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Objective:To explore the effects of stepped-care intervention on disease adaptation and medical coping among young and middle-aged patients undergoing early stage of peritoneal dialysis.Methods:Totally, 72 young and middle-aged patients undergoing early stage of peritoneal dialysis from January 2018 to December 2019 in the Affiliated Hospital of Guilin Medical College were divided into experimental group and control group according to drawing lots methods, each group contained 36 cases. The control group received routine nursing, while patients in the experimental group were given stepped-care intervention for 6 times. Before and after intervention, the effects was assessed by Self-report Pychosocial Adjustment to Illness Scale (PAIS-SR) and Medical Coping Modes Questionnaire (MCMQ), respectively.Results:After intervention, the health care scores, ability to work scores, family relationship scores, communication scores, entertainment scores, psychological condition scores and total PAIS-SR scores were 7.88±1.53, 9.12±1.30, 6.62±1.10, 6.74±1.31, 6.44±1.80, 8.29±1.83, 50.35±4.26 in the experimental group, significantly lower than those in the control group 8.70±1.33, 10.06±1.90, 7.61±1.66, 7.73±1.86, 7.48±2.15, 9.45±1.60, 56.58±5.04 ( t values were 2.317-5.464, P<0.01 or 0.05). the MCMQ scores in facing were 12.97±2.44 in the experimental group, significantly higher than that in the control group 11.58±2.33; the avoidance and yielding scores were 16.41±1.46, 13.44±1.83 in the experimental group, significantly lower than those in the control group (17.76±1.52, 14.73±2.36), the differences were statistically significant ( t values were 2.389, 3.696, 2.496, P<0.05). Conclusions:Stepped-care intervention can improve the ability of disease adaptation and promote the positive transformation of young and middle-aged patients undergoing early stage of peritoneal dialysis.
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Objective@#To investigate the clinicopathological features of long-term tumor-free survival in patients with untreated primary diffuse large B-cell lymphoma (DLBCL) of the tonsil.@*Methods@#The study included 80 consultation cases of primary tonsillar DLBCL from April 2006 to July 2017 in the Department of Pathology, Beijing Friendship Hospital, Capital Medical University. The patients were divided into two groups: experimental groups of 10 untreated patients with long-term tumor-free survival, and 70 patients who had been treated (control group). The clinical data, histopathological features, immunohistochemical staining, and molecular biology test results of the patients were analyzed retrospectively.@*Results@#Patients who had long-term tumor-free survival with untreated primary diffuse large B-cell lymphoma had the disease mostly confined to the tonsil. Biopsy showed that the tonsil structure was only partially effaced and the lesions were relatively "fresh". EBER and FISH test for t (14;18) results were negative. Gene rearrangement detection showed monoclonality. There was statistically significant difference between the age, bcl-2 expression, CMYC protein expression and co-expression of CMYC and bcl-2 between the untreated group and the treated group(P<0.05). Patient gender, tumor site, histological type and clinical stage showed no difference between the untreated group and the treated group (P>0.05); The median overall survival of the untreated group and treated group was 81 months and 20 months, respectively, and the difference was not statistically significant (P>0.05).In patients younger than 40 years of age, the untreated group had a statistically significant difference in primary site and CMYC protein expression compared with the treated group (P<0.05), and there was no statistical significance in other aspects.@*Conclusions@#Long-term tumor-free survival patients with untreated tonsillar primary DLBCL have relatively unique clinical characteristics. There is no significant difference in the prognosis between the untreated and treated groups, indicating radiotherapy and chemotherapy may not be required and therefore, avoiding related side effects.
