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Objective:To investigate the effects of thoracic paravertebral nerve block combined with propofol intravenous anesthesia (PPA) on hemodynamic parameters, inflammatory stress indexes, postoperative analgesia and immune indexes in patients with lung cancer undergoing radical surgery.Methods:116 patients with lung cancer admitted to the Southern Theater General Hospital from January 2020 to December 2021 were randomly divided into observation group and control group, with 58 patients in each group. The observation group received PPA combined with general anesthesia, and the control group received sevoflurane inhalation combined with general anesthesia; the hemodynamic parameters, the amount of anesthetic and analgesic drugs used during and after the operation, the pain score of the patients after the operation, the serum interleukin-6 (IL-6), interleukin-10 (IL-10), cortisol (Cor), norepinephrine (NE), vascular cell growth factor-C (VEGF-C), transforming growth factor-β 1(TGF-β1) and T lymphocytes before and after the operation, adverse reactions of the two groups were monitored and compared.Results:The intraoperative dosage of remifentanil and postoperative dosage of sufentanil in the observation group were lower than those in the control group (all P<0.05). There was no statistically significant difference in cardiac output (CO), systemic vascular resistance index (SVRI) and extravascular lung water index (EVLWI) between the observation group and the control group at T 0 to T 3 (all P>0.05); The mean arterial pressure (MAP) at T 1 to T 2 in the observation group was higher than that in the control group, and the MAP at T 3 was lower than that in the control group (all P<0.05). There was no significant difference between observation group and control group in Visual Analogue Scale (VAS) scores at resting state and coughing state 2 h after surgery(all P>0.05). The VAS scores in the observation group at resting state were lower than those in the control group at 4 h and 12 h after surgery (all P<0.05), and the VAS scores in the observation group at coughing state were lower than those in the control group at 4 h, 12 h and 24 h after surgery (all P<0.05). Before surgery, there was no significant difference in serum levels of IL-6, IL-10, Cor, NE, VEGF-C and TGF-β1 between observation group and control group (all P>0.05). The serum levels of IL-6, NE and VEGF-C in observation group were lower than those in control group 24 h after surgery (all P<0.05). Before surgery, there was no significant difference in CD3 +, CD4 + and CD8 + between observation group and control group (all P>0.05). 24 h after operation, the CD3 + in observation group was higher than that in control group ( P<0.05). The incidence of adverse reactions in observation group (10.34%) was lower than that in control group (24.14%, P<0.05). Conclusions:PPA anesthesia for patients undergoing radical resection of lung cancer is conducive to maintaining the stability of hemodynamic parameters, reducing the inflammatory stress response of patients, the impact of surgery on patients′ immune function, and the amount of anesthetic drugs and postoperative analgesics during surgery.
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Theaflavins are a class of natural products extracted from black tea or green tea, with significant anti-tumor effects on gastric cancer, liver cancer, breast cancer and other tumors. Theaflavins were once considered as the new products for anticancer therapy. However, the anti-tumor mechanism of theaflavins involves a variety of biological processes, and the regulation is complex. Therefore, this article summarizes the role of theaflavins in promoting tumor cell apoptosis, inducing tumor cell mitotic arrest and regulating tumor immunity, and reviews the inhibition of tumorigenesis and growth through MAPK, PI3K/AKT, Hedgehog, NF-κB, JAK/STAT and Wnt/β-Catenin signal pathways, in order to provide new ideas for cancer treatment and anti-cancer drug development.
