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Marsdenia tenacissima injection, a standard Marsdenia tenacissima extract (MTE), has been approved as an adjuvant therapeutic agent for various cancers. Our previous study showed that MTE inhibited the proliferation and metastasis of prostate cancer (PCa) cells. However, the underlying mechanisms and active ingredients of MTE against PCa were not completely understood. This study revealed that MTE induced significant decreases in cell viability and clonal growth in PCa cells. In addition, MTE induced the apoptosis of DU145 cells by reducing the mitochondrial membrane potential and increasing the expression of Cleaved Caspase 3/7, Cyt c, and Bax. In vivo, DU145 xenografted NOD-SCID mice treated with MTE showed significantly decreased tumor size. TUNEL staining and Western blot confirmed the pro-apoptotic effects of MTE. Network pharmacology analysis collected 196 ingredients of MTE linked to 655 potential targets, and 709 PCa-associated targets were retrieved, from which 149 overlapped targets were screened out. Pathway enrichment analysis showed that the HIF-1, PI3K-AKT, and ErbB signaling pathways were closely related to tumor apoptosis. Western blot results confirmed that MTE increased the expression of p-AKTSer473 and p-GSK3βSer9, and decreased the expression of p-STAT3Tyr705in vitro and in vivo. A total of 13 compounds in MTE were identified by HPLC-CAD-QTOF-MS/MS and UPLC-QTOF-MS/MS. Molecular docking analysis indicated that six compounds may interact with AKT, GSK3β, and STAT3. In conclusion, MTE induces the endogenous mitochondrial apoptosis of PCa by regulating the AKT/GSK3β/STAT3 signaling axis, resulting in inhibition of PCa growth in vitro and in vivo.
Subject(s)
Mice , Animals , Male , Humans , Mice, Inbred NOD , Mice, SCID , Marsdenia , Proto-Oncogene Proteins c-akt , Glycogen Synthase Kinase 3 beta , Molecular Docking Simulation , Phosphatidylinositol 3-Kinases , Tandem Mass Spectrometry , Prostatic Neoplasms , Apoptosis , STAT3 Transcription FactorABSTRACT
Objective:To investigate the value of short-time transcutaneous carbon dioxide pressure (TcPCO 2) and transcutaneous oxygen pressure (TcPO 2) monitoring in critically ill preterm infants. Methods:From January to December 2018, 62 critically ill neonates receiving respiratory support at Guangzhou Women and Children's Medical Center were retrospectively enrolled. A total of 348 sets of paired data including TcPCO 2/TcPO 2 and arterial carbon dioxide pressure (PaCO 2)/arterial oxygen partial pressure (PaO 2) were analyzed. The patients were divided into different groups based upon birth weight (23 cases>1 000 g-≤1 500 g, 129 sets of paired data; 18 cases≤1 000 g, 130 sets of paired data) and gestational age (16 cases born at ≤28 gestational weeks, 127 sets of paired data; 29 cases born at 28-34 gestational weeks, 159 sets of paired data) and the differences between groups were compared. The correlation and consistency of TcPCO 2/TcPO 2 and PaCO 2/PaO 2 were evaluated using Pearson's correlation and Blan-Altman scatter plots. Receiver operating characteristic (ROC) curve was drawn to analyze the diagnostic efficacy of TcPCO 2 in neonates with hypercapnia. Results:There was a positive correlation between TcPCO 2 and PaCO 2 in all patients ( r=0.913, 95% CI:0.894-0.929, P<0.05). In patients whose birth weight was>1 000 g-≤1 500 g or≤1 000 g, TcPCO 2 and PaCO 2 were positively correlated and the consistency were good ( r=0.909, 95% CI:0.874-0.935; r=0.934, 95% CI:0.908-0.953; both P<0.05), and the same finding was also observed in patients born at≤28 gestational weeks or 28-34 weeks of gestation ( r=0.938, 95% CI:0.913-0.956; r=0.871, 95% CI: 0.827-0.904; both P<0.05). The sensitivity, specificity and area under curve of TcPCO 2 in the diagnosis of hypercapnia were 90.91%, 85.85%, and 0.942, respectively. There was a poor correlation between TcPO 2 and PaO 2 in all patients and those with birth weight >1 000 g-≤1 500 g or gestational age 28-34 weeks (all r<0.75, all P<0.05). There was no correlation between TcPO 2 and PaO 2 in the birth weight ≤1 000 g and gestational age ≤28 weeks groups (both P>0.05). Conclusions:Short-time TcPCO 2 monitoring can accurately assess PaCO 2 in critically ill neonates requiring respiratory support and is of high diagnostic value for hypercapnia. However, TcPO 2 has limitation in evaluating PaO 2 and other indicators may need to be involved.
