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Objective:To investigate the application of sentinel lymph node biopsy (SLNB) in early-staged cervical cancer by laparoscopy.Methods:It was a prospective, single-arm, single-center clinical study. Seventy-eight cases of cervical cancer patients were collected from July 2015 to December 2018 at the Fourth Hospital of Hebei Medical University. All the patients were injected with tracer into the disease-free block of cervical tissue after anesthesia by the same surgeon who learned sentinel lymph node (SLN) mapping technique in Memorial Sloan-Kettering Cancer Center, and underwent SLN mapping followed by complete pelvic lymphadenectomy. Moreover, all the dissected lymph nodes were stained with hematoxylin eosin staining (HE) pathological examination. Besides, the negative SLN on hematoxylin-eosin staining were detected by immunohistochemistry cytokeratin staining micro-metastasis. To analyze the distribution, detection rate, false negative rate the sensitivity and negative predictive value of the SLN in early-staged cervical cancer by laparoscopy, and explore the value of SLN mapping in predicting the lymph nodes metastasis in early-staged cervical cancer.Results:The overall detection rate of SLN in cervical cancer was 99% (77/78), bilateral detection rate was 87% (68/78). The average of 12.4 lymph node (LN) and 3.6 SLN were dissected for each patients each side. SLN of cervical cancer were mainly distributed in the obturator space (61.5%, 343/558), followed by external iliac (23.5%, 131/558), common iliac (7.3%, 41/558), para-uterine (3.8%, 21/558), internal iliac (2.2%, 12/558), para abdominal aorta (1.1%, 6/558), and anterior sacral lymphatic drainage area (0.7%, 4/558). Fourteen cases of LN metastasis were found among all 78 cases. There were a total of 38 positive LN, including 26 SLN metastasis and 12 none sentinel LN metastasis. Through immunohistochemical staining and pathological ultra-staging, 1 SLN was found to be isolated tumor cells (ITC), and 5 SLNs were found to be micro-metastases (MIC), accounting for 23% (6/26) of positive SLN. SLN mapping with pathological ultra-staging improved the prediction of LN metastasis in cervical cancer (2/14). Metastatic SLN mainly distributed in the obturator space (65%, 17/26), peri-uterine region (12%, 3/26), common iliac region (15%, 4/26), and external iliac region (8%, 2/26). The consistency of the diagnosis of lymph node metastasis by SLN biopsy and postoperative retroperitoneal lymph node metastasis showed that the Kappa value was 1.000 ( P<0.001), indicated that the metastasis status of SLN and retroperitoneal lymph node were completely consistent. The sensitivity, specificity, accuracy, false-negative rate, and negative predictive value of SLN biopsy in the diagnosis of lymph node metastasis were 100%, 100%, 100%, 0, and 100%, respectively. Conclusions:SLN in early-staged cervical cancer patients were mainly distributed in the obturator and external iliac space, pathalogical ultra-staging of SLN could improve the prediction of LN metastasis. Intraoperative SLN mapping is safe, feasible and could predict the state of retroperitoneal LN metastasis in early-staged cervical cancer. SLNB may replace systemic pelvic lymphadenectomy.
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Traditional Chinese medicine shows good hypoglycemic effect with mild efficacy, long duration and few adverse reac-tions. In recent years, the researches on the hypoglycemic effect of Ruikang Hospital Affilliated to traditional Chinese medicine mainly started from the mechanism of new target protein and pathway, for example, Chinese medicine monomers or compounds including as-tragalus polysaccharide, curcumin, berberine, emodin, total saponins of momordicacharantia, total saponins of momordicacharantia, Yitangkang, Jiangtang Sanhuang tablets, Jianpixiaokefang and Tangnaikang granule can activate Adenosine monophosphate ( AMP)-activated protein kinase ( AMPK) to play hypoglycemic effect.
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Objective: To investigate the impact of improved AHA cardiovascular health behavior score (CHS) on short-time systemic blood pressure variability (SBPV) in elder population. Methods: A total of 2464 participants ≥ 60 years from 3 hospitals of Kailuan area were taken for cohort study. The participants had no cardiovascular disease, not taking anti-psychotic drug, Parkinson treatment drug, anti-depression drug and analgesic drug within 2 weeks. All participants received 24-hour ambulatory blood pressure monitoring (ABPM) and the 24-hour, day-time, night-time SBPV were deifned by the standard deviation of 24-hour, day-time, night-time systolic blood pressure. The influence of CHS on SBPV was studied by multi-linear regression analysis. Improved cardiovascular health behavior and factors implied as changing the vegetable intake amount to salt amount by American Humane Association, 2010; boundary of BMI based on《Guidelines for prevention of overweight and obesity in Chinese adults》; status of exercise was deifed as the ideal status: ≥80 min/week, general status: Results: Finally, 1812 participants were recruited for survey and they were divided into 3 groups according to improved CHS: Group①, CHS (0-4) points,n=56, Group②, CHS (5-9) pointsn=1600 and Group③, CHS (10-14) points,n=156. The 24-hour SBPV in Groups①,②and③were 16.02 mmHg, 14.91 mmHg and 13.18 mmHg; day-time SBPV were 15.42 mmHg, 14.50 mmHg and 13.22 mmHg; night-time SBPV were 12.68 mmHg, 11.44 mmHg and 10.16 mmHg, allP Conclusion: CHS was negatively related to short-time SBPV in elder population.
