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Objective To investigate the correlation between the expression of (epidermal growth factor receptor-2,HER-2) and clinicopathological features and survival of colorectal cancer.Methods From Jan 2005 to Dec 2015,all colorectal cancer cases were enrolled that the expression levels of HER-2 were detected in Guangdong Provincial People's Hospital.Clinicopathological features of the tumors and survival of the patients were analyzed.Results A total of 1 463 cases were collected in 10 years,including 711 cases (48.6％) of HER-2 (-),470 cases (32.1％) of HER-2 (+),249 cases (17％) of HER-2 (+ +),and 33 cases (2.3％) of HER-2 (+ + +).Correlation analysis shows that the expression levels of HER-2 were significantly correlated with tumor differentiation and the depth of tumor invasion(T stage),but not correlated with gender,age,tumor location,N stage,M stage,TNM stage and overall survival,and disease-free survival.Conclusion The expression of HER-2 may be related to tumor differentiation and growth infiltration,but it cannot be used as a predictor of prognosis in patients with colorectal cancer.
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Objective@#To investigate the feasibility and safety of the medial approach "four-step method" in the laparoscopic mobilization of splenic flexure.@*Methods@#A retrospective cohort study was performed. Clinical data of 157 colorectal cancer patients undergoing the medial approach "four-step method" in the laparoscopic mobilization of splenic flexure at Gastrointestinal Surgical Department of Guangdong Provincial People′s Hospital from July 2015 to June 2018 were retrospectively analyzed. Of 157 cases, 17 were transverse colon cancer, 94 were descending colon cancer, 25 were sigmoid cancer and 21 were rectal cancer; 89 were male and 68 were female; mean age was (61.8±10.3) years and mean body mass index was (23.2±3.7) kg/m2. The medial approach "four-step method" in the laparoscopic mobilization of splenic flexure was performed as follows: (1) The root vessels were treated with the "provocation" technique to expand the Toldt′s gap. This expansion was extended from the lateral side to the peritoneum reflex of left colonic sulcus, from the caudal side to the posterior rectal space, and from the cephalad side to the lower edge of pancreas. (2) The left colonic sulcus was mobilized, converging with the posterior Toldt′s gap. Mobilization was carried out from cephalad side to descending colon flexure, freeing and cutting phrenicocolic ligament and splenocolic ligament, and from caudal side to peritoneal reflex. (3) Gastrocolic ligament was moblized. Whether to enter the great curvature of stomach omentum arch when the gastrocolic ligament was cut, that was, whether to clean the fourth group of lymph nodes, should be according to the tumor site and whether serosal layer was invaded. (4) Transverse mesocolon was moblized and transected at the lower edge of the pancreatic surface, merging with the posterior Toldt′s gap, and from lateral side to lower edge of the pancreatic body, merging with the lateral left paracolonic sulcus. Safety and short-term clinical efficacy of this surgical procedure was summarized.@*Results@#All the patients completed this procedure. During operation, 3 cases were complicated with organ injury, including 1 case of colon injury, 1 case of spleen injury and 1 case of pancreas injury. No operative death and conversion to open surgery was found. The average operation time was (147.5±35.1) minutes, the average intra-operative blood loss was (40.8±32.7) ml and the average number of harvested lymph node was (16.1±5.8), including (4.0±2.3) of positive lymph nodes. The first exhaust time after surgery was (41.3±20.6) hours, the fluid intake time was (1.5±1.3) days, the postoperative hospital stay was (5.2±2.3) days. Eight (5.1%) cases developed postoperative complications, and all were improved and discharged after conservative treatments. According to the TNM classification system, postoperative pathology revealed that 31 patients were stage I, 51 were stage II, 53 were stage III, 22 were stage IV.@*Conclusion@#The medial approach "four-step method" is safe and feasible, which can effectively decrease the operation difficulty of the laparoscopic mobilization of the splenic flexure.
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Objective:To investigate the diagnostic value of different detection methods for Mycobacterium tuberculosis in bronchoalveolar lavage fluid (BALF) from patients with pulmonary tuberculosis.Methods:BALF from l00 patients in Changsha Central Hospital from January 2013 to December 2015 was collected.Among 100 patients,65 cases were clinically diagnosed as tuberculosis,and 35 cases served as control.BALF smear method,polymerase chain reaction (PCR) and membrane reverse dot blot (RDB) were used for synchronous detection of Mycobacterium tuberculosis.Results:The positive rates by BALF smear method,PCR and RDB were 43.08％,73.84％ and 92.31％,respectively (P＜0.05).Sensitivity,specificity,accuracy,and negative predictive value for BALF smear were 43.08％,88.57％,59.00％,and 45.59％,respectively;for PCR were 73.85％,100％,83.00％,and 67.31％,respectively;for RDB were 92.31％,100.00％,95.00％,and 87.50％,respectively.Conclusion:The technique of membrane RDB can not only accurately diagnose Mycobacterium tuberculosis,but also can rapidly and easily identify the resistance of Mycobacterium tuberculosis to streptomycin (SM),rifampicin (RFP) and isoniazid (INH) genotypes.It possesses high clinical value.
