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Objective:To investigate the application value of right-hand rule in determining left-right axis and fetal situs in prenatal MRI.Methods:The prenatal MRI data of 254 fetuses were included retrospectively in West China Second University Hospital, Sichuan University from December 2017 to February 2021, which were followed by clear postpartum diagnosis. Fetal left-right axis and situs (orientation of gastric vacuole, liver and heart) were determined by the same radiologist blindly using general experience and right-hand rule respectively, meanwhile, results and time of each case were recorded. The right-hand rule was described in detail below: use your right hand to make a fist, and with thumb outstretched; the fetal head was represented by your right fist, the forearm represented the fetal body, the dorsal side of your fist represented the fetal occiput and spine column, the palm side represented the fetal belly, and your four fingers represented the fetal face, then the left side of fetus was exactly the direction your thumb pointing to. The postpartum imaging was used as the gold standard for situs anomalies. The time to determine the fetal left-right axis was compared using paired t test for statistical analysis. Results:Four fetuses were found situs anomalies in postpartum imaging. There were 1 missed case and 1 misdiagnosed case when using general experience to determine fetal situs, neither missed case nor misdiagnosis were present when using right-hand rule. The average time of using general experience or right-hand rule to determine the fetal left-right axis and situs were (35±6)s and (24±9)s respectively, and the difference was statistically significant ( t=20.65, P<0.001). Conclusions:The right-hand rule is an accurate and efficient method for determining left-right axis and situs in prenatal MRI, which can effectively reduce missed diagnosis and misdiagnosis of situs anomalies, especially in situs inversus totalis.
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Breastcancerin females, which is consideredthe most dreadfuldisease in India andthe worldas compared toother gynaecological cancers,demands extensive care and proper medicationin order to control itsprogressive growth. In addition to the conventional care ofthe patients, Complementary andAlternative Medicine(CAM)is administeredin a controlled way through proper guidance and counselling in orderto attainimprovedphysical andmental health forthe patients.Objective: The aim of the study wasto assess the effectiveness of CAMcomprehensive nursing interventionsand their benefit forpatients who havebreast cancer and gynaecological tumours.Methods: Statistical data was used to map the adult womendiagnosed with breast and gynaecological cancer and who were set to start new chemotherapy treatments. A total of 450 patients from different states of East India were enrolled in the studyover a period of four years. The patients wereselectedbased on their preference for undergoing CAM.The research was conducted usingacross-sectionalanonymous self-administered questionnaireto examine women's perspectivestowards the use of CAM and itseffect on their mental andphysical health.Results:42%of the women preferred theuseofCAM astheir alternative treatment. Breast cancer patients disclosed that 48.1% of them had used CAM and 39% of women with gynaecological cancersstated that they had usedCAM. The results further indicated a less frequent deteriorationin the health of CAM users(38.4%) thantonon-users(55%). In terms of those who utilizedvitamins and nutritional diets,60% of the participants reported using a proper diet, including antioxidants, minerals, vitamins and herbs etc. 37% opted for spiritual healing through yoga, 26% utilized energy healing, 42.4% utilized acupuncture,72% preferred massagesand 23% of patients utilized chiropractic methods.The use of CAM was foundmainlyin the patients with proper education and awareness and those with a family history of cancer who were not receiving the necessary care from their previous primary physician.Conclusion:CAM still requiresextensive research in terms of its applications in dealing with patients and in orderto successfully launch programmes aimed at promoting its useworldwide andto eradicate all the other false notions about it.