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Objective@#To investigate the associations between early life exposure to particulate matter with an aerodynamic diameter less than 2.5 μm (PM 2.5 ) and the risk of autism spectrum disorder (ASD) among school aged children.@*Methods@#A total of 165 children with ASD and 165 age and gender matched typical development (TD) children were recruited. Children s basic information were obtained via questionnaires, and the severity of ASD symptoms was assessed with Social Responsiveness Scale (SRS). Early life PM 2.5 exposure (preconception, entire pregnancy, and the first two years after birth) were extracted from the Tracking Air Pollution in China (TAP) datasets. Conditional Logistic regression and generalized linear model were used to evaluate the associations of early life exposure to PM 2.5 with the risk and the ASD severity symptoms, respectively.@*Results@#The PM 2.5 exposure of ASD group during preconception[(55.08±9.34)μg/m 3], entire pregnancy[(50.44±8.71)μg/m 3], the first year after birth [(45.04± 8.25 )μg/m 3] and the second year after birth [(40.19±7.12)μg/m 3] were significant higher than those in TD children [(47.66± 7.63 , 44.19±7.16, 38.95±6.07, 35.76±5.65)μg/m 3]( t =7.94, 7.13, 7.70, 6.32, P <0.05). After adjusting for potential confounding, each increase of 1 μg/m 3 in PM 2.5 was associated with higher risk of ASD during preconception ( OR=1.21, 95%CI =1.13-1.29), entire pregnancy( OR=1.18, 95%CI =1.11-1.26), the first year after birth ( OR=1.30, 95%CI =1.18-1.43) and the second year after birth ( OR=1.29, 95%CI =1.17-1.42). No similar results were observed regarding the analyses of SRS total and sub scale scores( P >0.05).@*Conclusion@#Early life exposure to PM 2.5 is relate to the risk of ASD, these findings indicated that more attention should be paid to ambient PM pollution in the early life prevention and control of ASD.
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Objective:To explore the effect of postoperative delirium risk management in elderly patients with hip fragility fracture based on failure mode and effect analysis (FMEA) theory, and to provide a basis for reducing the incidence of postoperative delirium.Methods:A total of 50 patients admitted to the First Affiliated Hospital of Sun Yat-sen University due to hip fragility fractures from January to December 2019 were selected as the control group, and 50 patients admitted to the First Affiliated Hospital of Sun Yat-sen University for hip fragility fractures from January to December 2020 were selected as the observation group. The control group received routine care, and the observation group implemented risk control intervention measures based on FMEA theory on the basis of the control group. The risk priority number (RPN) value, incidence of delirium, duration of delirium, pain score, satisfaction, and average length of hospital stay were compared between the two groups of patients in each link of failure risk.Results:The RPN values of each link failure risk of the observation group were 100.80 ± 13.39, 103.96 ± 9.96, 103.76 ± 8.04, delirium duration was (36.33 ± 9.07) min, pain scores were 1.86 ± 0.76, 4.16 ± 1.17, average length of stay was (8.98 ± 4.64) days, and incidence of delirium was 6.0% (3/50), the RPN values of each link failure risk of the control group were 274.10 ± 8.48, 291.00 ± 10.10, 287.78 ± 11.64, delirium duration (78.70 ± 20.10) min, pain scores 2.26 ± 1.02, 4.74 ± 1.19, average length of stay was (11.50 ± 7.66) days, and incidence of delirium was 22.0% (11/50). The differences between two groups showed significant differences ( t values were 1.99-93.24, χ2=4.07, P<0.05). The patient satisfaction score of the observation group was 99.36 ± 1.01, which was higher than that of the control group 89.63 ± 2.62, and the difference was statistically significant ( t=24.50, P<0.05). Conclusions:The perioperative implementation of postoperative delirium risk management model based on FMEA theory in elderly patients with hip fractures can reduce the incidence of postoperative delirium, relieve pain, shorten hospital stay, and improve satisfaction degree. It is worthy of clinical promotion.
