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Objective@#To analyze the emotional and behavioral problems and associated factors of the only and non only child, and to provide some clues for further monitoring and intervention of psychological and behavioral development among preschool children.@*Methods@#Using a convenience sampling method, a total of 45 065 children enrolled in 153 kindergartens in 23 districts and counties of Chengdu were selected from May to June 2021 to investigate demographic characteristics and children s psycho behavioral development through online questionnaires filled out by their guardians. The Chi square tests were used to analyze whether the differences in abnormality rates of each dimension were statistically significant between the only and non only children. The emotional and behavioral problems of only children and non only children were analyzed by propensity score measurement.@*Results@#The detection rate of abnormal emotional behavior problems in children was 6.10%, including 6.34% in the only child group and 5.84 % in the non only child group. After matching, total difficulty score, and scores of emotional symptoms, conduct problems, hyperactive attention deficit, peer interaction, and social behavior differed between the only child group and the non only child group ( t =9.91, 8.97, 3.91, 15.57, -5.46, 4.08, P <0.01).@*Conclusion@#In terms of the total score of difficulties, emotional symptoms, moral problems, and hyperactivity attention defects, the non only child is better than the only child，but the opposite is true in terms of peer interaction and social behavior. Mental health conditions among the only child should be paid more attention. Whether or not the only child should be taken as an important consideration for preschool children s mental health care.
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Objective:To explore the application effect of the ternary linkage continuation care model based on cognitive balance theory in patients with rheumatoid arthritis (RA), and to provide a reference for the continuation care model of RA patients.Methods:The convenience sampling method was adopted. A total of 72 RA patients who were treated in Huainan First People's Hospital, Anhui Province from January to December 2020 were selected as the research objects, and they were divided into observation group and control group by random number table method with 36 cases in each group. The control group was given regular discharge guidance and health education, and the observation group was given ternary continuous care based on cognitive balance theory on the basis of the control group. The intervention time was 3 months. The fatigue state, pain catastrophe, exercise self-efficacy and hope index was evaluated by the Bristol Rheumatoid Arthritis Fatigue Multi-Dimensional Questionnaire (BRAF-MDQ), the Pain Catastrophic Scale (PCS), the Self-Efficacy for Exercise Chinese version(SEE-C), and the Herth Hope Index Scale-Chinese version (HHI-C) and the results were compared between the two groups before and after the intervention.Results:There was no significant difference in the score of BRAF-MDQ, PCS, SEE-C, HHI-C before the intervention between the two groups( P>0.05). The scores of physical fatigue, life fatigue, cognitive fatigue and emotional fatigue of BRAF-MDQ in the observation group after the intervention were (10.02 ± 0.85), (6.33 ± 0.58), (3.31 ± 0.48), (4.25 ± 0.56) points, respectively, significantly lower than those in the control group (12.97 ± 1.89), (8.94 ± 0.97), (6.55 ± 0.97), (5.92 ± 0.87) points, and the differences were statistically significant ( t values were 8.54-17.96, all P<0.05). The scores of contemplation, exaggeration, and helplessness of PCS in the observation group after the intervention were (5.66 ± 0.43), (4.12 ± 0.36), (3.31 ± 0.41) points, respectively, which were significantly lower than those in the control group (8.41 ± 0.88), (5.74 ± 0.85), (5.52 ± 0.86) points, and the differences were statistically significant ( t=16.85, 10.53, 13.92, all P<0.05). The scores of SEE-C and HHI-C were (60.22 ± 7.89), (37.48 ± 5.79) points in the observation group after the intervention, which were significantly higher than those in the control group (46.98 ± 5.84), (34.21 ± 4.93) points, and the differences were statistically significant ( t=8.09, 2.58, both P<0.05). Conclusions:The ternary linkage continuation nursing model based on the cognitive balance theory has a significant effect on alleviating the fatigue state and pain catastrophe of RA patients, and helps to improve the patients' hope level and exercise self-efficacy.
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In this paper, the clinical case, pathological and immunohistochemical analyses were performed on 10 patients with intrathyroidal thymic carcinoma admitted to our hospital.Combined with relevant literature, it was found that tumour cells expressing CD5 and CD117 had differential diagnostic significance. Surgical resection of the tumour was the first choice for treatment, whether radiotherapy, chemotherapy and monotherapy were administered remained controversial.