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Objective:To explore the clinical characteristics and short-term prognosis of reoperation of congenital muscular torticollis (CMT).Methods:A total of 12 cases of recurrent CMT treated in the First Affiliated Hospital of Zhengzhou University from May 2015 to May 2018 were recruited, involving 9 boys and 3 girls with the mean age of 13.2 (8-16) years.The causes of disease recurrence were analyzed, and the postoperative appearance of the children was observed by follow-up.In addition, the prognosis of CMT was evaluated by patient satisfaction survey and Lee score criteria.Results:Among the 12 patients, 10 cases were treated in other hospitals and 2 cases in this hospital.The age of the first surgery ranged from 6 months to 2.2 years.Surgical methods included minimally invasive small needle knife (2 cases), single head release of small incision (5 cases), simple amputation (7 cases) and broken end silk thread ligation (4 cases). During the second surgery, contracture and adhesion of sternocleidomastoid muscle at varying degrees were confirmed, including contracture and adhesion of platysma muscle (3 cases), difficulty in separation of jugular sheath (8 cases), and repair of rupture of internal jugular vein (2 cases). Bipolar release of sternocleidomastoid muscle was performed in all surgeries, and tension-free alignment of the neck to the midline was the complete basis for release.The postoperative appearance of all children was satisfied.They were followed up for an average of 2.3 (1.2-3.0) years.Nine and 3 cases graded more than 90 and 80 patient satisfaction scores, respectively.Lee scores reflected the range of motion of head and neck, and the distance and degree of head deviation from the midline, which yielded excellent, good and fair in 12 cases, 8 cases and 3 cases, respectively.Conclusions:Incomplete release is believed as the basic cause of recurrence in children with CMT.Meanwhile, muscle scar adhesion, early operative age, minimally invasive incision and lack of postoperative rehabilitation may also be the direct factors for CMT recurrence.For recurrent patients, satisfactory therapeutic effect can be achieved through bipolar release, especially complete release of the lower pole, combined with postoperative neck traction, fixation and rehabilitation exercise.
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Objective:To evaluate the effect of laparoscopic-assisted anorectoplasty in the treatment of children′s congenital anal atresia.Methods:In this study , 49 children undergoing laparoscopic-assisted anorectoplasty between Mar 2009 and Mar 2015 were compared in terms of outcomes with 42 children under going posterior sagittal anorectoplasty during this period.The post-operative complications, bowel functions and courses were evaluated.Results:The ratio of primary healing in laparoscopic-assisted anorectoplasty was higher than posterior sagittal anorectoplasty(22 % vs. 10%, χ 2=4.306, P=0.038), the age of sequential operation in the former was lower than control group [(9.9±6.5) d vs. (13.4±5.1) d, t=2.823, P=0.003]. The perioperative complications were lower than that in the control group(20% vs. 50%, χ 2=8.817, P=0.003), the bowel function was better than control group(χ 2=7.419, P=0.025). Conclusions:Perioperative complications in laparoscopic-assisted anorectoplasty is lower than posterior sagittal anorectoplasty, with better bowel function and higher primary healing rate.
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Objective@#To explore the long-term efficacy of laparoscopic-assisted anorectoplasty and conventional anorectoplasty in the treatment of children with high and middle anal atresia.@*Methods@#A retrospective cohort study was used. Inclusion criteria: (1) children with high and middle anal atresia; (2) complicated with rectourethral or rectovesical fistula; (3) complete follow-up data. Exclusion criteria: (1) complicated with 21-trisomy; (2) cerebral palsy and other mentaldisabilities; (3) Currarino syndrome; (4) FG syndrome. Clinical data of 88 patients with middle and high anal atresia, who complicated with rectourethral fistula or rectovesical fistula, and underwent anoplasty at Department of Pediatric Surgery, the First Affiliated Hospital of Zhengzhou University from January 2009 to June 2014 were enrolled in the study and analyzed. There were 24 cases with middle atresia and 64 cases with high atresia. All the cases were divided into 2 groups based on the operative method: laparoscopic group (laparoscopic-assisted anorectoplasty, 49 cases), pena group (posterior sagittal anorectoplasty, 39 cases). The demographic features of two groups were comparable. There were no statistically significant differences in gender, age, body mass, classification of anomaly types and sacral ratio (all P>0.05). Student t test and Chi square tests were used to compare the surgical conditions (operative time, postoperative hospital stay and complications), anal function (Kelly score), constipation (Krickenbeck constipation score) and anorectal pressure.