[Ethiop. J. Health Dev. 2022; 36(2):000-000]Keywords: Breast Cancerand gynaecological tumours,Complementary And Alternative Medicine (CAM), Complementary Oncology,Quality Of Life, Nutritional Diet and Spiritual Healing, HRQL (Health-Related Quality Of Life).IntroductionCancer has been the primaryconcern in Indiafrom the onset,resulting in thousands of deaths due to the lack of adequatemedication and therapy.Breast cancer is considered to bea common invasive form of cancer which is responsible for the second highest mortality rate among the primaryfatal conditions of cancer-causing deaths in women. Under the National Cancer Registry Program,the breast, cervix, uteri,and oral cavity(7)are the most common cancer sitesin women. According to statistics, 50-60% of all cancers amongIndian women are commonly found inthe cervix uteri, breast, corpus uteri and ovaries,which are the main organs forcancer invasion. The percentage of women who experience these types of cancer is increases, with more women becoming susceptible to breast cancer, in women up to 3-8% suffer fromovarian cancer,0.5-4.8%have cancer of the corpus uteri, 1-3% have vulva and/or gestational trophoblastic tumours and a staggering75,000 or more women have breast cancer. With the advancements of the disease through time,research programs were also improved in order to enable the improvement of existing measures and/or the development of new measures aimed at combating the diseas and decreasing mortality rates. Apart from the conventional chemotherapy technique,various other programs have been introduced andencorporated into treatment regimes in order to improve the lives of those who are affected by cancer.Complementary andAlternative Medicine (CAM) emphasizesthe methods and practices that are therapeutic and which help diagnose or curethe disease,these methods are intended tocomplement the conventional methods and can be used in place of mainstream medicine. Women with breast cancer and other gynaecological tumoursare increasingly inclined towards the use of CAM. With the increasing number of cancer reports in Indiaand the world,and with the principal amount leading to mortality, women with proper education and awareness are inclined to choosealternative methods rather than the old conventional ones. The side-effects resulting from the chemotherapy are immense and toxic,which is one of the reasons women are inclined to choose.Various research projects and cumulative studies have been conducted in order to review and discoverthe
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Breast Neoplasms , Medical Oncology , Medicine , Neoplasm, Residual , DietABSTRACT
ObjectiveTo study the mechanism of Shenbai Jiedu prescription inhibiting the proliferation of HCT116 colorectal cancer （CRC） cells by regulating the phosphatase and tensin homolog deleted on chromosome ten （PTEN）/phosphatidylinositol 3-kinase （PI3K）/ protein kinase B （Akt） signaling pathway. MethodShenbai Jiedu prescription was extracted by water extraction and alcohol precipitation to prepare freeze-dried powder. HCT116 cells were cultured in vitro， and treated with different concentrations of Shenbai Jiedu prescription （2， 4， 8， 16 g·L-1）. The inhibitory effect of Shenbai Jiedu prescription on the proliferation of HCT116 cells was tested by methyl thiazolyl tetrazolium （MTT）. Real-time quantitative PCR was used to detect the mRNA expression levels of PTEN， PI3K， Akt， glycogen synthase kinase-3β （GSK-3β）， c-Myc， survivin and Cyclin D1. Western blot was employed to measure the protein expression levels of PTEN， phosphorylated PTEN （p-PTEN）， PI3K， Akt， phosphorylated Akt （p-Akt）， GSK-3β， phosphorylated GSK-3β （p-GSK-3β）， c-Myc， survivin and Cyclin D1， β-catenin nuclear import was explored by immunofluorescence assay. ResultCompared with the control group， Shenbai Jiedu prescription inhibited the proliferation of HCT116 cells in a dose-dependent manner （P<0.01）. Compared with the control group， the mRNA expression levels of PTEN and GSK-3β were up-regulated whereas those of PI3K， Akt， c-Myc， survivin and CyclinD1 were down-regulated after treatment with Shenbai Jiedu prescription （P<0.01）. The protein expression levels of PTEN， p-PTEN and GSK-3β were up-regulated whereas those of PI3K， Akt， p-Akt， GSK-3β， p-GSK-3β， c-Myc， survivin and CyclinD1 were down-regulated （P<0.05， P<0.01）. Immunofluorescence assay showed that Shenbai Jiedu prescription suppressed β-catenin nuclear import in HCT116 cells. ConclusionShenbai Jiedu prescription inhibited the proliferation of HCT116 cells via the mechanism of regulating the PTEN/PI3K/Akt signaling pathway.
