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【Objective】 To study the characteristics of HIV infection among voluntary blood donors in Shijiazhuang from 2011 to 2021, so as to provide reference for decision making in the control of HIV for blood centers. 【Methods】 The confirmatory results of HIV reactive samples in initial screening among voluntary blood donors from 2011 to 2021 in our center were statistical analyzed. 【Results】 A total of 2 008 299 samples from 1 667 315 blood donors were detected, among which 3 217 samples were HIV reactive and 234 were confirmed positive, with the positive rate at 11.65/100 000 and the prevalence of 14.03/100 000. The prevalence in men was higher than that in women (16.52/100 000 vs 1.39/100 000), in first-time blood donors higher than that in repeated donors (17.27/100 000 vs 8.12/100 000), in whole blood donors higher than that in plateletpheresis donors (12.01/100 000 vs 8.41/100 000), and the differences were statistically significant (P<0.05). The male homosexual transmission was the main routes of transmission, accounting for 62.39% (146/234). And 72% of double-reagent reactive samples were confirmed positive. Four samples were screened in the serological window period and 6 samples were from HIV positive confirmed donors. 【Conclusion】 The HIV prevalence among voluntary blood donors in Shijiazhuang was low. A certain percentage of repeated blood donors got newly infected. NAT could shorten the detection window period of HIV. Since some confirmed positive samples had not been detected out by NAT, publicity and education should be strengthened to reduce the probability of infected or high-risk groups to participate in blood donation.
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To evaluate the clinical effects and pathological characteristics of gastric tumors of fundic gland type treated with endoscopic submucosal dissection (ESD), data of 7 patients who treated by ESD and whose postoperative pathology indicated gastric adenocarcinoma of fundic gland type or gastric oxyntic gland adenoma in Endoscopic Center of Beijing Chao-Yang Hospital of Capital Medical University from August 2018 to June 2022 were collected. The clinical characteristics, surgical complications, preoperative and postoperative pathological data and follow-up data were evaluated. The lesions of the 7 patients were all located at gastric fundus, and were treated by ESD successfully. No bleeding, perforation or other complications occurred during and after the operation. Postoperative pathology showed that tumor cells originated from deep mucosa with an invasive growth pattern. Most of tumor surfaces were covered with normal concave epithelium. Tumors infiltrated into submucosa in 4 patients, and submucosa infiltration depth was more than 500 μm (550 μm) in 1 patient. Immunohistochemistry showed that MUC-6 was diffusely positive, indicating that the tumor originated from the main cell source. The expressions of MUC-2, MUC-5AC, CDX-2, CD10, and CgA were negative in all cases. With the mean follow-up time of 21 months, the ulcer healed well after the operation, with no recurrence. Gastric tumors of fundic gland type have relatively unique biological characteristics, and ESD is the preferred treatment. In addition, the histological characteristics can be used to differentiate from other gastric tumors by immunohistochemistry.
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Objective To investigate the value of ultrasound and contrast-enhanced ultrasound (CEUS) in the differential diagnosis of mass-type autoimmune pancreatitis (AIP) and pancreatic ductal adenocarcinoma (PDAC). Methods A retrospective analysis was performed for the clinical data, ultrasound findings, and CEUS findings of 11 patients with mass-type AIP who were diagnosed in Tangshan Workers' Hospital from January 2015 to December 2020, and their characteristic manifestations were analyzed and compared with the data of 23 patients with PDCA. The chi-square test was used for comparison of categorical data between two groups. Results For the 11 patients with mass-type AIP, CEUS had a diagnostic accuracy of 63.64%, and all of these patients had hypoechoic single lesions; the patients with clear boundaries, regular morphology, pancreatic duct dilatation or cutoff, and blood flow signal accounted for 54.55%, 63.64%, 18.18%, and 36.36%, respectively, while in the PDCA group, such patients accounted for 30.43%, 34.78%, 78.26%, and 21.74%, respectively, and there was a significant difference in the presence or absence of pancreatic duct dilatation or cutoff between the two groups( χ 2 =11.089, P 0.05). For the 11 patients with mass-type AIP, CEUS showed that 7 patients (63.64%) had hyperenhancement and 4 (36.36%) had iso-enhancement in the arterial phase, and 5 patients (45.45%) had hyperenhancement in the arterial phase and 6 (54.55%) had iso-enhancement in the venous phase; for the 23 patients with PDCA, 22 (95.65%) had hypoenhancement of lesions in both arterial and venous phases, and there were significant differences in the enhancement pattern in arterial and venous phases between the two groups ( χ 2 =30.345 and 30.084, both P < 0.05). Conclusion The enhancement pattern of CEUS and the presence or absence of pancreatic duct dilatation or cutoff have a relatively high value in the differential diagnosis of mass-type AIP and PDCA.
