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Objective:To evaluate the feasibility of a novel liver fiducial marker implantation method for internal fixation and removal of rabbit livers, in order to use in Cyberknife tracking therapy.Methods:Experiments were conducted in vivo and in vitro. In the in vivo experiment, three fiducial markers were implanted percutaneously in each liver of ten rabbits under anesthesia, and the fourth fiducial marker with an external catheter and fixed thin wire was implanted ten days later. After the reference group (the first and the second maker), and the casing group (the first and the fourth marker) were respectively registered and tracked with the Cyberknife, the implantation success rate, registration accuracy, and removal safety of fiducial markers were assessed. The tensile test was performed using liver in vitro by measuring the resistance required to dislodge the spring coil fiducial markers and the fiducial markers without spring coil from liver. Results:The intrahepatic catheter implantation and removal of fiducial marker in rabbit liver had a success rate of 100% and no distant migration. The operation-related and postoperative complications were not occurred. All fiducial markers were successfully traced. Compared to the reference group, the casing group had slightly higher translational errors in supero-inferior and antero-posterior directions ( Z=-11.77, -4.57, P<0.05), and lower translational errors in left-right direction ( Z=-2.52, P<0.05). The dislodgement forces for spring coil fiducial markers was (2.23±0.85) N, significantly different with (0.81±0.13) N for fiducial markers without spring coil ( Z=- 2.31, P < 0.05). Conclusions:The spiral coil structure provides superior fixation in the punctured needle channel, the thin line limits the distant displacement of the fiducial marker outside the liver, and the catheter establishes a channel for the removal. The general operation is simple and easy.
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OBJECTIVE To explore the risk signal of ixazomib and provide a reference for clinically rational drug use. METHODS The Open Vigil 2.1 online tool was used to extract the data of adverse drug events （ADE） reported by the database of FDA adverse event reporting system （FAERS） from the launch of ixazomib in America （November 20th， 2015） to the latest update of the Open Vigil website （March 31st， 2023）. The data were mined by using the proportional reporting ratio （PRR） and Bayesian confidence propagation neural network （BCPNN） of the proportional imbalance method. The signals were coded by system organ class （SOC） and preferred term （PT） according to MedDRA v25.1. RESULTS A total of 13 841 ADE reports with ixazomib as the “primary subject” were extracted， involving slightly more male patients （49.53%）， and most of them were 65 years old and above （72.48%）； the reports came from 57 countries/regions， mainly America （52.90%）. A total of 186 positive signals were excavated， with 51 high-intensity， 99 medium-intensity， and 36 low-intensity signals， involving 19 SOCs. The top 50 PT in frequency and signal intensity of PRR included neuropathy peripheral （414 cases， high-intensity signal）， platelet count decreased （379 cases， high-intensity signal）， thrombocytopenia （360 cases， high-intensity signal）， cytopenia （75 cases， high-intensity signal） and neurological symptoms （41 cases， high-intensity signal）. SOC involved included nervous system disorders， investigations， and blood and lymphatic system disorders. ADE occurred most frequently in gastrointestinal diseases （2 588 cases）， including diarrhea （1 077 cases， high-intensity signal）， nausea （737 cases， medium-intensity signal）， vomiting （459 cases， medium-intensity signal）， constipation （275 cases， medium-intensity signal）， and so on. The positive signals of infections and infestations contained the largest number of PTs， and most of them were not recorded in the drug instruction， including 12 high-intensity signals （1 030 cases） and 30 medium-intensity signals （627 cases）， which were mainly distributed in lung infection， upper respiratory infection， gastrointestinal infection， sepsis， herpes zoster and so on. The signals of cardiac amyloidosis （7 cases， high-intensity signal） and acute coronary syndrome （14 cases， high-intensity signal） of cardiac disorders and renal dysfunction （91 cases， medium-intensity signal） of renal and urinary disorders were all strong and had not been recorded in the drug instruction. CONCLUSIONS In addition to routine attention to the common ADE of ixazomib in gastrointestinal diseases，nervous system disorders and blood and lymphatic system disorders， clinical attention should also be paid to various infections that may occur during the treatment of patients， and the occurrence of cardiovascular toxicity and renal dysfunction should be monitored.
