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【Objective:】 To understand the current status and related impacts of medical risk perception and treatment decision-making in preoperative patients with malignant tumors. 【Methods:】 The 350 malignant tumor patients who were hospitalized for surgical treatment in two tertiary hospitals in Liaoning Province were selected. The general information questionnaire, medical risk perception questionnaire, and participation in treatment decision-making questionnaire were used as survey tools. SPSS26.0 software, data statistical methods such as the Kappa test and multiple linear regression were used to analyze valid data. 【Results:】 Among the 350 subjects, the mean scores of the actual level of participation in treatment decision-making and attitude towards participation in treatment decision-making were(1.75±0.50) and(1.56±0.52), respectively, and the consistency between them was poor(Kappa=0.134, P<0.001). The total score of medical risk perception in preoperative patients with malignant tumors was(57.13±16.2). The results of multiple linear regression analysis showed that the actual degree of patient participation in treatment decision-making was influenced by the experience of surgical treatment(β=-1.744, P<0.05), economic risk in medical risk perception(β=0.478, P<0.05), and time risk (β=0.478, P<0.05). Economic risk in medical risk perception(β=0.043, P<0.05), time risk (β=0.646, P<0.05), and psychological risk(β=-0.329, P<0.05) were the influencing factors of patients’ attitude towards participating in treatment decision-making. 【Conclusion:】 Medical professionals should pay more attention to the influence of medical risk perception of malignant tumor patients on treatment decision-making. Malignant tumor patients should fully exercise their right to choose treatment plans independently, and jointly improve the actual level and attitude of the group when participating in treatment decision-making.
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Objective@#To investigate the clinicopathologic features of patients with high-grade B-cell lymphomas (HGBL) that have rearrangements of MYC, bcl-6 and bcl-2.@*Methods@#One hundred and fifty-eight B-cell lymphomas patients from Institute of Hematology and Blood Diseases Hospital from January 2016 to April 2017 were detected by fluorescence in situ hybridization (FISH) with double color split-apart probes.@*Results@#Among 158 B-cell lymphomas, 3 cases with MYC, bcl-2 and bcl-6 rearrangements were identified, 1 of which also had CCND1/IgH translocation. All three patients were of older age, with poor prognostic parameters, multiple organs involvements, elevated LDH and advanced-tumor stage. Two of the three patients were treated with high-intensity chemotherapy and had no remission with an overall survival of 9 months and 11 months respectively. One patient had follow-up with no treatment. Histologically, all three cases showed a spectrum of morphologic features. Although initially categorized as lymphoblastic lymphoma, diffuse large lymphoma and mantle cell lymphoma respectively, two cases were associated with germinal center B-cell (GCB) immunophenotype and 1 case with non-GCB immunophenotype. They had a high proliferation index as assessed by immunostaining for Ki-67 (60%-90%).@*Conclusions@#MYC+ bcl-2+ bcl-6+ HGBL is an aggressive disease with multiple organ involvement, high serum LDH levels, advanced stage disease, poor prognosis and shorter patient survival. The diagnosis should be made by histopathology combined with FISH analysis. Its separation from other types of B cell large cell lymphoma is of clinical importance.
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Objective To investigate the clinical significance of serum interleukin-6(IL-6),C-reactive protein(CRP) and procalcitonin(PCT) in early diagnosis of postoperative infection after artificial femoral head replacement in rabbits.Methods Selected 64 healthy New Zealand white rabbits,and randomly divided them into the experimental group and the control group,with 32 cases in each group.All of the 64 rabbits underwent left femoral hip replacement.Rabbits in the experimental group were injected with staphylococcus aureus into the left hip joint immediately after artificial femoral head replacement,while rabbits in control group were injected with the same amount of saline.The changes of IL-6,CRP and PCT in synovial fluid of all rabbits were measured.Took synovial fluid and 3 pieces of synovial membrane to make bacterial culture 9 days after surgery.Results The bacterial culture of the experimental group was positive for staphylococcus aureus while it was negative in the control group.One day after surgery,the levels of IL-6,CRP and PCT in synovial fluid of two groups were significantly higher than those before operation(P0.05).The levels of IL-6,CRP and PCT in the synovial fluid of the experimental group were significantly higher than those of the control group at the 3rd,6th and 9th day after operation(P0.05),and IL-6 and CRP gradually restored preoperative level at 9th days after operation(P>0.05).The sensitivity and specificity of IL-6,CRP and PCT combined test were 96.9% and 90.6% respectively,which were significantly higher than those of individual indexes.Conclusion Combined detection of serum IL-6,CRP and PCT levels in the infection model of artificial femoral head replacement can provide some help for the early diagnosis of infection after clinical hip arthroplasty.