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Objective:To investigate the risk factors related to extrathyroidal extension (ETE) of differentiated thyroid carcinoma (DTC) and the specific effects on the prognosis.Methods:The clinical data of 592 patients with newly diagnosed DTC admitted to our hospital from Jun. 2015 to Jun. 2016 were retrospectively analyzed. The data including the maximum tumor diameter and lymph node metastasis were collected, and the survival data were followed up. Chi-square test and Logistic regression were used to analyze the risk factors associated with ETE. Kaplan-Meier method and Cox proportional risk model were used to analyze the effect of ETE on disease-free survival.Results:There were 100 ETE of 592 DTC patients (16.9%) . Univariate analysis showed that the risk factors for ETE were the largest tumor diameter ≥2 cm, multiple lesions, and lymph node metastasis in the lateral cervical region ( P<0.01) . The follow-up time was 29 to 64 months, and the median follow-up time was 60 months. The 3-year and 5-year DFS rates of patients with DTC and ETE were 86.9% and 83.2% respectively, which were significantly lower than those of patients without ETE ( P<0.001) . Univariate analysis showed that ETE ( P<0.001) was a risk factor for postoperative recurrence in patients with DTC. Cox multivariate regression showed that ETE (HR: 10.564, 95% CI 3.712-30.063, P<0.001) was an independent risk factor for postoperative recurrence in patients with DTC. Conclusions:DTC accompanied by ETE is associated with risk factors such as large tumor diameter and multiple lesions, which has a lower 5-year DFS. Patients with the above characteristics should consider the possibility of ETE before surgery, and focus on long-term follow-up after surgery.
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Objective:To investigate the effects of miR-497 on cytobiology behaviors of papillary thyroid carcinoma (PTC) by targetingly regulating the expression of Yes-associated protein 1 (YAP1) .Methods:Human TPC-1 cells were divided into control group, miR-497 group, si-YAP1 group and miR-497+si-YAP1 group. The liposome transfection was conducted by LipofectamineTM3000. The targeted relationship between miR-497 and YAP1 was validated by Luciferase Reporter Assay. The cell proliferation activity in each group was detected by MTT method. The apoptosis rates were analyzed by flow cytometry. The number of invasion cells was detected by Transwell. The cell migration rates were detected by scratch assay. The expression of Cyclin D1, matrix metalloproteinase 2 (MMP-2) , MMP-9, matrix metalloproteinase inhibitor-1 (TIMP-1) and activated caspase 3 (cleaved Caspase-3) was detected by Western blot. SPSS 22.0 was used to analyze data, and normally distributed measurement data were expressed as ( ± s) . One-way ANOVA was analyzed for the difference between multiple groups, and SNK-q were analyzed for the difference between two groups. Results:Compared with the control group, the expression of YAP1 mRNA and protein was decreased in miR-497 group and si-YAP1 group ( q=14.682, 14.597; 23.743, 23.571; P<0.05) , cell proliferation activity, number of invasion cells and migration rate were decreased ( q=4.724, 4.568, 3.841; 4.216, 3.952, 3.274; P<0.05) , apoptosis rate was increased ( q=3.783; 4.336; P<0.05) , expression of CyclinD1, MMP-2, MMP-9 and cleared Caspase-3 proteins was decreased ( q=5.823, 5.981, 6.036, 6.485; 5.934, 6.110, 6.573, 6.614; P<0.05) , and expression of TIMP-1 protein was increased ( q=6.071; 6.148; P<0.05) . Compared with si-YAP1 group, miR-497 level was increased in miR-497+si-YAP1 group ( q=14.726, P<0.05) , the expression of YAP1 mRNA and protein was decreased ( q=3.089, 3.126; P<0.05) , cell proliferation activity, number of invasion cells and migration rate were decreased ( q=2.654, 2.537, 2.246; P<0.05) , apoptosis rate was increased ( q=2.875, P<0.05) , expression of CyclinD1, MMP-2, MMP-9 and cleared Caspase-3 proteins was decreased ( q=4.371, 4.365, 4.383, 4.368; P<0.05) , and expression of TIMP-1 protein was increased ( q=4.275, P<0.05) . Conclusion:MiR-497 can negatively targetingly regulate the expression of YAP1, inhibit proliferation, invasion and migration of TPC-1 cells.
