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ObjectiveTo study the effect of Qizhu Kang'ai prescription （QZAP） on the gluconeogenesis enzyme phosphoenolpyruvate carboxykinase 1 （PCK1） in the liver of mouse model of liver cancer induced by diethylnitrosamine （DEN） combined with carbon tetrachloride （CCl4） and Huh7 cells of human liver cancer， so as to explore the mechanism on regulating metabolic reprogramming and inhibiting cell proliferation of liver cancer cells. MethodDEN combined with CCl4 was used to construct a mouse model of liver cancer via intraperitoneal injection. A normal group， a model group， and a QZAP group were set up， in which QZAP （3.51 g·kg-1） or an equal volume of normal saline was administered daily by gavage， respectively. Serum and liver samples were collected after eight weeks of intervention. Serum alanine aminotransferase （ALT）， aspartate aminotransferase （AST）， γ-glutamyltransferase （γ-GT）， and alpha-fetoprotein （AFP） in mice were detected to evaluate liver function changes of mice in each group. Hematoxylin-eosin （HE） staining and Sirius red staining were used to observe pathological changes in liver tissue. In the cell experiment， Huh7 cells were divided into blank group， QZAP low， medium， and high dose groups and/or PCK1 inhibitor （SKF-34288 hydrochloride） group， and Sorafenib group. The corresponding drug-containing serum and drug treatment were given， respectively. Cell counting kit-8 （CCK-8） method， colony formation experiment， Edu fluorescent labeling detection， intracellular adenosine triphosphate （ATP） content detection， and cell cycle flow cytometry detection were used to evaluate the proliferation ability， energy metabolism changes， and change in the cell cycle of Huh7 cells in each group. Western blot was used to detect the protein expression levels of PCK1， serine/threonine kinase （Akt）， phosphorylated Akt （p-Akt）， and cell cycle-dependent protein kinase inhibitor 1A （p21）. ResultCompared with the model group， the pathological changes such as cell atypia， necrosis， and collagen fiber deposition in liver cancer tissue of mice in the QZAP group were alleviated， and the number of liver tumors was reduced （P<0.01）. The serum ALT， AST， γ-GT， and AFP levels were reduced （P<0.01）. At the cell level， compared with the blank group， low， medium， and high-dose groups of QZAP-containing serum and the Sorafenib group could significantly reduce the survival rate of Huh7 cells （P<0.01） and the number of positive cells with Edu labeling （P<0.01） and inhibit clonal proliferation ability （P<0.01）. The QZAP groups could also reduce the intracellular ATP content （P<0.05） and increase the distribution ratio of the G0/G1 phase of the cell cycle （P<0.05） in a dose-dependent manner. Compared with the model group and blank group， PCK1 and p21 protein levels of mouse liver cancer tissue and Huh7 cells in the QZAP groups were significantly reduced （P<0.05，P<0.01）， and the p-Akt protein level was significantly increased （P<0.01）. Compared with the blank group， the ATP content and cell survival rate of Huh7 cells in the SKF-34288 hydrochloride group were significantly increased （P<0.05）， but there was no statistical difference in the ratio of Edu-positive cells and the proportion of G0/G1 phase distribution. Compared with the SKF-34288 hydrochloride group， the QZAP combined with the SKF-34288 hydrochloride group significantly reduced the ATP content， cell survival rate， and Edu-positive cell ratio of Huh7 cells （P<0.05） and significantly increased the G0/G1 phase distribution proportion （P<0.05）. ConclusionQZAP may induce the metabolic reprogramming of liver cancer cells by activating PCK1 to promote Akt/p21-mediated tumor suppression， thereby exerting an anti-hepatocellular carcinoma proliferation mechanism.
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Objective:To evaluate the role of P2X4 receptor (P2X4R) in the maintenance of trigeminal neuralgia and the relationship with p38 mitogen-activated protein kinase (p38 MAPK)/brain-derived neurotrophic factor (BDNF) signaling pathway in rats.Methods:Forty-eight clean-grade healthy adult male Sprague-Dawley rats, weighing 190-230 g, aged 2-3 months, were divided into 4 groups ( n=12 each) using a random number table method: sham operation group (S group), trigeminal neuralgia group (TN group), trigeminal neuralgia+ dimethylsulfoxide (DMSO) group (TN+ DMSO group), and trigeminal neuralgia+ P2X4R specific antagonist 5-BDBD group (TN+ 5-BDBD group). The model was developed by chronic constriction of the infraorbital nerve. The infraorbital nerve was only exposed without ligation in group S. At 3, 7, 10 and 14 days after developing the model, 5 μg/μl 5-BDBD 10 μl was intrathecally injected in TN+ 5-BDBD group, and 2% DMSO 10 μl was intrathecally injected in TN+ DMSO group. The facial mechanical pain withdrawal threshold (MWT) was measured at 1 day before developing the model and 1, 3, 7, 10, 14 and 28 days after developing the model (T 0-6). The rats were sacrificed and the trigeminal ganglia were taken for determination of the expression of P2X4R, p38 MAPK, phosphorylated p38 MAPK (p-p38 MAPK) and BDNF (by Western blot) and contents of tumor necrosis factor (TNF)-α and interleukin (IL)-1β and IL-6 (by enzyme-linked immunosorbent assay). Results:Compared with group S, the MWT was significantly decreased at T 1-6, the expression of P2X4R, p-p38 MAPK and BDNF in trigeminal ganglion was up-regulated, and the contents of TNF-α, IL-1β and IL-6 were increased in TN group ( P<0.05). Compared with TN group, the MWT was significantly increased at T 3-6, and the expression of P2X4R, p-p38 MAPK and BDNF in trigeminal ganglion was down-regulated, and the contents of TNF-α, IL-1β and IL-6 were decreased in TN+ 5-BDBD group ( P<0.05), and no significant change was found in the indexes mentioned above in TN+ DMSO group ( P>0.05). Conclusions:P2X4R is involved in the maintenance of trigeminal neuralgia in rats, which may be related to the activation of p38 MAPK/BDNF signaling pathway and the increase in inflammatory mediator release.