@*Results@#Children of both groups all completed operation ssuccessfully. There were no statistically significant differences between laparoscopic group and pena group in the operative time [(120±31) minutes vs. (112±23) minutes, t=1.343, P=0.091] and postoperative hospital stay [(7.1±2.3) days vs. (10.7±3.3) days, t=6.021, P=1.000]. Complications were more common in the pena group [16.3% (8/49) vs. 35.9% (14/39), χ2=4.436, P=0.035]. The main complications in laparoscopic group were anal prolapse (8.2%, 4/49) and anal stenosis (6.2%, 3/49), while in pena group were anal stenosis (12.8%, 5/39) and perioperative perianal skin erosion (10.3%, 4/39). As for the anal function, the degree of feces, defecation control and sphincter contractility, the single scoring differences of Kelly scoring system were not statistically significant between the two groups, but the proportion of good function in the laparoscopic group was higher than that in the pena group [67.3% (8/49) vs. 38.5% (15/39), χ2=7.308, P=0.007]. Constipation occurred in 6 (12.2%) patients in the laparoscopic group, of whom 5 were improved by diet regulation and 1 required laxatives, while 9 (23.1%) patients developed constipation in the pena group, of whom 4 were improved by diet regulation and 5 required long-term laxatives. The difference of constipation ratio was not statistically significant (χ2=1.802, P=0.180). There were no cases of Krickenbeck constipation grade 3. Compared to the pena group, the laparoscopic group had higher anal resting pressure [(33.35±9.69) mmHg vs. (27.68±10.74) mmHg, t=2.599, P=0.011], higher dilating pressure [(9.00±5.61) mmHg vs.(6.51±3.24) mmHg, t=2.462, P=0.016], higher maximal squeeze pressure [(65.80±17.23) mmHg vs. (56.74±18.93) mmHg, t=2.389, P=0.019] and longer maximal contraction time [(21.16±5.02) seconds vs. (18.44±7.24) seconds, t=2.079, P=0.041]. The rectal resting pressure [(5.36±3.00) mmHg vs. (4.61±3.93) mmHg, t=1.015, P=0.312] was not statistically significantly different.@*Conclusions@#Compared with posterior sagittal anorectoplasty, laparoscopic-assisted anorectoplasty in the treatment of high and middle anal atresia has better long-term efficacy with less perioperative complications.
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0bjective To synthesis evidence of self-efficacy-based interventions to improve self-management and health behaviour change in patients with diabetes. Methods PubMed, Cochrane, MEDLINE, CINAHL, EBSCO and Web of Science were searched from 1977 to August 2018. The primary outcomes were self-efficacy and self-care ability. Pooled effect sizes of standardised mean difference ( SMD ) were calculated if outcome measurements and the units were different, and if outcome measurements and the units were the same, such as measuring blood glucose by HbA1c, weighted mean difference ( WMD ) were used to calculate pooled effect sizes. Results Nine eligible randomised control trials (RCTs) including 1578 participants were identified. The results showed that interventions based on self-efficacy significantly improved patients′self-efficacy ( SMD=0.69, 95% CI :0.58 to 0.80, P＜0.05) and self-management ( SMD=0.93,95% CI : 0.74 to 1.12, P＜0.05), helped them control blood glucose ( WMD=-0.69, 95% CI :-0.85 to-0.52, P＜0.05), reduced hospitalisation and emergency times, and improved their quality of life ( SMD=0.52,95% CI : 0.32 to 0.72, P＜0.05). Conclusions Even though the results showed significant improvement in self-efficacy and self-management after interventions, the conclusion needs to be generalised with caution because of the quality of RCTs and high heterogeneity. Future trials could consider RCTs with high quality, appropriate sample size, specific component of diabetes management, and reliable and valid scales or objective measures as outcomes.
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Objective@#To explore the treatment effect of pedicled myocutaneous island flap of anterolateral thigh muscle on the suprapubic defect caused by bladder exstrophy in children.@*Methods@#The clinical data of 3 adolescents with bladder exstrophy were analyzed. All 3 cases underwent one-stage Kelly procedure and received the treatment using pedicled myocutaneous island flap of anterolateral thigh muscle to repair the suprapubic defect. The bladder expansion was performed with ileal sarcoplasmic layer graft, and the Cohen ureteral reimplantation was performed as well, for 1 case 1, 1 year after the first operation. The others 2 patients didn′t receive the second operation.@*Results@#All operations were successful. The femoral donor regions were directly closed. Postoperative follow-up period was 1-7 years. The myocutaneous island flaps were survived and grew well. All incisions of the femoral donor region were primary healing without scar hypertrophy. Urinary continence was achieved in 2 cases, and partially achieved in 1 case. Recurrent urinary tract infection, recurrent fever or abdominal pain were not observed in all patients.@*Conclusions@#The pedicled anterolateral thigh myocutaneous island flap is an alternative way to repair suprapubic defect caused by bladder exstrophy.
