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Objective To investigate the association between atherogenic index of plasma (AIP) and metabolic associated fatty liver (MAFLD) in type 2 diabetes mellitus (T2DM). Methods A total of 375 patients with T2DM who were hospitalized and treated in Department of Endocrinology, The First Affiliated Hospital of Zhengzhou University, from September 2021 to September 2022 were enrolled, and according to the presence or absence of MAFLD, they were divided into T2DM+MAFLD group with 245 patients and T2DM group with 130 patients. Related clinical data were recorded, and AIP was calculated. According to the quartiles of AIP, the patients were divided into Q1 group (AIP≤0.20), Q2 group (0.20 0.48). The independent-samples t test was used for comparison of normally distributed continuous data between groups, and the Wilcoxon rank-sum test was used for comparison of non-normally distributed continuous data between groups; the trend chi-square test was used for the trend analysis of categorical data. The multivariate logistic regression analysis was used to investigate the effect of AIP on MAFLD, and the receiver operating characteristic (ROC) curve and the area under the ROC curve (AUC) were used to assess the value of the indicators such as AIP, body mass index (BMI), and alanine aminotransferase (ALT) in predicting T2DM with MAFLD. Results Compared with the T2DM group, the T2DM+MAFLD group had significant increases in BMI, systolic pressure, uric acid, fasting blood glucose, glycosylated hemoglobin, ALT, aspartate aminotransferase, gamma-glutamyl transpeptidase, alkaline phosphatase, triglyceride, low-density lipoprotein, and AIP and a significant reduction in high-density lipoprotein (all P < 0.05). The trend chi-square test showed that the prevalence rate of MAFLD in T2DM patients tended to increase with the increase in AIP level ( χ trend 2 =20.338, P < 0.05). The multivariate logistic regression analysis showed that compared with the Q1 group, the Q4 group had a significant increase in the risk of MAFLD (odds ratio =2.396, 95% confidence interval: 1.018-5.640, P =0.045). The ROC curve analysis showed that the diagnostic model of AIP combined with BMI and ALT had the best diagnostic performance (AUC=0.816), with a sensitivity of 70.2% and a specificity of 78.5% at the optimal cut-off value of 0.670. Conclusion AIP is an independent risk factor for MAFLD in T2DM patients, and AIP combined with BMI and ALT has a good predictive value for T2DM with MAFLD.
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Objective:To explore the safety of cyclophosphamide combined with taxane chemotherapy in triple-negative breast cancer patients with chronic renal failure and the management strategy of complications.Methods:Data of 8 patients with triple-negative breast cancer and chronic renal failure admitted to our hospital from Jun 2016 to Dec 2019 were retrospectively analyzed.Results:Eight patients received standard cyclophosphamide combined with taxane (TC regimen) chemotherapy after operation, 5 of which received docetaxel 75 mg/m 2 + cyclophosphamide 600 mg/m 2, and 3 received albumin paclitaxel 260 mg/m 2+ cyclophosphamide 600 mg/m 2, during chemotherapy, only leukopenia, hair loss and gastrointestinal reactions occurred in grades 3 to 4, and the incidence was 25%, 25% and 12%, respectively. Four patients adjusted the dosage due to adverse reactions. One patient quit, the remaining patients successfully completed 4 cycles of chemotherapy. The average serum creatinine before chemotherapy was (498±63) μmol/L, and after chemotherapy, it was (518±61) μmol/L ( t=-2.335, P>0.05). Conclusions:Combined with chronic renal failure is not a contraindication to postoperative chemotherapy for patients with breast cancer. It is safe to choose standard TC regimen and adjust the dose of adjuvant chemotherapy for patients with triple-negative breast cancer.
