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Objective: To explore the feasibility and safety of the gasless transoral vestibular robotic thyroidectomy using skin suspension. Methods: The clinical data of 20 patients underwent gasless transoral vestibular robotic thyroidectomy in the Department of Otorhinolaryngology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University from February 2022 to May 2022 were retrospectively analyzed. Among them, 18 were females and 2 were males, aged (38.7±8.0) years old. The intraoperative blood loss, operation time, postoperative hospital stay, postoperative drainage volume, postoperative pain visual analogue scale (VAS) score, postoperative swallowing function swallowing impairment score-6 (SIS-6), postoperative aesthetic VAS score, postoperative voice handicap index-10 (VHI-10) voice quality, postoperative pathology and complications were recorded. SPSS 25.0 was used for statistical analysis of the data. Results: The operations were successfully completed without conversion to open surgery in all patients. Pathological examination showed papillary thyroid carcinoma in 18 cases, retrosternal nodular goiter in 1 case, and cystic change in goiter in 1 case. The operative time for thyroid cancer was 161.50 (152.75, 182.50) min [M (P25, P75), the same below] and the average operative time for benign thyroid diseases was 166.50 minutes. The intraoperative blood loss 25.00 (21.25, 30.00) ml. In 18 cases of thyroid cancer, the mean diameter of the tumors was (7.22±2.02) mm, and lymph nodes (6.56±2.14) were dissected in the central region, with a lymph node metastasis rate of 61.11%. The postoperative pain VAS score was 3.00 (2.25, 4.00) points at 24 hours, the mean postoperative drainage volume was (118.35±24.32) ml, the postoperative hospital stay was 3.00 (3.00, 3.75) days, the postoperative SIS-6 score was (4.90±1.58) points at 3 months, and the postoperative VHI-10 score was 7.50 (2.00, 11.00) points at 3 months. Seven patients had mild mandibular numbness, 10 patients had mild cervical numbness, and 3 patients had temporary hypothyroidism three months after surgery and 1 patient had skin flap burn, but recovered one month after surgery. All patients were satisfied with the postoperative aesthetic effects, and the postoperative aesthetic VAS score was 10.00 (10.00, 10.00). Conclusion: Gasless transoral vestibular robotic thyroidectomy using skin suspension is a safe and feasible option with good postoperative aesthetic effect, which can provide a new treatment option for some selected patients with thyroid tumors.
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Male , Female , Humans , Adult , Middle Aged , Thyroidectomy/adverse effects , Robotic Surgical Procedures/adverse effects , Retrospective Studies , Blood Loss, Surgical , Hypesthesia/surgery , Neck Dissection/adverse effects , Thyroid Neoplasms/surgery , Pain, Postoperative/surgery , Postoperative Complications/etiologyABSTRACT
Objective: To explore the association between sleep duration and the risk of frailty among the elderly over 80 years old in China. Methods: Using the data from five surveys of the China Elderly Health Influencing Factors Follow-up Survey (CLHLS) (2005, 2008-2009, 2011-2012, 2014, and 2017-2018), 7 024 elderly people aged 80 years and above were selected as the study subjects. Questionnaires and physical examinations were used to collect information on sleep time, general demographic characteristics, functional status, physical signs, and illness. The frailty state was evaluated based on a frailty index that included 39 variables. The Cox proportional risk regression model was used to analyze the correlation between sleep time and the risk of frailty occurrence. A restricted cubic spline function was used to analyze the dose-response relationship between sleep time and the risk of frailty occurrence. The likelihood ratio test was used to analyze the interaction between age, gender, sleep quality, cognitive impairment, and sleep duration. Results: The age M (Q1, Q3) of 7 024 subjects was 87 (82, 92) years old, with a total of 3 435 (48.9%) patients experiencing frailty. The results of restricted cubic spline function analysis showed that there was an approximate U-shaped relationship between sleep time and the risk of frailty. When sleep time was 6.5-8.5 hours, the elderly had the lowest risk of frailty; Multivariate Cox proportional risk regression model analysis showed that compared to 6.5-8.5 hours of sleep, long sleep duration (>8.5 hours) increased the risk of frailty by 13% (HR: 1.13; 95%CI: 1.04-1.22). Conclusion: There is a nonlinear association between sleep time and the risk of frailty in the elderly.
