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Objective:To investigate the feasibility and effectiveness of incision subcutaneous porous catheter combined with ropivacaine analgesia in enhanced recovery after laparoscopic gastrointestinal surgery.Methods:The clinical data of 140 patients underwent gastrointestinal surgery from August 2021 to April 2022 in Shanghai Fourth People′s Hospital, School of Medicine, Tongji University were retrospectively analyzed. Among them, 70 patients were given routine postoperative analgesia (control group), and 70 patients were given incision subcutaneous porous catheter combined with ropivacaine analgesia on the basis of routine postoperative analgesia (observation group). The visual analogue score (VAS) 4, 24, 32, 48, 56 and 72 h after operation was evaluated; and the complications of subcutaneous catheterization, incision infection, postoperative nausea vomiting, neurological symptoms, time to extubation, patient satisfaction degree, recovery time of intestinal function and hospital stay were recorded.Results:The VAS 4, 24, 32, 48, 56 and 72 h after operation in observation group was significantly lower than that in control group: 1.000 (- 0.250, 2.250) scores vs. 1.000 (- 1.000, 3.000) scores, 2.000 (1.000, 3.000) scores vs. 4.000 (2.000, 6.000) scores, 1.000 (0.000, 2.000) scores vs. 3.000 (1.000, 5.000) scores, 2.000 (1.000, 3.000) scores vs. 3.000 (1.750, 4.250) scores, (1.100 ± 0.934) scores vs. (2.085 ± 0.943) scores and (0.985 ± 0.842) scores vs. (1.814 ± 0.921) scores, and there was statistical difference ( P<0.05 or <0.01). The recovery time of intestinal function and hospital stay in observation group were significantly shorter than that that in control group: (1.743 ± 0.557) d vs. (2.200 ± 0.714) d and (8.043 ± 1.160) d vs. (8.757 ± 1.221) d, and there were statistical difference ( P<0.01); there were no statistical differences in the rate of incision infection, incidence of postoperative nausea vomiting, time to extubation and patient dissatisfaction rate between two groups ( P>0.05); there were no the complications of subcutaneous catheterization and neurological symptoms in two groups. Conclusions:The incision subcutaneous porous catheter combined with ropivacaine analgesia after laparoscopic gastrointestinal surgery is a safe, effective and feasible method. Multimodal analgesia under enhanced recovery after surgery can increase the postoperative recovery after gastrointestinal operations and shorten the postoperative hospital stay.
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【Objective】 To explore the research status, hot spots and trends of platelet rich plasma (PRP). 【Methods】 With "platelet rich plasma (PRP)" and its Chinese equivalent as the subject words, the PRP related articles during January 1, 2013 to December 31, 2022 from PubMed and CNKI database were retrieved. The bibliometric analysis was performed by Bicomb 2.0 software to extract the annual number of literature publications, authors, journals and high-frequency theme words/sub theme words. The gCLUTO software was used to evaluate and visualize the results, and strategic diagram was drawn according to the results of biclustering. 【Results】 A total of 9 066 PRP related articles were retrieved (7 027 from PubMed, 2 039 from CNKI), and the number of publications showed an increasing trend year by year. Papers have been published in 1 527 journals in PubMed, among which the journal with the highest number of publications was Arthroscopy: Journal of Arthroscopic & Related Surgery (175 articles), followed by American Journal of Sports Medicine (171 articles ) and Journal of Cosmetic Dermatology (121 articles) . PRP-related studies were published in 541 journals in CNKI, with the top 3 journals as Chinese Tissue Engineering Research (113 articles), Chinese Aesthetic Medicine (64 articles) and Chinese Journal of Blood Transfasion (45 articles) . In Pubmed, Anitua Eduardo (84 articles), Filardo Giuseppe (53 articles) and Cole Brian J (44 articles) were the top three productive authors on PRP; Cheng Biao from the General Hospital of Southern Theater Command of Chinese PLA was the most productive Chinese author (25 articles) . Shan Guiqiu from the General Hospital of the Southern Theater Command of the Chinese People's Liberation Army published the most articles(29 articles) in CNKI. American journals published the most articles (2 745 articles ), accounting for 39.06% of the total articles, followed by British and Swiss journals, with 1 499 articles and 550 articles, respectively. A total of 42 high-frequency subject words/sub-subject words were selected from PubMed, and were classified into 6 roups, while 30 high-frequency subject words were selected from CNKI and grouped into 5 categories. The strategic coordinates show that the treatment of rotator cuff and tendon injury with PRP in PubMed, the study of PRP and tissue engineering materials in CNKI are the core themes of current PRP research. 【Conclusion】 The strategic coordinate map and bibliometrics can reveal the current research status of PRP and predict future research hotspots, but current research cores of PubMed and CNKI are not consistent, and further research is still needed.