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@#The Universal Definition and Classification of Heart Failure consensus has proposed the universal definition, classification and staging criteria of heart failure. The prevalence of heart failure is still increasing, and the phenotype of heart failure with preserved ejection fraction (HFpEF) is becoming more and more common. Neuro-endocrine antagonists are effective in treating patients with heart failure with reduced ejection fraction (HFrEF). However, there is no effective drug that can improve the clinical prognosis of patients with HFpEF. The pathophysiological mechanism of HFpEF involves metabolic-inflammatory mechanism disorders, epicardial fat tissue accumulation, and coronary microvascular dysfunction. The exploratory treatment of these mechanisms requires further research to confirm whether it is beneficial to patients with HFpEF. In addition, the improvement of ejection fraction and the recovery of cardiac function in patients with HFrEF after treatment cannot interrupt the drug treatment of heart failure.
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Objective:To analyze the epidemiological characteristics of acute paraquat(PQ)poisoning in children in southwest Shandong, and the risk factors for pulmonary interstitial fibrosis.Methods:This retrospective study was performed on the clinical data of children with acute PQ poisoning admitted from January 2013 to December 2017 in 12 hospitals in southwest Shandong.All participants were divided into pulmonary interstitial fibrosis group and no pulmonary interstitial fibrosis group on the basis of the chest CT 14 days after poisoning.The epidemiological characteristics and risk factors of pulmonary interstitial fibrosis were analyzed.Results:During the study period, a total of 307 children with acute PQ poisoning were admitted to 12 hospitals, of which 61 (19.87%) were suffering from acute PQ poisoning.Forty-nine cases with complete clinical data were analyzed, including 26 male and 23 female patients poisoned by oral.The age distribution ranged from 8 months to 14 years.Poisoning mainly occured from July to September of each year.The mortality of acute PQ poisoning was 8.2%(4/49), and the incidence of pulmonary interstitial fibrosis in survival patients was 44.4%(20/45). Statistical differences ( P<0.05) were found between the pulmonary interstitial fibrosis and no pulmonary interstitial fibrosis, with regard to the times of blood purification, the time from poison exposure to blood purification, the application rate of glucocorticoids, the concentration of PQ in urine, the pediatric critical illness score, the time from poison exposure to gastric lavage, the white blood count at admission, serum creatinine, arterial blood lactate, PaO 2, PaCO 2, and PaO 2/FiO 2; however, there was no significant difference in the proportion of blood purification treatment, the mode of blood purification treatment, alanine aminotransferase, aspartate aminotransferase, urea nitrogen, creatine kinase and troponin.Stepwise logistic regression analysis showed that the time from exposure to poison to gastric lavage( OR=0.683, 95% CI 0.210-2.222)and to blood purification( OR=0.0133, 95% CI 0.004-0.042), the times of blood purification( OR=2.862, 95% CI 1.450-5.648), concentration of PQ in urine( OR=1.435, 95% CI 1.085-1.898), and the use of glucocorticoids( OR=0.190, 95% CI 0.048-0.757) were the risk factors for pulmonary interstitial fibrosis( P<0.05). Conclusion:Early gastric lavage and blood purification, increasing the frequence of adminitrating purification appropriately, using low-dose glucocorticoids can reduce the incidence of pulmonary interstitial fibrosis of children with acute PQ poisoning.