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Aged , Humans , Aged, 80 and over , Frailty/epidemiology , Sleep Duration , Prospective Studies , Sleep/physiology , China/epidemiologyABSTRACT
Objective: To investigate the safety, efficacy, locally control and survival results of transoral Da Vinci robotic surgery for salvage treatment of locally recurrent nasopharyngeal carcinoma. Methods: This retrospective study included 33 patients with locally recurrent nasopharyngeal carcinoma (stage rT1-2, partial rT3) underwent transoral Da Vinci robotic surgery between October 2017 and January 2020. There were 20 males and 11 females, with an average age of (47.9±10.5) years. The lesions were localized in nasopharyngeal cavity in 14 cases, with extending to parapharyngeal space in 6 cases and the floor of sphenoid sinus in 13 cases. Transnasal endoscopy was used to assist surgery if necessary. SPSS 25.0 statistical software was used for statistical analysis. Results: Transoral robotic nasopharyngectomy was successfully performed in all cases without conversion to open surgery, of which 13 cases were combined with transnasal endoscopic surgery. The average operation time was (126.2±30.0) min, ranging from 90 to 180 min. The postoperative pathological margin was R0 (31 cases) and R1 (2 cases), with no tumor residue. Complications of surgery mainly included symptoms of headache, nasal dryness and velopharyngeal insufficiency without nasopharyngeal hemorrhage. Follow-up time was from 3 to 54 months. One case had tumor recurrence 11 months after operation, 1 case had ipsilateral cervical lymph node metastasis 27 months after operation, 2 cases had distant metastasis and 1 case died of nasopharyngeal hemorrhage 3 months after operation. The 1-year, 2-year and 3-year overall survival rates were 97.0%, 96.0% and 92.9%, respectively and the local recurrence free rates were 97.0%, 95.7% and 91.7%, respectively. Conclusion: Transoral robotic nasopharyngectomy is safe and feasible for local recurrent nasopharyngeal carcinoma in selected patients, with higher local control rate and quality of life.
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Adult , Female , Humans , Male , Middle Aged , Nasopharyngeal Carcinoma/surgery , Nasopharyngeal Neoplasms/pathology , Neoplasm Recurrence, Local/surgery , Quality of Life , Retrospective Studies , Robotic Surgical ProceduresABSTRACT
Objective:To investigate the incidence and risk factors of polymyxin B-associated acute kidney injury (AKI) in patients with severe infections caused by extensive drug resistance Gram negative bacteria (XDR-GNB)in intensive care unit (ICU).Methods:A retrospective study of adult patients with severe infection who received polymyxin B for more than 3 days in the department of critical care medicine of Nanjing Drum Tower Hospital Affiliated to Nanjing University Medical School from April 1st 2018 to January 31st 2020 were performed. AKI was diagnosed by Kidney Disease: Improving Global Outcomes (KDIGO) criteria. The baseline data, indicators during treatment period and prognostic factors were compared between AKI group and non-AKI group. Factors with statistically significant difference in univariate analysis and important clinical factors were included in the Logistic regression model to analyze the risk factors of AKI.Results:Seventy-two patients were treated with polymyxin B for more than 3 days. Forty-nine patients were finally enrolled, with 32 patients developing polymyxin B-associated AKI, and the incidence was 44.4%. The baseline data was balanced in AKI group and non-AKI group, and there was no significant difference in the prognosis [death or discharge without medial order (cases): 14 vs. 6, discharged for improvement (cases): 18 vs. 11, χ 2 = 0.329, P = 0.566]. Polymyxin B-associated AKI occurred from 1 day to 14 days after treatment, with an average of (6.8±3.8) days. Among the 32 AKI patients, 2 cases were lost to follow up after discharge, while renal function recovered in 18 cases and unrecovered in 12 cases. The prognosis of patients without recovery of renal function was significantly worse than that of patients with renal function recovery [death or discharge without medial order (cases): 12 vs. 2, discharged for improvement (cases): 0 vs. 16, P = 0.000]. Single factor analysis showed that daily dosage of polymyxin B in AKI group was higher than that in non-AKI group (mg: 151.6±23.7 vs. 132.4±30.3), numbers of patients with daily polymyxin B dose ≥ 150 mg, using vasoactive drugs, or severe hypoalbuminemia (albumin≤25 g/L) were higher than those in non-AKI group (cases: 29 vs. 10, 18 vs. 4, 9 vs. 0), with statistically significant differences (all P < 0.05). Multivariate Logistic regression analysis showed that daily dosage of polymyxin B ≥ 150 mg and use of vasoactive drugs were independent risk factors for polymyxin B-associated AKI [odds ratio ( OR) = 37.466, 95% confidence interval (95% CI) was 2.676-524.586, P = 0.007; OR = 22.960, 95% CI was 1.710-308.235, P = 0.018]. Conclusions:Comparing with non-AKI patients, more patients with polymyxin B-associated AKI had severe hypoalbuminemia, and the probability of using vasoactive drugs and the daily dose of polymyxin B were higher than non-AKI patients. Daily dose of polymyxin B ≥ 150 mg and using vasoactive drugs were independent risk factors for polymyxin B-associated AKI.
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Traditional Chinese medicine（TCM） has the characteristics of multiple ingredients, multiple targets, and complex action pathways. Under the guidance of the holistic view and syndrome differentiation treatment, TCM and its compound have great advantages in the treatment of diseases, and its material basis and molecular mechanism of action is not clear, so there are great challenges in the research of TCM. Network pharmacology has become a new research method and technical means for the modernization of TCM. It is a research discipline derived from the study of the mechanism of TCM treatment of diseases with multi-component drugs and multiple targets under the guidance of system biology theory. It conforms to the systematic and holistic thinking mode of Chinese medicine. At present, there have been many researches on the application of Internet pharmacology in Chinese medicine, including the research on the basis and mechanism of the Chinese medicine single drug, drug pair and compound pharmacodynamics, the methods and applications of Internet pharmacology for Chinese medicine research application of combining pharmacology with other technologies. However, the rapid data update, the emergence of new databases, the types of algorithms and the use of tools have made the development of network pharmacology too fast. People have neglected to update the databases, tools and algorithms and compare the advantages of each database. This article summarizes and compares the database, tools and algorithms of the network pharmacology in the past three years, and describes the network through the substance basis of TCM, the pharmacological mechanism of TCM, the development of new drugs, the quality control of TCM, and the formulating rules of TCM. The application and problems of pharmacology in the field of TCM are expected to provide a reference for the research and application of network pharmacology in TCM.