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This patient presented with fever,seizure and bulging fontanelle when he was 6-month-old.According to the investigations,white blood cell (WBC),erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) increased significantly,and Streptococcus Pneumonia grew in both blood and cerebrospinal fluid (CSF).He responded to standard antibiotic treatment poorly even it lasted long enough.At the same time,the inflammation seemed to be over-activated,the WBC level was still elevated,high fever continued.Thus they thought of primary immunodeficiency and sent blood sample for gene panel testing (Sanger sequencing) but got negative result.At last,they added steroid together with anti-tuberculosis drug therapy,his temperature as well as the intracranial pressure became better ever since.At the age of 1 year and 1 month,he got another Streptococcus Pneumonia meningitis,while he was still on anti-tuberculosis drug therapy and tapering off steroid.At this time,he presented with coarse hair,hypohidrosis and delayed eruption of teeth,which strongly indicated Anhidrotic Ectodermal Dysplasia with Immunodeficiency (EDA-ID).NEMO is the most common gene responsible for EDA-ID and locates on X chromosome.It has a pseudogene named IKBKGP which locates downstream of NEMO.IKBKGP and NEMO share 3-10 exons with the homology of 99.8％,which makes it difficult to find out most real mutations within NEMO with Sanger sequencing.Then they performed PCR with the primer starting upstream of the shared exons.Finally,they found out the pathogenic mutation [c.505G ＞ C(p.A169P)] of NEMO,which has been reported.This finding led us to make the right diagnosis as well as the proper treatment and the prognosis for this patient.
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Objective To observe the clinical efficacy of the combination of modification ofChaihu Jia Longgu MuliDecoction with psychological intervention in the treatment of post tumor depression.MethodsTotally 122 cases of post tumor depression were divided into treatment group and control group by simple numeration table random method, with 61 cases in each group. The treatment group was given modification ofChaihu Jia Longgu Muli Decoction orally, at the same time psychological intervention was given. The control group was given escitalopram oxalate tablets for 6 weeks. HAMD scale scores of the two groups were observed before and after treatment to evaluate the clinical efficacy. Changes in life quality of two groups were scored with SF-36 scale. The adverse reactions were also observed.ResultsAfter treatment, the HAMD score of treatment group was lower than control group (P<0.05). The total effective rate was 88.52% (54/61) in the treatment group and 72.13% (44/61) in the control group, with statistical significance (P<0.05). The scores of life quality of treatment group were higher than control group (P<0.05), and the incidence of adverse reactions was lower than control group (P<0.05).Conclusion Combination of modification ofChaihu Jia Longgu MuliDecoction with psychological intervention in the treatment of post tumor depression can significantly improve the depressive state and life quality of the patients with post tumor depression, which is better than the control group, without significant adverse reactions.
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Objective To investigate the influence of anti-angiogenesis therapy on proliferation and apoptosis of fibroblasts derived from keloids. Methods Thirty pieces of keloids from a patient were implanted into subcutaneous tissue of the nude mice, 24 pieces of which survived were divided into three groups which were treated with perilesional injection of vascular endothelial growth factor( VEGF) (0.4 mg/0.2 mL) , Endostar(0.125 g/0.2 mL) and physiological saline (0.2 mL)on the 21 d, 23 d, 25 d, 27 d after implantation. Sample were collected on the 10th day after perilesional injection, the proliferating fibroblasts in keloid tissue were immunohistochemically detected by proliferating cell nuclear antigen (PCNA) expression. The apoptotic cell was detected by terminal deoxynucleotidyl transferase dUTP-nick end labeling (TUNEL) staining. Results IHC staining indicated that PCNA expression of fibroblasts was significantly increased in keloid tissue after VEGF injection, PCNA expression of fibroblasts was significantly reduced in keloid tissue after Endostar injection,TUNEL assay revealed lower apoptotic cells expression in the keloid tissue after VEGF injection and higher in the Endostar group than control group. The rate of proliferative index (PI) , apoptotic index(AI) and AI/PI of fibroblasts in keloid after VEGF (PI:41.13 ±2.29,AI:5.75 ±1.28,AI/PI: 0.14 ± 0.04)or Endostar injection (PI:27.25 ±2.61,AI:11.00±1.31,AI/PI:0.41 ±0.09)and control group (PI: 34.75 ±3.62,AI:7. 88 ± 1.64,AI/PI:0. 23 ±0.07) showed statistical differences. Conclusion Anti-angiogenesis therapy is shown to induce keloid regression through suppression of keloid fibroblast proliferation,induction of apoptosis, which may be a new approach for the treatment of keloids.