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Objective To investigate value of peripheral NLR and PLR for the survival of patients with neuroblastoma.Methods The clinical data of 41 neuroblastoma patients were analyzed by the Kaplan-Meier,Log-rank test,and multivariate COX regression.Results NLR,PLR levels of neuroblastoma patients were significantly higher than that in the healthy control group (1.81 ±0.29 vs.1.07 ±0.29,P ＜ 0.01) (169 ± 23 vs.76 ± 3,P ＜ 0.01);The elder the age,the higher the clinical stages,the higher the serum levels of NSE,and urine VMA were,the higher was the NLR (x2 =3.93,6.286,7.676,6.689,all P＜0.05) and PLR (x2 =4.111,5.707,8.019,8.922,all P ＜0.05).The higher the serum level of LDH,the higher was the NLR (x2 =7.769,P =0.02).3-year overall survival in low NLR group was 84％ and that in high NLR group was 73％ (x2 =4.002,P =0.045);3-year progression-free survival in low NLR group was 74％ and that in high NLR group was 50％ (x2 =4.082,P =0.043);3-year progression-free survival of low PLR group was 85％ and high PLR group was 38％ (x2 =9.388,P =0.002).The clinical stages,MYCN genetic expression,NLR levels were independent factors for the overall survial in patients with neuroblastoma (P ＜ 0.05).Conclusion Pretreatment NLR level can effectively predict the prognosis of neuroblastoma.
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Objective To evaluate the curative effect,safety and feasibility of interventional therapy for biliary restenosis occurring after surgical T-tube drainage.Methods The clinical data of 25 patients with biliary restenosis that occurred after surgical T-tube drainage,who were admitted to authors' hospital during the period from June 2014 to March 2016,were retrospectively analyzed.The primary diseases included bile duct carcinoma (n=6),gallbladder carcinoma (n=3),biliary stone (n=13),hepatocellular carcinoma (n=2)and gastric cancer after surgery (n=1).Abnormal junction of pancreatic duct and biliary duct was observed in 4 patients.Interventional procedure via T-tube route was carried out in 22 patients,and T-tube radiography with subsequent percutaneous transhepatic cholangial drainage (PTCD) was conducted in 3 patients.Biliary balloon expansion combined with biliary drainage was performed in 21 patients,and biliary metal stent implantation was adopted in 4 patients.For patients with benign biliary stricture,the drainage tube was retained for 2-3 months before it was removed.All the patients were followed up for 3-24 months at outpatient clinic or by the telephone.The curative effect was evaluated with drainage-tube radiography.Results The interventional operation was successfully accomplished in all patients,no procedure-related complications occurred,the technical success rate was 100％.In 15 patients with benign biliary stricture,biliary plasty with balloon expansion via the T-tube fistula was conducted,then a 10.2-12 F drainage catheter was placed in the biliary tract and the T-tube was pulled out.During the follow-up period,one patient with anastomotic stricture of bile duct carcinoma died of pulmonary infection at 8 months after treatment.Of the 10 patients with malignant stricture,the biliary obstruction was located above the T-tube level in 3,and all the 3 patients received PTCD.Among the 3 patients,2 patients had hepatocellular carcinoma complicated by biliary invasion,as the extent of the cancerous thrombus was very large,both internal drainage tube and external drainage tube had to be implanted.After jaundice regression,the two patients died of hepatic failure at one month and 2.2 months after the operation respectively.One patient with gallbladder carcinoma complicated by invasion of bile duct received implantation of biliary stent,and the patient died of tumor deterioration at 2.5 months after the procedure.In 7 patients,the biliary obstruction was located below the T-tube level.hnplantation of internal drainage tube and external drainage tube via the Ttube fistula was performed in 4 patients,and implantation of metal stent was adopted in 3 patients.Among them,2 patients with gallbladder carcinoma died of tumor deterioration at 3.8 months and 5 months after the operation respectively.In 5 patients with cholangiocarcinoma,biliary stent restenosis occurred in 2 at 3 months after the treatment,and PTCD was adopted.Three patients died of tumor deterioration complicated by organ function failure at 3.6 months,5.2 months and 9.0 months after the operation respectively.Conclusion For the treatment of biliary restenosis occurring after surgical T-tube drainage,interventional therapy is safe and feasible with reliable curative effect,it can significantly improve the life quality of patients.
