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Objective:To explore the causes and influencing factors of financial toxicity in young breast cancer survivors, and to provide evidence for intervention program development to improve financial toxicity in young breast cancer survivors.Methods:Using descriptive qualitative research methods, 29 young breast cancer patients from September to December 2021 in Breast Surgery Follow-up Clinic of Fudan University Shanghai Cancer Center were interviewed. The Nvivo 12.0 qualitative data analysis software was used to analyze the data.Results:Four themes were extracted as following, direct cost of cancer treatment was the primary cause of financial toxicity, indirect costs related to cancer and treatment cannot be ignored, long-term effects of cancer and treatment further exacerbated financial toxicity, and cancer-related financial toxicity was also influenced by a variety of other factors.Conclusions:Multiple causes affected the experience of financial toxicity in young breast cancer survivors. The occurrence and risks of financial toxicity in young breast cancer survivors should be assessed. Intervention and support should be provided to meet the needs of young breast cancer survivors.
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About 1/3 of patients with colorectal cancer have a genetic background. Familial colorectal cancer type X refers to colorectal cancer clinically in line with Amsterdam criteria Ⅱ, but genetic testing of which does not show microsatellite instability or DNA mismatch repair gene mutations. Its tumor cell gene is microsatellite stable. Attention should be paid to the differen-tiation from Lynch syndrome. Familial colorectal cancer type X is highly heterogeneous, without unclear etiology so far. It is recommended to refer to sporadic colorectal cancer for diagnosis, treatment, follow-up and prevention. The authors introduce the diagnosis and treatment of a case of familial colorectal cancer type X, in order to provide references for clinical diagnosis of this disease.
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Xiaoer-Feire-Kechuan (XFK) is an 11-herb Chinese medicine formula to treat cough and pulmonary inflammation.The complicated composition rendered its chemical analysis and effective-component elucidation.In this study,we combined quantitative analysis and bioactivity test to reveal the anti-inflammatory constituents of XFK.First,UPLC-DAD and UHPLC/Q-Orbitrap-MS methods were estab-lished and validated to quantify 35 analytes (covering 9 out of 11 herbs) in different XFK formulations.Parallel reaction monitoring mode built in Q-Orbitrap-MS was used to improve the sensitivity and selectivity.Then,anti-inflammatory activities of the 35 analytes were analyzed using in vitro COX-2 inhibition assay.Finally,major analytes forsythosides H,I,A (8-10),and baicalin (15) (total contents varied from 21.79 to 91.20 mg/dose in different formulations) with significant activities (inhibitory rate ≥ 80％) were proposed as the anti-inflammatory constituents of XFK.The present study provided an effective strategy to discover effective constituents of multi-herb formulas.
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Objective: To explore clinical features and prognosis of anastomotic leak (AL) after anterior resection following neoadjuvant chemoradiotherapy for rectal cancer patients. Methods: A retrospective cohort study was performed. Data were retrieved from colorectal cancer database of the Sixth Affiliated Hospital, Sun Yat-sen University. The clinical data of 470 patients with rectal cancer who underwent anterior resection after neoadjuvant chemoradiotherapy at our department from September 2010 to December 2018 were enrolled. Clinical features and outcome of postoperative AL were analyzed. The primary outcomes were the short-term and long-term incidence and severity of AL (ISREC grading standard was adopted). The secondary outcomes were the prognostic indicators of AL, including the secondary chronic presacral sinus, anastomotic stenosis and persistent stoma. Patients received regular follow-up every 3-6 months after surgery, including physical examination, blood test, colonoscopy and image; those received follow-up once a year after postoperative 2-year; those who did not return to our hospital received telephone follow-up. Data of this study were retrieved up to January 