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Objective:To investigate and compare the clinical characteristics, pathogen distributions and outcomes of bacterial meningitis in preterm and term infants.Methods:The data of 252 cases of neonatal bacterial meningitis hospitalized in Guangzhou Women and Children′s Medical Center from January 2013 to December 2018 were retrospectively analyzed and divided into two groups according to gestational age: preterm group( n=64)and term group( n=188). The clinical manifestations, laboratory examinations, pathogen distributions and clinical outcomes of the children in two groups were compared. Results:Fever was the most common clinical manifestation in both groups, but the incidences of lethargy, apnea and feeding intolerance in preterm group were significantly higher than those in term group( P<0.05). There was no significant difference in the rate of the first hemogram/cerebrospinal fluid abnormality between two groups( P>0.05). Sepsis, subdural effusion and hydrocephalus were the main complications in both groups.The incidence of complications in premature infants was 60.9%(39/64), which was significantly higher than that in full-term infants(44.7%, 84 /188) , with a statistically significant difference ( P<0.05). Escherichia coli and Streptococcus agalactiae were the most common pathogens in the preterm infants, whereas Klebsiella pneumoniae and Streptococcus agalactiae were the most common pathogens in the term infants.There was no statistical difference in the time of positive bacteria turning negative between two groups, but the course of antibiotics in preterm group was significantly longer than that in term group( P<0.05). The clinical cure/improvement rates in the two groups was about 95%, and the difference between two groups was not statistically significant( P>0.05). Conclusion:Early clinical manifestations of bacterial meningitis in preterm infants are atypical and relatively easy to be missed.The incidence of complications is significantly higher than that of full-term infants, and the duration of antibiotic use is longer.However, the clinical cure/improvement rate of premature infants is not worse than that of full-term infants after reasonable and standardized early treatment.
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Objective:To study the effects of enhanced breastfeeding management on the neurodevelopmental outcomes of preterm infants in neonatal intensive care unit (NICU).Methods:From January to December 2020, preterm infants with gestational age (GA) ≥32 weeks admitted to NICU of our hospital were randomly assigned into the enhance group and the control group. Breast-feeding education using WeChat and routinely playing recorded mother's sound to the infants were carried out in the enhance group, while conventional management was carried out in the control group. Breastfeeding status was followed up regularly in both groups. Mental development index (MDI) and psychomotor development index (PDI) at 6-month of corrected GA were measured using Infant Intelligence Development Scale.Results:A total of 109 cases were included in the enhance group and 118 cases in the control group. The breast-feeding rates in the enhance group were significantly higher than the control group at discharge, 3-month and 6-month of corrected GA [88.1% (96/109) vs. 61.0% (72/118), 90.8% (99/109) vs. 67.8% (80/118), 88.1% (96/109) vs. 61.9% (73/118)] ( P<0.05). MDI and PDI at 6-month of corrected GA in the enhance group were significantly higher than the control group [(106.2±10.7) vs. (101.9±11.4), (103.4±13.7) vs. (99.5±11.6)] ( P<0.05). Conclusions:Enhanced breast-feeding management is helpful improving the breast-feeding rate of preterm infants in NICU and beneficial to the neurodevelopment of preterm infants.
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【Objective】 To explore the clinical factors affecting the efficacy of red blood cell (RBC) transfusion in patients with bone marrow failure diseases (BMFD). 【Methods】 81 patients with BMFD admitted to our hospital from June, 2012 to May, 2020 were analyzed retrospectively. Hemoglobin (Hb) was used as quantitative judgment basis, and multiple stepwise regression analysis was used to screen out various factors affecting the efficacy of red blood cell transfusion. 【Results】 229 occasions of RBC transfusion were performed in 81 patients, and 129 refractory transfusions occurred, accounting for 51.97%. The clinical effect of RBC transfusion is related to hemorrhage, hepatosplenomegaly, infection, blood transfusion frequency, anemia degree and BSA. Multiple stepwise regression analysis showed that infection, hemorrhage and blood transfusion frequency are important factors affecting the infusion effect. 【Conclusion】 The efficacy of RBC transfusion in BMFD patients is affected by various clinical factors. Clinicians should personalize the infusion strategy, so as to improve the transfusion efficacy by reducing the transfusion frequency, and bleeding as well as avoiding the transfusion during fever.
