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Objective:To assess the efficacy of immunosuppressor on treatment of Henoch-Sch?nlein purpura nephritis(HSPN).Methods:Literatures were searched in PubMed, Cochrane library, Web of Science, Wanfang database, CNKI and CBM database from inception to January 2021.The studies that investigated the effect of immunosuppressor on HSPN outcomes were included.Article screening, data extraction and quality assessment were accomplished by two investigators independently, and statistical analyses were performed by STATA 14.Results:Ten studies were included with 443 cases, of which, 245 cases were in the experimental group while 198 cases were in the control group.The Meta-analysis showed that the experimental group had higher complete remission rate( OR=1.95, 95% CI 1.19-3.22, P=0.009), total remission rate ( OR=2.92, 95% CI 1.74-4.88, P<0.001), proteinuria decreasing level ( SMD=0.35, 95% CI 0.09-0.61, P=0.008), the increasing level of serum albumin ( SMD=1.27, 95% CI 0.43-2.11, P=0.003) and the increasing level of estimated glomerular filtration rate ( SMD=0.48, 95% CI 0.21-0.76, P=0.001), lower relapse rate ( OR=0.19, 95% CI 0.05-0.72, P=0.015) as well as death rate ( OR=0.19, 95% CI 0.04-0.78, P=0.021)than those of the control group. Conclusion:The immunosuppressor could enhance complete remission rate, total remission rate, proteinuria decreasing level, the increasing level of serum albumin and the increasing level of estimated glomerular filtration rate, reduce relapse rate and death rate of HSPN patients.
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BACKGROUND@#Primary lung cancer and metastatic lung cancer are common malignant tumors of the lung and are the main cause of cancer-related death. Advanced lung cancer and lung metastatic cancer are mainly treated by systemic therapy, and local treatment is also an effective treatment for the refractory or recurrent lesions in the lungs after systemic treatment. ¹²⁵I radioactive particle implantation, as an efficient conformal radiotherapy, has a certain control effect on localized lung cancer. The purpose of this study was to investigate the clinical efficacy and safety of computed tomography (CT) guided percutaneous puncture of lung tissue with ¹²⁵I radioactive particle implantation in the treatment of advanced lung cancer and lung metastatic cancer.@*METHODS@#Continuouslycollectedthe clinical and pathological data of 105 patients with advanced lung cancer and metastatic lung cancer treated by ¹²⁵I radioactive seed implantation in the Department of Thoracic Surgery, First Affiliated Hospital of Zhejiang University School of Medicine from January 1, 2014 to November 30, 2018. The patients were followed until March, 2019. The clinical efficacy and complications of seedimplantation were analyzed.@*RESULTS@#A total of 105 patients were included in the study, 78 patients with advanced lung cancer and 27 patients with lung metastases. The median survival time after seed therapy was 395 days. The 1-year survival rate was about 78.1%, and the 2-year survival rate was about 56.1%. Seed implantation for advanced lung cancer is equivalent to lung metastasis. Seed combined with radiofrequency ablation, microwave ablation, and chemotherapy did not improve seed treatment. However, particle combined with external radiation therapy has a significant survival disadvantage compared with simple seed therapy.@*CONCLUSIONS@#The CT-guided ¹²⁵I radioactive seed implantation has controllable complications and can be used as a safe and effective treatment for advanced lung cancer and lung metastases.
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Objective:To investigate the application value of three-dimensional power Doppler ultrasound in the clinical diagnosis of endometrial polyps.Methods:Seventy-three patients with suspected endometrial lesions admitted to Xin'an International Hospital of Zhejiang Province from June 2018 to June 2019 were enrolled.Three-dimensional power Doppler ultrasound and hysteroscopy were performed on the patients.The results of hysteroscopy and three-dimensional power Doppler ultrasound diagnosis and ROC curve were analyzed.Results:In 73 patients, the pathological diagnosis showed that there were 35 cases in the non-polyp group and 38 cases in the polyp group.The area and standard error under the three-dimensional Doppler ultrasound curve were 0.93 and 0.04, respectively.The area under the hysteroscopic curve and the standard error were 0.92.0.03, respectively, there was no statistically significant difference in the area of ROC curve between the two diagnostic methods ( P=0.051). Conclusion:Three-dimensional power Doppler ultrasound in the diagnosis of endometrial polyps is highly accurate and similar to hysteroscopy.In the clinical examination of endometrial polyps, three-dimensional energy Doppler ultrasonography is worthy of promotion and application.