2020. Univariate χ(2) test and multivariate logistic analysis were used to identify risk factors of AL and prognostic factors of persistent stoma. Results: There were 331 males (70.4%) with the average age of (53.5±11.6) years. Distance from tumor to anal verge ≤ 5 cm was found in 228 (48.5%) patients. The diverting stoma was performed in 440 (93.6%) patients. After a median follow-up of 28 months, AL was found in 129 (27.4%) patients, including 67 (14.3%) patients with clinical leak (ISREC grade B-C). The median time for diagnosis of AL was 70 days (2-515 days) after index surgery. Common symptoms included sacrococcygeal pain (27.9%, 36/129), purulent discharge through anus (25.6%, 33/129), and rectal irritation (17.8%, 23/129). Sixty five point one percent (84/129) of the defect site was at the posterior wall of the anastomosis. Transanal incision and drainage or lavage (27.9%, 36/129) and percutaneous drainage under ultrasound or CT (17.1%, 22/129) were the most common management. Chronic presacral sinus tract could not be evaluated in 12 patients because imaging was performed more than 1 year after the operation. Evaluation beyond 1 year showed that 73 of 458 eligible patients (15.9%) were found with chronic presacral sinus, accounting for 62.4% (73/117) of patients with AL; 69 of 454 (15.2%) were diagnosed with anastomotic stenosis, of whom 49 were secondary to AL; 59 of 470 (12.6%) had persistent stoma due to AL. Univariate analysis showed that male, operative duration > 180 minutes, intraoperative blood loss >150 ml, and pelvic radiation injury were associated with AL (all P<0.05). Multivariate analysis showed that male (OR=1.72, 95% CI: 1.04-2.86, P=0.036), intraoperative blood loss > 150 ml (OR=1.82, 95% CI: 1.11-2.97, P=0.017), and pelvic radiation injury (OR=4.90, 95% CI: 3.09-7.76, P<0.001) were independent risk factors of AL after anterior resection. For patients with AL, clinical leak (ISREC grade B-C) (OR=9.59, 95% CI: 3.73-24.69, P<0.001), age ≤55 years (OR=3.35, 95% CI: 1.35-8.30, P=0.009), distance from tumor to anal verge ≤ 5 cm (OR=3.33, 95% CI: 1.25-8.92, P=0.017), and pelvic radiation injury (OR=3.29, 95% CI: 1.33-8.14, P=0.010) were independent risk factors of persistent stoma. Conclusions: AL after anterior resection following neoadjuvant chemoradiotherapy for rectal cancer patients is common. Among patients with AL, the proportion of those needing persistent stoma is high. Pelvic radiation injury is significantly associated with occurrence of AL and subsequent persistent stoma. Sphincter-preserving surgery for rectal cancer should be selectively used based on the risk of pelvic radiation injury, which is beneficial to reduce the incidence of AL and improve the quality of life.
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Adult , Aged , Humans , Male , Middle Aged , Anastomosis, Surgical , Anastomotic Leak , Chemoradiotherapy , Neoadjuvant Therapy , Prognosis , Quality of Life , Rectal Neoplasms/surgery , Retrospective StudiesABSTRACT
Aim To study the effects of daidzein on sodium channel current ( /Na) in ventricular myocytes of rats and the mechanism of its antiarrhythmia. Methods The effect of daidzein on the viability of ventricular myocytes was delected by MTT assay; single ventricular myocytes from rats were isolated by single enzymatic hydrolysis; the changes of /N, and its dynamic characteristics in rat ventricular myocytes before and after administration of daidzein were observed, recorded and analyzed by cell patch clamp technique. Results MTT experiments showed that the ICjo of daidzein was 30 to 100 jjimol • L"1 ,so the concentration of 0. 3 - 10 jimol • L"1 was chosen for the subsequent experiments. When daidzein was given 0. 3,1,3,10 pjnol • L"',the /Nb amplitude of ventricular myocytes in rats showed a concentration-dependent inhibition. The concentration of daidzein 0. 3 imol • L"1 also had certain effect on the time course of /Nt. The /Nl, peak decreased gradually over time. The 1,3,10 jimol • L"1 daidzein raised the I-U curve obviously. Under the same condition, the activation curve moved to the direction of depolarization. The steady-state inactivation curve shifted toward hyperpolarization, and the t value of the recovery curve was prolonged after inactivated state. Conclusions Daidzein significantly inhibited the Na∗ channel of ventricular myocardium in rats, which may l)e one of its mechanisms of anti-arrhythmia.