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Objective: To investigate the relationship of clinicopathological characteristics with neoadjuvant chemotherapeutic efficacy and prognosis of inflammatory breast cancer (IBC) patients. Methods: Medical records of 81 patients who underwent neoadjuvant chemotherapy for IBC in Tianjin Medical University Cancer Institute and Hospital between January 2010 and December 2013, were retrospectively analyzed. Clinicopathological features, response to neoadjuvant chemotherapy, and prognostic factors were studied by univariate and multivariate analyses. Results: The 3-year overall survival rate (OS) and disease-free survival rate (DFS) of patients were 53.1％ and 37.0％, respectively. The pathologic complete response (pCR) rate of patients after accepting neoadjuvant chemotherapy was 13.6％ (11/81). Statistically significant association was observed between pCR and pathological types in IBC (P0.05). Preoperative lymph node stage was an independent prognostic factor of overall survival (OS) and disease- free survival (DFS) in IBC patients (P<0.05). Neoadjuvant chemotherapy and lymph vessel tumor emboli were independent factors of DFS (all P<0.05). Conclusion: Clinicopathological characteristics of IBC patients affected chemosensitivity. We could predict the prognosis of these patients by preoperative lymph node stage and lymph vessel tumor emboli and select chemotherapy to achieve the best curative effect.
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Objective:To discuss dexamethasone on proliferation of mouse thyroid follicular cells and apoptosis. Methods:Taken BALB/c mice thyroid tissue to trypsin+Ⅱcollagenase digestion organizations get thyroid follicular cells,and expression of thyro-globulin determined whether or not the target cell. Then different concentrations of dexamethasone to stimulate target cells,and the use of MTT,flow cytometry cell proliferation rate,apoptosis rate and the apoptosis-related gene expression analysis. Results: Trypsin joint type Ⅱ collagenase treatment of thyroid tissue to obtain a stable passage of thyroid follicular epithelial cells,and cells stably expressing thyroglobulin. At the same time, different concentrations of dexamethasone on cell proliferation difference was statistically significant (F=8. 544, P<0. 05 ), and the suppression of drug action have interaction ( F = 4. 532, P<0. 05 );in addition, differently dexamethasone concentration 10-6 mol/L, 10-5 mol/L, 10-4 mol/L, the apoptosis rates were 13. 39% ± 0. 79%, 17. 43% ± 1. 38%, 26. 42%±1. 74%,both with 0 mol/L to plug betamethasone 4. 51%± 0. 06% apoptosis rate differences were statistically significant (P<0. 05,P<0. 01),while the difference in the expression of apoptotic genes trend still showed a dose-dependent manner. Conclusion:Dexamethasone can effectively inhibit thyroid follicular cell proliferation and induce apoptosis through a variety of apoptotic pathways.
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OBJECTIVE According to the characteristics of ophthalmic surgical instruments,to select the best sterilization method in order to guide clinic.METHODS The different methods of disinfection and sterilization,surgical volume and postoperative infection of ophthalmic surgical instruments from 2005 to 2007 were reiewed and compared the current pros and cons of various sterilization methods.RESULTS The use of low-temperature sterilizer before(2005) the number of surgical cases of 2275 cases,the infection rate was 0.04%;the use of low temperature plasma sterilizer after the(2006) the number of surgical cases of 2752 cases,the infection rate was 0;the use of low-temperature plasma and low-temperature steam formaldehyde sterilization sterilization(2007) Example surgery for 2830 cases,the infection rate was 0.035 percent;low-temperature sterilization of surgical instruments can ensure sterilization,but also enhance the volume of surgery.CONCLUSIONS Hydrogen peroxide plasma sterilization technology with the use of low-temperature range,fast,convenient and reliable features,more suitable for ophthalmic surgical instruments after the section of the sterilizer.
