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Objective:To investigate the value of three-dimensional (3D) CT in diagnosing cricoarytenoid dislocation.Methods:From January 2021 to December 2021, 31 patients with unilateral cricoarytenoid dislocation who had been treated by reduction forceps at the Affiliated BenQ Hospital of Nanjing Medical University were collected retrospectively, and their voice recovered or improved significantly after therapy. The preoperative CT images were reconstructed by volume rendering (VR). The dislocated side (left and right), type of dislocation (total dislocation and subluxation), and dislocation direction (anterior, posterior, internal and external dislocation) of cricoarytenoid dislocation were observed. According to arytenoid articular surface of cricoid cartilage exposed completely or not (caused by arytenoid displacement), they were divided into complete dislocation and subluxation. According to the direction of arytenoid displacement and the part of arytenoid articular surface of cricoid cartilage exposed, they were divided into anterior, posterior, internal and external dislocation. According to the shape of the vocal cords on laryngoscope, anterior and posterior dislocation of each case was judged, and then compared with that of CT.Results:On VR images, there were 28 cases of cricoarytenoid subluxation (90.3%, 28/31) and 3 cases of complete dislocation (9.7%, 3/31). Left cricoarytenoid dislocation was 26 cases (83.9%, 26/31) and right cricoarytenoid dislocation was 5 cases (16.1%, 5/31). Posterior dislocation was 28 cases (90.3%, 28/31) and anterior dislocation was 3 cases (9.7%, 3/31). There were 23 cases of internal dislocation (74.2%, 23/31), 2 cases of external dislocation (6.4%, 2/31), and 6 cases without obvious internal and external dislocation (19.4%, 6/31). Three cases of complete dislocation were left posterior internal dislocation.There were 24 cases of left posterior dislocation (77.4%, 24/31), 4 cases of right posterior dislocation (12.9%, 4/31), 2 cases of left anterior dislocation (6.4%, 2/31) and 1 case of right anterior dislocation (3.2%, 1/31). On laryngoscope, there were 19 cases of posterior dislocation (61.3%, 19/31), 9 cases of anterior dislocation (29.0%, 9/31), 3 cases were difficult to assess (9.7%, 3/31) because of aryepiglottic fold covering. Sixteen cases (55.2%, 16/28) were consistent with 3D CT, and 12 cases (42.8%, 12/28) were inconsistent.Conclusion:The 3D CT is a reliable method to evaluate cricoarytenoid dislocation, which can show dislocated side, type and direction of cricoarytenoid dislocation clearly.
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Objective@#To investigate the survival rate and changing trends of kidney cancer patients in Qidong City from 1972 to 2016, so as to provide insights into kidney cancer control.@*Methods@#Data pertaining to the incidence of kidney cancer in Qidong City from 1972 to 2016 were captured from the Qidong Municipal Cancer Registration System, and the final follow-up period was December 31, 2021. The observed survival rate, relative survival rate and standardized relative survival rate of kidney cancer were calculated to analyze the survival of kidney cancer, and the trends in survival were analyzed among kidney cancer patients from 1972 to 2016 using annual percent change (APC).@*Results@# A total of 554 kidney cancer patients were reported in Qidong City from 1972 to 2016. The 1-, 3- and 5-year observed survival rates, relative survival rates and standardized relative survival rates were 62.27%, 50.54% and 44.04%; 64.31%, 55.71% and 51.93%; and 61.71%, 51.90%, and 51.68%, respectively. The 5-year observed survival rate, relative survival rate and standardized relative survival rate of kidney cancer appeared a tendency towards a rise in Qidong City from 1972 to 2016, with APC of 2.83% (t=4.303, P=0.004), 2.82% (t=3.978, P=0.005) and 3.96% (t=5.898, P=0.001), and the 5-year relative survival rate of kidney cancer was comparable between men and women (53.05% vs. 50.40%; χ2=4.872, P=0.676). There was an age-specific 5-year relative survival rate of kidney cancer (χ2=35.144, P<0.001), with the greatest among patients at ages of 35 to 44 years (64.49%) and the lowest at ages of 75 years and older (30.11%).@*Conclusion@#The 5-year survival rate of kidney cancer cases appeared a tendency towards a rise in Qidong City from 1972 to 2016. Further specific interventions, depending on age, are needed for management of kidney cancer.
