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@#Standardization is the universal language of the world, and standardization of traditional Chinese medicine (TCM) is essential for its communication in China and globally. However, the principles and methods of TCM acupuncture standardization have been unclear and inadequate in the early stages. Based on an investigative approach to understanding the current status, identifying problems, and finding solutions, our team has established basic principles of TCM acupuncture that embody Chinese wisdom, evaluated the international strategic environment systematically, proposed the principle of “importance of harmony and exercise of impartiality”, and established basic working principles. A series of methods for TCM acupuncture standard development and evaluation have been constructed, including general standards for the revision of TCM acupuncture standards, the first TCM acupuncture clinical research management specification, a shared full chain technology platform, a data center, and an evaluation research base for TCM acupuncture clinical research. Evaluation criteria for ancient literature and expert experience, a recommendation method for the “three main and three auxiliaries” TCM guideline for prevention were established, and quantifiable assessment methods of TCM standard applicability were proposed. These findings provide methodological guidance for TCM acupuncture standardization.
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Abstract@#As an important part of the social psychological service system, social organizations provide collaborative support for the management of mental health in primary and middle schools. Based on a case of Wuhan psychological service center, the significant contributions were made by social organizations, including system building,technique provides,field supervision and resource aggregation. Social organizations efforts include improving school psychology service system, exploring school based curriculum in respond to needs, seeking solutions of the crisis, and collaborating with social resources to guide multilateral support. The path of social organizations in participating in the mental health management, the limitations and needed support would be explored.
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Abstract@#Mental health services in primary and middle schools are facing multiple challenges, including dramatic increase in mental health support, low rate of mental health screening, high vigilance against psychological therapies, and lack of initiatives among students. The interdisciplinary integration of artificial intelligence (AI) and psychology in China, combined with biosensors, language recognition, blood spectrum sensing, and counseling big data, has pointed to a novel mental health service model. This new model, incorporating human computer interaction and objective algorithm, fits the contemporary students characteristics. Through monitoring real time physiological status, regulating emotional responses, and modifying cognitive modes, AI to mental health services can work effectively in mental health screening and counseling in primary and middle schools. It may become an innovative approach to build artificial intelligence for mental health service in schools.
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Objective@#Testicular germ cell tumors (TGCT) are the most common cancer among men aged 15 to 39 years. Previous studies have considered factors related to TGCT survival rate and race/ethnicity, but histological type of the diagnosed cancer has not yet been thoroughly assessed.@*Methods@#The data came from 42,854 eligible patients from 1992 to 2015 in the Surveillance Epidemiology and End Results 18. Frequencies and column percent by seminoma and nonseminoma subtypes were determined for each covariates. We used Cox proportional hazard regression to assess the impact of multiple factors on post-diagnostic mortality of TGCT.@*Results@#Black males were diagnosed at a later stage, more commonly with local or distant metastases. The incidence of TGCT in black non-seminoma tumors increased most significantly. The difference in survival rates between different ethnic and histological subtypes, overall survival (OS) in patients with non-seminoma was significantly worse than in patients with seminoma. The most important quantitative predictor of death was the stage at the time of diagnosis, and older diagnostic age is also important factor affecting mortality.@*Conclusion@#Histological type of testicular germ cell tumor is an important factor in determining the prognosis of testicular cancer in males of different ethnic groups.