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Objective@#To analyze the epidemiological characteristics of acute paraquat(PQ)poisoning in children in southwest Shandong, and the risk factors for pulmonary interstitial fibrosis.@*Methods@#This retrospective study was performed on the clinical data of children with acute PQ poisoning admitted from January 2013 to December 2017 in 12 hospitals in southwest Shandong.All participants were divided into pulmonary interstitial fibrosis group and no pulmonary interstitial fibrosis group on the basis of the chest CT 14 days after poisoning.The epidemiological characteristics and risk factors of pulmonary interstitial fibrosis were analyzed.@*Results@#During the study period, a total of 307 children with acute PQ poisoning were admitted to 12 hospitals, of which 61 (19.87%) were suffering from acute PQ poisoning.Forty-nine cases with complete clinical data were analyzed, including 26 male and 23 female patients poisoned by oral.The age distribution ranged from 8 months to 14 years.Poisoning mainly occured from July to September of each year.The mortality of acute PQ poisoning was 8.2%(4/49), and the incidence of pulmonary interstitial fibrosis in survival patients was 44.4%(20/45). Statistical differences (P<0.05) were found between the pulmonary interstitial fibrosis and no pulmonary interstitial fibrosis, with regard to the times of blood purification, the time from poison exposure to blood purification, the application rate of glucocorticoids, the concentration of PQ in urine, the pediatric critical illness score, the time from poison exposure to gastric lavage, the white blood count at admission, serum creatinine, arterial blood lactate, PaO2, PaCO2, and PaO2/FiO2; however, there was no significant difference in the proportion of blood purification treatment, the mode of blood purification treatment, alanine aminotransferase, aspartate aminotransferase, urea nitrogen, creatine kinase and troponin.Stepwise logistic regression analysis showed that the time from exposure to poison to gastric lavage(OR=0.683, 95%CI 0.210-2.222)and to blood purification(OR=0.0133, 95%CI 0.004-0.042), the times of blood purification(OR=2.862, 95%CI 1.450-5.648), concentration of PQ in urine(OR=1.435, 95%CI 1.085-1.898), and the use of glucocorticoids(OR=0.190, 95%CI 0.048-0.757) were the risk factors for pulmonary interstitial fibrosis(P<0.05).@*Conclusion@#Early gastric lavage and blood purification, increasing the frequence of adminitrating purification appropriately, using low-dose glucocorticoids can reduce the incidence of pulmonary interstitial fibrosis of children with acute PQ poisoning.
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Objective@#To investigate the prognostic value of N-terminal B-type natriuretic peptide (NT-proBNP) on all-cause mortality in heart failure patients with preserved ejection fraction (HFpEF) at real world scenarios.@*Methods@#Patients who met the diagnostic criteria of HFpEF in the China National Heart Failure Registration Study (CN-HF) were divided into death and survival groups. The demographic data, physical examination, results of the first echocardiography, laboratory results at admission, complications, drug use and clinical outcomes were obtained from CN-HF. The univariate Cox proportional hazard model was used to screen the variates that might predict prognosis, and then the covariates with statistical significance were included in the multivariate Cox regression model to analyze the predictive value of baseline NT-proBNP on all-cause death. Spearman correlation analysis was used to evaluate the relationship between NT-proBNP and estimated glomerular filtration rate (eGFR), so as to further explore the predictive value of the interaction between renal dysfunction and NT-proBNP on death. Since NT-proBNP did not obey the binary normal distribution, it was expressed by the natural logarithm of NT-proBNP (LnNT-proBNP).@*Results@#A total of 1 846 HFpEF patients were enrolled in this study, with an average age of 71.5 years, 1 017 males(55.1%), median NT-proBNP 860 ng/L, and median eGFR 73.9 ml·min-1·1.73m-2. After a median follow-up of 34 months, 213 (11.5%) patients died. Patients in the death group were older, with higher NYHA classification Ⅲ-Ⅳ ratio, longer hospital stay, higher serum potassium and NT-proBNP level, prevalence of complications of diabetes mellitus, arrhythmia and atrial fibrillation, use of angiotensin receptor antagonist(ARB), mineralocorticoid receptor antagonists (MRA), diuretic and digoxin was significantly higher in death group than in survival group. Body mass index (BMI), diastolic blood pressure, left ventricular ejection fraction (LVEF), hemoglobin, serum cholesterol(TC), serum triglycerides (TG) and eGFR, and use of angiotensin converting enzyme inhibitors (ACEI), statins and aspirin were lower in death group than in survival group. Univariate Cox regression analysis showed that NT-proBNP was a predictor of all-cause death in HFpEF patients (HR=2.522, 95%CI 2.040-3.119, P<0.001). Multivariate Cox regression analysis showed that the elevated NT-proBNP remains as the independent predictor of all-cause death in patients with HFpEF (HR=1.230, 95%CI 1.049-1.442, P=0.011) after adjusting for age, BMI, diastolic blood pressure, LVEF, hemoglobin, serum potassium, serum sodium, TC, serum high-density lipoprotein cholesterol (HDL-C), TG, eGFR, atrial fibrillation, as well as the treatment of ACEI/ARB, MRA, diuretics and digoxin. Spearman correlation analysis showed that LnNT-proBNP was negatively correlated with eGFR (r=-0.361, P<0.001), but there was no interaction between NT-proBNP and renal dysfunction in predicting death in HFpEF patients (P>0.05).@*Conclusion@#The elevated level of NT-proBNP at admission is an independent predictor of all-cause mortality in HFpEF patients.