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Five new flavonoid derivatives, cajavolubones A-E (1-5), along with six known analogues (6-11) were isolated from Cajanus volubilis, and their structures were elucidated by spectroscopic analysis and quantum chemical calculations. Cajavolubones A and B (1 and 2) were identified as two geranylated chalcones. Cajavolubone C (3) was a prenylated flavone, while cajavolubones D and E (4 and 5) were two prenylated isoflavanones. Compounds 3, 8, 9 and 11 displayed cytotoxicity against HCT-116 cancer cell line.
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Flavonoids/chemistry , Cajanus , Molecular Structure , Chalcones/chemistryABSTRACT
@#Objective To investigate the expression of α7 nicotinic acetylcholine receptor (α7 nAChR) in thymocytes of patients with myasthenia gravis (MG) and its effect on cytokine secretion and T cell proliferation. Methods Patients with MG who underwent expanded thoracoscopic thymectomy in the Comprehensive Diagnosis and Treatment Center of the Henan Provincial People’s Hospital from June 2021 to June 2022 were selected and allocated to a MG group. Patients who underwent partial thymectomy to expose the surgical field during the cardiac disease surgery from June 2021 to September 2022 in the Department of Adult Cardiac Surgery of Fuwai Huazhong Cardiovascular Hospital were selected as the control group. Thymic single cell suspensions were prepared from MG and control groups, and the expression of α7 nAChR in thymocytes of the two groups was detected by real-time polymerase chain reaction and Western blotting. Then CD3/CD28 monoclonal antibody coupled with magnetic beads was used to induce T cell activation, and the levels of cytokines interferon-gamma (IFN-γ), tumor necrosis factor-α (TNF-α), interleukin-4 (IL-4), IL-6, IL-10, IL-17, and IL-21 in thymocytes of the two groups were detected by enzyme-linked immunosorbent assay (ELISA). The activated T cells of the MG group were divided into a blank control group, an α7 nAChR antagonist group, and an α7 nAChR agonist group according to different treatment methods. After 72 hours of culture, IFN-γ, TNF-α, IL-4, IL-6, IL-10, IL-17, and IL-21 expression levels in the culture supernatant were measured by ELISA. Afterwards, CD4-PE and CD8-APC antibodies were added, and the proliferation of T cell subsets was detected by flow cytometry. Results A total of 10 MG patients were collected, including 3 males and 7 females with an average age of 19.25±6.28 years; and 15 control patients were collected, including 6 males and 9 females with an average age of 26.18±6.77 years. Compared with the control group, the mRNA and protein levels of α7 nAChR in the thymocytes of MG group were decreased, and the expression levels of IFN-γ, TNF-α, IL-4, IL-6 and IL-21 in the supernatant were increased (P<0.05), but there was no statistical difference in the expression of IL-10 and IL-17 (P>0.05). The cell-culture experiment showed that compared with the blank control group, the levels of IFN-γ, TNF-α, IL-6 and IL-21 secreted by T cells in the α7 nAChR antagonist group were increased (P<0.05), while they were decreased in the α7 nAChR agonist group (P<0.05). There was no statistical difference in the secretion levels of IL-4, IL-10 or IL-17 among the three groups (P>0.05). CD4+ T and CD8+ T cells in the α7 nAChR agonist group were significantly less than those in the blank control group and α7 nAChR antagonist group (P<0.001), while they were significantly more in the α7 nAChR antagonist group than those in the blank control group (P<0.001). Conclusion The expression of α7 nAChR in thymocytes of MG patients is decreased, and α7 nAChR may be involved in the inflammatory response in thymocytes and thus in thymic function.