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Objective:To evaluate the effect of autologous platelet plasmapheresis (APP) and reinfusion on acute kidney injury (AKI) after total aortic arch replacement.Methods:Sixty American Society of Anesthesiologists physical status Ⅲ or Ⅳ patients of both sexes, aged 18-64 yr, with body mass index of 19-34 kg/m 2, scheduled for total aortic arch replacement under general anesthesia, were divided into 3 groups( n=20 each)using a random number table method: APP-reinfusion group (group A), acute normovolemic hemodilution (ANH) group (group N) and autologous blood withdrawal-reinfusion group (group C). In group A, APP was completed before the operation, concentrated red blood cells were transfused timely according to the intraoperative conditions, and platelet-poor and platelet-rich plasma were transfused after protamine neutralization.In group N, ANH was completed before the operation, and the whole blood released was transfused after protamine neutralization.Autologous blood withdrawal and washed red blood cell (RBC) transfusion were only performed in group C, and autologous blood withdrawal was performed in group A and group N. Cervical venous blood and urine samples were collected at 10 min after anesthesia induction (T 1), at 5min after cardiopulmonary bypass (T 2), immediately after the end of surgery (T 3), at 24h and 48h after surgery (T 4、5) for determination of the concentrations of hematocrit (Hct), plasma free hemoglobin (fHb), urinary neutrophil gelatinase-associated lipocalin (NGAL), tissue metalloproteinase-inhibitor -2 (TIMP-2) and insulin-like growth factor binding protein-7 (IGFBP-7) and for calculation of [TIMP-2]×[IGFBP-7]. Glomerular filtration rate (GFR) and concentrations of reatinine (Scr), urea, uric acid and cystatin C were measured before surgery, on the right postoperative day, and at 1, 2 and 3 days after surgery.The intraoperative requirements for allogeneic blood product transfusion, postoperative mechanical ventilation time, duration of intensive care unit (ICU) stay and hemodialysis were recorded. Results:Compared with group C, the postoperative requirement for allogeneic RBC transfusion in group A and group N and the allogeneic platelet transfusion in group A were significantly reduced, Hct at T 2 in group N was decreased, fHb at T 3 and T 4 in groups N and group A was decreased, Scr concentration on the right postoperative day and at 1 day after operation in group A was decreased, and cystatin C concentration on the right postoperative day and at 2 and 3 days after operation in group A was decreased ( P<0.05). Compared with group N, the postoperative requirement for the allogeneic platelet transfusion, concentrations of NGAL and TIMP-2 at T 3-5, IGFBP-7 concentration and [TIMP-2]×[IGFBP-7] at T 3 and T 4, Scr concentration on the right postoperative day and at 1 day after operation and cystatin C concentration on the right postoperative day and at 2 and 3 days after operation were significantly decreased in group A ( P<0.05). Conclusion:APP-reinfusion provides better efficacy in alleviating postoperative AKI than ANH in the patients undergoing total aortic arch replacement.
