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Objective:To explore the effect of pediatric massage combined with nerve growth factor treatment on the neurological function of children with acute ischemic hypoxic encephalopathy (HIS).Methods:A total of 96 children with HIS who were treated in Hubei Maternal and Child Health Hospital affiliated to Tongji Medical College of Huazhong University of Science and Technology from February 2017 to October 2019 were selected for the study. The children were divided into 2 groups using a random number table method, with 48 cases in each group. The control group was treated with nerve growth factor on the basis of conventional treatment, and the observation group was treated with pediatric massage on the basis of the control group. The clinical efficacy, neurobehavior, intelligence index, EEG index, cerebral blood flow and hematology index were compared between the two groups.Results:The total effective rate of the observation group was 95.84%, which was higher than 81.25% of the control group, and the difference between the two groups was statistically significant ( χ2=5.03, P=0.025). The 28-day NBNA score ( t=-2.55, P=0.012) and three-month MDI and PDI of the observation group were significantly higher than those of the control group ( t values were -3.43, -2.65, all Ps<0.01). After treatment, the EEG spike wave amplitude of the two groups of children decreased significantly, and the decrease was greater in the observation group[(35.02 ± 4.16) mV vs. (46.92±5.81)mV, t=11.54]. After treatment, the cerebral blood flow of the two groups of children increased significantly, and the increase was more significant in the observation group [(179.36 ± 22.25) ml/(100 g?min) vs. (158.30±14.92) ml/(100 g?min), t=-5.45]. After treatment, the levels of MBP, NSE and VEGF in the two groups of children decreased significantly, but the decrease in the observation group was greater ( t values were 3.29, 4.07, 8.17, all Ps<0.01). Conclusion:Pediatric massage combined with nerve growth factor alone can improve the curative effect of children with HIS, improve neurobehavioral and intelligent indicators, increase cerebral blood flow, and reduce EEG spike wave amplitude and MBP, NSE and VEGF levels.
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In order to overcome the difficulty in lung parenchymal segmentation due to the factors such as lung disease and bronchial interference, a segmentation algorithm for three-dimensional lung parenchymal is presented based on the integration of surfacelet transform and pulse coupled neural network (PCNN). First, the three-dimensional computed tomography of lungs is decomposed into surfacelet transform domain to obtain multi-scale and multi-directional sub-band information. The edge features are then enhanced by filtering sub-band coefficients using local modified Laplacian operator. Second, surfacelet inverse transform is implemented and the reconstructed image is fed back to the input of PCNN. Finally, iteration process of the PCNN is carried out to obtain final segmentation result. The proposed algorithm is validated on the samples of public dataset. The experimental results demonstrate that the proposed algorithm has superior performance over that of the three-dimensional surfacelet transform edge detection algorithm, the three-dimensional region growing algorithm, and the three-dimensional U-NET algorithm. It can effectively suppress the interference coming from lung lesions and bronchial, and obtain a complete structure of lung parenchyma.
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Algorithms , Neural Networks, Computer , Tomography, X-Ray ComputedABSTRACT
Objective: To compare the mutation status of epidermal growth factor receptor (EGFR) between different lesions and clini-cal characteristics of synchronous multiple ground-glass nodules (SMGGNs). Methods: A retrospective analysis was conducted using clinical data from 35 patients with SMGGNs who were admitted to and received surgery at The Fourth Hospital of Hebei Medical Uni-versity Hospital from January 2017 to December 2018. Next generation sequencing (NGS) was performed for all surgical specimens to detect the mutation status of exons 18, 19, 20, and 21 of the EGFR gene to analyze the relationship between the EGFR mutation sta-tus of the lesions and patient gender, age, lesion location, imaging manifestation of nodules, and adenocarcinoma pathological type . Results: The EGFR mutation rate was 65.7% (23/35 patients). Non-smoking patients and females had higher EGFR mutation rates (P=0.015, P<0.001). The EGFR mutation rate of invasive adenocarcinoma nodules was higher than those of atypical adenomatous hyper-plasia, adenocarcinoma in situ, and minimally invasive adenocarcinoma ( P<0.001). Exon 19 deletion and L858R mutation were the most common mutations of the EGFR gene. There was no significant difference between the pathological subtypes of adenocarcino-ma and the EGFR mutant subtype (P=0.707). Among the 27 patients with multiple nodules with detectable EGFR mutations, the EGFR mutation rate was 85.2% (23/27 patients). Conclusions: The EGFR gene mutation status is different in patients with multiple pulmo-nary ground-glass nodules, suggesting that the occurrence and development of each nodule are independent events. EGFR gene muta-tion is closely related to the development of ground-glass nodules, especially in the invasion of tumors.
