ABSTRACT
Objective:To investigate the clinical features, characteristics under white-light endoscopy and endoscopic ultrasonography, and treatment strategies of gastritis cystica profunda (GCP) accompanied with or without neoplastic lesions.Methods:Clinical data of 35 patients, who were pathologically diagnosed as having GCP after endoscopic or surgical resection in Beijing Friendship Hospital, Capital Medical University from January 2015 to February 2021, were retrospectively collected, including 27 patients with neoplastic lesions. The demographic information, clinical manifestations, endoscopic features, treatment methods, and pathological results of GCP were summarized.Results:Thirty-five patients with GCP were 68.26±8.08 years old, and mostly male (80.00%, 28/35). The most common symptom was upper abdominal pain, accounting for 31.43% (11/35), and 25.71% (9/35) had no symptoms. Other symptoms included acid reflux, heartburn, abdominal distension, anemia, and choking sensation after eating. The most common site of GCP was cardia (51.43%, 18/35), and the main endoscopic manifestations of GCP were flat mucosal lesions (68.57%, 24/35), mainly 0-Ⅱa and 0-Ⅱa+Ⅱc type lesions, accounting for 66.67% (16/24). The second common endoscopic manifestation was polypoid eminence (20.00%, 7/35). Endoscopic ultrasonography was performed in 15 patients, with main manifestations of uniform hypoechoic with or without cystic echo (73.33%, 11/15). Among the GCP cases, 33 patients received endoscopic resection, and 2 received surgical treatment. The treatment processes were all successfully completed, and en-bloc resection was accomplished for all lesions receiving endoscopy, with the mean endoscopic operation time of 86.13 min. One patient suffered postoperative delayed bleeding after ESD which was stopped by endoscopic hemostasis. Final pathological results showed that the proportion of GCP complicated with neoplastic lesions was 77.14% (27/35), 68.57% (24/35) with early gastric cancer or precursor. Twenty-three cases achieved R0 resection. One case showed positive basal resection margin and vascular invasion, and recurrence happened in situ at the 5th month of follow-up, surgical resection was then performed. The endoscopic complete resection rate was 95.83% (23/24).Conclusion:GCP usually occurs in middle-aged and elderly male, often located in cardia, manifested mainly as flat mucosal lesions and polypoid changes. Endoscopic ultrasonography shows a high diagnostic value for GCP, and endoscopic treatment is safe and effective minimally invasive treatment for GCP.
ABSTRACT
Objective:The paper aims to investigate the current situation and influencing factors of clinical research data sharing of gastroenterology collaboration network of Beijing municipal hospitals so as to provide reference basis for establishing data sharing mode of collaboration center.Methods:A total of 13 gastroenterology department of Beijing municipal hospital collaboration network units enrolled the research. Each department selected 10-15 clinicians for a questionnaire survey. A total of 157 valid questionnaires were collected.Results:The awareness rate of public data platform(realized at least one) is 81.5%. The rate of browsing public data platform is 65.6%. The rate of downloading and uploading rare data are 13.4% and 1.3%, respectively. As the level of professional titles increases, the proportion of clinicians realizing and downloading raw data has increased significantly( P<0.05). In this survey, 31.3% clinicians used the sharing data from other hospitals within the research group and 53.5% clinicians indicated that there is the data sharing platform based on hospital information system within their hospital/department. The rate of willing to share clinical data is 73.3%. However, a majority of clinicians are inclined to accept the sharing within the research group/hospital, and they prefer to share their data when their papers or research results are published. Data storage is mainly numerical and text structured data. Sharing risk, sharing platform, sharing system and data itself are the top four factors affecting data sharing. Conclusions:Relevant departments should strive to establish sharing mechanism, build sharing platforms, refine the sharing access qualification and improve the sharing awareness of medical personnel so as to lay a necessary foundation for further open sharing of big data on digestive diseases.