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Objective:To explore the effectiveness of folate-coupled quantum dots (FA-QD) immunomagnetic beads method for detecting circulating tumor cells (CTC) in epithelial ovarian cancer and the association of CTC with clinicopathological features of tumor patients.Methods:A total of 67 ovarian cancer patients in Shanxi Provincial People's Hospital from August 2019 to January 2020 were selected. Ovarian cancer SKOV-3 cells were divided into 5 cell number gradients (0, 100, 150, 200, 300), the detection rates of CTC were compared by using epithelial cell adhesion molecule (EpCAM) immunomagnetic beads (single standard method) and FA-QD immunomagnetic beads method (double standard method). The number of CTC in peripheral blood of ovarian cancer patients was detected by using FA-QD immunomagnetic beads method, and those with positive CTC under fluorescence microscope were treated as CTC positive patients. The association of CTC with clinicopathological factors and tumor markers of tumor patients was analyzed.Results:The average capture efficiency rate of CTC in SKOV-3 cells detected by FA-QD immunomagnetic beads method (83.4%) was higher than that by EpCAM immunomagnetic beads method (70.3%). Among 67 patients of ovarian cancer, the proportion of CTC positive patients was 30.0% (3/10) in stage Ⅰ-Ⅱ, 91.9% (34/37) in stage Ⅲ, 95.0% (19/20) in stage Ⅳ, and the difference was statistically significant ( P < 0.05). The proportion of CTC positive patients with lymph node metastasis was higher than that of patients without lymph node metastasis [97.1% (33/34) vs. 69.7% (23/33)], and the difference was statistically significant ( P < 0.05). The proportion of CTC positive patients with human epididymis protein 4 (HE4)>110 pmol/L was lower than that of patients with HE4 ≤ 110 pmol/L [58.8% (10/17) vs. 92.0% (46/50)], and the difference was statistically significant ( P = 0.005). There were no statistically significant differences in the proportion of CTC positive patients stratified by age, menopause, pathological differentiation, distant metastasis, carbohydrate antigen (CA) 125, CA199, carcino-embryonic antigen (CEA) (all P > 0.05). Conclusions:FA-QD immunomagnetic beads method can effectively detect CTC in peripheral blood of patients with epithelial ovarian cancer. The level of CTC in patients with epithelial ovarian cancer is related to lymph node metastasis, clinical TNM stage and HE4 level.
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Objective@#To analyze the status of follow-up cell testing of HIV/AIDS cases among young students aged 15-24 in Guangdong Province from 2008 to 2019.@*Methods@#Using the historical database downloaded from the AIDS Comprehensive Prevention and Control Information System from January 1, 2018 to December 31, 2019, eligible newly discovered cases were screened by year and were linked with follow-up database. Joinpoint regression model and trend test were used to explore the annual changes in the follow-up and CD4 testing status, and Logistic regression was used to analyze relevant influencing factors.@*Results@#The number of infected students showed a rapid upward trend before 2015(APC=41.7，β=0.3，P<0.01), and the growth rate slowed down(APC=3.6，β=-0.3，P<0.01). The proportion of follow-up and CD4 testing completed within one year increased from 58.3% in 2008 to 93.6% in 2019, and the timely detection rate increased from 33.3% in 2008 to 86.2% in 2019. The Cochran Armitage trend test was statistically significant. Pairwise comparison test showed time trends of the idnex differed in regions and education groups (Z=4.7，8.7，9.8，P<0.01). The Pearl River Delta region, cases from other cities in the province, with precise transmission routes, from voluntary counseling and testing, and cases flowing within the province, the proportion of follow up and testing completed within one year is relatively high (P<0.05).@*Conclusion@#The growth rate of HIV/AIDS cases among young students aged 15-24 in Guangdong Province has slowed down in recent years. The route of infection, source and flow of cases affect follow-up and testing compliance. And to do a good job of referrals for off-site mobility, and explore and promote student-friendly VCT service models.
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Objective:To observe the clinical characteristics and reproductive outcome of patients with globozoospermia syndrome (also called round-headed spermatozoa).Methods:The data of 5 patients with round-headed spermatozoa and 20 healthy men in the reproductive center of Shanxi Maternal and Child Hospital and Shanxi People′s Hospital from July 2016 to March 2020 were collected. Among them, the wife was healthy. The peripheral blood chromosome, AZF gene, semen routine and morphology, sex hormone series were detected for the man, and the outcome of intracytoplasmic sperm injection (ICSI) was observed for the patients.Results:The average length of infertility in 5 patients with round-headed sperm was (4.4±1.8)years, and the round-headed sperm rate of 5 patients were all over 95% (including 1 case with round-headed sperm rate of 99%, 3 cases with round-headed sperm rate of 98%, and 1 case with round-headed sperm rate of 96%). The chromosome, AZF gene of 5 patients were normal. The sperm motility [progressive motility(PR) rate+ non progressive motility (NP) rate] of patients with globozoospermia syndrome was significantly lower than that of the healthy control group ( P<0.05). There was no significant difference in sex hormone, sperm count, sperm density, PR(%) and sperm DNA fragmentation rate compared with normal fertility group ( P>0.05). All the 5 patients were treated by assisted reproductive technology with ICSI. Two patients were pregnant, including one patient with abortion and one patient with singleton. Conclusions:There are no other abnormal phenotypes in patients with round-headed spermatozoa except for the low morphology and motility of round headed spermatozoa. Assisted reproductive technology may be an effective way to assist pregnancy.
