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Objective:To evaluate the impact of sarcopenia on survival and treatment-related toxicity in postoperative recurrent esophageal squamous cell carcinoma (ESCC) patients treated with chemoradiotherapy.Methods:Clinical data of 147 patients with postoperative locoregional recurrent ESCC receiving chemoradiotherapy in Huai'an First People's Hospital from 2016 to 2017 were retrospectively analyzed. Pectoralis muscle area (PMA) was determined using routine pre-radiotherapy CT simulation scan above the aortic arch level. Sarcopenia was defined as a cut-off value of pectoralis muscle index (PMI) (PMA/height 2) <11.55 cm 2/m 2 for males and <8.69 cm 2/m 2 for females. The incidence of toxicity, 1- and 3-year overall survival (OS) rates were statistically compared between patients with and without sarcopenia. Results:Sarcopenia was detected in 49 of 147 (33.3%) patients. The incidence of grade 3-4 toxicities in sarcopenic patients was significantly higher compared to that in their counterparts without sarcopenia (40.8% vs. 18.4%, P=0.005). In addition, patients with sarcopenia had significantly worse 1-year (61.2% vs. 82.7%) and 3-year OS rates (10.2% vs. 28.6%) than those without sarcopenia (both , P<0.001). Multivariate analysis showed that sarcopenia was an independent prognostic factor for poor OS ( P<0.001). Conclusion:PMI based on CT simulation scan has prognostic value in postoperative locoregional recurrent ESCC patients treated with chemoradiotherapy, which probably serves as a novel diagnostic tool for sarcopenia.
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Objective: To compare the effectiveness of the intermittent suture and the cosmetic suture in total knee arthroplasty (TKA). Methods: A clinical data of 48 patients with knee osteoarthritis, who underwent initial TKA between January 2017 and April 2018, was retrospectively analyzed. Among them, 23 patients underwent intermittent suture (group A) and 25 patients underwent cosmetic suture (group B). There was no significant difference in gender, age, body mass index, disease duration, degrees of varus and valgus deformities, knee society score (KSS), visual analogue scale (VAS) score, and levels of interleukin-6 (IL-6), procalcitonin (PCT), C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR) in serum before operation between the two groups ( P>0.05). KSS scores at 1 and 6 months after operation were used to assess the knee function. VAS scores at 1, 3, and 5 days after operation were used to assess the pain degree of knee. Levels of IL-6, PCT, CRP, and ESR in serum at 1 day and 1 month after operation were recorded to evaluate the risk of periprosthetic infection. Likert score at 6 months after operation was used to evaluate the satisfaction of incision. The hospitalization time after operation was also recorded. Results: All patients were followed up 7- 17 months (mean, 11.3 months). There was no significant difference in hospitalization time after operation between two groups ( t=-1.907, P=0.063). The Likert score in group A was significantly lower than that in group B ( t=-2.196, P=0.033). The VAS score, KSS clinical score and KSS functional score at different time points after operation were significantly better than those before operation in two groups ( P0.05). There was no significant difference in the levels of IL-6, PCT, CRP, and ESR between the two groups at different time points after operation ( P>0.05). Conclusion: Cosmetic suture is superior to intermittent suture in incision appearance and pain management, but there is no significant difference in short-term joint function and risk of periprosthetic infection after TKA.
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Objective:To investigate whether the overexpression of Oct4B1 gene induces epithelial mesenchymal transition in human colorectal cancer SW480 cells and its possible mechanism.Methods: Experimental group(SW480-Oct4B1):Transfection of SW480 cell lines in colorectal cancer with Oct4B1 overexpression plasmid;Control group(SW480-Oct4B1):negative control plasmid with G418 resistance.Stably transfected cell lines were obtained by G418 culture medium.The two groups were compared with:①Detection of Oct4B1 gene expression in stably transfected cell lines by RT-qPCR;②Scratches and Transwell assays were used to estimate migration and invasion;③Detection of EMT related markers E-cadherin,N-cadherin and Vimentin protein expression by Western blot assay;④Detection of Twist gene and protein expression by RT-PCR and Western blot assays.Results: The transient transfection was confirmed by RT-qPCR and the stable transfected cell lines were obtained from two groups of cells transfected with G418 culture medium.Compared with the control group:①RT-qPCR revealed increased expression of Oct4B1 gene in the experimental group(P<0.01);②Cell migration and invasion were significantly increased(P<0.01);③Epithelial marker:the expression of E-cadherin protein was significantly decreased (P<0.01),interstitial marker:the expression of N-cadherin and Vimentin protein was significantly increased (P<0.01);④Twist mRNA and protein expression were significantly increased(P<0.01).Conclusion: Overexpression of Oct4B1 gene can induce epithelial mesenchymal transition in human colorectal cancer SW480 cells,its molecular mechanism may be related to the promotion of Twist expression.
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With the continuous deepening of the reform of medical system and progressively improvement of the modern hospital management system , the accounting of medical insurance payments plays an important role in the cycle of the whole hospital financial accounting .Executing the corresponding financial analysis , clerks from the finan-cial department can find out the healthcare issues , and accordingly take effective measures .
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In order to adapt to the change of hospital internal economic management mode gradually from empirical formula and extensive management to scientific and fine management, so as to improve financial management effectiveness. Methods:The strategic principle was combined with the practice of the hospital financial management. From the perspective of financial strategy, the specific measures of improving hospital financial management effectiveness was analyzed to promote the overall hospital development. Results: According to the classification of hospital financial strategy, measurement of improving financial management effectiveness was proposed. Conclusion: To analyze the problem of hospital economic manager using financial strategic thinking to improve the effect of the hospital financial management, not only is the beneficial trial of practice and innovation, but also is the inevitable requirement of adapting to the future development of the hospital, which has important practical guiding significance.
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OBJECTIVE: To assess the efficacy and safety of compound azintamide and trimebutine maleate in the treatment of functional dyspepsia (FD) in elderly patients. METHODS: 48 elderly patients with FD up to Rome Ⅲ were randomly divided into two groups. Treatment group were given 200 mg trimebutine maleate tid at 15 min before meal and 2 pieces of compound azintamide tid after meal for 4 weeks (n=23). Control group were given 200 mg trimebutine maleate tid for 4 weeks (n=25). Questionnaire survey was applied to detect the index of dyspeptic symptoms and drug toxity before and after treatment. RESULTS: The patients with FD in two groups were matched well in respect of age, sex and index of dyspeptic symptoms. Routine therapy was achieved and adverse reaction wasn’t found. Curative efficacy and symptom score in treatment group were significantly better than in control group after 4 weeks of treatment, such as poor appetite, abdominal distension, early satiety, belching , except upper abdominal pain and burning sensation (P