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Objective:To study the neurophysiological features of Kennedy disease (KD) and to figure out the function of the nervous system.Methods:Subjects were recruited from the outpatient and the ward of Peking University Third Hospital from November 2010 to November 2022. Sixty patients with KD (29 patients with KD alone, 31 KD cases with the complication of diabetes mellitus) and 60 patients with diabetic polyneuropathy (DPN) were included in this study. Electrophysiological tests were performed in all subjects, including electromyogram, nerve conduction study, somaosensory evoked potential (SEP), contact heat evoked potential (CHEP) and triple stimulation technique (TST). Student′s t-tests were conducted to compare differences intra or inter groups of nerve conduction velocity and action potential of nerve conduction study, latency and interphase of SEP, initial peak latency of CHEP and other parameters. Results:Compared with the normative value, the amplitude of the sensory nerve action potential (SNAP) declined by 30%-80% in KD patients [median nerve (0.7±0.4) μV, ulnar nerve (0.8±0.3) μV, sural nerve (1.8±0.1) μV], the amplitude of the median and ulnar nerves was lower than the sural nerves ( t=2.43, P=0.010; t=2.40, P=0.010). The conduction time of peripheral segments of SEP and CHEP was prolonged by 115%-130%, while that of the central segments was prolonged by 104%-115% in SEP. TST test/TST control declined by 40%-60% in 17 patients with KD. The amplitude of SNAP declined by 30%-50% in patients with DPN [median nerve (2.9±0.5) μV, ulnar nerve (2.6±0.6) μV, sural nerve (1.6±0.2) μV], the amplitude of the sural nerves was lower than the median and ulnar nerves ( t=2.52, P=0.006; t=2.47, P=0.007). The conduction time of peripheral segments of SEP and CHEP was prolonged by 75%-112%, while that of the central segments was normal in both SEP and CHEP in DPN patients. Compared with DPN patients, the upper limb SNAP amplitude was lower in KD patients with the complication of diabetes mellitus [median nerve (0.7±0.3) μV, t=3.18, P=0.001; ulnar nerve (0.8±0.4) μV, t=3.20, P=0.001]. Conclusions:Sensory nerve is involved in patients with KD, including the large fiber and the small one. The central segments was abnormal in the deep sensory pathway, and the pyramid tract may be involved besides the anterior horn cell.
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In this paper, the domestic and international demand and development trend of clinical diagnostic radionuclides are analyzed, and the medium and high-energy cyclotrons, adequate and systematic facilities, and preparation techniques required for the production of medical radionuclides based on solid targets are introduced. This paper focuses on the research and development carried out by some important medical institutions and scientific research institutes in China over the years in the aspects of medium and high-energy cyclotrons, beam transmission lines, high-power irradiation target stations and new medical isotope production processes etc. It also looks forward to some new directions for the development of medical radionuclides in China during the 14th Five-Year Plan period.
