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Nasopharyngeal carcinoma is one of the most common malignant head and neck tumors, and radiotherapy is the main treatment. However, radio-resistance is a key cause of local recurrence of nasopharyngeal carcinoma. Therefore, overcoming the radio-resistance of nasopharyngeal carcinoma and enhancing the radiosensitivity have become urgent problems in the treatment of nasopharyngeal carcinoma, which also play a key role in improving the overall survival rate of patients. In this article, recent studies on DNA, non-coding RNA (ncRNA), protein and cell behaviors related to radio-resistance of nasopharyngeal carcinoma were reviewed, aiming to provide valuable ideas for clinical treatment of nasopharyngeal carcinoma.
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Objective:To investigate the levels of knowledge, attitudes and practice of general practitioners on potentially inappropriate medication(PIM)in the elders in Shanxi Province and to explore its relevant factors.Methods:A cross-sectional survey on knowledge, attitudes and practice of general practitioners on PIM in the elders was conducted from January to February 2021. A self-designed questionnaire was used for the survey, which included the basic information of general practitioners and the knowledge, attitudes and practice of elderly PIM. The convenient sampling method was used to select 16 primary, secondary and tertiary hospitals from the general practice alliance units in Shanxi Province, and 257 general practitioners in the selected hospital were recruited as the research objects. The related factors were investigated by univariate regression and multiple stepwise linear regression analyses.Results:A total of 257 questionnaires were distributed, and 248 valid questionnaires were recovered, with an effective rate of 96.5%. The scores of elderly PIM knowledge, attitudes and behavior of 248 general practitioners were (31.4±9.2), (32.9±4.6) and (34.9±8.3), respectively, with the scoring rates of 62.8% (31.4/50.0), 82.3% (32.9/40.0) and 69.8% (34.9/50.0). The total score was (99.2±16.3), and the total score rate was 70.9% (99.2/140.0). There was a statistically significant difference in the total score of elderly PIM knowledge, attitudes and practice among general practitioners with different educational background, work units, professional title, awareness level of PIM and needs for PIM training( F=6.14,4.39 and 5.38, t=2.97 and 2.62, all P<0.05). Multivariate analysis showed that general practitioners with undergraduate and graduate education and higher professional titles had better knowledge, attitudes and practice of PIM ( t=2.69, 2.98 and 2.36, all P<0.05), and general practitioners without knowledge of PIM and no needs for PIM training had worse knowledge, attitudes and practice of PIM ( t=-2.96 and -2.09, all P<0.05). Conclusions:The knowledge, attitudes and behavior intervention of general practitioners on elderly PIM needs to be improved. It is necessary to strengthen the elderly PIM knowledge and skill training for general practitioners with low educational background, lower professional titles without awareness and training of PIM.
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Objective:To investigate the effect of body mass index (BMI) on clinical pregnancy and neonatal outcomes in patients with polycystic ovary syndrome (PCOS) during frozen-thawed embryo transfer.Methods:A total of 650 patients with PCOS who received routine in vitro fertilization or intracytoplasmic sperm injection treatment for frozen-thawed embryo transfer from June 2014 to June 2019 in Tianjin Central Hospital of Gynecology Obstetrics were retrospectively analyzed. According to BMI, PCOS patients were divided into group A (18.5≤BMI<23 kg/m 2, n=253), group B (23≤BMI<25 kg/m 2, n=167), and group C (BMI≥25 kg/m 2, n=230). The general information, clinical pregnancy outcomes, pregnancy complications, the incidence of macrosomia and low-birth-weight infants were compared in the three groups, and the influencing factors of neonatal birth weight were analyzed. Results:The embryo implantation rate, clinical pregnancy rate, and ongoing pregnancy rate all showed downward trend with the increase of BMI, but the differences were not statistically significant (all P>0.05). The live birth rate in group C [47.0% (108/230)] was significantly lower than those in groups A and B, with statistical significance ( χ2 =7.43, P=0.024). The late miscarriage rate was higher in group C [9.4% (13/139)] than in groups A and B ( χ2 =7.66, P=0.022). The birth rates of macrosomia in groups B [22.2% (16/72)] and group C [21.1% (16/76)] were significantly higher than that in group A, and the difference was statistically significant ( χ2 =14.15, P=0.001). There was no statistically significant difference in the incidence of gestational diabetes between the three groups ( χ2 =3.81, P=0.149). The incidence of hypertension disorders complicating pregnancy increased with the increase of BMI, and the difference was not statistically significant ( P>0.05). Regression analysis showed that macrosomia was significantly associated with maternal pre-pregnancy BMI and gestational weeks, and the risk of macrosomia increased by 15% (95% CI: 3%-28%) for every increase in maternal BMI. Conclusions:The embryo implantation rate, clinical pregnancy rate, and ongoing pregnancy rate of PCOS patients in frozen-thawed embryo transfer cycles show downward trend with the increase of BMI. Obese patients with PCOS have a significant increase in late miscarriage rate and a significant decrease in live birth rate. The incidence of hypertension disorders complicating pregnancy in PCOS patients in the obese group has an increasing trend, and the birth rate of macrosomia has increased significantly. Therefore, it is recommended that obese women with PCOS lose weight scientifically before pregnancy to improve pregnancy and neonatal outcomes.