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Objective To observe the clinical effects of chimney technique combined with thoracic endovascular aortic repair(TEVAR) in the treatment of type B aortic dissection.Methods The clinical datas of 56 patients with type B aortic dissection in our hospital were analyzed retrospectively.According to the surgical intervention method,they were divided into observation group (22 cases,TEVAR + chimney technique) and control group (34 cases,TEVAR alone).Surgery related indicators,incidence of postoperative short-term complications and mortality between the two groups were compared.Results The success rates in both groups were 100％,and the surgical time in observation group was longer than that in control group (P ＜ 0.05).There were no significant differences in blood loss,eating time,off-bed time and hospitalization time between the two groups(P ＞ 0.05).The incidence of complications of observation group and control group within 2 weeks after operation were 18.2％ and 5.8 ％ respectively,the difference was not significant(P ＞ 0.05),as well as mortality and incidence of longterm complications during the followed period (P ＞ 0.05).Conclusion The perioperative indexes of single endovascular repair and its combination with chimney technique for the treatment of type B aortic dissection are similar.Chimney technique can reconstruct important branch flows,especially for patients with insufficiency of landing zone.However,particular attention needs to be paid to postoperative complications to avoid negative effect on the prognosis of patients.
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<p><b>OBJECTIVE</b>To analyze the spatial-temporal distribution of Hepatitis E (HEV) in Hunan province from 2006 to 2014.</p><p><b>METHODS</b>Data related to HEV cases in Hunan province from 2006 to 2014 were collected from the Infectious Diseases Reporting Information System in the formation System of Disease Prevention and Control of China. Based on ArcGIS (10.2) and SaTScan(version 9.1), spatial autocorrelation analysis and space-time clustering analysis were used to study the prevalence on HEV.</p><p><b>RESULTS</b>A total of 7 124 HEV cases were reported with 3 deaths during this period. The average annual incidence rate was 1.22/10(5). Most of the cases were over 55 years old and the majority of them (54.15%) were farmers. The distribution of HEV showed differences on locations and the regions with high incidence seen in northern and western areas of Hunan. However the regions with low incidence appeared in central or southern parts of Hunan. Data from the global spatial autocorrelation analysis showed that there was space autocorrelation on the HEV incidence rates in counties (cities, districts) (Moran'I was positive,P<0.05). A total of 31 countries were found in the high-high region with most of the clusters located in northern and western Hunan. According to local indication of spatial autocorrelation analysis, 31 countries in high-high region all showed statistically significant differences (P<0.05). RESULTS from the space-time scan showed 7 space-time clustering areas, including those most likely in the western Hunan area (2012-2014); the secondary clusters in northern Hunan areas (2011-2014).</p><p><b>CONCLUSIONS</b>Significant cluster pattern was found in the distribution of HEV in Hunan province. Clusters found in northern and western of Hunan province were seen more than in other regions.</p>
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Adult , Aged , Humans , Middle Aged , China , Epidemiology , Cities , Cluster Analysis , Farmers , Hepatitis E , Epidemiology , Incidence , Prevalence , Seroepidemiologic Studies , Space-Time Clustering , Spatial AnalysisABSTRACT
Objective:To analyze the characteristic peaks of gypsum fibrosum from authentic product area Hubei Yingcheng via X-ray diffraction. Methods:The fingerprint and common peaks of gypsum fibrosum from different areas were analyzed via X-ray diffrac-tion, and the characteristic peaks of gypsum fibrosum from authentic product area Hubei Yingcheng were identified Results:The finger-prints of X-ray diffraction of gypsum fibrosum from different areas were obtalned. Sixteen common peaks were determined, and two characteristic peaks of gypsum fibrosum from authentic product area Yingcheng were determined via X-ray diffraction with interplanar spacing of 1. 68 and 1. 51, respectively. Conclusion:The determination of two characteristic peaks of gypsum fibrosum from authentic product area Hubei Yingcheng can distinguish gypsum fibrosum from the other areas and provide basis for the quality evaluation of gyp-sum fibrosum.
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Objective:To investigate gypsum fibrosum from different habitats by scanning electron microscopy ( SEM) . Methods:Gypsum fibrosum samples from different habitats were scanned by an electronic microscope. Results: The results of SEM showed that gypsum fibrosum (CaSO4·2H2O) from different habitats was with the crystal structure of fibrous,tabular or flaky aggregation. The sur-face amplification of gypsum fibrosum from Hubei showed obvious black spots,while that from the other habitats was without the feature. Conclusion:The method is simple and accurate, which can be used to investigate gypsum fibrosum from different habitats.