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Objective:To develop radiopharmaceuticals for targeted alpha therapy (TAT), a simple and useful 225Ac- 213Bi generator was developed to provide a short half-life α-emitter 213Bi. Methods:DIPEX resin was used as the stationary phase of the generator, a Sep-Pak Alumina N Plus Light Cartridge column was utilized as the column to construct the generator, and hydrochloric acid was used as the eluent. The γ spectrometer was used to determine the purity of the eluted 213Bi and verify the method to measure the radioactivity of 225Ac and 213Bi by using radioisotope calibrators. The elution curves of the generator at various settings were analyzed to find the best elute and storage conditions. Results:Using commercial 225Ac, 100 mg DIPEX resin and a Sep-Pak Alumina N Plus Light Cartridge column, a 225Ac- 213Bi generator with a column volume of 0.35 ml was constructed, which could be eluted 213Bi with a syringe drenched with hydrochloric acid. The produced 213Bi was pure, and the measured half-life was (45.75±0.12) min, which was consistent with the theoretical value (45.6 min). CRC ? calibrators with setting numbers of #086 and #018 could measure the activity of 225Ac and 213Bi with the average errors of -2.6% and + 0.2% respectively. The eluent for the 225Ac- 213Bi generator was 2 mol/L hydrochloric acid, of which 320 μl was required only to get 90% elution yield. The generator was recommended to be stored directly in the eluent to avoid drying. Conclusion:The 225Ac- 213Bi generator can be constructed to obtain 213Bi for TAT.
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Autophagy is a basic cellular mechanism, which not only acts as a " housekeeper" in the normal physiological and biochemical processes of cells, but also participates in the occurrence and development of many diseases. Many studies have shown that autophagy is closely related to prostatitis, benign prostatic hyperplasia and prostate cancer. Autophagy plays an important role both in the onset of the disease and in the treatment of the disease. This article expounds the influence and mechanism of autophagy in prostate diseases, and provides new ideas and methods for the diagnosis and treatment of prostate diseases.
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With the accelerated development of aging society, the incidence of glaucoma is increasing in recent years.Glaucoma is a primary cause of irreversible blindness worldwide and affects the visual and life quality of patients, which will bring great burden to the prevention and control of blindness in China. Terminology and Guidelines for Glaucoma formulated by European Glaucoma Society (EGS) is a classic document of Glaucoma guidelines.Recently, EGS released the Terminology and Guidelines for Glaucoma (5th edition), which put forward some updated concepts of diagnosis and therapy of glaucoma, primarily in several renewed key issues and the problems to be avoided in clinical practice.In the document, central corneal thickness is not recommended to correct intraocular pressure during the diagnosis and follow-up of glaucoma, and gonio-imaging devices do not replace gonioscopy in the diagnosis of angle-closure glaucoma, and optical coherence tomogranphy should not be used as the sole indicator in the early evaluation and dynamic monitoring of glaucoma.In addition, some available suggestions about anti-glaucoma drugs and surgeries are recommended for the managements of glaucomatous patients.The updated recommendations in the Terminology and Guidelines for Glaucoma (5th edition) are enunciated in this paper.
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The pathogenesis, diagnosis and management of glaucoma are complex and the population with glaucoma is huge in China now.With the development and popularization of cataract surgery, the visual disability and blindness caused by glaucoma are becoming more and more prominent.With the advantages of the combination of clinical pathway and public health in China, it is necessary to pay close attention to the following focuses of the prevention and control of glaucoma according to China's national conditions.(1)The awareness of glaucoma prevention and control should be strengthened, and the relevant screening technology and the construction of special team should be promoted to achieve the goal of early screening, early diagnosis and early treatment.(2)The diagnosis and treatment guidelines for glaucoma should be further well-established to promote the application of appropriate technologies in glaucoma diagnosis and treatment.In addition, glaucoma should be included in the chronic disease management system to accelerate the establishment and improvement of a three-level medical network system.(3)At the same time, the rehabilitation measurement for the patients with glaucomatous low vision should be reinforced to reduce the glaucomatous blindness rate.(4)The whole-process management for glaucoma patients should be enhanced, and nationwide popular science education should be well implemented.