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Small intestinal bacterial overgrowth(SIBO)is associated with various diseases in children.The pathogenesis involves gastric acid secretion, intestinal motility, anatomical structure and immune function.Breath test is widely used clinically because its simplicity and noninvasion, but its sensitivity and specificity are unstable.Bacterial culture of proximal intestinal fluid has been the gold standard in the past, but it is not easy to be popularized clinically for invasive examination.Next generation sequencing technology may provide function and composition of the intestinal flora.Finding a simple and accurate detection method to diagnose SIBO is an urgent problem.This paper reviews the progress in research on the pathogenesis and diagnostic methods of SIBO in children.
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Objective To investigate the inhibitory effect of apigenin-7-o-glucoside (AGL) on the viability of Huh7 cells and tumor growth in Huh7-xenograft tumor nude mice. Methods CCK-8 was used to detect the proliferation inhibitory effect and the half inhibitory concentration of AGL on Huh7 cells. The mitochondrial membrane potential measurement was used to analyze the early apoptosis of Huh7 cells after AGL treatment. Flow cytometry was used to analyze the effect of AGL on Huh7 cell apoptosis, and Western blot was used to explore the expression level of the proteins associated with apoptosis and inflammation, as well as the possible related mechanism. In Huh7-xenograft tumor nude mice, vernier caliper was used to measure tumor volume to analyze the effect of AGL on tumor growth rate. HE staining was used to observe the pathological state of mouse organs, and the inflammation-related factors in serum were detected with ELISA. Results After Huh7 cells were treated with AGL, the mitochondrial membrane potential reduced, the content of ROS increased and the apoptosis rate was increased to 25.23% by 50 μmol/L AGL treatment; while the expression levels of Bax, Bad, Cleaved Caspase-3 and Cleaved Caspase-9 increased, and the expression levels of Bcl2 and Bcl-xL decreased, the phosphorylation level of NF-κB, IKKα/β and IκBα decreased; the tumor growth rate decreased, the serum IL-6 and TNF-α levels significantly decreased, while the IL-2 and IL-10 levels increased. Conclusion AGL could promote the apoptosis of Huh7 cells and relieve the tumor development in Huh7-xenograft tumor nude mice, which may be related to the NF-κB pathway.
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Extranodal natural killer/T-cell lymphoma (ENKTCL) is the subtype of non-Hodgkin lymphoma with high heterogeneity and invasiveness. Though most ENKTCL patients are present as early-stage at diagnosis, clinical prognosis significantly differs due to the limitations of clinical staging. Radiotherapy (RT) and chemotherapy (CT) are the first-line treatments for early ENKTCL patients. However, there is no consensus on the combined modalities of RT and CT, and their optimal strategy. With the continuous renewal of clinical staging and prognostic models, early-stage ENKTCL patients tend to accept risk-adapted treatment with proper stratification. In this review, the latest research progresses on clinical staging, prognostic models and treatment were retrospectively analyzed, aiming to provide references for clinical decision-making.
