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Objective To retrospectively analyze the epidemiological trend of children with lower gastrointestinal bleeding in recent 10 years,and investigate the change of their disease burden,so as to provide a theoretical basis for the accurate prevention and control of children's lower gastrointestinal bleeding. Methods A total of 671 children with "lower gastrointestinal bleeding" who were diagnosed in our hospital from 2012 to 2021 were collected as research subjects. To analyze the microscopic examination rate and common etiology of lower gastrointestinal bleeding in children in the past 10 years,as well as the epidemiological characteristics of different age groups, different regions and different basic diseases; Calculate and compare the rate of disability life lost (YLD), early death life lost (YLL) and disability adjusted life year (DALY) of children with lower gastrointestinal bleeding within 10 years, and calculate the annual change percentage (AAPC) to analyze the change trend of disease burden. Results The microscopic examination rate of children with lower gastrointestinal bleeding showed a trend of increasing in the past 10 years (P18 years old, hypertension and gastroenteritis. The DALY rate, YLL rate and YLD rate caused by lower gastrointestinal bleeding in the past 10 years showed an upward trend (P<0.05). Conclusion The microscopic examination rate of lower gastrointestinal bleeding in children was graduallyincreasing,and the prevalence rate of basic diseases such as boys,hypertension and gastroenteritis was increasing;in addition,the disease burden caused by children's lower gastrointestinal bleeding was also increasing year by year and should be protected.
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Objective:To investigate the application value of single-port laparoscopic left lateral donor liver acquisition in pediatric living donor liver transplantation (PLDLT).Methods:The retrospective and descriptive study was conducted. The clinical data of the donor and recipient who were admitted to Beijing Friendship Hospital of Capital Medical University for PLDLT in January 2020 were collected. The donor was a male, aged 28 years with body mass as 62 kg, height as 174 cm and body mass index (BMI) as 20.5 kg/m 2. The recipient was the daughter of the donor, aged 1 year with body mass as 9 kg, height as 75 cm and BMI as 16.0 kg/m 2. The donor underwent single-port laparoscopic left lateral donor liver acquisition. The recipient underwent living donor liver trans-plantation by the same operation team. Observation indicators: (1) intraoperative conditions; (2) postoperative conditions; (3) follow-up. Results:(1) Intraoperative conditions. The donor under-went single-port laparoscopic left lateral donor liver acquisition successfully, with the single-port access system being placed through a transumbilical incision. The operation time, the warm ischemia time of the donor liver and volume of intraoperative blood loss were 240 minutes, 3 minutes and 40 mL, respectively, of the donor. The weight of the donor liver was 233.6 g, and the corrected graft-to-recipient body weight ratio was 2.60%. The recipient underwent living donor liver transplantation successfully. (2) Postoperative conditions. The donor began to take liquid diet at postoperative day 1, and results of laboratory examination showed that the alanine aminotransferase (ALT), aspartate aminotransferase (AST), glutamyltransferase (GGT) and total bilirubin (TBil) of the donor was 239 U/L, 116 U/L, 53 U/L and 22.57 μmol/L. The donor began to take diet with high quality proteins at postoperative day 2, and to get for out-of-bed activities moderately. The donor′s peritoneal drainage fluid was light red at postoperative day 3, and no fluid accumulation was found in the operation area after abdominal B-ultrasound examination, so the peritoneal drainage tube was removed. The donor was discharged at postoperative day 4. The liver function of the recipient recovered to normal level 2 weeks after the operation. (3) Follow-up. The donor was followed up by outpatient examination 2 weeks after discharged, and results of laboratory examination showed that the ALT, AST, GGT and TBil was 44 U/L, 25 U/L, 53 U/L and 9.22 μmol/L, respectively. Neither the donor nor the recipient had complication ≥Ⅱ grade of the Clavien-Dino classification, such as biliary fistula and vascular complication during the 6 months after operation.Conclusion:Single-port laparoscopic left lateral donor liver acquisition can be used into the PLDLT.
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Objective:To quantify any correlation between serum levels of omega-3 polyunsaturated fatty acids (ω3-PUFAs) and post-stroke cognitive impairment (PSCI).Methods:The clinical data of 77 patients hospitalized after a first stroke were analyzed. The Minimum Mental State Examination (MMSE) was used to divide them into impaired (PSCI) and unimpaired (non-PSCI) cohorts. The serum levels of ω3-PUFAs, α-linolenic acid (ALA), eieosapentaenoic acid (EPA) and dueosahexenoie acid (DHA) were compared between the two groups and correlated with the individuals′ MMSE scores.Results:The average ALA, EPA, DHA and total ω3-PUFAs levels of PSCI group were in most cases significantly lower than those of the non-PSCI group. Spearman correlation analysis showed that serum DHA level was a weak positive predictor of the MMSE scores (R=0.32, P≤0.05). Logistic regression analysis indicated that low serum DHA level was an independent risk factor for PSCI ( P≤0.01). Conclusions:Cognitively impaired stroke survivors tend to have lower serum ω3-PUFAs levels than those without cognitive impairment. There is a weak positive correlation between serum DHA levels and MMSE scores. Low serum DHA level is an independent risk factor for PSCI. The serum level of ω3-PUFAs is of high value in the auxiliary diagnosis and evaluation of PSCI.