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Objective:To investigate the influence of trimethylamine N-oxide(TMAO)on the development of early neurological deterioration(END)in diabetic patients with acute ischemic stroke.Methods:In this cross-sectional study, 108 type 2 diabetes patients with acute ischemic stroke treated at the Department of Neurology in the Affiliated Wuxi People’s Hospital of Nanjing Medical University between October 2019 and November 2020 were consecutively recruited.END was defined as an increase in the National Institutes of Health Stroke Scale(NIHSS)≥ 2 points and exclusion of intracranial hemorrhage or bleeding transformation in cranial imaging evaluation within 5 days of initial deterioration of neurological dysfunction.The patients were divided into 2 groups, an END(n=36)group and a non-END group(n=72). Fasting plasma TMAO was measured using isotope dilution liquid chromatography coupled to tandem mass spectrometry.Results:Of the 108 patients, 36(33.3%)were diagnosed with END, and their plasma TMAO levels were significantly higher compared with patients without END( Z=-3.500, P<0.001). For prediction of END, the area under the ROC curve for plasma TMAO levels was 0.707(95% CI: 0.603-0.811, P<0.001). The frequencies of END in subjects grouped via tertiles of TMAO were 22.2%, 19.4% and 58.3%, respectively, with significant differences between the 3 groups( χ2=14.979, P=0.001). Univariate analysis showed that elevated TMAO( OR=1.160, 95% CI: 1.050-1.282, P=0.004)was associated with END.A multivariate logistic regression model further confirmed the association between TMAO and END( OR=1.145, 95% CI: 1.033-1.269, P=0.010). Conclusions:Increased plasma TMAO levels are associated with END in diabetic patients with acute ischemic stroke.
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ObjectiveTo analyze the polarized light microscopic characteristics， the composition of physical phases and their relative contents of Maifanitum from different origins， and to establish the Fourier characteristic fingerprint of Maifanitum powder crystals by X-ray diffraction（XRD）. MethodA total of 26 batches of Maifanitum samples were selected， and the microscopic characteristics of the sample powders and grinding flakes were observed by polarized light microscopy under single polarized light and orthogonal polarized light， and the main phase compositions and their relative contents were analyzed by powder crystal XRD technique， and the XRD Fourier characteristic fingerprint of Maifanitum was established. The incident light source of XRD was Cu target Kβ radiation， the light tube voltage and light tube current were 40 kV and 40 mA， respectively， the divergence slit was 1°， the scattering slit was 1°， the receiving slit was 0.2 mm， the scanning speed was 5°·min-1 with continuous scanning and scanning range of 5-90°（2θ）， and the step length was 0.02°. ResultThe polarized light micrographs of powders and grinding flakes of Maifanitum were obtained， and the main phases were plagioclase， potassium feldspar and quartz， and a few samples also contained illite， pyrite， iron dolomite， calcite， iron amphibole and chlorite， etc. The relative total content of feldspar phases was 61.9%-82.4%， and the relative content of quartz was 12.6%-33.6%. The XRD Fourier fingerprint analysis method of Maifanitum with 13 common peaks as the characteristic fingerprint information was established， and the similarity calculated by the mean correlation coefficient method was 0.920 9-0.997 7， the similarity calculated by the mean angle cosine method was 0.940 5-0.998 4， the similarity calculated by the median correlation coefficient method was 0.921 1-0.997 5， and the similarity calculated by the median angle cosine method was 0.947 5-0.998 2. ConclusionThe polarized light microscopic identification characteristics of Maifanitum are mainly plagioclase， quartz and potassium feldspar， and the technique of powder crystal XRD Fourier fingerprint analysis can be used for the identification of Maifanitum.
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OBJECTIVE To explore the way to re-use epidermal growth factor receptor-tyrosine kinase inhibitors （EGFR-TKI） in patients with EGFR-TKI-induced interstitial pneumonia （IP）， using osimertinib as an example. METHODS The IP treatment regimen and re-use of EGFR-TKI regimen in a patient who developed IP after the use of osimertinib were analyzed. And a literature review was made by combining the characteristics of the cases which reported in the literature and the characteristics of this case. RESULTS The patient’s IP symptoms due to treatment with osimertinib had resolved after treatment. The patient’s IP symptoms also did not worsen after using almonertinib in combination with hormones as re-use of EGFR-TKI regimen. However， almonertinib was discontinued as the patient experienced disease progression. The adverse reactions of IP needed to be dealt with in time， the EGFR-TKI should be discontinued and symptomatic treatment should be given. CONCLUSIONS EGFR-TKI targeted therapy could be re-selected by replacing EGFR-TKI， adjusting the dose of EGFR-TKI， and using hormones in combination. EGFR-TKI-induced adverse drug reactions of IP are rare， but need to be observed closely. If other EGFR-TKI is used， close monitoring of adverse reactions and curative effects are also required in order to adjust the patient’s treatment plan in time.