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OBJECTIVE： To provide reference for reducing the rate of outpatient/emergency intravenous infusion in paediatric and improving the safety of drug use in children. METHODS： The comprehensive intervention of outpatient/emergency intravenous infusion in paediatric by pharmacists of our hospital though multiple measures was introduced， such as education training， system construction and management， multi-party monitoring and intervention. Related data were selected before （Jan-Jun. 2018） and after intervention （Jul.-Dec. 2018） to evaluate intervention effects， involving paediatric outpatient/emergency intravenous infusion rate， antibiotics intravenous infusion rate， the rate of intravenous infusion prescription， total cost of antibiotics， TCM injection， adjunctive drugs and key monitoring drugs in infusion prescriptions. RESULTS： Through the comprehensive intervention of pharmacists， related indexes of outpatient/emergency intravenous infusion in paediatric were decreased greatly in our hospital. The rate of intravenous infusion， the rate of antibiotics intravenous infusion， the rate of intravenous infusion prescription and the rate of antibiotics intravenous infusion prescription were decreased from 19.52％， 15.46％， 20.29％， 11.20％ to 10.37％， 8.55％， 10.25％， 6.64％（P＜0.001）， respectively. Total cost of antibiotics， TCM injection， adjunctive drug and key monitoring drug were decreased respectively in infusion prescriptions （P＜0.001）. CONCLUSIONS： The comprehensive intervention measures taken by pharmacists in our hospital can reduce the rate of outpatient/emergency intravenous infusion in paediatric and the medical cost， and promote the safety of drug use in children.
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Objective To investigate the relationship among serum heat shock protein 70 (HSP70), suppressor of Cytokine Signaling-3 ( SOCS-3) and immune factor in pregnant women with hypertension,and to analyze the diagnostic value of the two indicators. Methods Eighty-six pregnant women with hypertension who were treated in the Second People′s Hospital of Yichang from January 2016 to February 2018 were selected,according to the severity of the disease,they were divided into pre-eclampsia (51 cases) and severe pre-eclampsia group (35 cases),another 40 normal pregnant women in the same period were selected as control group. The serum levels of HSP70 and SOCS-3,plasma immunoglobulin A (IgA), immunoglobulin M ( IgM), immunoglobulin G ( IgG), complement C3 and complement C4 levels were detected in each group,the correlation between serum HSP70 and SOCS-3 levels and immune factors were analyzed. ROC curve was used to analyze the predictive value of serum HSP70 and SOCS-3 in hypertensive disorder complicating pregnancy. Results The serum HSP70 of pre eclampsia and severe preeclampsia group was ( 3. 92 ± 0. 35 ) μg/L, the serum HSP70 of eclampsia group was ( 6. 45 ±0. 78) μg/L,which were significantly higher than that of the control group ( 0. 36 ± 0. 07) μg/L, the differences were statistically significant (t＝63. 272,49. 202,P＜0. 05),the serum SOCS-3 of pre eclampsia and severe preeclampsia group was (0. 22±0. 08) ng/L,the serum SOCS-3 of eclampsia group was (0. 10 ±0. 03) ng/L,which were significantly lower than ( 0. 62 ± 0. 11) ng/L that of the control group ( 0. 62 ±0. 11) ng/L,the differences were statistically significant (t＝－20. 078,－27. 079,P＜0. 05),the serum HSP70 of eclampsia group was significantly higher than that of the pre eclampsia and severe preeclampsia group,the difference was statistically significant (t＝－20. 402,P＜0. 05),the serum SOCS-3 of eclampsia group was significantly lower than that of the pre eclampsia and severe preeclampsia group,the difference was statistically significant ( t＝8. 462, P＜0. 05) . The plasma IgM was ( 1. 83 ± 0. 56) g/L, IgG was ( 7. 94 ±1. 34) g/L,complement C3 was (0. 95±0. 08) g/L,complement C4 was (0. 24±0. 08) g/L in the pre eclampsia and severe preeclampsia group, the plasma IgM was ( 1. 42 ± 0. 58 ) g/L, IgG was ( 5. 23 ±1.13) g/L,complement C3 was (0.73±0.12) g/L,complement C4 was (0.13±0.05) g/L in the eclampsia group,the plasma IgM was (2. 55±0. 53) g/L,IgG was (11. 04±2. 15) g/L,complement C3 was (1. 28 ±0. 15) g/L,complement C4 was (0. 35±0. 08) g/L in the control group (IgM:t＝－6. 232,－8. 815, P＜0. 05;IgG: t＝－8. 426,－14. 340, P＜0. 05; C3: t＝－13. 470,－17. 364, P＜0. 05; C4: t＝－6. 510,－14. 040,P＜0. 05),the plasma levels of IgM,IgG,complement C3 and complement C4 in eclampsia group were significantly lower than those in pre eclampsia and severe preeclampsia group ( t＝3. 288,－9. 805, 10. 209,7. 217,P＜0. 05). Pearson correlation analysis showed,there was a negative correlation among serum HSP70 and plasma IgM,IgG,complement C3 and complement C4 in hypertensive women with gestational hypertension (r＝－0. 446,－0. 537,－0. 426,－0. 428,P＜0. 05),serum SOCS-3 was positively correlated with plasma IgM,IgG,complement C3 and complement C4 (r＝0. 423,0. 507,0. 416,0. 407,P＜0. 05),there was no correlation among serum HSP70, SOCS-3 and plasma IgA in pregnant women with hypertension ( r＝－0. 082,0. 093,P＞0. 05). The area under the ROC curve of HSP70 was 0. 821,and the critical value of the prediction was more than 0. 89 μg/L,the sensitivity of HSP70 to pregnant women with hypertension was 86. 3%,the specificity was 76. 4%,the area under the ROC curve of SOCS-3 was 0. 759,the critical value of the prediction was less than 0. 035 ng/L,and the sensitivity of SOCS-3 to pregnant women with hypertension was 79. 4%,and the specificity was 71. 6%. Conclusion The abnormal increase of serum HSP70 and abnormal decrease of SOCS-3 in pregnant women with hypertension, maternal serum HSP70 and SOCS-3 levels are closely related to immune factors,the serum HSP70 and SOCS-3 may be used as early predictors of hypertensive disorder complicating pregnancy.
