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Hepatic encephalopathy (HE) is a common complication and an independent risk factor for death in patients with liver cirrhosis. Brain lactate level is associated with the progression and severity of HE, and research on brain lactate level may help to further explain the pathogenesis of HE. This article summarizes the metabolic process of brain lactate, the association between brain lactate level and HE, and the potential therapeutic targets for HE and provides a reference for clinicians to further systematically evaluate the progression, treatment outcome, and prognosis of patients with HE, in order to reduce the medical burden of patients and improve the prognosis of patients with HE.
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Objective:To identify the classification characteristics and quality of life (QOL) of breast cancer (BC) patients during chemotherapy, so as to provide basis for improving the sleep and QOL of this group.Methods:A cross-sectional investigation was completed among 421 BC patients in 5 tertiary hospitals in Shanghai, Wuhan, Tangshan and Nanning in 1-12 months of 2016 using validated instruments including self-made general information questionnaire, Pittsburgh Sleep Quality Index (PSQI) and Functional Assessment of Cancer Therapy-Breast (FACT-B).Results:Four latent class of patients were identified through latent profile analysis (LPA), named by badly worse sleep quality(SQ) (C1, n=23), medium-SQ with difficulty to fall asleep (C2, n=127), medium-SQ with worse sleeping process (C3, n=30), none sleep disorders (C4, n=241). Total points of SQ among C1-C4 had significant difference ( χ2 value was 309.28, P<0.05). Age, BMI, job status, whether had surgery and course of chemotherapy between classes had statistically significant differences ( χ2 values were 9.57-25.28, all P<0.05). It had significant difference between C2 and C3, C2 and C4, C3 and C1, C3 and C4 on QOL ( χ2 values were 5.96-52.73, all P<0.05). Conclusion:SQ of BC patients during chemotherapy has heterogeneity among population. Different features of SQ of BC patients have different performance on QOL. Health professionals should keep an eye on patients with features of older age, high BMI, in job status, already received surgery and during early-stage chemotherapy, provide personal nursing intervention to improve SQ and QOL.
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It is known that LINC01018 and CDK6 are associated with the occurrence, progression and recurrence of malignant tumor. Our preliminary data showed that the expression of LINC01018 was down-regulated and that of CDK6 was up-regulated, which were related with the malignancy grade. Bioinformatics suggested that E2F1 binding site exist in the CDK6 promoter region, and LINC01018 might interact with E2F1. Thus we speculate that the expression of LINC01018 in malignant tumor is decreased. The interaction between LINC01018 and E2F1 activates E2F1, promotes the transcription activation of CDK6, and affects tumor proliferation, invasion and metastasis. All these are expected to reveal the effect and mechanisms of LINC01018 in the development and regulation of malignant tumor, and provide new ideas and evidences for its treatment.
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OBJECTIVE@#To report the clinical manifestation and genetic characteristics of a child with Thiamine metabolism dysfunction syndrome 5.@*METHODS@#Clinical data and genetic results were collected and analyzed. Peripheral blood samples of the child and their parents were collected for whole exome sequencing, and the functional effect of the variants on the TPK1 enzyme activity was verified by an in vitro assay.@*RESULTS@#A four-year-old boy presented with preschool onset of ataxia were characterized. High-throughput sequencing identified a novel homozygous variant of TPK1 gene c.382G>A (p.Leu128Phe). His father and mother were both found carrying the variant. The variant protein showed a 30.9% reduction in TPK1 enzyme activity compared with the wildtype.@*CONCLUSION@#A novel pathogenic variant has been identified in a boy with thiamine metabolic dysfunction syndrome type 5.
