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We describe a case of spontaneous conception following ovarian stimulation, in which a singleton pregnancy was revealed by ultrasound at 17 gestational weeks, with a multi-cystic "honeycomb" pattern in part of the placenta. With close monitoring, the patient delivered a healthy male neonate through cesarean section at 38 gestational weeks. The clinical findings, combined with ultrasound, laboratory, pathological, and immunohistochemistry examination, and short tandem repeat genotyping, confirmed a twin pregnancy consisting of a complete mole and coexisting fetus. No obvious abnormalities were found in the mother or the boy during a four-and-a-half-year's follow-up.
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Objective:To explore the application of enhanced recovery around surgery (CMERAS) by integrated Traditional Chinese Medicine & western medicine in perioperative period of laparoscopic anterior resection for rectal cancer patients.Methods:100 patients with rectal cancer who were treated by laparoscopic anterior resection in Shuguang Hospital from July 2017 to July 2019 were divided into two groups with random number table method, 50 patients in each group. The control group received enhanced recovery after surgery (ERAS) perioperative treatment and the observation group received CMERAS perioperative treatment. Both groups were treated for 7 days. The degree of intestinal cleansing during the operation and postoperative rehabilitation quality were observed of the two groups, including the time of first exhaust, hospitalization time and the incidence of complications. Serum CRP level was detected by immunoturbidimetry, serum IL-6 level was detected by chemiluminescence immunoassay and peripheral blood CD4, CD8 and CD4/CD8 were detected by flow cytometry. Adverse reactions were recorded for the two groups.Results:There was no significant difference in the degree of intestinal cleansing between the two groups during operation ( Z=-1.140, P=0.254). The first postoperative exhaust time in the observation group (29.7 ± 4.6 h vs. 36.1 ± 3.8 h, t=7.590) was earlier than that of the control group, the hospitalization time (4.2 ± 0.5 d vs. 4.7 ± 0.6 d, t=4.379) was less than that of the control group, and the incidence of complications [8.0% (4/50) vs. 30.0% (15/50), χ2=6.498] was lower than that of the control group ( P<0.01). On the third day after the operation, serum CRP (11.84 ± 4.69 mg/L vs. 23.63 ± 5.04 mg/L, t=12.106) and IL-6 (34.31 ± 5.93 ng/L vs. 44.39 ± 8.81 ng/L, t=6.714) in the observation group were lower than those in the control group ( P<0.05). CD4 levels [(37.74 ± 7.28)% vs. (33.55 ± 5.07)%, t=-3.344], CD4/CD8 ratio (1.36 ± 0.27 vs. 1.13 ± 0.22, t=-4.920) were higher than those in the control group ( P<0.01), and CD8 levels [(28.04 ± 4.68)% vs. (30.22 ± 4.04)%, t=2.487] was lower than that of the control group ( P<0.05). There were no adverse reactions in two groups during the treatment. Conclusion:CMERAS could promote the perioperative recovery of patients with rectal cancer if treated with laparoscopic anterior resection and fewer complications would occur.
