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Objective:To evaluate the effect of perioperative transcutaneous electrical acupoint stimulation (TEAS) on postoperative cellular immune function in the patients undergoing posterior spinal internal fixation.Methods:Ninety patients, aged 40-70 yr, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ, undergoing elective posterior spinal internal fixation in our hospital, were divided into 2 groups ( n=45 each) using a computer-generated table of random numbers: routine group and experiment group.Total intravenous anesthesia was used in routine group, while total intravenous anesthesia combined with TEAS was applied in experiment group.In experiment group, bilateral Zusanli and Sanyinjiao acupoints were stimulated with 2/15 Hz disperse-dense waves at the intensity that could be tolerated by patients at 30 min before induction of anesthesia, maintaining with 2/100 Hz disperse-dense waves from the end of induction until the end of operation at the same stimulation intensity before induction.Bilateral Neiguan and Taichong acupoints were stimulated for 30 min each time with 2/15Hz disperse-dense waves once a day at 1st-4th days after operation.In routine group, the electrodes were connected at the same time period, but no stimulation was given.Venous blood samples were collected before induction of anesthesia, at 1 h after surgery, and on 1st, 3rd, and 5th days after surgery, and the percentage of CD3 + , CD4 + , CD8 + T lymphocytes, CD4 + /CD8 + ratio, WBC count and percentage of neutrophils (NE%) were determined by flow cytometry, and the consumption of intraoperative anesthetics, use of postoperative analgesics, nausea and vomiting, dizziness, infection and length of hospital stay were recorded. Results:Compared with routine group, the total consumption and consumption index of remifentanil were significantly decreased, the percentage of CD3 + T lymphocytes was increased on 3rd and 5th postoperative days, the NE% was decreased on 1st postoperative day, and the incidence of dizziness was decreased ( P<0.05), and no significant change was found in the other indicators in experiment group ( P>0.05). Conclusions:Perioperative TEAS can improve postoperative cellular immune function and has a certain potential value in preventing postoperative infection in the patients undergoing posterior spinal internal fixation.
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Objective:To investigate the expression pattern of TCR variable region subfamily (Vβ and Vδ) in patients with mature T-cell lymphoma (TCL), and to compare the diagnostic value of TCRVβ and TCRVδ analysis in TCL.Methods:The TCRVβ flow cytometry kit was used to detect the expression of Vβ subtypes of αβT cell in 199 patients with αβ TCL and 398 patients with non-TCL, who hospitalized in Jiangsu Provincial People Hospital from 2011 to 2020. Among them, 185 cases of αβ TCL and 355 cases of non-TCL also underwent TCRβ and TCRγ gene rearrangement detection. The TCRVδ based 10-color protocol was used to detect the expression of Vδ subtypes in 24 cases of γδTCL, 10 cases of normal controls, and 15 cases with reactively higher CD4 and CD8 double-negative ratio from 2017 to 2020, and 24 cases of γδTCL and 15 cases with reactively higher CD4 and CD8 double-negative ratio underwent TCRβ, TCRγ and TCRδ gene rearrangement detection. The diagnostic performance and degree of coincidence for detecting malignant clonality were compared between TCRVβ and TCRVδ analysis and the TCR gene scanning method.Results:In the 199 cases of αβ TCL, 182 cases (91.5%) showed restricted expression or the sum of the positive percentages of the subgroups was less than 30% for the 24 TCRVβ subtypes. Among them, the subfamily members with the highest incidence of clonal T lymphocytes were TCRVβ13.2 (12.6%, 23/182) and TCRVβ3 (8.2%,15/182); the TCRVβ subtypes showed nonclonal results in 99.0% (394/398) of non-TCL. All 24 cases of γδTCL (100%) showed abnormal distribution patterns of Vδ1 and Vδ2, of which 19 cases showed restricted expression of Vδ1, and the remaining 5 cases had negative expression of either Vδ1 or Vδ2, and the positive rate of Vδ1 cells was significantly higher than that of Vδ2 cells (79.9%±10.8% vs 0.7%±0.3%, P<0.001). Among the normal control and cases with reactively higher CD4 and CD8 double-negative ratio, the positive rate of Vδ2 cells was significantly higher than that of Vδ1 cells (73.7%±6.7% vs 15.6%±4.2%, P<0.001), and all cases (25/25) showed a normal distribution pattern. In terms of the diagnostic performance of TCL, there was no significant difference of sensitivity and specificity between TCR variable region subfamily detection by flow cytometry and TCR gene scanning technology (the sensitivity was 92.4% and 91.4% respectively; the specificity was 99.0% and 95.9% respectively, P=0.065), and the coincidence rate of the two diagnostic methods is high (Kappa=0.809, P<0.001). Conclusion:Detection of TCR variable region subfamily by flow cytometry could quickly and effectively diagnose mature TCL.