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Objective To observe the correlation between CEUS quantitative parameters of carotid plaques and leukocytes in patients with acute ischemic stroke.Methods Sixty-two patients with large artery atherosclerosis stroke (LAAS group) confirmed by CT or MRI were enrolled,while 54 patients in the same period of hospitalization,age and gender-matched,no history of cardiovascular events with atherosclerosis were taken as control group.The correlation between CEUS quantitative parameters of carotid plaques and leukocytes in two groups were compared.Multiple linear regression model was built and the risk factors of CEUS quantitative parameters were analyzed.Results The total leukocytes count,neutrophils count and neutrophil/lymphocyte ratio in LAAS group were higher,while the lymphocytes count was lower than those in control group (all P＜0.05).CEUS parameters,including timeqntensity curve (TIC) peak (TIC-P),mean (TIC-M),fitting curve (FC) peak (FC-P),sharpness (FC-S) and area under the curve (FC-AUC) of carotid plaques were higher than those in control group (all P＜0.05),while neutrophils count and neutrophil/lymphocyte ratio were positively correlated with FC-AUC (r=0.298 and 0.739,respectively;all P＜0.05).Total leukocytes count was independent risk factor of TIC-P,and neutrophil/lymphocyte ratio was independent risk factor of FC-AUC (all P＜0.05).Conclusion CEUS quantitative parameters of carotid plaques related to leukocytes count.Increased leukocytes or neutrophil/ lymphocyte ratio might rise vulnerability of plaques.
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Objective: To develop an HPLC-DAD method for the simultaneous determination of five active flavonoids (quercetin, kaempferol, apigenin, 3-methoxyl-quercetin, nobiletin) in Centipeda minima (L.) A.Br.et Aschers.Methods: The chromatographic separation was performed on a Diamonsil C18 column (200 mm×4.6 mm,5 μm) with the mobile phase of 0.1% phosphoric acid-acetonitrile with gradient elution at the flow rate of 0.8 ml·min-1.The detection wavelength was set at 360nm,and the column temperature was maintained at 30 ℃.Results: Quercetin, kaempferol, 3-methoxyl-quercetin, apigenin and nobiletin was linear within the range of 0.002 3-0.093 0 μg·μl-1(r=0.999 5) , 0.002 2-0.087 0 μg·μl-1(r=0.999 6),0.002 0-0.079 0 μg·μl-1(r=0.999 8), 0.000 9-0.037 0 μg·μl-1(r=0.999 8) and 0.000 8-0.031 0 μg·μl-1 (r=0.999 9), respectively.The average recovery was 97.66%(RSD=1.17%), 98.33%(RSD=1.16%), 98.63%(RSD=1.10%), 98.40%(RSD=1.52%) and 98.10%(RSD=1.36%)(n=6) , respectively.Conclusion: The method is convenient, accurate and reproducible, which can be used for the quality control of Centipeda minima (L.) A.Br.et Aschers.