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With the development of endoscopic thyroidectomy, the complications of thyroidectomy and the formation of cervical scar are effectively reduced, which are recognized by surgeons and patients.However, with the development of artificial and robot endoscopic thyroid surgery, there are many kinds of operation methods and approaches.Different operation methods and approaches have their own advantages and disadvantages.In the scope of indications, endoscopic thyroidectomy with artificial and robot has the same effect as traditional thyroidectomy, and has a broader application prospect
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With the development of endoscopic thyroidectomy, the complications of thyroidectomy and the formation of cervical scar are effectively reduced, which are recognized by surgeons and patients.However, with the development of artificial and robot endoscopic thyroid surgery, there are many kinds of operation methods and approaches.Different operation methods and approaches have their own advantages and disadvantages.In the scope of indications, endoscopic thyroidectomy with artificial and robot has the same effect as traditional thyroidectomy, and has a broader application prospect
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Objective@#To investigate the safety of argatroban in vertebral artery stenting and its effect on postoperative restenosis.@*Methods@#From January 2013 to September 2017, patients undergoing vertebral artery stenting in the Department of Neurology, Jinling Hospital were enrolled prospectively. They were divided into agatraban group and heparin group by random number table method. The argatroban group received argatroban anticoagulation during the procedure, and was continuously used for 5 d after procedure; while the heparin group underwent heparin anticoagulation during the procedure, and used saline as placebo after procedure. Clinical follow-up was performed at 1, 3, and 6 months after procedure. Digital subtraction angiography, CT angiography, or magnetic resonance angiography were performed at 6 months to evaluate the restenosis of the treated blood vessels. The primary endpoints included intraoperative safety, in-stent restenosis after procedure, and any clinical events that occurred during the follow-up period, including stroke, cardiovascular events, and death. Major safety events included bleeding from various organs, allergic reactions, liver dysfunction, and embolism events. Kaplan-Meier survival curve was used to evaluate the incidence of vascular events during the follow-up period.@*Results@#A total of 105 patients were enrolled in the analysis, including 53 in the argatroban group and 52 in the heparin group. During the periprocedural period, no hemorrhagic events, allergic reactions, liver dysfunction or embolism events occurred in both groups. There were no significant differences in preoperative vertebral artery stenosis degree, postoperative residual stenosis degree, and stenosis degree at 6 months after procedure between the two groups, but the increase of stent stenosis at 6 months after procedure in the agatroban group was significantly lower than that in the heparin group (13.56%±26.41% vs. 4.25%±15.76%; P=0.031). There was no significant difference in the incidence of stroke recurrence (P=1.000) and clinical events (P=0.739) between the two groups during the long-term follow-up period.@*Conclusions@#It is safe to use agatraban anticoagulant therapy in the vertebral artery stenting. Continuous use of agatraban anticoagulation after procedure may effectively reduce the increase of stent stenosis at 6 months after procedure.
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OBJECTIVE@#In order to obtain more decision information from Digital Radiography(DR) images, an improved image enhancement algorithm is proposed based on the algorithm of Gauss-Laplacian pyramid.@*METHODS@#The original algorithm is improved on the basis of the human visual characteristics and better enhancements, the low frequency components of the image is histogram equalized to make the image gray scale more balanced, and the high frequency component is enhanced by a hierarchical exponential enhancement to make the details of the image clearer.@*RESULTS@#The improved algorithm improves the contrast of DR images in chest, pelvic and spine, and makes the image more layered and obtains good image enhancement effect.@*CONCLUSIONS@#The results show that the improved algorithm is superior to the traditional algorithm in terms of image enhancement.
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Humans , Algorithms , Image Enhancement , Radiographic Image EnhancementABSTRACT
Objective To investigate the safety of argatroban in vertebral artery stenting and its effect on postoperative restenosis.Methods From January 2013 to September 2017,patients undergoing vertebral artery stenting in the Department of Neurology,Jinling Hospital were enrolled prospectively.They were divided into agatraban group and heparin group by random number table method.The argatroban group received argatroban anticoagulation during the procedure,and was continuously used for 5 d after procedure;while the heparin group underwent heparin anticoagulation during the procedure,and used saline as placebo after procedure.Clinical follow-up was performed at 1,3,and 6 months after procedure.Digital subtraction angiography,CT angiography,or magnetic resonance angiography were performed at 6 months to evaluate the restenosis of the treated blood vessels.The primary endpoints included intraoperative safety,in-stent restenosis after procedure,and any clinical events that occurred during the follow-up period,including stroke,cardiovascular events,and death.Major safety events included bleeding from various organs,allergic reactions,liver dysfunction,and embolism events.Kaplan-Meier survival curve was used to evaluate the incidence of vascular events during the follow-up period.Results A total of 105 patients were enrolled in the analysis,including 53 in the argatroban group and 52 in the heparin group.During the periprocedural period,no hemorrhagic events,allergic reactions,liver dysfunction or embolism events occurred in both groups.There were no significant differences in preoperative vertebral artery stenosis degree,postoperative residual stenosis degree,and stenosis degree at 6 months after procedure between the two groups,but the increase of stent stenosis at 6 months after procedure in the agatroban group was significantly lower than that in the heparin group (13.56％ ±26.41％ vs.4.25％ ± 15.76％;P =0.031).There was no significant difference in the incidence of stroke recurrence (P =1.000) and clinical events (P=0.739) between the two groups during the long-term follow-up period.Conclusions It is safe to use agatraban anticoagulant therapy in the vertebral artery stenting.Continuous use of agatraban anticoagulation after procedure may effectively reduce the increase of stent stenosis at 6 months after procedure.