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Adult , Humans , Male , Health Status Disparities , Neoplasms, Germ Cell and Embryonal/pathology , Prognosis , Risk Factors , SEER Program/statistics & numerical data , Seminoma/pathology , Survival Rate/trends , Testicular Neoplasms/pathology , United States/ethnologyABSTRACT
Objective@#To compare and correlate the findings of intravoxel incoherent motion (IVIM) magnetic resonance (MR) imaging and arterial spin labeling (ASL) imaging in characterizing parotid gland tumors. @*Materials and Methods@#We retrospectively reviewed 56 patients with parotid gland tumors evaluated by MR imaging. The true diffusion coefficient (D), pseudo-diffusion coefficient (D*), and fraction of perfusion (f) values of IVIM imaging and tumor-to-parotid gland signal intensity ratio (SIR) on ASL imaging were calculated. Spearman rank correlation coefficient, chi-squared, Mann-Whitney U, and Kruskal-Wallis tests with the post-hoc Dunn-Bonferroni method and receiver operating characteristic curve assessments were used for statistical analysis. @*Results@#Malignant parotid gland tumors showed significantly lower D than benign tumors (p = 0.019). Within subgroup analyses, pleomorphic adenomas (PAs) showed significantly higher D than malignant tumors (MTs) and Warthin’s tumors (WTs) (p < 0.001). The D* of WTs was significantly higher than that of PAs (p = 0.031). The f and SIR on ASL imaging of WTs were significantly higher than those of MTs and PAs (p < 0.05). Significantly positive correlation was found between SIR on ASL imaging and f (r = 0.446, p = 0.001). In comparison with f, SIR on ASL imaging showed a higher area under curve (0.853 vs. 0.891) in discriminating MTs from WTs, although the difference was not significant (p = 0.720). @*Conclusion@#IVIM and ASL imaging could help differentiate parotid gland tumors. SIR on ASL imaging showed a significantly positive correlation with f. ASL imaging might hold potential to improve the ability to discriminate MTs from WTs.
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OBJECTIVE: To compare the diagnostic performance of readout-segmented echo-planar imaging (RS-EPI)-based diffusion kurtosis imaging (DKI) and that of diffusion-weighted imaging (DWI) for differentiating malignant from benign masses in head and neck region. MATERIALS AND METHODS: Between December 2014 and April 2016, we retrospectively enrolled 72 consecutive patients with head and neck masses who had undergone RS-EPI-based DKI scan (b value of 0, 500, 1000, and 1500 s/mm2) for pretreatment evaluation. Imaging data were post-processed by using monoexponential and diffusion kurtosis (DK) model for quantitation of apparent diffusion coefficient (ADC), apparent diffusion for Gaussian distribution (Dapp), and apparent kurtosis coefficient (Kapp). Unpaired t test and Mann-Whitney U test were used to compare differences of quantitative parameters between malignant and benign groups. Receiver operating characteristic curve analyses were performed to determine and compare the diagnostic ability of quantitative parameters in predicting malignancy. RESULTS: Malignant group demonstrated significantly lower ADC (0.754 ± 0.167 vs. 1.222 ± 0.420, p < 0.001) and Dapp (1.029 ± 0.226 vs. 1.640 ± 0.445, p < 0.001) while higher Kapp (1.344 ± 0.309 vs. 0.715 ± 0.249, p < 0.001) than benign group. Using a combination of Dapp and Kapp as diagnostic index, significantly better differentiating performance was achieved than using ADC alone (area under curve: 0.956 vs. 0.876, p = 0.042). CONCLUSION: Compared to DWI, DKI could provide additional data related to tumor heterogeneity with significantly better differentiating performance. Its derived quantitative metrics could serve as a promising imaging biomarker for differentiating malignant from benign masses in head and neck region.
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Humans , Diffusion , Echo-Planar Imaging , Head , Magnetic Resonance Imaging , Neck , Population Characteristics , Retrospective Studies , ROC CurveABSTRACT
AIM:To comparatively analyze the effect of wavefront aberration or corneal topography guided laser-assisted in situ keratomileusis (LASIK) on the visual quality in patients with myopia after surgery. METHODS: During the period of January 2016 to January 2017, 100 patients (a total of 200 affected eyes) with myopia in our hospital were selected as the subjects, and they were randomly divided into Group A and Group B with 50 cases in each group. Before surgery, the eyes were examined and LASIK was performed. During surgery,the corneal stroma of eyes in Group A was cut individually according to the results of wavefront aberration examination while the individual cutting in Group B was performed according to the data of corneal topography. The visual acuity and visual quality were compared between the two groups after surgery. RESULTS: There was no significant difference of the visual acuity between the two groups before surgery (P>0.05). The Log MAR uncorrected visual acuity (UCVA), Log MAR BCVA and diopter were significantly improved at 6mo after surgery (P<0.05), and the diopter of Group A at 6mo after surgery was lower than that of Group B (P<0.05). There was no significant difference of contrast sensitivity (CS) between the two groups before surgery (P>0.05). But CS of different optotypes in two groups at 3mo after surgery were all better than those before surgery (P<0. 05). There was no significant difference between the two groups in CS under the bright and non-glare condition at 3mo after surgery (P>0.05). However, CS of Group A under bright glare, dark with glare and dark without glare states were significantly better than those of Group B (P<0. 05). There was no significant difference of detection results of wavefront aberrations between the two groups before surgery(P>0 05). At 3mo after surgery, the total aberrations, total higher-order aberrations,comatic aberrations and spherical aberrations significantly increased in two groups (P<0.05), and the increase in Group A was obviously lower than that in Group B (P<0.05). CONCLUSION: Both of wavefront aberration and corneal topography guided individualized excimer surgery can significantly improve the visual acuity of patients with myopia, but the former has more advantages in improving the visual quality.