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Child, Preschool , Humans , Male , Genetic Testing , Homozygote , Mutation , Thiamine , Exome SequencingABSTRACT
Objective To observe the effect of Tomatis converted auditory training on the executive functioning of breast cancer patients undergoing chemotherapy.Methods Eighty breast cancer patients with the executive dysfunction who were undergoing chemotherapy were divided into a control group and an experimental group,each of 40.The experimental group was given Tomatis high and low frequency auditory training,while the control group was given ordinary music training.The patients in both groups were treated in 4 stages,each of 5 consecutive days with intervals of 21 days.The Chinese Version of the Behavioral Assessment of Dysexecutive Syndrome (BADS) was used to evaluate both groups before and after the intervention,including rule transformation ability,problem solving ability,planning ability,supervising ability and organizing ability.Results After the intervention,the experimental group had a significantly higher average score than before the intervention in the rule-switching card test,the action planning test,the key-finding test,and the modified six-element test.Their average BADS score was also significantly improved.The control group showed a significantly better average score only in the key-finding test and in its average BADS total score.After the intervention,the experimental group had a significantly higher average score than the control group in the rule-switching card test and the action planning and six-element tests.Its average BADS rating was also significantly better.Conclusion Tomatis high and low frequency auditory training can improve the executive function of patients undergoing chemotherapy for breast cancer.Its effect is better than that of ordinary music training.
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Objective To investigate the occurrence of common symptoms in breast cancer patients in different chemotherapy periods and to analyze the relationship with the chemotherapy periods. Methods A total of four hundred and fifty?six breast cancer patients receiving chemotherapy in Tangshan Cancer Hospital from August 2016 to August 2017 were investigated via common symptom questionnaire among breast cancer patients. The results of the investigation were statistically analyzed, and the relationship between chemotherapy related symptoms and chemotherapy periods was analyzed by multiple Logistic regression analysis. Results In terms of the 20 kinds of chemotherapy symptoms, among the patients whose incidence rate was >50％ had 9 kinds of symptoms. Multivariate Logistic regression analysis showed that alopecia (95％ CI=5. 820～562. 784,P=0. 001) ,skin allergy ( 95％ CI=0. 002～0. 157,P<0. 001) ,cancer caused insomnia( 95％ CI=1. 179～25. 638, P=0. 030) ,dry mouth ( 95％ CI=0. 008～0. 470,P=0. 007) ,vaginal dryness or burning heat ( 95％ CI=13. 368～647. 615 P<0. 001) ,oral ulcer ( 95％CI=0. 026～0. 654,P=0. 013) ,abnormal defecation ( 95％ CI=0. 025～0. 749,P=0. 022),memory loss (95％CI=1. 065～19. 415,P=0. 041),distal phalanges numbness (95％ CI=0. 004～0. 421,P=0. 007),poor appetite (95％ CI=1. 189～65. 964,P=0. 033),local skin irritation /ulceration ( 95％ CI=0. 003～0. 143, P<0. 001 ) were associated with the chemotherapy, the difference was statistically significant. The above symptoms can be divided into 3 symptom groups by factor analysis,and they were respectively medicine side effect symptom cluster, neuropsychiatric symptom cluster and mucocutaneous symptom cluster. Conclusion There are many symptom clusters that affect the life and rehabilitation level in patients with breast cancer during chemotherapy, and are closely related with the chemotherap cycle. Doctors should adopt a scientific model of symptom management and take measures to improve the survival state of the patients.
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Objective To observe the effect of TOMATIS auditory training on improving cognitive and post-traumatic stress disorder in patients after breast cancer chemotherapy. Methods Eighty invasive ductal carcinoma of breast cancer patients with cognition and psychological disorders were selected in the breast department of Tangshan People's Hospital from October 2016 to September 2017. All patients were randomly divided into control group ( n=40) and experimental group ( n=40) . The experimental group was given the TOMATIS high and low audio frequency auditory training,and the control group was given ordinary music training. Before and after the intervention, the Chinese version of the Montreal cognitive assessment scale ( MoCA) and the post-traumatic stress disorder scale ( PTSD-SS) were evaluated for both groups of pa-tients. Results After the intervention,the experimental group had significantly higher scores in visual struc-ture skills((3. 83±0. 71)vs(2. 68±0. 57)),executive function ((2. 23±0. 53)vs(1. 55±0. 50)),attention and concentration((1. 55±0. 78)vs(1. 23±0. 53)),language((1. 50±0. 75)vs(1. 08±0. 47)),calculation ((2. 00±0. 60)vs(1. 45±0. 75)),abstract thinking((1. 63±0. 54)vs(1. 00±0. 51)),memory((4. 68± 0. 47)vs(2. 70±0. 72)),directive force((5. 25±0. 54)vs(3. 90±0. 81)) and total score((22. 65±2. 89)vs (15. 58±2. 10))than the control group(all P<0. 05). After intervention,the scores of subjective assessment of traumatic events((2. 60±0. 63)vs(3. 98±0. 62)),repeated recurring experiences((24.05±2.72)vs (26. 70±2. 28)),avoidance symptoms((24. 35±1. 64)vs(26. 40±1. 19)),increased alertness((24. 23± 1. 80)vs(25. 45±1. 20)),impaired social function((7. 28±1. 01)vs(8. 68±0. 66)),and total scores((85. 85±5. 13)vs(94. 63±2. 92)) in the experimental group were significantly lower than those in the control group,and the differences were statistically significant ( all P<0. 01) . Conclusion TOMATIS auditory train-ing can effectively improve the cognitive function and psychological state in breast cancer chemotherapy pa-tients,which is worthy of popularization and application.