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Objective: To explore the correlation of dual-source computed tomography [DSCT]/dual-energy imaging with pathological grading of lung adenocarcinoma
Methods: A total of 47 patients with lung adenocarcinoma were selected. Tissues were histopathologically confirmed by routine DSCT scanning and dual-energy enhanced scanning. Arterial-phase and venous-phase iodine distribution images and single-energy images at 40-190 keV were obtained. The region of interest was outlined to obtain CT values. The iodine concentrations of each tumor in two phases were recorded to calculate normalized iodine concentrations [NICs]
Results: The maximum diameter and minimum diameter of tumors in low differentiation [LD] group were significantly higher than those of high differentiation [HD] group [P<0.05]. In LD group, 70.8% of margins were lobulated, which significantly exceeded that of HD group [30.4%] [P<0.05]. Besides, 26.1% of patients in HD group were complicated with ground-glass opacity, which was significantly higher than that of LD group [4.2%] [P<0.05]. In venous phase, there were significant differences between the two groups at low energy levels [40-70 keV] [P<0.05]. At high energy levels [80-190 keV], the CT values of LD group were slightly higher than those of HD group. In arterial and venous phases, NICs of HD group were lower than those of LD group [P>0.05]
Conclusion: HD and LD groups could be predictably distinguished by single-energy images at low energy levels [40-70 keV] in the venous phase. Quantitative analysis of NIC in the venous phase is also valuable for predicting the pathological grade of lung adenocarcinoma
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Objective To evaluate the role of extracellular signal-regulated kinase (ERK) signaling pathway in morphine-or sufentanil-induced inhibition of arrhythmia induced by myocardial ischemia-reperfusion (I/R) in rats and the relationship with connexin43 (Cx43).Methods Forty-eight healthy SPF adult male Sprague-Dawley rats,weighing 200-300 g,were randomly divided into 6 groups (n=8 each) using a random number table:sham operation group (group S);I/R group;morphine group (group M);sufentanil group (group Suf);morphine + ERK inhibitor PD98059 group (group MP);sufentanil + PD98059 group (group SP).Myocardial ischemia was induced by 30 min occlusion of the left anterior descending branch of the coronary artery,followed by reperfusion.In M and Suf groups,the animals were subjected to three cycles of 5-minute drug infusion (morphine 0.3 mg/kg and sufentanil 3 μg/kg,respectively) via the femoral vein interspersed with 5-minute drug-free periods starting from the time point immediately before ischemia.PD98059 10 mg/kg was injected intravenously at 10 min before ischemia in MP and SP groups.The development of ventricular arrhythmia was recorded within 30 min of ischemia and 30 min of reperfusion,and the arrhythmia was scored (AS).The animals were then sacrificed at 120 min of reperfusion,and the myocardial specimens were obtained for determination of the expression of total Cx43 (t-Cx43),phosphorylated Cx43 (p-Cx43),and phosphorylated ERK (p-ERK) by Western blot.Results Compared with group S,the AS was significantly increased,and the expression of p-Cx43 was significantly down-regulated in the other groups,and the expression of t-Cx43 and p-ERK was significantly down-regulated in I/R,SP and MP groups (P＜0.05).Compared with group I/R,the AS was significantly decreased,and the expression of t-Cx43,p-Cx43 and p-ERK was significantly up-regulated in M and Suf groups (P ＜ 0.05).Compared with M and Suf groups,the AS was significantly increased,and the expression of t-Cx43 and p-Cx43 was significantly down-regulated in SP and MP groups (P ＜ 0.05).Conclusion The mechanism by which morphine or sufentanil inhibits arrhythmia induced by myocardial I/R is associated with up-regulated expression of myocardial Cx43 after activation of ERK signaling pathway in rats.
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Objective:To assess the effect of combined cognitive rehabilitation training on improving cogni-tive dysfunction in amphetamine-type stimulant dependent patients.Methods:Subjects who met the clinical diagno-sis of ATS dependence by DSM-IV in compulsory isolation detoxification institute were randomly assigned into in-tervention group (n =30 )and control group (n =26 ).Control group received a regular education.Intervention group also received a combined cognitive rehabilitation training besides regular education,including psychological and physical rehabilitation for 24 weeks.The Chinese version of CogState Battery (CSB)was used to assess cogni-tive function at baseline and 24 weeks after the intervention.Results:No significant difference was found on all sub-scales scores of CogState Battery between two groups at baseline.At 24 weeks after the intervention,compared to control group,the intervention group had more improvements in three sub-scale scores,i.e.,One Card LearningTask [(0.06 ±0.12)vs. (-0.03 ±0.14),P0.05 ).Conclusion:The combined cognitive rehabilitation training could improve amphetamine-type stimulant dependent patients'visual learning and memory,working memory and spatial working memory,while have no significant im-provement on other cognitive functions.