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OBJECTIVE@#To explore the genetic basis for a girl with febrile convulsion as the main manifestation.@*METHODS@#The child was subjected to whole exome sequencing (WES) and copy number variation sequencing(CNV-seq). Fluorescence quantitative PCR was carried out to validate the microdeletion in her family.@*RESULTS@#The 7-year-old girl was diagnosed with febrile convulsion (complex type) for having fever for 3 days, mild cough and low thermal convulsion once. Her father, mother and aunt also had a history of febrile convulsion. A heterozygous deletion with a size of approximately 1.5 Mb was detected in the 16p13.11 region by WES and CNV-seq. The deletion has derived from her father and was confirmed by fluorescence quantitative PCR.@*CONCLUSION@#16p13.11 microdeletion syndrome has significant clinical heterogeneity. Different from those with epilepsy, mental retardation, autism, multiple malformations, carriers of 16p13.11 deletion may only manifest with febrile convulsion. Deletion of certain gene(s) from the region may be related to febrile convulsion and underlay the symptom of this child.
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Child , Female , Humans , DNA Copy Number Variations , Epilepsy , Seizures/genetics , Seizures, Febrile/genetics , Exome SequencingABSTRACT
Objective To investigate the rationality and efficacy of enhanced recovery after surgery (ERAS) in liver transplant recipients. Methods Clinical data of 465 liver transplant recipients were retrospectively analyzed. All recipients were divided into the ERAS group (n=163) and control group (n=302) according to whether they received ERAS. The severity of disease in the ERAS group was worse than that in the control group. Operation situations including the operation time, anhepatic phase and intraoperative blood transfusion volume of the liver transplant recipients were observed and recorded. Postoperative recovery conditions including the length of intensive care unit (ICU) stay, total length of hospital stay, total ventilator removal time at postoperative 28 d and postoperative re-intubation rate were recorded. The survival rates at 90 d, 180 d and 1 year after liver transplantation were calculated. The influencing factors of survival rate of liver transplant recipients were analyzed. Results The anhepatic phase in the ERAS group was 45 (39, 53) min, significantly longer than 40 (32, 48) min in the control group (P < 0.05). The volume of erythrocyte infusion in the ERAS group was 10 (7, 13) U, significantly less than 18 (10, 28) U in the control group (P < 0.05). The length of postoperative ICU stay and total length of hospital stay in the ERAS group were 135 (84, 212) h and 24 (18, 33) d, significantly shorter than 154 (103, 253) h and 34 (20, 50) d in the control group (both P < 0.05). Total ventilator removal time at postoperative 28 d was 26 (25, 27) d, significantly longer than 26 (23, 27) d in the control group (P < 0.05). The postoperative re-intubation rate in the ERAS group was 11.0%, significantly lower than 20.8% in the control group (P < 0.05). The 90 d, 180 d and 1-year survival rates in the ERAS group were 92.8%, which were significantly higher than 81.1%, 78.1% and 75.7% in the control group (all P < 0.05). ERAS and operation time were the independent influencing factors of survival rate of liver transplant recipients (both P < 0.05). Conclusions ERAS after liver transplantation can improve the survival rate of recipient, shorten the length of hospital stay, reduce the re-intubation rate and accelerate the rehabilitation after liver transplantation.