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Objective To evaluate the safety and efficiency of thrombectomy with clamping embolus technique ( TCET ) by partial retrieving stent comparing with conventional stent retrievers thrombectomy (CSRT) for acute ischemic stroke.Methods Retrospective analysis was performed in 42 consecutive patients treated by stent retrievers thrombectomy between January 2015 and November 2016 for acute intracranial large vessel embolism . Data on recanalization rates , procedure duration , thrombectomy attempts, one-pass rate, postoperative subarachnoid hemorrhage (SAH),and modified Rankin Scale (mRS) score during 90 days follow-up were compared between TCET and CSRT groups .Results Recanalization rate was 90.0%(18/20) in TCET group and 90.9% (20/22) in CSRT group, post-procedural SAH was 10.0%(2/20) in TCET group and 13.6% (3/22) in CSRT group, good outcome (mRS score≤2) was 60.0%(12/20) in TCET group and 59.1% (13/22) in CSRT group, all without significant differences (P>0.05).The number of thrombectomy attempts with TCET was significantly lower than that with CSRT (1.7 ±0.5 vs 2.6 ±0.8, t=2.118, P=0.040), the procedure duration with TCET was significantly shorter than that with CSRT ( (36.8 ±8.6) min vs (55.5 ±10.5) min, t=-3.493, P=0.001) and one-pass thrombectomy rate with TCET was significantly higher than that with CSRT ( 60.0% ( 12/20 ) vs 22.7%(5/22), χ2 =6.041,P=0.014) .Conclusion TCET is safe and feasible for acute ischemic stroke and might improve the efficiency of thrombectomy comparing with CSRT .
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Objective To evaluate the safety and efficiency of thrombectomy with clamping embolus technique ( TCET ) by partial retrieving stent comparing with conventional stent retrievers thrombectomy (CSRT) for acute ischemic stroke.Methods Retrospective analysis was performed in 42 consecutive patients treated by stent retrievers thrombectomy between January 2015 and November 2016 for acute intracranial large vessel embolism . Data on recanalization rates , procedure duration , thrombectomy attempts, one-pass rate, postoperative subarachnoid hemorrhage (SAH),and modified Rankin Scale (mRS) score during 90 days follow-up were compared between TCET and CSRT groups .Results Recanalization rate was 90.0%(18/20) in TCET group and 90.9% (20/22) in CSRT group, post-procedural SAH was 10.0%(2/20) in TCET group and 13.6% (3/22) in CSRT group, good outcome (mRS score≤2) was 60.0%(12/20) in TCET group and 59.1% (13/22) in CSRT group, all without significant differences (P>0.05).The number of thrombectomy attempts with TCET was significantly lower than that with CSRT (1.7 ±0.5 vs 2.6 ±0.8, t=2.118, P=0.040), the procedure duration with TCET was significantly shorter than that with CSRT ( (36.8 ±8.6) min vs (55.5 ±10.5) min, t=-3.493, P=0.001) and one-pass thrombectomy rate with TCET was significantly higher than that with CSRT ( 60.0% ( 12/20 ) vs 22.7%(5/22), χ2 =6.041,P=0.014) .Conclusion TCET is safe and feasible for acute ischemic stroke and might improve the efficiency of thrombectomy comparing with CSRT .
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Objective To identify the differential inflammation factors in nephroblastoma tissue using proteomics technology and analyze its relationship with clinical stage,pathological phenotype,lymph node metastasis,vascular invasion.Methods From Jan 2010 to Dec 2014,nephroblastoma tumor tissues from 40 patients were obtained.Meanwhile,the 35 tissue near proximal kidney and 25 tissues distal kidney were also obtained.The classification of clinical stage included Ⅰ stage in 6 cases,Ⅱ stage in 12 cases,Ⅲ stage in 13 cases and Ⅳ stage in 9 cases.Other characters contained good prognosis type in 37 case,poor prognosis type in 3 cases,lymphatic metastasis in 17 cases,no sign of lymphatic metastasis in 23 cases,vascular invasion in 9 cases and non-vascular invasion in 31 cases.The SELDI-TOF-MS was used for screening differential protein peaks among three groups.Then,SPE and TRICINE-SDS-PAGE were used to separate and purificate the protein,which showed high peaks expression in tumor tissue,respectively.After in-gel digestion,we received the identification of targeted proteins according to sequence information through Nano-LC-MS/MS.Finally we compared differential expression of inflammatory peaks in different groups of clinical stage,pathological type,lymph node metastasis and vascular invasion.Results All the peaks high expression in tumor tissue,m/z12138 and m/z 13462 are identified as MIF and NAP-2.Expression of two protein peaks in tumor tissue(1437.8 + 997.3,1730.4 + 1147.8) is higher than those in proximal tissue (952.6 + 591.2,1031.1 + 1120.8) and in distal tissue(315.4 + 296.5,114.7 + 118.9),which showed the significant difference (P ＜ 0.001).According to the clinic stage classification,the expression of those protein were 678.8 + 189.0,746.2 + 238.7 in stage Ⅰ,664.0 + 202.0,1180.7 + 404.9 in stage Ⅱ,1524.7+407.9,2160.4 + 1252.3 in stage Ⅲ and 2850.2 + 861.2,2498.4 + 1290.5 in stage Ⅳ.Based on the other characters,expression of those protein were the 1271.7 + 809.2,1553.3 + 991.4 in good prognosis type,3487.2 + 166.2,3915.1 +507.3 in poor prognosis type,2207.1 +961.7,2569.5 + 1285.2 in lymph node metastasis,869.2 + 474.6,1110.2 + 433.6 in non-lymph node metastasis,2850.2 + 861.2,2498.4 +1290.5 in vascular invasion and 1027.8 + 521.3,1507.5 + 1019.9 in non-vascular invasion.All the comparison results have significant statistical difference (P ＜ 0.001).Conclusion MIF and NAP-2significantly increase in nephroblastoma tumor tissue.Meanwhile,there was obvious relationship between those protein with clinical stage,pathological type,lymph node metastasis and vascular invasion.