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Objective To investigate the clinical significance of the levels of serum C-reactive protein (CRP), peripheral blood ratio of neutrophil to lymphocyte (N/L) and plasma D-dimer in patients with different types of atrial fibrillation (AF) and the predictive value of the above index levels in occurrence of complicated left atrial appendage thrombosis in such patients. Methods A prospective study was conducted, one hundred and forty patients with non-valvular AF admitted to Cangzhou Central Hospital from May 2013 to December 2016 were enrolled, including 57 patients with paroxysmal AF in paroxysmal AF group and 83 patients with persistent AF in persistent AF group; in the mean time, 40 healthy persons having passed physical examination with normal sinus rhythm were volunteers assigned in a healthy control group. 83 patients with persistent AF were followed up for 1 year, and by the esophageal echocardiography, 13 cases with left atrial appendage thrombosis (AF combined with thrombosis group) and 70 cases with non-thrombotic patients (simple AF group) were found. In the morning on the day of entrance into the respective group, fasting venous blood was taken from the patients, and the peripheral blood N/L ratio, serum CRP, plasma D-dimer and B-type natriuretic peptide (BNP) levels were checked; the left atrial diameter (LAD), left atrial ejection fraction (LAEF), left atrial peak strain rate (LASRs) during left ventricular systolic phase, early diastolic peak blood flow velocity of mitral annulus/mitral annulus root side wall velocity peak value (E/Ea) ratio were measured by the trans-thoracic echocardiography, and the differences in above indexes were compared among various groups; the risk factors of persistent AF associated with left atrial appendage thrombosis were analyzed by multivariate Logistic regression; the receiver operation characteristic (ROC) curve was used to analyze the predictive value of D-dimer and BNP levels for persistent AF associated with left atrial appendage thrombosis. Results The peripheral blood N/L ratio (2.68±0.58, 2.59±0.62 vs. 1.82±0.29), CRP (mg/L: 19.87±3.28, 20.74±4.31 vs. 8.65±1.06), BNP (ng/L: 364.79±54.18, 145.86±51.90 vs. 139.40±48.29), LAD (mm: 40.79±3.90, 34.28±2.13 vs. 33.90±2.51), LAEF (0.16±0.07, 0.39±0.08 vs. 0.56±0.10), LASRs (s-1: -1.65±0.23, -1.98±0.32 vs. -3.49±0.53), E/Ea ratio (4.38±0.48, 4.29±0.52 vs. 4.09±0.64) levels in the persistent AF group and the paroxysmal AF group were significantly higher than those of healthy control group, and BNP, LAD, LAEF in persistent AF group were significantly higher than those of the paroxysmal AF group (all P ＜ 0.05). N/L ratio (3.19±0.47 vs. 2.62±0.58), serum CRP (mg/L:24.38±5.26 vs. 18.92±3.45), plasma D-dimer (mg/L: 2.56±0.41 vs. 1.57±0.39), BNP (ng/L: 659.35±78.29 vs. 381.22±69.43) and LAD (mm: 42.12±4.28 vs. 36.78±3.42), E/Ea ratio (6.79±0.62 vs. 4.59±0.59) in AF combined with thrombosis group were significantly higher than those in simple AF group (all P ＜ 0.05), and LAEF (0.29±0.05 vs. 0.30±0.06), LASRs (-1.79±0.27 vs. -1.86±0.39) were lower than those in simple AF group, but the differences were of no statistical significance (all P ＞ 0.05). Multivariate Logistic regression analysis showed: plasma D-dimer [odds ratio (OR) = 2.458, 95% confidence interval (95%CI) = 1.764 - 3.016, P = 0.035], BNP (OR = 2.631, 95%CI =1.589 - 3.127, P = 0.021), LAD (OR = 5.572, 95%CI = 4.031 - 6.452, P = 0.001) and E/Ea ratio (OR = 1.995, 95%CI =1.674 - 3.851, P = 0.003) were the independent risk factors for persistent AF combined with left atrial appendage thrombosis. The ROC curve showed: when plasma D-dimer and BNP levels could predict the patients with persistent AF complicated with left atrial appendage thrombosis, the area under the ROC curve (AUC) was 0.872 and 0.741, respectively, and when the plasma D-dimer was 1.45 mg/L and BNP was 569.33 ng/L respectively, the sensitivity of diagnosis for the above patients was 67.81%, 62.25%, and the specificity was 75.90% and 57.62% respectively. Conclusions The levels of serum inflammatory markers, plasma biological markers and left atrial function were different in patients with different types of AF. The left atrial enlargement, left ventricular diastolic dysfunction, elevation of plasma D-dimer and plasma BNP levels are the independent risk factors for patients with persistent AF complicated with left atrial appendage thrombosis. When diastolic dysfunction occurs in the left ventricle, the elevated levels of plasma D-dimer and natriuretic peptide have predictive value for left atrial appendage thrombosis.