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Objective To study the clinical significance for the establishment of diagnosis of small bowel obstruction by selective small bowel enterography through a nasointestinal decompression tube. Methods Tirty-five patients with small bowel obstruction, with no strangulation or other contraindications, were intubated with a 300 cm nasointestinal decompression tube till upper jejunum under X-ray monitoring. The patients firstly underwent intra-small-intestinal suction therapy. When the tube reached the diseased region, a selective small bowel enterography was performed. Under X-ray inspection, 20-100 ml of 76% meglumine diatrizoatis and 50-200 ml of air were slowly injected via the decompression tube to perform double contrast intestinal radiography. Results Intubation was successful in all the 35 patients. Mter the small intestinal decompression therapy. Obstruction was cured in 20 cases, alleviated in 15 cases, and 10 cases received operation. Small bowel enterography in this series was all of high quality, there were 6 cases in which no abnormal X-ray findings, adhesive small bowel obstruction was suggested in 15 cases, small bowel tumor was identified in 4 cases (3 metastatic tumor, 1 small bowel cancer), small bowel Crohn's disease in 3 cases, radioactive enteritis in 3 cases, enteric intussusception in 2, polyp of the small intestine in one, and carcinoma of the ascending colon in one. Conclusions The nasointestinal decompression intubation with X-ray monitoring serves a dual function for the patients with intestinal obstruction, it decompresses the small bowel and does small intestinal radiography, in this way the locale of obstruction was found and the cause of the obstruction identified.
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To investigate the clinical features and principles of diagnosis and treatment of early postoperative inflammatory ileus (EPII). The clinical data of 69 patients with EPII treated in this hospital were retrospectively reviewed. EPII mostly occurred in 3-11d after abdominal surgery, and the average time was 5d. Sixty two cases were cured in a mean period of (22±13)d through combination therapy including gastroenteral decompression, somatostatin, dexamethasone and total parenteral nutrition (TPN). Seven cases were cured by operation. EPII is a special type of early intestinal obstruction which often occurs in two weeks after abdominal operation. Its typical symptoms are abdominal distension; conservative therapy is effective for most cases and reoperation is usually contradicted.
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Objective To study the relationship between calcitonin gene related peptide(CGRP)and enhanced osteogencsis after brain injury by investigating the expression of CGRP in callas and the level of CGRP in serum of rats with brain injury and femoral fracture.Method The experiment was conducted in the Laboratory of Surgery,Affiliated Hospital of North Claim Coal Medical College.Totally 56 male Sprague-Dawley(SD)rats were divided randomly into 3 groups:fracture group(n=24),fracture with brain injury group(n=24)and normal control group(n=8).The parietal skull revealed,the bone windowwas opened,rats models of brain injury were established by falling freely,and rats models of fracture were established by cutting the right middle femur.The rats in normal control group were killed at the 21 days after operation,the rats in other two groups were killed at 7,14and 21 days after operation,respectively.The X-ray of femoral fracture was obtained,the CGRP concentration in serum was detected by mdioimmunoassay,and tissues at 5mm above and below the fracture were stained by HE and SP immtmohistochemistry to observe the expressions of CGRP and the fracture healing.The data were expressed as mean±SEM and ahalyzed with student't t test with SPSS,Results The serum levels of CGRP in fracture group were(91.58±28.67)ng/L,(102.46±27.95)ng/L,(86.54±24.13)ng/L at 7,14,21 days after operation,respectively,which were significantly higher than that in the control group.In fracture with brain injury group,the serum levels of CGRP(165.49±43.28)ng/L significantly increased at 7 days after operation,and compared with fracttwe group,there was significant difference.The serum levels of CGRP decreased at 14,21 days after operation,with 104.72±31.36)ng/L,(74.93±21.57)ng/L,respectively,and compared with fracture group,there was significant difference at 21 days.The mean optical density in callus of the fracture in brain injury group (0.496±0.108)were higher than that in the fracture group[(0.348±0.076)]at 7 days after operation(P＜0.01),but there were no significant difference on the 14 and 21 days.Conclusions CGRP may play a role in osteogenesis after brain injury.