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Objective:To observe the susceptibility factors of elderly patients with corynebacterium striata in sputum of lower respiratory tract and analyze its clinical therapeutic effect.Methods:The clinical data of 192 elderly inpatients infected with corynebacterium striatum detected in sputum of lower respiratory tract were retrospectively analyzed in Quanzhou First Hospital Affiliated to Fujian Medical University from January 2019 to June 2021.The detection rate of corynebacterium striata was calculated, and the susceptibility factors and clinical efficacy were compared between the infection group(n=102)and the colonization group(n=90).Results:The detection rate of corynebacterium striata(detected cases / numbers of qualified lower respiratory tract sputum specimen)was 0.8%(72/8976)from January to December 2019, 2.3%(134/5877)from January to December 2020, and 3.0%(121/4 039)from January to June 2021, the difference was statistically significant( χ2=93.93, P<0.01). The detection rates of corynebacterium striatum during three corresponding periods in elderly patients were 0.6%(57/8 976), 1.4%(81/5 877)and 1.9%(78/4 039), respectively, with statistically significant differences( χ2=45.57, P<0.01). The incidences or values of following indexes were higher in infection group than in colonization group: age of patients, admission of intensive care unit, malnutrition, use of hormones, combined use of antibiotics, use of invasive mechanical ventilation, use of fiber bronchoscope, reduced cough reflex, other basic diseases, and so on, but the differences were not statistically significant(all P>0.05). The clinical effective rates were 41.2%(42/102)in the infection group and 48.9%(44/90)in the colonization group, respectively, and the differences was not statistically significant( P>0.05). Only 25 patients(24.5%)in the infected group were treated on corynebacterium striatum according to drug sensitivity results.Among them, the clinical effective rate of the treatment group and the untreated group was 68.0%(17/25)and 32.5%(25/77), respectively, the difference was statistically significant( χ2=9.84, P<0.01). The clinical effective rate of untreated group was lower than that of colonization group, the difference was statistically significant( χ2=4.62, P<0.05). Conclusions:The detection rate of corynebacterium striatum in elderly patients is high, and increases year by year.Patients infected with corynebacterium striatum usually has a variety of susceptibility factors, if not taking effective treatment measures, may have adverse outcomes.In clinical work, it is necessary to pay attention to and reduce the susceptibility factors of corynebacterium striatum, and to correctly interpret the etiological reports, so as to adopt a reasonable and effective therapeutic schedule.
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Ischemic brain stroke is pathologically characterized by tissue acidosis, sustained calcium entry and progressive cell death. Previous studies focusing on antagonizing N-methyl-d-aspartate (NMDA) receptors have failed to translate any clinical benefits, suggesting a non-NMDA mechanism involved in the sustained injury after stroke. Here, we report that inhibition of intracellular proton-sensitive Ca2+-permeable transient receptor potential vanilloid 3 (TRPV3) channel protects against cerebral ischemia/reperfusion (I/R) injury. TRPV3 expression is upregulated in mice subjected to cerebral I/R injury. Silencing of TRPV3 reduces intrinsic neuronal excitability, excitatory synaptic transmissions, and also attenuates cerebral I/R injury in mouse model of transient middle cerebral artery occlusion (tMCAO). Conversely, overexpressing or re-expressing TRPV3 increases neuronal excitability, excitatory synaptic transmissions and aggravates cerebral I/R injury. Furthermore, specific inhibition of TRPV3 by natural forsythoside B decreases neural excitability and attenuates cerebral I/R injury. Taken together, our findings for the first time reveal a causative role of neuronal TRPV3 channel in progressive cell death after stroke, and blocking overactive TRPV3 channel may provide therapeutic potential for ischemic brain injury.