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Objective The study was to compare the effect of sufentanil and morphine preconditioning on ischemia /reperfusion-induced ventricular arrhythmias and the expression and distribution of myocardial Cx43 in rats.The regulation mechanisms that how sufentail and morphine lead to the change of Cx43 were also studied.Methods 32 male SD rats were randomly divided into 4 groups:sham operation group (group C),ischemia/reperfusion (group I/R),morphine preconditioning group(group M) and sufentanil preconditioning group(group S),each group had 8 rats.Established myocardial ischemia/reperfusion model,continuous recorded Ⅱ ECG,mean arterial pressure(MAP) and heart rate(HR).The ventricular arrhythmias at the 30 min before reperfusion was observed and the ventricular arrhythmias score of each group was calculated by ECG analysis; expression and distribution of Cx43 protein were observed by immunohistochemical technique.Results Compared with group C,the HR,MAP,RPP of group I/R were decreased obviously (P ＜ 0.05),while the arrhythmia score was significantly higher(P ＜ 0.05).Compared with group I/R,the extent of the declined of HR,MAP,RPP of group M and group S were eased significantly(P ＜ 0.05) and arrhythmia score was significantly lower(P ＜ 0.05).The HR,MAP,RPP of group M and group S are closer(P ＞ 0.05).Compared with the group C,Cx43 expression level in group I/R was significantly reduced (P ＜ 0.05) and the distribution was disordered,while compared with the group I/R,Cx43 expression level in group M and group S were significantly increased (P ＜ 0.05),and its distribution was structured.In group M and group S,Cx43 expression level were closer(P ＞ 0.05) and so as their distribution.Conclusion Sufentanil and morphine could inhibit the reduction of myocardial Cx43 expression level and improve its distribution which could played an important role in anti-arrhythmic during ischemia-reperfusion.
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Objective To explore the auditory P300 potentials in rehabilitated male patient of heroin addicts (MPHD),as well as the change of P300 amplitude in the drug craving state.Methods Rehabilitated MPHD patients (n =20) and healthy controls (n =20) underwent standard auditory P300 test.Only the patient group completed auditory P300 test after viewing neutral video and drug craving video respectively.Results Rehabilitated MPHD patients showed reduction of P300 amplitude (Cz:(2.72 ± 1.90) μV vs (3.99 ± 1.74) μV ; Pz:(4.48 ± 1.87) μV vs (5.61 ± 1.39) μV ; P ＜ 0.05) than that of healthy controls in standard auditory P300 test.Patients who had been successfully induced by drug craving video demonstrated higher P300 amplitude (Pz:(5.00± 1.68) μV vs (4.19 ± 1.62) μV; P＜0.05) after viewing drug craving video than that of viewing neutral video.Conclusion MPHD patients have cognitive impairment in their rehabilitation period;and P300 index can partially reflect the attention change in patients' drug craving state.
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TROP2 (trophoblastic cell surface protein 2),a cell-surface glycoprotein,is named after its high expression only in trophoblast cells.Recent studies found that TROP2 protein is overexpressed in a variety of human epithelial cancers,and it is associated with the prognosis.However,the mechanism is still not clear.
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Objective This study was to explore the expression and significance of HMA2 in bladder cancer , analyze its correlations to clinicopathologic and recurrence of bladder cancer. Methods The expression of HMGA2 protein in 148 specimens of bladder cancer and 30 specimens of normal bladder tissues was detected by immunohistochemtry, its correlations to clinicopathologic features was analyzed. Results There was no expression of HMGA2 protein in normal bladder tissues,while the expression level of HMGA2 protein was getting higher with the increase of tumor pathology grade and stage. The positive rate of HMGA2 protein was 21.3% in G1 bladder cancer, 60. 3% in G2 bladder cancer, 82.1% in G3 bladder cancer, its difference is significant (P＜0. 001). It was significantly lower in non-muscle invasive bladder cancer than in muscle invasive bladder cancer (43.3% vs 72. 7%, P=0. 003). The patients were followed up for 2～95 months, patients of recurrence was 64,HMGA2 protein expression was significantly higher in patients with recurrence than with non-recurrence (54.7% vs 25.0%, P=0. 007). Conclusions The expression of HMGA2 protein was highly in bladder cancer, the positive rate of HMGA2 protein expression was related with classification,TMN stage and recurrence, but not with sex, age, tumor number (P＞0. 05). The detection of the expression of HMGA2 protein is in favor of diagnosis and prognostic evaluation of bladder cancer.