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Objective To investigate the clinical prognostic features of pediatric differentiated thyroid carcinoma (DTC).Methods A retrospective analysis of clinical data of 56 cases of pediatric differentiated thyroid carcinoma under 14 years old admitted in our hospital from Aug.2009 to Oct.2018 was performed.KaplanMeier method and COX proportional hazards model were used to analyze the factors affecting the disease-free survival of patients.Results The follow-up period was from 6 months to 82 months,and the median follow-up time was 28 months.Recurrence occurred in 15 patients,with a survival rate of 100％.The 3-and 5-year disease-free survival rate was 67.4％ and 63.5％.Univariate analysis showed that tumor diameter ＞2 cm (P=0.046),multiple lesions (P＜0.001),cervical lymph node metastasis (P=0.008),and extra thyroidal extension (ETE) (P=0.035) were related factors affecting postoperative recurrence,while gender,age,Hashimoto's thyroiditis,tumor TNM stage,central lymph node metastasis and surgical approach were not related to postoperative recurrence.COX multivariate analysis showed that multiple lesions (HR:8.815,P=0.010) was the independent factor influencing the prognosis of pediatric differentiated thyroid carcinoma.Conclusions Multiple lesion is an independent influencing factor for the recurrence of pediatric differentiated thyroid carcinoma patients after surgery.Meanwhile,total thyroidectomy and long-term follow-up should be followed.Although the metastasis rate of lymph node and distant organ are high,overall prognosis is good in pediatric DTC.
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OBJECTIVE@#To study the effect of CYP2D610 (c.100 C>T) on plasma trough concentrations of metoprolol and its metabolite α-hydroxy metoprolol, blood pressure and heart rate in patients with coronary artery disease.@*METHODS@#The patients with coronary artery disease taking metoprolol tablets (=128) and those taking metoprolol sustained-release tablets (=126) were genotyped for CYP2D610 using Taqman real-time quantitative PCR. The trough concentrations of metoprolol and α-hydroxy metoprolol were determined with UPLC-MS/MS, and the dose-normalized concentrations (C/D) were compared among the patients with different CYP2D610 genotypes in both groups. Resting blood pressure and heart rate were recorded in all the patients when the concentration of metoprolol reached the steady state and were compared among the patients with different genotypes.@*RESULTS@#In patients taking metoprolol sustained-release tablets, the plasma trough concentration of α-hydroxy metoprolol was significantly associated with the systolic blood pressure (=0.0204). The CYP2D610 poor metabolizers showed a significant association with the C/D of metoprolol and α-hydroxy metoprolol ( < 0.01) in patients receiving metoprolol in both formulations, and in both groups, the C/D of metoprolol was significantly higher in the patients with a TT genotype than in those with a CC or CT genotype ( < 0.01); compared with those with the CT genotype, the patients with the TT genotype had a significantly lower C/D of α-hydroxy metoprolol ( < 0.01). In patients taking metoprolol sustained-release tablets, those with the CT (=0.0281) and TT (=0.0196) genotypes had lower diastolic blood pressure than patients with the CC genotypes, but the systolic blood pressure or heart rate did not differ significantly among them.@*CONCLUSIONS@#CYP2D610T allele mutation can reduce the metabolism of metoprolol, increase the C/D of metoprolol and decrease the C/D of α-metoprolol and diastolic blood pressure in patients with coronary artery disease, but CYP2D610 variation does not significantly affect systolic blood pressure or heart rate in the patients when the concentration of metoprolol reaches a steady state.