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AIM: To observe the structure changes of vitreous and retina after YAG laser ablation in patients with physiological vitreous floaters.METHODS: The selected 40 patients of physiological vitreous floaters,before YAG laser ablation,were checked for best corrected visual acuity,non-contact intraocular pressure,took their anterior segment photos,measured their foveola thickness(FT) and retinal nerve fiber layer(RNFL) by OCT.The YAG laser ablation was completed by one experienced surgeon.After the YAG laser ablation,all patients were checked for non-contact intraocular pressure and gave pranoprofen eye drops tid for 3d.At 2d,1wk,1 and 3mo after the surgery,they were reviewed for best corrected visual acuity,non-contact intraocular pressure.At 3mo later anterior segment photos were taken.At 1wk,1 and 3mo after the surgery,FT and RNFL were measured again.RESULTS: The postoperative 2d,1wk,1 and 3mo,best corrected visual acuity,non-contact intraocular pressure of the patients had no significant difference with preoperative(P>0.05).The preoperative anterior segment photos showed obvious single or sheet opacity of vitreous,the postoperative 3mo photos showed that vitreous opacities decreased or disappeared,no other abnormal changes were found.The preoperative OCT data showed that FT was 214.60±9.35μm,the postoperative 1wk,1 and 3mo FT were 213.75±9.07μm,213.40±8.83μm,213.85±9.22μm.The preoperative RNFL were upper 130.26±14.23μm,lower 133.15±14.46μm,nasal 82.48±13.50μm,temporal 75.40±11.89μm;The postoperative 1wk RNFL were upper 130.02±14.02μm,lower 132.99±14.05μm,nasal 82.35±13.07μm,temporal 75.42±11.66μm.The postoperative 1mo RNFL were upper 130.28±14.43μm,lower 133.08±13.99μm,nasal 82.31±13.72μm,temporal 75.45±12.03μm.The postoperative 3mo RNFL were upper 130.43±14.30μm,lower 133.22±14.20μm,nasal 82.27±13.11μm,temporal 75.46±11.91μm.The differences of preoperative and postoperative 1wk,1 and 3mo FT and RNFL had no statistical significance (P>0.05).CONCLUSION: YAG laser ablation has no adverse effects to vitreous and retinal structure in patients with physiological vitreous floaters,it is effective and safe.
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Background:Small intestinal bleeding is difficult to diagnose and treat because of its complex etiology and limit to examination method. Aims:To analyze the etiology,diagnosis,treatment and prognosis of small intestinal bleeding. Methods:The clinical data of 118 consecutive patients with small intestinal bleeding admitted from Oct. 2006 to Oct. 2016 at Daping Hospital,the Third Military Medical University were retrospectively analyzed. Results:Melena was the most common manifestation of small intestinal bleeding (41. 5％),followed by dark bloody stool,positive fecal occult blood test,hematochezia,and anemia with unknown cause. The major causes of bleeding were benign or malignant tumors (43. 2％),vascular lesions (28. 0％)and inflammatory lesions (15. 3％). Diagnosis was made by means of capsule endoscopy,colonoscopy,digital subtraction angiography (DSA),barium meal examination,multi-slice CT (MSCT)and CT enterography (CTE). Forty-one patients were treated by surgical operation,7 by selective arterial embolization,2 by endoscopic therapy,56 by conservative therapy,and all these patients achieved hemostasis. One patient died of massive hemorrhage and 11 were discharged with giving up of treatment. Conclusions:The leading cause of small intestinal bleeding is tumor,followed by vascular and inflammatory lesions. Capsule endoscopy is able to make definite diagnosis with high accuracy,and MSCT is the most widely used diagnostic approach. In addition to conventional treatment,surgical operation,interventional and endoscopic therapies also play important roles in treating small intestinal bleeding.
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To investigate the effects of isovitexin Ⅳ on transient outward potassium current in rat ventricular myocytes. In this study, MTT assay was used to investigate the safe range of isovitexin. The results showed that the IC₅₀ of the drug was in the range of 10-30 μmol•L⁻¹, and the drug concentration of 1-3 μmol•L⁻¹ for the patch clamp test was within the safe range. In addition, the single ventricular myocytes were obtained by single-enzymatic hydrolysis through aortic retrograde perfusion. The transient outward potassium current (Ito) of rat ventricular myocytes was guided and measured by whole-cell patch-clamp technique and the changes of current characteristics were recorded after isovite was applied. When the concentration of IV was less than 0.1 μmol•L⁻¹, there was no significant effect on Ito. However, with the increase in the concentration of IV (≥0.3 μmol•L⁻¹), the peak of Ito was decreased gradually, from (32.32±2.9) pA/pF to （25.83±4.3） pA/pF, 1 μmol•L⁻¹ IV and (19.51±3.5) pA/pF, 3 μmol•L⁻¹ IV respectively, with an inhibition effect in a concentration-dependent manner. In the range of 1-3 μmol•L⁻¹, IV down-regulated the I-V curve of Ito significantly. The activation curve showed that IV can enable the maximum half activation potential (V1/2) to move to the positive direction, and the V1/2 was increased from (19.59±1.6) mV to (22.81±1.7) mV and (28.86±1.4) mV at concentration of 1, 3 μmol•L⁻¹, meanwhile the activation curve moved to the right. However, the maximum half inactivating potential (V1/2) of the steady-state inactivation curve of Ito was significantly decreased from (－51.43±0.99) mV to (－61.81±1.3) mV with concentration of 1 μmol•L⁻¹ and (－71.50±1.4) mV with concentration of 3 μmol•L⁻¹. The inactivation time constant of recovery from inactivation (τ) was up-regulated significantly from (94.89±0.73) ms to (118.5±1.5) ms and (162.4±1.4) ms at concentration of 1, 3 μmol•L⁻¹ respectively. Meanwhile IV could enable the inactivation recovery curve to move to the right, which suggested that it can prolong the recovery time from inactivation of the transient outward potassium channel. In conclusion, isovitexin had a high inhibitory effect on Ito in rat ventricular myocytes.