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Objective@#To explore the characteristics of the default memory network (DMN) and working memory network (WMN) at resting state brain functional network of exercise addiction people.@*Methods@#Twenty-nine sports addicts and 26 non-sports addicts matched by sex, age, average education level and sports dependence were screened by the exercise addiction index (EAI). Resting status brain scanning was performed with 3.0T magnetic resonance scanner.Sparse approximation coefficients independent component analysis (SACICA) model was used to analyze the independent components of brain networks.@*Results@#Compared with the DMN template, four features were extracted, including " basic conformity" , " less frontal lobe" , " more frontal lobe" and " less occipitoparietal lobe" . Compared with the parameters of " basic conformity" , the proportion of exercise addiction group (33.3%, 9/27) was higher than that of control group (18.2%, 4/22). In the other three parameters, the proportion of exercise addiction group (37.0%, 10/27; 3.7%, 1/27; 22.2%, 6/27) was lower than those of control group (45.5%, 10/22; 22.7%, 5/22; 27.3%, 6/22). But Chi-square test showed that there was no significant difference between the two groups(all P>0.05). Compared with the WMN template, six features were extracted, including " basic conformity" , " more frontal and parietal lobes" , " more parietal lobes" , " more frontal lobes" , " less frontal lobes" and " less parietal lobes" . The percentages of the first three features in exercise addiction group (22.2%, 6/27; 7.4%, 2/27; 7.4%, 2/27) were less than those in the control group (45.5%, 10/22; 22.7%, 5/22; 9.1%, 2/22), while the percentages of the last three features in the exercise addiction group (7.4%, 2/27; 37.0%, 10/27; 14.8%, 4/27) were higher than those in the control group (4.5%, 1/22; 13.6%, 3/22; 0, 0). Chi-square test showed that there was no significant difference in all features between the two groups was statistically(P>0.05).@*Conclusion@#No significant characteristic changes are found in DMN and WMN networks of exercise addiction population.
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Objective To investigate the effects of protein intake in the early phase and later phase on the outcomes of critically ill patients.Methods A total of 326 critically ill patients admitted in intensive care unit of our hospital from September 2016 to March 2018 were enrolled in this prospective observational study.According to the 28-day prognosis of patients,they were divided into death group and survival group.Early protein target (EPT) was defined as the daily protein intake≥0.8 g/ (kg · d) on days 1-3,and late protein target (LPT) was defined as the daily protein intake≥0.8 g/ (k · d) on days 4-7.Results Daily protein intakes on day 1 and day 3 and cumulative protein intakes on days 1-3 were significantly higher in non-survivors than in the survivors (P＜0.05),but daily protein intakes on day 2,4,5,6 and 7 and cumulative protein intakes on days 4-7 and 1-7 showed no significant difference between two groups (P＞0.05).Hospital mortality was the lowest in the LPT group,the highest in the EPT,and in the middle in the EPT+LPT group and non-EPT+non-LPT group (P＜0.05).The survival curve analysis showed that the survival time of the EPT-only group was significantly lower than that of the LPT-only group (P＜0.05).Multivariate analysis showed that age,sex,cumulative protein and caloric intakes on days 1-7 were the independent risk factors for mortality.Conclusion Early low protein intake is benefit for the outcomes of critically ill patients,and combined with adequate intake of protein in the later stage may further improve the outcomes.