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Objective:To evaluate the clinical value of three-dimensional ultrasound imaging in the localization and shaping of intrauterine contraceptive device.Methods:A total of 46 patients with abnormal intrauterine contraceptive device positions who admitted to Xin'an International Hospital from May 2018 to May 2019 were selected.All patients were examined by two-dimensional ultrasound and three-dimensional ultrasound, and the results were compared with the surgical results of the patients.The application value of three-dimensional ultrasound in the localization and shaping of intrauterine contraceptive device was analyzed.Results:By surgery pathology diagnosed with synthetic in palace in 2 cases, synthetic down in 29 cases, synthetic part or security in 15 cases.The two-dimensional ultrasonic diagnosis of patients with synthetic in the palace in 2 cases, synthetic down in 30 cases, synthetic part or security embedded in 11 cases, abnormal suspicious uncertain in 3 cases, 3 cases of missed diagnosis, 1 case of misdiagnosis.The three-dimensional ultrasound diagnosis in patients with synthetic in the palace in 2 cases, synthetic down in 29 cases, synthetic part or security embedded in 14 cases, abnormal suspicious uncertain in 1 case, no misdiagnosis, missed diagnosis in 1 case, pure synthetic down patients can be removed under hysteroscopy.Patients with IUD outside the uterus were removed laparoscopically without IUD rupture or residual fragments.And synthetic guided by hysteroscopy in patients with incarcerated during extraction, 3 cases of synthetic fracture or residual fragments occurring and compared with synthetic down the difference was statistically significant (χ 2=4.982, P<0.05), compared with the synthetic located outside the uterus, the difference was statistically significant (χ 2=4.634, P<0.05), the incidence of completely bypassed economizer fracture or residual fragments was higher than partial incarceration patients (χ 2=4.845, P<0.05). Conclusion:Three-dimensional ultrasound has higher accuracy in positioning and shaping the intrauterine contraceptive device of patients, which can guide clinicians to choose the treatment program.
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Objective:To explore the material basis and molecular mechanism of Liu-He-Dan (LHD) in treating acute pancreatitis (AP).Methods:Active chemical components of LHD, their corresponding targets and related AP pathogenic genes were searched and selected in the Encyclopedia of Traditional Chinese Medicine (ETCM) and disease information related databases (OMIM, DisGeNET, HPO, and NCBI), respectively. The protein-protein interaction (PPI) was analyzed through the STRING database. Enrichment analysis on those targets was performed by using CPBD and STRING databases to examine the function and pathway involved in the treatment of AP by active chemical components of LHD. Finally, " Chinese medicinal materials-active chemical components-targets-pathways" network was constructed by Cytoscape 3.6.0.Results:Network analysis showed that a total of 111 active chemical components of LHD were correlated with 39 targets of AP. The gene ontology functional enrichment analysis of 39 targets by CPBD and STRING databases obtained 575 enrichment results of biological process, 49 results of molecular function and 26 results of cellular components; Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis obtained 46 enrichment results involved in pancreatic secretion, bile secretion, RRAR signaling pathway, arachidonic acid metabolism and calcium signaling.Conclusions:The molecular mechanism of LHD in the treatment of AP by multiple components, multiple targets and multi-signaling pathways was preliminarily determined, which provides a basis for further analysis on active chemical components of LHD and molecular function.
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@#Background and Objectives: Stroke mimics are medical conditions producing stroke-like symptoms but eventually get diagnosed as non-stroke diseases. Epileptic seizure is a common type of stroke mimic. The purpose of this study is to investigate the application of emergency multimodal computed tomography (CT) in the diagnosis of epileptic seizure. Methods: We retrospectively reviewed the case group of patients with suspected stroke in the emergency stroke care service of the First Affiliated Hospital of Suzhou University from September 2017 to October 2019. We included those who underwent multimodal CT, including non-contrasted cranial CT, CT perfusion with CT angiography, and were ultimately diagnosed as epileptic seizures. Ten patients with acute anterior circulation ischemic stroke were assigned as controls. Results: A total of five cases met the inclusion criteria. Multimodal CT was completed within 2.25 to 3.50h from symptom onset. On CT perfusion, hyperperfusion was shown in four cases and slightly increased perfusion in one case with epileptic seizures. Cerebral blood flow and cerebral blood volume were significantly increased, while time to peak and mean transit time decreased in the regions of interest of the epileptic hemisphere when compared to either the non-affected hemisphere or the ischemic area in the control group (P<0.05). The abnormal perfusion areas did not follow vascular territory supply and CT angiography did not show vessel occlusion in the case group. Conclusion: Emergency multimodal CT could be used effectively to differentiate epileptic seizure from stroke.