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Objective:To investigate the role of depth of anesthesia monitoring in predicting postoperative cognitive impairment in elderly cancer patients.Methods:The clinical data of 70 elderly cancer patients in Shanxi Province Cancer Hospital from February 2020 to February 2021 were retrospectively analyzed. According to the postoperative cognitive function, they were divided into the postoperative cognitive impairment group (20 cases) and the normal postoperative cognitive function group (50 cases). Statistical analyses of the mini mental state examination (MMSE) score of cognitive function, mean arterial pressure (MAP) and bispectral index score (BIS) before anesthesia (T 0), before skin incision (T 1), 1 h after skin incision (T 2), 2 h after skin incision (T 3), at the completion of surgery (T 4), and at the time point of extubation (T 5), as well as the levels of interleukin-6 (IL-6) and central nervous specific protein (S100-β) at 1 d before operation, immediately after surgery and 1 d after surgery between the two groups were performed. Results:The MMSE score of patients in the postoperative cognitive impairment group was lower than that in the normal postoperative cognitive function group [(21±3) points compared with (25±5) points], and the difference between the two groups was statistically significant ( t = 2.98, P < 0.05). The MAP of the two groups at T 1, T 2, T 3, T 4, and T 5 gradually increased (both P < 0.05), the MAP at T 1, T 2, T 3, T 4 was lower than that at T 0 (all P < 0.05), and the MAP at T 5 was higher than that at T 0 (both P < 0.05). There were no statistical differences in MAP between the two groups at T 0, T 1, T 2, T 3, T 4, and T 5 (all P > 0.05). BIS values of the two groups at T 0, T 1, T 2, and T 3 gradually decreased (both P < 0.05), BIS values at T 4 and T 5 gradually increased (both P < 0.05). At T 2 and T 3, BIS value of the postoperative cognitive impairment group was lower than that of the normal postoperative cognitive function group (both P < 0.05). The duration of BIS < 45 in the postoperative cognitive impairment group was longer than that in the normal postoperative cognitive function group [(44.1±7.7) min than (12.6±2.2) min], and the difference between the two groups was statistically significant ( t = 26.68, P < 0.001). The levels of IL-6 and S100-β in the two groups were gradually increased 1 d before surgery, immediately after surgery and 1 d after surgery (both P < 0.05). On the 1st day after surgery, the S100-β level in the postoperative cognitive impairment group was higher than that in the normal postoperative cognitive function group ( P < 0.05). Conclusions:The application of depth of anesthesia monitoring is of high value in predicting postoperative cognitive impairment in elderly cancer patients.
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OBJECT IVE To analyze the situation of comprehensive drug evaluation research in China. METHODS Using the method of bibliometrics ，CiteSpace 5.8.R3 analysis tool was used to summarize the research situation and hotspots from 6 dimensions，such as safety ，effectiveness，economy，innovation，suitability and accessibility. RESULTS & CONCLUSIONS At present，there were many types of researches on safety and effectiveness. The economic evaluation was increasing. There were still not much researches on the comprehensive evaluation of drugs from 6 dimensions. Researchers were concentrated ，and there was less collaboration between researchers or research institutions. In terms of methods ，systematic review ，meta-analysis，clinical observational research and retrospective research were more common. The topic selection of antibacterial drugs ，anti-tumor drugs ， and cardiovascular drugs were more popular. It is recommended to establish a unified method and standard for clinical comprehensive evaluation of drugs ，clarify the coordination medianism of the comprehensive drug evaluation ，make full use of real-world data to enrich the contents of 6 dimensions，implement quality control for all segments of the evaluation ，and form a comprehensive evaluation report with sufficient evidence and definite results ，so as to promote the clinical application of the results.
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Objective:To investigate the relationship between the expression level of circular RNA_0005414 and islet cell function in type 2 diabetes patients.Methods:A total of 110 patients with type 2 diabetes and 106 cases of normal glucose tolerance (control group) in Uygur populations, 64 cases of type 2 diabetes mellitus and 63 cases of normal glucose tolerance (control group) in Han populations were enrolled in the study. All subjects underwent oral glucose tolerance test chemistry panel. Homeostasis model assessment for insulin resistance (HOMA-IR) and β cell function (HOMA-β) were evaluated by homeostasis model as islet cell function indexes. The differentially expressed circular RNAs were screened using RNA sequencing from the peripheral blood monocytes of 5 Uygur patients with type 2 diabetes mellitus and matched controls. The expression level of a significantly up-regulated circular RNA_0005414 was detected and verified, and the relationship between the expression level of circular RNA_0005414 and islet cell function was analyzed.Results:Differential expression profiles of circular RNAs were found in Uygur type 2 diabetic patients . The expression level of circular RNA_0005414 in Uygur type 2 diabetic group was higher than that in Uygur control group ( P<0.01), the expression level of circular RNA_0005414 in Han type 2 diabetic group was higher than that in Han control group ( P<0.01), the expression level of circular RNA_0005414 in Uygur type 2 diabetes group was higher than that in Han type 2 diabetes group, but the difference was not statistically significant ( P>0.05). In the Uyghur and Han groups, Spearman correlation analysis showed that the expression level of circular RNA_0005414 was positively correlated with fasting blood glucose, 2 h plasma glucose after glucose loading, HbA 1C, total cholesterol, fasting insulin, HOMA-IR ( P<0.05) and negatively correlated with HOMA-β ( P<0.01). Partial correlation analysis showed that circular RNA_0005414 expression level was positively correlated with fasting blood glucose, HbA 1C, and HOMA-IR ( P<0.01). Multivariate linear regression analysis showed that circular RNA_0005414 was the only factor affecting HOMA-β in Uygur patients with type 2 diabetes. Conclusion:The expression level of circular RNA_0005414 was closely related to islet cell function in Uygur type 2 diabetes patients, the up-regulation of circular RNA_0005414 may be involved in the occurrence and development of type 2 diabetes in Uygur.