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Objective To study the life quality and influencing factors for empty nester elderly in rural area in Hunan,and to provide the scientific basis for the effective interventions.Methods The two villages of Yiyang and Huaihua were randomly selected by cluster sampling from June 2011 to December 2011 in Hunan.Data of the world health organizations quality of life instrument-short version (WHOQOL-BREF) was collected by face to face interview with the empty nesters.The risk factors for the quality of life in empty nester elderly in rural area were analyzed by the multiple linear regression analysis.Results A total of 785 valid questionnaires were acquired,among which 472 cases were from empty nester elderly (60.1％,472/785),the average age of them was (69.3±7.3) years,and the male:female ratio was 1.1:1 (250:222).The literacy of 81.8％ of empty nester elderly were under junior middle school,69.7％ of them married with consorts who were still living,74.4％ of them were farmer,75.2％ of them had monthly income under 500 Yuan,56.4％ of them got the income from their own labor,69.9％ of them considered that their relationship with children were harmony.64.2 ％ of empty nester elderly in village suffered from chronic diseases and 16.7 ％ of them suffered from accidental injury within the last one year.The scores in physiological health,psychological health and quality of life were lower in empty nester elderly than in the non-empty nester elderly [(60.8±15.7) vs.(63.1±13.5),(59.0±12.1) w (64.6±17.4),(59.5±9.8) vs.(63.0 ± 10.1),t=3.18,4.43,4.91,all P＜0.05].The multiple linear regression analysis showed that the influencing factors for quality of life in empty nester elderly were education background,marital status,source of finance,relationship with children,chronic disease and accidental injury within the last one year (β=1.693,2.426,0.779,1.060,-7.007,-3.784,all P＜0.05).Conclusions The empty-nest elderly accounts for more than half of the elderly in rural area,who have the lower levels in physio-psychological health and quality of life.We should improve their awareness and knowledge of health,build their harmonious relationship with spouse and children,improve the social security and medical insurance system,actively promote the knowledge of chronic disease and accidental injury,in order to improve the quality of life in empty nester elderly and achieve the healthy aging.
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ObjectiveTo investigate the prognostic factors of non-small cell lung cancer (NSCLC) after resection.MethodsClinical data of 131 NSCLC patients who underwent resection were reviewed and divided into chemotherapy group(86 cases) and non-chemotherapy group(45 cases) according to the treatment method.Survival rate was calculated by Kaplan-Meier method.The prognosis was analyzed by Cox proportional hazards model.ResultsThe median survival time (MST) of squamous cell carcinoma (76 cases),bronchial alveolar cell carcinoma( 8 cases),adenocarcinoma( 35 cases ),adenosquamous carcinoma (12 cases) was 60,54,34,24 months respectively (P＜0.05).For the patients of stage Ⅰ B,the MST of chemotherapy group and non-chemotherapy group was 75 and 76 months respectively(P ＞ 0.05 ).Multivariate analysis showed that tumor size,T stage,N stage,chemotherapy were independent prognostic factors (P =0.080,0.002,0.000,0.029).Conclusions Squamous cell carcinoma and bronchial alveolar cell carcinoma have better prognosis than adenocarcinoma,adenosquamous carcinoma.For the patients of stage Ⅰ B,the survival time can't be prolonged through platinum-based chemotherapy.Tumor size,T stage,N stage,chemotherapy are independent prognostic factors.
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This paper introduces reformation of course system for five-year clinical medicine specialty in three aspects: orientation of course arrangement ,basic structure and major features of new teaching model. By adjusting the teaching plan and setting up new course system optimally, we have made an active attempt on new teaching model for bringing up high-quality medical talent.
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Objective To investigate the expression of nerve growth factor(NGF)in the adrenaline medullary chromaffin cells(AMCC)and the morphological and functional changes in AMCC of asthmatic rats.Methods The 32 SD rats were randomly divided into two groups:control group(n=8)and asthma group(n=8).Asthma models were established by sensitization and challenge with ovalbumin(OVA).By means of immunohistochemistry(SP)combined with the micro-image analysis to investigate the alterations of NGF immunoreactivity in asthmatic rats and by means of light microscopy and electron microscopy to investigate the ultrastructural changes in AMCC,and detect the concentration of adrenaline and noradrenaline in serum by enzyme-linked- immunosorbent assay(ELISA).Results The positive immunoreactivity was increased in asthmatic AMCC compared with the controls(P
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Objective To study the clinical significance of changes of plasma nitric oxide (NO) and tumor necrosis factor (TNF) levels in patients with congestive heart failure (CHF).Methods Plasma NO and TNF in 68 CHF cases were tested.30 healthy subjects served as normal controls.Results Plasma NO and TNF levels in CHF patients were obviously higher than those in normal subjects (P