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Objective To analyze the short-term clinical efficacy of the treatment of ipsilateral femoral intertrochanteric fractures with femoral head necrosis through total hip arthroplasty combined with internal fixation.Methods From January 2011 to June 2014 a total of 28 cases of ipsilateral femoral intertrochanteric fractures with femoral head necrosis were selected,and they were all treated with open reduction and greater trochanter plate fixation combined with total hip arthroplasty.The time of operation, amount of bleeding,time of bone healing of the greater trochanteric fracture,postoperative complications, rate of internal fixation device loosening,incidence of infection,and the Harris score of the hip joint before and after operation were recorded and statistically analyzed.Results The mean operative time was (174.0±27.1)min and the mean blood loss was (530.0±132.0)mL.There were 2 cases of deep venous thrombosis in the lower extremities,and there was no serious complications occured among the remaining cases.All patients were followed up for 12 to 24 months,averagely (16.3±7.0) months.All the 28 patients get bony union of the large trochanter,with the average healing time of (5.0±1.5) months.The preoperative Harris score was (28.0±7.1) points, while it was (86.5±5.3) points after the surgery, and the difference was statistically significant(t=-21.699,P=0.000).At the end of the follow-up,there was no internal fixation device loosening, no cable breakage,and no infection cases.Conclusion Total hip arthroplasty combined with internal fixation for the treatment of ipsilateral femoral intertrochanteric fractures with femoral head necrosis, especially the large trochanteric fractures, were of reliable fracture fixation, good initial stability and good joint function recovery.And it can maintain fracture stability and early recovery of joint function,so that intertrochanteric fractures and femoral head necrosis were treated simultaneously,and its recent clinical results were satisfactory.
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Objective To investigate the effects of melatonin on the changes of superoxide dismutase ( SOD ) , reactive oxygen species (ROS),and malondialdehyde(MDA) in N2A cells under hypoxia conditions.Methods Randomly divided the primary cultured neuroblasto-ma cells of mouse into the control group ,hypoxia group ,and MT treatment group .The MT treatment group were given melatonin 5μg/mL for 24 h to set up the treatment model .Rsbiotech of the hypoxia group and MT treatment group were given gaseous mixture of 95%N2 and 5%CO2 ,The ischemia hypoxia model of N 2A cells was set up with cells in the oxidative stress state and cultured for 24 hours at low concentra-tions of serum .The content of SOD , ROS, and MDA was measured respectively by xanthine oxidase , fluorogenic quantitative detection and thiobarbituric acid chromatometry .Results The expression of SOD in hypoxia group and MT treatment group were significantly decreased compared with that in control group(P<0.05).The level of SOD in MT treatment group significantly recovered compared with hypoxia group with singnificant difference (P<0.05).The expression of MDA and ROS in hypoxia group and MT treatment group were significantly in-creased compared with that in control group (P<0.05).The level of MDA and ROS in MT treatment group significantly recovered compared with hypoxia group with singnificant difference (P<0.05).Conclsion Melatonin provides a protective effect on the secondary damage of nerve cells with hypoxia ischemia .The possible mechanism is melatonin could play the role of free radical scavenging and up -regulate the ex-pression level of antioxidants .