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Objective:To investigate the effect of interventional embolization of prostate artery in patients with benign prostatic hyperplasia with prostatic volume>80 ml.Methods:A total of 56 patients with BPH combined with hypertension, diabetesand heart disease with prostate volume>80 ml in Meizhou People′s Hospital from April 2018 to November 2020 were selected. They were divided into the study group and the control group according to a simple random number table, 28 cases in each group. The patients in the study group were performed prostatic arterial embolization, and the patients in the control group were performed transurethral resection of the prostate. The efficacy, perioperative conditions, preoperative and 1 month after operation serum total prostate specific antigen (TPSA) level, free prostate specific antigen (FPSA) level, prostate volume, and international prostate symptom score (IPSS) were compared between the two groups. The sexual life quality after operation for 6 months was compared between the two groups.Results:The efficacy of the two groups had no significant difference ( P>0.05). The intraoperative blood loss, postoperative catheterization, postoperative hospital stay in the study group were less than those in the control group: (10.65 ± 1.89) ml vs. (119.64 ± 23.60) ml, (2.16 ± 0.39) d vs. (3.05 ± 0.61) d, (3.03 ± 1.82) d vs. (7.10 ± 2.39) d, the differences were statistically significant( P<0.05). The levels of serum TPSA, FPSA and prostate volume, IPSS at the first month after surgery in the two groups had no significant differences ( P>0.05). After operation for 6 months, the scores of Chinese Index of Sexual Function for Premature Ejaculation-5 (CIPE-5) and International Index of Erectile Function (IIEF-5) in the study group were higher than those in the control group: (18.63 ± 2.51) scores vs. (15.71 ± 2.29) scores, (16.38 ± 4.14) scores vs. (13.98 ± 3.82) scores, the differences were statistically significant ( P<0.05). Conclusions:Prostate arterial embolization is effective in BPH patients with prostate volume>80 ml and underlying diseases. Compared with transurethral prostatectomy, it has the advantage of faster recovery after surgery, and it has an ideal effect in controlling diseases, improving urination function, and quality of sexual life.
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Objective:To investigate the success rate, operation time and complications of ultrasound combined with X-ray-guided precise implantation of totally implantable access port (TIAP) in the chest wall.Methods:A total of 623 patients who underwent implantation of totally implantable venous access ports in the chest wall in Meizhou People's Hospital, China between January 2015 and August 2018 were included in this study. In group A ( n = 320), jugular or subclavian access ports were precisely implanted in the chest wall under the guidance of ultrasound combined with X-ray. During the surgery, color Doppler ultrasound was used to guide the puncture and a C-arm machine was used to locate the position of catheter tip. In group B ( n = 303), venous access ports were implanted using the conventional method. Subclavian vein puncture was performed using anatomic landmarks and the depth of catheterization was estimated by experience. The success rate of the first implantation, operation time, and complications (pneumothorax, hemothorax, catheter displacement, poor position of catheter tip, skin infection, and thrombosis) were compared between the two groups. Results:There were no statistical differences in baseline data between the two groups ( P > 0.05). The success rate of the first implantation in the group A was significantly higher than that in the group B [100% (320/320) vs. 93.06% (282/303), χ2 = 22.95, P < 0.01]. The operation time in the group A was significantly shorter than that in the group B [(26.48 ± 5.49) minutes vs. (35.51 ± 14.37) minutes, t = -10.25, P < 0.01]. In group A, 2 patients developed pneumothorax and healed after conservative treatment, 6 patients had thrombosis, and the incidence of complications was 2.5% (8/320). In group B, complications occurred in 67 patients, including pneumothorax in 9 patients, poor catheter tip position in 17 patients, thrombosis in 36 patients, and skin infection in 1 patient, and the incidence of complications was 22.11% (67/303). There was significant difference in the incidence of complications between the two groups ( χ2 = 56.53, P < 0.01). In group B, 6 out of 9 patients developing pneumothorax were healed after closed thoracic drainage, and 4 patients underwent a secondary surgery because of catheter displacement into the internal jugular vein. Conclusion:Precise implantation of venous access ports in the chest wall guided by ultrasound combined with X-ray has the advantages including 100% success rate of first precise implantation, few complications, short operation time, high comfort, safety and efficacy.