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Objective To investigate the influence of preoperative splenectomy on the prognosis after liver transplantation.Methods The retrospective cohort study was conducted.The clinical data of 95 patients who underwent liver transplantation in the Third Affiliated Hospital of Sun Yat-sen University between January 2004 and January 2014 were collected.Thirty-five patients undergoing preoperative splenectomy and pericardial devascularization and 60 undergoing spleen-preserving liver transplantation were allocated into the study group and control group,respectively.All patients received modified piggyback liver transplantation by the same team.Observation indicators:(1) intra-and post-operative situations;(2) follow-up and survival.The follow-up using telephone interview and outpatient examination was performed once every a week within 3 months postoperatively,once every one month within 6 months postoperatively and once every 3 months after 1 year postoperatively up to January 2016,including routine blood test,plasma-drug concentration of immunosuppressive agent and function of liver and kidney.Ultrasound and abdominal CT were used to monitor the long-term complication and survival.The measurement data with normal distribution were represented as (x)±s,and comparison between groups was done by the t test.Comparison of count data was done by the chi-square test.Results (1) Intra-and post-operative situations:all patients underwent successful liver transplantation.The operation time,volumes of intraoperative blood loss and blood transfusion were (483 ± 136) minutes,(5 683±2 950) mL,(4 887±3 682) mL in the study group and (392± 103)minutes,(3 522± 1 885)mL,(3 455±2 630)mL in the control group,respectively,with statistically significant differences between groups (t=3.683,4.358,2.202,P＜0.05).Six patients in the study group had intraoperative portal vein thrombosis (PVT),including 4 in level 1,1 in level 2 and 1 in level 3,and no patients in the control group,showing a statistically significant difference between groups (x2 =1.979,P＜0.05).Five patients with PVT in level 1 or 2 underwent thrombectomy and then end-to-end anastomosis of PV.One patient with PVT in level 1 had PVT recurrence and was cured by postoperative thrombolytic therapy.One patient with PVT in level 3 received PV reconstruction using artificial blood vessels,and had PVT recurrence and then was cured.There was no PV stenosis between groups.The levels of platelet at 1,3 and 7 days postoperatively were (75±60)× 109/L,(71± 45)×109/L,(111±73)×109/L in the study group and (57±32) ×109/L,(52±46) ×109/L,(87±53)×109/L in the control group,respectively,with statistically significant difference between groups (t =1.909,1.957,1.848,P＜ 0.05).The levels of platelet at 14 and 30 days postoperatively were respectively (230± 152)× 109/L,(310± 140)× 109/L in the study group and (193± 125)× 109/L,(286±62)× 109/L in the control group,with no statistically significant difference between groups (t=1.284,1.199,P＞0.05).The cases with postoperative infection,acute rejection,new-onset PVT in level 1-2 and 3-4 and PV stenosis were respectively 23,0,2,0,2 in the study group and 35,1,2,0,1 in the control group,with no statistically significant difference between groups (x2 =1.171,0.590,0.547,1.184,P＞0.05).Patients with postoperative infection and acute rejection were improved by symptomatic treatment.Two patients in the study group with PVT underwent anticoagulant and thrombolytic therapy,including 1 receiving interventional thrombectomy therapy.Two patients in the control group with new-onset PVT were cured by anticoagulant and thrombolytic therapy.Three patients with PV stenosis underwent percutaneous transhepatic portography (PTA) for balloon dilation,including 1 in the study group with good improvement after stent implantation.(2) Follow-up and survival:95 patients were followed up for 3-24 months,with an average time of 18 months.During the follow-up,the rate of chronic rejection in study and control groups was 5.7％(2/35) and 5.0％(3/60),showing no statistically significant difference between groups (x2 =0.023,P＞0.05).The 1-and 2-year accumulative survival rates were respectively 91.4％ (32/35),82.9％ (29/35) in the study group and 93.3％ (56/60),76.7％(46/60) in the control group,with no statistically significant difference between groups (x2 =0.780,P＞0.05).Conclusion The splenectomy before liver transplantation is easy to form PVT,increase time and difficulty of transplantation surgery,however,it doesn't increase complication risk after transplantation and affect postoperative survival.
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Objective To investigate the characteristics of cognitive development of children with attention deficit hyperactivity disorder (ADHD) by using resting-state functional magnetic resonance imaging (fMRI) degree centrality (DC) from the view of neuro-imaging.Methods Forty-five ADHD children were diagnosed at specialist clinic of Changzhou Children's Hospital,Nantong University from June 2015 to December 2016,and they were divided into 3 groups according to their ages (children aged 7-8 years old,9-10 years old and 11-12 years old,15 children in each group) and received the resting-state fMRI scans.DC value was used to analyze fMRI data.Comparative analysis was done pairwise between the three groups.Results Compared with 7-8 years old group,9-10 years old group showed lower DC value in cerebellum posterior lobe (t =-4.36) and higher DC in inferior parietal lobe (t =-5.86),and the differences were statistically significant (all P ＜ 0.05,after correction).Compared with 7-8 years old group,11-12 years old group showed lower DC value in cerebellum posterior lobe (t =-4.99) and higher DC in left superior temporal gyrus (t =5.18) and superior frontal gyrus (t =4.58),and the differences were statistically significant (all P ＜ 0.05,after correction).Compared with 9-10 years old group,11-12 years old group showed lower DC value in inferior parietal lobe (t =-5.71) and higher DC value in left superior temporal gyrus (t =5.05) and superior frontal gyrus (t =4.36),and all the differences were statistically significant (all P ＜ 0.05,after correction).Conclusion Children with ADHD at different ages had different characteristics of brain regions of fMRI.It can offer objective evidence for early cognitive intervention of children with ADHD at different ages.