ABSTRACT
Objective:To investigate the safety, efficacy and survival of brentuximab vedotin (BV) monotherapy and BV combined with chemotherapy for relapsed or refractory lymphoma.Methods:A total of 47 patients with relapsed or refractory Hodgkin's lymphoma (HL) in First Medical Center of PLA general Hospital and Fourth Medical Center of PLA General Hospital from October 2011 to December 2018 were admitted, including 35 cases (BV monotherapy group) and 12 cases (BV combined with chemotherapy group); there were 8 cases of relapsed or refractory anaplastic large cell lymphoma (ALCL), 4 cases in BV monotherapy group and 4 cases in BV combined with chemotherapy group. The safety, clinical efficacy and survival of two neoplasms in different groups were compared.Results:For relapsed or refractory HL, the objective remission rate (ORR) and complete remission rate (CRR) was 67.7% (21/31) and 16.1% (5/31), and the median progressive-free survival (PFS) time was 3.5 months (1.5-24.0 months) in BV monotherapy group; ORR and CRR was 81.8% (9/11) and 27.3% (3/11), and median PFS time was 5.5 months (2.0 - 24.0 months) in BV combined with chemotherapy group; there was no statistical difference in ORR and CRR between the both groups (χ 2 = 0.788, P = 0.375; χ 2 = 0.654, P = 0.419). There were 4 cases in BV monotherapy group for ALCL, of which 3 could be evaluated for efficacy, including 1 case of complete remission (CR) and 1 case of partial remission (PR); there were 4 cases in BV combined with chemotherapy group for ALCL, of which 4 could be evaluated for efficacy, including 2 cases of CR and 2 cases of PR. The common adverse events in BV monotherapy group were anemia, leukopenia, thrombocytopenia, fever, elevated transaminase, fatigue, nausea, peripheral neuritis and cough. Grade ≥3 adverse events were mainly anemia, thrombocytopenia and leukopenia. The common adverse events of BV combined with chemotherapy group were similar to those of BV monotherapy group, and there were significant differences in bone marrow suppression (thrombocytopenia, leukopenia) between the two groups (all P < 0.05). Conclusions:The clinical efficacy of BV combined with chemotherapy is better than that of BV monotherapy in treatment of relapsed or refractory lymphoma, and the survival time is prolonged. The adverse reaction of BV combined with chemotherapy is mainly manifested in bone marrow suppression, and the safety and tolerability of patients are acceptable.
ABSTRACT
Objective Taking the Digestive Medical Coordinated Development Center of Beijing Municipal Administration of Hospitals (hereinafter referred to as the "Digestive Medical Coordinated Development Center") as an example ,this paper aims to ex-plore the idea of building a collaborative development system of medical disciplines dominated by advantageous disciplines .Methods Summarizing the construction experience of the Digestive Medical Coordinated Development Center to illustrate the significance ,identify existed challenges and construction pathways of the center .Results The Digestive Medical Coordinated Development Center has built a series of public service platforms for its member institutions ,and improved the system and incentive mechanism to gather the develop-ment synergy of the center .Conclusions Based on the advantages of the collectivized management of Beijing Municipal Administration of Hospital ,the Digestive Medical Coordinated Development Center advances synchronously in the dimensions of scientific research , medical treatment ,information construction and talent ,as well as formed its own development characteristics and accumulated valuable experience for the construction of discipline collaboration center of municipal hospitals .
ABSTRACT
Objective To investigate the effect of 12-O-tetradecanoylophorbol-13-decanoate(TPD)on protection against acute intestinal radiation injury of mice and the possible mechanism.Methods Twenty female BALB/c mice aged 6-8 weeks were divided by random number table method into the control group and TPD groups(25,50,and 100 μg/kg). A radiation-damaged model of mice was irradiated by 10 Gy 60Co γ-rays,while the TPD groups were pretreated for 3 d with caudal vein injection before irradiation.The survival time of 20 days and the number of crypts at 3.5 days after irradiation were detected.Rat intestinal epithelial cells(IEC-6)were treated with 1 nmol/L TPD for 12 h before irradiation with 10 Gy 60Co γ-rays,and CCK-8 was used to detect the capability of cell proliferation at 0,1,2,3 and 4 d after irradiation. Results The mice in the control group survived for an average of 4.2 days,compared to 10 days in the optimal TPD group (100 μg/kg).The average number of crypts in the control group and the best TPD group was 11.0 ±1.3 and 35.1 ±1.9 respectively.The proliferation activity of IEC-6 was measured for four consecutive days.The average D value of the TPD groups was significantly higher than that of control.Conclusion TPD has a protective effect against acute intestinal radiation injury, and its protective mechanism may be achieved by promoting intestinal crypt cell proliferation and increasing the number of crypts in the intestine.