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Objective:To predict the sepsis patients with bad outcomes in short term and help clinical physicians to take intervention measures to reduce the mortality.Methods:A total of 900 patients with sepsis who were hospitalized in the Dongyang Peoples’ Hospital between 1st Jan 2013 and 30th Mar 2021 had been involved in this study. Information including gender, age and examination results of first time within 24 hours following hospitalization were collected. Independent risk factors of death in 30 days were screened by logistic regression analysis and further confirmed by stepwise regression analysis. Based on the screened variables, nomogram prediction model was established. Finally, the prediction model was evaluated for its prediction power by the area under the curve of receiver operating characteristic (AUC), calibration accuracy by GiViTI calibration curve and clinical effectiveness by decline curve analysis (DCA). The established prediction model was validated by using bootstrap assay.Results:Stepwise regression analysis results showed that B-type natriuretic peptide, lactic acid, albumin, oxygenation index, mean artery pressure, hematocrit and heart rate within 24 hours after hospitalization were significantly associated with death in 30 days among patients with sepsis. The AUC of prediction model was 0.846, with P of 0.886 in calibration curve, calibration slope of 1.0, R2 of 0.385, brier scaled value of 0.092 and DCA curve above the two extreme curves. In validation using bootstrap, the prediction model owned an AUC of 0.854, a P of 0.994 in calibration curve, a brier scaled value of 0.090, a calibration slope of 1.0 and a R2 of 0.389. Also, its DCA curve was above the two extreme curves. Conclusions:B-type natriuretic peptide, Lactic acid, albumin, oxygenation index, mean artery pressure, hematocrit and heart rate within 24 hours after hospitalization were independent risk factors of death in 30 days among patients with sepsis. The established prediction model in this study owned good prediction power of sepsis patients who owned high risk of death in 30 days.
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Objective:To explore the causes and preventive measures of early complications after free gracilis muscle transfer in reconstruction of brachial plexus injury, and to improve the postoperative function of the transferred gracilis muscle.Methods:Patients were recruited from August, 2005 to December, 2016. All 111 patients of brachial plexus injury underwent reconstructive surgery using 122 free gracilis flaps. Early postoperative complications, including recipient site, donor site and systemic complications, were closely observed and recorded. Outcome measurements included incidence and timing of flap compromise, type of flap compromise, causes of vascular occlusion and salvage rate. The postoperative strength of gracilis was evaluated according to the BMRC score. The data were statistically analyzed. The difference was statistically significant if P<0.05. Results:The survival rate of 122 free gracilis transfers was 98.4% (120/122). Early complications occurred in 32 cases (including 2 complications in 6 patients) : 27 cases with recipient site complications (84.4%), 4 with donor site complications and 7 with systemic complications. Among the 32 cases of complications, 17 flap compromises caused by vascular obstruction and 15 of them were salvaged completely after exploration. Flap crisis was the main issue that affected the postoperative function of gracilis muscle, and 58.8% (10/17) of patients with vascular crisis showed muscle strength above M 3 after surgery. The main causes of vascular crisis were venous tortuosity and venous thrombosis, which had nothing to do with operation time and intraoperative blood loss. Conclusion:Flap crisis is the main factor affecting the postoperative function of gracilis. The rate of flap salvage can be tremendously increased by early detection, re-exploration and effective management of the flap crisis.
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Objective:To explore the correlation between the number of sentinel regional lymph node (SALN) and non-sentinel regional lymph node (NSALN) metastasis in patients with early breast cancer after sentinel regional lymph node (SALN) biopsy.Methods:Retrospectively selected 400 female patients with early breast cancer who underwent SALN biopsy at the Department of Thyroid and Breast Surgery, Yijishan Hospital of Wannan Medical College from January 2016 to July 2021, and summarized and analyzed their clinical case data. The Chi-square test or Fisher exact probability method was used to compare the count data between groups. Perform single-factor analysis on the research indicators, then screen out indicators with statistically significant differences, then perform multi-factor Logistic regression analysis, draw a receiver operating characteristic curve, and combine the area under the curve to establish a predictive model.Results:SALN biopsy was performed in 400 patients with early breast cancer. A total of 1 504 lymph nodes were detected in 320 cases of total mastectomy, with an average of 4.7, 47 cases of macrometastasis, and 2 cases of postoperative macrometastasis. The false negative rate was 4.3%. Among 400 cases, 67 cases were positive for SALN, and the positive rate was 16.75% (67/400). The results of univariate analysis showed that the number of tumor thrombus in the vessel, the number of positive SALN and the metastasis of NSALN were closely related ( χ2=8.775, 16.53, P=0.003). The results of multivariate Logistic regression analysis showed that the number of tumor thrombi and SLN-positive ≥3 in the vessel were independent predictive risk factors for NSLN metastasis ( OR=16.149, 95% CI: 3.016-86.473, P<0.001; OR=31.76, 95% CI: 5.242-192.43, P<0.001). SALN positive was closely related to NSALN metastasis, but as the number of SALN detected increases (more than 6) and when only 1 to 2 SALN was positive, the probability of NSALN metastasis was significantly reduced ( P<0.05). Conclusions:The positive number of SALN and intravascular tumor thrombolus were closely related to NALN metastasis. SALN positive number ≥3 was the most important independent predictor of NSALN metastasis. The recurrence risk of sentinel lymph node can be reduced by increasing the number of SALN detected, when 1-2 positive sentinel lymph node are detected and the number of sentinel lymph node detected >6, axillary lymph node dissection can be exempted as appropriate.