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<p><b>Objective</b>To explore the inhibitory effect of polyphyllin Ⅰ (PPⅠ) on the proliferation of castration-resistant prostate cancer PC3 cells and its molecular mechanism.</p><p><b>METHODS</b>We cultured human prostate cancer PC3 cells in vitro and treated them with PPⅠ at the concentrations of 0 (blank group), 0.4, 0.8, 1.2, 1.6, 2.0, and 2.4 μmol/L for 24, 48, and 72 hours, respectively. Then we detected the proliferation of the cells by MTT assay, measured their apoptosis by flow cytometry, and determined the expressions of p-ERK1/2, ERK1/2, NF-κB/p65 and DNMT1 proteins as well as the level of NF-κB/p65 in the cells additionally treated with the ERK1/2 inhibitor SP600125 by Western blot.</p><p><b>RESULTS</b>Compared with the blank control group, the PPⅠ-treated PC3 cells showed a concentration- and time-dependent reduction of the survival rate (1.00 ± 0.00 vs 0.85 ± 0.05, P < 0.01) at 0.4 μmol/L after 48 hours of intervention, concentration-dependent early apoptosis at 0.8 μmol/L (4.83 ± 0.95 vs 13.83 ± 2.97, P < 0.01), time-dependent increase of the expressions of p-ERK1/2 (1.00 ± 0.00 vs 1.73 ± 0.17, P < 0.01) and ERK1/2 (1.00 ± 0.00 vs 1.36 ± 0.12, P < 0.01) at 2 hours, and concentration-dependent decrease of the expressions of NF-κB/p65 and DNMT1 at 1.2 μmol/L (1.00 ± 0.00 vs 0.78 ± 0.10 and 0.63 ± 0.06, P < 0.01) and 1.6 μmol/L (1.00 ± 0.00 vs 0.67 ± 0.11 and 0.52 ± 0.09, P<0.01). Inhibition of ERK1/2 phosphorylation with PD98059 markedly reversed PPⅠ-induced decrease of the NF-κB/p65 expression as compared with that in the PPⅠ group (0.86 ± 0.18 vs 0.43 ± 0.09, P < 0.05).</p><p><b>CONCLUSIONS</b>PPⅠ induces the early apoptosis and suppresses the proliferation of PC3 cells, probably by activating the ERK1/2 pathway and inhibiting the expressions of the NF-κB/p65 and DNMT1 proteins.</p>
Subject(s)
Humans , Male , Apoptosis , Cell Proliferation , DNA (Cytosine-5-)-Methyltransferase 1 , Metabolism , Diosgenin , Pharmacology , Flavonoids , Metabolism , MAP Kinase Signaling System , Mitogen-Activated Protein Kinase 1 , Metabolism , Mitogen-Activated Protein Kinase 3 , Metabolism , NF-kappa B , Metabolism , PC-3 Cells , Phosphorylation , Prostatic Neoplasms, Castration-Resistant , Drug Therapy , Metabolism , Pathology , Signal Transduction , Transcription Factor RelA , MetabolismABSTRACT
OBJECTIVE@#To obtain three-dimensional intraosseous artery of the hamate and to provide the vascular anatomy basis of hamate fracture fixation.@*METHODS@#PbO (lead monoxide, Sinopharm Chemical Reagent Beijing Co. Ltd) was ground into particles less than 40 μm and suspended in turpentine oil (Chemical Reagent Beijing Co. Ltd) at ratios of 1 g : 1.5 mL, 1 g : 1 mL and 1 g : 0.5 mL. Three specimens were investigated. Brachial arteries were cannulated and perfused with lead-based contrast agent. Hamates were harvested and scanned using micro-computed tomography (microCT). The acquisition protocols were as follows: CT scan setup: total rotation [Degrees], 360; rotation steps, 360; X-ray detector setup: transaxial, 2048; axial, 2048; exposure time, 1 500 ms, Binning, 1; system magnification: high-med. X-ray tube setup: 80 kV, 500 mA current. The down-sampling factor used in the reconstruction was 2. The effective voxel size of the final image was 27.30 μm. The three-dimensional model of the hamate was generated and the distribution and pattern of vessels were evaluated.@*RESULTS@#There were abundant extraosseous vessels around the hamate. They were mainly running in the tendons and ligaments around the hamate. Four vascular zones were identified on the hamate surface. They were on the palmar platform of the hamate body, on the dorsal side, on the ulnar side and on the tip of hamulus, namely. There were anastomoses among 4 vascular zones. We did not observe any vessels penetrating through the articular cartilage. The extraosseous vessels of the vascular zones gave a number of intraosseous branches into the hamate. The hamate body received intraosseous blood supply from the dorsal, palmar and ulnar while the hamulus from the palmar, ulnar and hamulus tip. There were some intraosseous branches anastomosing with each other.@*CONCLUSION@#The extraosseous and intraosseous vessels of the hamate were more than what used to be considered. The hamate body and hamulus received blood supply from multiple directions and arteries anastomosed extensively both outside and inside the hamate, making it possible that the intraosseous perfusion survived after fracture. It is likely that the nonunion after the hamate fracture is not caused by the vascular damage but the malalignment of the fragments.