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Objective:To analyze the clinical efficacy and safety of stent implantation combined with drug therapy and drug therapy alone in patients with vertebral artery initial stenosis.Methods:A total of 112 patients with vertebral artery initial stenosis who were treated in Wuzhou Workers′ Hospital from January 2016 to June 2018 were selected and divided into drug group and stent + drug group according to random number table method, with 56 patients in each group. The drug group received drug therapy alone, and stent + drug group received stent implantation combined with drug therapy. The incidence of ischemic events in posterior circulation, the improvement of vascular stenosis rate and the improvement of neurological function injury were observed in the two groups after 12 months of treatment.Results:The success rate in the stent + drug group was 100.0%(56/56). The rate of vascular stenosis in the stent + drug group was lower than that in the drug group: (15.21 ± 3.74)% vs. (18.62 ± 4.27)% ; but the incidence of restenosis was higher than that in the drug group:26.79%(15/56) vs. 7.14%(4/56), the differences were statistically significant ( P<0.05). The total incidence of ischemic events in the posterior circulation after treatment in the stent + drug group was lower than that in the drug group: 8.93%(5/56) vs. 28.57%(16/56), and the difference was statistically significant ( χ2 = 7.092, P = 0.008). After treatment, the National Institutes of Health Stroke Scale (NIHSS) and Modified Rankin Scale (MRS) in the stent + drug group were lower than those in the drug group: (2.30 ± 0.36) scores vs. (3.75 ± 0.52) scores, (4.11 ± 0.51) scores vs.(6.14 ± 0.57) scores, and the differences were statistically significant ( P<0.05). Conclusions:The application of stent implantation combined with drug regimen in the treatment of patients with vertebral artery initial stenosis can effectively reduce the neurological damage of patients, andimprove the total effective rate, which is conductive to the improvement of patients′ quality of life, but the rate of stent restenosis is high.
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Objective:To investigate the safety and prognostic value of neoadjuvant chemotherapy and surgery for advanced gastric cancer patients with para-aortic lymph node metastasis.Methods:Clinicopathological data of 25 patients admitted to the Department of Gastrointestinal Surgery, Fujian Cancer Hospital from Jan 2015 to Jun 2017 were retrospectively analyzed. All patients were treated with SOX chemotherapy for 3 cycles. D 2 + paraaortic lymphadenectomy was performed in patients with stable disease (SD) . After operation, SOX regimen was used for 5 cycles of chemotherapy. Results:After 3 cycles of neoadjuvant chemotherapy, there were 2 cases with progressive disease, 6 cases of SD and 17 cases of partial remission. There was no treatment-related death. Twenty-three patients underwent surgery, including 19(76%) patients of R 0 resection. Tirty-four out of 128 para aortic lymph nodes were metastatic. Postoperative complications occurred in 5(22%) patients, with no mortality . The median progression free survival time and median overall survival time were 20 and 29 months respectively. The 1, 3-year overall survival rates were 80% and 48%, and the 1-year and 3-year progression free survival rates were 72% and 38%, respectively. For those with para-aortic lymph node metastasis the 1-year and 3-year OS rate were 70% and 17%, respectively. Multivariate analysis showed that the efficacy of neoadjuvant chemotherapy was an independent prognostic factor. Conclusion:Neoadjuvant chemotherapy is among others an independent prognostic factor affecting the post-op survival of advanced gastric carcinoma with para-aortic lymph node metastasis.
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The pathogenesis of autoimmune diseases(AID)involves the inflammatory response of the human body, and inflammatory pathways are also shared by mechanisms of aging.Clinical observations of AID have revealed evidence of aging-related diseases in younger adults.This article reviews the literature related to research progress on AID combined with aging-related diseases, such as cardiovascular diseases, diabetes and osteoporosis, and briefly explains the underlying mechanisms, in order to promote interdisciplinary research between the two fields.
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Objective:To explore the application effect of the flipped micro-lecture teaching mode in the teaching of medical biochemistry.Methods:A total of 115 clinical medicine students in Batch 2016 from Zhejiang Chinese Medical University were selected as the experimental group, and 120 stomatology students were selected as the control group. Teachers applied the "before-class, in-class, after-class" serial design to conduct flipped micro-lecture in the experimental group, and the traditional teaching was used in the control group. We evaluated the teaching effect through self-directed learning tests and questionnaire survey after the teaching experiment.Results:Flipped micro-lecture teaching improved students' learning effect, enhanced their learning enthusiasm, gradually led them into autonomous learning of medical biochemistry, and improved their team collaboration ability.Conclusion:The combination of Flipped Classroom and micro-lecture is of great significance to promote the transformation of curriculum education modes and cultivate innovative medical talents.