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Objective:To determine clinical curative effects of ozone therapy for pemphigus vulgaris.Methods:Ozone hydrotherapy was used as an aid treatment for 32 patients with pemphigus vulgaris.The hydropathic compression of potassium permanganate solution for 34 patients with pemphigus vulgaris served as a control.The main treatment for both groups were glucocorticoids and immune inhibitors.The lesions of patients,bacterial infection,usage of antibiotics,patient's satisfaction,and clinical curative effect were evaluated in the 2 groups.Results:There was no significant difference in the curative effect and the average length of staying at hospital between the 2 groups (P＞0.05).But rate for the usage of antibiotics was significantly reduced in the group of ozone hydrotherapy (P=0.039).The patients were more satisfied in using ozone hydrotherapy than the potassium permanganate solution after 7-day therapy (P＞0.05).Conclusion:Ozone hydrotherapy is a safe and effective aid method for pemphigus vulgaris.It can reduce the usage of antibiotics.
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OBJECTIVE:To evaluate the risk factors for antibiotic-associated diarrhea (AAD) in Chinese adult patients systematically,and to provide evidence-based reference in clinic. METHODS:Retrieved from CNKI,VIP,CBM,Wanfang database,PubMed and Embase,etc.,disease control studies about AAD risk factors of Chinese adult patients were collected.The retrieval time limit ranged from Jan. 2000 to Jan. 2018. Meta-analysis was performed by using Rev Man 5.2 software after data extraction and quality evaluation of included literatures with NOS scale. RESULTS:A total of 14 literatures were included, involving 20 914 patients. The result of Meta-analysis showed that age ≥65 years [OR＝2.36,95%CI(1.99,2.79),P＜0.001], fasting [OR＝4.65,95%CI(3.79,5.69),P＜0.001],use of acid suppressant [OR＝5.82,95%CI(3.77,8.98),P＜0.001],serum albumin ≤30 g/L [OR＝2.40,95%CI(2.00,2.88),P＜0.001],invasive operation [OR＝3.95,95%CI(3.03,5.15),P＜0.001], stay in ICU [OR＝2.93,95%CI(2.38,3.60),P＜0.001],hospitalization time ≥10 d [OR＝4.08,95%CI(3.31,5.03),P＜0.001], antibiotic species ≥3 kinds [OR＝1.98,95%CI(1.56,2.51),P＜0.001] and duration of antibiotics use ≥10 d [OR＝6.16,95%CI (3.22,11.76),P＜0.001] were significantly correlated with the occurrence of AAD. CONCLUSIONS:Age ≥65 years,fasting, use of acid suppressant,serum albumin ≤30 g/L,invasive operation,stay in ICU,time of hospitalization ≥10 d,antibiotic species≥3 kinds and duration of antibiotics use≥10 d are risk factors for AAD in Chinese adult patients.