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Objective@#To study the therapeutic value of endoscopic ultrasonography-guided hepaticogastrostomy(EUS-HG) for patients with high malignant biliary obstructive jaundice.@*Methods@#A total of 56 patients with high malignant obstructive jaundice hospitalized at the Second Affiliated Hospital of Nanjing Medical University and the Second Affiliated Hospital of Xuzhou Medical University from January 2014 to December 2017 were included in the study. There were 29 males and 27 females with median age of 72 (60-82) years. Patients were randomized into two groups according to the random number table, the EUS-HG group (n=20) treated with EUS-HG and the percuteneous transhepatic cholangiodrainge(PTCD) group (n=36) treated with PTCD. The operative success rate, curative effect, complications and operation cost were compared between the two groups, and the median unblock period of plastic double pig tail stent was observed.@*Results@#(1)The success rates were 100% in both groups. (2) Preoperative and one-month postoperative levels of the following were tested and compared. Levels of total bilirubin were 362.15±138.27 μmol/L, 56.85±28.57 μmol/L in the EUS-HG group and 356.47±130.69 μmol/L, 60.93±25.79 μmol/L in the PTCD group, respectively. Levels of alkaline phosphatase were 896.57±357.29 U/L, 146.59±48.63 U/L in the EUS-HG group and 883.65±364.32 U/L, 151.57±49.73 U/L in the PTCD group, respectively. Levels of alanine aminotransferase were 252.36±38.77 U/L, 60.29±31.57 U/L in the EUS-HG group and 246.26±32.57 U/L, 62.56±32.87 U/L in the PTCD group. Levels of aspartate aminotransferase were 259.37±30.64 U/L, 62.28±26.58 U/L in the EUS-HG group and 242.37±29.52 U/L, 60.28±29.57 U/L in the PTCD group, and there was no significant difference between the two groups (P>0. 05). CRP levels were 52.57±31.95 mg/L, 16.95±8.77 mg/L in the EUS-HG group and 53.42±35.79 mg/L, 25.13±14.77 mg/L in the PTCD group (P<0.05). (3)There was significant difference in remission rate of anorexia and abdominal distension between the two groups [80.0%(16/20) VS 52.8%(19/36), P<0.05]. There was no significant difference in symptom relief of jaundice, pruritus or abdominal pain between the two groups [90.0%(18 /20)VS 91.7%(33/36), P>0.05]. (4) The incidence of total complications in the EUS-HG group (20.0%, 4/20) was significantly lower than that in the PTCD group (47.2%, 17/36, P<0.05). (5)The cost of operation in the EUS-HG group (22 685.26±2 356.16 yuan) was slightly higher than that in the PTCD group (20 529.57±4 135.63 yuan, P>0.05). (6) The median unblock period of double pig tail plastic stents in EUS-HG group patients was 102 days.@*Conclusion@#EUS-HG is a safe and effective method for the treatment of high malignant biliary obstructive jaundice. It can be used as the first choice for treatment after failure of conventional ERCP.
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Objective To study the therapeutic value of endoscopic ultrasonography-guided hepaticogastrostomy( EUS-HG) for patients with high malignant biliary obstructive jaundice. Methods A total of 56 patients with high malignant obstructive jaundice hospitalized at the Second Affiliated Hospital of Nanjing Medical University and the Second Affiliated Hospital of Xuzhou Medical University from January 2014 to December 2017 were included in the study. There were 29 males and 27 females with median age of 72 (60-82) years. Patients were randomized into two groups according to the random number table, the EUS-HG group ( n=20) treated with EUS-HG and the percuteneous transhepatic cholangiodrainge( PTCD) group (n=36) treated with PTCD. The operative success rate, curative effect, complications and operation cost were compared between the two groups, and the median unblock period of plastic double pig tail stent was observed. Results (1) The success rates were 100％ in both groups. (2) Preoperative and one-month postoperative levels of the following were tested and compared. Levels of total bilirubin were 362. 15 ± 138. 27 μmol/L, 56. 85 ± 28. 57 μmol/L in the EUS-HG group and 356. 47 ± 130. 69 μmol/L, 60. 93 ± 25. 79 μmol/L in the PTCD group, respectively. Levels of alkaline phosphatase were 896. 57±357. 29 U/L, 146. 59±48. 63 U/L in the EUS-HG group and 883. 65 ± 364. 32 U/L, 151. 57 ± 49. 73 U/L in the PTCD group, respectively. Levels of alanine aminotransferase were 252. 36±38. 77 U/L, 60. 29±31. 57 U/L in the EUS-HG group and 246. 26 ± 32. 57 U/L, 62. 56 ± 32. 87 U/L in the PTCD group. Levels of aspartate aminotransferase were 259. 37 ± 30. 64 U/L, 62. 28 ± 26. 58 U/L in the EUS-HG group and 242. 37 ± 29. 52 U/L, 60. 28±29. 57 U/L in the PTCD group, and there was no significant difference between the two groups (P>0. 05). CRP levels were 52. 57±31. 95 mg/L, 16. 95±8. 77 mg/L in the EUS-HG group and 53. 42± 35. 79 mg/L, 25. 13 ± 14. 77 mg/L in the PTCD group ( P<0. 05) . ( 3 ) There was significant difference in remission rate of anorexia and abdominal distension between the two groups [ 80. 0％( 16/20) VS 52. 8％( 19/36) , P<0. 05] . There was no significant difference in symptom relief of jaundice, pruritus or abdominal pain between the two groups [ 90. 0％( 18 /20) VS 91. 7％( 33/36) ,P>0. 05] . ( 4) The incidence of total complications in the EUS-HG group ( 20. 0％,4/20) was significantly lower than that in the PTCD group (47. 2％,17/36, P<0. 05). (5)The cost of operation in the EUS-HG group (22685. 26±2356. 16 yuan) was slightly higher than that in the PTCD group (20529. 57±4135. 63 yuan, P>0. 05). (6) The median unblock period of double pig tail plastic stents in EUS-HG group patients was 102 days. Conclusion EUS-HG is a safe and effective method for the treatment of high malignant biliary obstructive jaundice. It can be used as the first choice for treatment after failure of conventional ERCP.