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Objective@#To investigate the relationship between hemoglobin levels and prognosis of cerebral infarction in elderly patients aged 75 years and over.@*Methods@#A retrospective analysis of 238 elderly patients (≥75 years old) with cerebral infarction admitted into our hospital from January 2016 to June 2018 was performed. The age, gender, serum creatinine and risk factors for stroke (hypertension, diabetes, dyslipidemia, homocysteine, atrial fibrillation, smoking, drinking), coronary heart disease, previous stroke history, tumor history, National Institutes of Health Stroke Scale (NIHSS) score, hemoglobin, hematocrit and other basic data were recorded. The patients were divided into the group with good prognosis (mRS score ≤ 2) and the group with poor prognosis (mRS score > 2). The relationship between hemoglobin levels and the prognosis of cerebral infarction in elderly patients were analyzed.@*Results@#After 6 months of follow-up, 124 (52.1%, 124/238) stroke patients had a good prognosis, and 114 (47.9%, 114/238) patients had a poor prognosis, including 21 deaths. Anemia at admission (OR=2.433, 95%CI: 1.213-4.591, P=0.011), new-onset anemia after hospitalization (OR=2.615, 95%CI: 1.333-6.521, P=0.043) and the low level of minimum hemoglobin during hospitalization (OR=0.847, 95%CI: 0.671-0.971, P=0.038) were independent risk factors for poor prognosis in elderly stroke patients aged ≥75 years. New-onset anemia after hospitalization (OR=1.015, 95%CI: 1.002-1.027, P=0.022), the low level of minimum hemoglobin during hospitalization (OR=0.801, 95%CI: 0.654-0.981, P=0.027), the decrement of hemoglobin ≥20 g/L (OR=1.342, 95%CI: 1.011-1.763, P=0.000) at reexamination were independent risk factors for the mortality in elderly patients with cerebral infarction.@*Conclusions@#Anemia at admission, new-onset anemia after hospitalization, and the low level of minimum hemoglobin during hospitalization are independent predictors for poor prognosis in cerebral infarction patients aged ≥75 years. The decrement of hemoglobin ≥20 g/L after admission is an independent predictor for high mortality in elderly patients with cerebral infarction.
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Objective@#To study the hemodynamic changes of fetal umbilical artery (UA) and middle cerebral artery (MCA) and its influence on fetal outcome using color Doppler ultrasound.@*Methods@#Fifty pregnant women who underwent color Doppler ultrasound examination in Zhejiang Xin'an International Hospital from June to December 2018 with normal prenatal examination were selected as control group, and 80 pregnant women with oligohydramnios during the same period of pregnancy were selected as observation group. Color Doppler ultrasound examination was performed on both groups of pregnant women. The results of color Doppler ultrasound examination were compared between the two groups of pregnant women, and the fetal prognosis was followed up.@*Results@#Compared with the control group, the peak systolic velocity/end diastolic velocity (S/D), resistance index (RI) and pulsatility index (PI) values of UA in the observation group were significantly increased, while the S/D, RI and PI values of MCA were significantly decreased, and there were significant differences (P < 0.05). In addition, UA of 34 cases (42.5%) in observation group had S/D ≥ 3, which was much higher than that of 8 cases (16.0%) in control group, and there was significant difference (P < 0.05). The difference between the two groups was statistically significant (P < 0.05). The incidence of fetal distress, intrauterine growth retardation (IUGR) and Apgar < 4 points in observation group were significantly higher than those in control group [26.2%(21/80) vs. 12.0%(6/50), 15.0%(12/80) vs. 2.0%(1/50), 7.5% (6/80) vs. 0], and the difference were statistically significant (P < 0.05).@*Conclusions@#Prenatal color Doppler ultrasound can accurately detect the hemodynamic indexes of UA and MCA, predict the fetal intrauterine development, evaluate the fetal outcome, and provide scientific basis for clinical diagnosis.