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Objective To discuss the clinical effects of arthroscopy combined with Brostrom repair in the treatment for chronic ankle instability talofibular ligament injury.Methods From January 2012 to June 2015,42 cases of chronic ankle instability in our hospital were performed modified Brostrom repair.All the cases were evaluated by AOFAS scoring system.Results All the patients were followed up for 9 to 17 months,an average of (12.7±3.5)months.At the last follow-up,all cases could participate in normal daily running training mission.Activity levels of 2 cases with cartilage injury had a decline than before.The others were able to attend the confrontational training.Postoperative AOFAS score(88.4±4.9) increased compared with preoperative score (43.3±7.8),the difference was significant(P<0.05).ConclusionThe curative effect of arthroscopy combined with Brostrom repair in treatment of chronic ankle instability talofibular ligament injury is satifactory.It can be helpful to the wounded rapid rehabilitation and good for the popularization and application in basic-level hospitals.
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Objective To evaluate the efficacy of the autologous epidermal grafting combining with NB-UVB radiation on the treatment of stable vitiligo.Methods Autologous epidermal graft acquired by suction blister under negative pressure were transplanted onto the laser-abraded depigmented areas,then the narrow-band UVB radiation was given after grafting to 35 patients with stable vitiligo.The onset time and the area repigmentation of every epidermal graft 3 months latter were observed (digital image contrasted before and after treatment).The results were compared with 37 cases only treated with autologous epidermal grafting.Results Both onset time and the cure rate in combined treatment group were statistically significant (P＜0.05) as compared with control group.Conclusions The combination of autologous epidermal grafting with NB-UVB radiation can shorten the onset time of repigmentation and promote generation and extension of the melanin.
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Objective To observe the change of the balance between regulatory T (Treg) cells and T helper 17(Th17) cells in peripheral blood of the patients with serofast syphilis .Methods From January 2010 to September 2012 ,28 patients with serofast syphilis in our department were selected into the observation group and 30 normal persons were selected into control group .Flow cytometry was used to measure the expression of Treg cells ,Th17 cells ,specific transcription factors Foxp3 and ROR-γ in the pe-ripheral blood .The comparative analysis was carried out .Results The proportion of Treg cells in the peripheral blood of the obser-vation group was (34 .02% ± 12 .31% ) ,which was higher than (21 .86% ± 8 .24% ) in the control group(P<0 .05) ,and the pro-portion of Th17 cells in the peripheral blood of the observation group was (3 .08% ± 2 .17% ) ,which was lower than (9 .13% ± 1 .96% ) in the control group(P<0 .01);the expression level of Foxp3 of CD4+ T cells was (2946 .35 ± 995 .63) in the observation group ,which was higher than (2468 .74 ± 869 .63) in the control group(P< 0 .05),and the expression level of ROR-γwas (1438 .29 ± 659 .31) ,which was lower than(1831 .25 ± 426 .37) in the control group(P<0 .05) .All above differences had signifi-cantly statistical significance .Conclusion The Treg/Th17 cell balance is abnormal in peripheral blood of the patients with serofast syphilis .This cellular immunity suppression of human body may be the reason leading to serofast syphilis .
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BACKGROUND: Ischemia/reperfusion can induce degenerative alterations in articular cartilage. However, the precise mechanism remains poorly understood. OBJECTIVE: To observe the morphological changes and the apoptosis of articular cartilage of femoral head epiphyses with ischemia/reperfusion. METHODS: A total of 80 Sprague-Dawley rats were randomly assigned to two groups: ischemia/reperfusion (model of ischemia/reperfusion in hip joint) and sham-surgery (exposure of abdominal aorta for 5 minutes) groups, with 40 animals in each group. Articular cartilages of femoral head epiphysis were col ected in 6, 12, 24, and 48 hours, 5 days, and 2 and 4 weeks after operation. Morphology of articular cartilage of femoral head epiphyses was examined by light microscope, and cel apoptosis was detected by TUNEL method. RESULTS AND CONCLUSION: Light microscopy showed chondrocytes degeneration and reduction, as wel as fibrosis in matrix of cartilage in the ischemia/reperfusion group. Chondrocyte apoptosis was observed in both groups by TUNEL. Several apoptotic cells, less than five, were observed in the sham-surgery, while 10-30 apoptotic cells were found in ischemia/reperfusion group at 48 hours. Results indicated that ischemia/reperfusion can induce degenerative changes in articular cartilage of femoral head epiphyses, and cel apoptosis in developing hip joint may participate in damage of articular cartilage. Inhibition of chondrocyte apoptosis in articular cartilage may be useful for the prevention and cure of early osteoarthritis.