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Objective 3D printing has been used in the assistanceof surgical planning and the development of personal-ized prostheses.This study was to determine the feasibility of using a 3D printer for the purpose of producing personalized pros-theses for complex rib fracture fixation .Methods Using data from a high-resolution CT scan of 10 ribs of 3 cases with rib frac-ture, rib moldswere generated with computer software and fabricated with the 3D printer using the fused deposition modeling method.The 3D printing molds were used for custom-designed titanium plate.Results The average length of the 3D models of ribs is 8.45 cm.The mean time of fabricating models was 18.8 minutes and 4.6 gram polylactic acid was consuming on aver-age.The mean error of dimension of 3D models is less than 0.2 mm.Reshaping plates spends 3.3 minutes on average.Radio-logical follow-up for bothcases demonstrated successful fixation at 3 months.Conclusion These cases demonstrate the feasibili-ty of the use of 3D modeling and printing to develop personalizedplates and can ease the difficulty of complex rib fracture .
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Objective To study the clinical efficacy of intra-operative implantation of 125Ⅰ particles to treat advanced pancreatic cancer,and to evaluate the treatment effects on pain relief and survival of patients.Methods A retrospective study was conducted on 53 patients who were treated in the Third Affiliated Hospital of Inner Mongolia Medical University from May 2013 to November 2016.The patients were divided into the particle implantation group (n =32,palliative operation combined with intra-operative implantation of 125Ⅰ particles or just intra-operative implantation) and the control group (n =21,palliative operation).The outcomes on pain relief and median survival after operation were compared between the 2 groups.Results Patients in the implantation group were implanted with 20 to 70 (41.4± 12.1) particles.There were no postoperative complications such as pancreatic fistula and bleeding.There was also no perioperative death.Of the 46(86.8％) patients who were followed-up,three patients were still alive at the time the data were analyzed.The postoperative survival time of the patients ranged from 3 to 27 months.For the implantation group,the median survival time was 11.5 months.The 3-,6-,12-,24-months survival rates were 100.0％,90.6％,65.6％,15.6％,respectively.Postoperative pain relief happened in 92.6％ of patients.For the control group,postoperative survival time ranged from 2 to 17 months.The median survival time was 7 months.The 3-,6-,12-,24-months survival rates were 95.2％,57.1％,9.5％,0,respectively.Postoperative pain relief happened in 16.7％ of patients.Postoperative pain relief for patients in the implantation group was significantly better than the preoperative,and than patients in the control group (both P ＜ 0.05).The Log-rank test showed a significant difference in survival between the two groups (P＜0.05).Conclusion Particle implantation significantly relieved pain and prolonged survival time of the patients.