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Objective:To analyze the value of dual energy CT parameters combined with serum procollagen Ⅰ N-terminal propeptide (PⅠNP) and beta C-terminal cross-linked telopeptide of type Ⅰ collagen (β-CTX) in differential diagnosis of spinal bone metastasis from lung cancer and myeloma.Methods:The clinical data of 54 patients with spinal bone metastasis from lung cancer and 50 patients with myeloma in Jincheng People′s Hospital from October 2019 to March 2021 were analyzed retrospectively. All patients were examined by dual energy CT on the day of admission, and the CT values at the energy levels of 40 to 80 keV (energy interval of 10 keV) were recorded. The serum PⅠNP and β-CTX levels were detected by chemiluminescent assay before treatment. The pathological examination results were taken as gold standard, and the CT values at the energy levels of 40 to 80 keV by dual energy CT and serum PⅠNP and β-CTX levels were compared between 2 groups. Receiver operating characteristic (ROC) curve was used to analyze the differential diagnosis value of the CT values at the energy levels of 40 to 80 keV, serum PⅠNP and β-CTX levels alone and combination.Results:The CT values at the energy levels of 40 to 80 keV by dual energy CT and serum PⅠNP and β-CTX levels in patients with spinal bone metastasis from lung cancer were significantly higher than those in patients with myeloma: 79.86 (61.20, 116.32) HU vs. 58.29 (46.92, 64.03) HU, 64.48 (50.27, 90.08) HU vs. 45.78 (38.59, 56.75) HU, 57.35 (43.31, 78.04) HU vs. 43.62 (36.91, 54.06) HU, 52.05 (42.98, 75.79) HU vs. 41.26 (32.84, 51.76) HU, 45.52 (38.55, 63.59) HU vs. 36.68 (28.72, 49.83) HU, 66.35 (31.15, 81.97) μg/L vs. 31.38 (27.76, 34.50) μg/L and 0.61 (0.48, 0.67) μg/L vs. 0.49 (0.47, 0.52) μg/L, and there were statistical differences ( P<0.05 or <0.01). ROC curve analysis result showed that the sensitivity of the combination of the CT values at the energy levels of 40 to 80 keV by dual energy CT was higher than those alone (83.33% vs. 59.26%, 61.11%, 62.96%, 64.81% and 66.67), the area under the curve (AUC) was also higher than those alone (0.882 vs. 0.798, 0.811, 0.817, 0.801 and 0.773), and there were statistical differences ( P<0.01 or <0.05); the sensitivity of the combination of serum PⅠNP and β-CTX levels was higher than those alone (81.48% vs. 57.41% and 62.96%), the AUC was higher than those alone (0.829 vs. 0.753 and 0.729), and there were statistical differences ( P<0.01 or <0.05); the sensitivity of all indexes combined in the differential diagnosis of spinal bone metastasis from lung cancer and myeloma was higher than those of the combination of the CT values at the energy levels of 40 to 80 keV by dual energy CT, the combination of serum PⅠNP and β-CTX levels (98.15% vs. 83.33% and 81.48%), the same as AUC (0.976 vs. 0.882 and 0.829), and there were statistical differences ( P<0.01); there were no significant differences in the specificity of each index alone and combination ( P>0.05). Conclusions:Compared with myeloma, the CT values at the energy levels of 40 to 80 keV by dual energy CT, serum PⅠNP and β-CTX levels in patients with spinal bone metastasis from lung cancer are increased, and the combination of the above indexes has ideal value in differential diagnosis of the two diseases.