ABSTRACT
<p><b>OBJECTIVE</b>To investigate the therapeutic effectiveness and side effects of decitabine combined with or without cytarabine-based low dose regimen for acute myeloid leukemia in geratic patients.</p><p><b>METHODS</b>Clinical data of 8 geratic patients (aged over 70 years) suffered from acute myeloid leukemia from September 2009 to March 2012 were analyzed retrospectively, including age, sex, peripheral blood and bone marrow characteristics and so on. These patients were treated by an 1-hour intravenous infusion of decitabine 20 mg/mper day for 5 consecutive days every 4 weeks combined with or without low dose regimen dominantly consisting of cytarabine 20 mg per day as subcutaneous injection for seven consecutive days. The therapeutic effectiveness and side-effects were evaluated.</p><p><b>RESULTS</b>Among 8 patients, incinding 3 males and 5 females aged between 71-84 years old, their median white blood cell count was 31.2(1.38-179)× 10/L, and median bone marrow blast cell ratio was 42.7(23-94)% at the initial diagnosis.The median treatment courses was 2.5 (1-20).After treatment by this protocol,2 patients achieved complete remission(CR) (25%), 2 patients achieved partial remission (PR)(25%), 3 were not relieved, and 1 died, thus the overall response rate reached to 50% (4/8). The median overall survival time was 9.5 (2-36) months, and the overall survival time of 3 patients reached 1 year or more. The main side-effects of treatment were grade III-IV of myelosuppression (87.5%) and pneumonia (50%).</p><p><b>CONCLUSION</b>Decitabine combined with or without cytarabine-based low dose regimen is promising for the treatment of geriatric acute myeloid leukemia, thus improving the overall response rate, and prolonging overall survival time.</p>
ABSTRACT
AIM To observe the effects of aqueous extract of Isatidis Radix (AEIR) on formation of hyperlipidemia in rats.METHODS Seventy-two male SD rats were randomly divided into six groups,normal control group,model group,AEIR low-dose (20 mg/kg),middle-dose (40 mg/kg),high-dose (80 mg/kg)groups and fenofibrate (20 mg/kg) group.Drugs were intragastrically administered for 40 days,body weights were recorded every five days.The rats in the normal control group were fed with ordinary diet,those in the other five groups were fed with high fat diet.At the end of experiment,the rats were killed,then ratio of fat weight to body weight,serum lipid level,LPL,HL,MDA and SOD were detected.The pathological changes of liver tissue were observed by light microscope.RESULTS AEIR significantly decreased body weight,fat weight and ratio of fat weight to body weight;significantly reduced the levels of TC,TG and LDL;significantly enhanced the activities of LPL and HL;significantly decreased MDA content and increased SOD activity in serum and liver tissue.Compared with the model group,the adipose degeneration of liver tissue in the various AEIR groups and fenofibrate group was improved.CONCLUSION AEIR can prevent the formation of hyperlipidemia in rats by regulating lipid metabolism.
ABSTRACT
Objective To investigate the relationship between benign paroxysmal positional dizziness (BPPV) and cerebrovascular disease and to promotethe practice of evidence bases medicinein thediagnosis,treatment and recurrenceprevention of BPPV in the elderly.Methods A total of 80 elderly patients were consecutively recruited from the Dizziness Outpatient Clinic from January 2013 to June,2014,with 80 non-BPPV elderly individuals receiving routine physical checkups during the same period serving as the control group.Clinical characteristics,lab test results and imaging data were compared between the two groups.Single factor and multivariate logistic regression analyses were conducted to identify independent risk factors for BPPV in the elderly.Results The experimental group showed higher rates of lacunar infarction,leukoaraiosis and intracranial artery stenosis than the control group(x2 =10.180,4.606 and 3.956,respectively;P=0.001,0.032 and 0.047,respectively).The prevalences of hyperlipidemia and type 2 diabetes were higher in the BPPV group than in the control group(x2 5.013 and 6.041,respectively;P=0.025 and 0.014,respectively).Differences in number of carotid atherosclerotic plaque cases,total cholesterol,triglyceride,homocysteine and uric were found between the two groups (x2 =11.237,t=2.862,2.230 and 4.270,respectively;P=0.001,0.005,0.027 and 0.000,respectively).Multivariate logistic regression analysisfound that blood uric acid,hyperglycemia,type 2 diabetes and hypertension were independent risk factors for BPPV (OR=1.006,7.104,3.152 and 3.273,respectively;P=0.005,0.000,0.004 and 0.002,respectively).The existence of carotid atherosclerotic plaques also increased the risk of BPPV (OR =384.570,95 ％ CI:46.935～ 3151.055,P =0.000).Conclusions BPPV in the elderlyis closely associated with cerebrovascular disease and its risk factors.Therefore,it is of great clinical significance to assess cerebrovascular function and carotid atherosclerotic plaque development for improved prognosis and effective prevention of recurrence of BPPV in the elderly.