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Objective: To evaluate the clinical efficacy and long-term efficacy of Shunwei Jiangni Fang in treating the liver- spleen- stomach disharmony and cold- dampness- heat recurrent reflux esophagitis. Methods: A total of 100 recurrent RE patients were divided into treatment group and control group by the random and control principle, with 50 cases in each group. Patients of 2 groups were treated with Shunwei Jiangni Fang and pantoprazole sodium entericcoated capsules respectively for 8 weeks. By comparing TCM syndrome scores and esophagus 24 h- pH parameters improvement, the clinical efficacy and safety of Shunwei Jiangni Fang in treating the liver-spleen-stomach disharmony and cold-dampness-heat recurrent reflux esophagitis, and perform statistics on the recurrence 6 months after treatment ending were evaluated. Results: ① For the patients with TCM syndromes in the treatment group, 4 cases were recovered, 17 cases were improved, 22 cases were effective, and the total effective rate was 86％; for the patients with TCM syndromes in the control group, 2 cases were recovered, 8 cases were improved, 14 cases were effective, and total effective rate was 48％. Difference of total effective rate for 2 groups was significant (P ＜ 0.05). The heartburn, belching, dry mouth, bitter taste, tiredness, distended abdomen and sticky stool in treatment group were more improved than those of control group (P ＜ 0.05); ② In the control group, the patient's 24 h-pH parameters could be improved, especially, the 24h gastric reflux times and times of reflux ＞ 5min could be reduced more than the control group, and difference was significant (P ＜ 0.05). ③ The treatment group was able to improve the patients' esophageal mucosal inflammation, with no statistically significant difference from the control group (P ＞ 0.05). ④ At 6 months after treatment, the recurrence rate of treatment group and control group was 6.0％ and 28％ respectively, and difference was significant (P ＜ 0.05). Conclusions: Shunwei Jiangni Fang can treat the liver-spleen-stomach disharmony and cold-dampness-heat recurrent reflux esophagitis, with apparently efficacy. It can effectively improve the clinical symptoms, reduce the reflux occurrence times, reduce esophageal mucosal inflammation, lower the recurrence rate, prevent apparent adverse reactions, thus, it shall be widely promoted.
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Objective To compare the diagnostic value of shear wave elastography and 18F-FDG PET/CT imaging in diagnosis of thyroid microcarcinoma.Methods Shear wave elastography and 18F-FDG PET/CT data of patients with thyroid nodules confirmed by pathology were analyzed retrospectively.The sensitivity,specificity,accuracy,positive and negative predictive value of the two methods in diagnosis of malignant thyroid micronodules were compared.Results In all of the 48 micronodules,37 were malignant,11 were benign.The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of shear wave elastography and 18F-FDG PET/CT were 91.89％ (34/37),81.82％ (9/11),89.58％ (43/48),94.44％ (34/36),75.00％ (9/12) and 29.73％ (11/37),72.73％ (8/11),39.58％ (19/48),78.57％ (11/ 14),23.53％ (8/34),respectively.The sensitivity,accuracy and negative predictive value between the two methods had statistical difference (all P＜0.05),and the specificity and positive predictive value between the two methods had no statistical difference (both P＞0.05).Conclusion Compared to 18F FDG PET/CT imaging,the diagnositic value of shear wave elastography in diagnosis of thyroid microcarcinoma has obvious advantages.
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Objective@#To investigate the safety and efficacy of the Weitan Waifu patch on the postsurgical gastroparesis syndrome (PGS) of gastrointestinal cancer.@*Methods@#The multi-center, double-blind, randomized controlled trial was conducted with superiority design. Patients with PGS of gastrointestinal cancer diagnosed in 4 AAA hospitals and the abdominal symptom manifested as cold syndrome by Chinese local syndrome differentiation were recruited. These patients were randomly divided into two groups according to 1∶1 proportion. Placebo or Weitan Waifu patch was applied in control group or intervention group, respectively, based on the basic treatments, including nutrition support, gastrointestinal decompression, promoting gastric dynamics medicine.Two acupuncture points (Zhongwan and Shenque) were stuck with placebo in control group or patch in treatment group. The intervention course was 14 days or reached the effective standard.@*Results@#From July 15, 2013 to Jun 3, 2015, 128 participants were recruited and 120 eligible cases were included in the full analysis set (FAS), and 60 cases in each group. 88 cases were included in the per-protocol set (PPS), including 45 cases in the treatment group and 43 cases in the control group. In the FAS, the clinical effective rate in the treatment group was 68.3%, significantly superior than 41.7% of the control group (P=0.003). The medium time of effective therapy in the treatment group was 8 days, significantly shorter than 10 days in the control group (P=0.017). In the FAS, 3 adverse events occurred in the treatment group, including mild to moderate decrustation, pruritus and nausea. The incidence rate of adverse events was 5.0% (3/60) and these symptoms were spontaneously remitted after drug withdrawal. No severe adverse events were observed in the control group. There was no significant difference between these two groups (P=0.244).@*Conclusion@#Weitan Waifu patch is a safely and effectively therapeutic method for patients with PGS (cold syndrome) of gastroenterological cancer.@*Trial registration@#International Standard Randomized Controlled Trial Number Register, ISRCTN18291857