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Objective To investigate the relationship between hemoglobin levels and prognosis of cerebral infarction in elderly patients aged 75 years and over.Methods A retrospective analysis of 238 elderly patients (≥75 years old) with cerebral infarction admitted into our hospital from January 2016 to June 2018 was performed.The age,gender,serum creatinine and risk factors for stroke (hypertension,diabetes,dyslipidemia,homocysteine,atrial fibrillation,smoking,drinking),coronary heart disease,previous stroke history,tumor history,National Institutes of Health Stroke Scale (NIHSS) score,hemoglobin,hematocrit and other basic data were recorded.The patients were divided into the group with good prognosis (mRS score ≤ 2) and the group with poor prognosis (mRS score ＞ 2).The relationship between hemoglobin levels and the prognosis of cerebral infarction in elderly patients were analyzed.Results After 6 months of follow-up,124 (52.1％,124/238) stroke patients had a good prognosis,and 114 (47.9％,114/238) patients had a poor prognosis,including 21 deaths.Anemia at admission (OR =2.433,95％CI:1.213-4.591,P=0.011),new-onset anemia after hospitalization (OR =2.615,95％CI:1.333-6.521,P =0.043) and the low level of minimum hemoglobin during hospitalization (OR =0.847,95 ％ CI:0.671-0.971,P =0.038) were independent risk factors for poor prognosis in elderly stroke patients aged ≥75 years.New-onset anemia after hospitalization (OR =1.015,95％ CI:1.002-1.027,P--0.022),the low level of minimum hemoglobin during hospitalization (OR =0.801,95％CI:0.654-0.981,P=0.027),the decrement of hemoglobin ≥ 20 g/L (OR =1.342,95％ CI:1.011-1.763,P =0.000) at reexamination were independent risk factors for the mortality in elderly patients with cerebral infarction.Conclusions Anemia at admission,new-onset anemia after hospitalization,and the low level of minimum hemoglobin during hospitalization are independent predictors for poor prognosis in cerebral infarction patients aged ≥75 years.The decrement of hemoglobin ≥20 g/L after admission is an independent predictor for high mortality in elderly patients with cerebral infarction.
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study the hemodynamic changes of fetal umbilical artery (UA) and middle cerebral artery (MCA) and its influence on fetal outcome using color Doppler ultrasound. Methods Fifty pregnant women who underwent color Doppler ultrasound examination in Zhejiang Xin'an International Hospital from June to December 2018 with normal prenatal examination were selected as control group, and 80 pregnant women with oligohydramnios during the same period of pregnancy were selected as observation group. Color Doppler ultrasound examination was performed on both groups of pregnant women. The results of color Doppler ultrasound examination were compared between the two groups of pregnant women, and the fetal prognosis was followed up. Results Compared with the control group, the peak systolic velocity/end diastolic velocity (S/D), resistance index (RI) and pulsatility index (PI) values of UA in the observation group were significantly increased, while the S/D, RI and PI values of MCA were significantly decreased, and there were significant differences (P<0.05). In addition, UA of 34 cases (42.5%) in observation group had S/D≥3, which was much higher than that of 8 cases (16.0% ) in control group, and there was significant difference (P < 0.05). The difference between the two groups was statistically significant (P < 0.05). The incidence of fetal distress, intrauterine growth retardation (IUGR) and Apgar < 4 points in observation group were significantly higher than those in control group [26.2%(21/80) vs. 12.0%(6/50), 15.0%(12/80) vs. 2.0%(1/50), 7.5% (6/80) vs. 0], and the difference were statistically significant (P < 0.05). Conclusions Prenatal color Doppler ultrasound can accurately detect the hemodynamic indexes of UA and MCA, predict the fetal intrauterine development, evaluate the fetal outcome, and provide scientific basis for clinical diagnosis.