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Objective To investigate activities of daily living,depression,anxiety,fatigue and cognitive impairments at 18 months after attack in patients with mild ischemic stroke.Methods In this cross-sectional study,86 patients with acute ischemic stroke were hospitalized in the Neurology Department of Shanghai Ruijin Hospital from January 2013 to April 2013.Among them,58 cases who were eventually interviewed and selected,were divided into mild stroke group[NIHSS ≤3,n=37]and medium-severe stroke group[NIHSS＞3,n=21]according to the admission score of the National Institutes of Health Stroke Scale (NIHSS).Follow-up was done at 1.5 years after stroke to assess NIHSS,modified Rankin scale(mRS),Stroke Impact Scale(SIS),Hamilton depression scale(HAMD),Hamilton Anxiety Scale(HAMA),Modified Fatigue Impact Scale(MFIS)and Montreal Cognitive Assessment(MoCA).Meanwhile,35 patients with high risk of ischemic cerebrovascular disease were evaluated by HAMD,HAMA,MFIS and MoCA.Results Patients in the mild stroke group showed significantly better prognoses identified by the assessed scores of NIHSS[median(M) =0,interquartile range(IQR) =0,z =-3.879],mRS[M=1,IQR =1,z =-2.381],SIS-total score[697.36 ± 85.66,t =2.351] and SIS-Stroke recovery score (84.15 ± 11.94,t-3.696),as well as the SIS partial items,including strength (79.49 ± 15.88,t =2.099),instrumental activities of daily living[M=97.5,IQR=10,z=-2.858],locomotivity[M=97.2,IQR=0,z=3.083],hand function[M 100,IQR=20,z=-2.259]and social participation[M=90.6,IQR=28,z=2.582],at 1.5 year follow-up.These parameters were markedly different from those in the medium-severe group(all P＜0.05).Additionally,the high-risk group for cerebrovascular disorder showed no case with depression,anxiety and fatigue,but showed 10 cases(28.6 ％) with cognitive impairments.Furthermore,the mild stroke group versus the medium-severe stroke group showed a similar incidences of depression (16.2 ％ vs.38.1％,P =0.061),anxiety(10.8 ％ vs.19.0 ％,P =0.443),fatigue (35.1％ vs.38.1％,P =0.822) and cognitive impairments (59.5％ vs.66.7％,P=0.587).Conclusions The motor function-evaluated activities of daily living are little affected in mild ischemic stroke at 18months follow-up,but rates of depression,anxiety,fatigue and cognitive decline are not uncommon.
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Objective To assess the influence of miRNA (miR)-124 ,miR-26A and miR-126 single nucleotide polymorphism (SNPs) on the prognosis in patients with colorectal cancer (CRC) .Methods A total of 724 cases of patients with CRC treated in this hospital from July 2011 to December 2013 served as the research subjects .The peripheral blood samples were collected ,and genotype analysis of miR-124 rs531564 ,miR-26A rs7372209 and miR-126 rs4636297 SNPs locus were performed by using the PCR-LDR .The patient′s overall survival (OS) and progression-free survival (PFS) were calculated by using Kaplan-Meier method ,and the univariate log-rank method was used to analyse the influence of different genotypes and haplotypes of SNPs on OS and PFS .Re-sults The OS after operation in CRC patient′s carrying miR-124 rs531564 CG genotype was decreased compared with that in pa-tients carrying CC genotype ,and the patient′s death risk was increased[HR2 =1 .450 ,95% CI(1 .043-2 .017) ,P=0 .026];the pa-tient′s death risk in patients carrying GG genotype was also increased compared with that in patients carrying CC genotype [HR2 =2 .339 ,95% CI(1 .171-4 .674)];in the dominant gene model ,the OS in patients carrying CG +GG genotype was significantly de-creased compared with patients carrying CC genotype [HR2 = 1 .532 ,95% CI(1 .119 -2 .096) ,P= 0 .008];in the recessive gene model ,no statistically significant difference was found in OS between patients carrying GG genotype and those carrying CC + CG genotype[HR2 =1 .975 ,95% CI(1 .000-3 .900) ,P=0 .0052];in the co-dominant model ,compared with patients carrying CC+CG genotype ,the OS in patients carrying CG genotype was decreased and their death risk was increased [HR2 =1 .395 ,95% CI(1 .007-1 .931)] .There was no correlation of miR-26A rs7372209 locus and miR-126 rs4636297 locus gene SNPS to OS and PFS in CRC patients (P>0 .05) .Conclusion miR-124 rs531564 gene polymorphism might be an independent influence factor of the prognosis in CRC patients .