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Objective To investigate the relationship between subclinical hypothyroidism (SCH) and early neurological deterioration (END) in patients with acute ischemic stroke.Methods The consecutive inpatients with first-ever acute ischemic stroke were enrolled.SCH was defined as thyroid stimulating hormone ＞ 5.0 mU/L and thyroid function was normal.END was defined as an increase of ≥ 1 point in motor power or an increase of ≥ 2 points in the total National Institute of Health Stroke Scale (NIHSS) score within 7 days.Univariate analysis was used to compare the differences in baseline data between END group and non-END group,multivariable logistic regression analysis was used to determine the independent correlation between SCH and END in acute ischemic stroke.Results A total of 198 patients were enrolled,48(24.2％) with END.The age (67.1± 8.5 yearsvs.63.9± 9.0 years;t=2.169,P=0.031),homocysteine level (15.1 ± 5.6 μmol/L vs.13.2 ± 4.5 μmol/L;t =2.353,P =0.020),high-sensitive C-reactive protein (median and interquartile range,5.5 [1.7-8.7] g/L vs.2.9[1.0-5.0] g/L;Z =2.765,P =0.006),baseline NIHSS score (4.0[6.0-8.0] vs.4.0[2.0-6.0];Z=2.681,P=0.007),and the proportion of patients with diabetes mellitus (29.2％ vs.16.0％;x2 =4.065,P =0.044)) in the END group were significantly higher than those in the non-END group,and the proportion of patients with SCH (10.4％ vs.28.7％;x2 =4.086,P=0.043) was significantly lower than that of the non-END group.Multivariate logistic regression analysis indicated that SCH was an independent protective factor for END in acute ischemic stroke after adjusted for age,sex and other potential confounders (odd ratio 0.221;95％ confidence interval 0.055-0.801;P =0.022).Conclusions The END risk is lower in acute ischemic patients with SCH.
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Objective To evaluate the feasibility of the posterior C2 pedicle screw placement (C2 PSP) by MPR techniques of helical CT.Methods Totally 250 patients (500 sides) who underwent head and neck CTA examination were enrolled.The bony parameters and the arterial parameters were measured after MPR.The bony parameters included pedicle diameter (D),isthmus height (T),internal height (H),and the arterial parameters included medial shifting:lateral (L),neutral (N),medial (M);and the degree of riding included below (b),within (w),above (a).The prevalence of narrow pedicles,high-riding vertebral arteries (HRVA) and the subtypes of IAVA in the general population were calculated,and the statistical analysis between narrow pedicles,HRVA,IAVA and C2 vertebral arteries groove (C2 VAG) injury were performed.Results The rate of narrow pedicles and HRVA were 14.40％ (72/500) and 24.60％ (123/500;x2=141.984,P＜0.001).When it came to the simulation of the C2 PSP inserting,the incidence of C2 VAG injuries was 19.40％ (97/500).In narrow pedicle and HRVA patients,the C2 VAG injuries incidence were higher than that of without narrow pedicle and HRVA patients (both P＜0.001).In 58 sides (58/500,11.60 ％),the narrow pedicles and HRVA occurred simultaneously.There were statistical significance differences of narrow pedicles and HRVA and the C2 VAG injuries in different types of IAVA (all P＜0.001),the subtypes of IAVA M-a consisted most common,which account for 55.56％ (40/72),46.34％ (57/123) and 48.45％ (47/97),respectively.Conclusion Most of the C2 VAG injuries happened in narrow pedicles,HRVA or IAVA M-a type patients.MPR can be used to comprehensively evaluate osseous and arterial parameters,which will provide anatomy foundation to the screw placement of C2 pedicles.
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Objective To investigate the dosimetric influence of dwell weight standard deviation (DWSD) and applicator displacement in cervical cancer patients treated with three-dimensional brachytherapy.Methods A total of 20 cervical cancer patients who had completed radical treatment were selected in this study.The Fletcher applicator (Nucletron#189.730) was used for these patients.A new plan,based on the former CT images and structures,was designed for each patient.In former and new plans,dwell weight was recorded,and DWSD was calculated.Two groups,low-DWSD (LDWSD,0.141-0.299) and high-DWSD (HDWSD,0.211-0.337),were set according to the DWSD size for the two plans.Dosimetric effects from ± 1 mm displacement of tandem applicator or ovoid applicator were simulated with Oncentra (R) Brachy V4.3 treatment planning system.D100,D90,and V150 for clinical target volume (CTV)and D0.1cc,D1cc,and D2cc for the bladder,rectum,and sigmoid were evaluated.Dosimetric comparisons were made between the LDWSD group and HDWSD group to study the dosimetric effects of DWSD and applicator displacement in cervical cancer patients.Results The dosimetric effects from applicator displacement increased with increasing DWSD.If there was a 1 mm displacement of tandem applicator or ovoid applicator,D100,D90,and V150 of CTV were 3.0％,23.8％,and 4.8％ higher or 0.5％,1.2％,and 5.2％ higher in the HDWSD group than in the LDWSD group;D0.1cc,D1cc,and D2cc of the bladder and rectum were significantly higher in the HDWSD group than in the LDWSD group,particularly for the sigmoid (up 44.0％,22.8％,and 16.8％) and (up 10.3％,14.4％,and 12.4％).Conclusions DWSD should be considered in plan evaluation for cervical cancer patients treated with three-dimensional brachytherapy.The dosimetric influence from applicator displacement can be decreased by reducing DWSD properly.