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Meckel's diverticulum is the most common congenital anomaly of the gastrointestinal tract,affecting approximately 2％ of the population.It is a true diverticulum occurring on the anti-mesenteric border of the distalileum,typically within 100 cm of the ileo-caecal valve.Neoplasms arising in Meckel's diverticula are uncommon,and those reported in the literature are mainly carcinoid tumors,followed by gastrointestinal stromal tumors (GIST) and benign leiomyomas.Adenocarcinomas are extremely rare.Tumors in Meckel's present non-specifically with gastrointestinal complaints,such as bleeding,obstruction,inflammation or perforation.The suspicion of a Meckel's tumor is often not thought of at the initial.In this article we describe a 57-year-old woman who presented with massive rectal bleeding and severe anemia,later found to be caused by a adenocarcinoma arising from Meckel's diverticulum.The tumor was unfortunately highly aggressive.Multiple liver metastases had already existed when we discovered the primary mass.Later we performed a partial resection of the ileumto cease the bleeding.Meckel's diverticulum and the tumor were resected simultaneously.The pathological diagnosis confirmed adenocarcinoma arising from the Meckel's diverticulum.The final stage was pT4NxM1,stage Ⅳ according to the Union for International Cancer Control (UICC) classification.After operation we gave the patient firstline,mFOLFOX6 chemotherapy,but it turned out to be not effective.Rapid progress of the liver metastases and suspicion of multiple lung metastasis in short time after therapy indicated a bad outcome.We believe this is the first case of adenocarcinoma in a Meckel's diverticulum to be reported in domestic literature.The diagnosis of Meckel's tumor should be considered as inpatients' acute gastrointestinal complaints;when found incidentally at laparotomy,it should be carefully examined for any gross abnormality and resection should be considered.
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Objective To observe the effect of ultrasound guided transversus abdominis plane block used in laparoscopic radical resection of rectal cancer in elderly patients on postoperative analgesic and impact on immune function. Methods Sixty cases need laparoscopic radical resection of rectal cancer in elderly patients with admission order number to take the digital randomized method was divided into abdominal transverse muscle block group and saline control group. The transversus abdominis plane block group underwent ultrasound guided transversus abdominis plane block after induction of general anesthesia while accepted intravenous injection of 0.25%ropivacaine hydrochloride of 30 ml; Saline control group took equal volume intravenous saline. After operation all were given analgesia pump: Sufentanil 1.00 μg/kg + Ondansetron 16.00 mg + Dezocine 10.00 mg + saline to configure for 100 ml, and set 2 ml/h and 15 min of automatic control time. To observe visual analogue score (VAS) and related indexes of hemodynamics before anesthesia (T0), 1 h after operation (T1), 12 h after operation (T2), 24 h after operation (T3) and 48 h after operation (T4) between two groups; Record 24 h analgesia pressing times and total postoperative Sufentanil; And take venous blood to measure CD4+%, CD8+% level by flow cytometry and determinate interferon gamma (IFN-γ) by enzyme-linked immunosorbent assay; Then compare postoperative adverse reactions of two groups. Results Compared with saline control group,transversus abdominis plane block group' MAP decreased in T1, T2, and HR decreased in T2 and T3 (P < 0.05). Transversus abdominis plane block groups' MAP in T1 was higher than T0, and HR in T1, T2 was higher than that of T0 (P < 0.05). Compared with saline control group, transversus abdominis plane block group' VAS scores were lower at the T1, T2, T3, T4, else postoperative 24 h pressing times and amount of Sufentanil were decreased (P < 0.05). Compared with saline control group, transversus abdominis plane block group' CD4+% levels increased in T1, T2, T3 and T4, IFN-γ levels in T2, T3 points were higher (P < 0.05). Compared with the saline control group, transversus abdominis plane block group' rate of adverse reactions was lower (P < 0.05). Conclusion Ultrasound guided transversus abdominis plane block used in laparoscopic radical resection of rectal cancer in elderly patients has better postoperative analgesic effect, stable hemodynamics and less postoperative pain, and it has protective effect on immune function and lower incidence of adverse reactions, so clinical application is safety.