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Objective To explore the expression of CXCR7 in bladder cancer and analyze its clinical significance and relationship with bladder cancer recurrence. Methods The expressions of CXCR7 protein in 148 specimens of bladder cancer and 30 specimens of normal bladder tissues were detected by immunohistochemical staining and its clinical significance was then analyzed. Results The expression of CXCR7 protein was higher in bladder cancers than in the adjacent normal tissues (P＜0.01). CXCR7 protein expression rates were 49. 4% and 71.2% in mutifocal tumors and unifocal tumors, while 34.0%, 65.8% and 78. 6% in G1, G2, and G3 tumors, respectively (P＜0. 01). Expression of CXCR7 protein was higher in muscle invasive bladder cancers than in non-muscle invasive bladder cancers (72. 7% versus 51.9% ,P＜0.05). In patients followed up for 2-95 months, CXCR7 protein expression was significantly higher in patients with recurrence than with non-recurrence (64. 1% versus 32.5%, P＜0.01). Kaplan-Meier analysis and the log-rark test showed that the recurrence-free survival was significantly different between the group of lower CXCR7 expression group and the higher expression group (P＜0.01). Conclusions The expression of CXCR7 protein is high in bladder cancer and the analysis of CXCR7 protein expression is potentially valuable in prognostic evaluation of bladder cancers. CXCR7 may play a role in the development of bladder urothelial cell cancer.
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Objective To investigate the expression of Oct4 protein and analyze its correlation with the clinic pathological features and prognosis of non-muscle-invasive bladder cancer.Methods The oct4 protein expression was assessed by immunohistochemical analysis in 87 specimens of bladder transitional cell carcinoma and 15 specimens of adjacent normal tissues.A correlation between Oct4 and clinic pathological features was analyzed.Results The positive rate of Oct4 protein was significantly higher in bladder cancer than that in normal bladder tissue (P＜0.01).The positive rate of Oct4 protein was 40.7％ in G1 bladder cancer,69.4％ in G2 bladder cancer and 91.7％ in G3 bladder cancer,and the differences was significant (P＜0.01).All patients were followed up for 3-78 months,and 63 of them relapsed.The expression of Oct4 protein was significantly higher in patients of recurrence than in non-recurrence (77.8％ ∶ 37.5％,P ＜ 0.01 ).21 patients of recurrence were in progression,and the expression of Oct4 protein had no significant differences between patients of progression and non-progression (71.4％ ∶65.2％,P ＞0.05).The positive rate of Oct4 protein was not related with gender,age,tumor number and size (P ＞0.05).Conclusion The detection of Oct4 protein is in favor of early detection of bladder tunor,estimation the degree of differentiation and surveillance for recurrence of superficial bladder cancer.
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Objective:To understand whether or not biofeedback therapy(BT)and cue- exposure therapy(CET)could decrease craving and heroin-related cue reactivity in abstinent heroin dependents.Methods:Adopting stratified sampling means,60 abstinent heroin dependents whose craving increased after cue exposed,were allocated to experiment group(n=36)and control group(n=24).The control group dependents received assistance and education.Beside the assistance and education,the experiment group also received 12 times combination therapies of BT and CET.Results:After therapies,the experiment group dependents' craving,EMG and skin conductance(SC)were all decreased compared with control group before cue exposures and after cue exposures[Before cue exposures,the indexes were:craving(3.06±7.26)mm vs.(22.32±20.26)mm;EMG(8.52±4.23)μV vs.(12.06±5.17)μV,SC(2.14±1.43)μS vs.(4.61±2.24)μS.After cue exposures the indexes were:craving(6.97±10.30)mm vs.(33.14±25.40)mm,MEG(8.72±4.31)μV vs.(14.79±5.86)μV,SC(2.15±1.33)μS vs.(4.49±2.59)μS;Ps≤0.01.Conclusion:The combination of biofeedback therapy and cue-exposure therapy could decrease the dependents' craving and cue reactivity sensitivity.