elbow joint performance score(MEPS) was used to evaluate recovery of elbow joint function, VAS score was used to evaluate relieve degree of pain at 3 months after operation.@*RESULTS@#All patients were followed up for 8 to 24 months with an average of (14.0±2.6) months. The time of fracture healing ranged from 2.5 to 4.0 months with an average of(3.0±1.2) months without complications. Postoperative MEPS score at 3 months was 91.0±2.3, and 15 patients got excellent results, 4 good, and 2 moderate; VAS score was 1.95±0.34 at 3 months after operation.@*CONCLUSIONS@#Dual plate internal fixation triceps through approach for the treatment of type C3 fracture of distal radius could provide satisfactory surgical field exposure, facilitate for reduction and internal fixation of joint fracture, could obtain good elbow joint function and is beneficial for early functional exercise.
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Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Bone Plates , Fracture Fixation, Internal , Radius , Radius Fractures , Diagnosis , Retrospective Studies , Treatment OutcomeABSTRACT
Objective To explore the method and clinical effects of treatment for correcting severe contracture nasal deformity after rhinoplasty.Methods Totally 19 patients with severe contracture nasal deformity after rhinoplasty were treated with a new procedure in our hospital since March 2014.The soft tissue was treated with manual traction preoperatively to improve nasal skin and mucosa extensibility and flexibility.The costicartilage was taken as structure transplantation to build the nasal support structure.Results This group of patients were followed up for 5-27 months,contracture of nasal deformity was corrected and the shape of the nose was improved with no obvious contracture deformation.Conclusions Nasal shape is improved by nasal scaffold and coated tissue.It is a simple and feasible method to modify the condition of soft tissue by manual traction and autogenous costicartilage support reconstruction to ensure the long-term efficacy of backing;two combination therapy for correction of iatrogenic contracture nasal deformity can achieve better long-term nasal prolonged postoperative effect,which is suitable for clinical promotion.
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Objective To investigate the spatial relationship between intraparotid facial nerve and parotid ducts in different types of parotid neoplasms with 3D improved motion-sensitized driven-equilibrium pulse (3D-iMSDE) MR neurography, and to guide the operation plan. Methods By means of prospective research methods, the sequences of 3D-iMSDE and 3D-T2-fast field echo (3D-T2-FFE) were obtained in 30 healthy volunteers and 40 patients with parotid gland tumors, respectively. All patients with parotid mass were found by physical examination, by maxillofacial surgeons or by ultrasonography or other imaging examinations. Facial nerve trunk with its first branches and parotid ducts were evaluated independently on images of iMSDE and T2-FFE sequence for volunteers. The signal intensity ratio (SIR) of both facial nerve and parotid ducts were compared respectively in two sequences The relationship between intraparotid facial nerve and parotid ducts with the lesion were analyzed on images of iMSDE and T2-FFE sequences for 40 patients. The results were compared with intra-operative anatomy and post-operative pathological findings.Wilcoxon symbolic rank test, t test and chi-square test were used Results The image scores of intra-parotid facial nerve and parotid ducts in iMSDE sequence were higher than that of T2-FFE sequence in all 30 healthy volunteers. The difference was statistically significant (Z=-6.197,P<0.05). Both the facial nerve and parotid duct on images of iMSDE sequence had higher SIR than that of T2-FFE. The differences were statistically significant (t=10.772,11.586, respectively;P<0.05). Forty patients with parotid gland tumors had a total of 41 lesions. Compared with the intraoperative anatomy, the accuracy of iMSDE and T2-FFE sequences in showing the relationship between the facial nerve and its primary branches with the mass were 36/41 (87.8%), and 22/41 (53.7%) respectively, and the accuracy of the two sequences in showing the relationship between the dominant duct of the parotid gland and the mass were 38/41 (92.7%) and 30/41 (73.2%), respectively.The accuracy rate in showing the relationship between facial nerve and its primary branch and the mass on images of iMSDE sequence were higher than that of T2-FFE sequence, and also in showing the relationship of parotid duct and the mass. The statistical differences were significant (χ2=9.725, 5.513;P<0.05,respectively). In the iMSDE sequence, the relationship between the facial nerve and its first branches (temporofacial and cervicofacial division) with the tumor was correctly demonstrated in 36 cases. 38 cases of parotid ducts were satisfactorily displayed on image of iMSDE sequence. Conclusions The 3D-iMSDE MRN sequence can correctly show the relationship between intraparotid facial nerve and parotid duct and the parotid gland neoplasms.