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Objective To explore the clinical effect of hysteroscopic scar defect correction in the treatment of cesarean scar.Methods Eighty-four cases patients with cesarean section uterine incision scars who were treated in Affiliated Hospital of Hubei Polytechnic University from August 2015 to July 2016 were selected and randomly divided into observation group with hysteroscopic surgery and control group with vaginal surgery,42 cases in each group.The operation condition,clinical efficacy and the incidence of complications of the two groups were observed and compared.Results The amomt of blood loss,hospitalization expenses,hospitalization time and operation time in the observation group were (22.45±3.78) ml,(3028.89±218.79) yuan,(3.89 ±0.80) d,(20.13±2.90) min respectively,in the control group were (40.56±5.48) ml,(4189.58±269.78)yuan,(5.46 ± 1.02) d,(30.78 ± 6.99) min respectively,the differences were significant (P ＞ 0.05).The incidence of infection,relapse and incisional wound healing in the observation group were significantly lower than in the control group,the differences were significant (P＜0.05).The total effective rate was 90.48％ in the observation group and 85.71％ in the control group after treatment,the difference was not significant(P ＞0.05).Conclusion Hysteroscopic scar repair has the same effect as that of vaginal surgery,but the rate of blood loss and complication is lower than that of vaginal operation,which is safer and more effective.
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Objective To investigate the influence of the genotype distribution of methylenetetrahydrofolate reductase (MTHFR) C677T,A1298C and methionine synthase reductase (MTRR) A66G in threatened abortion of Chinese Han gestationalage women in Sanya city,which involved in the folic acid biosynthetic pathway among.Methods One hundred and thirty-nine samples of case group and the same number of control group were recruited from Sanya region in Hainan Province.Genomic DNA was extracted from the mucosal epithelium of the subjects.The gene polyrnorphisms of MTHFR and MTRR were detected by Fluorescence quantitative PCR technology.The distribution frequencies of both case group and control group.were analyzed and compared,to investigate the effect of the gene polymorphisms on threatened abortion.Results Both the case group and the control group complied with Hardy-Weinberg law.The genotype frequency of MTHFR C677T,MTHFR A1298C and MTRR A66G were not significantly different.Conclusion This study suggests that the gene polymorphism which involved in folic metabolism was not significantly different from the group of threatened abortion and the control group,and whether the metabolism related genes are the risk factors of threatened abortion need to be further discussed.
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[Objective]To investigate the relationship of baseline antimullerian hormone(AMH)and live birth rate of IVF/ICSI and further explore the prognostic effect of AMH on live birth rate.[Methods]All non-polycystic ovary patients who underwent their first embryo transfers in our unit and had basal serum AMH evaluated between 2010 and 2015 were evaluated in this retrospective study. Patients were grouped according to their AMH level,i.e. low AMH group with AMH less than 1.1 ng/mL(n = 485),middle AMH group with AMH between 1.1 ng/mL and 7.0 ng/mL (n = 1 989),and high AMH group with AMH higher than 7.0 ng/mL (n=468). For age subgroup analysis,patients were stratified as follow:group A(age≤29 years),group B(30~34 years),group C(35~39 years)and group D(over 40 years). We compared clinical outcomes between AMH groups in different age groups usingunivariate and multivariate analysis. ROC analysis was utilized to assess predictive value of AMH on live birth rate.[Results](1)In both fresh and frozen embryo transfers,baseline AMH was significantly related to clinical outcomes. The lower AMH was,the lower implantation rate,clinical pregnancy rate,and live birth rate. However,higher miscarriage rate was observed. All difference reached statistically significant.(2)In age subgroup analysis,we demonstrated AMH was related to live birth rate in patients in group A,B, and C,regardless of fresh or frozen embryo transferred. In those over 40 years,AMH was related to live birth rate in frozen cycles (P < 0.05)but not fresh cycles(P = 0.092). The further multivariate analysis confirmed the above results after controlling po?tential confounding variables.(3)The AUC of ROC analysis for AMH predicting live birth rate were 0.647,0.633 for fresh and fro?zen cycles respectively.[Conclusion]Baseline AMH as one of excellent ovarian reserve markers ,was significantly related to live birth rate in fresh or frozen cycles. Baseline AMH was an independent prognostic factor of live birth rate,but its predictive value on live birth rate was of limited clinical value.