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Humans , Adrenergic beta-Antagonists , Chromatography, Liquid , Coronary Artery Disease , Cytochrome P-450 CYP2D6 , Genotype , Metoprolol , Tandem Mass SpectrometryABSTRACT
Objective To analyze the clinical features of medullary thyroid carcinoma(MTC) and the risk factors of cervical lymph node metastasis.Methods A retrospective analysis of 84 cases of thyroid surgery in the First Affiliated Hospital of Zhengzhou University from Jan.2012 to Jun.2018 and confirmed by routine pathology as MTC patients was performed.Chi-square test and logistic regression were used to analyze patients' age,gender,clinical features such as tumor diameter,number of lesions,and invasion of the capsule and risk factors associated with cervical lymph node metastasis.Results Statistical analysis found that the incidence of lymph node metastasis significantly increased in patients with central region ≥ 1 cm (x2=4.196,P=0.041),multiple lesions (x2=5.946,P=0.015),and thyroid capsule invasion (x2=15.277,P＜0.001) and the difference was statistically significant.The incidence of cervical lymph node metastasis was significantly higher in patients with the tumor diameter ≥ 1 cm(x2=5.269,P=0.022),multiple lesions(x2=4.550,P=0.033),and thyroid capsule invasion(x2=19.253,P＜0.001) and the difference was statistically significant.Logistic regression analysis showed that thyroid capsule invasion was an independent risk factor for central lymph node metastasis (OR=7.551,P=0.001) and cervical lymph node metastasis (OR=8.067,P＜0.001).Of the 84 patients who received calcitonin before surgery,56 patients had preoperative calcitonin＞200 pg/ml,and the cervical lymph node metastasis rate was 55.4％ (31/56).28 patients had preoperative calcitonin＜200 pg/ml,and the cervical lymph node metastasis rate was 28.6％ (8/28).The former increased and the difference was statistically significant.Of the 18 patients who underwent preoperative detection of carcinoembryonic antigen (CEA),8 patients had CEA＞30 ng/ml,cervical lymph node metastasis was 75％ (6/8);10 patients had CEA＜30 ng/ml,and the cervical lymph node metastasis was 60％(6/10).Conclusions Higher cervical lymph node metastasis is a clinical feature of MTC.For patients with thyroid capsule invasion,the risk of cervical lymph node metastasis is significantly increased,and prophylactic cervical lymph node dissection is required.Preoperative detection of calcitonin and CEA can be used to diagnose MTC and predict lymph node metastasis.The cervical lymph node dissection can be considered with reference to the concentration.
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Objective Investigated the clinical features and risk factors of pulmonary metastasis in children with papillary thyroid carcinoma aiming to provide guide for clinical work.Methods Collected the informations of 40 patients with under the age of 14,who underwent surgery in the Thyroid surgery of the First Affiliated Hospital of ZhengZhou University and confirmed for the papillary thyroid carcinoma by the postoperative pathology.At the same time,excluded studies with history of head and neck malignancy or lyphoma or secondary thyroid cancer,papillary thyroid carcinoma with hyperthyroidism and cases of imcomplete informations.The age of the 40 patients was 3 to 14 years old,12 were boy and 28 were girl.The largest tumor diameter was 7.5 cm,and the smallest was 0.3 cm.Tumor lesions were solitary in 22 cases and multiple lesions were in 18 cases.There were 33 cases of cervical lymph node metastases and 7 cases of no cervical lymph nodes.There were 10 cases of pulmonary metastasis and 30 cases of non-pulmonary metastasis.This research adopted chi-square test and Logistic regression statistical analysis of related risk factors and clinical features,including patients' age,gender,tumor diameter,number of lesions,surgical methods,neck lymph node metastasis,and pulmonary metastasis.Results The positive rate of plumonary metastsis in children with papillary thyroid carcinoma was 25％ (10/40),statistical analysis found that the positive rate of children with lung metastasis (x2 =8.620,P =0.003),tumor diameter over 2 cm (x2 =5.763,P =5.763) and the difference was statistically significant higher.Logistic regression analysis showed that the number of risk factors was multifocal papillary thyroid carcinoma in children lung metastasis (OR =13.058,P =0.028).Conclusions Higher lung metastasis is a clinical feature of thyroid papillary carcinoma in children.The risk of lung metastasis was significantly higher for children with thyroid papillary carcinoma who had multiple lessions.
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Objective To explore the clinical results of benign thyroid nodule by ultrasound guided interventional radiofrequency ablation(RFA).Methods The radiofrequency ablation therapy was utilized to treat 129 patients with 149 thyroid nodules.The size and the related complications were observed during the follow-up.Using the t-test of paired design,the nodules volume decreased rate were calculated.Results At the 3rd and the 6th month after operation,all thyroid nodules in size to differert degree (P ＜0.05).Six patients felt pain in the neck.The pain was alleviated after ablation.Two patients had skin puncture site redness,which was cured after anti-inflammation treatment.There was no skin burn,perforation of the esophagus,trachea injury,hoarseness,bucking and other complications.Conclusions Ultrasound-guided RFA may be an effective and useful nonsurgical alternative in the treatment of thyroid nodules.It is clinically prospective for application.