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Objective:To investigate the value of first-trimester uterine artery Doppler pulsatility index (PI) in the prediction of preeclampsia (PE) in twin pregnancies.Methods:From April 2014 to October 2016, women with twin pregnancies undergoing Down's screening at 11 +0-13 +6 gestational weeks in Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine were recruited in this prospective cohort study. Bilateral uterine artery PI values were measured by Doppler ultrasound at the first trimester. Pregnancy outcomes and the incidence of PE were followed up. The participants were classified into four groups according to their pregnancy outcomes: early-onset PE (<34 weeks), late-onset PE (≥34 weeks), gestational hypertension and normal groups. Differences in the multiples of median of uterine artery PI (PI MoM) and rates of abnormal PI MoM (≥ P90) were compared among the four groups using the Kruskal-Wallis test, Chi-square test or Fisher exact test. The performance of uterine artery PI in the prediction of PE was evaluated using receiver operating characteristic (ROC) curve. Results:A total of 1 223 twin pregnancies were recruited and 185 of them were excluded for not meeting the eligibility criteria. The 1 038 cases enrolled successfully were 231 monochorionic diamniotic (MCDA) and 807 dichorionic diamniotic (DCDA) twin pregnancies. The incidences of early-onset PE, late-onset PE and gestational hypertension were 3.47% (36/1 038), 7.03% (73/1 038) and 2.79% (29/1 038), respectively. No significant difference was observed in PI MoM [ M( P25~ P75), 1.06 (0.80-1.32), 1.05 (0.75-1.30), 0.99 (0.73-1.23), 1.03 (0.80-1.27); χ2=0.396, P=0.941] or the rates of abnormal PI MoM [8.33% (3/36), 6.85% (5/73), 13.79% (4/29), 10.11% (91/900); Fisher's exact test, P=0.703] among the four groups. Furthermore, there was no significant difference in PI MoM between normal MCDA and DCDA twin pregnancies [1.04 (0.81-1.29) vs 1.03 (0.79-1.27), χ2=0.095, P=0.758]. The area under the ROC curve showed that first-trimester uterine artery PI had limited value in the prediction of early-onset PE (0.514, 95% CI: 0.413-0.615), late-onset PE (0.499, 95% CI: 0.428-0.570) and gestational hypertension (0.530, 95% CI:0.418-0.643) in twin pregnancies. Conclusion:First-trimester uterine artery PI has limited value in predicting early- or late-onset PE in twin pregnancies.
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OBJECTIVE：To study the protective effect of timosaponin BⅡ（TB-Ⅱ）on blood vessels and explore its possible mechanism. METHODS ：Using aquaculture water as blank control ，the effects of 100，200 and 400 μg/mL TB-Ⅱ treatment for 48 h on the situation of subintestinal veins （SIVs）in normal zebrafish embryos 24 h after fertilization （24 hpf）were investigated. PTK787（0.06 μg/mL），a tyrosine kinase inhibitor ，was used to induce the model of zebrafish intestinal vascular injury ；using combing with 0.1％ dimethyl sulfoxide but no PTK 787 as blank control ，combing with PTK 787 but no drug as model control ，the effects treatment of 100，200 and 400 μg/mL TB-Ⅱ for 48 h on the SIVs of zebrafish model with vascular injury were investigated. Relative expressions of fam-like tyrosine kinase 1（Flt-1），kinase insert domain containing receptor （Kdr），kinase insert domain containing receptor l （Kdr-l），vascular endothelial growth factor A （VEGF-A），tumor necrosis factor α（TNF-α）and interleukin 6 （IL-6）mRNA were detected by RT-PCR. RESULTS ：100 μg/mL TB-Ⅱ could significantly increase the sprouting vessel of normal zebrafish SIVs sprouting vessel number （P＜0.05），and 200 μg/mL TB-Ⅱ could significantly increase SIVs number of normal zebrafish （P＜0.05）. Compared with blank control ， SIVs treatment （P＜0.01），and the relative expressions of Flt-l ， Kdr，Kdr-l，VEGF-A，TNF-α and IL-6 mRNA were alse decreased significantly （P＜0.05 or P＜0.01）. After treated 化。E-mail：pn333@163.com with different concentrations of TB- Ⅱ ，SIVs number of vascular injury model zebrafish increase d to different extents ；relative expressions of Flt-l ，Kdr，Kdr-l，VEGF-A，TNF-α and IL-6 mRNA were increased to different extents. There was no significant difference in SIVs number and the expression of Flt-l ，TNF-α mRNA in zebrafish treated with 100 μg/mL TB-Ⅱ and the expression of TNF-α mRNA in zebrafish treated with 400 μg/mL TB-Ⅱ， but there was statistical significance in other indexes （P＜0.05 or P＜0.01）. CONCLUSIONS ：TB-Ⅱ has a certain function of promoting angiogenesis and repairing damaged blood vessels ，and its mechanism is related to the up-regulation of vascular endothelial growth factor receptor and pro-inflammatory cytokine expression.