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@#Objective To exploring the effectiveness of perioperative application of new surgical clinical classification and staging for myasthenia gravis (MG) in reducing the incidence of postoperative myasthenic crisis (MC). Methods The clinical data of patients with generalized MG admitted to the Comprehensive Treatment Center for Myasthenia Gravis of Henan Provincial People’s Hospital from January 2018 to June 2022 were retrospectively analyzed, who were scored with myasthenia gravis-activities of daily living (MG-ADL) score and quantification of the myasthenia gravis (QMG) score at the first visit, 1 day before surgery, and 3 days after surgery. The patients were divided into a group A (typeⅡ) and a group B (typeⅢ+Ⅳ+Ⅴ) by the new surgical clinical classification and staging of MG according to the disease progression process, and all patients underwent expanded thoracoscopic thymus (tumor) resection after medication and other interventions to control symptoms in remission or stability. The incidence of MC and the efficiency rate after surgery were analyzed. The normal distribution method and percentile method were used to calculate the unilateral 95% reference range of the QMG score and MG-ADL score. Results Finally 126 patients were enrolled, including 62 males and 64 females, aged 13-71 years, with an average age of 46.00±13.00 years. There were 95 patients in the group A and 31 patients in the group B, and the differences of the preoperative baseline data between the two groups were not statistically significant (P>0.05). The incidence of postoperative MC was 1.05% (1/95) in the group A and 3.23%(1/31) in the group B (P>0.05). The effective one-sided 95% reference range of the QMG score and MG-ADL score 1 day before surgery was 0-7.75 and 0-5.00, and there was no postoperative death in both groups. Conclusion The new surgical clinical classification and staging of MG can guide the timing of surgery, which can benefit patients undergoing surgery for MG and greatly reduce the incidence of postoperative MC.
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Objective:To analyze the survival rate of malignant tumor in the elderly over 60 years old in Qidong city from 1972 to 2016, and to provide basis for prognosis evaluation and prevention.Methods:Based on the data of 66 386 patients with malignant tumor in the elderly over 60 years old in the Qidong cancer registration and reporting system, the survival outcome was tracked by the method of active follow-up and passive follow-up.All of these data were then analyzed by stratification of sex, age, tumor site and hospital level.Results:During the period of 1972 to 2016, the total number of patients with malignant tumors in the elderly were 66 386 cases, accounting for 56.66% of patients in all age groups.The observed survival rate(OSR)of 5 and 10 years were 14.52% and 9.53% and relative survival rate(RSR)of 5 and 10 years were 19.76% and 18.92%, respectively, in the elderly in Qidong.The 5-year RSR was 16.98% for males and 23.91% for females, being a statistically significant( χ2=339.83, P<0.001). The 5-year RSRs of elderly patients in males and females increased from 7.53% and 15.83% in 1972-1976 to 28.06% and 39.01% in 2012-2016, respectively.The 5-year RSR of 60-64, 65-69, 70-74, 75-79, 80-84 and 85 years old and over were 22.84%, 20.53%, 17.74%, 18.30%, 18.02% and 14.06%, respectively, with a statistically significant difference( χ2=694.27, P<0.001). Among the top 10 major malignancies, the ranks of 5-year RSR from high to low were breast cancer, prostate cancer, bladder cancer, colorectal cancer, malignant lymphoma, gastric cancer, liver cancer, esophageal cancer, lung cancer, and pancreatic cancer, respectively.A comparison between 2002--2016 and 1972--1986 showed that the increased rank of absolute values of RSR from highest to lowest were prostate cancer, colorectal cancer, female breast cancer, bladder cancer, gastric cancer, malignant lymphoma, liver cancer, esophageal cancer, lung cancer, and pancreatic cancer, respectively.The 5-year RSR of patients diagnosed in the district / township hospitals, county hospitals, city-level 3A hospitals and provincial-level 3A hospitals were 13.97%, 23.71%, 26.12% and 28.55%, respectively, with a statistically significant difference( χ2=841.93, P<0.001). In the 45 years, the average annual percentage change(AAPC)ratio of 5-year OSR was 3.88%( t=6.75, P<0.001), and the 5-year RSR was 3.69%( t=7.44, P=0.001); the AAPC of the 5-year RSR was 3.91%( t=9.66, P<0.001)in males and 3.42%( t=6.08, P=0.001)in females.The AAPC ratio of 5-year RSR in each age group were 4.08% for 60-64 years, 4.18% for 65-69 years, 3.91% for 70-74 years, 3.12% for 75-79 years, 3.81% for 80-84 years, 0.51% for 85 years old and over, respectively.Except for age group of 85 years old and over( P=0.615), significant rising trends were observed in all age groups( P<0.01). Conclusions:Malignant tumors in the elderly have become the major cancer burden in Qidong, and there are significant gender and age differences.The overall survival rate in elderly patients with malignant tumors has been significantly improved in the past 45 years, which may be related to the improvement in the level of diagnosis and treatment and the service capacity of hospitals.
