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There are two modes to display panoramic movies in virtual reality (VR) environment: non-stereoscopic mode (2D) and stereoscopic mode (3D). It has not been fully studied whether there are differences in the activation effect between these two continuous display modes on emotional arousal and what characteristics of the related neural activity are. In this paper, we designed a cognitive psychology experiment in order to compare the effects of VR-2D and VR-3D on emotional arousal by analyzing synchronously collected scalp electroencephalogram signals. We used support vector machine (SVM) to verify the neurophysiological differences between the two modes in VR environment. The results showed that compared with VR-2D films, VR-3D films evoked significantly higher electroencephalogram (EEG) power (mainly reflected in α and β activities). The significantly improved β wave power in VR-3D mode showed that 3D vision brought more intense cortical activity, which might lead to higher arousal. At the same time, the more intense α activity in the occipital region of the brain also suggested that VR-3D films might cause higher visual fatigue. By the means of neurocinematics, this paper demonstrates that EEG activity can well reflect the effects of different vision modes on the characteristics of the viewers' neural activities. The current study provides theoretical support not only for the future exploration of the image language under the VR perspective, but for future VR film shooting methods and human emotion research.
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Humans , Arousal , Electroencephalography , Emotions/physiology , Motion Pictures , Virtual RealityABSTRACT
Virtual reality (VR) is a three-dimensional virtual technology which generates virtual world by computer simulation. VR provides users with the simulation of visual, auditory and tactile senses, so that users can observe things in the virtual space as in the real world. Electroencephalogram(EEG) is the direct reflection of the activation of neurons in the cerebral cortex. The combination of VR and EEG has become an important method of brain science research. However, the existing research lacks a systematic arrangement of combination of VR and EEG. In this paper, the related research of VR combined with EEG in the past 20 years were summarized, the corresponding experimental paradigm, research methods and results were introduced, and finally the future research directions of the combination of VR and EEG were prospected.
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Sepsis 3.0 is defined as a life-threatening organ dysfunction caused by the host' uncontrol response to infection, with poor prognosis, high morbidity and fatality. Sepsis is one of the main causes of death in severe patients. As lack of comprehensive recognition of its pathogenesis, there were not specific treatment on it. It is reported that the T-cell immunoglobulin and mucin-domain-containing molecule (Tim) of Tim-1 play critical role in sepsis inflammation, immune tolerance and apoptosis, which is relative specific factor in assessment of sepsis prognostic and treatment efficiency, indicating that it could be a novel target in sepsis as well as provide a novel direction. This article mainly stated the discovery, structure, distribution and immune effect of Tim-1 as well as the possible role of TIM-1in immunosuppression, lymphocyte proliferation and apoptosis, in order to provide reference for further research the treatment of sepsis.
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Objective:To summarize the clinical features, genetic testing and treatment efficacy of 6 children with Dent disease.Methods:Six children diagnosed with Dent disease in Guangzhou Women and Children′s Medical Center from January 2014 to March 2019 were enrolled.Their medical history, clinical manifestations, laboratory results, genetic test results, and proteinuria level, calciuria level and renal function after medication were measured.Results:All patients were male, with the onset age ranged from 1 to 9 years old.They were followed up for 6 months to 4 years.All the children had low molecular weight proteinuria.Urine protein electrophoresis showed that the ratio of low molecular weight proteinuria in only 2 cases was more than 50%.Renal biopsy suggested that all cases were combined with glomerular lesions.Five cases had hypercalciuria.Under the microscope, there were 5 cases of hematuria.Two case had rickets, and there was no renal calcium deposition and hypophosphatemia.Five cases were detected with CLCN5 mutations, of which p. C160Yfs*49 and p. G523D were first reported.One case had an OCRL1 mutation.Patients were treated with Hydrochlorothiazide and angiotensin converting enzyme inhibitor (ACEI). The 24 h urinary calcium level after treatment was lower than that before treatment [0.40 (0.24, 0.43) mmol/kg vs.0.12 (0.11, 0.14) mmol/kg, U=2.00, P<0.01]. However, there was no significant decrease in the 24 h-urinary protein level before and after treatment [77.09 (62.41, 88.01) mg/kg vs.80.33 (66.03, 92.52) mg/kg, U=12.00, P>0.05]. Conclusions:Dent disease is mainly characterized by low molecular weight proteinuria, and some patients may not be associated with hypercalciuria.Gene tests help to identify the disease type.ACEI and Hydrochlorothiazide can reduce the urinary calcium level, but cannot improve the level of urinary protein.