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PurposePrimary chest wall rhabdomyosarcoma (RMS) is very rare with limited imaging characteristic studies in the literature. This paper analyzes the CT imaging features of chest wall RMS in children to improve the diagnostic accuracy.Materials and MethodsThe imaging data of contrast enhanced CT scan of pathology conifrmed chest wall RMS in ifve children were analyzed.ResultsThe lesion was located in the anterior chest wall in one case, in the posterior chest wall in two cases, and the lateral chest wall in two cases (axillary). The tumors were round or spindle in shape with shallow spiculation. Plain CT showed heterogeneous density with patchy low-density necrotic area in two cases, and homogeneous attenuation in three patients. In all ifve cases there was no calciifcation or fatty tissue. The tumor involvement of adjacent spinal canal was seen in one case. Visceral compression was evident including lung parenchyma in one case, heart and liver in one case. Tumor blood vessel growth was seen in two cases. All ifve lesions were adjacent to the ribs, humerus, scapula and the spine with bone destruction in one case. On contrast enhanced scan, all ifve cases demonstrated heterogeneous mild to moderate enhancement, more prominent in the periphery. There were enlarged feeding arteries. Necrotic areas did not enhance. In two cases there were pulmonary metastases. Pleural effusion and ascites were identiifed in one case. There was lymph node metastasis in one case.ConclusionThe CT manifestation of children's chest wall RMS for chest wall include large soft tissue mass, heterogeneous density, no calciifcation or fatty tissue, partial necrosis, adjacent tissue compression, lymph node or distant metastasis. Combining with clinical manifestations, comprehensive analysis of contrast enhanced CT imaging can improve diagnostic accuracy.
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Objective To compare the clinical diagnostic value of ultrasound and magnetic resonance imaging (MRI) in breast cancer.Methods Ultrasound and MRI were performed in patients with breast disease.The postoperative pathological examination results were seemed as diagnostic criteria.The diagnostic accuracy was analyzed in two kinds of imaging examination.Results The diagnostic accuracy of MRI in breast cancer(86.9％) was significantly higher than the accuracy of ultrasonic diagnosis(39.3％),the sensitivity and specificity of MRI were significantly higher than those in ultrasonic diagnosis,the rate of missed diagnosis and misdiagnosis rate of MRI were lower than those of ultrasonic diagnosis,the differences were statistically significant (x2 =6.583,12.573,4.892,23.175,8.649,all P ＜ 0.05).Conclusion Ultrasound and MRI have high ability in diagnosis of breast cancer.MRI diagnostic efficacy has more advantages,but the ultrasound is convenient to operate and repeate inspection,can be used in screening.
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OBJECTIVE:To probe into the mechanism of Shenqi decoction on inhibiting apoptpsis of myocardial cell in?duced by ischemic reperfusion.METHODS:The mice were randomly divided into Shenqi decoction group(high,middle and low dosage groups),isosorbide dinitrate control group,blank control group and model group.The Shenqi decoction group and isosorbide dinitrate group were respectively administered with drugs by lavage for5days while the blank control group and model group were respectively administered with normal sodium by lavage for5days.Except the blank control group the is?chemic reperfusion model of each group was made,then the activity of superoxide dismutase(SOD),the level of malondi?aldehyde(MDA)of cardiac muscle tissues were determined;the apoptotic index of myocardial cells and the expression of apoptosis-correlated protein Bcl-2and Bax were analyzed.RESULTS:Compared with the model group,the SOD activity and Bcl-2express index have been increased,but MDA level and bax express index have been decreased in Shenqi decoction group.CONCLUSION:Shenqi decoction does have a good protection effect on myocardial ischemia and myocardial cell injury induced by postischemia reperfusion.
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OBJECTIVE:The effects of Astragulus injection on cardiac function in myocardial infarction convalescents were observed.METHODS:42 cases were randomly divided into two groups(therapeutic group and control group).21 cases in therapeutic group were treated with routine treatment and 21 cases in control group were treated with Astragulus injection on the basis of routine treatment for three weeks.The ejection fraction(EF),early diastolic peak velocity of blood flow(E),late diastolic peak velocity of blood flow(A) and A/E of all patients were measured with pulse ultrasonic Doppler cardiography before and after the treatment.RESULTS:After the treatment,the EF,E and A/E were improved (P