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Objective To build a more perfect serum protein ifngerprint models for early diagnosis of ganglioneuroblas-toma (GNB) in children. Methods Thirty children with GNB and 30 normal control children were recruited. Serum samples were collected. Nonspeciifc serum protein was detected and studied by MB-WCX processing, SELDI-TOF-MS mass spectrom-etry system and MALDI-TOF/TOF platform. Results Through the SELDL-TOX-MS processing, a peak at 5920 m/z protein markers, and the expression of the markers was high in GNB children (6180.6±2328), compared with normal control children (419.1±493.3), the difference was statistically signiifcant (P<0.05);MALDI-TOF/TOF platform showed that the protein with a peak at 5920 m/z is identiifed as ApoC-Ⅲ. Conclusions m/z peak of 5920 protein is suggested as speciifc biomarker of GNB in children, can provide signiifcant reference for early diagnosis of ganglioneuroblastoma, and prognostic monitoring.
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Objective To explore the prognostic effect of hyperintense vessel sign (hyperintense vessel sign,HVS) in fluid-attenuated inversion recovery (FLAIR) on endovascular recanalization of acute ischemic stroke.Methods The clinical and imaging data of the patients with acute middle cerebral artery (MCA) occlusion treated by endovascular therapy from January 2013 to october 2015 were analyzed retrospectively.The inclusion criteria:(1)＜8 h after symptom onset;(2) The preoperative MRI included conventional non-enhanced MR,FLAIR,diffusion-weighted imaging (DWI),magnetic resonance angiography (MRA) and DWI-ASPECTS (Alberta Stroke Program Early CT Score) ≥7;(3) acute MCA occlusion verified by conventional angiography and recanalizations (TICI score of 2b and 3) were obtained after endovascular therapy;(4) postoperative similar MR examinations were performed within one week.The patients were divided into group A (HVS score＜5) and B (HVS score≥5).The clinical outcomes and radiological characteristics were compared between two groups.Results There were 15 patients in group A and 33 patients in group B.No significant differences were noted in onset-to-MRI interval (4.8±0.7 h vs 4.6± 0.6 h),MRI-to-recanalization interval (2.1 ±0.5 h vs 2.2±0.5 h) and preoperative DWI-ASPECTS score (7.8± 0.9 score vs 8.2± 1.0 score) between the two groups (all P＞0.05).Significant differences were noted in NIHSS score at admission (14.6±2.6 score vs 10.1±2.2 score),grade of collateral circulation (1.6±0.3 score vs 2.4± 0.4 score),postoperative DWI-ASPECTS score (5.6±0.8 score vs 7.3±0.9 score),postoperative extension of DWI-ASPECTS score (2.2±0.4 score vs 0.9±0.2 score),the incidence of cerebral hemorrhage transformation (26.7％ vs 12.1％) and mRS score at 3 months (3.2±0.5 score vs 2.3±0.4) score between the two groups (all P＜0.05).Conclusion HVS score is clearly associated with collateral circulation and high HVS score indicates better functional outcomes than low HVS score.