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Objective To investigate the levels and clinical significance of homocysteine (Hcy) and neutrophil-to-lymphocyte ratio (NLR) in patients with nonalcoholic fatty liver disease (NAFLD) and type 2 diabetes mellitus (T2DM). Methods A total of 528 patients with NAFLD who were treated in Department of Endocrinology, The First Affiliated Hospital of Jinzhou Medical University, from January to December 2019 were enrolled, and according to the presence or absence of T2DM, they were divided into non-T2DM group and T2DM group. A total of 79 T2DM patients without NAFLD were selected randomly. General data and laboratory markers were recorded for the three groups. A one-way analysis of variance was used for comparison of normally distributed continuous data between groups, and the chi-square test was used for comparison of categorical data between groups; a binary logistic regression analysis was used to determine risk factors, and odds ratio ( OR ) and its 95% confidence interval ( CI ) were used to represent relative risk; the receiver operating characteristic (ROC) curve was used to evaluate predictive efficiency. Results The T2DM group had significantly higher systolic blood pressure (SBP), diastolic blood pressure, and body mass index than the non-T2DM group (all P < 0.05), and there were significant differences between any two of the three groups in Hcy, NLR, alanine aminotransferase, aspartate aminotransferase, gamma-glutamyl transpeptidase, uric acid, and fasting blood glucose (all P < 0.05). There were significant differences in neutrophil count, lymphocyte count, and high-density lipoprotein cholesterol (HDL-C) between the T2DM group and the non-T2DM group (all P < 0.05), and there was a significant difference in total cholesterol between the T2DM group and the simple T2DM group and between the non-T2DM group and the simple T2DM group ( P < 0.05). SBP ( O R =1.040, 95% C I : 1.015-1.065), HDL-C ( OR =0.040, 95% CI : 0.007-0.228), NLR ( OR =6.285, 95% C I : 1.504-27.108), and Hcy ( O R =1.291, 95% C I : 1.127-1.423) were independent risk factors for NAFLD with T2DM. Hcy had an area under the ROC curve (AUC) of 0.741 (95% CI : 0.698-0.783, P < 0.01) in predicting NAFLD with T2DM, with a Youden index of 0.394, a sensitivity of 69.6%, and a specificity of 69.8% at the optimal cut-off value of 15.31 μmol/L. NLR had an AUC of 0.782 (95% C I : 0.744-0.820, P < 0.01) in predicting NAFLD with T2DM, with a Youden index of 0.443, a sensitivity of 72.1%, and a specificity of 72.2% at the optimal cut-off value of 2.12. Hcy combined with NLR had an AUC of 0.845 (95% C I : 0.812-0.878, P < 0.01) in predicting NAFLD with T2DM, with a Youden index of 0.549, a sensitivity of 71.8%, and a specificity of 83.1%. Conclusion Hcy and NLR are risk factors for NAFLD with T2DM and have a certain predictive value. Combined measurement of Hcy and NLR can improve the diagnostic efficiency of NAFLD with T2DM and help clinicians with diagnosis in the early stage.
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Objective To investigate the levels and clinical significance of homocysteine (Hcy) and neutrophil-to-lymphocyte ratio (NLR) in patients with nonalcoholic fatty liver disease (NAFLD) and type 2 diabetes mellitus (T2DM). Methods A total of 528 patients with NAFLD who were treated in Department of Endocrinology, The First Affiliated Hospital of Jinzhou Medical University, from January to December 2019 were enrolled, and according to the presence or absence of T2DM, they were divided into non-T2DM group and T2DM group. A total of 79 T2DM patients without NAFLD were selected randomly. General data and laboratory markers were recorded for the three groups. A one-way analysis of variance was used for comparison of normally distributed continuous data between groups, and the chi-square test was used for comparison of categorical data between groups; a binary logistic regression analysis was used to determine risk factors, and odds ratio ( OR ) and its 95% confidence interval ( CI ) were used to represent relative risk; the receiver operating characteristic (ROC) curve was used to evaluate predictive efficiency. Results The T2DM group had significantly higher systolic blood pressure (SBP), diastolic blood pressure, and body mass index than the non-T2DM group (all P < 0.05), and there were significant differences between any two of the three groups in Hcy, NLR, alanine aminotransferase, aspartate aminotransferase, gamma-glutamyl transpeptidase, uric acid, and fasting blood glucose (all P < 0.05). There were significant differences in neutrophil count, lymphocyte count, and high-density lipoprotein cholesterol (HDL-C) between the T2DM group and the non-T2DM group (all P < 0.05), and there was a significant difference in total cholesterol between the T2DM group and the simple T2DM group and between the non-T2DM group and the simple T2DM group ( P < 0.05). SBP ( O R =1.040, 95% C I : 1.015-1.065), HDL-C ( OR =0.040, 95% CI : 0.007-0.228), NLR ( OR =6.285, 95% C I : 1.504-27.108), and Hcy ( O R =1.291, 95% C I : 1.127-1.423) were independent risk factors for NAFLD with T2DM. Hcy had an area under the ROC curve (AUC) of 0.741 (95% CI : 0.698-0.783, P < 0.01) in predicting NAFLD with T2DM, with a Youden index of 0.394, a sensitivity of 69.6%, and a specificity of 69.8% at the optimal cut-off value of 15.31 μmol/L. NLR had an AUC of 0.782 (95% C I : 0.744-0.820, P < 0.01) in predicting NAFLD with T2DM, with a Youden index of 0.443, a sensitivity of 72.1%, and a specificity of 72.2% at the optimal cut-off value of 2.12. Hcy combined with NLR had an AUC of 0.845 (95% C I : 0.812-0.878, P < 0.01) in predicting NAFLD with T2DM, with a Youden index of 0.549, a sensitivity of 71.8%, and a specificity of 83.1%. Conclusion Hcy and NLR are risk factors for NAFLD with T2DM and have a certain predictive value. Combined measurement of Hcy and NLR can improve the diagnostic efficiency of NAFLD with T2DM and help clinicians with diagnosis in the early stage.