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Objective To study the clinical value of heat shock protein (HSP)70 in the diagnosis of neonatal asphyxia and the correlation of HSP70 and Neonatal Behavioral Neurological Assessment (NBNA)score.Methods From January 2014 to June 2016,full-term neonates born in our hospital were enrolled in the study and assigned into mild and severe asphyxia groups.Normally delivered full-term infants were assigned to the control group.Blood from umbilical artery were extracted immediately after birth and HSP70 levels were detected using ELISA.The NBNA scores were recorded at the 7th,14th and 28th-day after birth.Results HSP70levels in both mild (n =46 )and severe (n =35 )asphyxia groups were significantly higher than the control group(n =50)[(14.4 ±2.7)ng/ml、(17.7 ±4.5)ng/ml than(11 .9 ± 2.3)ng/ml,P <0.05].The severe asphyxia group had even higher HSP70 levels than the mild asphyxia group (P <0.05).The NBNA scores of both asphyxia groups were significantly lower than the control group (P <0.05).The umbilical pH values of both two asphyxia groups were also significantly lower than the control group(P <0.05).Correlation analysis showed that HSP70 level was negative correlated with NBNA score (7th,14th,28th-day)(r =-0.574、-0.493、-0.208,P <0.05).The HSP70 level was negatively correlated with umbilical pH (r =-0.576,P <0.05).The area under curve(AUC)for HSP70 levels to predict asphyxia was 0.798(95%CI 0.722 ~0.874,P <0.05).Conclusions HSP70 level in umbilical cord blood can be used as an indicator for neonatal asphyxia.The more severe the asphyxia,the higher the HSP70 levels and the lower NBNA score and umbilical pH.
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Objective The aim of this study was to investigate mutations of 41 STR loci. Methods 4546 bloodstain samples were typed from 1932 father–mother–child trios by using AGCU_21+1, AGCU_EX22 and GlobalFiler_ExpressTM amplification Kit. Calculate the mutation rates of STR loci. Results 154 mutations were identified at 32 of the 41 loci. The average mutation rate was 1.0×10-3per locus(95%CI: 0.8~1.1×10-3), and the mutations of SE33 was highest. 152(98.7%) mutation events were one-step mutation, 2(1.3%) events were two-steps. The mutation events occurred in 150 father–mother–child triplets. The mutations in 146(97.3%) triplets occurred at single locus, 8 mutations were observed at two loci in 4(2.7%) triplets simultaneously. 104 paternal and 22 maternal mutations could be determined under 79212 paternal and maternal allelictransfers. The ratio of paternal versus maternal mutations was 4.7:1, and 28 unassigned mutations were observed. Conclusion STR mutation are common in paternity testing, and we should pay more attention to it.
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Objective To evaluate the effect of ischemic postconditioning on myocardial injury in the patients undergoing cardiac valve replacement under cardiopulmonary bypass (CPB).Methods Thirty patients of both sexes,aged 21-59 yr,of American Society of Anesthesiologists physical status Ⅱ or Ⅲ (New York Heart Association Ⅱ or Ⅲ),with left ventricular ejection fraction ≥ 40％,scheduled for elective cardiac valve replacement under CPB,were divided into 2 groups (n=15 each) using a random number table:control group (C group) and ischemic postconditioning group (P group).In group P,ischemic postconditioning was induced by 3 cycles of 30 s aortic unclamping followed by 30 s cross-clamping starting from 5 min before complete opening of the ascending aorta.After induction of anesthesia and before operation (T1),at 1 h after opening of the ascending aorta (T2),at the end of operation (T3),and at 12,24 and 48 h after opening of the ascending aorta (T4-6),blood samples were taken from the radial artery for determination of plasma concentrations of heart-type fatty acid-binding protein (H-FABP),ischemia-modified albumin (IMA),and cardiac troponin Ⅰ (cTnI).Myocardial specimens in the right auricle were obtained at T2,and the pathological changes were examined using an optical microscope.Results The concentrations of plasma cTnI at T2-6 and H-FABP and IMA at T2-5 were significantly higher than those at T1 in the two groups (P＜0.05).Compared with group C,the concentrations of plasma cTnI at T2-6,H-FABP at T2-4,and IMA at T2,3 were significantly decreased (P＜0.05),and the pathological changes of myocardial tissues were significantly reduced in group P.Conclusion Ischemic postconditioning can reduce myocardial injury in the patients undergoing cardiac valve replacement under CPB.