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Objective To evaluate the effect and mechanism of rivaroxaban, an inhibitor of coagulation factor Ⅹa (FⅩa), on endotoxin-induced injury to human umbilical vein endothelial cells (HUVEC). Methods When cultured HUVEC grow to 80% fusion, they were divided into four groups according to the random number method: blank control group (DMEM medium), lipopolysaccharide (LPS) group (cells were challenged by 100 μg/L LPS for 16 hours), FⅩa+LPS group (cells were challenged by LPS for 16 hours after they were cultured with 100 nmol/L FⅩa for 24 hours), and FⅩa+RIV+LPS group (cells were challenged by LPS for 16 hours after they were cultured with 100 nmol/L FXa and 1 μmol/L rivaroxaban for 24 hours). After each group of cells were challenged with LPS, the cell activity was detected by the cell proliferation and toxicity kit (CCK-8); the cell migration ability was detected by cell scratch experiments;the abilities of cells migration were measured by scratch-wound-healing assay; the apoptosis of cells were evaluated using flow cytometry; the endothelial barrier of cells was assessed by Transwell and Evans blue; the levels of tumor necrosis factor-α(TNF-α), interleukin (IL-1β, IL-6) were detected by the enzyme linked immunosorbent assay (ELISA); the expressions of nuclear factor-κB (NF-κB) and mitogen activated protein kinase (MAPK) signaling pathway were detected by Western Blot. Results Compared with blank control group, the cell viability in LPS group was significantly decreased, and the migration ability, number of apoptotic cells, and barrier permeability of endothelial cells was significantly increased, the levels of TNF-α, IL-1β and IL-6 were significantly increased, and the expressions of phosphorylation of c-Jun N-terminal kinase (p-JNK), phosphorylation of p38MAPK (p-p38MAPK), phosphorylation of transforming growth factor kinase 1 (p-TAK1) and phosphorylation of NF-κBp65 (p-NF-κBp65) were significantly increased. It indicated that LPS could stimulate the inflammatory response of vascular endothelial cells, and had a significant impact on cell activity, apoptosis and function. There was no significant difference in above indexes between FⅩa+LPS group and LPS group, except for the level of IL-6 being higher in FⅩa+LPS group. Compared with FⅩa+LPS group, in FⅩa+RIV+LPS group, the cell activity was significantly increased (A value: 0.42±0.02 vs. 0.33±0.02), and migration ability was significantly decreased (folds: 1.78±0.17 vs. 2.24±0.20), the number of apoptotic cells was significantly decreased [(11.30±0.70)% vs. (21.03±0.19)%], and permeability of monolayers endothelial cells was significantly decreased [(149±12)% vs. (253±15)%], the levels of inflammatory cytokines were significantly decreased [IL-1β(ng/L): 163.2±20.7 vs. 477.8±20.2, IL-6 (ng/L): 69.3±0.5 vs. 238.0±24.1, TNF-α(ng/L): 117.0±13.1 vs. 196.2±4.5], the expressions of p-TAK1 and p-NF-κBp65 were significantly decreased (p-TAK1/TAK1: 0.74±0.09 vs. 1.85±0.15, p-NF-κBp65/NF-κBp65: 1.15±0.17 vs. 2.36±0.20), with statistically significant differences (all P <0.05). There was no significant difference in the p-JNK, p-p38MAPK expressions between FⅩa+RIV+LPS group and FⅩa+LPS group (p-JNK/JNK: 1.64±0.12 vs. 1.65±0.15, p-p38MAPK/p38MAPK: 2.31±0.32 vs. 2.35±0.20, both P > 0.05). Conclusion Rivaroxaban can effectively relieve the inflammatory response of HUVEC stimulated by LPS, which may be related to the inhibition of NF-κB signaling pathway activation rather than MAPK signaling pathway.
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Objective To develop the Quality of Life Questionnaire with traditional Chinese medicine characteristics for patients with ulcerative colitis.Methods The pool of entries were initially formed by using literature review,theoretical analysis and interviews.Delphi technique was used to formulate.quality of life questionnaire for patients with ulcerative colitis through a two-round expert consultation among 22 experts in 9 provinces.Results In two-round surveys,the rates of questionnaire retrieve were 95.7％ and 100.0％,respectively.The authoritative coefficients was 0.85,the coordination coefficients were 0.288 and 0.290,respectively,P＜ 0.01.The preparation of the primary scale consisted of physical,psychological,independence and social function of 4 dimensions and 48 items.Conclusions A reliable and valid questionnaire with traditional Chinese medicine characteristics for evaluation of quality of life for patients with ulcerative colitis was developed.It can be used to provide reference for the evaluation of the quality of life for patients with ulcerative colitis in China.