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Objective:To evaluate the clinical efficacy of Sini-Jia-Huanglian Decoction on chronic heart failure (CHF) with qi deficiency and blood stasis syndrome. Methods:A total of 100 patients with CHF and qi deficiency and blood stasis syndrome in Handan Mingren hospital from January 2018 to June 2019 who met the inclusion criteria were divided into two groups according to the random number table method, 50 cases in each group. The control group was treated with conventional western medicine therapy, and the treatment group was treated with Sini-Jia-Huanglian Decoction on the basis of the control group. Both groups were treated for 30 days. TCM syndrome score was performed before and after treatment. The level of N-terminal-pro-B-type natriuretic peptide (NT-proBNP) was detected by radioimmunoassay. The levels of peptide and galectin 3 (Gal-3) were detected by ELISA. The exercise tolerance was measured by 6-minute walking test, the clinical efficacy was tevaluated. Results:The total effective rate of the treatment group was 92.0% (46/50), and the control group was 76.0% (38/50), there was significant difference between the two groups ( χ2=4.762, P=0.029). After treatment, the scores of shortness of breath, palpitation, dyspnea, dizziness, chest pain and total scores in the treatment group were significantly lower than those in the control group ( t values were 4.257, 8.493, 8.211, 4.481, 5.500, 6.977, respectively, all Ps<0.01). After treatment, the levels of NT-proBNP (2 349.61 ± 683.50 ng/L vs. 3 026.27 ± 714.35 ng/L, t=4.840), and peptide (12.16 ± 3.43 ng/L vs. 17.52 ± 3.98 ng/L, t=7.214) and Gal-3 (3.01 ± 0.82 μg/L vs. 3.94 ± 0.93 μg/L, t=5.304) in the treatment group were significantly lower than those in the control group ( P<0.01), and the walking distance of 6 minutes (450.66 ± 79.25 m vs. 384.49 ± 70.16 m, t=4.421) was significantly longer than that of the control group ( P<0.01). Conclusions:The Sini-Jia-Huanglian Decoction can improve the heart function and clinical symptoms of CHF patients with qi deficiency and blood stasis syndrome, and improve the clinical efficacy.
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Cognitive reappraisal is an important strategy for emotion regulation. Studies show that even healthy people may not be able to implement this strategy successfully, but the underlying neural mechanism behind the behavioral observation of success or failure of reappraisal is unclear. In this paper, 28 healthy college students participated in an experiment of emotional regulation with the cognitive reappraisal strategy. They were asked to complete the cognitive psychological questionnaires before the experiment. Their behavioral scores and scalp electroencephalogram (EEG) signals were collected simultaneously during the experiment. We divided all the subjects into two groups, according to the statistical test of valence scores. Then we analyzed their questionnaires, early event-related potential (ERP) components N200, P200, and late positive potential (LPP), and calculated the correlation between the valence score and the amplitude of LPP. The results showed that, in both groups, compared with negative-watching, the reappraisal induced larger N200 and P200 components and there were two modulation patterns ("increase" and "decrease") of the reappraisal effect on the amplitude of early LPP (300-1 000 ms after stimulus onset). Moreover, correlation analysis showed that significant positive correlation between two differences in the successful group, i.e., the greater difference in the valence scoresin between reappraisal and negative-watching, the greater difference in the amplitude of early LPP between reappraisal and negative-watching; but no such effect was found in the failure group. These results indicated that, whether reappraisal was successful or not, no significant effect on early ERP components was found; and there were different patterns of the reappraisal effect on early LPP. The difference between successful and failure groups was mainly reflected in early LPP, that is, the EEG characteristics and behavioral scores of successful group were significantly positively correlated. Furthermore, the small sample analysis showed that this correlation only existed in the pattern of "increase". In the future, more research of this modulation mode is necessary in order to find more stable EEG characteristics under successful cognitive reappraisal in emotion regulation.