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Objective:To explore the sequence of reduction and fixation in the treatment of middle and lower tibiofibular fractures on the same plane using tibial intramedullary nailing plus fibular plating.Methods:A retrospective analysis was performed of the 58 patients with middle and lower tibiofibular fractures on the same plane from January 2016 to December 2017. They were 38 males and 20 females, aged from 20 to 65 years (average, 40 years). The left side was affected in 30 cases and the right in 28. By the AO classification, 27 cases were type 42-A, 18 ones type 42-B and 13 ones type 42-C. Of them, 33 had the fibula reduced and fixated first (the fibular group) while 25 had the tibia reduced and fixated first (the tibial group). The 2 groups were compared in terms of operation time, rate of tibial closed reduction, rate of dynamization of intramedullary nails, fracture healing time and postoperative complications.Results:All the patients were followed up for 12 to 24 months (average, 17.2 months). The operation time in the fibular group was 96 minutes ± 15 minutes, significantly shorter than that in the tibial group (116 minutes ± 19 minutes)( P<0.05). The rate of tibial closed reduction was 84.8% (28/33) in the fibular group and 60.0%(15/25) in the tibial group, presenting a significant difference ( P<0.05). There were no significant differences between the 2 groups in the rate of dynamization of intramedullary nails, fracture healing time or postoperative complications ( P>0.05). Conclusions:Tibial intramedullary nailing plus fibular plate osteosynthesis is an effective treatment for the middle and lower tibiofibular fractures on the same plane. When the fracture line is not located in the narrow segment of the tibia, reduction and fixation of the fibula first is advantageous over reduction and fixation of the tibia first, because it can facilitate tibial reduction and nail placement and improve surgical efficiency without increasing the fracture healing time.
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In the current study, we aim to investigate whether post-traumatic stress disorder (PTSD) is associated with structural alterations in specific subfields of hippocampus comparing with trauma-exposed control (TC) in a relatively large sample. We included 67 PTSD patients who were diagnosed under Diagnostic and Statistical Manual of Mental Disorders (4th Edition) (DSM-Ⅳ) criteria and 78 age- and sex-matched non-PTSD adult survivors who experienced similar stressors. High resolution T1 weighted images were obtained via a GE 3.0 T scanner. The structural data was automatically segmented using FreeSurfer software, and volume of whole hippocampus and subfield including CA1, CA2-3, CA4-DG, fimbria, presubiculum, subiculum and fissure were extracted. Volume differences between the two groups were statistically compared with age, years of education, duration from the events and intracranial volume (ICV) as covariates. Hemisphere, sex and diagnosis were entered as fixed factors. Relationship between morphometric measurements with Clinician-Administered PTSD Scale (CAPS) score and illness duration were performed using Pearson's correlation with SPSS. Comparing to TC, PTSD patients showed no statistically significant alteration in volumes of the whole hippocampus and all the subfields ( > 0.05). In male patients, there were significant correlations between CAPS score and volume of right CA2-3 ( = 0.197, = 0.034), right subiculum ( = 0.245, = 0.016), and duration statistically correlated with right fissure ( = 0.247, = 0.016). In female patients, CAPS scores significant correlated with volume of left presubiculum ( = 0.095, = 0.042), left subiculum ( = 0.090, = 0.048), and left CA4-DG ( = 0.099, = 0.037). The main findings of the current study suggest that stress event causes non-selective damage to hippocampus in both PTSD patients and TC, and gender-specific lateralization may underlie PTSD pathology.