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Objective To evaluate the effect of three-point rigid internal fixation technique in reduction malarplasty for prominent malar complex.Methods From January of 2014 to January of 2017,45 patients with prominent malar complex were treated with double L shape osteotomy combined bony Z plasty and three-point rigid internal fixation for prominent malar complex.The preoperative and postoperative photographs were taken to monitor the contour improvement,the adverse effects were recorded,and 3D CT was used to assess the bone union situation at 6 months after operation.Results All the wounds got primary intention healing and no severe complication occured in perioperative period.3D CT showed good bone recovery 6 months after operation.Postoperative appearance of all cases showed that the width of middle face was efficiently reduced.All patients expressed high levels of satisfaction.Conclusions Reduction malarplasty with three-point rigid internal fixation for prominent malar complex is an effective and safe method for the treatment of prominent malar complex.
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Objective To explore the comprehensive approach and efficacy of secondary unilateral cleft rhinoplasty by using autologous costal cartilage grafts.Methods Secondary rhinoplasty was performed in 28 patients with unilateral cleft-lip nasal deformity.The costal cartilage was harvested through a mini-invasive incision.Septal deviation was corrected,and nasal tip framework was reconstructed with the autologous costal cartilage through direct transcolumellar incision.Diced cartilage fragments were used to augment the depressed alar base.Nasolabial muscles were repositioned to restore the balance of muscular tension system.Results The appearance of the nasal deformity was greatly improved in all the 28 cases postoperatively by follow-up from 3 to 12 months.Increased stability and symmetry of the nasal tip,along with the improvement of nasal breathing function was achieved and sustained effectively.Conclusions Definitive secondary unilateral cleft rhinoplasty using autologous costal cartilage grafts provides good aesthetic and functional results.
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Objective To analyze the effects of bone morphogenetic protein 7 (BMP 7) on insulin signaling pathway in mice and its involved molecular mechanisms. Methods To increase BMP7 expression in liver, adenovirus bearing BMP7 was injected into mice via tail vein. The impact of BMP7 overexpression on glucose metabolism was assayed by glucose tolerance test and insulin tolerance test. The levels of proteins involved in insulin signaling pathway and c-Jun N-terminal kinase ( JNK) signaling pathway were analyzed by Western blot. Results The blood glucose level was increased by BMP7 overexpression (P>0. 05), while the glucose tolerance and insulin tolerance were decreased by BMP7. The p-Akt and p-GSK3βin liver and epididymal white adipose tissue (WAT) were reduced in the BMP7-overexpressed mice (P>0. 01), indicating insulin signal transduction was inhibited. In gastrocnemius muscle, the insulin signal transduction was not altered by BMP7. Mechanistically, the JNK pathway was activated by BMP7 in liver and epididymal WAT (P>0. 01), while the JNK pathway in skeletal muscle was not changed. Conclusions In mice, BMP7 elevated blood sugar and decreased glucose and insulin tolerance. BMP7 inhibited the insulin signaling pathway in liver and WAT. These inhibitory effects on insulin signaling pathway was likely to be achieved by an activating JNK signaling pathway.
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Objective To investigate the patellofemoral joint overstuffing in total knee replacement without patella resurfacing and try to define the incidence and the mechanism.Methods The imaging data of 117 patients (37 males and 80 females;55-73 years old with a mean age of 65.4±5.63) who underwent TKA operation without patella resurfacing for terminal osteoarthritis were analyzed retrospectively between 2005 to 2015.The DR X-ray system was used to get the full extension lateral films preand post-operatively (within one week) and to complete the digital measurement with the built-in PACS system.The involved parameters included patella thickness,anterior femur offset and patella femur distance pre-and post-operatively.The postoperative patellofemoral joint overstuffing was defined as the over 1 mm increase in the postoperative patella femur distance when compared with that preoperatively.The differences between the overstuffing group and non-overstuffing group and the characteristics between male group and female group were compared.Results The postoperative patella femur distance was 33.10± 1.56 mm,which was significantly thicker than that preoperatively (30.69± 1.45 mm).The anterior femur offset (6.93±0.36 mm) at postoperative was significantly larger than that at preoperative (4.50±0.92 mm).Postoperative patellofemoral joint overstuffing occurred in 79 patients with the incidence of 67.5％.There was no difference in the incidence of postoperative patellofemoral joint overstuffing among different manufacturers.In overstuffing group,the preoperative anterior femur offset was 3.89±0.21 mm,which was significantly less than that in none-overstuffing group (5.72±0.24 mm).However,there was no statistical difference between the two groups in preoperative patella thickness,postoperative patella thickness and postoperative anterior femur offset.The incidence of postoperative overstuffing in female group was 78.8％ (63/80),which was significantly higher than that in male group which was 43.2％ (16/37).The preoperative anterior femur offset (4.30±0.81 mm) in female was significantly less than that in man (4.94±1.00mm).The relative risk for postoperative overstuffing in female was 1.82.Conclusion Patellofemoral joint overstuffing occupies 67.5％ total knee replacement without patella resurfacing.Female patients have a higher incidence of patellofemoral joint overstuffing,which may be caused by the thinner anterior femoral offset in anatomy.