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OBJECTIVE:To provide basis and thinking for the development of medicines for treating depression. METHODS:Rats with adaptive feeding for 7 d were randomly divided into normal group,depression group and treatment group(citalopram hy-drobromide 1 mg/kg),8 in each group. Rats in depression group and treatment groups randomly received once low-density stimula-tion in a day [catching tail stimulation(1 min),frequent flashing stimulation(120 times/min,12 h),noise stimulation(4 h),ice water swimming stimulation(1 h),hot water stimulation(45 ℃,1 h),electric shocking foot(10 Hz,1 mA,each time interval of 100 ms,100 times),no food and no water(24 h)] for 21 d to reduce stress depression model. Body mass of rats in 0,7 d of adaptive feeding and 7,14,21 d of stress were respectively weighed,and horizontal activity and vertical activity frequencies in open field test were detected. After stress,rats were intragastrically administrated related medicines for 30 d,then 5-hydroxytrypta-mine (5-HT) and tryptophan hydroxylase (TPH) expressions in brain,liver,kidney tissues were determined. RESULTS:Com-pared with normal group,the increasing trend of body mass in depression group and treatment group slowed down from the 14 d of stress(P<0.05). The horizontal activity frequencies in depression group and treatment group in 14,21 d of stress slowed more ob-viously than the previous time point (P<0.05 or P<0.01);vertical activity frequencies in 21 d of stress slowed more obviously than the previous time point (P<0.05 or P<0.01). After 30 d of administration,horizontal activity and vertical activity frequen-cies in treatment group were increased more obviously than the previous time point (P<0.01). Compared with depression group,brain tissue of rats,indicating that TPH can be used as a target for depression treatment.
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Objective To study the correlations between the leptin levels and the prevalence cervical carcinoma. Methods Blood samples were collected from 79 patients with cervical squamous cell carcinoma, 28 patients with cervical intraepithelial neoplasia and 35 healthy donors. The serum leptin concentrations were measured by enzyme linked immunosorbent assay. Meanwhile, tissue samples were obtained from the patients with cervical cancer and cervical intraepithelial neoplasia, Then the expressions oleptin in these tissues were detected by Western blot. Results The level of serum leptin in the patients with cervical cancer was significantly higher than those both in the patients with cervical epithelial tumor and in the healthy control group. the Western blot results also confirmed that the the expressions of leptin in the tumor tissues were atwas the highest level. Conclusion The elevated levels of leptin in serum and tumor tissues of patients with cervical cancer suggest that leptin may be involved in the occurrence and development of cervical cancer.
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Objective The purpose of this study is to study the expression of miR -221 in cervical cancer tissues and its relationship with HPV infection .Methods HR-HPV infection was detected by HC2,and 30 cases of HR-HPV negative and 5 cases of HR-HPV positive cervical cancer tissues were collected .Mean-while,30 cases of normal cervical tissues in patients with benign disease were collected as control group .The ex-pression of miR -221was detected by RT -PCR,preliminarily investigating the relationship between miR -221 expression and the occurrence of cervical cancer and HPV infection .Through transfection of miR-221 and anti-miR-221 into HPV16-positive cervical carcinoma cell line Caski and HPV 16-negative cervical carcinoma cell line C33a,we observed the role of miR -221 on the migration and invasion of Caski cells and C 33a cells.Results Compared with normal cervical tissues , the expression of miR -221 in cervical cancer was significantly in-creased,the difference was statistically significant( P<0.01);and the expression of miR-221 was closely correl-ative to the patients with or without lymph node metastasis ,pathological grade and clinical stage ( P<0 .01 );the expression of miR-221 in HR-HPV positive cervical cancer tissues was higher than in HR -HPV negative cer-vical cancer tissues(P<0.01);transfection of miR -221 and anti-miR-221 could promote or downregulate C33 a and Caski cells migration and invasion ,and the changes between two groups had statistical significance ( P<0.05).Conclusion The increased expression of miR -221 in cervical cancer tissues is closely related to the oc-currence and development of cervical cancer and HPV infection .