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Objective To investigate the application effect of nasojejunal feeding tube nutrition in patients with severe traumatic brain injury. Methods The clinical data of 54 patients with severe traumatic brain injury admitted to the Department of Surgical Critical Care Medicine,the Third Affiliated Hospital,Sun Yatsen University between June 2012 and December 2014 were analyzed retrospectively. They were divided into either a nasojejunal feeding tube nutrition support group (nasojejunal group,n = 26)or an asogastric feeding tube nutrition support group (asogastric group,n = 28)according to the different ways of enteral nutrition. All patients began to receive nasal feeding whole protein preparations (enteral nutritional emulsion,TPF-D)from the second day after admission to intensive care unit (ICU). The time to reach the enteral nutrition support target,the time of parenteral nutritional support,nutritional index (albumin and hemoglobin),the time admission to ICU,and the incidences of infection and gastrointestinal complications in both groups were observed. Results (1)According to the body weight to calculate calorie demand, the nasojejunal group reaching the time of enteral nutrition support target was faster than that of the asogastric group (3. 0 ± 0. 8 d vs. 7. 7 ± 2. 5 d). There was significant difference between the 2 groups (P 0. 05). Conclusion Nasojejunal feeding tube nutrition support may be faster to achieve the target of enteral nutrition supports and shorten the time in ICU.
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Objective To summarize the treatment experience of sepsis after liver transplantation.Methods The clinical features and treatment methods of 1 patient developing sepsis after liver transplantation, who was admitted and treated in the Surgical Intensive Care Unit of the Third Affiliated Hospital of Sun Yat-sen University in September 201 4,were retrospectively studied.The interpretation of International Guidelines for Management of Severe Sepsis and Septic Shock (SSC Guidelines)and relevant literature were reviewed.Results One male patient at the age of 50 years old developed high fever and decrease of blood pressure at 1 d after liver transplantation,and was diagnosed as septic shock.The symptoms were relieved after the appropriate treatment like goal-directed fluid resuscitation,anti-infection and blood purification,etc.And the patient was discharged in stable conditions.Conclusions It is easy to develop infection after liver transplantation and the fatality rate of sepsis caused by infection is high.Once the sepsis occurs,clinicians must perform early goal-directed therapy and bundle therapy according to the SSC Guidelines positively,and select the appropriate drugs according to the pathogen culture results in order to reduce the fatality rate.
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An automatic control system was designed to suppress pathological tremor on wrist joint with two degrees of freedom (DoF) using functional electrical stimulation (FES). The tremor occurring in the wrist flexion-extension and adduction-abduction was expected to be suppressed. A musculoskeletal model of wrist joint was developed to serve as the control plant, which covered four main muscles (extensor carpi radialis longus, extensor carpi ulnaris, flexor carpi radialis, and flexor carpi ulnaris). A second-order mechanical impedance model was used to describe the wrist skeletal dynamics. The core work was to design the controller and a hybrid control strategy was proposed, which combined inverse model based on feed forward control and linear quadratic regulator (LQR) optimal control. Performance of the system was tested under different input conditions (step signal, sinusoidal signal, and real data of a patient)., The results indicated that the proposed hybrid controller could attenuate over 94% of the tremor amplitude on multi-DoF wrist joint.