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<p><b>OBJECTIVE</b>To observe the efficacy difference between scrapping therapy combined withDecoction and the single application ofDecoction for perimenopausal syndrome (PMS) with pattern of fire excess fromdeficiency.</p><p><b>METHODS</b>Eighty patients were assinged into an observation group and a control group, 40 cases in each one. Patients in the control group were treated with oral administration ofDecoction to clear heart heat and nourish kidney. One dose of the decoction was taken by two times within one day. Based on the treatment of the control group, patients in the observation group were additionally treated with scrapping therapy along the urinary bladder meridian of foot-, heart meridian of hand-and kidney meridian of foot-; the scrapping therapy was performed at Back-points, Shenmen (HT 7), Yongquan (KI 1), Taixi (KI 3), Zhaohai (KI 6), Sanyinjiao (SP 6), Zusanli (ST 36), etc.; the treatment was given once every week. Four weeks of treatment were taken as one course in two groups, and totally 2 courses were given. The modified Kupperman score, menopausal quality of life (MENQOL), level of serum estrogen (E), follicle stimulating hormone (FSH) and luteinizing hormone (LH) before and after treatment as well as the clinical efficacy were valuated between the two groups.</p><p><b>RESULTS</b>After treatment, each item score and total score of modified Kupperman were reduced apparently in the two groups (<0.01,<0.05) except dyspareunia score in the control group. The score of hot flash and sweating, paresthesia, depression, fatigue, arthralgia, palpitation, formication, urinary symptoms and total score in the observation group were superior to those in the control group (<0.01,<0.05). After treatment, the total score and each dimension score of MENQOL were obviously decreased in the two groups (all<0.01), and the scores of vasomotor symptoms, psychosocial condition and physical condition in the observation group were significantly lower than those in the control group (<0.01,<0.05). There were no significant differences of serum hormone levels before and after treatment between the two groups (all>0.05), however, after treatment, the serum Elevel had the tendency to raise and serum LH, FSH levels had the tendency to decrease in the observation group. The total effective rate was 97.4% (37/38) in the observation group, which was higher apparently than 81.1% (30/37) in the control group (<0.01).</p><p><b>CONCLUSIONS</b>The scrapping therapy combined withDecoction or the simple application ofDecoction can both improve PMS symptoms and the quality of life, delay the ovary recession; the combination of scrapping therapy andDecoction achieve superior efficacy on PMS syndrome to the simple application ofDecoction.</p>
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Quercetin is widely known as potent natural antioxidant and scavenger of reactive oxygen species [ROS] and nitric oxide both in vitro and in vivo. Quercetin has a wide range of biological functions and health-promoting effects. There are more and more interests in the addition of this flavonol to various traditional food products. However, the in vitro toxicity of quercetin to mature human sperm remains unknown. In this study, we investigated the in vitro effects of quercetin on human sperm functions. The results showed that the total sperm motility were significantly inhibited compared to the controls following exposure to 100, 200 and 400micro M quercetin for 6 and 12h; quercetin did not affect human sperm viability. The acrosome reaction and capacitation induced by progesterone were dose-dependently inhibited by quercetin. Furthermore, quercetin induced a significantly decrease of human sperm [Ca2[+]]i after 2 min above 50 micro M, and dose-dependently decreased the protein-tyrosine phosphorylation of human sperm. Our results indicated that quercetin may decrease sperm [Ca2[+]]i, suppresse tyrosine phosphorylation, and subsequently inhibit sperm functions
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Objective To investigate operation time on biliary duct stone with acute gallstone pancreatitis.Methods The clinical data of 44 patients with acute gallstone pancreatitis who were admitted to Department of General Surgery,Taicang First People's Hospital for surgical management from January 2011 to December 2013 were retrospectively analyzed.Patients were divided into early surgery group and delayed surgery group according to the timing.Early surgery group was defined as the patients whose symptoms of pancreatitis were basically disappeared after conservative treatment and surgery was performed within two weeks,while delayed surgery group was defined as the patients who underwent surgery after two weeks.Results Of the 44 acute gallstone pancreatitis cases,18 patients were males,and 26 were females,with median age of 54 years