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OBJECTIVE@#To explore the association between rare HSPB1 variants and amyotrophic lateral sclerosis (ALS).@*METHODS@#We performed next-generation sequencing for 166 Chinese ALS patients to screen for possible pathogenic rare variants of HSPB1. The control individuals were obtained from 1000 Genome Project and an in-house whole-exome sequencing database. The Sequence Kernel Association Test (SKAT) and the SKAT-optimal test (SKAT-O) were used to identify the association between rare HSPB1 variants and ALS.@*RESULTS@#We identified 3 possible pathogenic rare variants of HSPB1 (all were missenses), including c.379C>T (p.R127W), c.446A>C (p.D149A) and c.451A>C (p.T151P). Compared with 1000 Genome Project, SKAT p=3.61×10@*CONCLUSIONS@#Rare variants of HSPB1 are probably associated with the pathogenesis of ALS.
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Humans , Amyotrophic Lateral Sclerosis/genetics , Asian People , Heat-Shock Proteins , Heterozygote , High-Throughput Nucleotide Sequencing , Molecular Chaperones , PhenotypeABSTRACT
Objective: To investigate the effects of silencing P75 neurotrophin receptor (P75NTR) and nerve growth factor (NGF) overexpression on the proliferative activity and ectopic osteogenesis ability of bone marrow mesenchymal stem cells (BMSCs) combined with demineralized bone matrix for heterotopic osteogenesis. Methods: BMSCs of Sprague Dawley (SD) rats were cultured and passaged by adherent isolation method. The third generation BMSCs were transfected with lentivirus mediated P75NTR gene silencing (group B), NGF overexpression gene (group C), P75NTR silencing and NGF overexpression double genes (group D), respectively, and untransfected cells as control (group A). After 7 days of transfection, the expression of fluorescent protein of the target gene was observed by fluorescence microscope; cell counting kit 8 method was used to detect the cells activity for 8 days after transfection; the expressions of P75NTR and NGF proteins in each group were detected by Western blot. The adhesion of BMSCs to demineralized bone matrix (DBM) was observed by inverted phase contrast microscope and scanning electron microscope after transfection of p75NTR silencing and NGF overexpression double genes. After transfection, BMSCs and DBM were co-cultured to prepare 4 groups of tissue engineered bone, which were respectively placed in the dorsal subcutaneous tissue of 8-week-old SD rats to construct subcutaneous ectopic osteogenesis model ( n=6). HE staining was performed at 4 and 8 weeks after operation. ALP staining was used to observe the formation of calcium nodules at 8 weeks after operation. The expressions of Runt-related transcription factor 2 (Runx2), alkaline phosphatase (ALP), and osteocalcin (OCN) were detected by real-time fluorescent quantitative PCR. Results: At 7 days after transfection, there was no fluorescence expression in group A, red fluorescence expression was seen in group B, green fluorescence expression in group C, and red-green compound fluorescence expression in group D. The fluorescence expression rate of target gene was about 70%. Western blot detection showed that the relative expression of P75NTR protein in groups A and C was significantly higher than that in groups B and D, and the relative expression of NGF protein in groups C and D was significantly higher than that in groups A and B ( P<0.05). With the passage of time, the cell proliferation activity increased in all groups, especially in group D, which was significantly higher than that in group A at 3-8 days ( P<0.05). The results of inverted phase contrast microscope and scanning electron microscope showed that BMSCs could adhere well to DBM. In the subcutaneous ectopic osteogenesis experiment, HE staining showed that at 4 and 8 weeks after operation, the more bone tissue was formed in group D than in the other 3 groups. ALP staining showed that group D had the highest ALP activity and better osteogenic expression. Compared with group A, the relative expressions of Runx2, ALP, and OCN mRNAs in group D were significantly higher than those in group A ( P<0.05). Conclusion: Silencing P75NTR and NGF overexpression double genes co-transfected BMSCs with DBM to construct tissue engineered bone has good ectopic osteogenic ability. By increasing NGF level and closing P75NTR apoptosis channel, it can not only improve cell activity, but also promote bone tissue regeneration.