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OBJECTIVE@#To investigate the effect of the chemoprotectant tempol on the anti-tumor activity of cisplatin (DDP).@*METHODS@#The cellular toxicity of tempol in human colon cancer SW480 cells and mouse colon cancer CT26 cells were evaluated using MTT and cell counting kit-8 assays. CalcuSyn software analysis was used to determine the interaction between tempol and DDP in inhibition of the cell viability. A subcutaneous homograft mouse model of colon cancer was established. The mice were randomly divided into control group, tempol group, cisplatin group and tempol + DDP treatment group with intraperitoneal injections of the indicated agents. The tumor size, body weight and lifespan of the mice were measured, and HE staining was used to analyze the cytotoxic effect of the agents on the kidney and liver. Immunohistochemistry and Western blotting were performed to detect the expression of Bax and Bcl2 in the tumor tissue, and TUNEL staining was used to analyze the tumor cell apoptosis. The level of reactive oxygen species (ROS) in the tumor tissue was determined using flow cytometry.@*RESULTS@#Tempol showed inhibitory effects on the viability of SW480 and CT26 cells. CalcuSyn software analysis showed that tempol had a synergistic anti-tumor effect with DDP (CI < 1). In the homograft mouse model, tempol treatment alone did not produce obvious anti-tumor effect. HE staining showed that the combined use of tempol and DDP alleviated DDP-induced fibrogenesis in the kidneys, but tempol also reduced the anti-tumor activity of DDP. Compared with the mice treated with DDP alone, the mice treated with both tempol and DDP had a significantly larger tumor size ( < 0.01) and a shorter lifespan ( < 0.05). Tempol significantly reversed DDP-induced expression of Bax and Bcl2 in the tumor tissue and tumor cell apoptosis ( < 0.001), and obviously reduced the elevation of ROS level in the tumor tissue induced by DDP treatment ( < 0.05).@*CONCLUSIONS@#Tempol can attenuate the anti-tumor effect of DDP while reducing the side effects of DDP. Caution must be taken and the risks and benefits should be carefully weighed when considering the use of tempol as an anti-oxidant to reduce the toxicities of DDP.
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Animals , Humans , Mice , Antineoplastic Agents , Antioxidants , Apoptosis , Cell Line, Tumor , Cell Proliferation , Cisplatin , Cyclic N-Oxides , Pharmacology , Drug Resistance, Neoplasm , Spin LabelsABSTRACT
Objective@#The incidence and distribution of positional deformities(PD)were studied by measuring cranial types of infants aged 0-6 months of 3 hospitals in Chongqing, and the recommended values of local PD were discussed.@*Methods@#Data of 3 406 infants with 0-6 months head size measurements were collected from the Second Affiliated Hospital of Army Military Medical University, Yongchuan Maternal and Child Health Care Hospital and Wanzhou Maternal and Child Health Care Hospital from September 1, 2017 to August 31, 2018, cranial vault asymmetry(CVA)and cranial index(CI)were calculated.According to different age groups, observe the distribution of cranial types, and use the current international common diagnostic criteria to understand the incidence of cranial abnormalities, and analyze the distribution of percentile values of CVA and CI in infants in Chongqing.@*Results@#According to the current international standard diagnosis of PD, the incidence of simple brachycephaly was the highest(39.9%)in the overall cranial abnormalities of infants, followed by brachycephaly with plagiocephaly was the second(36.1%), simple plagiocephaly was the lowest(6.9%), and normal cranial type only accounted for 17.1%.The detection rates of plagiocephaly(36.9%)and brachycephaly(67.0%)were the lowest in the 0-2 months group, and the highest in the 3-4 months group(47.3%/83.3%), and then decreased in the 5-6 months group(46.6%/80.2%).@*Conclusion@#The basic values of cranial type measurement of full-term infants in chongqing were significantly different from international reports, mainly due to the large CI value.The general international diagnosis standard for positional deformities do not conform to Chinese infants.We suggest that the reference value for positional deformities in this region is as follows: CVA≥0.4 cm is abnormal, of which 0.4 cm≤CVA<0.6 cm for mild plagiocephaly, 0.6 cm≤CVA<1.0 cm for moderate plagiocephaly, CVA≥1.0 cm for severe plagiocephaly; 82%≤CI≤91% is abnormal, of which 91%≤CI<94% for mild brachycephaly; 94% ≤CI<99% for moderate brachycephaly; CI≥ 99% for severe brachycephaly.CI≤82% is scaphocephaly.
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Objective@#To evaluate the value and safety of therapeutic endoscopic retrograde cholangiopancreatography (ERCP) in elderly patients.@*Methods@#The clinical data of 377 elderly patients with therapeutic ERCP from January 2010 to September 2017 in Changzhou First People′s Hospital of Jiangsu Province were retrospectively analyzed. Among them, there were 34 patients (observation group) aged ≥ 90 years and 343 patients (control group) aged 75 to 89 years old. The results of ERCP examination, treatment of bile duct stones and related complications were compared between 2 groups.@*Results@#There was no statistical difference in the success rate of ERCP between 2 groups (P>0.05). There were no statistical difference in detection rates of bile duct stones, cholangiocarcinoma and benign biliary stricture between 2 groups (P<0.05); however, the detection rates of duodenal papillary carcinoma and nipple diverticulum in observation group were significantly higher than those in control group: 11.8% (4/34) vs. 2.0% (7/343) and 38.2% (13/34) vs. 18.7% (64/343), and there were statistical differences (χ2 = 10.326 and 7.294, P<0.01). There were 21 patients with bile duct stones in observation group, including 14 patients with multiple stones; there were 241 patients with bile duct stones in control group, including 188 patients with multiple stones. The maximum stone diameter, rate of in-line stent drainage and rate of extracorporeal lithotripsy in multiple stones patients of observation group were significantly higher than those in multiple stones patients of control group: (1.5 ± 0.3) cm vs. (1.2 ± 0.4) cm、9.5% (2/21) vs. 1.7% (4/241), 4.8% (1/21) vs. 0.4% (1/241), and there were statistical differences (P<0.05). There was no statistical difference in incidence of ERCP complications between observation group and control group: 14.7% (5/34) vs. 6.7% (23/343), P>0.05; but the incidence of cardiac accidents in observation group was significantly higher than that in control group: 5.9% (2/34) vs. 1.2% (4/343), and there was statistical difference (χ2 = 4.393, P<0.05). There was no statistical difference in the length of hospital stay between observation group and control group: (11.5 ± 5.0) d vs. (13.2 ± 5.8), P>0.05.@*Conclusions@#Therapeutic ERCP is an important treatment for elderly patients with biliary and pancreatic diseases. For patients over 90 years old, ERCP is safe and reliable, but it is necessary to actively pay attention to comorbidities, especially cardiac function.