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Humans , Algorithms , Cognition , Electroencephalography , Emotional Regulation , Emotions , Evoked PotentialsABSTRACT
Objective@#To investigate the clinical, imaging and molecular characteristics of primary hyperoxaluria type 1 (PH1) in children and to sum up existing evidence for further understanding the phenotype-genotype correlation of infantile PH1.@*Methods@#This retrospective analysis was based on the medical records of children with PH1 diagnosed by gene test in the Department of Nephrology, Guangzhou Women and Children′s Medical Center from June 2016 to May 2019. Targeted exome sequencing was performed on tubular disease-related genes of the probands and Sanger sequencing was conducted to validate suspected pathogenic variants of family members. Logistic regression analysis of NC and CCr was adopted to show the relation between NC and renal function. The literature review was conducted, and the clinical, imaging and molecular biogenetic characteristics of the disease were analyzed and summarized.@*Results@#A total of 7 children from 6 families were enrolled. The median age of onset was 5 months. The median age of diagnosis was 8 months. Five cases had progressed to end-stage renal disease (ESRD), one case had chronic kidney disease (CKD) stage 1, and the other one had CKD stage 2. Four cases died, one case maintained on hemodialysis, and the other two non-dialysis cases were followed up. Among the 7 cases, 4 patients had infantile PH1, 1 patient had child and adolescent type, 1 patient had family type and the other one had unknown classification. There were two siblings (the younger brother had uremia and the sister had normal renal function) who had the delayed diagnosis for 5 and 3 years respectively. All patients in this cohort had proteinuria and microscopic hematuria, but no patients had gross hematuria. Three cases had hypercalciuria. Comprehensive diagnostic imaging evaluation include CT scan, MR scan, radiography and ultrasound led to the diagnosis of nephrocalcinosis (NC) in 5 cases, including 4 cases of simple NL and 1 case of NC with nephrolithiasis (NL), 1 case of multiple NL and 1 case of microcrystal deposition in renal medulla. However, only one case of NC was identified by ultrasound, the other 4 cases of NC were identified by radiograph examination. In the logistic regression analysis involving NC and creatinine clearnce rate (CCr), the results showed that NC was an independent risk factor for renal dysfunction (OR 2.5, 95%CI 0.7-1.2, P<0.05). All the 7 cases had AGXT gene variant, including homozygous variant in 4 cases and compound heterozygous variant in 3 cases. A total of 9 variant genotypes were found, and exon 6 variants were found in 4 children. Among them, there were 3 cases with c.679_680delAA. To our knowledge, both c.679_680delAA and c.190A>T in the cohort have not been reported previously.@*Conclusions@#Infantile PH1 is the most common type of PH1 in children, which progresses rapidly or even begins with renal failure, with poor prognosis. It is also highly heterogeneous in phenotype and genotype. NC is an independent risk factor leading to renal failure. Radiograph examination showed high specificity for the diagnosis of NC. At present, the misdiagnosis and delayed diagnosis of PH1 are still common in China. It is of great significance to carry out quantitative determination of uric oxalate in order to reduce the misdiagnosis rate and enhance follow-up technologies for evaluating the therapeutic effect.
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Objective@#To evaluate the safety and efficacy of surgical treatment after neoadjuvant chemotherapy (NCT) for patients with cT4N+ colon cancer, and to explore whether the indication of NCT for colon cancer can be extended from cT4b to cT4N+ .@*Methods@#The clinical data of 40 patients with cT4N+ colon cancer who underwent neoadjuvant chemotherapy followed by surgical treatment was retrospectively analyzed. The safety of neoadjuvant chemotherapy, surgical complications, R0 resection rate, tumor regression grade and prognosis were evaluated.@*Results@#Of the 40 patients, 23 were male and 17 were female; the median age was 57 years old. All patients were well tolerated with chemotherapy, and only one case (1/40, 2.5%) had grade 3 chemotherapy-related adverse event. They all underwent surgery after chemotherapy, and 95.0% (38/40) achieved microscopically clear resection (R0). Of the 11 patients with cT4b, 54.5% (6/11) had undergone multivisceral resection (MVR). Postoperative pathological results showed that 12 patients had moderate to severe tumor regression, including one(1/40, 2.5%) achieved pathologic complete response (pCR). 29(72.5%) and 22 (55.0%) patients achieved down-staging of tumor T stage and N stage, respectively. The occurrence of surgical complications was 22.5% (9/40), including one case of anastomotic leakage (1/40, 2.5%). The 3-year disease-free survival and overall survival of the whole group were 75.0% and 80.0%, respectively.@*Conclusion@#Surgery after neoadjuvant chemotherapy is safe and effective for patients with cT4N+ colon cancer, therefore indications for neoadjuvant chemotherapy for advanced colon cancer can be extended to cT4N+ stage.