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Objective To analyze the impact of the differences in blood supply to hepatic hemangiomas on interventional treatment effectiveness and complications.Methods A retrospective study was conducted on 322 patients with liver hemangiomas treated from January 2008 to December 2015 in Tianjin Third Central Hospital.The hemangiomas were diagnosed and classified into 3 groups according to the blood supply to the hemangioma:the rich blood supply group (n =128),the moderate blood supply group (n =104) and the poor blood supply group (n =90).The hemangiomas were embolized via the hepatic artery,and the therapeutic effect and complication were compared and analyzed among the 3 different groups.The mean follow-up was 12 months.Results The therapeutic effect of hepatic artery embolization was optimal for the rich blood supply group in the first 3-months of follow-up (the significant efficiency,effective rates were 18.8％ and 35.2％ respectively).There was no significant difference between the rich blood supply group and the moderate blood supply group at 12th month follow-up.The treatment effect on the poor blood supply group was significantly worse than the other two groups on follow-up.Complications after treatment occurred most commonly in the rich blood supply group and it was the least common in the poor blood supply group (the incidence rates were 43.8％,36.6％ and 8.9％ respectively).However,severe post-treatment complications were apparently more common in the poor blood supply group than the other two groups.Conclusions The therapeutic effects of transcatheter arterial embolization on hepatic hemangioma can differ because of the diversity in blood supply.In clinical practice,attention should be paid to the proper choice of treatment according to the blood supply to the lesion.Serious complications can occur after treatment.
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Lung cancer is the leading cause of cancer-related deaths worldwide, among which more than half of non-small cell lung cancer had been locally advanced or distant metastasis at the time of diagnosis.Therefore,it has a poor prognosis.In recent years,long non-coding RNA(lncRNA)has drawn great attention in the field of oncology.Abnormally expression of lncRNA plays an important role in the development of non-small cell lung cancer through different transcriptional, post-transcriptional or epigenetic mechanisms.This review summarizes the current literature on lncRNA in non-small cell lung cancer, introduces the functions and influences of lncRNA in the biology of non-small cell lung cancer and highlights its clinical potential value as a tumor biomarker and potential therapeutic target.
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Objective To study the immune efficacy of ginsenoside Re as the adjuvant of anti-caries subunit vac-cine rPAc. Methods 40 mice were randomly diveded into four groups:anti-caries vaccine group( rPAc group) ,gin- senoside Re groups( Re group) , Re+rPAc group, normal saline group( NS group) . Mice were intranasally immu-nized twice on weeks 0 and 2 with rPAc,Re,Re+rPAc or normal saline,respectively. Concentration of specific anti-bodies in serum and saliva were detected by enzyme-linked immunosorbent assay(ELISA). In addition, cytokine production of spleen lymphocyte responses were also evaluated. 24 Wistar rats,infected with S. mutans Ingbritt, were randomly diveded into four groups:rPAc group,Re group, Re+rPAc group, NS group. Rats were jmmunized intranasally with rPAc,Re, Re+rPAc or normal saline,respectively. The Keyes method was used to determine the caries activity. Results The level of serum specific anti-PAc IgG, IgG1,IgG2a and saliva anti-PAc IgA were sig-nificantly higher in Re+rPAc group (P＜0. 05). In addition, the expression of cytokines interluekin-4 and inter-feron-γ were significantly upregulated in Re+rPAc group than those in any other groups(P＜0. 01). Re+rPAc im-munized rats showed significantly fewer E,Ds and Dm lesions than rPAc-immunized rats,Re-immunized rats or NS-immunized rats(P＜0. 05). Conclusion Re as the adjuvant of anti-caries subunit vaccine rPAc triggers a stronger humoral and cellular response against dental caries,and Re is a promising adjuvant for anti-caries vaccine rPAc.