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This study examined the analgesic effect of diprospan in rats with trigeminal neuralgia. Rat model of trigeminal neuralgic pain was established by loosely ligating the left infraorbital branch of the trigeminal nerve. After allodynia developed, the rats were randomly divided into 2 groups (n=20 in each): diprospan group, in which the rats received diprospan (7 mg/mL, 0.1 mL) injected to the left infraorbital foramen area; control group, in which saline (0.1 mL) was administered as the same manner as the diprospan group. The pain threshold (PT) in the left infraorbital area was measured before and 2, 6, and 8 weeks after the administration. The expression of neuropeptides [substance P, preprotachykinin A (PPTA), calcitonin gene-related peptide (CGRP)] in the trigeminal nerve was detected at the same time points as the PT measurement by immunohistochemistry or in situ hybridization method. The results showed that in the diprospan group, the PT was 10.65±1.26, 10.77±1.19 and 14.13±1.34 g 2, 6, and 8 weeks after the administration respectively, significantly higher than that before the administration (PT value: 0.36±0.11) (P0.05). The PT in the diprospan group was significantly greater than that in the saline group 2 and 6 weeks post-administration (P<0.05). In the diprospan group, the expression levels of neuropeptides were significantly reduced as compared with those in the saline group 2 and 6 weeks post-administration (P<0.05). It was concluded that diprospan has an obvious analgesic effect on the trigeminal neuropathic pain partly by reducing the expression of neuropeptides in the trigeminal ganglia.
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Objective To study the risk prediction for new intracerebral hemorrhage (ICH) with high sensitivity C-reactive protein ( hs-CRP) level. Methods In a retrospective, nested, case-controlled study, 323 cases of ICH were identified and matched with 646 controls. The hs-CRP levels at baseline were compared between the two groups. The relevance of different hs-CRP levels and the risk of ICH were analyzed. Results The ICH group had a higher median hs-CRP levels (1.10 mg/L) as compared with the control group (0. 66 mg/L) with significant difference ( P<0.01 ). In addition, the increase of risk associated with hs-CRP levels was primarily observed in the individuals with the highest quartile of hs-CRP levels(>2.12 mg/L). These patients had an increased risk of ICH (OR 2. 58, 95% CI 1. 77 to 3. 76) as compared with those in the lowest quartile(≤=0.30 mg/L). Individuals with basiline hs-CRP levels above the specified cut point of 3 mg/L ormore and those in the 80th percentile were at a markedly increased risk of ICH (for specified cut point of 3 mg/L,0R2.26, 95% CI 1.60-3.20, P<0.01; for 80th percentile, OR 2.24,95% CI 1.60-3.13, P <0.01, respectively). Conclusions Risk of ICH might be predicted with the level of hs-CRP. With the increase of hs-CRP level at baseline, the risk of ICH was increased.
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Objective To observe the distribution and influence factors of serum high sensitivity C-reactive protein (hs-CRP) in general population. Methods In a cross-sectional population survey, a total of 101 510 subjects who were employed by Kailuan Group had been carried out a healthy examination in the period of 2006 to 2007. In the statistical analysis, we observed 91 123 subjects (males 72 805, females 18 318) who had full information and met the inclusion criteria of the study. Results ( 1 ) The geometric means of hs-CRP were 0. 70 mg/L, 0. 70 mg/L and 0. 73 mg/L in all subjects, males and females,respectively, the 95th percentiles were 6.28 mg/L, 6.20 mg/L and 6.49 mg/L, respectively. The concentrations of hs-CRP increased with age in both males and females (P trend = 0. 001 ). Serum hs-CRP geometric mean was 0. 54 mg/L and the 95th percentile was 5.40 mg/L in health group, while the geometric mean was 0. 80 mg/L and the 95th percentile was 6. 57 mg/L in non-health group. (2) Multiple linear regression analysis showed that concentrations of hs-CRP were positively associated with gender, age,systolic blood pressure, body mass index, total cholesterol, triglycerides, fasting blood glucose, smoking history, history of coronary heart disease and stroke history, but concentrations of hs-CRP were inversely related with diastolic blood pressure, high-density lipoprotein cholesterol and alcohol history. Conclusion Serum concentrations of hs-CRP level increased with age, concentrations of hs-CRP were higher in females than males; a variety of cardiovascular factors effected the concentrations of hs-CRP.
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Objective: To study the relation among inducible nitric oxide synthase(iNOS), endothelial nitric oxide synthase(eNOS) and vascular endothelial growth factor (VEGF)in oral squamous cell carcinoma(OSCC) and their relation to clinical pathology and angiogenesis.Methods:OSCC tissue specimens were surgically obtained from 64 patients,the expression of iNOS,eNOS and VEGF in the samples were studied by immunohistochemistry technique. Microvessel density(MVD) was measured by counting the endothelial cells stained with anti-FⅧRAg antibody. Results: ①Positive VEGF and iNOS and eNOS immunostaining was detected in 39(60.94%),42(65.63%)and 45( 70.31%)of the cases respectively.②Expression of VEGF was significantly related to that of iNOS(P05).③MVD in OSCC tissue was positively correlated with the expression of VEGF and iNOS(P05).④VEGF expression was positively correlated to the pathological grade of OSCC(P0.05).Conclusion:iNOS,rather than eNOS, plays a positive role in OSCC development.iNOS and VEGF have a positive correlation in angiogenesis of OSCC.