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Objective:To investigate the correlation between serum C1q/tumor necrosis factor-associated protein 3 (CTRP3), soluble growth stimulation expression gene 2 protein (sST2), Elabela and prognosis in patients with acute ST-segment elevation myocardial infarction (ASTEMI) after percutaneous coronary intervention (PCI).Methods:The clinical data of 118 ASTEMI patients underwent PCI from March 2019 to March 2021 in Beijing Luhe Hospital, Capital Medical University were retrospectively analyzed. According to whether major adverse cardiovascular events (MACE) occurred within 90 d, the patients were divided into MACE group (36 cases) and non-MACE group (82 cases). The levels of CTRP3, sST2 and Elabela were detected by enzyme linked immunosorbent assay, and the patients were divided into high CTRP3 group and low CTRP3 group, high sST2 group and low sST2 group, high Elabela group and low Elabela group according to the median, there were 89 cases in each group. MACE was the end point event. Kaplan-Meier survival curve was drawn, and compared by log-rank test. Multivariate Cox regression was used to analyze the influencing factors of MACE after PCI in patients with ASTEMI. Receiver operating characteristic (ROC) curve was drawn to analyze the prediction efficiency of MACE.Results:The sST2 in MACE group was significantly higher than that in non-MACE group: (49.56 ± 17.67) μg/L vs. (30.76 ± 12.83) μg/L, the CTRP3 and Elabela were significantly lower than those in non-MACE group: (0.82 ± 0.42) μg/L vs. (2.02 ± 0.58) μg/L and (17.66 ± 3.85) μg/L vs. (21.84 ± 3.18) μg/L, and there were statistical differences ( P<0.01). The incidence of MACE in low CTRP3 group was significantly higher than that in high CTRP3 group: 49.15% (29/59) vs. 11.86% (7/59), the incidence of MACE in lowe Elabela group was significantly higher than that in high Elabela group: 42.37% (25/59) vs. 18.64% (11/59), and there were statistical differences ( χ2 = 19.35 and 7.84, P<0.01); the incidence of MACE in high sST2 group was significantly higher than that in low sST2 group: 38.98% (23/59) vs. 22.03% (13/59), and there was statistical difference ( χ2 = 4.00, P<0.05). The time from admission to MACE was defined as the survival time. Kaplan-Meier survival curve analysis result showed that the survival time in high CTRP3 group was significantly longer than that in low CTRP3 group: (81.02 ± 3.23) d vs. (56.31 ± 4.74) d, the survival time in low sST2 group was significantly longer than that in high sST2 group: (74.52 ± 3.87) d vs. (61.12 ± 5.07) d, the survival time in high Elabela group was significantly longer than that in low Elabela group: (77.95 ± 3.48) d vs. (58.64 ± 4.89) d, and there were statistical differences ( P<0.05). Multivariate Cox regression analysis result showed that the LVEF, TnI, CTRP3, sST2 and Elabela were independent influencing factors of MACE after PCI in patients with ASTEMI ( HR = 1.632, 1.124, 0.712, 1.482 and 0.676; 95% CI 1.531 to 3.271, 1.012 to 1.482, 0.547 to 0.842, 1.063 to 1.852 and 0.536 to 0.725; P<0.01). ROC curve analysis result showed that the cut-off values of CTRP3, sST2 and Elabela in prediction MACE after PCI in patients with ASTEMI were 0.79, 52.17 and 16.82 μg/L respectively, areas under curve were 0.833, 0.732 and 0.739 respectively. Conclusions:CTRP3, sST2 and Elabela can be used as indicators to predict the early prognosis of ASTEMI patients after PCI.
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With serious environmental problems and the aging of population， the incidence of cancers worldwide has increased dramatically. For modern medicine， cancer is an incurable malignant disease with a high metastasis rate and strong cell proliferation and invasion ability. At present， clinical anti-cancer therapies mainly include chemotherapy and radiotherapy， but most chemotherapy drugs can cause serious side effects. Therefore， Chinese medicine with high safety has been widely used in anti-cancer treatment， which can inhibit the proliferation of cancer cells， improve the quality of life， and prolong life. Ligustrazine is a pyrazine alkaloid isolated and purified from Chuanxiong Rhizoma， which has pharmacological effects， such as anti-fibrosis， anti-oxidation， and anti-tumor. In recent years， ligustrazine， as an index active component of Chuanxiong Rhizoma alkaloids， has gradually become one of the hot spots in clinical medical research due to its pharmacological actions， and its anti-tumor effect has attracted more attention from researchers. The present study mainly investigated the anti-cancer effect of ligustrazine from the induction of tumor cell apoptosis and autophagy， inhibition of cell proliferation and migration， reversal of multidrug resistance of cancer cells， and inhibition of angiogenesis， and the anti-tumor efficacy was observed in various malignancies such as gastric cancer， lung cancer， rectal cancer， bladder cancer， breast cancer， and ovarian cancer. In addition， ligustrazine can be combined with cisplatin， paclitaxel， podophyllotoxin， chalcone， curcumin， and other drugs to exert an anti-tumor effect. This study conducted a literature review based on the anti-tumor mechanism of ligustrazine to provide a reference for the treatment of clinical malignancies.