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Objective:To investigate the fertility intention and psychological pressure of women of childbearing age in Yanshan County, Jiangxi Province, and to provide data support for the targeted promotion of fertility.Methods:Using the method of random sampling, women of childbearing age in 10 communities in Yanshan County, Jiangxi Province were given questionnaires and psychological stress rating tables to understand the basic information, the status of marriage and childbearing, childbearing intentions, and the Chinese version of the Perceived Stress Scale (CPSS) score, and explore the related factors that may affect childbearing intentions and psychological stress of women of childbearing age.Results:In this survey, 1 500 questionnaires were distributed to women of childbearing age, 913 of which were returned, and 65.0%(593/913) of them were willing to have children. The CPSS score of women of childbearing age was 8-28(16.84±2.75). The CPSS scores of women of childbearing age in different occupations were statistically significant ( P<0.05). Public officials (including civil servants and employees of public institutions) had the least psychological pressure, while self-employed and other (unemployed) had the most psychological pressure. There was no significant difference in CPSS scores among women of childbearing age with different education levels, annual income levels, marital status and willingness to have children (all P>0.05). The correlation analysis showed that there was a statistical significance between the psychological pressure of women of childbearing age and their occupation ( r=0.230, P<0.05), and there was no significant correlation between other factors such as education level, annual income, fertility desire, fertility status, etc. and psychological pressure (all P>0.05). Conclusions:The fertility intention desire of women of childbearing age in Yanshan County, Jiangxi Province is basically normal, and the desire to have more children is not strong. There is no significant correlation between fertility intention and psychological pressure. The psychological pressure of women of childbearing age is significantly related to their occupation.
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Objective:To analyze the survival of pancreatic cancer cases in Qidong County, Jiangsu Province from 1972 to 2016, and provide a basis for the prognosis evaluation and prevention of pancreatic cancer.Methods:Data from a total of 4 341 registered pancreatic cancer patients in Tumor Registry of Qidong from January 1972 to December 2016 were selected, and all the patients were followed up until December 31, 2021. 1-, 3- and 5-year observed survival rate (OSR) and relative survival rate (RSR) were calculated and tested by Hakulinen likelihood ratio test method using SURV (3.01) software. Age-standardized relative survival rate (ARSR) was calculated according to the International Cancer Survival Standard (ICSS). Joinpoint (4.7.0.0) software was used to conduct the annual percentage change (APC) of pancreas cancer survival rate.Results:1-, 3- and 5-year OSR of pancreatic cancer were 13.82%, 5.87% and 4.70%, and 1-, 3- and 5-year RSR were 14.50%, 6.80% and 6.02%, respectively. 1-, 3- and 5-year RSR increased from 11.76%, 4.84% and 3.29% in 1972—1976 to 18.80%, 7.39% and 6.49% in 2012—2016. The uptrends of RSR were statistically significant (χ 2=59.84, P<0.001). 1-, 3- and 5-year RSR for male were 14.31%, 6.40% and 5.82%, and 1-, 3- and 5-year RSR for female were 14.74%, 7.28% and 6.26%, respectively. There was no statistically significant difference on RSR between male and female (χ 2=6.68, P=0.463). The 5-year RSR for the age group of 45-54, 55-64, 65-74, and ≥75 years old were 8.14%, 6.74%, 4.69% and 5.24%, respectively, and the survival rate was decreased with age. There was a statistically significant difference on RSR among different age groups (χ 2=19.52, P=0.012). 1-, 3- and 5-year ARSR of pancreas cancer were 14.67%, 6.84% and 6.04%. For male, 1-, 3- and 5-year ARSR were 14.36%, 6.42% and 5.79%, and for female were 15.25%, 7.55% and 6.47%, respectively. Period trend analysis showed that the APC of 1-, 3- and 5-year ARSR was 0.91% ( t=1.94, P=0.094), -0.22% ( t=-0.30, P=0.774) and -0.77% ( t=-0.95, P=0.374) from 1972 to 2016 in Qidong. The APC of 5-year ARSR in male and female were -1.50% ( t=-1.31, P=0.232) and 1.11% ( t=0.37, P=0.722); there were no statistically significant increase or decrease for both male and female among ARSR in nine periods (5 years as a period). The APC of 5-year RSR among 45-54, 55-64, 65-74 and ≥75 years old were 2.46% ( t=0.57, P=0.588), 3.16% ( t=0.87, P=0.413), 0.95% ( t=0.26, P=0.805) and -2.56% ( t=-2.61, P=0.035), respectively. Except for ≥75 years old age group who had a statistically significant downward trend, there were no statistically significant upward trend in the other age groups. Conclusions:The overall survival rate of pancreatic cancer in Qidong from 1972 to 2016 has been at a low level, and it is necessary to introduce a standardized multi-disciplinary treatment mode to improve treatment efficacy and survival rate.