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Humans , Beijing , Brachial Artery , Fluoroscopy , Fractures, Bone/diagnostic imaging , Hamate Bone/injuries , Ulna , Wrist Injuries/diagnostic imaging , X-Ray MicrotomographyABSTRACT
Objective To understand serum trough concentrations (Cmin) of teicoplanin and target concentration achieved in severely infected patients after three days treatment with different loading doses of teicoplanin,and find out optimal loading dose.Methods Severely infected patients who admitted to the intensive care unit(ICU) of a hospital from February 1,2016 to February 28,2017 were enrolled in the study.According to different drug loading doses (teicoplanin standard dose:6mg/kg;high dose:10mg/kg) and different creatinine clearance rates (Ccr:50mL/min as standard value),patients were divided into four subgroups:group of standard dose and normal Ccr (GsD1),group of standard dose and low Ccr (GSD2),group of high dose and normal Ccr (GHD1),group of high dose and low Ccr(GHD2).Serum Cmin,percentage of achieving target concentration,and adverse reactions of teicoplanin in different groups were compared.Results A total of 49 patients were enrolled in the study,17 patients were in GSD group,Cmin on 4th day before administration was (5.98 ± 2.67)mg/L;32 patients were in GHD group,Cmin on 4th day before administration was (9.05 ± 4.25)mg/L;Cmin in GHD group was higher than that in GsD group,and there was statistical difference between two groups(t=3.10,P=0.003).Values of Cmin in GSD1,GSD2,GHD1,and GHD2 groups were (5.78±2.72),(6.34±2.78),(8.21 ±3.77),and (12.07±4.81) mg/L respectively,differences among four groups were statistically significant(F =4.766,P =0.006).The Cmin in GHD2 group was higher than those in GHD1,GSD2,and GsD1 groups,percentage of achieving the target concentration were 9.09％ (1/11),16.67％ (1/6),28.00％(7/25),and 71.43％ (5/7) respectively,differences were statistically significant(x2=8.766,P=0.033).Complications associated with teicoplanin such as rash,damage to hepatic and renal function were not observed in all patients during the treatment course.Conclusion Whether the Ccr is normal or not,target Cmin can not be achieved early in patients given teicoplanin with standard loading dose;in patients with low Ccr,given high loading dose,target Cmin can be achieved early;while in patients with normal Ccr,higher loading dose may be needed.
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Objective It is a great challenge to perform hip revision surgery especially with severe proximal femoral bone de -fect.This study aims to discuss the short-medium clinical outcomes of using nonmodular full-coated tapered stem in femoral revision with Paprosky Ⅲ bone defect. Methods From May 2011 to October 2015, 58 patients(58 hips)diagnosed as ostiolysis/aseptic loosening with severe femoral bone defect(Paprosky Ⅲ)were treated with hip revision surgery.The cases of septic loosening and tumor were excluded.Harris scoring system and pain visual analogue scale(VAS)were used pre-and post-operatively to evaluate the function of hip joints and the pain level.Radiograph was used to evaluate loosening,subsidence and bone healing of the prosthesis. Results All patients were followed-up with 24-67 months,the mean follow up time was 49.3±12.7 months.None of the patients showed infec-tion or surrounding bone fracture.Dislocation happened in one case after surgery and was treated with manipulative reduction without re -currence.One case had progressive subsidence which led to aseptic loosening and was treated with re-revision.By the end of last follow-up,Haris Score was improved from preoperative 41.6±6.9 points to 83.1±5.7 points, VAS score decreased from preoperative 6.7 ±1.6 points to 2.5 ±1.2 points,(P<0.05). Conclusion Nonmodular full-coated tapered stem can obtain good clinical effect in femoral revision with severe proximal bone defect.
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Objective To compare the effects of oral use of Compound Danshen Dripping Pills and Mecobalamin Tablets on hemorheology and nerve conduction velocity of diabetic peripheral neuropathy patients. Methods A total of 70 diabetic peripheral neuropathy patients were randomized into treatment group and control group, 35 cases in each group. Both groups were given fundamental treatment for controlling blood glucose, blood lipids and blood pressure, and additionally the treatment group was treated with Compound Danshen Dripping Pills orally and the control group was treated with Mecobalamin Tablets orally. The treatment for the two groups lasted 3 continuous months. The changes of hemorheology and nerve conduction velocity of the two groups were observed before and after treatment. Results After treatment, indexes of hemorheology and nerve conduction velocity of the two groups were much improved(P<0.05 compared with those before treatment). The improvement of hemorheology indexes in the treatment group was superior to that in the control group (P < 0.05), but the difference of improvement of nerve conduction velocity was insignificant between the two groups (P > 0.05). Conclusion The effects of oral use of Compound Danshen Dripping Pills on the nerve conduction velocity of diabetic peripheral neuropathy patients are similar to those of Mecobalamin Tablets, but the pills have better effects on improving hemorheology than the tablets. The results indicated that Compound Danshen Dripping Pills are effective on improving blood flow and nerve conduction velocity of the limbs of the patients.
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OBJECTIVE To study the toxicological effect of matrine (MT) on PC12 cells and the mechanism of mitochondrial damage. METHODS After treatment with MT 2, 4 and 8 mmol·L-1for 8, 16,24 and 48 h,respectively,the viability of PC12 cells was measured with methylthiazolyltetrazolium assay.PC12 cells were treated with MT 2,4 and 8 mmol·L-1for 24 h,before the morphological changes were observed by Hoechst33342 staining. The superoxide dismutase (SOD) activity and malondialde-hyde (MDA) content in cells were detected using hydroxylamine method and thiobarbituric acid method, apoptosis rate and reactive oxygen species (ROS) of PC12 cells were detected with flow cytometry, mitochondrial membrane potential (MMP) was detected with JC-1 staining, and the expressions of procaspase 3, procaspase 9, cleaved-caspase 3, Bax and Bcl-2 were detected with Western blotting. RESULTS MT inhibited the growth of PC12 cells in a time-and concentration-dependent manner.After being treated with MT for 24 h,the nuclei of PC12 cells in MT groups showed chromatin agglutination and partial rupture to different degrees,and compared with normal control group,the apoptosis rates of MT 2,4 and 8 mmol·L-1groups were significantly increased(P<0.01).Intracellular ROS and MDA levels increased (P<0.05, P<0.01), SOD activity decreased (P<0.01), and MMP decreased. The expressions of procaspase 9, procaspase 3 and Bcl-2 were significantly decreased (P<0.01, P<0.05), the expres-sions of cleaved-caspase 3 and Bax were significantly increased(P<0.05,P<0.01),and the ratio of Bcl-2/Bax was significantly decreased (P<0.01). CONCLUSION MT has toxic effect on PC12 cells and induces apoptosis through ROS mediated mitochondrial pathway.