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Objective To evaluate the efficacy and safety of solifenacin in the treatment of bladder spasm after surgical operation of chlidren hypospadias.Methods From January 2014 to May 2015,60 cases of children more than 4 years old after surgical operation of hypospadias who had symptom of bladder spasm on the day of surgery were assigned into the study group (n =30) and control group (n =30),based on simple randomization.On the first day,the frequency of spasm,the duration of spasm and the incidence of urine extravasation were recorded regarded as the first day condition of bladder spasm.Patients in the study group were treated with solifenacin (5 mg once daily) for a nine days period from l th day postoperation.Patients in the control group were not treated with solifenacin.The frequency of spasm,the duration of spasm and the incidence of urine extravasation of the two groups were recorded and compared on the 3th and 9th day.Adverse events with solifenacin of two groups were recorded.The function of liver and kidney in the study group were recorded and compared.Results There were statistically significant differences(P ＜0.01) in favor of the study group over the control group in the aspect of the frequency of spasm,the duration of spasm and the incidence of urine extravasation on the 3th and 9th day.In the study group,the data compared among l th,3th and 9th was statistically significantly different,opposite to the control group.There was no statistically significant difference between the liver and kidney function of preoperation and the 9th day in the study group.The frequency of adverse events between two groups had no statistically significant difference.Conclusions Solifenacin is effective and safe in the treatment of bladder spasm after surgical operation of chlidren hypospadias
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Objective To test the differential proteomics by using proteomic technology of children diagnosed with nephroblastoma and healthy children,thereby for screening non-stress-related protein markers of Wilms' tumor.Methods The serum of children with Wilms' tumor,children with trauma in 1-3 hours and healthy children were collected in the First Affiliated Hospital of Zhengzhou University from May 2010 to May 2014.Then,the differential proteomics were screened and the interference of traumatic stress proteins in the process were eliminated by using proteomic technology of surfaced enhanced laser desorption/ionization time of flight mass spectroscopy (SELDI-TOF-MS),matrix-assisted laser desorption/ionization time-of-flight mass spectroscopy (MALDI-TOF-MS),high performance liquid chromatography(HPLC),and two dimensions-liquid chromatography-linear trap quadrupole-mass spectrometer(2D-LC-LTQ-MS),therefore the non-stress-related protein biomarkers of Wilms' tumor were determined.Results A mass-to-charge ratio 6630.58 Da protein or peptide was selected as tumor-specific marker.And there were no same or similar proteins in mass spectrometry of children with traumatic stress by SELDI-TOF-MS.Finally,by purification through HPLC and identification through MALDI-TOF-MS and 2D-LC-LTQ-MS,apolipoprotein CI(APO CI) was found to be the non-stress-related serum protein of Wilms' tumor.Conclusions It is identified that APO CI is an important serum protein biomarker of Wilms' tumor by using proteomic technology in eliminating the influences of interference factors of stress.Therefore,the results provide possibilities of further studies and investigating the mechanisms of the protein expression changes and early diagnosing the Wilms' tumor.
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<p><b>OBJECTIVE</b>To screen and identify the serum specific protein markers of patients with gastric cancer by proteomics technology, and to provide more comprehensive serum protein fingerprint model for the early diagnosis of gastric cancer.</p><p><b>METHODS</b>Preoperative and postoperative blood samples were collected from 60 gastric cancer patients. Mass spectrometry (SELDI-TOF-MS) technology was used to detect and screen serum specific proteins in gastric cancer patients(preoperative group, postoperative group, metastasis group), and the result was compared with normal control group. Gel electrophoresis(TRICINE SDS-OAGE) technology was applied in the separation and purification for those different protein. Matrix assisted laser desorption ionization tandem time-of-flight mass spectrometry (MALDI-TOF/TOF) technology was used in the identification for the proteins following separation and purification.</p><p><b>RESULT</b>Mass spectrometry data of preoperative group and normal group resulted in 15 specific m/z peak(P<0.01). SVM screened by a combination of the highest index model Youden get m/z peak at 6 449.1 protein markers. The protein expression of preoperative group was significantly higher than that of normal group(2 299.3±2 029.3 vs. 509.5±168.3, P<0.01). Mass spectrometry data of preoperative group and postoperative group resulted in 6 specific m/z peak(P<0.01). SVM screened by a combination of the highest Youden index model indentified get m/z peak at 6 449.2 protein markers. The protein expression of preoperative group was significantly higher than that of postoperative group(1 247.9±685.0 vs. 476.5±157.8, P<0.01). Mass spectrometry data of preoperative group and metastasis group resulted in 12 specific m/z peak (P<0.01). SVM screened by a combination of the highest Youden index model indentified get m/z peak at 6 448.9 protein markers. The protein expression of metastasis group was higher than that of preoperative group(1 506.9±1 036.5 vs. 649.7±621.0). MALDI-TOF/TOF identified that the protein with m/z peak at 6 449 was Apo CIII(.</p><p><b>CONCLUSION</b>Apo CIII( may be the specific serum protein marker of gastric cancer, which may provide a more comprehensive serum protein fingerprint model for the early diagnosis of gastric cancer and a new way for further research.</p>