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BACKGROUND: Demineralized bone matrix contains many kinds of active factors such as bone morphogenetic protein 2, which can promote bone marrow mesenchymal stem cells to transform into chondrocytes and promote their proliferation under specific joint microenvironment. OBJECTIVE: To explore the osteogenic differentiation of bone marrow mesenchymal stem cells in vitro induced by demineralized bone matrix and its research value as cell carrier scaffold in the treatment of bone defect. METHODS: Rat femur bone marrow mesenchymal stem cells were isolated and adhered with whole bone marrow. Bone marrow mesenchymal stem cells at passage 3 were selected and cultured with complete medium and 50 mg/L demineralized bone matrix inducer. The proliferation and viability of bone marrow mesenchymal stem cells were determined by CCK-8 assay. Alkaline phosphatase activities were quantitatively measured by enzyme labeling at 7 and 14 days after culture. Calcium nodule formation was observed by alizarin red staining 21 days after culture. The expression of osteogenesis-related factors was detected by qRT-PCR 21 days after culture. Demineralized bone matrix and bone marrow mesenchymal stem cells were cultured for 21 days. The adhesion of them was observed by ordinary optical inverted phase contrast microscope and scanning electron microscope. RESULTS AND CONCLUSION: (1) The number of cells on days 5 and 6 in the demineralized bone matrix group was higher than that in the complete medium group (P < 0.05). (2) Alkaline phosphatase activities were significantly higher in the demineralized bone matrix group than in the complete medium group at 7 and 14 days (P < 0.05). (3) Calcium nodules were more in the demineralized bone matrix group than in the complete medium group. (4) The expression of RUNX2, ALP, OCN and OPN was significantly higher in the demineralized bone matrix group than in the complete medium group (P < 0.05). (5) The adherence of bone marrow mesenchymal stem cells was good on the demineralized bone matrix; cells were distributed in the space between scaffolds and crawled with each other. (6) The results showed that demineralized bone matrix could induce bone marrow mesenchymal stem cells to differentiate into osteoblasts, and the adhesion was good, which provided theoretical reference for the research of tissue engineering composite materials.
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Recently, ferroptosis, an iron-dependent novel type of cell death, has been characterized as an excessive accumulation of lipid peroxides and reactive oxygen species. Emerging studies demonstrate that ferroptosis not only plays an important role in the pathogenesis and progression of chronic diseases, but also functions differently in the different disease context. Notably, it is shown that activation of ferroptosis could potently inhibit tumor growth and increase sensitivity to chemotherapy and immunotherapy in various cancer settings. As a result, the development of more efficacious ferroptosis agonists remains the mainstay of ferroptosis-targeting strategy for cancer therapeutics. By contrast, in non-cancerous chronic diseases, including cardiovascular & cerebrovascular diseases and neurodegenerative diseases, ferroptosis functions as a risk factor to promote these diseases progression through triggering or accelerating tissue injury. As a matter of fact, blocking ferroptosis has been demonstrated to effectively prevent ischemia-reperfusion heart disease in preclinical animal models. Therefore, it is a promising field to develope potent ferroptosis inhibitors for preventing and treating cardiovascular & cerebrovascular diseases and neurodegenerative diseases. In this article, we summarize the most recent progress on ferroptosis in chronic diseases, and draw attention to the possible clinical impact of this recently emerged ferroptosis modalities.
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Animals , Chronic Disease , Ferroptosis , Physiology , Iron , Metabolism , Reactive Oxygen SpeciesABSTRACT
The pathogenesis and clinical manifestations of glaucoma in children are quite complex and diverse.Because the visual function of childhood is in a developing stage, even the intraocular pressure is controlled well, the visual function of childhood glaucoma patients is often poor from ametropia and amblyopia.So the prognosis is unsatisfying.New diagnostic classification of childhood glaucoma of the World Glaucoma Association showed that, except for glaucoma associated with acquired conditions and secondary glaucoma following cataract surgery, ocular anterior segment dysplasia in tissue structure and genetic factors are involved in the pathogenesis to different degrees in other classifications of childhood glaucoma.Therefore, it is very important for researchers to actively carry out genetic evaluation for childhood glaucoma.Current research status of molecular genetics in childhood glaucoma is briefly described here to emphasize that the researchers should make full use of available disease resources in China to carry out the study of molecular genetics in the diagnosis and classification of childhood glaucoma, which can provide more evidences for the prevention and treatment of blindness in children and healthy birth policy.