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Objective:To investigate the discriminant function of optical coherence tomography angiography (OCTA) in the diagnosis of primary open angle glaucoma (POAG) and to evaluate the correlation between vessel density, as measured by OCTA, and visual field mean defect (MD) in patients with POAG.Methods:A case control study was designed.Ninety-five eyes of 54 patients with POAG and ninety-six eyes of 48 healthy subjects in Changsha Aier Eye Hospital were included in this study.The vessel density in the radial peripapillary capillary (RPC) network, the macular vessel density, the ganglion cell complex (GCC) layer thickness, the macular thickness, and the retinal nerve fiber layer thickness were tested for correlation with MD.The aera under the receiver operating characteristic (ROC) curves (AUC), as well as sensitivities at fixed vessel density specificities in the RPC network, and macular regions were analyzed.ROC regression was used to evaluate the effect of covariates on the diagnostic abilities.The study protocol was approved by the Ethics Committee of Changsha Aier Eye Hospital.Written informed consent was obtained from all subjects prior to entering the study cohort.Results:Compared with the normal control group, the macular area and vessel density in the RPC network were significantly decreased in the POAG group ( P<0.001). Also in the POAG group, except for the capillary density inside the disc, all other measurements including the density of superficial capillaries in the macula, the density of deep capillaries in the macula, the density of RPC layers around the optic disc, the average capillary density of the optic disc RPC layer, the capillary density of the optic disc RPC layer (above, below, nasal, and temporal), the thickness of the retinal nerve fiber layer, the thickness of the whole macular layer, and the thickness of the GCC layer of the macula area were positively correlated with the MD value ( r=0.586, 0.352, 0.610, 0.592, 0.598, 0.589, 0.445, 0.587, 0.578, 0.530, 0.609; all at P<0.01). The AUCs of vessel densities ranged from 0.623 to 0.927.The highest diagnostic efficiency was the RPC vessel density (whole image), the AUC value was 0.927. Conclusions:The OCTA parameters have a high diagnostic ability for POAG, except for the capillary density of inside the disc, all other vascular parameters are positively correlated with the MD value.
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Objective: To explore the application value of shear wave elastography (SWE) and γ-glutamyl transpeptidase/platelet ratio (GPR) in diagnosis of liver fibrosis in chronic hepatitis B (CHB) patients. Methods: A total of 116 patients with CHB were collected. SWE examinations and blood routine and liver function tests were performed before liver biopsy. Liver hardness measurement (LSM) was recorded, and GPR was calculated. According to the Metavir scoring system, liver fibrosis was classified as F0, F1, F2, F3 and F4 in the pathologic examinations. The correlations of SWE, GPR and liver fibrosis stages were analyzed. Receiver operating characteristic curve (ROC) was drawn, and Elast PQ and GPR for diagnosis of liver fibrosis in patients with CHB were compared. The diagnostic value of Elast PQ of liver fibrosis in patients with ALT below 2 times of the upper limit of normal (ULN) value was analyzed. Results: Elast PQ and GPR were all positively correlated with liver fibrosis staging (r=0.94, P<0.01; r=0.92, P<0.01). The diagnostic efficiency of Elast PQ was superior to that of GPR for F1-F3 fibrosis stages (Z=2.21, P=0.03; Z=2.16, P=0.03; Z=2.27, P=0.02), of Elast PQ in patients with ALT≤1×ULN was better than that in patients with 1×ULN
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Objective@#To explore changing trend in prognosis of primary hypopharyngeal carcinoma and to analyze the reasons at the Eye, Ear, Nose and Throat Hospital of Fudan University.@*Methods@#We retrospectively analyzed the clinical data of 461 patients with primary hypopharyngeal carcinoma treated at the Eye, Ear, Nose and Throat Hospital of Fudan University from 2003 to 2007 (Group 1) and 2010 to 2014 (Group 2) according to the inclusion criteria. 142 from Group 1, including 133 males and 9 females, rangedfrom 38 to 82 years old and 319 from Group 2, including 313 males and 6 females, ranged from 39 to 81 years old, were included in this work. The laryngeal function preservation rate, survival outcome, application and effect of pre-and post-operative adjuvant therapy were compared. SPSS 24.0 was used for statistical analyses.