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Objective To investigate the relationship between the sensitivity of gastric cancer cells to arsenic trioxide（As2O3）and the level of reactive oxygen species（ROS）production.Methods The viability of gastric cancer cell lines MGC803,BGC823 and SGC7901 treated with As2O3 was determined by MTT assay.ROS levels of the gastric cancer cells before and after the treatment of As2O3 were detected by flow cytometry.Results Cell growth was significantly inhibited by As2O3 in time-and dose-dependent manner in three gastric cancer cell lines.The IC50（72 h）of As2O3 for MGC803,BGC823 and SGC7901 was about 2.8,3.1 and 10.2 μmol/L,respectively.IC50（72 h）of MGC803 and BGC823 was lower than that of SGC7901（P 0.01）,gastric cancer cell line SGC7901 was less sensitive than the others.The inherent ROS level of MGC803,BGC823 and SGC7901 was 20.3±2.0,64.2±3.3 and 57.7±2.0.After treatment with As2O3 5 μmol/L for 24 h,the peak level of ROS in MGC803 and BGC823 cells increased to 100.8±3.8 and 103.5±2.3,compared with inherent ROS level,the difference had statistical significance（P 0.001,P 0.01）,but the inherent ROS level in SGC7901 cells was 56.5±2.4（P 0.05）.Conclusion The sensitivity of gastric cancer cells to arsenic trioxide is associated with the increase of reactive oxygen species level.
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Neural pathways and synaptic connections from the trigeminal mesencephalic nucleus (Vme) neurons to the cranial motor nuclei were studied in the rat using double labelling methodologies of intracellular Neurobiotin staining combined with retrograde horseradish peroxidase (HRP) transport, anterograde biotinylated dextran amine (BDA) tracing combined with retrograde HRP transport, and a dual fluorescent labelling of BDA anterograde combined tracing with Cholera Toxin B (CTB) retrograde transport. Direct projections and synapses were demonstrated from Vme neuronal boutons to motoneurons (MNs) of the trigeminal motor nucleus (Vmo), the hypoglossal nucleus (Ⅻ) and the ambiguus nucleus (Amb). Indirect projections and pathways from Vme neurons to the cranial motor nuclei including Vmo, Ⅻ, the facial nucleus (Ⅶ) and the cervical spinal cord (C1～5) were seen to relay on their premotor neurons. The premotor neurons of above cranial motor nuclei were overlapped in bilateral premotor neuronal pool including the parvocellular reticular formation (PCRt) and its alpha division (PCRtA), the dorsomedial part of the spinal trigeminal nucleus oralis (Vodm), and interpolaris (Vidm), the medullary reticular nucleus dorsal division (MdD), the supratrigeminal region (Vsup) and the dorsomedial part of the principal trigeminal sensory nucleus (Vpdm).Synapses between Vme neuronal boutons and Vmo and Ⅻ MNs and Ⅻ premotor neurons were predominantly asymmetric.There were four types of synaptic organizations, i.e. synaptic convergence; synaptic divergence presynaptic inhibition and afferent feedforward inhibition seen between Vme boutons and Vmno, Ⅻ MNs and between Vme boutons and Ⅻ premotor neurons.The results of present studies have demonstrated direct pathways from the trigeminal proprioceptive afferents to Vmo, Ⅻ and Amb MNs, and indirect pathways from the trigeminal proprioceptive afferents to bilateral Vmno, Ⅻ, Ⅶ and C1～s via their premotor neurons. It provides neuroanatomical network to elucidate trigeminal proprioceptive afferents coordinate oral motor behaviors.