ABSTRACT
Objective To investigate the relationship between benign paroxysmal positional dizziness (BPPV) and cerebrovascular disease and to promotethe practice of evidence bases medicinein thediagnosis,treatment and recurrenceprevention of BPPV in the elderly.Methods A total of 80 elderly patients were consecutively recruited from the Dizziness Outpatient Clinic from January 2013 to June,2014,with 80 non-BPPV elderly individuals receiving routine physical checkups during the same period serving as the control group.Clinical characteristics,lab test results and imaging data were compared between the two groups.Single factor and multivariate logistic regression analyses were conducted to identify independent risk factors for BPPV in the elderly.Results The experimental group showed higher rates of lacunar infarction,leukoaraiosis and intracranial artery stenosis than the control group(x2 =10.180,4.606 and 3.956,respectively;P=0.001,0.032 and 0.047,respectively).The prevalences of hyperlipidemia and type 2 diabetes were higher in the BPPV group than in the control group(x2 5.013 and 6.041,respectively;P=0.025 and 0.014,respectively).Differences in number of carotid atherosclerotic plaque cases,total cholesterol,triglyceride,homocysteine and uric were found between the two groups (x2 =11.237,t=2.862,2.230 and 4.270,respectively;P=0.001,0.005,0.027 and 0.000,respectively).Multivariate logistic regression analysisfound that blood uric acid,hyperglycemia,type 2 diabetes and hypertension were independent risk factors for BPPV (OR=1.006,7.104,3.152 and 3.273,respectively;P=0.005,0.000,0.004 and 0.002,respectively).The existence of carotid atherosclerotic plaques also increased the risk of BPPV (OR =384.570,95 ％ CI:46.935～ 3151.055,P =0.000).Conclusions BPPV in the elderlyis closely associated with cerebrovascular disease and its risk factors.Therefore,it is of great clinical significance to assess cerebrovascular function and carotid atherosclerotic plaque development for improved prognosis and effective prevention of recurrence of BPPV in the elderly.
ABSTRACT
Objective To investigate the current situation of nursing research based on Omaha system in China. Methods All the nursing research based on Omaha System were retrieved and collected by using China National Knowledge Infrastructure, Wanfang database and VIP database, NoteExpress software for the management of documents was used. Based on the classification of nursing research literature, a content analysis of system analysis model analyzed the documents had been retrieved. Results Sixty-four pieces of literature were included, and thirteen categories system were formed. The transverse reliability coefficient of all kinds of system were 0.940-1.000, the longitudinal reliability coefficient were 0.658-1.000. Conclusions The study of nursing research based on Omaha system in China is booming, which is also facing challenges, and has a broad space for exploration.
ABSTRACT
Purpose To investigate the significance of procedural arteriography in interventional embolization of adrenal metastasis, due to the fact that it is usually difficult to seek feeding arteries in the treatment of adrenal metastasis using interventional embolization. Materials and Methods Eighteen patients with adrenal metastasis were treated with procedural arteriography and interventional embolization therapy, the source and number of feeding arteries was retrospectively analyzed. Results The total success rate of procedural arteriography was 95.5%. The abnormal feeding arteries which were discovered by procedural arteriography accounted for 29.0%. The number of feeding arteries was two, which were mainly derived from inferior suprarenal artery and superior suprarenal arteries. Conclusion The source of feeding arteries of adrenal metastasis is abundant and the variability is obvious, thus procedural arteriography should be used to the greatest extent during operation of digital subtraction angiography to avoid omission of feeding arteries.