@*Results@#There were 62 patients with early disease (T1-2N0) including 18 in Group 1 and 44 in Group 2, in whom 3 (16.7%) underwent surgical procedures with laryngeal function preservation in Group 1, while, 30 (68.2%) underwent laryngeal function preservation surgery in Group 2. The laryngeal function preservation rate showed an obviously upward trend in recent years (χ2=13.617, P<0.001), whereas, the recurrence-free survival rate (RFS) and overall survival rate (OS) showed no significant differences between two groups (P=0.469 and 0.808, respectively). Among the 399 patients with advanced disease, 124 were in Group 1 and 275 in Group 2. After propensity score matching (PSM) was used, the OS rate was significantly higher for Group 2 than Group 1 (P=0.017), while the application of laryngeal function preservation surgery was significantly higher in Group 2 (χ2=4.686, P=0.030). The application rates of preoperative adjuvant therapy and postoperative adjuvant chemotherapy were significantly higher in group 2 than in group 1 (χ2=5.687, P=0.017; χ2=19.407, P<0.001).@*Conclusion@#The application of laryngeal function preserving surgery significantly increases the retention rate of laryngeal functions in patients with early-stage hypopharyngeal carcinoma, with similar long-term survival outcomes. The application of comprehensive treatment including preoperative adjuvant therapy and postoperative adjuvant treatments, especially postoperative chemoradiotherapy, shows an obvious increase in the function preservation rate and long-term survival in patients with advanced hypopharyngeal carcinoma.
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Objective:To observe the macular vascular density and the area of foveal avascular zone(FAZ) in the follow eyes of monocular retinal vein occlusion (RVO) patients.Methods:Retrospective case-control study. From May to November 2018, 78 follow eyes of 78 monocular RVO patients who were clinically diagnosed in Changsha Aier Eye Hospital were included in the study. Among them, 44 were male and 34 were female. The average age was 53.17±10.12 years. There were 42 patients with central retinal vein occlusion(CRVO group) and 36 patients with branch retinal vein occlusion (BRVO group). Forty-two eyes of 33 gender and age matched healthy volunteers were selected as the control group. Among them, 17 were male (22 eyes) and 16 were female (20 eyes), with the mean age of 53.48±10.84 years. OCT angiography was performed on all eyes in CRVO group, BRVO group and control group. The scanning region in the macular area was 6 mm× 6 mm. Macular vascular density and FAZ area in the superficial and deep retinal capillary plexi were measured.Results:The mean overall vascular density measured in the entire scan was lower in the CRVO group( t=-4.26, -4.93) and BRVO group ( t=-4.79, -4.74) compared with the control group in both the superficial and deep capillary plexus ( P<0.05). The reduce degree of vascular density in the deep capillary plexus (CRVO group:5.51%, BRVO group:4.58%) was higher than that in the superficial plexus (CRVO group:4.13%, BRVO group:3.50%). In the CRVO group, the FAZ area decreased compared with the control group ( t=-3.43, P<0.05). There was no statistically significant difference in the area of FAZ between the BRVO group and the control group ( t=-0.10, P>0.05). Conclusions:The macular vascular density in the follow eyes of monocular RVO patients is lower than that of normal healthy eyes. The reduce degree of vascular density in the deep capillary plexus is higher than that in the superficial plexus. Compared with normal healthy eyes, the FAZ area in the follow eyes of monocular CRVO patients decreased, while it did not change significantly in the follow eyes of monocular BRVO patients.
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Objective To analyze the risk factor of delayed gastric emptying (DGE) and the impact of DGE on prognosis after radical gastrectomy of distal gastric carcinoma.Methods The clinical and pathological data of 1 447 distal gastric cancer patients undergoing gastrectomy from Jul 2007 to Jan 2018 at Fujian Tumour Hospital was analyzed retrospectively.Result DGE was found in 101 patients (7.0％),occurring at a median of (6.0 ± 2.1) d after surgery.It was significantly correlated with age,diabetes,hypoproteinemia,preoperative pyloric obstruction,operation time,surgical mode,anastomotic procedure,postoperative analgesia(all P ＜ 0.05).Multivariate analysis showed that hypoproteinemia,diabetes,pyloric obstruction in preoperative period,surgical mode,postoperative analgesia,anastomotic procedure were independently associated with DGE.The average hospitalization time for DGE was significantly higher than patients with non DGE(16.3 ± 4.2) d vs.(8.1 ± 2.1) d,P ＜ 0.05.The five-year survival of patients with DGE and non DGE were 54.9％ and 54.2％ respectively(P ＞0.05) Conclusion DGE prolonged hospital stay,but did not influence patients' prognosis.
