ABSTRACT
To compare carbon nanoparticles with methylene blue for sentinel lymph nodes mapping in laparoscopic staging of early endometrial carcinoma.Forty five patients with stage I or stage Ⅱ endometrial carcinoma undergoing laparoscopic operation from January 2016 to January 2018 were randomly divided into two groups:methylene blue was applied in 20 cases and carbon nanoparticies were applied in 25 cases for sentinel lymph node (SLN) mapping in laparoscopic staging;and the images of two tracers were compared.The development time of nano-carbon group was shorter[(16.4±3.4) min vs.(21.0±5.9)min,t=3.26,P=0.02] and duration was longer [(73.1 ± 14.3) min vs.(54.6 ± 14.9)min,t=5.41,P=0.04] than those of methylene blue group.In lymphatic mapping,the detection rate of SLN in nano-carbon group was significantly higher than that of methylene blue group [95％ (21/22)vs.5/18].For detection of metastatic SLN,the sensitivity of methylene blue group was 1/2 and that of nano-carbon group was 4/4 (x2=66.70,P＜0.01).The results indicate that both methylene blue and Nano-carbon tracer can be used for SLN mapping in laparoscopic staging of early endometrial carcinoma,and nano-carbon tracer is recommended as the first choice to predict pelvic lymph node metastasis in endometrial carcinoma surgery.
ABSTRACT
Objective To investigate the changes of serum retinol binding protein 4 (RBP4) concentration in peripheral blood of normal gravidas at different stages during pregancy and the differential expression of serum RBP4 in gravidas with fetal growth restriction (FGR) in second trimester.Methods This study enrolled 80 gravidas who received routine prenatal examination and delivered in the Beijing Luhe Hospital Affiliated to Capital Medical University from January 2014 to January 2015,Forty gravidas were classified to FGR group as the birth weight of their fetuses was below two standard deviations or below the 10th percentile for the corresponding gestationas and same sex,or less than 2 500 g after 37 weeks.The other 40 gravidas who delivered newborns with normal birth weight (2 500 g ＜ birth weight ＜ 4 000 g) were used as control group.Levels of serum RBP4,plasma albumin,fasting blood glucose,triglyceride,total cholesterol,low density lipoprotein-cholesterol (LDL-C),hemoglobin,fasting insulin and vitamin A were determined before pregnancy and at 12-16,20-24,28-32 and 36-40 weeks of gestation.Homeostasis model assessment-insulin resistance (HOMA-IR) was calculated.Independent sample t test or analysis of variance,Chi-square test or Fisher exact test was used for statistical analysis.Pearson correlation was used to analyze the relationship between peripheral blood RBP4 level and neonatal birth weight at 20-24 weeks.Results (1) Serum RBP4 levels in normal gravidas were (24.65± 10.02),(29.86±23.40),(56.10± 12.28),(65.80±20.56) and (53.71 ±24.17) μg/ml before pregnancy and at 12-16,20-24,28-32 and 36-40 weeks of gestation,respectively,showing a gradually increasing trend with gestational week until a peak at 28-32 weeks and then followed by a decrease (F=14.173,P＜0.001).(2) The body mass index and placental weight of gravidas in FGR group were lower than those in control group [20.7±3.3 vs 22.9±2.1,(401.3±56.2) vs (501.3±64.7) g;t=22.590 and 2.487,both P＜0.05].(3) The fasting blood glucose,fasting insulin,HOMA-IR,RBP4 and plasma albumin in FGR group were lower than those in control group [(4.06± 0.4) vs (4.38 ± 0.4) mmol/L,(21.84± 15.2) vs (31.76 ± 1.5) μ U/ml,0.5 ± 0.2 vs 0.7±0.2,(41.78± 12.8) vs (65.80±20.5) μg/ml,(35.1 ±2.7) vs (36.5±2.3) g/L;t=3.419,2.355,3.419,6.263 and 2.462,all P＜0.05].Maternal serum RBP-4 at 20-24 weeks of normal gravidas and FGR gravidas were positively correlated with the birth weight of newborns (r=0.717 and 0.748,both P＜0.05).Conclusions Serum RBP4 of gravidas may be associated with the occurrence of FGR.
ABSTRACT
This study was aimed to evaluate the efficacy and safety of acupuncture treatment for diabetic peripheral neuropathy.MEDLINE, EMBASE, China National Knowledge Infrastructure (CNKI), and Wanfang database were searched. The study endpoints included clinical total efficacy, peripheral nerve conduction velocity and adverse reactions. The Review Manager software 5.2 was used in the bias and risk assessment as well as efficacy. GRADE profiler software was used to evaluate quality of evidences. The results showed that there were 18 randomized controlled trials (RCTs) with 1158 patients included. The clinical total efficacy rate of acupuncture treatment was obviously better than the drug control group [RR: 1.38, 95%CI (1.25, 1.53),P < 0.000 01]. The sensory nerve conduction velocity was that for nervus medianus, the acupuncture treatment group was superior to the drug control group [MD = 2.55, 95%CI (1.23, 3.87),P = 0.000 1]; for nervus peroneus communis, the acupuncture treatment group was superior to the drug control group [MD = 3.42, 95%CI (2.56, 4.28),P < 0.000 01]. The motor nerve conduction velocity was that for nervus medianus, the acupuncture treatment group was superior to the drug control group [MD= 4.10, 95%CI (1.01, 7.19),P = 0.009); for the nervus peroneus, the acupuncture treatment group was superior tothe drug control group [MD = 3.09, 95%CI (1.99, 4.19),P < 0.000 01]. The adverse reactions and safety indicators were that no adverse reaction was reported in both studies with no abnormal safety indicator. The quality of evidence showed that the sensory nerve conduction velocity for nervus peroneus communis was moderate; the motor nerve conduction velocities for nervus medianus and nervus peroneus communis were low. While, the clinical efficacy rate and the quality of evidence for sensory nerve conduction velocity of nervus medianus were relatively low. It was concluded that the current clinical evidences were uncertain for the efficacy and safety of acupuncture in diabetic peripheral neuropathy treatment.