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Objective To investigate expression,significance and relationship of IMP3 and CD44v6 protein in papillary thyroid carcinoma.Methods Immunohistochemical method was used to investigate the expression of IMP3 and CD44v6 protein in 30 cases PTC(10 follicular variant of papillary carcinoma cases,20 conventional papillary thyroid carcinoma cases),20 PTC with lymph node metastasis cases,20 benign tissues of thyroid cases.Quantitative analysis of the detection was conducted by Biosens Digital Imaging System vl.6 (professional image analysis software),and the target integral optical density (IOD) was used for the judgement parameter.Results IMP3 and CD44v6 expression in the PTC is higher than in benign group,the difference was statistically significant (P ＜ 0.05) ; IMP3 and CD44v6 expression in PTC with lymph node metastasis was higher than without lymph node metastasis in the organization to express,the difference was statistically significant (P ＜ 0.05) ; There was a positive correlation between IMP3 and CD44v6 expression and metastasis in PTC (r =0.903,P ＜ 0.05).Conclusions The expression of IMP3 and CD44v6 protein was closely correlated with the invasion and metastasis of PTC.IMP3 and CD44v6 protein might be considered as molecular markers for PTC.
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Objective Using an adenoviral vector , the wild-type PTEN gene was transduced into activated hepatic stellate cell (HSC) in vitro and the phosphorylation status of Akt were investigated. Methods The wild type PTEN gene was transduced into activated HSC in vitro mediated by adenoviral vector. The expressions of PTEN and total Akt in HSC were measured by Western blot and Real-time fluorescent quantitation PCR. And the expressions of phosphorylated Akt (Thr308) in HSC was determined by Western blot. Results The data showed that exogenous wild type PTEN gene was successfully transduced and expressed in activated HSC in vitro. The over-expression of wild type PTEN resulted in the significant down-regulated expression of phosphorylated Akt (Thr308) in activated HSC (P 0.50). Conclusions The overexpression of wild-type PTEN can negatively regulate PI3K/Akt signaling transduction by inhibiting the phosphorylation of Akt in activated HSC in vitro.
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Objective To explore mycocardial protection effect of sevoflurane post-conditioning in off-pump coronary artery bypass grafting (OPCABG) surgery,and the mechanism of mycocardial protection of sevoflurane post-conditioning.Methods Thirty six patients undergoing OPCABG were randomly divided into three groups:at 1.5 MAC (minimum alveolar concentration) for 5 minutes first,with an interruption control group (Cont group),sevoflurane preconditioning group (SPC group),and sevoflurane postconditioning group (SPO group).All patients were administrated by intravenous anesthetic drug,both for induction and maintenance.No special interventions were used in Cont group.However,in SPC group,12 patients inhaled sevoflurane for 10 minutes,then continued for 5 minutes,total 10 minutes before the anastomotic between mammary artery and anterior descending artery.In SPO group,12 patients inhaled sevoflurane at 1.5 MAC for 2 minutes before the anastomosis of last one coronary artery,and continued for 8 minutes.Four time points were focused on including T1 (accomplishment of induction),T2 (1 hour after the coronary revascularization),T3 (6 hour after the coronary revascularization),and T4 (24 hour after the coronary revascularization).Blood samples were drawn from the internal jugular vein for the measurement of the plasma concentrations of TNT-hs (highly sensitive cardiac troponin T),CK-MB (creatine phosphokinase isoenzyme),NT-proBNP (N-Terminal fragment of the prohormone Brain-Type Natri-uretic Peptide),and TNF-α (tumornecrosis factor-α).Results All the patients completed the trials without significant adverse effects.The age,gender,ejection fraction,and operative time among three groups were no statistically significant difference (P ＞ 0.05).Stay time in postoperative ICU and hospital were significantly less than Cont group (P ＜ 0.05).Compared to the pre-operative baseline,all patients'plasma concentrations of TNT-hs,CK-MB,NT-proBNP,and TNF-α were significantly increased at 1 h,6 h,and 24 h after coronary revascularization (P ＜0.05).TNT-hs in Cont group showed a persistent increase,while in other two groups (SPC and SPO),TNT-hs reached the peak concentrations at 6 hours after the coronary revascularization,which were same with CK-MB,TNF-α,and MDA in all groups;NT-proBNP reached the peak at coronary revascularization after 24 h.Compared to Cont group,TNT-hs,CK-MB,and TNF-α in groups SPC and SPO were significantly lower at 6 h,24 h after coronary revascularization; NT-proBNP was significantly lower only at 24 h after coronary revascularization.Conclusions Sevoflurane post-conditioning in OPCABG has identified myocardial protection,which was comparable with sevoflurane preconditioning.