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Objective To observe the changes in voriconazole plasma trough concentration in critical patients,and explore its optimal dosage.Methods A retrospective analysis was carried out in critical patients with voriconazole and voriconazole therapeutic drug monitoring (TDM) in intensive care unit (ICU) of the Affiliated Drum Tower Hospital of Nanjing University Medical School from December 2014 to December 2016.The patients' age,sex,dose,and other general information,voriconazole trough concentrations,influence of proton pump inhibitors (PPIs) on plasma trough concentrations,efficacy were analyzed retrospectively.Results 150 times of voriconazole plasma trough concentration in 99 patients were enrolled,and it was found that only 76.00％ (114/150) reached the target concentration (1-5.5 mg/L),13.33％ (17/150) ＜ 1 mg/L and 12.67％ (19/150) ＞ 20 mg/L.Significant difference was observed between old patients (≥60 years old) and other patients (＜ 60 years old) (P ＜ 0.05),age (P =0.000) was found to be correlated to plasma trough concentrations by multiple linear regression analysis,but sex,body weight,weighted dose,APACHE2 score,total bilirubin and albumin don,t;there was no significant difference of plasma trough concentration of voriconazole between the use of PPIs,the concentration tended to increase with pantoprazole (P =0.054),and was statistically different compared with that of esomeprazole (P =0.036);There was no significant difference in mortality between patients with targeting trongh plasma concentrations and those without (x2 =0.059,P =0.809).Conclutions Voriconazole plasma trough concentration has great variation between individuals,so constant monitoring is necessary.Age and the combination of PPIs show a relatively significant influence on the serum trough concentrations,and they should be taken into consideration in dosage to be given.
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Objective To investigate the status quo of disaster preparedness of emergency nurses in Ningxia and analyze its contributing factors.Methods A total of 268 emergency nurses from eight hospitals in Ningxia were investigated with the Chinese version of Disaster Preparedness Evaluation Tool.Results The scores of disaster preparedness of emergency nurses in Ningxia were 4.54±1.10.Nurses with low,middle and high levels of disaster preparedness were 23 (8.58％),130 (48.51％) and 115 (42.91％),respectively.Nurses with low,middle and high levels of preparedness of disaster were 35(13.06％),120(44.78％) and 113(42.16％),respectively.Nurses with low,middle and high levels of disaster response were 15(5.60％),157(58.58％) and 96(35.82％),respectively.Nurses with low,middle and high levels of post-disaster recovery were 28 (10.45％),124 (46.27％) and 116 (43.28％),respectively.Disaster training (t=-7.411,P＜0.001) and work experience (t=-2.850,P=0.005) were two independent contributing factors.Conclusion The scores of disaster preparedness of emergency nurses in Ningxia were in the middle level.Disasterpreparedness of emergency nurses should be improved via multi-level and multi-form disaster knowledge and skill training.
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Objective To investigate the status quo of disaster preparedness of emergency nurses in Ningxia and analyze its contributing factors.Methods A total of 268 emergency nurses from eight hospitals in Ningxia were investigated with the Chinese version of Disaster Preparedness Evaluation Tool.Results The scores of disaster preparedness of emergency nurses in Ningxia were 4.54±1.10.Nurses with low,middle and high levels of disaster preparedness were 23 (8.58％),130 (48.51％) and 115 (42.91％),respectively.Nurses with low,middle and high levels of preparedness of disaster were 35(13.06％),120(44.78％) and 113(42.16％),respectively.Nurses with low,middle and high levels of disaster response were 15(5.60％),157(58.58％) and 96(35.82％),respectively.Nurses with low,middle and high levels of post-disaster recovery were 28 (10.45％),124 (46.27％) and 116 (43.28％),respectively.Disaster training (t=-7.411,P＜0.001) and work experience (t=-2.850,P=0.005) were two independent contributing factors.Conclusion The scores of disaster preparedness of emergency nurses in Ningxia were in the middle level.Disasterpreparedness of emergency nurses should be improved via multi-level and multi-form disaster knowledge and skill training.