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Objective@#To determine the relationship between nodal disease distribution patterns and oncological outcome and optimum management of cN0/cN1 patients with hypopharyngeal squamous cell carcinoma (HPSCC).@*Methods@#The collected clinical data and the follow-up disease-free survival (DFS) information from 154 patients with HPSCC treated between 2001 and 2014 in Eye Ear Nose and Throat Hospital of Fudan University were retrospectively analyzed. Kaplan-Meier method was used to calculate DFS rate. Log-rank test and Cox regression model were performed to evaluate the survival prognostic factors for univariate and multivariate analyses.@*Results@#Among 154 patients (63 cN0 patients, 91 cN1 patients) with HPSCC,in whom 148 were male, 6 were female, with an arerage age of (58.6±9.9), 63 cN0 patients received lateral neck dissection, of whom 9 were histologically positive nodes. Particularly, occult metastasis rate was 15.6%(7/45) for HPSCC in pyriform sinus and 18.2%(2/11) for HPSCC in posterior pharyngeal wall. Among 91 cN1 HPSCC, 34 underwent radical neck dissection and 54 underwent selective neck dissection. DFS for patients(T3-4N1) with radical neck dissection was lower than that for patient with selective neck dissection(15.2% vs.39.5%, χ2=5.153, P<0.05). The DFS of cN0 HPSCC was overestimated by the false-negative patients (cN0→pN+) for cN0 HPSCC and the DFS of cN1 HPSCC was underestimated by the false-positive(cN1→pN0) for cN1 HPSCC.@*Conclusions@#For cN1 HPSCC, compared with radical neck dissection, selective neck dissection may be considered as a more adequate method for removal of metastatic lymph nodes. Postoperative combined therapy and follow-up strategy should be established according to pathological N staging.
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Objective To analyze and summarize the risk factors of radial artery spasm in patients with acute myocardial infarction treated by radial artery interventional therapy??Methods From August 2017 to August 2018,257 patients with chest pain in Deyang Second People＇s Hospital were selected and treated by percutaneous coronary intervention ( PCI) through radial artery approach??According to the presence or absence of radial artery spasm, the patients were divided into two groups??The radial artery fistula group (RAS) and the non?RAS group??All data were statistically analyzed using SPSS 19??0 software??Results The following indicators were statistically different between the RAS group and the non?RAS group: age,gender, diabetes,hypertension,hyperlipidemia,smoking history,radial artery anatomy,catheter exchange times,radial artery diameter／height, radial artery diameter／catheter diameter, anxiety, excessive operation time, intraoperative moderate to severe forearm pain, the number of stents, grade 2, 3, and 4 of radial artery pulsation??There were significant differences between two groups(all P＜0??05)??Multivariate analysis showed:gender(OR(95%CI): 0??92( 0??897－0??944),P＝0??043), hyperlipidemia ( OR ( 95%CI): 3??249 ( 2??508－4??208),P＝0??016),radial artery anatomy ( OR( 95%CI): 5??19 ( 2??090－12??886, P＝0??012), catheter exchange times( OR(95%CI): 6??19(3??087－12??413,P＝0??011),radial artery diameter／height( OR(95%CI): 3??56 ( 1??527－8??302, P＝0??035), radial artery diameter／catheter diameter ( OR ( 95%CI): 2??968 (1??665－5??291),P＝0??029),intraoperative moderate to severe forearm pain( OR(95%CI): 3??543(1??394－9??006), P ＝ 0??039 ) were independent risk factors for the induction of radial artery spasm in the interventional treatment of the radial artery??The difference between the two groups was statistically significant??ROC curve analysis showed that the area under the curve of the number of catheter exchanges, radial artery diameter／height, radial artery diameter／catheter diameter and the combined diagnosis were 0??806,0??674,0??645,and 0??895,respectively??By comparison,AUC of the combined diagnosis were highest, followed by catheter exchange times, radial artery diameter／height and radial artery diameter／catheter diameter were relatively lower??The best diagnostic point of catheter exchange times was 11??585, with a sensitivity of 0??86 and a specificity of 0??58??The best diagnostic point of radial artery diameter／height was 11??145,with a sensitivity of 71??8% and a specificity of 0??56??The best diagnostic point of arterial diameter／catheter diameter was 9??31,with a sensitivity of 95??3 and a specificity of 32??0%??The best diagnostic point of the combined diagnosis was 9??63, with a sensitivity of 0??72 and a specificity of 0??88??Conclusion Independent risk factors for radial artery spasm in the interventional treatment of the radial artery include catheter exchange times, radial artery anatomy, radial artery diameter／height, intraoperative moderate and severe forearm pain,hyperlipidemia,age and gender,and female incidence is greater than male??