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Objective To analyze the diagnosis and treatment of pancreatic trauma with main pancreas duct break. Methods Forty-four cases of severe pancreatic trauma with main pancreas duet break were retrospectively analyzed including their diagnosis and different operation performed according to the severity of pancreatic trauma. Results All of severe pancreatic trauma could be diagnosed by CT scan and B-ultrasonic examination. But the main pancreas duct break or not should be determined by surgical exploration. Emergency operations were performed for all cases , distal part pancreaticojejunostomy in 27 cases; modified duodeno-divertiulaization in 3 cases, duode-nojejunostomy in 3cases, pancreaticeduodenectomy in 2 cases, 41 cases were cured. The mortality was 6.8%. Conclusion CT scan is the most helpful means to diagnose pancreatic trauma. An appropriate and timely emergen-cy operation is the key to reduce mortality.
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OBJECTIVE To provide a practical action plan which can prevent and control the similar occurrence through studying the epidemiological characteristics of a norovirus-induced diarrhea outbreak in the wards of our hospital. METHODS To obtain the information about the epidemic situation of norovirus involving 15 patients in the two wards of our hospital, during the period from Nov 12 to 15, 2006. RESULTS It was a norovirus gastroenteritis outbreak in the 8 cases among 15 patients and there were other 7 sporadic cases. The consummate monitoring system on nosocomial infection could gain the information of disease, and be very helpful to control its transmission. Beijing Municipal Center for Quality Control and Improvement of the Management of Nosocomial Infection was known the information and shared it among different kinds of hospitals. Thus an unnecessary panic was avoided in Beijing at that time. CONCLUSIONS The social factor, senile situation and immunocompromise are the causes of this norovirus outbreak. The effective control measures and the information exchange in time could prevent the spread of infection. It is shown that the nosocomial infection monitoring network could catch the epidemic tendency of nosocomial infection sensitively, so to strengthen the monitoring network is the key.
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OBJECTIVE To investigate the hospitals containing above 500 sickbeds in the Beijing area,in order to find out the relationship between the environmental sanitation monitoring(including air,object surface,medical personnel hand,using desinfectant compound,and ultraviolet lamps) and the hospital infection control.METHODS Choosing hospitals with above 500 sickbeds in Beijing,through a written survey and questionnaire covering the actual environmental sanitation monitoring quantity,the positive rate and the situations of hospital infections outbreak in 2005,then calculate the statistical analysis.RESULTS After calculating the environmental sanitation monitoring cost for the hospitals with above 500 sickbeds,it could conclude the monitoring expense for 1000 sickbeds hospital per year for each bed was 192.10 RMB;the monitoring expense for 500 sickbeds hospital per year for each bed was 145.60 RMB.It could also conclude the positive rate of object surface and the hands of medical personnel was higher.CONCLUSIONS Through the analysis,each hospital carries out the monitor according to the requirement of the "Standards",the monitoring expense for hospitals with 1000 sickbeds is higher that of hospitals with 500 sickbeds.It is no correlation between the hospital monitoring positive rate and the hospital infection outbreak.The medical personnel′s knowledge of hospital infection control and hand hygiene training must be strengthened.
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Objective To study significance of anicteric biliary tract dilatation in early diagnosis and treatment of patients with periampullary carcinoma.Method Review the resection rate and survival rate of 16 periampullary carcinoma patients with anicteric biliary tract obstruction found out by B-ultrasound,CT or PTC during 13 years(1986-1999).Result The operative resection rate was 87.50%(14/16) ,5-year survival rate was 43.75%(7/16),3-year survival rate was 62.50%(10/16).Conclusions Biliary tract dilatation existed before icterus occurred,while syndromes such as upset of upper abdomen,reclusion, epigastralgia distention and anorexia, may occur 1-3 months ahead of icterus occurred in patients with periampullary carcinoma. If the patient has syndromes mentioned above, more than 40 years of age and biliary tract dilatation found by B-ultrasound, CT,PTC or ERCP, periampullary carcinoma should be considered. The patients should be checked by operation,so as to raise the operative resection rate and survival rate.