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<p><b>OBJECTIVE</b>To evaluate the short-and mid-term curative effect of high fibular osteotomy on knee osteoarthritis.</p><p><b>METHODS</b>From October 2014 to July 2016, 76 patients with knee osteoarthritis were treated with high fibular osteotomy. There were 22 males and 54 females, ranging in age from 47 to 82 years old, with an average of 61.62 years old. Internal tenderness of the knee joint was examined preoperatively. Preoperative examination showed medial knee pain and medial positive McMurray sign. Preoperative AP and lateral X-ray films of the weight-bearing side of the knee showed the narrowing of the medial space. The knee medial space, femoral and tibial angle, VAS pain score and the American Knee Society(AKS) score were evaluated after operation.</p><p><b>RESULTS</b>Compared with the preoperative one, the postoperative knee medial gap was widened obviously. The femur and tibia angle after operation was bigger than that before surgery. The VAS was improved from preoperative 5.70±1.56, to 3.70±1.03 at the 1st week after operation, 3.20±0.95 at the 1st month after operation, 2.35±0.99 at the 3rd month after operation, and 2.10±0.97 at the 1st year after operation. According to the AKS score, the preoperative pain score of knee joint was 14.45±1.76, the activity score of knee joint was 12.60±1.98, and the stability score was 12.15±1.72; after operation, the above scores were improved to 42.60±2.28, 21.80±2.14, and 20.85±2.16 respectively.</p><p><b>CONCLUSIONS</b>The high fibular osteotomy with less complications is simple. It can effectively alleviate the pain of the knee joint and improve the function of knee joint, and the clinical effect is satisfactory.</p>
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Background The primary reason to trabeculectomy failure is fibrosis of conjunctiva and episclera because of progressive fibroblast proliferation and collagen deposition of the filtration bleb.Conventional methods of inhibiting bleb scarring was intraoperative application of mitomycin C (MMC),but many complications occured after surgery.Researches showed that bevacizumab was an antifibrotic agent,and whether it can suppress scarring of filtering bleb after trabeculectomy is concerned.Objective The aim of this study was to evaluate the antifibrotic efficacy of bevacizumab after trabeculectomy in rabbits.Methods Forty New Zealand rabbits were randomly divided into four groups.Trabeculectomy was performed on the right eyes of each rabbits.The rabbits received subconjunctival injection of 0.05 ml bevacizumab (25 mg/ml) at the end of operation in the bevacizumab single injection group.The same dose of bevacizumab was respectively injected at the end of operation as well as 3 days and 7 days after operation in the bevacizumab repitition injection group,and 0.05 ml normal saline solution was used in the same way in the normal saline group.In the MMC group,MMC cotton patch with 0.2 mg/ml was placed under the Tenon caplsule and scleral flap for 3 minutes during operation.The intraocular pressure (IOP),bleb area and shape were evaluated during the 28-day period.The animals were sacrificed on postoperative day 14 and 28,respectively for the histopathologic examination of bleb.The expression of CD31 in the bleb was detected by immunohistochemistry for the calculation of microvessels.All experiments were performed in accordance with the ethics code for animal experimentation and approved by the Institutional Review Board of Tianjin Eye Hospital.Results No significant difference was found in the postoperative IOP among the groups (F =0.88,P =0.47).Compared with the bevacizumab single injection group,MMC group and normal saline group,the shape of bleb was higher and much diffuse with sparse vessels 7 days after operation in the bevacizumab repitition injection group.The survival time of bleb was 27 days,19 days and 13 days in the bevacizumab repitition injection group,the bevacizumab single injection group,MMC group and normal saline group,respectively.The percentage of collagen deposition area was (49.18±1.54)％,(26.41±1.23)％,(50.68±1.87)％ and (70.63±1.81)％ at day 14 postoperative in the bevacizumab single injection group,bevacizumab repitition injection group,MMC group and normal saline group,respectively,with the largest area in the normal saline group,and percentage of collagen deposition area was significantly reduced in the bevacizumab repitition injection group compared with the bevacizumab single injection group (all at P＜0.05).The percentage of collagen deposition area was (66.82±1.53)％ at day 28 postoperative in the bevacizumab repitition injection group,while complete scarring was seen in other 3 groups.The number of microvessels was least at postoperative day 14 in the bevacizumab repitition injection group compared with the bevacizumab single injection group,MMC group and normal saline group (all at P ＜ 0.05).The number of microvessels was more in postoperative day 28 in the bevacizumab repitition injection group (3.51 ±0.31) compared with other groups (all at P ＜ 0.05).Conclusions Subconjunctival injection of bevacizumab following trabeculectomy can improve the successful rate of surgery by remaining the survival time of filtering bleb,inhibiting the bleb scarring in rabbits.