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To investigate the status of visual disability population in Yuzhong district of Chongqing, in order to provide a counter measure for improving their quality of life.METHODS:The data of visual disability population was analyzed, which was registered in federation of the disabled of Yuzhong district of Chongqing from January 21, 2009 to July 17, 2013, collected the information of their gender and age constituent ratio, visual disability level differences, and the differences of their disability pathogeny.RESULTS: There was no significant difference between the total numbers of male and female visual disability, and before the age of 60, the number of male was more than female, but after 60, it was opposite. The grade four of visual disability accounted for the largest proportion, followed by a level of grade one, two, and three. The main causes of visual disability in proper order were:ametropia ( high myopia) , retina and pigment membrane disease, ocular trauma, optic nerve disease, glaucoma, corneal disease, congenital anomaly or eccyliosis, cataract, amblyopia, agnogenic, methysis, trachoma, and the others ( hyperpyrexia) .CONCLUSlON: The diagnosis and treatment of juvenile in Yuzhong district must be strengthened, also include retina and pigment membrane disease, to reduce the visual disability caused by these diseases.
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<p><b>OBJECTIVE</b>Through the observation, analysis, and treatment to lots of clinical patients with unusual feeling symptom of pharynx (UFSP), followed by the functional examination of autonomic nerve, putting forward the clinical classify and therapy of UFSP.</p><p><b>METHODS</b>Through the clinical history inquired, routine examination, 24 hours pH value determined of esophagus, erect experiment, and coefficient of variation of the R-R(CVR-R) examination of electrocardiogram etc, divided the UFSP into two types: the type of pathogeny clear and the type of pathogeny unclear. The clear-type was further classified into five subtypes: the type of a mental scar, the type of morbid state of mind, the type of reflux esophagitis, the type of climacteric syndrome and menstrual disorder, and the type of functional disturbance of independence nerve.</p><p><b>RESULTS</b>In the cases of 256, 106 were cured,76 were positive effective, 41 were effective, with total effective rate of 87.1%. Thirty three (12.9%) cases were not cured. Forty six (18.0%) of them with the type of a mental scar were whole cured. One hundred and thirty six (53.1%) of them with the type of morbid state of mind had a 93.4% (127) effective rate. Twenty one (8.2%) of them with the type of reflux esophagitis had 71.4% (15) effective rate. Among 35 (13.7%) cases of climacteric syndrome and menstrual disorder type, 29 cases were cured with a 82.9% effective rate. Twelve (4.7%) cases of the type of functional disturbance of independence nerve had 50% effective rate. Six (2.3%) cases of the pathogeny unclear type'were not cured.</p><p><b>CONCLUSIONS</b>UFSP could be clinical classified and treated followed the detail inquiry of medical history and relative examination.</p>
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Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Esophagitis, Peptic , Laryngeal Diseases , Classification , Psychology , Pharyngeal Diseases , Classification , Psychology , Pharynx , Sensation Disorders , ClassificationABSTRACT
0.05)was observed between the research group and the control.Conclusion:Pedicled greater omentum efficaciously reduced the incidence rate of anastomotic fistula in TME of rectal carcinoma.