old (range 26-83 years old).Forty-two cases were mild acute pancreatitis and the other two cases were severe acute pancreatitis.Preoperative imaging indicated both cholecystolithiasis and choledocholithiasis in 5 patients,cholecystolithiasis alone in 39 patients.The 5 patients underwent cholecystectomy and choledocholithotomy with T-tube drainage.Among these 5 cases,one patient with concomitant acute suppurative cholangitis had an emergency surgery,two patients with Ranson score ≤3 had early surgery,and two patients with Ranson score ≥4 had delayed surgery,and all the patients were cured and discharged.Thirty-nine cases with cholecystolithiasis alone were treated with laparoscopic cholecystectomy.Among the 39 patients,25 patients underwent early laparoscopic cholecystectomy,and the other 14 patients underwent delayed surgery,and all the patients were cured and discharged.When compared with delayed group,the average age and Ranson score of early group were lower [(46 ± 12) yrs vs (64 ± 11) yrs and (1.0 ± 0.5) vs (1.5 ± 0.8)],and the median hospital length of stay and the cost were significantly less in the early group than those in the delayed group [(14.0 ± 2.8) d vs (18.1 ± 3.3) d and (17 899 ± 3461) Yuan vs (23 710 ± 3230) Yuan],and the difference between the two groups was statistically significant (P＜0.05).Nevertheless,there was no difference between the operation time and recovery time.There was no conversion to open surgery or post-operative complication in the two groups.Conclusions For severe acute pancreatitis,the delayed operation is recommended when the symptom of pancreatitis is completely improved after conservative management,while for mild acute pancreatitis,early surgery does not increase operation difficulty and complication,and it can decrease the length of hospital stays and costs.
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Objective AMI is a prevalent global health condition.This study assessed the effects of PLGF and VEGF in a rat model of post-AMI.Methods Wistar rats underwent LAD ligation and injection of VEGF,PLGF,VEGF + PLGF,antiVEGFR1,anti-VEGFR2,anti-VEGFR1 + anti-VEGFR2,IgG2α,or saline,into the infarct border zone.We also set up a pseudo-operation group.Two weeks later,heart function was detected by hemodynamic and geometry,then the hearts were dis sected and HE stained.We assessed vW factor and α-SMA by immunohistochemistry and cardiomyocyte apoptosis rate by TUNEL.Results Rats in the VEGF + PLGF group performed significantly well in cardiac function,had weaker LV remodeling and less cardiomyocyte apoptosis.There were no obvious changes in VEGF group.The use of VEGFR1/VEGFR2 antibody didnt deteriorate the rat's cardiac function.More new-born arteries were seen in PLGF and VEGF + PLGF rats,and change wasnt found in other groups.Lastly,the most angiogenesis,the least left ventricular remodeling and the best heart function were observed in VEGF + PLGF group.Conclusion Earlier intervention with PLGF or VEGF + PLGF can improve heart function in rats with AMI; VEGF alone didnt improve heart function.VEGFR1/VEGFR2 antibody didnt aggravate the rat's heart function.This indicates that left ventricular and coronary remodeling may involve other factors.
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Objective To analyze left ventricular (LV) global systolic function in patients with coronary artery disease(CAD) and their changes after percutaneous coronary intervention(PCI) using velocity vector imaging(VVI). Methods Eighteen healthy adults and twenty two patients with CAD were enrolled in this study. Two-dimensional dynamic images of standard apical four-chambers, two-chambers and parasternal short-axis views at the level of mitral valve and apex were obtained in VVI condition. All patients were examined 1 day before PCI, 1 week, 1 month and 3 months after PCI respectively. LV rotation degree, rotation velocity at baseline and apex were measured using the off-line syngo US workplace software and LV twist, torsion were calculated as global motion condition. Results LV ejection fraction(LVEF) and peak torsion at myocardial infarction group were lower than those at normal control and myocardial ischemia group. After PCI, LVEF were gradually improved in both myocardial infarction group and myocardial ischemia group,while changes of LV apex rotation degree and velocity, peak twist and peak torsion between two groups were opposite: those parameters of the former increased 1 week or 1 month after PCI but decreased 3 months after PCI,while those of the latter decreased 1 week after PCI but increased gradually 1 month and 3 months after PCI. Conclusions LV twist and torsion can be evaluated exactly by VVI.Compared with LVEF, LV twist and torsion can preferably reflect the different characteristic of LV global systolic function after coronary artery recanalization in myocardial infarction group and myocardial ischemia group.