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Objective:To evaluate the clinical application of the SITA faster (SFR) visual field strategy in glaucoma patients.Methods:A diagnostic test was adopted.A total of 72 subjects who visited the Eye and ENT Hospital Affiliated to Fudan University during September 2018 to February 2019 were collected, including 28 normal subjects (56 eyes) and 44 glaucoma patients (86 eyes). The consistency and convenience of visual field tests were evaluated using SITA Standard (SS) and SITA Fast (SF), or SS and SITA Faster (SFR) in normal subjects and glaucoma patients.Test duration, visual field index (VFI), mean deviation (MD) and the number of defect points with probabilities of <5%, <2%, <1%, and <0.5% in the pattern deviation probability plots were recorded, and tested for difference, correlation and consistency.This study followed the Declaration of Helsinki.Written informed consent was obtained from all subjects prior to their entering the study cohort.The study protocol was approved by the Ethics Committee of the Eye and ENT Hospital of Fudan University.Results:For all of the included subjects, the mean test durations of SF and SFR were (64±13)% and (44±10)% compared to that of SS, respectively.MD and VFI evaluated by SS and SF, or by SS and SFR, showed no significant difference in either the normal subjects or the glaucoma patients (all at P>0.05). Across all included subjects, the positive correlation and consistency of MD and VFI were good ( r=0.99, P<0.01). However, for the results of the probability points in the pattern deviation probability blot, there was no difference among normal subjects, but the correlation and consistency were not good.In the deviation probability blot, there was a greater number of defect points of P<0.5% in glaucoma patients evaluated via SS compared to those evaluated by SFR, and the difference was statistically significant ( Z=-2.28, P=0.02). Apart from this, the number of defect points in glaucoma patients showed no difference between SS and SF, or between SS and SFR, and the correlation and consistency were higher in glaucoma patients than those in the normal subjects. Conclusions:Compared with SF and SS, SFR saves more test time.Except for partial variances in the pattern deviation probability blot, the difference between visual field strategies is relatively small and the results are basically consistent.
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OBJECTIVE: To analyze the current status of tumor-related occupational protection knowledge among medical staffs in comprehensive hospitals. METHODS: A stratified random sampling method was used to select 572 medical workers from 24 comprehensive hospitals as study subjects, including 289 nurses and 283 medical doctors. The Survey on Occupational Protection Knowledge and Management of Hospital Tumors was used to investigate the research subjects. RESULTS: i) The awareness status of the tumor-related occupational protection knowledge: the awareness rate of sharps injuries that should be included in occupational protection management was as high as 93.7%, while the awareness rate of standard operating procedures for occupational protection in working post was only 32.9%. ii) Evaluation on the management of tumor-related occupational protection in the hospital: most medical personnel think that medical occupational protection is very important to medical quality and safety, and they are not satisfied with personal protective equipment(PPE), various protective facilities and medical devices. The satisfaction scores of subjects in the nursing group on the use of PPE, the convenience of PPE, the reliable quality of PPE, the use of occupational health protection facilities, and the degrees of satisfaction with the occupational protective functions of medical devices and materials were lower than those in the medical group(P<0.05). iii) The awareness status on the knowledge of the management of tumor-related occupational protection in medical staffs of hospital: The awareness rate of items that the hospital′s prominent warning signs for medical waste places, equipment and materials was 89.9%, and the awareness rate of items that the contents of occupational safety and personal protection in the operating procedures of the workplace can meet the protection needs was only 38.1%. The awareness rates of understood that occupational exposure management department has regular inspections and supervision for related work in various departments, and can easily obtain occupational protection standard procedures and emergency treatment plans, the purchase information of work injury insurance, hospital′s prominent warning signs for places, equipment and materials were setting up in the nursing group were higher than that of the medical group(P<0.05). CONCLUSION: Hospitals should strengthen the related training on occupational protection operation specification and protective measures, improve the protection awareness of medical staffs, and make them actively use medical equipment and consumables with occupational protection functions, so as to reduce occupational exposure.