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Objective To evaluate the advantage of using computer navigation system in the resection of rib tumors.Methods We carried out rib tumor resection in 5 patients using computer navigation system.Preoperative CT of each patient was performed.The preoperation CT-based planning was made for every patient with the navigation system software including confirming the tumor surgical margin and designing resection margin.A C-arm scan was carried out intraoperatively.With image fusion of both data,tumor resection were performed under navigation image guidance.Results The mean time of image fusion was 58 minutes.Four tumor resection specimens showed safe and clear margins.Histological examination of all tumor specimens showed tumor-free margins.One patient who was suspected lung cancer with bone metastases was performed a biopsy under navigation image guidance and obtained a pathology diagnose successfully.Conclusion The computer navigation system helps surgeons determine the surgical margin,implement precision tumor resection and reduce surgical damage.
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To strengthen the pediatric residents' communication ability in rediatric residency standardized training is very important for improving quality of medical provider-patient relationship and prevent medical disputes. At present, in China's pediatric medical units at all levels of medical care for the hospitalized children groups there exist such characteristics as only child, parents doting over their children, excessive stress and fear in diagnosis and treatment and so on. From the analysis of current status, it can be seen that in clinical practice, pediatric physicians' doctor-patient communi-cation is affected by three aspects: children, parents, physicians , and there exist such problems as children's lack of coordination, parents' lack of medical care knowledge, residents' lack of clinical and communication experience. Therefore, it is necessary to strengthen the special training of pediatric residents' doctors and patients in the standardized training period, establish the feedback mechanism of communication between doctors and patients and. make targeted improvements in view of the weak link in the communication between doctors and patients, so as to improve the training program of the pediatric residents' doctor-patient communication ability.
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Objective To examine the correlation between the ultrasonic feature of tibial nerve and the scores of Michi?gan neuropathy screening instrument(MNSI)in type 2 diabetic mellitus (T2DM) and to provide information for early diagno?sis of diabetic peripheral neuropathy(DPN). Methods Based on scores of MNSI, 95 cases of T2DM patients were divided into three different groups:group B(0-2.4 scores), C(2.5-4.4 scores)and D(≥4.5 scores). Ultrasound parameters of group A (n=30) were compared with group B (n=32), group C (n=31) and group D (n=32). These parameters includes nerves′s an?teroposterior dimension, transverse diameter, cross-sectional area and fasciculus echo, thescreen clothstructure, epineuri?um and the demarcation with neighbourhood structures. Correlation of MNSI with ultrasound performance of tibia nerve was also tested. Results Compared with group A, transverse diameter in group B did not show a obvious change, but anteropos?teror dimension, transverse diameter, cross-sectional area in group C, group D all increase.(P 0.05). There was a positive correlation between the nerves′s anteroposterior di?mension, transverse diameter, cross-sectional area with MNSI, rs were 0.656、0.657 and 0.681 respectively (P<0.05 in all three cases). Conclusion Certain correlation was observed between MNSI and tibial never ultrasonic feature in T2DM pa?tients;the higher MNSI scores , the greater chance of presence of abnormal sonographic features of tibial nerve.
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<p><b>OBJECTIVE</b>To investigate the clinical features, diagnostic and therapeutic methods of primary hepatic neuroendocrine carcinoma.</p><p><b>METHODS</b>The clinicopathological data of fourteen patients with primary hepatic neuroendocrine carcinoma confirmed by pathology were analyzed retrospectively and related literatures were reviewed.</p><p><b>RESULTS</b>The fourteen patients, including eight males and six females, had an age range of 23-58 years (mean 45.9 years). Four tumors were located in the right liver lobe, four in the left liver lobe and six in both. The clinical manifestations were nonspecific and variable. The most common clinical manifestation was abdominal distention or right upper quadrant pain. Radiological findings were not specific and could not distinguish primary hepatic neuroendocrine tumor from hepatocellular carcinoma. Diagnosis of primary hepatic neuroendocrine tumor was confirmed by pathology using immunohistochemical staining and by the absence of extrahepatic primary lesions. Extrahepatic primary neuroendocrine carcinoma was ruled out by ultrasonography, computed tomography (CT), magnetic resonance imaging (MRI), positron emission tomography-computed tomography (PET-CT), preoperative gastrointestinal endoscopy and long-term postoperative follow up. Three patients received surgical treatment, two cases received surgical resection and radiofrequency ablation (RFA), six patients received transarterial chemoembolization, one case received orthotopic liver transplantation, one case only received exploratory laparotomy, and one case received chemotherapy. All 14 patients were followed up and seven of them are still alive, the others died of liver failure or recurrence.