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Objective@#To evaluate the efficacy and safety of low dose sublingual nifedipine dripping pills (5 mg) in treating moderate and severe hypertension in comparison with normal dose (10 mg) of sublingual nifedipine dripping pills.@*Methods@#This study was designed as a randomized, double-blind, positive drug parallel controlled, multi-center, non-inferiority clinical trial. Patients with moderate and severe hypertension were enrolled by 14 clinical trial centers, randomly divided into the trial group (sublingual 5 mg nifedipine dripping pills) and the control group (sublingual 10 mg nifedipine dripping pills). The changes in blood pressure were monitored continuously within 2 hours after the initial administration, repeated the dose in 20 minutes interval after the initial administration for up to additional 3 doses (maximum 4 doses) if the antihypertensive efficacy was not satisfactory. The efficacy of antihypertensive therapy between the two groups was evaluated by repeated administration rates and blood pressure changes at 60 minutes post the initial administration, and the safety of treatment was evaluated by recording adverse event rate of the two groups.@*Results@#The anti-hypertensive effective rates at 60 minutes after sublingual administration were 83.5% (202/242) and 86.7% (208/240) respectively between the trial group and control group (χ2=1.307, P=0.253) . On the aspect of antihypertensive effectiveness at 60 minutes after single dose of sublingual administration, the anti-hypertension effective rates of the trial group and the control group were 85.6% (154/180) and 87.2% (164/188) respectively (χ2=0.221, P=0.639). Prevalence of the repeated administration was also similar between the two groups (25.6%(62/242) in the trial group and 21.7% (52/240) in the control group, χ2=1.043, P=0.307). On the safety aspect, there was no adverse events/reactions in the trial group, but there were 15 cases of adverse events/reactions occurred in control group (6.25%, χ2=15.611, P<0.001).@*Conclusions@#In the treatment of moderate to severe hypertension, the antihypertensive efficacy of low dose nifedipine dripping pills is similar to that of conventional dosage, and the safety profile of low dose nifedipine dripping pills is better than that of the conventional dose.
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Objective@#To understand the perceptions, attitudes and treatment selection of Chinese surgeons on the "watch and wait" strategy for rectal cancer patients after achieving a clinical complete response (cCR) following neoadjuvant chemoradiotherapy (nCRT).@*Methods@#A cross-sectional survey was used in this study. Selection of subjects: (1) Domestic public grade III A (provincial and prefecture-level) oncology hospitals or general hospitals possessing the radiotherapy department and the diagnosis and treatment qualifications for colorectal cancer. (2) Surgeons of deputy chief physician or above. Using the "Questionnaire Star" online survey platform to create a questionnaire about cognition, attitude and treatment choice of the "watch and wait" strategy after cCR following nCRT for rectal cancer. The questionnaire contained 32 questions, such as the basic information of doctor, the current status of rectal cancer surgery, the management of pathological complete remission (ypCR) after nCRT for rectal cancer, the selection of examination items for diagnosis of cCR, the selection of suitable people undergoing "watch and wait" approach, the nCRT mode for promotion of cCR, the choice of evaluation time point, the willingness to perform "watch and wait" approach and the treatment choice, and the risk and monitoring of "watch and wait" approach. A total of 116 questionnaires were sent to the respondents via WeChat between January 31 and February 19, 2019. Statistical analysis was performed using Fisher′s exact test for categorical variables.@*Results@#Forty-eight hospitals including 116 surgeons meeting criteria were enrolled, of whom 77 surgeons filled the questionnaire with a response rate of 66.4%. "Watch and wait" strategy was carried out in 76.6% (59/77) of surgeons. Seventy surgeons (90.9%) were aware of the ypCR rate of rectal cancer after preoperative nCRT and 49 surgeons (63.6%) knew the 3-year disease-free survival of patients with ypCR in their own hospitals. Fifty-five surgeons (71.4%) believed that patients with ypCR undergoing radical surgery met the treatment criteria and were not over-treated. Three most necessary examinations in diagnosing cCR were colonoscopy (96.1%, 74/77), digital rectal examination (DRE) (90.9%,70/77) and DWI-MRI (83.1%, 64/77). Responders preferred to consider a "watch and wait" strategy for patients with baseline characteristics as mrN0 (77.9%, 60/77), mrT2 (68.8%, 53/77) and well-differentiated adenocarcinoma (68.8%, 53/77). Sixty-six surgeons (85.7%) believed that long-term chemoradiotherapy (LCRT) with combination or without combination of induction and/or consolidation of the CapeOX regimen (capecitabine + oxaliplatin) should be the first choice as a neoadjuvant therapy to achieve cCR. Forty-one surgeons (53.2%) believed that a reasonable interval of judging cCR after nCRT should be ≥ 8 weeks. Forty-four surgeons (57.1%) routinely, or in most cases, informed patient the possibility of cCR and proposed to "watch and wait" strategy in the initial diagnosis of patients with non-metastatic rectal cancer. Thirteen surgeons (16.9%) would take the "watch and wait" strategy as the first choice after the patient having cCR. Fifty-two surgeons (67.5%) would be affected by the surgical method, that was to say, "watch and wait" approach would only be recommended to those patients who would achieve cCR and could not preserve the anus or underwent difficult anus-preservation surgery. Sixteen surgeons (20.8%) demonstrated that "watch and wait" strategy would not be recommended to patients with cCR regardless of whether the surgical procedure involved anal sphincter. Eleven surgeons (14.3%) believed that the main risk of "watch and wait" approach came from distant metastasis rather than local recurrence or regrowth. Twenty-nine of surgeons (37.7%) did not understand the difference between "local recurrence" and "local regrowth" during the period of "watch and wait". Twenty-six surgeons (33.8%) thought that the monitoring interval for the first 3 years of "watch and wait" strategy was 3 months, and the follow-up monitoring interval could be 6 months to 5 years. Surgeons from cancer specialist hospitals had higher approval rate, notification rate, and referral rate of "watch and wait" strategy than those from general hospitals. Thirty-one surgeons (42.5%) considered that the difficulty and concern of carrying out "watch and wait" approach in the future was the disease progress leading to medical disputes. Twenty-six surgeons (35.6%) demonstrated that their concern was lack of uniform evaluation standard for cCR.@*Conclusions@#Chinese surgeons seem to have inadequate knowledge of non-operative management for rectal cancer patients achieving cCR after nCRT and show relatively conservative attitudes toward the strategy. Chinese consensus needs to be formed to guide the non-operative management in selected patients. Chinese Watch & Wait Database (CWWD) is also needed to establish and provide more evidence for the use of alternative procedure after a cCR following nCRT.