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Objective To observe the effect of ultrasound guided transversus abdominis plane block used in laparoscopic radical resection of rectal cancer in elderly patients on postoperative analgesic and impact on immune function. Methods Sixty cases need laparoscopic radical resection of rectal cancer in elderly patients with admission order number to take the digital randomized method was divided into abdominal transverse muscle block group and saline control group. The transversus abdominis plane block group underwent ultrasound guided transversus abdominis plane block after induction of general anesthesia while accepted intravenous injection of 0.25%ropivacaine hydrochloride of 30 ml; Saline control group took equal volume intravenous saline. After operation all were given analgesia pump: Sufentanil 1.00 μg/kg + Ondansetron 16.00 mg + Dezocine 10.00 mg + saline to configure for 100 ml, and set 2 ml/h and 15 min of automatic control time. To observe visual analogue score (VAS) and related indexes of hemodynamics before anesthesia (T0), 1 h after operation (T1), 12 h after operation (T2), 24 h after operation (T3) and 48 h after operation (T4) between two groups; Record 24 h analgesia pressing times and total postoperative Sufentanil; And take venous blood to measure CD4+%, CD8+% level by flow cytometry and determinate interferon gamma (IFN-γ) by enzyme-linked immunosorbent assay; Then compare postoperative adverse reactions of two groups. Results Compared with saline control group,transversus abdominis plane block group' MAP decreased in T1, T2, and HR decreased in T2 and T3 (P < 0.05). Transversus abdominis plane block groups' MAP in T1 was higher than T0, and HR in T1, T2 was higher than that of T0 (P < 0.05). Compared with saline control group, transversus abdominis plane block group' VAS scores were lower at the T1, T2, T3, T4, else postoperative 24 h pressing times and amount of Sufentanil were decreased (P < 0.05). Compared with saline control group, transversus abdominis plane block group' CD4+% levels increased in T1, T2, T3 and T4, IFN-γ levels in T2, T3 points were higher (P < 0.05). Compared with the saline control group, transversus abdominis plane block group' rate of adverse reactions was lower (P < 0.05). Conclusion Ultrasound guided transversus abdominis plane block used in laparoscopic radical resection of rectal cancer in elderly patients has better postoperative analgesic effect, stable hemodynamics and less postoperative pain, and it has protective effect on immune function and lower incidence of adverse reactions, so clinical application is safety.
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Objective@#To explore the effect of anterior alveolar bone reconstruction achieved through autogenous block bone from the wisdom teeth extraction zone in onlay grafting technique. @*Methods@#The 20 patients with bone defect of anterior teeth area were selected. They all had impacted teeth with no infection factors of pericoronitis to be removed. They were treated with autogenous block bone grafts from wisdom teeth extraction zone in onlay grafting technique respectively. The changes of thickness and the height of the bone measured from CBCT before and after 6 months of the surgery were carefully compared. Questionnaire from the patients opinion of acceptance was also be collected. @*Results@# Acceptance questionnaire showed an average score of 55 points (60 full score). Among them, 75% of paitients showed totally supportion and 25% showed basically supportion. The thickness was 6.73 ± 0.28 mm after the surgery compared with 2.26 ± 0.57 mm before the surgery which illustrated a significant difference (F = 6.32, P<0.001). The height didn't change obviously before 14.32 ± 0.31 mm and after 14.56 ± 0.35 mm the surgery. The technique of using autogenous block bone from the wisdom teeth extraction zone improved the compliance of patients with surgery. It can provide good osteogenesis effect and solve other oral diseases at the same time. @*Conclusion@#The Onlay grafting technique which using autogenous block bone from the wisdom teeth extraction zone was a simple and effective techniques for anterior alveolar bone augmentation.