ABSTRACT
Objective To investigate the molecular mechanism how edaravone reduces cytotoxicity caused by hypoxia/reoxygenation-induced injury.Methods Ischemia model-hypoxia/ reoxygenation model which also called oxygen and glucose deprivation/reoxygenation model (OGD-R) was established.Cells were divided into control group,OGD-R group,OGD-R with edaravone of different concentration groups Cells of OGD-R model were pretreated with the appropriate concentration of edaravone or combine with the specific channel blockers LY294002 and MK2206 individually,the expression levels of ERK,AKT and Bcl-2 were detected with Western-blot,while the expression levels of BDNF and Bcl-2 mRNA detected with RT-PCR,the expression levels of BDNF protein detected with ELISIA,the levels of LDH releasing and Hoechst33258 staining used with homologue assay kit or regents.Results The pretreatment of cultured neurons with edaravone alleviated hypoxia/reoxygenation induced neuronal injury in a dose-dependent manner (LDH releasing reduced,Caspase-3 activity and ratio of nuclear pyknosis declined).The edaravone pretreatment did not increase significantly the p-ERK expression levels,but the amount of p AKT expression was significantly increased(P＜0.01).Pretreatment of edaravone(10 μmol/L) remarkably reduced the LDH release and declined the ratio of nuclear pyknosis after reoxygenation (P＜0.01),which was inhibited by MK2206.Compared to OGD-R,edaravone pretreatment markedly promoted BDNF and Bcl-2 mRNA expression at each time point,and the most pronounced effects occured at 8 h after OGDR.ELISIA analysis showed that BDNF protein level was significantly elevated after edaravone pretreatment at the same point.Western blot analysis indicted that edaravone pretreatment significantly enhanced Bcl-2 protein expression at 8 h after OGD-R,which was blocked by MK2206.Conclusions Edaravone may alleviate hypoxia/reoxygenation induced neuronal injury by enhancing BDNF and Bcl-2 expression and inhibiting Caspase-3 activity through activation of the PI3K/Akt pathway.
ABSTRACT
Objective To observe the curative effect of pure 1 25 I treatment to non-small cell lung cancer combined obstructive pneumonia.Methods 28 cases with non-small cell lung cancer combined obstructive pneumonia were enrolled.Treatment planning system was used to calculate the dosage of tumor and make up the therapeutic plan.CT-guided radiation treatment of particle im-plantation was then conducted.Follow-up was done to evaluate the curative effect one to two months after treatment.Results The total effective rate of therapeutic evaluation was 89.3%.Clinical symptoms including chest distress,hard breathing and fever were ameliorated remarkedly.Life quality score of appetite and fatigue was also improved.White blood cell reduced significantly in blood routine examination.Conclusion There is a definite curative effect of pure 1 25 I treatment to non-small cell lung cancer combined ob-structive pneumonia.