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Objective To evaluate the value and safety of therapeutic endoscopic retrograde cholangiopancreatography (ERCP) in elderly patients. Methods The clinical data of 377 elderly patients with therapeutic ERCP from January 2010 to September 2017 in Changzhou First People′s Hospital of Jiangsu Province were retrospectively analyzed. Among them, there were 34 patients (observation group) aged≥90 years and 343 patients (control group) aged 75 to 89 years old. The results of ERCP examination, treatment of bile duct stones and related complications were compared between 2 groups. Results There was no statistical difference in the success rate of ERCP between 2 groups (P＞0.05). There were no statistical difference in detection rates of bile duct stones, cholangiocarcinoma and benign biliary stricture between 2 groups (P﹤0.05); however, the detection rates of duodenal papillary carcinoma and nipple diverticulum in observation group were significantly higher than those in control group: 11.8% (4/34) vs. 2.0% (7/343) and 38.2% (13/34) vs. 18.7% (64/343), and there were statistical differences (χ2=10.326 and 7.294, P﹤0.01). There were 21 patients with bile duct stones in observation group, including 14 patients with multiple stones; there were 241 patients with bile duct stones in control group, including 188 patients with multiple stones. The maximum stone diameter, rate of in-line stent drainage and rate of extracorporeal lithotripsy in multiple stones patients of observation group were significantly higher than those in multiple stones patients of control group: (1.5 ± 0.3) cm vs. (1.2 ± 0.4) cm、9.5% (2/21) vs. 1.7% (4/241), 4.8% (1/21) vs. 0.4% (1/241), and there were statistical differences (P﹤0.05). There was no statistical difference in incidence of ERCP complications between observation group and control group: 14.7% (5/34) vs. 6.7% (23/343), P＞0.05; but the incidence of cardiac accidents in observation group was significantly higher than that in control group: 5.9% (2/34) vs. 1.2% (4/343), and there was statistical difference (χ2=4.393, P﹤0.05). There was no statistical difference in the length of hospital stay between observation group and control group: (11.5 ± 5.0) d vs. (13.2 ± 5.8), P＞0.05. Conclusions Therapeutic ERCP is an important treatment for elderly patients with biliary and pancreatic diseases. For patients over 90 years old, ERCP is safe and reliable, but it is necessary to actively pay attention to comorbidities, especially cardiac function.
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Objective To compare the clinical efficacy of minimally invasive surgery and traditional surgery in the treatment of multiple benign mammary lumps.Methods A retrospective study was conducted to select 158 patients with multiple benign breast masses admitted to Yijishan Hospital of Wannan Medical College from July 2016 to February 2018,all of them were female,average age was (28.3 ± 6.6) years old,range from 19 to 51 years old.The patients were divided into minimally invasive group (n =122) and traditional group (n =36) according to different surgical methods.The minimally invasive group was treated by minimally invasive rotary excision,while the traditional group was treated by traditional surgery.The operation time,number of incisions,average length of incisions,cumulative length of incisions and healing time of incisions were compared between the two groups.The incidence of local hematoma,local infection,breast deformity and local residual were compared after operation,and the satisfaction of the two groups was aslo compared.Normal distribution measurements were expressed by mean ± standard deviation (Mean ± SD),independent sample t test was used for inter-group comparison;non-normal distribution measurements were expressed by median (quartile spacing) [M(P25,P75)],Mann-Whitney U test was used for inter-group comparison.Chi-square test or Fisher exact probability test was used to compare the count data between the two groups.Results As compared to the traditional group,the minimally invasive group had shorter operation time (20.0 min vs 40.0 min,Z =-8.590,P ＜ 0.001),less number of incisions (1.0 vs 2.0,Z =-4.423,P ＜0.001),smaller average surgical incision length (3.8 mm vs 35.5 mm,Z =-9.211,P ＜ 0.001),smaller cumulative surgical incision length (4.0 mm vs 67.2 mm,Z =-9.130,P ＜ 0.001),quicker postoperative recovery (4.0 d vs 7.0 d,Z =-9.334,P ＜ 0.001).There were no significant differences between the two groups in incidence of postoperative hematoma (4.1％ vs 2.8％,x2 =0.000,P =1.000),incidence of infection (0 vs 2.8％,P =0.228),incidence of postoperative breast shape change (1.6％ vs 2.8％,x2 =0.000,P =1.000),and incidence of residual (0.8％ vs 0,P =1.000).Psychological satisfaction of patients in minimally invasive group (95.1％) was significantly higher than that in traditional group (58.3％),the difference was statistically significant (P ＜ 0.001).Conclusions Compared with traditional surgery,the application of minimally invasive surgery in the treatment of multiple benign mammary lumps has many advantages,such as shorter operation time,less number of incisions,smaller surgical incision length,quicker postoperative recovery and higher satisfaction of patients after operation.It has not significantly increased postoperative complications.It is worthy of clinical application and promotion.