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OBJECTIVE: To observe the impact of energy saving light,incandescent light and circadian light on the ethology of depressive rats and explore its possible mechanism on affecting the secretion of melatonin. METHODS: Thirty rats aged 6weeks were randomly selected from 40 specific pathogen free health female SD rats after they adapted to the living environment,depressive rat models were established in the rats by bilateral ovariectomy combined with isolated living and chronic unpredictable mild stress stimulation at the age of 11-14 weeks. Then these 30 ovariectomized rats were randomly divided into 3 intervention groups,including an energy saving light group,an incandescent light group and a circadian light group,with 10 rats in each group. The rats in these 3 groups were given specific experimental light intervention for 3 weeks respectively at the age of 17 weeks. The other 10 rats were raised in conventional environment as the control group. Their body weights were measured at the age of 17,19,20 and 21 weeks. The ethology tests were carried out by sucrose preference test and the open-field test at the age of 7,14 and 20 weeks respectively. The melatonin levels in peripheral blood of 7 time points from 19: 30 to 8: 30 were measured in the rats at age of 21 weeks. One rat in each group at every time point was randomly selected for examination. RESULTS: At the age of 17 weeks before light-intervention,the body weights of rats in 4 groups showed no significant difference( P > 0. 05). After light-intervention,at the age of 17-20 weeks,the body weights of rats in 3 intervention groups were gradually increased with the increase of age( P < 0. 05).There was no significant difference between body weights of rats at the age of 21 weeks and those at the age of 20 weeks in each group( P > 0. 05). At age of 7 weeks,no significant differences were found in sucrose consumption and standing scores among these 4 groups( P > 0. 05). After the depressive models were established,at the age of 14 weeks before light-intervention,in rats of these 3 intervention groups,the sucrose consumption and standing scores were lower than those of the control group( P < 0. 05),and there was no significant difference found in the above 2 indexes among these 3intervention groups( P > 0. 05). At the age of 20 weeks after light-intervention,the sucrose consumption and standing scores were not significantly different from each other among the 4 groups( P > 0. 05). The peak levels of melatonin in the peripheral blood of rats in these 3 intervention groups were higher than that in the control group. The peak levels onsets of melatonin in peripheral blood of rats in the circadian light group and the energy saving light group were earlier or 2 hours delayed compared to that of control group,while it was similar between the incandescent light group and control group.CONCLUSION: The circadian light,the energy saving light and the incandescent light are similarly effective in improving the behaviors of depressive rats. The circadian light can delay the onset of peak level of melatonin in peripheral blood.
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OBJECTIVE: To evaluate the differences in the apparent diffusion coefficient (ADC) measurements based on three different region of interest (ROI) selection methods, and compare their diagnostic performance in differentiating benign from malignant orbital tumors. MATERIALS AND METHODS: Diffusion-weighted imaging data of sixty-four patients with orbital tumors (33 benign and 31 malignant) were retrospectively analyzed. Two readers independently measured the ADC values using three different ROIs selection methods including whole-tumor (WT), single-slice (SS), and reader-defined small sample (RDSS). The differences of ADC values (ADC-ROI(WT), ADC-ROI(SS), and ADC-ROI(RDSS)) between benign and malignant group were compared using unpaired t test. Receiver operating characteristic curve was used to determine and compare their diagnostic ability. The ADC measurement time was compared using ANOVA analysis and the measurement reproducibility was assessed using Bland-Altman method and intra-class correlation coefficient (ICC). RESULTS: Malignant group showed significantly lower ADC-ROI(WT), ADC-ROI(SS), and ADC-ROI(RDSS) than benign group (all p 0.05). The ROI(SS) and ROI(RDSS) required comparable measurement time (p > 0.05), while significantly shorter than ROIWT (p < 0.05). The ROI(SS) showed the best reproducibility (mean difference ± limits of agreement between two readers were 0.022 [-0.080-0.123] × 10(-3) mm2/s; ICC, 0.997) among three ROI methods. CONCLUSION: Apparent diffusion coefficient values based on the three different ROI selection methods can help to differentiate benign from malignant orbital tumors. The results of measurement time, reproducibility and diagnostic ability suggest that the ROI(SS) method are potentially useful for clinical practice.