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Objective To evaluate the levels of pulmonary surfactant protein D (SP-D) and 56-kD human type Ⅰ protein(HTI-56) in bronchoalveolar lavage fluid and serum of children with mycoplasma pneumoniae pneumonia,as well as their potential as biomarkers of mycoplasma pneumoniae pneumonia.Methods A retrospective study was conducted in 57 children with mycoplasma pneumoniae pneumonia from June 2011 to June 2016 in our hospital.In this study,the levels of SP-D and HTI-56 in bronchoalveolar lavage fluid and serum were determined and compared between unilateral lung infection and bilateral lung infection.Results SP-D and HTI-56 levels were significantly higher in bronchoalveolar lavage fluid samples (P ＜ 0.05)compared with bronchoalveolar lavage fluid samples from uninfected lungs (P ＜ 0.05).However,the serum levels of SP-D and HTI-56 in children with unilateral lung infection and bilateral pulmonary infection were not significantly different (P ＞0.05).Conclusion High levels of SP-D and HTI-56 in bronchoalveolar lavage fluid samples from infected lungs may reflect damage to alveolar epithelial cells caused by mycoplasma pneumoniae.
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Objective To investigate the application of hysterosalpingography (HSG)with iopromide in diagnosing female infer-tility.Methods 549 infertile women had performed HSG with iopromide,and X-ray images were analyzed retrospectively.Results Prevalence of uterine hypoplasia in primary infertility was higher in the minority than in the ethnic Han.Tubal obstruction was more common than hydrosalpinx and severe fimbria adhension.92.3% of the infertile women had pelvic inflammation disease.The dose of iopromide could be increased in need.Conclusion Prevalence of uterine hypoplasia is different as ethnic difference.Obstruction is the most common factor in tubal infertility.It is safe to use iopromide in HSG.
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Objective To analyze the association of polymorphisms of estrogen receptor (ER) α and β genes with systemic lupus erythematosus (SLE) in Chinese Han cohort of Yunnan Province.Methods XbaⅠ and Pvu Ⅱ of ERα gene,Rsa Ⅰ and Alu Ⅰ of ERβ gene were typed by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) in 697 SLE patients and 638 healthy controls.The frequency distribution of the alleles and genotypes were analyzed by Hardy-Weinberg equilibrium test and x2 test.Results ① For ERα gene,the frequency of minor allele of Pvu Ⅱ C in SLE patients was significantly higher than healthy controls (x2=15.427,P=0.001);the allele frequencies of XbaⅠ in SLE patients showed no significant difference compared with healthy controls (P＞0.05).The frequency of minor genotype of Pvu Ⅱ CC in SLE patients was significantly higher than healthy controls (x2=17.371,P=0.011).The frequency of two locus haplotype AATT in SLE patients was significantly lower than healthy controls (x2=6.333,P=0.012);the frequency of the two locus haplotype AACC in SLE patients was significantly higher than healthy controls (x2=7.771,P=0.038).② For ERβ gene,the frequency of minor allele RsaⅠ A in SLE patients was significantly lower than healthy controls (x2=12.595,P=0.013);the allele frequencies of Alu Ⅰ in SLE patients showed no significant differences compared with the healthy controls (P＞0.05).The frequency of minor genotype AA of Rsa Ⅰ in SLE patients was significantly higher than healthy controls (x2=41.456,P=0.000).The frequency of two locus haplotype AAGG in SLE patients was significantly higher than healthy controls (x2=37.063,P=0.000).The frequency of the two locus haplotype AAGA in SLE patients was significantly lower than healthy controls(x2=21.086,P=0.001).③ Pvu Ⅱ C was related with splenomegaly (x2=4.212,P＜0.05).The two locus haplotype AGTC of Xba Ⅰ and Pvu Ⅱ was related with edema (x2=7.898,P＜0.05).Conclusion There are associations between the polymorphisms of ERα and ERβ genes and SLE.The ERα and ERβ genes may be the susceptible genes for SLE in Yunnan Han Chinese Cohort.
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Objective To compare the curative effect of hepatocyte growth factor(HGF) in treatment of infant hepatitis syndrome (IHS) caused by cytomegalovirus with ganciclovir.Methods Sixty-eight cases with infant hepatitis syndrome caused by cytomegalovirus from neonatology department of our hospital from September 2010 to September 2014 were randomly divided into two groups, the observation group (32 cases)took HGF and ganciclovir therapy and the control group (36 cases) only received ganciclovir treatment Both groups were given conventional guard liver therapy.After one month of treatment, liver function, cytomegalovirus DNA content,extinction time of jaundice, treatment efficiency and the adverse reaction rate were evaluated for two groups.Results Liver function of children in observation group improved significantly after treatment compared with the control group, CMV-DNA quantitatively lower than the control group, the extinction time of jaundice was earlier than the latter,and the overall treatment efficiency was higher in observation group (P ＜0.05);The adverse reaction has no significant difference between two groups (P ＞ 0.05).Conclusion HGF combined with ganciclovir treatment can significantly improve liver function in patients of IHS caused by cytomegalovirus infection, and can collaboratively reduce viral load.Symptoms subside quickly with fewer adverse reactions, which is worthy of clinical promotion.