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Objective@#To establish depression model in female C57BL / 6 mice using chronic unpredictable stress + sleep deprivation + castration and observe the change of behavior and neuroendocrine of this model to provide basis for screening anti-depressant drugs.@*Methods@#To simulate the etiopathological mechanism of perimenopausal depression or depression symptoms, C57BL/6 female adult mice were exposed to chronic unpredictable stress + sleep deprivation + castration to establish perimenopausal depression model. The mice were randomly divided into perimenopausal group, model group, sham operation group, which of behavioral and neuroendocrine differences were observed.@*Results@#(1)Compared with the sham operation group((21.48±0.79)g, (0.02±0.06), (93.02±6.17)%) and the perimenopausal group((22.02±0.15)g, (0.06±0.09)score, (90.30±11.68)%), the body weight ((20.16±1.03)g), coat state score (0.39±0.04) and sucrose preference((58.11±11.97)%) in the model group had significant differences(all P<0.05). (2)Compared with the perimenopausal group and sham operation group, the horizontal movement, the vertical movement score and the percentage of central cells in the open field experiment, the percentage of immobility state and immobility state in forced swimming and tail suspension experiment of model mice were all significantly different (P<0.05). (3)Compared with the perimenopausal group and the sham-operation group, the latent period of eating, the total time of exploration and single exploration in NSFT had significant difference(P<0.05). (4)Compared with the sham operation group((46.16±7.72)pmol/ml, (320.77±23.19)ng/ml) and the perimenopausal group ((9.75±1.77)pmol/ml, (386.42±37.58)ng/ml), serum estradiol ((9.99±0.37)pmol/ml) were elevated and corticosterone ((426.31±105.01)ng/ml) were increased in the model group, which had significant differences (P<0.05).@*Conclusion@#C57BL/6 female mice show depression-like behavior after ovariectomy, 4 weeks of chronic unpredictable stress and sleep deprivation intervention.
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Objective@#To investigate relationship between the clinicopathological features and prognosis of T1 esophageal carcinoma.@*Methods@#Data from 212 T1 primary esophageal cancer patients, who underwent radical surgery in The Fourth Hospital of Hebei Medical University from Jan 2001 to Dec 2009 were enrolled. There were 148 males and 64 females. There were 91 patients with stage pT1a and 121 patients with stage pT1b.@*Results@#The survival of the 212 patients was 27~108 months, and the median survival was 80.8 months. The 1, 3, and 5 year survival rates of patients with stage T1a were 100%, 97.8% and 94.5%, respectively, and the median survival was 86.8 months. The 1, 3, and 5 year survival rates of patients with stage T1b were 100%, 95.9% and 74.4%, respectively, and the median survival was 76.2 months. The rate of lymph node metastasis in 121 patients with stage T1b was 26.4% (32/121). The lymph node metastasis rates in patients with stage sm1, sm2 and sm3 were 11.6% (3/26), 15.0% (6/40) and 41.8% (23/55), respectively. There was no significant difference in lymph node metastasis between stage sm1 patients and stage sm2 patients (P=0.973). Lymph node metastasis rates in patients with stage sm3 were higher than those in stage sm1 and sm2 (P<0.05).@*Conclusion@#Radical resection of esophageal carcinoma with peripheral lymph node dissection is recommended for patients with T1b esophageal carcinoma.
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Objective To investigate the tumor molecular mechanism of Hedgehog/Gli in promoting the epithelial-mesenchymal transition (EMT) in gastric cancer AZ521 cells. Methods After 24 h of treatment with GANT61,the mRNA expression of Gli1,Gli2, N-cadherin,and E-cadherin in the AZ521 cell line were detected by real-time fluorescence quantitative PCR. A Western blotting assay was conducted to determine the expression of the above cytokines,p-AKT and AKT. The effect of GANT61 on invasion was observed by transwell assay. N-Shh stimulation of the Hedgehog pathway was conducted to confirm the changes in these cytokines. Results GANT61 significantly downregulated the mRNA expression of Gli1,Gli2,and N-cadherin,but upregulated E-cadherin mRNA expression. The Western blotting assay revealed that GANT61 downregulated the protein expression of Gli1,Gli2,p-AKT,and N-cadherin,but upregulated E-cadherin expression. Furthermore,GANT61 inhibited the invasion. N-Shh proteins up-regulated Gli1,Gli2,and N-cadherin mRNA,protein expression and p-AKT protein expression,but downregulated E-cadherin mRNA and protein expressions. N-Shh promoted the invasion of tumor cells. Conclusion Downregulation of Gli1 and Gli2 can inhibit the invasion and metastasis in gastric cancer cells,which may be related to the promotion of EMT by Gli through the PI3K/AKT pathway.