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Objective To study and analyze the trend of diabetes death and the impact of life expectancy in Qidong City, Jiangsu Province from 1990 to 2019, and to provide a basis for formulating health policies. Methods Based on the surveillance data of deaths from all causes in Qidong City and the population data over the years from 1990 to 2019, the residents' diabetes mortality and temporal trends were analyzed. Joinpoint4.7.0.0 software was used to calculate relevant indicators including crude mortality (CR), age-standardized rates by China population (CASR), annual percentage change (APC), potential years of life lost (PYLL), and potential years of life lost rate (PYLLR). Results The CR of diabetes in Qidong City from 1990 to 2019 was 15.12/100 000, with a rate of 12.72/100 000 in males and a rate of 17.45/100 000 in females. The total CASR was 7.58/100 000, including 6.47/100 000 for males and 8.59/100 000 for females. Trend analysis showed that the APC of CR and CASR was 9.31% and 5.26% in males, and 8.12% and 4.40% in females, respectively. The APC of CR and CASR in the 45-64 years old group was 2.59% and 4.85%, respectively. The APC of CR and CASR in the 65 years old and above group was 7.20% and 9.79%, respectively. There were statistically significant differences except for the 15-44 years old group. The life expectancy of residents in Qidong City rose from 73.95 years in 1990 to 82.91 years in 2019 (APC=0.38, P<0.001), and life expectancy without diabetes rose from 74.01 years in 1990 to 83.39 years in 2019 (APC=0.39, P<0.001). Conclusion In the past 30 years, the diabetes mortality and life loss of residents in Qidong City have been increasing year by year and the trend is obvious. Women's diabetes mortality and life loss are higher than those in men. The level and increase rate of diabetes mortality in the high age group are higher than those in the low age group. It is necessary to carry out key intervention for the corresponding population.
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Objective To understand the death status, mortality trend, cause of death and life loss of injury and poisoning among residents in Qidong City, Jiangsu Province from 1990 to 2019, and to provide a reference for formulating public health policies. Methods Data on injury and poisoning death of residents in Qidong City from 1990 to 2019 were collected through the death cause registration and monitoring system of Qidong City, Jiangsu Province. Indicators such as crude death rate (CR) and standardized death rate (CASR), average years of lost life (AYLL), and potential years of life lost rate (PYLLR) were calculated. Annual percentage change (APC) was used to analyze the trend of death from injury and poisoning. Results From 1990 to 2019, 18 163 residents in Qidong City, Jiangsu Province died of injuries and poisoning. The CR was 53.12/100 000 (APC=0.74%), and the CASR was 39.43/100 000 (APC=-1.86%). The male CR was 66.90 100 000 (APC=0.75%), and the male CASR was 52.42/100 000 (APC=-1.75%), while the female CR was 39.69/100 000 (APC=0.73%), and the female CASR was 26.63/100 000 (APC=-2.14%). Analysis of the standardized mortality rate showed a downward trend year by year (P<0.001). PYLL caused by injury and poisoning was 318 502.50 person-years (APC=-4.00%), AYLL was 26.02 years/person (APC=-3.26%) and the PYLLR was 10.39‰ (APC=-3.54%). The top five death causes of injury and poisoning are motor vehicle accidents, suicide, drowning, accidental falls and accidental poisoning, accounting for 87.17% of the total deaths from injuries and poisoning. Drowning was the leading cause of death for children aged from 0 to 14. Motor vehicle accidents were the leading cause of death for residents aged from 15 to 64, and accidental falls were the leading cause of death for residents over 65. Conclusion Injury and poisoning are one of the main causes of death among residents in Qidong City, Jiangsu Province. The distribution characteristics of injurie and poisoning deaths of different genders and ages are different. According to their distribution characteristics, targeted and specific measures should be taken to reduce mortality.