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<p><b>OBJECTIVE</b>To establish the risk model for predicting the progression within 1 year of patients with gastric neuroendocrine neoplasms(gNEN) and to evaluate its value of prediction.</p><p><b>METHODS</b>Clinical data of 127 gENE patients with histologically comfirmed sporadic gNEN from January 1999 to February 2015 in Nanfang Hospital of Southern Medical University(n=63) and The First Affiliated Hospital of Sun Yat-sen University(n=64) were collected retrospectively. Twenty-five patients without follow-up were excluded, so a total of 102 cases were enrolled in the analysis. Tumor size enlargement, lesion number increase, recurrence after resection of primary tumor and emergence of tumor metastasis were defined as tumor progression. Patients were divided into progression group (above definitions occurred within 1 year, n=56) and non-progression group (above definitions did not occur within 1 year, n=46). Logistic regression analysis was used to identify the influencing factors of progression within 1 year and the regression equation was acquired, then the probability of progression within 1 year of gNEN patients was obtained to predict the grading: grade I(: the probability of tumor progression within 1 year was < 25.0%; grade II(: this probability was from ≥25.0% to <50.0%; grade III(: this probability was from ≥50.0% to <75.0%; grade IIII(:this probability was ≥75.0%. Spearman correlation analysis was used to study the correlation between predictive grading and the occurrence of disease progression in patients with gNEN NET within 1 years. The ROC curve of different prediction methods was drawn, then the area under the curve(AUC), sensitivity and specificity were calculated and compared.</p><p><b>RESULTS</b>Multivariate regression analysis showed that tumor size(OR=1.048, 95%CI:1.014-1.083, P=0.005), Ki-67 index(OR=2.045, 95%CI:1.261-3.316, P=0.004), and surgical resection of the primary lesion(OR=0.074, 95%CI:0.011-0.497, P=0.070) were independent influencing factors of the progression of gNET within 1 year. The regression equation was as below: P(Y)=1/[1+ e -(-0.934+0.047a+0.715b-2.597c)]. (a: tumor size, b: Ki-67 grading, c: undergoing the surgical resection of the primary lesion). Prediction grading was based on regression equation: 28 cases (29.2%) belonged to grade I(, 9 cases (9.4%) to grade II(, 24 cases (25.0%) to grade III(, and 35 cases (36.5%) to grade IIII(. The probability of progression within 1 year of patients in grade I(, II(, III( and IIII( was 10.7% (3/28),5/9, 58.3%(14/24), and 91.4%(32/35) respectively, with significant difference (χ=41.236, P=0.000). Prediction grading was positively correlated with the occurrence of tumor progression in gNEN patients within 1 year(r=0.644, P=0.000). The AUC of prediction grading to predict the progression of gNEN within 1 year was 0.857, while the sensitivity was 85.2% and the specificity was 69.0%. DeLong method was used to compare the AUC values of prediction grading, Ki-67 grading and TNM staging. Comparison result revealed that the predictive value of prediction grading was not significantly different with that of TNM staging (P=0.303), but was better than that of Ki-67 grading (P=0.006).</p><p><b>CONCLUSIONS</b>Our grading standard can objectively and accurately reflect the probability of progression within one year in gNEN patients. The later the grading, the higher the probability of progression within 1 year is for gNEN patients.</p>
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Aged , Female , Humans , Male , Middle Aged , Disease Progression , Multivariate Analysis , Neoplasm Recurrence, Local , Neoplasm Staging , Neuroendocrine Tumors , Pathology , Therapeutics , ROC Curve , Retrospective Studies , Risk , Sensitivity and Specificity , Stomach Neoplasms , Pathology , TherapeuticsABSTRACT
Objective To observe the clinical efficacy of thermal electroacupuncture therapy in treating lumbodorsal myofascitis. Method Sixty-two patients with lumbodorsal myofascitis were randomized into a treatment group of 30 cases and a control group of 32 cases. The treatment group was intervened by thermal electroacupuncture therapy, while the control group was by orally taking Meloxicam tablets. The Visual Analogue Scale (VAS) was observed before and after treatment, and the clinical efficacies were compared.Result The total effective rate was 100.0% in the treatment group versus 78.1% in the control group, and the difference was statistically significant (P<0.05). The VAS scores were significantly changed after treatment in both groups (P<0.05). After treatment, the VAS score in the treatment group was significantly different from that in the control group (P<0.05).Conclusion Thermal electroacupuncture therapy is an effective approach in treating lumbodorsal myofascitis.