</p><p><b>CONCLUSIONS</b>Primary hepatic neuroendocrine carcinomas are extremely rare. Its diagnosis should be confirmed by pathology. Preoperative fine needle biopsy is strongly recommended. Prognosis is relatively favorable. Surgical resection is treatment of first choice, and TACE, RFA, and chemotherapy can be used for unresectable patients.</p>
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Biopsy, Fine-Needle , Carcinoma, Hepatocellular , Pathology , Therapeutics , Carcinoma, Neuroendocrine , Pathology , Therapeutics , Catheter Ablation , Chemoembolization, Therapeutic , Hepatectomy , Liver , Pathology , Liver Neoplasms , Pathology , Therapeutics , Magnetic Resonance Imaging , Positron-Emission Tomography , Prognosis , Retrospective Studies , Tomography, X-Ray ComputedABSTRACT
<p><b>OBJECTIVE</b>To investigate the promoter methylation of p16, FHIT and RASSF1A gene and telomere damage in the workers exposed to coal tar pitch, and to explore the effective biomarker of occupational exposure to coal tar pitch.</p><p><b>METHODS</b>180 cases of workers exposed to coal tar pitch in a certain carbon plant named as exposure group, and 145 healthy cases with a medical examination in the first affiliated hospital of Zhengzhou University were selected as control group. Relative telomere length in peripheral blood DNA was detected using real-time quantitative PCR, and the promoter methylation rate of p16, RASSF1A and FHIT gene in peripheral blood DNA were determined by real-time quantitative methylation specific PCR. The relative telomere length and gene promoter methylation in two groups were compared, and influencing factors were analyzed.</p><p><b>RESULTS</b>Relative telomere length in exposed group was lower than that in the control group, and the difference was statistically significant (Z = -5.395, P < 0.001). There was no significant difference in the promoter methylation rate of p16, FHIT and RASSF1A gene between the two groups (P > 0.05). Stratification analysis by gender, age, and smoking, we found that when the age was less than or equal to 40, the promoter methylation rate of p16 in exposed group was more than that in control group, and the difference was statistically significant (Z = -1.914, P = 0.011).</p><p><b>CONCLUSION</b>Occupational exposure to coal tar pitch may induce leukocyte DNA telomere length of human peripheral blood shortened, and may not change the promoter methylation rates of p16, FHIT and RASSF1A gene.</p>
Subject(s)
Humans , Acid Anhydride Hydrolases , Genetics , Coal Tar , Cyclin-Dependent Kinase Inhibitor p16 , Genetics , DNA Methylation , Leukocytes , Neoplasm Proteins , Genetics , Occupational Exposure , Promoter Regions, Genetic , Telomere , Tumor Suppressor Proteins , GeneticsABSTRACT
BACKGROUND:Gene transfer techniques have been actively used in tissue regeneration therapy. Bone morphogenetic protein 7 with osteoinductive properties can effectively promote osteoblast growth and new bone formation. OBJECTIVE:To explore the influence of bone morphogenetic protein 7 adenovirus gene transfection on the biological function of bone marrow stromal stem cels.METHODS:Goat bone marrow stromal stem cels were isolated, cultured and transfected by recombinant adenovirus containing bone morphogenetic protein 7 (Adeno-BMP7). Cel ultrastructure was observed by transmission electronic microscope, cel cycle was detected by flow cytometry, expression of bone morphogenetic protein 7 was measure by western blot assay, and Von Kossa staining was used to observe the formation of calcium nodules. Bone marrow stromal stem cels transfected for 3 days and untransfected were used to prepare coral-cel complexes that were injected subcutaneously into the back of nude mice for 4 weeks and 8 weeks, folowed by gross observation and histological examination. RESULTS AND CONCLUSION: Adeno-BMP7-transfected bone marrow stromal stem cels appeared to have active substance synthesis and metabolism. Adeno-BMP7 transfection played no effect on the cel cycle of bone marrow stromal stem cels. Bone morphogenetic protein 7 was expressed in the transfected bone marrow stromal stem cels. Larger calcium nodules were visible after Adeno-BMP7 transfection. Adeno-BMP7-transfected bone marrow stromal stem cels showed stronger osteogenic capability and higher bone quality. These results demonstrate that Adeno-BMP7 transfection can effectively promote the osteogenic differentiation of bone marrow stromal stem cels.