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Objective To analyze the efficacy and complications of interventional treatment in hepatic hemangiomas with poor blood supply,and to explore the mode of treatment.Methods From May 2013 to October 2016,at Tianjin Third Central Hospital,82 patients with hepatic hemangiomas with poor blood supply were enrolled and divided into intervention group,puncture group and combination group.Conventional hepatic artery intubation was performed in intervention group,using a microcatheter to superselect to hemangioma and injecting pingyangmycin-lipiodol emulsion into the tumor of hemangioma.Patients of puncture group underwent the ultrasound-guided percutaneous liver puncture,and the pingyangmycin-lipiodol emulsion was injected into the tumor.The patients of combination group first received intervention treatment,and the pingyangmycin-lipiodol emulsion were injected again into the tumor area lacking of iodized oil deposition through percutaneous transhepatic puncture.After treatment,the complications and clinical efficacy of patients in three groups were evaluated and the reasons of patients lost to follow-up were analyzed.The analysis of variance,Chi-square test and Fisher's exact test were performed for statistical analysis.For patients lost to follow up,intention-to-treat (ITT) analysis and per protocol (PP) analysis were used.Results Among 82 patients with hepatic hemangiomas with poor blood supply,there were 27 in intervention group,24 in puncture group and 31 in combination group.Seven patients developed serious complications such as liver failure.At three months after the treatment,the overall efficacy of combination group (20.9％,9/31) was higher than that of intervention group (7.4％,2/27) and puncture group (4.2 ％,1/24),and the differences were statistically significant (x2 =6.296,P =0.014;x2 =5.622,P =0.031).At six months after the treatment,the overall efficacy of combination group (ITT analysis 70.3 ％,26/37;PP analysis 71.0 ％,22/31) was still higher than that of intervention group (40.9％,9/22) and puncture group (7/18),and the differences were statistically significant (ITT analysis x2 =4.929 and 4.969,PP analysis x2 =4.789 and 4.851;all P＜0.05).At twelve months after the treatment,a total of 41 patients of three group were lost.Among them,the patients with ineffective treatment by clinical effect evaluation accounted for 63.4％ (26/41),which was higher than those with significantly effective treatment (12.2 ％,5/41) and those with effective treatment (24.4 ％,10/41),and the differences were statistically significant (x2=22.873 and 12.676,both P＜0.01).Conclusions The efficacy of the interventional treatment alone for hepatic hemangiomas with poor blood supply is poor and the complications should be considered when selecting the appropriate treatment methods.
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Objective To analyze the peri-procedural complications of coronary rotational atherectomy. Methods A total of 107 consecutive patients with coronary artery disease received rotational atherectomy from January 2012 to December 2016 were enrolled retrospectively. The occurrence rate and the management of peri-procedural complications were summarized. Results ① The serum level of CK-MB and cTnI in patients who received rotational atherectomy were signifi cantly elevated compared with the level before the procedure,[4.1(2.4-14.1)U/L vs.1.5(1.0-2.1)U/L,P<0.001]and[0.28(0.11-1.11)ng/ml vs.0.01 (0.01-0.02) ng/ml, P<0.001], respectively. Of the 107 target lesions, 104 (97.2%) were classifi ed as type B2 or C lesions.②Peri-procedural complications of coronary rotational atherectomy occurred in 21 patients (19.6%). There were 5 cases (4.7%) of coronary slow fl ow, 1 case (0.9%) of severe coronary spasm, 9 cases (8.4%) of coronary dissection after rotational atherectomy and 1 case (0.9%) of side branch occlusion. Six patients (5.6%) had severe sinus bradycardia, but only 1 patient required temporary pacemaker. Burr entrapment happened in 2 patients (1.9%). Peripheral vascular complications occurred in 2 patients (1.9%) with 1 case of femoral artery hematoma at puncture site and the other 1 case of mediastinal hematoma. One patient (0.9%) developed contrast induced nephropathy after the procedure. ③All the peri-procedural complications of rotational atherectomy were benign. The procedure instant success rate was 98.1%, with no acute or sub-acute stent thrombosis, cardiac death, emergent coronary artery bypass graft occurred during hospitalization. Conclusions The complications associated with coronary rotational atherectomy are not rare, but severe complications are not common. The procedure could be safely performed with a high instant success rate.