ABSTRACT
<p><b>BACKGROUND</b>Inflammation plays a pivotal role in the formation and progression of ischemic stroke. Recently, more and more epidemiological studies have focused on the association between C-reactive protein (CRP) -717A > G and -286C > T > A genetic polymorphisms and ischemic stroke. However, the findings of these researches are not conclusive.</p><p><b>METHODS</b>We performed a meta-analysis to determine whether these two polymorphisms are associated with the risk of ischemic stroke. Eligible studies were identified from the database of PubMed, Medline, Embase, Web of Science, CNKI, Weipu, and Wanfang. We calculated odds ratios (ORs) with 95% confidence intervals (CIs) to assess the strength of the association.</p><p><b>RESULTS</b>Four articles were included in our study, including 1926 cases and 2678 controls for -717A > G polymorphism, 652 cases and 1103 controls for -286C > T > A polymorphism. The results of meta-analysis showed that single nucleotide polymorphism (SNP) -717A > G was not significantly associated with the risk of ischemic stroke (GG vs. AA, OR = 1.12, 95% CI = 0.83-1.50, P = 0.207; GG + GA vs. AA, OR = 1.04, 95% CI = 0.93-1.17, P = 0.533; GG vs. GA + AA, OR = 1.10, 95% CI = 0.82-1.47, P = 0.220). Meta-analysis of SNP - 286C > T > A also demonstrated no statistical evidence of a significant association with the risk of ischemic stroke (AA vs. CC, OR = 0.86, 95% CI = 0.59-1.25, P = 0.348; AA vs. CC, OR = 0.92, 95% CI = 0.80-1.06, P = 0.609; AA vs. CC, OR = 0.89, 95% CI = 0.62-1.30, P = 0.374).</p><p><b>CONCLUSIONS</b>This meta-analysis demonstrated little evidence to support a role of CRP gene -717A > G, -286C > T > A polymorphisms in ischemic stroke predisposition. However, to draw comprehensive and more reliable conclusions, further larger studies are needed to validate the association between CRP gene polymorphisms and ischemic stroke in various ethnic groups.</p>
Subject(s)
Humans , Alleles , Brain Ischemia , Genetics , C-Reactive Protein , Genetics , Genetic Predisposition to Disease , Genetics , Genotype , Polymorphism, Single Nucleotide , Genetics , Stroke , Epidemiology , GeneticsABSTRACT
<p><b>OBJECTIVE</b>To analyze the cancer incidence and mortality of Henan province in 2009.</p><p><b>METHODS</b>On basis of the criteria of data quality from the National Central Cancer Registry (NCCR), data from 6 registries in Henan province were evaluated, covering 6 061 564 people, accounting for 6.45% of the total population in Henan in 2009. There were 3 104 991 people of males, and 2 956 573 people of females. The incidence, mortality, 10 most common cancers, constitution and cumulative rate (0-74 years old) were then calculated. The age-standardized rate was calculated and adjusted by the Chinese standard population in 1982 as well as the Segi's world standard population.</p><p><b>RESULTS</b>There were 12 091 new diagnosed cancer and 8040 death cases registered in Henan province in 2009. The rate of pathological diagnosis was 68.2% (8246/12 901) and only 1.75% (2116/12 901) had death certificates. The ratio of mortality and incidence was 0.66 (8040/12 091). The incidence rate was 199.47/100 000 (12 091/6 061 564) in total, and it was 216.36/100 000(6718/3 104 991) in males and 181.73/100 000(5373/2 956 573) among females. The standardized incidence by Chinese population was 126.50/100 000 and it was 166.08/100 000 by world's population. The cumulative rate was 19.95% between 0 and 74 years old. The incidence was the highest in Linzhou city, whose standardized incidence was 156.87/100 000 by Chinese population and the incidence was the lowest in Shenqiu city, whose standardized incidence was 104.82/100 000 by Chinese population. The morphology verified cases accounted for 68.2% (8246/12 091), death certification cases only accounted for 1.75% (2116/12 091), and mortality to incidence ratio was 0.66 (8040/12 091). The crude incidence in cancer registration areas of Henan province was 199.47/10 000 (12 091/6 061 564), 216.36/10 000(6718/3 104 991) for males, 181.73/10 000 (5373/2 956 573) for females, age-standardized incidence rates by Chinese standard population and by world standard population were 126.50/10 000 and 166.08/10 000 with cumulative incidence rate (0-74 age years old) of 19.95%. The crude mortality in cancer registration areas of Henan province was 132.64/100 000 (8040/6 061 564), separately 160.58/100 000 (4986/3 104 991) for males and 103.30/10 000 (3054/2 956 573) for females. The age-standardized mortality rates by Chinese standard population and by world's standard population were 78.41/10 000 and 107.49/10 000. The cumulative mortality rate (0-74 age years old) was 12.18%. The mortality rate was the highest in Linzhou city, whose standardized rate was 93.35/100 000 by Chinese population, and the lowest mortality rate was in Yuzhou city, whose standardized rate was 67.95/100 000. The most common cancers were lung cancer, esophageal cancer, gastric cancer, liver cancer, breast cancer, rectum cancer, brain nervous system cancer, colon cancer, cervical cancer and uterus cancer, all of which accounted for 82.23% (9943/12 091) of the registered cancers.Lung cancer, esophageal cancer, gastric cancer, liver cancer, breast cancer, rectum cancer, brain nervous system cancer, pancreas cancer, colon cancer and gallbladder carcinoma were the major causes for the death, accounting for 86.30% (6938/8040) of all cancer deaths.</p><p><b>CONCLUSION</b>Both incidence and mortality of cancer in Henan province were lower than the level in China, prevention and control should be implemented based on practical situation.</p>