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Transcranial magnetic stimulation (TMS) combined with electroencephalography(EEG) has become an important tool in brain research. However, it is difficult to remove the large artifacts in EEG signals caused by the online TMS intervention. In this paper, we summed up various types of artifacts. After introducing a variety of online methods, the paper emphasized on offline approaches, such as subtraction, principal component analysis and independent component analysis, which can remove or minimize TMS-induced artifacts according to their different characteristics. Although these approaches can deal with most of the artifacts induced by TMS, the removal of large artifacts still needs to be improved. This paper systematically summarizes the effective methods for artifacts removal in TMS-EEG studies. It is a good reference for TMS-EEG researchers while choosing the suitable artifacts removal methods.
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OBJECTIVE@#To summarize and analyze the postoperative short-term complications of laparoscope-assisted transanal total mesorectal excision (taTME) for rectal cancer patients after neoadjuvant therapy.@*METHODS@#A prospectively established database on taTME patients at Peking University Cancer Hospital was screened with the following conditions: data retrieval from June 2016 to August 2018, pathologically confirmed adenocarcinoma, receiving preoperative neoadjuvant chemoradiotherapy or chemotherapy. The transabdominal procedure and the transanal procedure were performed simultaneously in the taTME operation. Occurrence of complications during perioperative period (within postoperative 3 months) in these patients, especially anastomosis-related complications and their management were analyzed. The relevant complications were recorded according to the Clavien-Dindo (CD) grading criteria. The severity of anastomotic leakage and anastomotic stenosis was evaluated according to criteria developed by the International Rectal Cancer Research Group.@*RESULTS@#A total of 29 patients were enrolled in this study. In the 29 patients, 25 (86.2%) were male and 4 (13.8%) were female, the median age was 60 (range, 30 to 72) years, the median body mass index was 25.8 (range, 19.8 to 36.4) kg/m, the median distance from the tumor to anal verge was 4 (range, 2 to 8) cm. All the patients completed laparoscope-assisted taTME operations successfully without conversion to laparotomy, intra-operative severe complication or death. The median operation time was 300 (range, 198 to 405) minutes, and the median intra-operative blood loss was 100 (range, 50 to 200) ml. All the TME specimens were complete according to the Nagtegaal standard. All the patients underwent prophylactic ileostomy. Hartmann procedure was performed in one case due to poor blood supply in the proximal bowel without the possibility of anastomosis. Anal sphincter preservation rate was 96.6% (28/29). The median postoperative exhaust time was 2 (range, 1 to 10) days, and the median postoperative hospital stay was 9 (range, 7 to 24) days. Fifteen patients (51.7%) had postoperative complications, among which serious complication (CD grade IIIb and above) accounted for 6.9% (2/29). No perioperative death was observed. Five patients (17.2%) presented anastomosis-related complications, including 2 cases of grade C anastomotic leakage due to anastomotic rupture, who underwent abdominal perineal resection 1 month after operation; 2 cases of grade B anastomotic leakage, who improved after conservative treatment; 1 case of grade A anastomotic stenosis, who improved with anal expansion 1 month after operation. The incidence of postoperative infection was 24.1% (7/29), including 6 cases of pelvic infection and 1 case of trocar site infection, all of which were CD grade II. One case had incomplete intestinal obstruction (CD grade II); 1 case had gastroplegia; 1 case had abdominal trocar hernia. All the patients were followed up for a median of 12.0 (range, 3.9 to 29.9) months. Seven cases did not undergo ileal stoma closure. The anal sphincter preservation rate was 75.9% (22/29).@*CONCLUSION@#Pelvic infection and anastomosis-related complications are common after laparoscope-assisted taTME surgery for rectal cancer patients following neoadjuvant chemoradiotherapy, which require active management and appropriate treatment.