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Objective To estimate the gene mutation and the protein expression of v-Raf murine sarcoma viral oncogene homolog B1 (BRAF) in esophageal cancer.Methods From February 2014 to September 2015,75 patients with esophageal cancer who received operation were enrolled.Tissues of cancer,adjacent to cancer and far from cancer were taken.The mutation and protein expression of BRAF were detected.The relationship between BRAF protein positive expression and clinical characteristics of patients with esophageal cancer was analyzed.The enumeration data was compared by chi-square test.Results The mutation of exon 11 and exon 15 of gene BRAF was not found in the tissues of esophageal cancer.Among 75 esophageal cancer,a base C or T inserted in the exon 11 was found in five Ⅲb TNM stage cases,and the expression of BRAF at protein level was positive in 46 cases (61.3％).Among 57 tissues adjacent to cancer,nine cases (15.8 ％) was BRAF positive at protein level.Among 75 tissues far from cancer,five(6.7％) was BRAF positive at protein level.The difference among three groups was statistically significant (x2 =61.098,P＜0.05).The positive rates of BRAF expression at protein level in patients with esophageal cancer at Ⅰ,Ⅱ and Ⅲ TNM stage were 21.7％ (5/23),70.8％ (17/24) and 85.7 ％ (24/28),respectively.The positive rates of BRAF expression at protein level in patients with and without lymph node metastasis were 81.6％ (31/38) and 40.5％ (15/37).The positive expression of BRAF at protein level was related with TNM stage and lymph node metastasis (x2 =23.136 and 13.313,both P＜0.01),however it was not related with gender,age and the degree of tumor differentiation (all P＞0.05).Conclusions There is base insertion in the exon 11 of gene BRAF in esophageal cancer,but gene mutation is not found.BRAF is highly expressed in esophageal cancer,which is related with TNM stage and lymph node metastasis,and BRAF could be an indicator of assessment of degree of malignancy and prognosis of esophageal cancer.
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Objective Esophageal spindle cell carcinoma is a rare type of esophageal squamous cell carcinoma , which was usually named esophageal carcinosarcoma .This article was to discuss the clinical characteristics , treatment and prognostic factors of e-sophageal spindle cell carcinoma . Methods The clinical and pathological data of 28 cases of esophageal spindle cell carcinoma were retrospectively analyzed .The prognostic factors was analyzed for various factors including gender , age, smoking history , tumor loca-tion, tumor size, lymph node metastasis, histological type, pathological staging and adjuvant treatment regimen .Kaplan-Meier method was applied to calculate the survival rate , log rank method for single prognostic factor analysis and Cox proportional hazard regression model for multivariate analysis of prognosis . Results One-year, three-year, and five-year survival rates were 89.3%(25/28), 67.1%(19/28), 38.5%(10/28)respectively.Single factor analysis showed that the pathological type , N stage, T stage, pTNM stage were the factors influencing the prognosis(P﹤0.05), while gender, age, smoking and drinking history, tumor location, tumor size, operation incision selection , adjuvant treatment regimen were not .Multivariate analysis showed pTNM stage were the independent fac-tors affecting the prognosis of esophageal spindle cell carcinoma (χ2 =13.104, P=0.000). Conclusion Esophageal spindle cell carcinoma is a rare kind of esophageal squamous cell carcinoma with less invasiveness , low rate of lymph node metastasis and good progno-sis.Radical operation is the preferred treatment .
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ObjectiveTo analyze the application value of diffusion-weighted magnetic resonance imaging (DWMRI) in gross tumor volume (GTV) delineation of esophageal squamous cell carcinoma (SCC).MethodsTwenty-nine patients with esophageal SCC treated with radical surgery were analyzed.Routine CT scan,MRI T2-weighted and DWMRI were employed before surgery;diffusion-sensitive gradient b-values were taken 400,600 and 800 s/mm2.GTVs were delineated using CT,MRI T2-weighted images and DWMRI under different b-value images.The length of GTVs measured under different images was compared with the pathological length and confirm the most accurate imaging condition.Use radiotherapy planning system to fuse DWMRI images and CT images to investigate the possibility of delineate GTVs on fused images.ResultsThe difference of GTV length value between CT,T2 WI images and specimen was 3.36 mm and 2.84 mm.When b =400,600 and 800 s/mm2,the difference between GTV length value on the DWMRI images and on specimen was 0.47 mm,-0.47 mm and - 1.53 mm;the correlation coefficient of the measuring esophageal lengths on DWMRI images and the pathological lengths was 0.928,0.927 and 0.938.DWMRI images and CT images could fuse accurately on radiotherapy planning system.GTV margin could.show clearly on fused images.ConclusionsDWMRI images can display the esophageal carcinoma lengths and margin accurately.When DWMRI images fused with CT images,GTV margin could show clearly,it can be used to delineate GTV accurately.
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Objective:To explore the clinical significance of labelling MM C-CH 40 in the radical operation of gastric cancer.Methods:Fifty seven patients with gastric cancer were randomly divided into two groups-labelling group and control group.In the labelling group,MM C-CH 40 was injected into the periphery of tumor through gastroscope before operation,then performed radical gastrectomy,the dyed lymph nodes were regarded as marker of the operation.Results:(1)In the labelling group,the average number of eliminated lymph nodes(41.5) was far higher than that of control group (24.4).(2)In the labelling group,of the total eliminated lymph nodes,dyed lymph nodes were 67.1%.(3)In the case of lymph node metastasis,the average number eliminated in the labelling group was 10.05,and that of the control group was 6.74.(4) Inject MM C-CH 40 into the periphery of tumor through gastroscope one week before operation could get a satisfactory result.Conclusion:MM C-CH 40 labelled lymph nodes can guide the radical gastrectomy.
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0.50).ConclusionsThe use of high-frequency electrotome significantly increases the postoperative perineal complications. The packing of greater omentum and perineal electromagnetic wave irradiation reduce the occurrence of the side effects.