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Objective:To discuss the effect of sarcopenia (Sa) on the prognosis of transjugular intrahepatic portosystemic shunt (TIPS) in patients with portal hypertension (PHT).Methods:Totally 131 PHT patients treated with TIPS were retrospectively collected from August 2013 to December 2017 in the First Affiliated Hospital of USTC, and were divided into the Sa group [maximum transverse diameter of the psoas major muscle/height (TPMT/H) ≤16.8 mm/m, n=60] and the control group (TPMT/H>16.8 mm/m, n=71). The patients were followed up with a median time of 42 months. The Kaplan-Meier method was used to calculate the incidence of hepatic encephalopathy, recurrence rate of PHT-related complications and survival rate of PHT patients after TIPS, and the differences were compared by Log-rank test. Results:The incidences of hepatic encephalopathy within 6 months after TIPS and severe hepatic encephalopathy requiring hospitalization in the Sa group [36.7% (95%CI 24.5%-48.8%) and 15.0% (95%CI 6.0%-24.0%)] were higher than those of the control group [15.7% (95%CI 7.3%-24.1%) and 2.8% (95%CI 0-6.7%)], with statistically significant differences (χ2=7.843, 16.442, P=0.005, 0.001). The 5-year overall recurrence rate of PHT-related complications of the Sa group after TIPS [15.8% (95%CI 6.4%-25.2%)] was higher than that of the control group [5.7% (95%CI 0.2%-11.2%)], with a statistically significant difference (χ2=4.431, P =0.035. The 1, 3 and 5-year survival rates in the Sa group were 88.3% (95%CI 80.3%-96.3%), 86.7% (95%CI 78.1%-95.3%) and 77.8% (95%CI 65.1%-90.5%) respectively, which were all lower than those of the control group [97.2% (95%CI 93.3%-100%), 95.8% (95%CI 91.1%-100.0%) and 93.7% (95%CI 87.6%-99.87%) respectively], and the difference was statistically significant (χ2=5.055, P=0.025). Conclusion:Sa has a higher incidence in PHT patients, which can increase the incidence of hepatic encephalopathy and recurrence rate of PHT-related complications, and can decrease the survival rate in PHT patients after TIPS. Hence, the Sa is an indicator of the poor prognosis in PHT patients with TIPS.
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Objective To study the correlation between characteristic parameters of photoplethysmography( PPG)and severity of coronary artery lesions.Methods Two hundred and twenty-six CHD patients who underwent CAG in our hospital from August 2018to November 2018were divided into single-vessel lesion group(n=55),double-vessel lesion group(n=74)and multi-vessel lesion group(n=97)according to their CAG.Their stiffness index(SI),crest time(CT),normalized crest time(NCT)and crest time ratio(CTR)were recorded by PPG and analyzed by correlation analysis.Results The SI was significantly different in single-vessel lesion group,double-vessel lesion group and multi-vessel lesion group(6.479±0.819m/s,6.692±1.051m/s and 6.943±1.096m/s,P=0.024).No significant difference was detected in CT,NCT and CTR among single-vessel lesion group,double-vessel lesion group and multi-vessel lesion group(P＞0.05).The SI was positively correlated with the severity of coronary artery lesions(r=0.162,P=0.015).Conclusion The SI is correlated with the severity of coronary artery lesions,which is of a certain value in predicting the severity of coronary artery lesions.