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To better analyze the problem of abnormal neuromuscular coupling related to motor dysfunction for stroke patients, the functional coupling of the multichannel electromyography (EMG) were studied and the difference between stroke patients and healthy subjects were further analyzed to explore the pathological mechanism of motor dysfunction after stroke. Firstly, the cross-frequency coherence (CFC) analysis and non-negative matrix factorization (NMF) were combined to construct a CFC-NMF model to study the linear coupling relationship in bands and the nonlinear coupling characteristics in different frequency ratios during elbow flexion and extension movement. Furthermore, the significant coherent area and sum of cross-frequency coherence were respectively calculated to quantitatively describe the intermuscular linear and nonlinear coupling characteristics. The results showed that the linear coupling relationship between multichannel muscles was different in frequency bands and the overall coupling was stronger in low frequency band. The linear coupling strength of the stroke patients was lower than that of the healthy subjects in different frequency bands especially in beta and gamma bands. For the nonlinear coupling, the intermuscular coupling strength of stroke patients in different frequency ratios was significantly lower than that of the healthy subjects, and the coupling strength in the frequency ratio 1∶2 was higher than that in the frequency ratio 1∶3. This method can provide a theoretical basis for exploring the intermuscular coupling mechanism of patients with motor dysfunction.
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Humans , Case-Control Studies , Electromyography , Muscle, Skeletal , Stroke , Stroke RehabilitationABSTRACT
Objective@#To evaluate the oncologic and functional outcomes of supracricoid partial laryngectomy (SCPL) in the treatment of laryngeal carcinoma.@*Methods@#A total of 298 laryngeal carcinoma patients who underwent SCPL treatment from January 2005 to December 2013 were reviewed retrospectively. Clinical data of demographic and clinical characteristics, postoperative complications, rehabilitation information, recurrence and metastasis were analysed. Survival and local control were used to evaluate the clinical outcome.Data were analyzed by SPSS 23.0 software.@*Results@#Thirty-one patients with supraglottic carcinoma underwent cricohyoidoepiglottopexy (CHEP)and 267 with glottic carcinoma underwent cricohyoidopexy (CHP) were enrolled in this study. The mean duration of followed up was 74 months, ranging from 12 to 146 months. Fifty-four cases died at last follow-up. With respect to 31 patients with supraglottic carcinoma, 5- and 10-year overall survival rates and disease specific survival rates all were 78.1%; 5- and 10-year disease free survival rates were 72.1% and 63.7% respectively; and 5- and 10-year local control rates were both 84.2%. In 267 patients with glottic carcinoma, 5- and 10-year overall survival rates were 85.8% and 77.1% respectively; 5- and 10-year disease specific survival rates were 86.6% and 78.4% respectively; 5- and 10-year disease free survival rates were 80.6% and 74.2% respectively; and 5- and 10-year local control rates were 90.0% and 89.4% respectively. The survival rate of patients with glottic carcinoma at stage T1 was higher than that at stage T2 or T3, and the disease free survival rate of patients with early stage was superior than that of patients with advance stage. Cox regression analysis showed that tumor stage T2, and T3, tumor recurrence, and tumor metastasis were independent risk factors for survival. Furthermore, nasogastric feeding tube removal rate was 100% and the decannulation rates of SCPL were 96% in the patients with SCPL.@*Conclusions@#SCPL is a safe procedure with tumor resection for laryngeal carcinoma, with preserving of swallowing, respiration, and phonation functions, and has excellent survival and local control rates. This procedure could be considered as a standard function-sparing treatment for selected patients with laryngeal carcinoma of stages T1b-T3.