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Adult , Aged , Female , Humans , Male , Middle Aged , Anal Canal , Laparoscopes , Neoadjuvant Therapy , Postoperative Complications , Rectal Neoplasms , TherapeuticsABSTRACT
Objective To investigate the effects of RYGB on hepatic and peripheral insulin sensitivity in type 2 diabetes rats and the mechanisms.Methods Sprague-Dawley rats were divided into 2 groups:diabetic RYGB group (n =10) and diabetic sham RYGB group (n =10).The hyperinsulinemiceuglycemic clamp with tracer infusion was completed at 2 weeks postoperatively to assess insulin sensitivity.The lipid content in liver tissue was examined.Malondialdehyde (MDA) and superoxide dismutase (SOD) activities in the liver were measured.The protein expressions of PERK and p-PERK in livers were also detected by Western blot.Results RYGB significantly improved hepatic insulin sensitivity index and decreased hepatic triglyceride concentration (P ＜ 0.05),without an improvement in peripheral insulin sensitivity.The ratio of MDA to SOD and the protein expression of p-PERK in the livers were lower in the RYGB group than in the sham RYGB group.Conclusions The increased insulin sensitivity after RYGB occurs earlier in the liver than in the muscle tissue.The amelioration of hepatic tissue lipotoxicity after RYGB decreased the degrees of oxidative stress and endoplasmic reticulum stress,which may contribute to the improved hepatic insulin sensitivity.
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Objective To investigate the clinical significance of individualized neoadjuvant chemotherapy for renal carcinoma to reduce side effects under the guidance of gene detection.Methods From January 2011 to March 2014,two hundred and twelve patients with renal carcinoma treated in Cangzhou Central Hospital were enrolled in the study and randomly divided into the gene detection group (102 cases) and non-gene detection group (110 cases).The gene detection group was detected by the real time fluorescence quantitative (RT-PCR) method and the drug sensitivity test was carried out,and the patients were given neoadjuvant chemotherapy based on the results of drug sensitivity test.The patients in the non-gene detection group were treated with the national comprehensive cancer network (NCCN) experience regimen.The incidence of chemotherapy side effects was compared between the two groups.Results The 1 year survival rate of the gene test group was higher than that in the non-gene detection group (87.25％ (89/102) vs.77.27％ (85/ 110),x2 =4.67,P＜0.05),and the 3 year survival rate increased (70.58％ (72/102) vs.64.54％ (71/110),x2 =4.510,P＜ 0.05) as well,the differences were statistically significant (P ＜ 0.05).The incidence of liver injury in the gene detection group was 17.64％ (18/102),which was lower than that in the control group 30％ (33/110),the difference was statistically significant (x2 =4.42,P ＜ 0.05).In the gene detection group,the incidence of leukocyte 3～4 level inhibition was 27.5％ (28/102),which was higher than that in the non-gene detection group 21.8％ (24/110).The difference was statistically significant (x2 =4.940,P ＜ 0.05).Conclusion Genetic polymorphisms detection is a guide to the application of tumor sensitive drugs in the individualized neoadjuvant chemotherapy of renal carcinoma.It can improve the therapeutic effect,and also reduce the occurrence of liver injury caused by side effects of chemotherapy and has high clinical application value.
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Objective To explore the effects of Roux-en-Y gastric bypass (RYGB) on hepatic autophagy in obese diabetic rats.Methods Sprague-Dawley diabetes rats were randomly divided into three groups:diabetic group(n =8),diabetic sham RYGB group (n =8) and diabetic RYGB group (n =8).Hyperinsulinemic-euglycemic clamps with tracer infusion were completed to assess insulin sensitivity (IS).Triglyceride (TG) levels in liver tissue were tested.The protein expression levels of P62 (sequestosome 1)and the conversion of LC3 (microtubule-associatedprotein 1 light chain 3) in liver were detected by Western blot.The concentration of glucagon-like peptide-1 (GLP-1) in plasma was detected by ELISA and the correlation between GLP-1 and autophagy was analyzed in 2 weeks after operation.Results In comparison with diabetic and diabetic sham RYGB groups,IS increased by 63％ (F =10.87,P ＜ 0.01) and TG content decreased by 91％ (F =146.3,P ＜ 0.01) in the liver in RYGB group.In RYGB group,the conversion of LC3-Ⅰ to LC3-Ⅱ raised(F =17.01,P ＜ 0.01),the protein expression of P62 decreased(F =19.77,P ＜0.01) and the concentration of GLP-1 in plasma increased by 90％ (F =112.8,P ＜ 0.01).The marked increase of autophagy in liver after RYGB correlated with the plasma GLP-1 level (r2 =0.66,P =0.014 3)Conclusions RYGB reduces hepatic lipid toxicity and improves lipid metabolism disorder by increasing autophagy,increased GLP-1 secretion after RYGB may be one of the reasons for activating autophagy.