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Objective The incidence and distribution of positional deformities ( PD) were studied by measuring cranial types of infants aged 0-6 months of 3 hospitals in Chongqing, and the recommended values of local PD were discussed. Methods Data of 3406 infants with 0-6 months head size measurements were col-lected from the Second Affiliated Hospital of Army Military Medical University, Yongchuan Maternal and Child Health Care Hospital and Wanzhou Maternal and Child Health Care Hospital from September 1, 2017 to August 31, 2018, cranial vault asymmetry ( CVA) and cranial index ( CI) were calculated. According to different age groups, observe the distribution of cranial types, and use the current international common diagnostic crite-ria to understand the incidence of cranial abnormalities, and analyze the distribution of percentile values of CVA and CI in infants in Chongqing. Results According to the current international standard diagnosis of PD, the incidence of simple brachycephaly was the highest ( 39. 9％) in the overall cranial abnormalities of infants, followed by brachycephaly with plagiocephaly was the second (36. 1％), simple plagiocephaly was the lowest (6. 9％), and normal cranial type only accounted for 17. 1％. The detection rates of plagiocephaly (36. 9％)and brachycephaly ( 67. 0％) were the lowest in the 0-2 months group, and the highest in the 3-4 months group (47. 3％/83. 3％), and then decreased in the 5-6 months group (46. 6％/80. 2％). Conclusion The basic values of cranial type measurement of full-term infants in chongqing were significantly different from inter-national reports, mainly due to the large CI value. The general international diagnosis standard for positional deformities do not conform to Chinese infants. We suggest that the reference value for positional deformities in this region is as follows: CVA≥0. 4 cm is abnormal, of which 0. 4 cm≤CVA<0. 6 cm for mild plagiocepha-ly, 0. 6 cm≤CVA<1. 0 cm for moderate plagiocephaly, CVA≥1. 0 cm for severe plagiocephaly; 82％≤CI≤91％ is abnormal, of which 91％≤CI <94％ for mild brachycephaly; 94％ ≤CI <99％ for moderate brachycephaly; CI≥99％ for severe brachycephaly. CI≤82％ is scaphocephaly.
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OBJECTIVE： To optimize the water extraction technology of Bupi yangshen granules， and to provide basis for the follow-up research and development of it. METHODS： The contents of astragaloside Ⅳ and salvianolic acid B in water extract of Bupi yangshen granules， were determined by HPLC-ELSD and HPLC-DAD. Using the comprehensive score of contents of astragaloside Ⅳ and salvianolic acid B and extract yield as index， weight coefficient of indicators were determined by AHP， CRITIC and AHP-CRITIC mixed weighting method. L9（34） orthogonal test was used to optimize decoction time， water volume and decoction times in water extraction technology of Bupi yangshen granules. Validation test was also performed. RESULTS： The weight coefficient determined by AHP-CRITIC mixed weighting method was the most reasonable. The optimal extraction technology was decocting twice， adding 12-fold water， 1 h each time. The results of 3 times of validation test showed that the average contents of astragaloside Ⅳ and salvianolic acid B were 8.79， 609.50 mg （total amount of 121 g medicinal herbs extracted from whole prescription）， respectively. The average extract yield was 31.24％. Average comprehensive score was 96.59（RSD＝1.01％，n＝3）. CONCLUSIONS： The optimized water extraction technology is reproducible， stable and feasible. It can provide a scientific basis for the follow-up development and industrial production of Bupi yangshen granules.
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OBJECTIVE： To establish the method for the content determination of astragaloside Ⅳ， emodin and chrysophanol in Jianpi yishen pills （JYP） and to investigate the effects of JYP on calcium， phosphorus metabolism and inflammatory factors in chronic renal failure （CRF） model rats. METHODS： HPLC method was adopted. The determination of astragaloside Ⅳ， emodin and chrysophanol was perform on Agilent Zorbax SB-C18， Agilent TC C18 column， respectively； mobile phase consisted of acetonitrile-water （36 ∶ 64， V/V） and methanol-0.1％ phosphoric acid solution （75 ∶ 25， V/V）； the detectors were evaporative light-scattering detector and diode-array detector （detection wavelength of 254 nm）； the column temperatures were set at 30 ℃and 25 ℃ at the flow rate of 1.0 mL/min； the sample sizes were 20 and 10 μL. SD rats were randomly divided into normal group， model group， Niaoduqing group （1.80 g/kg） and JYP low-dose， medium-dose and high-dose groups （1.71， 3.43， 6.85 g/kg）， with 10 rats in each group. Except for normal group， CRF model of other groups were established by 5/6 nephrectomy in other groups. Four months after modeling， normal group and model group were given constant volume of water intragastrically； admi- nistration groups were given relevant medicine intragastrically， once a day， for consecutive 12 weeks. The levels of serum creatinine （Scr）， urea nitrogen （BUN）， parathyroid hormone （PTH） and inflammatory factors （IL-6， TNF-α） were measured by ELISA. Methyl thymol blue colorimetric method and phosphomolybdic acid method were used to detect the contents of blood calcium and phosphorus. Correlation of inflammatory factors with related calcium and phosphorus metabolism indexes （blood calcium， blood phosphorus， PTH） were investigated with Pearson assay. RESULTS： The linear range of astragaloside Ⅳ， emodin and chrysophanol were 54.537-381.759， 2.960-20.720， 6.318-44.223 μg/mL， respectively. The limits of quantitation were 0.010， 0.288， 0.216 μg/mL； the limits of detection were 0.003， 0.096， 0.072 μg/mL. RSDs of precision， reproducibility and stability tests were all lower than 3.0％. The recoveries were 97.18％-102.33％（RSD＜3％，n＝9）. After modeling （before medication）， serum contents of Scr and BUN in model group and administration group were increased significantly， compared with normal group （P＜0.01）. After medication， above indexes of administration group were decreased significantly， compared with model group and the same group before medication （P＜0.01）. Compared with normal group， the content of blood calcium were decreased significantly， while the contents of IL-6 and TNF-α were increased significantly （P＜0.01）. Compared with model group， the content of blood calcium were increased significantly in JYP medium-dose and high-dose groups， while serum content of PTH in Niaoduqing group， serum contents of PTH and IL-6 in JYP medium-dose and high-dose groups as well as serum content of TNF-α in administration group were decreased significantly （P＜0.05 or P＜0.01）. JYP had no significant effect on blood phosphorus in rats， and there was no correlation of inflammatory factors with related calcium and phosphorus metabolism indexes （P＞0.05）. CONCLUSIONS： The established content determination method is simple， specific and sensitive， and can be used for content determination of astragaloside Ⅳ， emodin and chrysophanol in JYP. JYP can improve renal function of CRF model rats， relieve calcium metabolism disorder and inhibit the expression of inflammatory factors.