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Humans , Diffusion , Methods , Orbit , Retrospective Studies , ROC CurveABSTRACT
<p><b>PURPOSE</b>It is becoming increasingly clear that genetic factors play a role in traumatic brain injury (TBI), whether in modifying clinical outcome after TBI or determining susceptibility to it. MicroRNAs are small RNA molecules involved in various pathophysiological processes by repressing target genes at the post- transcriptional level, and TBI alters microRNA expression levels in the hippocampus and cortex. This study was designed to detect differentially expressed microRNAs in the cerebrospinal fluid (CSF) of TBI patients remaining unconscious two weeks after initial injury and to explore related single nucleotide polymorphisms (SNPs).</p><p><b>METHODS</b>We used a microarray platform to detect differential microRNA expression levels in CSF samples from patients with post-traumatic coma compared with samples from controls. A bioinformatic scan was performed covering microRNA gene promoter regions to identify potential functional SNPs.</p><p><b>RESULTS</b>Totally 26 coma patients and 21 controls were included in this study, with similar distribution of age and gender between the two groups. Microarray showed that fourteen microRNAs were differentially expressed, ten at higher and four at lower expression levels in CSF of traumatic coma patients compared with controls (p<0.05). One SNP (rs11851174 allele: C/T) was identified in the motif area of the microRNA hsa-miR-431-3P gene promoter region.</p><p><b>CONCLUSION</b>The altered microRNA expression levels in CSF after brain injury together with SNP identified within the microRNA gene promoter area provide a new perspective on the mechanism of impaired consciousness after TBI. Further studies are needed to explore the association between the specific microRNAs and their related SNPs with post-traumatic unconsciousness.</p>
Subject(s)
Adult , Humans , Male , Middle Aged , Brain Injuries, Traumatic , Cerebrospinal Fluid , Genetics , Computational Biology , MicroRNAs , Cerebrospinal Fluid , Genetics , Polymorphism, Single Nucleotide , Unconscious, PsychologyABSTRACT
<p><b>PURPOSE</b>To investigate the in vitro effect of short interfering RNAs (siRNAs) against Nogo receptor (NgR) on neurite outgrowth under an inhibitory substrate of central nervous system (CNS) myelin.</p><p><b>METHODS</b>Three siRNA sequences against NgR were designed and transfected into cerebellar granule cells (CGCs) to screen for the most effcient sequence of NgR siRNA by using reverse transcription polymerase chain reaction (RT-PCR) and immunofluorescence staining. NgR siRNA sequence 1 was found the most efficient which was then transfected into the CGCs grown on CNS myelin substrate to observe its disinhibition for neurite outgrowth.</p><p><b>RESULTS</b>Compared with the scrambled control sequence of siRNA, the NgR siRNA sequence 1 significantly decreased NgR mRNA level at 24 h and 48 h (p <0.05), which was recovered by 96 h after transfection. NgR immunoreactivity was also markedly reduced at 24 and 48 h after the transfection of siRNA sequence 1 compared with that before transfection (p<0.05). The NgR immunoreactivity was recovered after 72 h post-transfection. Moreover, the neurite outgrowth on the myelin substrate was greatly improved within 72 h after the transfection with siRNA sequence 1 compared with the scrambled sequence-transfected group or non-transfected group (p<0.05).</p><p><b>CONCLUSION</b>siRNA-mediated knockdown of NgR expression contributes to neurite outgrowth in vitro.</p>
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Animals , Rats , Cells, Cultured , Myelin Sheath , Physiology , Neuronal Outgrowth , Physiology , Nogo Receptor 1 , Genetics , Physiology , RNA, Small Interfering , Rats, Sprague-DawleyABSTRACT
OBJECTIVE@#To explore the effect of ulinastatin (UTI) continuous infusion combined Rivaroxaban on the deep vein thrombosis in patients undergoing major orthopedic surgery.@*METHODS@#Forty-five patients undergoing major orthopedic surgery were randomly divided into three groups:ulinastatin continuous infusion (Uc) group, ulinastatin single injection (Us) group and control (C) group. All patients received patient-controlled intravenous analgesia (PCIA) after operation, and took Rivaroxaban 10 mg orally 12 hours after operation. Ulinastatin (5 000 U/kg) was given intravenously to both Uc and Us groups preoperatively. Group C was given isometric normal saline, group Uc was pumped UTI continuous intravenously at the end of surgery (10 000 U/kg) to 48 hours through PCIA pump. The values of hematocrit (HCT), thrombomodulin (TM), Interleukin (IL-6), thrombin-antithrombin complex (TAT), D-Dimer (D-D) were normally tested before surgery (T1), at the end of the surgery (T2), 12 hours (T3), 24 hours (T4) and 48 hours (T5) after surgery.@*RESULTS@#Compared with T1, there was an upward tendency in TM, IL-6, TAT, and D-D after operation in group C group (P0.05).@*CONCLUSIONS@#During the perioperative period, ulinastatin continuous infusion combined Rivaroxaban can correct blood hypercoagulability through different approaches in patients undergoing major orthopedic surgery.