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Biotin-thiamine-responsive basal ganglia disease is a rare treatable autosomal recessive neurometabolic disorder caused by mutations in SLC19A3 gene, encoding a transporter of thiamine across the plasma membrane. In the present study, a 29-year-old male patient with epilepsy as the first symptom, accompanied by hypokinesia, extraocular muscle paralysis and delayed dystonia was reported. The brain magnetic resonance imaging revealed abnormal symmetrical signals of bilateral caudate nucleus and lenticular nucleus. The patient was diagnosed as biotin-thiamine-responsive basal ganglia disease by gene detection. After treatment with biotin and thiamine, the symptoms were relieved and the brain lesions subsided.
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Objective:To evaluate the clinical outcomes of patients with borderline developmental dysplasia of the hip (BDDH) and cam-type femoroacetabular impingement syndrome (FAIS) after hip arthroscopy.Methods:Data were retrospectively reviewed for patients with BDDH and cam-type FAIS who underwent hip arthroscopy surgery from June 2017 to December 2019. A total of 32 patients were enrolled, with a mean age of 36.13±8.67 years (range, 20-50 years), including 15 males and 17 females. The preoperative lateral center-edge angle was 22.3°±1.6° (range 20.1°-24.7°), while the preoperative α angle was 64.1°±4.6° (range, 56.0°-69.8°). All patients were treated with arthroscopic limited acetabular plasty, labral repair, femoral osteoplasty, and capsular plication after excluding from external hip diseases by ultrasound-guided hip blocking test. The visual analogue scale (VAS), modified Harris Hip Scores (mHHS) and International Hip Outcome Tool-12 (iHOT-12) scores were used to evaluate the clinical effects.Results:All patients were followed up, and the mean follow-up time was 2.5±0.8 years (range, 2.0-4.7 years). The VAS score decreased from 6.07±1.56 to 1.96±0.92 at 1 year and to 1.86±1.01 at 2 years after operation ( F=112.64, P<0.001); the mHHS score increased from 53.87±13.04 to 86.12±8.64 at 1 year and to 88.71±8.15 at 2 years after operation ( F=101.70, P<0.001); the iHOT-12 score was improved from 40.00±7.33 to 76.27±9.50 at 1 year and to 78.67±10.31 at 2 years after operation ( F=134.91, P<0.001). The α angle improved to 40.27°±4.52° (range, 34.8°-49.7°) with significant difference ( t=9.24, P<0.001). Conclusion:Hip arthroscopy can achieve satisfied short-term outcomes in treating BDDH and cam-type FAIS with few complications and less trauma.
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Objective:To explore the feasibility of recoverable fiducial marker implantation guided using the intelligent navigation bronchoscopy technology in the Cyberknife Synchrony-based respiratory tracking.Methods:CT scans of an inflatable pig lung after anti-rot processing were obtained. Then, eight simulated tumor lesion sites were designed in the left and right lung lobes using intelligent navigation software, with four classified as the sputum bronchial environment group and four classified as the wet bronchial environment group. Based on the implantation principle of Cyberknife fiducial markers, 32 recoverable fiducial markers were implanted around various simulated tumor lesions via bronchus under intelligent guidance. Then, the end-expiratory state of the pig lung was simulated, the pig lung was scanned again to obtain CT images of the implanted recoverable fiducial markers, and the number of successfully implanted fiducial markers was recorded. Eight deliverable Synchrony treatment protocols were designed using the Cyberknife planning system (Multiplan v4.6), and then the pig lung with simulated respiratory movements was exposed to radiation. After radiation, the implanted recoverable fiducial markers were retrieved using the bronchoscopy technique, and the number of successfully retrieved fiducial markers was recorded. Moreover, the translational errors, rotational errors, and rigid body errors were extracted from the Cyberknife log file and analyzed.Results:No recoverable fiducial markers slipped or fell during the experiment. Thirty-two recoverable fiducial markers were successfully implanted and recovered under the guidance of intelligent navigation bronchoscopy, with implantation and recovery success rates of both 100%. Moreover, the tracking rate and rigid body errors of the fiducial markers were 100% and less than 5 mm, respectively. The data from the Cyberknife log file indicated that there was no significant difference between the sputum bronchial environment group and the wet bronchial environment group in the translational errors in the left-right direction, the rotational errors in the roll direction, and the rotational errors in the pitch direction ( P>0.05). Compared to the wet bronchial environment group, the sputum bronchial environment group had slightly higher translational errors in front-back ( Z=-3.57, P<0.01) and cranio-caudal ( Z=-2.53, P<0.05) directions, lower rotational errors along the yaw axis ( Z = -3.88, P < 0.01), and lower rigid body error ( Z=-3.32, P<0.01), and the differences were all statistically significant. Conclusions:The recoverable fiducial marker implantation guided using the intelligent navigation bronchoscopy technology is feasible. Recoverable fiducial markers are stable in the bronchus of the phantom, and the Cyberknife tracking precision can meet clinical requirements. Therefore, the recoverable fiducial marker implantation guided using the intelligent navigation bronchoscopy technology has promising prospects in clinical and teaching applications.