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Objective To evaluate the efficacy of heat sensitive moxibustion plus herbal hot compress for primary dysmenorrhea. Methods Ninety patients with primary dysmenorrhea were randomly allocated to a treatment and a control group, with 45 patients in each group. The treatment group was treated with heat sensitive moxibustion plus herbal hot compress, and the control group received ibuprofen (slow-release capsule) for three menstrual cycles. Results At the end of the first menstrual cycle, the total instant effective rate in the treatment group was significantly higher than that in the control group (95.6%vs. 82.2%;χ2=4.050, P<0.05);at the end of the third menstrual cycle, healing rate (66.7% vs. 35.6%; χ2=8.720, P<0.05), total effective rate (97.8%vs. 80.0%;χ2=7.200, P<0.05) in the treatment group were significantly higher than those in the control group;at 6 months follow-up, the relapse rate in the treatment group were significantly lower than that in the control group (6.7% vs. 43.8%; χ2=4.050, P<0.05). Conclusion Heat sensitive moxibustion plus herbal hot compress is a effective approach for primary dysmenorrhea.
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Objective: To investigate the intervention effect of electroacupuncture on post-withdrawal anxiety and depression of those with heroin dependence. Method: One hundred and twenty heroin dependence cases were randomly allocated into 4 groups, including acupuncture group 1 using Jiaji (Ex-B 2) points and Shenshu (BL 23), acupuncture group 2 using points in the four limbs, simulation and control groups. Then the SAS and SDS changes were observed before the treatment and 4th, 8th and 10th week after. Result: At the 4th, 8th and 10th week, the SAS and SDS scores in acupuncture group 1 and 2 showed significant differences with the control group (P<0.01, P<0.05). There were significant differences between SAS changes in acupuncture group 1 and 2 but there was no significant difference in SDS changes. Conclusion:Electroacupuncture can improve the post-withdrawal anxiety and depression in heroin addicts.Jiaji (Ex-B 2) points showed significantly better effects in improving anxiety than points in four limbs but no significant difference in improving depression.
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<p><b>OBJECTIVE</b>This study was conducted to observe dynamically the serum and stool level of IL-2, IL-6 and IFN-alpha with RV enteritis, and to analyse the relation of them and their relation to clinical manifestations.</p><p><b>METHODS</b>The double-antibody sandwich ELISA technique was applied.</p><p><b>RESULTS</b>The positive rate of RV in 119 enteritis cases was 63.0% and the peak month was November. These cytokines had different peak phases in the course of disease. The earliest cytokine which had peak phase was IFN-alpha, the last ones were serum and stool IL-2. There was a negative relation between stool IL-2 and IL-6 (P<0.01). There were positive relation between IL-2 and IFN-alpha, stool IL-6 and IFN-alpha, serum IL-2 and IL-6, stool IL-2 and the recovery time of the enteritis (P<0.01 or P<0.05). Serum and stool level of IL-2 and IFN-alpha had positive relation to the number of lymphocyte plus mononuclear cells (P<0.01 or P<0.05).</p><p><b>CONCLUSIONS</b>IL-2, IL-6 and IFN-alpha play important roles of immunoregulation in RV enteritis, and have close relation to clinical manifestations.</p>