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Objective To explore the effects of corticosteroids on the recurrence of atrial fibrillation (AF) after radio fre-quency catheter ablation (RFCA ) .Methods A total of 50 patients with paroxysmal AF who underwent RFCA and then treated with corticosteroids from January 2011 to April 2014 were enrolled in this study .At the same period ,37 patients with paroxysmal AF who also underwent RFAC but without corticosteroids treatment were selected as control group .The follow-up was carried out by the fixed physician at 1st week ,1st month ,3rd months ,6th months ,12th months after RFCA through a telephone visit or a hos-pital visit ,including the 12-lead electrocardiogram (ECG) and the HOLTER examination ,symptom of heart-throb inquiry and the interpretation of ECG ,AF recurrence were analyzed and compared between hormone treatment group and control group .Results After 1 week treatment ,the maintenance rates of sinus rhythm in treatment group and control group were 80 .0% and 54 .1% ,re-spectively ,there was statistic difference(P < 0 .05) ,the recurrence of AF in treatment group was significantly decreased ;after 1 month treatment ,the maintenance rates of sinus rhythm in treatment group and control group were 80 .0% and 67 .6% ,respective-ly ,there was no statistic difference(P = 0 .187) ;after 12 months treatment ,the recurrence of AF in treatment group and control group ,was not found statistic significance(P= 0 .711) .Kaplan-Meier survival rate was drew to conduct Log-rank test ,the difference of AF recurrence between the two groups was no statistic significance(P= 0 .711) .Conclusion Transient use of small amounts of corticosteroids after AF ablation may be effective for preventing AF recurrences within 1 week after ablation but it is not effective for preventing AF recurrences at 1st month and 12th months after ablation .
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Objective To evaluate the early effect of Wallis interspinous dynamic stabilization system (Wallis system) in treatment of lumbar degenerative disease. Methods From January 2008 to Jan-uary 2009,21 patients(23 intervertebral spaces) with early lumbar disc herniation and lumbar spinal stenosis were treated with Wallis system. Four intervertebral spaces of L_(3-4) 19 intervertebral spaces of L_(4-5). Observed the time of total operation and implantation,the blood loss,and early recovery. The patients' visual analogue scale (VAS) and Oswestry disability index (ODI) scores were evaluated before and after operation. Results All patients were followed up for average (12.5 ± 0.4) months (7-18 months) after operation. The VAS and ODI scores at 7 days after operation dropped from (7.5 ± 1.5), (40.0 ± 2.0) scores before operation to (2.5 ± 0.5), (23.0 ± 1.5) scores (P < 0.01). Conclusion It is safe and easy to use Wallis system in the treatment of lumbar degenerative disease, with the advantage of mini-invasion and early effect.
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Objective To explore the experience on using duodenoscope to treat hepatolithiasis through normal physiological ways.Methods ERCP,EST were used firstly,then removed calculus of the extrahepatic bile duct.Endoscopic papillary balloon dilatation was used if there was stenosis of bile duct.Removed calculus when it had been crushed in the hepatic duct.Injected decoction to dissolve calculus through endoscopic nasobiliary drainage,or inserted the endoscopic retrograde biliary drainage when the calculus was hard to removded.Results 101 cases of calculus in the extrahepatic bile duct were all removed.215 cases of hepatolithiasis were cleaned out at first time.9 cases were cured 1 week after dissolving calculus through endoscopic nasobiliary drainage.59 cases carried out ERBD,and 21 of them were cured 3 months later,37 patients were still in regular follow-up.33 cases with stenosis of bile duct were treated by endoscopic papillary balloon dilatation,19 of them were cured,the others were inserted with the endoscopic retrograde biliary drainage.19 cases of cholangitic abscess were cured by endoscopic nasobiliary drainage.Conclusion Using duodenoscope to treat hepatolithiasis through normal physiological ways is safe and effectic.
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Objective To explore the experience of the double guide wires technology in the difficult ERCP examinations.Methods There were 776 difficult ERCP patients.701 cases with difficult cannulation of the bile duct had been inserted another guide wire into the upper left corner of the duodenal papilla after retained pancreatic guide wire.75 cases with difficult cannulation of the pancreatic duct had been inserted another guide wire into the right vertical direction of the duodenal papilla after retained a guide wire into the commom bile.Results 697cases(99.4%)with difficult cannulation of the bile duct were examined successfully at first time;74 cases(98.7%)with difficult cannulation of the pancreatic duct were examined successfully at first time.Conclusion Double guide wires technology is easy to use.The method of retaining a guide wire into the duct which was cannulated easily may increases the achievement ratio of cannulation into another duct.The check time was shortened significantly.