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Reducing intraocular pressure is the only proven effective treatment of glaucoma.Drug therapy,laser and open surgery are the mainstay clinical tools to achieve this goal and surgical treatment has always been one of the most important method.In recent years,a variety of new methods of glaucoma surgeries were employed in clinical practice,which gave glaucoma surgeons more options.Minimally invasive glaucoma surgery (MIGS) is undoubtedly a topic of intense interest.In addition to new surgical procedures,many glaucoma treatment concepts have been updated.The role of lens extraction in the treatment of angle-closure glaucoma is another hot debate recently.For some classic glaucoma surgery,such as the well-known ciliary body destructive surgery used to treat for absolute glaucoma,has been found useful for early or mid-term glaucoma patients.It suggests that we need to reconsider these classic surgeries.Finally,Chinese ophthalmologists are facing special challenges of our own.Without the aid of mitomycin C (MMC),how to achieve good effects of filtering surgery is a conundrum for everyone.With the abovementioned numerous questions,how to choose a reasonable glaucoma surgery method has become the concern of glaucoma specialists.This article will discuss the development of glaucoma surgery as well as special issues in glaucoma surgery in China,aiming to illustrate the above mentioned questions.
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Objective To detect the expression of costimulatory molecules B7-H4 and programmed death ligand 1 (PD-L1) in bladder cancer,and to explore the correlation between them and clinicopathological features of bladder cancer.Methods Immunohistochemical staining was used to detect the expression of B7-H4 and PD-L1 in 98 cases of bladder urothelial carcinoma,which were confirmed by pathology from August 2014 to December 2015 in our hospital.There were 23 females,aged 45-82 years,with an average age of 67.8 years.Among them,42 cases of adjacent normal tissues were used as controls.The clinical stage,histological grade and recurrence of bladder cancer were collected,and the correlation between them was analyzed.Results The positive rates of B7-H4 and PD-L1 in bladder urothelial carcinoma were 54.1％ (53/98) and 59.2％ (58/98),respectively,and there was no expression in normal bladder tissues (P ＜ 0.05).The positive expression rate of B7-H4 in muscle invasive bladder cancer (MIBC) patients was higher than that in non-muscle invasive bladder cancer (NMIBC) [73.5％ (25/34) vs.43.8％ (28/64),P =0.005].The positive expression rate of B7-H4 in high-grade patients was higher than that of low-grade [70.0％ (21/30) vs.47.1％ (32/68),P =0.036].The expression rate of B7-H4 in high-risk group was higher than that of low-intermediate risk group [57.1％ (20/35) vs.27.6％ (8/29),P =0.018].The positive expression rate of PD-L1 in patients with MIBC was higher than that in NMIBC [79.4％ (27/34) vs.48.4％ (31/64),P =0.003].The PD-L1 expression rate of histological high-level group was higher than that of low-level group [73.3％ (22/30) vs.52.9％ (36/68)],but the difference was not statistically significant (P =0.058).The PD-L1 expression rate in high-risk group was 68.6％ (24/35),and also higher than low-middle group 24.1％ (7/29) (P ＜ 0.05).There was a positive correlation between the expression of B7-H4 and PD-L1 in bladder urothelial carcinoma (r =0.318,P=0.002).The combined recurrence rate of the two groups was significantly higher than that of the negative expression of the two groups [66.7％ (14/21) vs.30.8％ (8/26),P=0.014].Conclusions The expression of B7-H4 and PD-L1 is up-regulated in bladder urothelial carcinoma,which is closely related to the clinical stage,histological grade,risk classification and recurrence of NMIBC.