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Objective@#To investigate the effects of probiotics on liver function, glucose and lipids metabolism, fecal flora in children with nonalcoholic fatty liver disease (NAFLD), and to further provide a reference for analyzing the feasibility and effectiveness of the treatment of NAFLD.@*Methods@#A total of 120 children with NAFLD during June 2017 to December 2018 in The Fenghua People’s Hospital of Ningbo were randomly divided into observation group and control group, 60 cases in each group. The control group received diet and exercise therapy, while the observation group received orally probiotics based on the control group, and the intervention lasted for 3 months. The indexes of liver function, glucose and lipids metabolism, the effective rate and imbalance of fecal flora in two groups were compared before and after intervention.@*Results@#Before treatment, there were no significant differences in alanine aminotransferase (ALT), aspartate aminotransferase (AST), glutamine transferase (GGT), total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), insulin resistance index (HOMA-IR) and imbalance of fecal flora in two groups were compared before and after intervention (P>0.05). For the comparisons after treatment in two groups, including the ALT (30.49±11.03 vs 24.76±9.54)U/L, AST (37.66±12.91 vs 32.05±12.38)U/L, GGT (20.81±8.32 vs 16.07±6.69)U/L, TC (3.90±0.93 vs 3.41±0.87)mmol/L, TG (1.50±0.42 vs 1.14±0.40)mmol/L, HOMA-IR (1.46±0.53 vs 1.22±0.45), these parameters in observation group was higher than those in control group, and the differences were statistically significant(t=3.04，2.43，3.44，2.98，4.81，2.67，P<0.05); After treatment, the imbalance of fecal flora in the observation group was better than that in the control group, and the difference was statistically significant (Hc=8.34, P=0.02).@*Conclusion@#Probiotics are beneficial for liver function, glucose and lipid metabolism, fecal flora for NAFLD patients in children, so as to enhance the therapeutic effect of NAFLD.
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Objective To investigate the impact of hepatitis A vaccine (HAV) intervention on clinical manifestations and impulse oscillometry (IOS) pulmonary function in children with asthma.Methods Eighty asthma children in the pediatric department of the Southwest Hospital of Third Military Medical University were selected as the control group,78 children were in the intervention group.The attenuated live HAV was adopted to conduct the intervention.The clinical manifestations and IOS pulmonary function were observed in 6 months and 12 mohths after inoculation.The case control study and analysis were performed.Results The symptom control and partial control rate at 6 months after HAV vaccine intervention in the intervention group was 89.8 ％,which was higher than 86.3 ％ in the control group,but the difference was not statistically significant (P＞0.05).The symptom control and partial control rate at 12 months after intervention in the intervention group was 92.3％,which in the control group was 87.6％,the asthma symptoms control situation in the intervention group was improved markedly,the difference was statistically significant (P＜0.05).The peripheral airway viscosity resistance (R5-R20) at 6 months after HAV vaccine intervention in the intervention group was lower than that in the control group,but there was no statistically significant difference (P＞ 0.05);Zrs,Fres,R5 at 12 months after intervention in the intervention group were lower than those in the control group,the difference was statistically significant (P＜0.05).Conclusion HAV vaccine intervention could improve clinical symptoms control and IOS lung function in children with asthma after one year.HAV vaccination has a protective effect on asthma in children.
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Objective To observe the expression change of melanoma-associated antigen(MAGE)-A9 in colorectal cancer (CRC)tissue and to explore its significance.Methods The samples in 23 cases of initially diagnosed CRC in the Affiliated Hospital of Nantong University from January 2006 to December 2008 were collected.The quantitative real-time(qRT)-PCR was adopted to detect MAGE-A9 mRNA expression in cancer tissue and corresponding paracancerous tissue.Its correlation with the clinicopatho-logical features and prognosis was analyzed.Results The positive rate of MAGE-A9 in CRC tissue was significantly higher than that in paracancerous normal tissue(P<0.05).MAGE-A9 protein expression in CRC was related to the clinicopathological features such as tumor differentiation degree(P=0.011),TNM stage(P=0.003),tumor infiltration depth(P=0.001)and lymph node me-tastasis(P=0.003).The survival analysis showed that the expression of MAGE-A9 was closely related to the prognosis of CRC pa-tients.Conclusion MAGE-A9 expression is increased in CRC tissue,suggesting the poor prognosis.