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Objective To study the nlanifestation and the clinical significance of the cerebral angiography of the isehemic cerebrovascular diseases.Methods Digital sublraction angiography(DSA)was taken in 312 patients with cerebral infarction and transient ischemic attack(TLA).The distribution of the lesion in the extra/intracranial arteries was compared.Results Cerebral angiography showed that the stenosis and occlusion was dominant in the intracranial arteries at the cerebral infarction in the internal carotid artery system and vertebrobasilar artery system[59.57%(56/94)and 61.90%(26/42)].TIA of internal carotid artery system was mainly because of stenosis of intracranial arteries (68.75%,22/32).TIA of vertebrobasilar artery system was mainly because of stenosis of extracranial arteries(61.70%,29/47).Conclusions The diseases of the intracranial arteries are the main causes of cerebral infarction(including internal carotid artery system and vertebrobasilar artery system) and TIA of internal carotid artery system. The diseases of the extracranial arteries are main causes of TIA of vertebrobasilar artery system.
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Objective To investigate the clinical significance of c-myc、Bcl-2 protein expression, DNA ploidy and their relationship in breast cancer. MethodsWT5”BZ The expression of c-myc、Bcl-2 protein in 146 breast tumor tissues was examined by using immunohistochemical methods(S-P)and DNA ploidy in 72 cases of breast carcinoma by flow cytometry. ResultsKG1 Nuclear expression of c-myc protein was detected in 9 6% of tumors, and it was related to the DNA aneuploidy and prognosis. Cytoplasmic expression of c-myc protein was present in 91 8% of the carcinomas. Moderate to strong c-myc protein expression in cytoplasmic was associated with the positive status of ER. Bcl-2 protein was positive in 78 8% of cancers. Overexpression of Bcl-2 protein was associated with ER(+) status and the lack of axillary lymph node metastasis. DNA aneuploidy was found in 51 4% of 72 cancers, it was related to nuclear expression of c-myc protein and prognosis.WT5”HZConclusion Nuclear expression of c-myc protein and DNA ploidy are important prognostic factors.
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Chemiluminescence method was used to measure: (1) active oxygen species generation induced by respiratory burst of polymor-phonuclear leucocytes (PMNs) from human blood stimulated with phorbol myristate acetate (PMA); (2) superoxide (O2) induced by xan-thine-xanthine oxidase system; (3) hydroxyl radicals ( ? OH ) generated by Vit C- Cu2+- zy-mosan; (4) the release of hydrogen peroxide (H2O2). Effects of polydatin IV on these active oxygen species were observed. The resultsshowed early stage of respiratory burst of PMNs was inhibited,but the later stage was delayed by polydatin IV, (2), (3) adn (4) were scavenged by polydatin IV and their median inhibitory concentrations (IC50?mol ? L-1) were 14.6,29.6 and 13.0 respectively. The results suggested that polydatin IV was a scavenger.
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The effects of tetrandrine on serum TXB2, 6 - Keto - PGF1?, LPO and lipids in patients(n= 40)with essential hypertension has been studied. The results showed that: (1) The levels of serum 6 - Keto -PGF1?,apoA1 in EHT were lower and the level of serum TXB2,LPO and apoB100 were higher than those in control. (2)Patients with essential hypertension treated with tetrandrine (0.1 ~ 0. 2g,tid,po)for 3 mon revealed that thelevels of TXB2, LPO and apoB100 were decreased, and the levels of apoA1 and 6 - Keto - PGF1? were increased. In conslusion,tetrandrine stimulated the synthesis of PGI2 and inhibited the release of TXA2 and normalized the metabolism of lipids in patients with essential hypertension.