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Objective To investigate cervical spinal upper motor neuron (UMN) dysfunction in patients with frail arm syndrome (FAS) by physical examination,triple stimulation technique (TST) and pectoralis tendon reflex tests.Methods Sixty-seven FAS patients,coming from Peking University Third Hospital from June 2013 to June 2016,underwent physical examination and routine electrophysiological tests.The pyramid signs,the results of pectoralis tendon reflex and TST were collected to estimate the function of cervical spinal UMN.Results On the time of diagnosis,weakness of bilateral proximal upper limbs was found in 61 patients,while weakness of unilateral proximal upper limb was found in six patients.There were 25 patients with tendon hyperreflexia,20 patients with tendon hyporeflexia and 22 patients with tendon areflexia.All the patients were pectoral muscle tendon hyperreflexia except one.UMN score of cervical region was 2.0 ± 0.5.Lower motor neuron score of cervical region was 2.0 ± O.2.The amplitude ratio of TSTtest/TSTcontrol was 78.31％ ± 6.52％.The latency and amplitude of quantitative detection of pectoralis tendon reflex was (7.80 ± 1.22) ms and (1.23 ± 0.14) mV,respectively.In the follow-up study,the tendon reflexes and the UMN score declined,the amplitude ratio of TSTtest/TSTcontrol decreased,while the lower motor neuron score increased and the latency of quantitative detection of pectoralis tendon reflex remained almost unchanged.Conclusion The results showed that there was cervical spinal UMN dysfunction in patients with FAS,and the pyramid signs were often concealed by muscle atrophy with progression of the disease.
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Objective To explore the status quo of the career planning of the second child nursery under the two-child fertility policy, and to provide reference for carrying out the targeted management intervention. Method From April to May of 2017, 592 nurses of the second child were surveyed using the general data questionnaire and the career planning scale. Results The nurses' career planning score (34.81 ± 3.59) was different, and the career planning of the two nurses with different age, job title, title, establishment, department and income and fertility was different and statistically significant. Nurses with plan to a second child are with less desire to further study and promotion than those without plan to a second child (all P<0.001) promotion to open more than two children before the low policy (P <0.05). Conclusion Nurses' career planning for births is on a middle level. Nursing managers should pay attention to the management of nurses' career planning , create a career development environment , provide humanistic care , strengthen self-awareness and career self-development of nurses who have two births , so as to improve the level of their career planning to promote the nursing team development.
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Background Glucocorticoid drugs have been used increasingly in ophthalmology.It has been established that glucocorticoid are associated with a rise in intraocular pressure (IOP) and the development of glaucoma.Selective laser trabeculoplasty (SLT) is thought to be effective in treating patients with glucocorticoidinduced elevated IOP.Objective This study was to assess the efficacy of SLT in lowering IOP in patients with glucocorticoid-induced ocular hypertension.Methods A retrospective case series study was adopted.SLT around 360° chamber angle was performed in 9 eyes of 9 patients with glucocorticoid-induced glaucoma in Eye & ENT Hospital of Fudan University,including 5 eyes of 5 patients owing to use of glucocorticoid eye drops for long-term after laser in situ keratomileusis (LASIK) and 4 eyes of 4 patients who received intravitreal injection of 0.1 ml triamcinolone acetonide (TA) (4.0 mg) for macular edema induced by central retinal vein occlusion(CRVO).All of the patients were lack of preexisting glaucoma or ocular hypertension and underwent unsuccessful maximum tolerated medical therapy before SLT treatment.The base IOP was 35-44 mmHg and glucocorticoid drugs were ceased for 2-12 months prior to the SLT.The patients were followed-up for 6 months.IOP was measured and recorded before and 1 hour,1 week,1 month and 3 months,6 months after SLT.The difference of IOP was compared by repeated measures analysis of variance and multiple comparison analysis.Results All the patients received single SLT operation.The mean IOP was (40.0±2.9) mmHg before operation,but the IOP was (37.9±8.1),(34.9±5.9),(27.6±6.7),(21.6±6.9) and (17.9±2.9)mmHg 1 hour,1 week,1 month,3 months and 6 months after SLT.The IOP at 1 month,3 months and 6 months after SLT were significantly lower than that before operation (all at P＜0.05).Two patients received a filtration surgery for uncontrolled IOP at 1 month and 3 months after SLT respectively,and another patient still used 2 kinds of lowing-IOP eye drops until the end of following-up duration.Conclusions SLT reduce IOP in 6 eyes of 9 patients with glucocorticoid-induced increased IOP from the initial 1 month through 6 months after SLT.