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Objective To determine the optimal injection dose of ozone for the treatment of lumbar intervertebral disc protrusion.Methods A total of 240 patients with lumbar intervertebral disc protrusion were randomly and equally divided into four groups,with 60 patients in each group.Under CT guidance intervertebral injection of ozone was performed.The injection dose of ozone(50 ug/ml)used for patients in group A,B,C and D was 10 ml,20 ml,30 ml and 40 ml respectively.Immediately after the procedure CT scanning was made to check the result. A follow-up lasting 6-12 months was carried out.Clinical observation,including the ablation degree of the nucleus puiposus,the therapeutic results and the adverse reactions,was conducted.The results were statistically analyzed and compared among the four groups.Results A significant difference in the therapeutic effect existed between group A(10 ml)and other three groups(P＜0.05),while no significant difference in the therapeutic effect existed among group B(20 ml),group C(30 ml)and group D(40 ml),with P＞0.05.The occurrence of complications was increasing with the injection dose used.Conclusion The optimal injection dose of ozone for the treatment of lumbar intervertebral disc protrusion is 20 ml.
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Objective To investigate the influence of erythropoietin in the metabolism of extracellular matrix after myocardial ischemia-reperfusion injury.Methods The langendroff reperfusion system was applied to investigate the protective function of EPO in ischemia-reperfusion condition in rats.The effects of EPO on extracellular matrix were observed by Western blot and signal pathway blocker.The LVEDP and infarction area were observed at the same time.Results EPO significantly improved LVEDP [(19.8±0.2) mmHg vs (35.9±0.2) mmHg,IR group vs EPO +IR group,P＜0.05]and decreased infarction area (35.26%±7.13% vs 62.70%±7.23%,IR group vs EPO+IR group,P＜0.05).The expression of MMPs was significantly decreased and the expression of collagenase Ⅰ/Ⅲ was significantly enhanced by EPO (MMP2 53.2+2.6 vs 21.2+2.5;MMP9 57.6±3.1 vs 19.2±2.6;IR group vs IR+EPO group (P＜0.05);collagen Ⅰ 43.2±2.2 vs 11.4±2.3;collagen Ⅲ 55.3±3.2 vs 18.1 vs 2.3;IR+EPO group vs IR group (P＜0.05).This function can be inhibited by Mek-Erk inhibitor.Conclusion EPO plays a role in the metabolism of extracellular matrix by Mek-Erk signal pathway,which can protect the heart tissue from ischemia-reperfusion injury.
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Objective To evaluate the value of left ventricular (LV) torsion for assessing left ventricular function in adult heart transplant patients using two-dimensional speckle tracking imaging.Methods Basal and apical LV short-axis view and apical LV long-axis view of two-demensional images were acquired in 30 heart transplant patients and 17 healthy volunteers. Using two-dimensional strain software,LV basal and apical rotation versus time profiles were obtained at their short-axis level respectively. LV torsion was defined as apical rotation relative to the base, so the LV torsion versus time profiles could be drawn. LV basal rotation,apical rotation,global torsion and their time to peak were respectively measured,and the rate of LV untwisting was calculated. Statistical analysis was used to find the difference between the two groups and to investigate the relationship between LV torsion or the rate of LV untwisting and echocardiographic parameters. Results LV apical rotation and LV global torsion in heart transplant group were significantly lower than those in normal group. LV global torsion inversely correlated with LV end systolic volume,positively with LV ejection fraction. There was no significant difference between the two groups in the rate of LV untwisting. The rate of LV untwisting didn't correlate with echocardiographic parameters. Conclusions LV torsion can be measured exactly by two-dimensional speckle tracking imaging, it can be used to quantify LV global systolic function in heart transplant patients.