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Objective: To explore the effect of ulinastatin (UTI) continuous infusion combined Rivaroxaban on the deep vein thrombosis in patients undergoing major orthopedic surgery. Methods: Forty-five patients undergoing major orthopedic surgery were randomly divided into three groups:ulinastatin continuous infusion (Uc) group, ulinastatin single injection (Us) group and control (C) group. All patients received patient-controlled intravenous analgesia (PCIA) after operation, and took Rivaroxaban 10 mg orally 12 hours after operation. Ulinastatin (5 000 U/kg) was given intravenously to both Uc and Us groups preoperatively. Group C was given isometric normal saline, group Uc was pumped UTI continuous intravenously at the end of surgery (10 000 U/kg) to 48 hours through PCIA pump. The values of hematocrit (HCT), thrombomodulin (TM), Interleukin (IL-6), thrombin-antithrombin complex (TAT), D-Dimer (D-D) were normally tested before surgery (T1), at the end of the surgery (T2), 12 hours (T3), 24 hours (T4) and 48 hours (T5) after surgery. Results: Compared with T1, there was an upward tendency in TM, IL-6, TAT, and D-D after operation in group C group (. P0.05). Conclusions: During the perioperative period, ulinastatin continuous infusion combined Rivaroxaban can correct blood hypercoagulability through different approaches in patients undergoing major orthopedic surgery.
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Congenital cataract, a clinically and genetically heterogeneous lens disorder is defined as any opacity of the lens presented from birth and is responsible for approximately 10% of worldwide childhood poor vision or blindness. To identify the genetic defect responsible for congenital nuclear cataract in a four-generation Chinese Han family, exome and direct Sanger sequencings were conducted and a missense variant c.139G>A (p.D47N) in the gap junction protein-alpha 3 gene (GJA3) was identified. The variant co-segregated with patients of the family and was not observed in unaffected family members or normal controls. The above findings indicated that the variant was a pathogenic mutation. The mutation p.D47N was found in the first extracellular loop (E1) domain of GJA3 protein. Our data suggest that exome sequencing is a powerful tool to discover mutation(s) in cataract, a disorder with high genetic heterogeneity. Our findings may also provide new insights into the cause and diagnosis of congenital nuclear cataract and have implications for genetic counseling.
Subject(s)
Adult , Animals , Asian People/genetics , Base Sequence , Cataract/congenital , Cataract/genetics , Cattle , Connexins/genetics , DNA Mutational Analysis , Exome/genetics , Female , Humans , Male , Middle Aged , Mutation , Pedigree , PhenotypeABSTRACT
Multiple endocrine neoplasia type 2 (MEN2) is an autosomal dominant disorder that can be distinguished as three different syndromes: multiple endocrine neoplasia type 2A (MEN2A), MEN2B and familial medullary thyroid carcinoma (FMTC). This disorder is usually caused by the mutations of the rearranged during transfection protooncogene gene (RET) or the neurotrophic tyrosine kinase receptor type 1 gene (NTRK1). To investigate the genetic cause in a Chinese Han family with MEN2A and the genotype-phenotype correlations, nine members belonging to 3 generations of MEN2A family with 5 affected subjects underwent genetic analysis. Standard GTG-banded karyotype analysis and sequencing of the RET and NTRK1 genes were performed to identify the genetic cause of this family. A heterozygous mutation p.Cys634Arg in the RET gene was identified in 5 patients with MEN2A and one asymptomatic family member. The phenotype of patients was that of classic MEN2A, characterized by medullary thyroid carcinoma and phaeochromocytoma. The clinical features of all cases with RET mutations varied greatly, including onset age of clinical manifestations, severity and comorbidities. Thus, this study not only identified the hereditary nature of the MEN2A in the cases, but also discovered a family member harboring the same p.Cys634Arg mutation, who was unaware of his condition. These finding may provide new insights into the cause and diagnosis of MEN2A and have implications for genetic counseling.