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<p><b>OBJECTIVE</b>To explore the applicable value of transanal total mesorectal excision (taTME) in male low rectal cancer patients with narrow pelvis-"difficult pelvis", which remains difficult for both open and laparoscopic sphincter-saving operations.</p><p><b>METHODS</b>Clinical data of male low rectal cancer patients diagnosed by pathology undergoing taTME between June 2016 and January 2018 at Peking University Cancer Hospital were collected. A retrospective cohort study was performed. Patients were selected according to the following criteria: (1) low rectal cancer, the distance between inferior margin of tumor and anal verge ≤5 cm; (2) the distance between two sciatic tubercles <5 cm; (3) body mass index (BMI) >25 kg/m; (4) tumor horizontal diameter ≤4 cm. Operation time, intraoperative blood loss, postoperative hospital stay, postoperative complications and anal function were analyzed.</p><p><b>RESULTS</b>A total of 20 patients were included in this study. All the patients received preoperative neoadjuvant chemoradiation and hybrid transabdominal and transanal surgery. The median BMI was 27.7(26.2-36.4) kg/m; the median distance between two sciatic tubercles was 92.5 (78-100) mm; the median distance between the inferior margin of tumor to the anal verge was 4 (2-5) cm; the median operation time was 302 (215-402) min; the median intraoperative blood loss was 100 (50-200) ml; the median postoperative hospital stay was 9 (5-15) d. Postoperative complications occurred in 5 patients (25%), including 3 pelvic infection, 1 intestinal obstruction, 1 anastomotic leakage receiving sigmoid colostomy. There was no perioperative death. Sphincter-preservation rate was 100%. Nineteen patients received anal manometry 1 month after operation with normal resting pressure (41.5±8.6) mmHg and squeeze pressure (121.0±11.6) mmHg. All the patients were followed up to March 2018, and the median follow-up time was 4.5 months. Only 1 patient had supraclavicular lymph node metastasis and no local recurrence was found.</p><p><b>CONCLUSIONS</b>The safety of transanal total mesorectal excision for male patients with low rectal cancer and difficult pelvis is acceptable. TaTME is helpful to preserve the anal sphincter.</p>
Subject(s)
Adult , Humans , Male , Anal Canal , General Surgery , Laparoscopy , Neoplasm Recurrence, Local , Pelvis , General Surgery , Postoperative Complications , Rectal Neoplasms , General Surgery , Retrospective Studies , Treatment Outcome , UniversitiesABSTRACT
Objective To assess the effects of removing indwelling urinary catheter at different timing on urinary retention puerper as who use patient controlled analgesia(PCA)after cesarean section. Methods Taking the database of PubMed,Embase,Cochrane Library,Medline,CNKI,CBM,VIP and Wanfang before December 2016 as the retrieval sources; collecting the Results of randomized controlled trial(RCT) about the incidence of postpartum urinary retention with PCA which removing the ureteral catheter after 24 hours, 36 hours, and 48 hours respectively; using RevMan 5.3 software for statistical analysis. Results A total of 10 study papers were collected, included involving 1 639 maternity patients.The incidence of urinary retention with ureteral catheter removal after 24 hours was higher than after 36 hours, the difference was statistically significant (RR=4.95, 95% CI 3.67-6.68, P<0.01); the incidence of urinary retention with ureteral catheter removal after 36 hours was higher than after 48 hours, the difference was statistically significant(RR=3.00,95% CI 1.66-5.41,P<0.01);the incidence of urinary retention with ureteral catheter removal after 24 hours was higher than after 48 hours the difference was statistically significant (RR=11.84, 95% CI 7.84-18.66, P<0.01). Conclusion In order to prevent the occurrence of urinary retention,the more appropriate timing to remove the urinary catheter after cesarean section with PCA is after 48 hours.
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Objective To analyze the long-term prognosis and prognostic factors of idiopathic collapsing focal segmental glomerulosclerosis (FSGS) and not otherwise specified FSGS in children. Methods The clinical, pathology and follow-up data of patients with idiopathic collapsing FSGS and not otherwise specified FSGS were analyzed retrospectively by Kaplan-Meier method, univariate and multivariate Cox regression analysis. Results A total of 64 patients (29 idiopathic collapsing FSGS and 35 not otherwise specified FSGS) were diagnosed by renal biopsy. The 4-year renal survival rate of idiopathic collapsing FSGS and not otherwise specified FSGS were 48.3%, 74.3% respectively. Univariate analysis revealed that the renal survival time were 25.41±3.28 months in idiopathic collapsing patients, and 35.53±2.73 months in not otherwise specified patients. The different is significant (χ2=4.07,P=0.044). Multivariate Cox regression analysis showed that poor treatment response (HR=5.92, P<0.05) and renal insufficiency at early stage (HR=2.45, P<0.05) were independent risk factors of prognosis. Conclusions Compared with patients with not otherwise specified FSGS, the renal survival time is shorter in idiopathic collapsing FSGS patients. Patients with renal insufficiency and poor response to treatment have poorer prognosis.