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Humans , Electric Stimulation , Muscle, Skeletal , Tremor , Therapeutics , Wrist , Wrist JointABSTRACT
Objective:To evaluate the impact and predictive value of neutrophil-to-lymphocyte ratio( NLR) ,derived neutrophil-to-lymphocyte ratio( d-NLR) ,platelet-to-lymphocyte ratio( PLR) and lymphocyte-to-monocyte ratio( LMR) on the prognosis of patients with colorectal cancer with curative resection.Methods: Retrospective analysis of 205 cases of clinical data and returning data after patients with colorectal cancer surgery,ROC curve was applied to determine thresholds for four biomarkers and their prognostic values were assessed using Kaplan-Meier curve,univariate and multivariate COX regression models of patients with NLR,D-NLR,PLR and LMR and other clinicopathological factors and the relationship between the 5-year recurrent-free survival( RFS).Results:According to the ROC curve,LMR could not be used as a potential diagnostic biomarker for subsequently analysis,for its AUC was less than 0.50, The optimal cut-off values were 3.12 with the highest specificity and sensitivity ( 75% and 73.1%) for NLR, while in the univariate analysis show,NLR,D-NLR and PLR were all risk factors of poor recurrence-free survival ( P<0.05 ) , the multivariate regression analysis,NLR≥3.12 and colorectal cancer staging were independent risk factors of prognosis of colorectal cancer.Conclusion:NLR≥3.12 can provide improved accuracy for predicting clinical outcomes in surgical CRC patients under surgery resection.
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A large number of studies have confirmed that antiplatelet agents reduce the relative risk of stroke,myocardial infarction,or death by an average of 22％.However,many patients still have thrombotic events during the period of taking anti-platelet agents,and this is called anti-platelet agent resistance.Its incidences reported are very different.The incidence of aspirin is 3％ to 85％,and that of clopidogrel is 28％ to 44％.The exact cause of antiplatelet agent resistance remains unclear.It may be associated with several factors,including decreased drug bioavailability,genetic polymorphisms,activation of other platelet activation pathways,and increased circulating platelets.Currently,a variety of laboratory methods have been used to detect antiplatelet agent resistance,its criteria are different.In addition,the response measures of antiplatelet agent resistance also have no conclusion,and this has brought greater difficulties for the prevention and treatment of stroke.
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Objective To investigate the protective effect of human umbilical cord mesenchymal stem cells (huc-MSC) on the ischemia-reperfusion injury (IRI) of moderately fatty liver in rats. Methods The rat fatty liver model was established by fat-rich diet feeding. 60 female SD rats were randomly divided into MSC-treated and control groups (n = 30). MSC-treated group was infused with MSC (2 x 106 cells resuspended in 1.5 ml of sterile phosphate-buffered saline solution, PBS) by intra-venous injection through the tail vein. The first dose was administered on day 1 before IRI, followed by another dose on day 3 postIRI. The control group was injected with sterile PBS alone at the same intervals. Blood and liver samples were collected at day 1,4 and 7 (10 rats at each time point) post-IRI respectively to test enzyme activities,biochemical and histological changes. Serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), superoxide dismutase (SOD), malondialdehyde (MDA) and tumor necrosis factor α (TNF-α) in liver tissue were measured. The pathological changes of liver tissue and apoptosis of hepatocytes were also assessed. Results Compared to the control group, the levels of ALT, AST, TNF-α, and MDA declined in the MSC-treated group on day 1 and day 4 post-IRI ( P ＜ 0. 05 ), while no difference was observed on day 7 post-IRI ( P ＞ 0. 05). There was no difference of the level of SOD between the two groups on day 1,4 and 7 post-IRI (P ＞0. 05). Pathological examination revealed inflammatory injury in the MSC-treated group was alleviated compared with that in the control group. Conclusion huc-MSC effects protection on the IRI of fatty liver in rats.
ABSTRACT
Medullary syndrome is a group of syndromes caused by medullary lesions,which is characterized by ipsilateral cranial nerve damage symptoms combining contralateral conductive fasciculus type sensory disturbance or hemiplegia.Medullary infarction is a major cause of medullary syndrome.Knowing medullary syndrome will have some help for the diagnosis and treatment of medullary vascular disease.
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OBJECTIVE: To ensure legal,rational and safe use of anesthetic drugs.METHODS: Based on the related laws and regulations as well as the actuality,the regulatory regime on the use of anesthetic drugs was set and enforced.RESULTS: The regulations about the use of anesthetic drugs were able to be implemented satisfactorily,and the regulatory regime has changed the abstract management connotation into rapid process.CONCLUSION: It's operative and efficient to adopt flow management on the use of anesthetic drugs.