Subject(s)
Humans , Biomarkers, Tumor , Blood , Blood Proteins , Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization , Stomach Neoplasms , Blood , DiagnosisABSTRACT
Objective To explore the determination of urinary angiotensinogen (uAGT) in the urine of children with obstructive hydronephrosis and its relationship with impaired renal function, to provide a new and rapid reference index for the preoperative evaluation and postoperative follow-up of the children with hydronephrosis.Methods The data were collected from 48 children who were diagnosed as unilateral congenital renal pelvis and ureter obstruction in the outpatient or inpatient Department of Pediatric Surgery of the First Affiliated Hospital of Zhengzhou University,which were divided into operation group and non-operation group.There were 28 children in operation group(who were all severe hydronephrosis) ,who were all operated with dismembered pyeloplasty.There were 20 children in the non-operation group (who were all mild and moderate hydronephrosis).They temporarily had no surgery signs and hydronephrosis did not become increasingly serious for assuring the regular outpatient follow-up after being diagnosed as hydronephrosis;there were 20 children in the control group, 10 of which were male, and 10 female.The males were hospitalized children with hydrocele and the females were with inguinal hernia.Gender composition among the 3 groups, and the average age difference was not statistically significant.The clean urina of children in 3 groups was collected,3 times for operation group, once before operation and once in 6 weeks and once in 12 weeks after operation;3 times for non-operation group and control group with interval of 6 weeks in outpatient clinic.The children in operation group and non-operation group were all scanned for glomerular filtration rate (GFR) of diseased renal with radionuclide;enzyme-linked immunosorbent assay (ELISA) was adopted to determine the content of uAGT in the urine of the 3 groups of children, and automatic biochemical analyzer was used to measure the amount of urine creatinine (uCr).Results Before operation, in 6 weeks and 12 weeks after operation, uAGT / uCr average water of non-operation group and control group was significantly lower than the operation group, all the differences were statistically significant (F =34.360,14.683,5.035, all P ＜ 0.05).Preoperative and postoperative uAGT / uCr and GFR of diseased renal were of negative correlation(r =-0.647,-0.786, all P ＜ 0.05).In operation group, the preoperative and postoperative GFR average of diseased renal was 37.18 ± 7.31 and 45.27 ± 8.18.The difference of GFR changes was statistically significant before and after treatment (t =-3.971, P =0.000).Conclusions uAGT/uCr increased evidently in congenital renal pelvis and ureter obstruction patients who needed operation, so increase of uAGT might be the indicator of impaired renal function caused by obstructive hydronephrosis of children.
ABSTRACT
Objective To investigate the suitable therapeutic schedule for Stanford B aortic intramural hematoma associated with calcification. Methods During the period from March 2009 to March 2012, a total of 15 patients of Stanford B aortic intramural hematoma with calcified plaque were admitted to authors’ hospital. The diagnosis was proved in all patients by CT angiography of the entire aorta with a 64-row CT scanner. Of the 15 patients, death occurred in one, thoracic endovascular aortic repair (TEVAR) treatment was adopted in 7 and conservative therapy was carried out in 7. All the patients were followed up for one year. CT angiography was employed at 3, 6 and 12 months after the treatment to evaluate the therapeutic results. Results One patient died of acute myocardial infarction after admission to hospital when the long-tem use of antiplatelet drugs was stopped. Seven patients received TEVAR treatment and the remaining 7 patients were treated with strict conservative therapy, and all these patients were asymptomatic at the time of discharge. During the follow- up period, CT angiography performed at 3, 6 and 12 months after the treatment showed that the intramural hematoma lesions gradually shrank or were absorbed in 13 patients, and the patients were asymptomatic. The remaining one patient was lost in touch. Conclusion The key to treat Stanford B aortic intramural hematoma with calcification is to prevent deterioration of the lesion. While strict conservative treatment is kept on, TEVAR should be promptly carried out for patients who need to take antiplatelet drugs over a long period of time, for patients whose clinical symptoms are not improved, for patients in whom the relived symptoms recur, and for patients whose CT angiography shows that the penetrating aortic ulcer becomes worse.