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Objective:To understand the expression levels of γδT cells and CD4 + CD25 + regulatory T cells in the peripheral blood of HIV-infected/AIDS patients, and explore the correlation and possible relationship between γδT cells and CD4 + CD25 + regulatory T cells in the progression of HIV infection/AIDS Mechanism. Methods:Immunofluorescent monoclonal antibody labeling technology and flow cytometry were used to detect 12 cases of AIDS, 19 cases of intermediate HIV infection, 15 cases of early HIV infection, and 30 cases of healthy physical examination in peripheral blood CD3 + T cells and CD4 + The expression levels of T cells, CD8 + T cells, γδT cells, CD4 + CD25 + regulatory T cells; Pearson was used to analyze the correlation between γδT cells and CD4 + CD25 + regulatory T cells. Results:The expression (Mean± SD, %) of γδT cells in the peripheral blood of the AIDS group, the mid-stage HIV infection group, the early HIV infection group and the healthy control group were: 4.46±1.37, 3.59±0.67, 3.12±0.33, 1.73±0.36, group The time ratio, F=6.091, P=0.018. The expression (Mean± SD, %) of CD4 + CD25 + regulatory T cells in the peripheral blood of the AIDS group, the mid-stage HIV infection group, the early HIV infection group, and the healthy control group were: 10.28±1.94, 7.37±1.03, 6.68±0.58, 4.03±0.82, ratio between groups, F=13.568, P=0.002. The comparison of γδT and CD4 + CD25 + regulatory T cells among the four groups is statistically significant, AIDS group>HIV mid-infection group>HIV early infection group>control group. In terms of correlation, γδT, CD4 + CD25 + regulatory T cells are negatively correlated with CD4 + T cells ( r value are -0.982, -0.712, P value are 0.001, 0.002, respectively), and positively correlated with CD8 + T cell counts ( r value are 0.873 , 0.809, P value are 0.000 and 0.000 respectively); γδT cells are positively correlated with CD4 + CD25 + regulatory T cells ( r=0.911, P=0.000). Conclusions:HIV infection induces the proliferation of γδT cells and CD4 + CD25 + regulatory T cells, both of which participate in the immune response caused by HIV infection. γδT cells are positively correlated with CD4 + CD25 + regulatory T cells, and the two may have a synergistic effect.
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Objective:To compare and analyze the differences of common dose indicators before and after operation of 3D-printing template assisted by CT-guided 125I seed implantation in the treatment of bone metastases to guide clinical application. Methods:A retrospective analysis of 12 lesions in the 10 patients (9 males and 1 female, median age 65 years), who underwent seed implantation surgery for bone metastases in the Tianjin Third Central Hospital from June 2019 to January 2021, was conducted. All the lesions were adopted for 3D-printing template to guide seed implantation and the prescribed dose was 120-140 Gy. The differences of common dose indicators between preoperative treatment plan and postoperative verification plan were compared, including D90 (dose received by 90% of the target volume), D100 (dose received by 100% of the target volume), V90 (the volume percent for tumor target volume receiving 90% of the prescribed dose), V100 (the volume percent for tumor target volume receiving 100% of the prescribed dose), V150 (the volume percent for tumor target volume receiving 150 % of the prescribed dose), as well as the quantity of seeds planned and actually used. The paired t-test was performed to compare and analyze those parameters. Results:There was no statistically significant difference in pre- and postoperative D90, D100, V90, V100, V150 ( P > 0.05). The actual quantity of seeds used after operation was more than that of the preoperative planned quantity and the difference was statistically significant ( t=-2.930, P < 0.05). Conclusions:The clinical use of 3D-printing template assisted by CT-guided 125I seed implantation for bone metastasis should be promoted since the dose is accurate and the requirements of preoperative plan can be achieved.