ABSTRACT
<p><b>OBJECTIVE</b>This study was to identify the efficacy of -80°C cryopreservated peripheral blood hemato-poietic stem cell (PBHSC) transplantation for hematopoietic reanstitution in patients.</p><p><b>METHODS</b>The efficacy of 104 patients underwent autologous peripheral blood hematopoietic stem cell transplantation using uncontrolled-rate freezing and storage at -80°C was evaluated.</p><p><b>RESULTS</b>This cryopreservation method could effectively cryopreserve peripheral blood stem cells. Out of 104 patients only 2 patients died, other patients got hematologic reconstition satisfactorily, the median engrafement times of neutrophils and platelet were 12 and 14 days respectively, the activity of cells after rehabilitation was 94%, the mean recovery rates of CD34(+) cells and mononuclear cells (MNC) were 86% and 80.3% respectively. There were no significant influences on engrafement time in sex, chemotherapy circles and radiotherapy. The engrafement of leukocytes associated with amount of CD34(+) cells.</p><p><b>CONCLUSION</b>This simple uncontrolled-rate freezing PBHSC at -80°C is safe, effective and economic, and can meet clinical needs. As compared with the classical cryopreservation, there were no significant differences in hematopoietic reconstitution. Therefore, this method worth to popularize and apply in clinic.</p>
Subject(s)
Humans , Blood Platelets , Blood Preservation , Cryopreservation , Freezing , Hematopoietic Stem Cells , Leukocytes , Neutrophils , Peripheral Blood Stem Cell TransplantationABSTRACT
At present, approximately 20% of Hodgkin lymphomas (HL) are relapsed and refractory, and therapeutic methods including chemotherapy, radiotherapy, and even stem cell transplantation are unsatisfactory. Brentuximab vedotin, composed of CD30 antibody and a chemotherapeutic agent, is a new targeted drug that eradicates tumor cells by binding to the CD30 antigen on their surface. In clinical trials, the response rate and complete remission rate of this drug were 73% and 40%, respectively, for relapsed and refractory HL. Here we report a case of CD30-positive relapsed and refractory HL that was treated with brentuximab. Before the treatment with brentuximab, the patient underwent chemotherapy, radiotherapy, and autologous stem cell transplantation. However, the disease continued to progress, affecting multiple organs and prompting symptoms such as persistent fever. After the treatment with brentuximab, the patient's condition improved. Body temperature returned to normal after 4 days. Lung nodules were reduced in size and number after a single course of treatment, and PET/CT showed partial remission and complete remission after 3 and 6 courses of treatment, respectively. The entire treatment process progressed smoothly, though the patient experienced some symptoms due to chemotherapy, including peripheral neuritis of the limbs, irritating dry cough, and mild increase in aminotransferase. No serious adverse effects were observed. The current general condition of the patient is good; the continuous complete remission has amounted to 6 months.
Subject(s)
Adolescent , Female , Humans , Antineoplastic Agents , Therapeutic Uses , Hodgkin Disease , Diagnostic Imaging , Drug Therapy , Metabolism , Pathology , Therapeutics , Immunoconjugates , Therapeutic Uses , Ki-1 Antigen , Metabolism , Neoplasm Recurrence, Local , PAX5 Transcription Factor , Metabolism , Positron-Emission Tomography , Stem Cell Transplantation , Tomography, X-Ray ComputedABSTRACT
Objective To explore the clinical characteristics of the elder patients with the invasive fungal infections (IFI) in gerontal hematological malignant. Methods 38 patients with IFI during Jan 2000 to October 2007 were enrolled to analyze retrospectively. Results A total of 38 cases of gerontal hematological malignancies were diagnosed IFI. Occurrence of IFI correlated with agranulocytosis persistence >5 days, broad - spectrum antibiotics using >7 days, complicating diabetes, the hospitalized day longer than 20 days,chemotherapy scheme combined with glucocorticoids. IFI clinical manifestation varied with different infection sites and different fungal species. Lung was the frequently fungal infection site(25 cases, 65.8 %). The most common fungal subtypes were Candida albicans (14 strains, 38.9 %) and aspergillus (7 strains, 19.4 %).Although amphotericin B and itraconozole were adopted to treat IFI, but there were still 10 cases of patients died because of severe respiratory failure. Conclusion Elder patients with gerontal hematological malignant with a marked increasing mortality of IFI, prognosis was poor. Morbidity concerned with many factors, early prophylaxis or empiric antifungal treatment should be adopt.
ABSTRACT
@#ObjectiveTo study changes of bone measured with quantitative ultrasound (QUS) in women of Guangzhou area and provide scientific basis for prevention and treatment of osteoporosis (OP).MethodsCalcaneus measurement was done with QUS in 647 women of Guangzhou area, and measurement data was analyzed.ResultsIn menopause and aged women, broadband ultrasound attenuation (BUA) showed a significantly decrease (P<0.01), whereas it decreased only slightly in early postmenopausal women (P>0.05). After the peak of BMD, speed of sound (SOS) showed a stepwise decline, and significantly decrease in menopause (P<0.01), but not significant over eighties (P>0.05). In contrast, stiffness index (STI) significantly decreased from the menopause, and it was a better indicator than BUA or SOS.ConclusionQUS can not only test bone mass but also assess microarchitecture, and it is nonradioactive, cheaper, easier to use, and may play a important role in diagnosis of osteoporosis and women and senile health.