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Objective Analyzed the cause and time of hypokalemia complication that dexamethasone used for hyperthyroidism preoperative preparation.Methods The study consisted of 161 patients with hyperthyroidism disease,who were used the dexamethasone in his or her preoperative preparation at the First Affiliated Hospital of Zhengzhou University between August 2011 and July 2013.Results In the 161 hyperthyroidism patients,composed of 41 men and 120 women,twenty-seven patients happened hypokalemia and 92.6％ occurred after the first.Twenty-six men patients developed hypokalemia complication when used dexamethasone for hyperthyroidism preoperative preparation,while only 1 woman patient occurred the hypokalemia complication.Among the 11 patients who with a history of thyrotoxic periodic paralysis,10 cases occurred after given dexamethasone hypokalemia,only 1 case has no hypokalemia.Conclusion Dexamethasone and other drug used in hyperthyroidism preoperative preparation,which was rapid,safe and effective,but it can lead to hypokalemia complication,especial in the 24 hours after the first use,should be brought clinical doctors attentions,and give timely diagnosis and treatment.
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Objective To observe the expression distribution of bone morphogenetic proteins (BMP) in the spinal cord of normal adult rats. Methods Expression of BMP2, BMP4, and BMP7, and their receptors BMPR Ⅰa, BMPR Ⅰb, and BMP Ⅱ were detected by immunochemistry analysis in the spinal cord of normal adult rats. Results Expression of BMPR Ia or BMPR Ib was observed in the motor neurons of the anterior horn, sensory neurons of the dorsal horn, oligodentrocytes, some microglia, and some astrocytes. Expression of receptor BMPR Ⅱ was found in the oligodentrocytes and motor neurons in the gray matter of anterior horn. It was also expressed in some glial fibrillary acidic protein (GFAP)-positive astrocytes in the white matter but not in the gray matter. BMP2 and BMP4 were not expressed in the spinal cord of normal adult rats by immunohistochemistry. BMP7 was expressed in all the APC-positive oligodentrocytes, all the NeuN-positive motor neurons in the anterior horn, and some astrocytes in the normal spinal cord. Phosphated pSmad 1/5/8 protein was expressed in all the oligodentrocytes, all the neurons, and some astrocytes, especially in the GFAP-positive astrocytes which were RC2-positive radial glia in the subventricular zone.Conclusion BMP7, BMP receptors, and phosphated pSmad 1/5/8 are expressed in many types of cells whereas BMP2 and BMP4 are not expressed in the spinal cord of normal adult rats, which suggests an important function of BMP signal pathway in the neuron and glia of spinal cord.
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Objective To investigate the expression of phosphorylation-mammalian target of rapamycin (p-mTOR) in endometrial carcinoma. Methods The expressions of p-mTOR protein in tissues from 45 cases of endometrial adenocarcinoma, 7 endometrial atypical hyperplasia, and 6 normal endometrium were detected by immunohistochemistry SP method. Results The expression of p-mTOR protein maily restricted to cytoplasm. Compared with normal endometrium, the expression of p-mTOR protein in the cases of endometrial atypical hyperplasia and endometrial adenocarcinoma was significantly up-regulation(2.36 ± 0.76vs 6.21 ± 1.19, 15.82 ± 2.64)( F = 11.37, P ＜ 0.05 ). There was significant difference of p-mTOR protein in different histology class in endometrial adenocarcinoma (F = 8.27, P ＜ 0.05), but there was no significant difference of p-mTOR protein in different pathological grade in endometrial adenocarcinoma (P ＞0.05).Conclusion The expression of p-mTOR protein may participate in the occurrence and development of endometrial carcinoma.