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Objective:To investigate the effect of amphotericin B or its liposomes combined with antimony sodium gluconate (antimonial) in the treatment of refractory Kala-azar.Methods:Four patients with Kala-azar who relapsed or were resistant to antimony after treatment were admitted to the First Hospital of Lanzhou University. The clinical medical records were retrospectively analyzed, including the general information (gender, age, etc), diagnosis and treatment process, clinical manifestations, treatment methods and treatment effect.Results:The clinical symptoms of four patients were relieved after treatment with amphotericin B or its liposomes combined with antimonial. Reexamination of bone marrow smear showed no Leishman-Donovan body. There was no recurrence after six months of follow-up.Conclusion:Amphotericin B or its liposomes combined with antimonial can be used in the treatment of refractory Kala-azar.
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Objective:To observe the efficacy of acupuncture combined with repetitive transcranial magnetic stimulation (rTMS) in the treatment of cognitive impairment after traumatic brain injury.Methods:A total of 40 patients were randomly divided into treatment group and control group with 20 cases each. The control group received routine basic therapy and cognitive function training, and the treatment group received rTMS combined with acupuncture based on the control group treatment. Both two groups were treated for 4 weeks. The MMSE, MoCA, latency and amplitude were used before and after treatment to compare the difference between the two groups.Results:The MMSE (23.60 ± 2.16 vs. 21.70 ± 2.87, t=-2.366) and MoCA (21.75 ± 3.35 vs. 19.05 ± 2.46, t=-2.903) scores in the treatment group were significantly higher than those in the control group ( P<0.05). There were no significant difference in latency and amplitude of motor evoked potential between both groups before and after treatment ( P>0.05). Conclusion:Acupuncture combined with rTMS can improve the cognitive function of patients with cognitive impairment after traumatic brain injury.
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Objective:To investigate the predictive value of C-reactive protein to lymphocyte ratio (CLR) for stroke-associated pneumonia (SAP).Methods:Consecutive patients with acute ischemic stroke admitted to the Department of Neurology, Guangming Ophthalmic Hospital from September 2018 to December 2020 were enrolled retrospectively. Fasting venous blood was taken the next morning after admission to detect the levels of C-reactive protein and lymphocytes. The baseline clinical data of the patients in the SAP group and the non-SAP group were compared. Multivariate logistic regression analysis was used to identify the independent predictors of SAP. The predictive value of CLR for SAP was evaluated by receiver operator characteristic (ROC) curve analysis. Results:A total of 479 patients with acute ischemic stroke were included. The median CLR was 3.69×10 -9, 81 patients (16.9%) had SAP. The incidence of SAP in the high CLR group was significantly higher than that in the low CLR group (26.7% vs. 7.1%; P=0.001). Univariate analysis showed that there were significant differences in age, atrial fibrillation, dysphagia, baseline National Institutes of Health Stroke Scale score, stroke etiology type, leukocyte count, fasting blood glucose, total cholesterol and CLR between the SAP group and the non-SAP group (all P<0.05). Multivariate logistic regression analysis showed that after adjusting for confounding factors, CLR was an independent predictor of SAP (odds ratio 3.472, 95% confidence interval 1.431-14.706; P=0.013). ROC curve analysis showed that the area under the curve of CLR predicting SAP was 0.735 (95% confidence interval 0.693-0.774; P<0.001). The optimal cut-off value was 6.14 ×10 -9. The sensitivity and specificity were 69.1% and 72.6% respectively. Conclusion:Higher baseline CLR can predict SAP risk in patients with acute ischemic stroke.
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Objective:To investigate the clinical characteristics, diagnosis, treatment and outcome of patients with human herpesvirus 7 (HHV-7) viral encephalitis after allogeneic hematopoietic stem cell transplantation (allo-HSCT).Methods:The clinical manifestations, laboratory characteristics, diagnosis and treatment process and outcome of 3 patients with HHV-7 viral encephalitis after allo-HSCT in Hebei Yanda Lu Daopei Hospital from 2018 to 2020 were retrospectively analyzed, and the related literature was reviewed.Results:The clinical features of 3 patients with HHV-7 viral encephalitis after allo-HSCT included fever, headache, vomiting, apathy, etc., without specific symptoms or signs. The conventional white blood cell count in the cerebrospinal fluid was normal or slightly higher, mainly lymphocytes, and the cerebrospinal fluid protein was normal or slightly higher. The HHV-7 virus DNA in cerebrospinal fluid was positive, and the treatment with ganciclovir or foscarnet was effective. The prognosis was favorable in two mild cases, but one case with cerebral hemorrhage died eventually.Conclusions:HHV-7 viral encephalitis is a rare infection after allo-HSCT, and it can be easily misdiagnosed due to lack of typical symptoms and indications for routine laboratory tests. The detection of HHV-7 DNA in the cerebrospinal fluid can help confirm the diagnosis. Currently, there is no standard treatment programs, but ganciclovir and foscarnet are effective.