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Objective To evaluate the clinicopathologic characteristics and prognosis of gastric stump cancer in relation to serum albumin level.Methods The clinical data of 149 gastric stump cancer patients treated from Jan 1999 to Jun 2015 were analyzed.Patients were divided into normal serum albumin group (＞ 35 g/L,n =81) and group of hypoalbuminemia (≤ 35 g/L,n =68).Results Clinicopathologic characteristics,tumor size,depth of invasion,lymph node status and TNM stage were significantly different between the two groups (P ＜ 0.05).Univariate analysis showed that factors that influence prognosis were serum albumin level,tumor size,serosal invasion,tumor location and tumor curative resection rate (all P ＜ 0.05).Cox's proportional hazard regression model showed that serum albumin level and tumor curative resection rate were independent prognostic factors for survival,lymph node matastasis(2.2 ±4.3) vs.(4.1 ±4.4)were significantly different between the two groups (P ＜0.05).The overall 5-year survival rate was 44.1％.The 5-year survival rate were 54.0％ for normal albumin group and 32.2％ for hypoalbuminemic group,P =0.011.Conclusion Lower preoperative serum albumin level is associated with poorer prognosis in gastric stump cancer patients.
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Objective:To investigate the types of non-tumor diseases in patients with cancer, and to explore the effects of those dis-eases on the diagnosis and treatment of cancer patients. Methods:We collected the medical records of cancer patients from January 2013 to December 2017 in Peking University Cancer Hospital, and screened for non-tumor diseases. The clinical records of the patients in this group were analyzed retrospectively, and the effects of those diseases on the diagnosis and treatment of tumors were dis-cussed. Results:Of the 1,323 cases of inter-hospital consultation, 1,153 cases of non-tumor disease (87.2％) were selected. There were 773 men (67.0％) and 380 women (33.0％) included. The median age was 62 (14-90) years. The primary tumor types included lung can-cer, gastric cancer, lymphoma, colorectal cancer, esophageal cancer, breast cancer, malignant melanoma, liver cancer, cholangiocarci-noma/gallbladder cancer, pancreatic cancer, and other tumors. Non-neoplastic diseases included cardiovascular disease in 356 cases (30.9％), respiratory system disease (17.0％) in 196 cases, digestive system disease in 107 cases (9.3％), skin and venereal diseases in 81 cases (7.0％), nervous system lesions (6.4％) in 74 cases, urinary system disease in 72 cases (6.2％), blood disease in 70 cases (6.1％), en-docrine and metabolic diseases in 47 cases (4.1％), autoimmune disease in 23 cases (2.0％), and other diseases (11.0％) in 127 cases. Impact on tumor diagnosis and treatment was as follows:direct, 771 cases (66.9％);no influence, 313 cases (27.1％);and uncertain, 69 cases (6.0％). Conclusions:Cardiovascular disease is a major non-tumor disease associated with cancer. Non-neoplastic diseases are important factors affecting the diagnosis and treatment plans of cancer.
ABSTRACT
Spt proteins are defined as a large family of transcription regulators of the yeast Saccharomyces cerevisiae. They are crucial components of the SAGA complex that regulates transcription through interaction with the TATA box in the upstream region of the target genes. About 10% of total gene transcriptions are related to Spt proteins and these genes are highly related to environmental stress response. Such vast regulation network and complex mechanisms have become a hotspot. Spt proteins are also important to suppress transposon-induced mutations, being a switch on regulation of transposon behaviors and adaptive evolution of Saccharomyces cerevisiae. Besides that, some Spt proteins are directly involved in regulating unsaturated lipid acids synthesis, which could remold the cell membrane to resist environmental stresses. Here, we review Spt proteins, the advances in Spt proteins study, and their potential applications in improving yeast's stress resistance through transcription regulation, transposon activity regulation and cell membrane alternation.