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Objective@#To investigate the risk factors affecting the short-term prognosis of patients with hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF), and establish a new scoring model to predict the short-term prognosis of patients.@*Methods@#This study enrolled 222 patients with HBV-ACLF. According to their clinical outcomes during hospitalization and 90 days after discharge, they were divided into survival and death group. Clinical data were collected to calculate the Child-Turcotte-Pugh (CTP), model for end-stage liver disease (MELD), albumin-bilirubin (ALBI), and age-bilirubin-international normalized ratio-creatinine (ABIC) scores for prognosis. Multivariate logistic regression analysis was used to analyze the independent risk factors affecting 90-day mortality in HBV-ACLF patients. Cox regression model was used to establish a new prediction model. Area under the receiver operating characteristic curve was used to calculate short-term prognostic value of the models. K-M survival curve was used to predict the prognosis of patients.@*Results@#CTP and ABIC scores were independent risk factors for 90-day mortality in HBV-ACLF patients, and the risk of death from liver failure had increased with increase of score. Cox regression model established a new predictive model CTP-ABIC = 0.551 × CTP + 0.297 × ABIC. Area under the receiver operating characteristic curve of all three scoring models (CTP, ABIC and CTP-ABIC) were 0.878, 0.829, 0.927, respectively. CTP-ABIC score was superior to the CTP and ABIC score (P value < 0.001). Patients with CTP-ABIC score ≥9.08 had higher mortality rate than patients with CTP-ABIC score < 9.08, and the difference was statistically significant (P < 0.001).@*Conclusion@#All three scoring systems can predict short-term prognosis in patients with HBV-ACLF, but the accuracy of CTP-ABIC is superior.
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Objective@#To analyze the diagnostic value of ultrasound guided 14 gauge coreneedle biopsy (US-CNB) in breast nodules.@*Methods@#We retrospectively analyzed the pathological results of US-CNB and surgical excision from 373 breast nodules in Peking University International Hospital from Sep 2016 to Nov 2018 to evaluate the accuracy of 14g US-CNB.@*Results@#A total of 349 patients(373 nodules)underwent US-CNB. US-CNB reported 282 benign lesions(75.6%, 282/373), 20 high-risklesions(5.4%, 20/373), and 71 malignant lesions(19.0%, 71/373). For 282 CNB reported benign lesions, the surgical pathology confirmed 235 lesions , 46 for high-risk lesions and 1 for malignant lesion with a concordancy of 83.3%(235/282)and the underestimation rate was 16.7%(47/282). US-CNB identified 20 high-risk lesions. According to surgical results, 15 were high-risk lesions and 5 were malignant lesions with a concordancy of 75% (15/20)and the underestimation rate was 25%(5/20). When it comes to malignant lesions, the excision results showed that 70 were malignant lesions and 1was high-risk lesion with a concordancy of 98.6%(70/71)and the overestimation rate was 1.4%(1/71). The concordance of the histological type , calculated for 50 invasive carcinomas, was 92% (46/50) with a kappa value of 0.77.The concordance of the histological grade could be calculated for 38 invasive ductal carcinomas with the Elston-Elllis Method . It was 89.5% (34/38) with a kappa value of 0.57.@*Conclusions@#The pathology result of 14gUS-CNB is in good consistency with surgical excision for breast benign and malignant lesions.
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Objective To analyze the diagnostic value of ultrasound guided 14 gauge coreneedle biopsy (US-CNB) in breast nodules.Methods We retrospectively analyzed the pathological results of US-CNB and surgical excision from 373 breast nodules in Peking University International Hospital from Sep 2016 to Nov 2018 to evaluate the accuracy of 14g US-CNB.Results A total of 349 patients (373 nodules) underwent US-CNB.US-CNB reported 282 benign lesions (75.6％,282/373),20 high-risklesions (5.4％,20/373),and 71 malignant lesions(19.0％,71/373).For 282 CNB reported benign lesions,the surgical pathology confirmed 235 lesions,46 for high-risk lesions and 1 for malignant lesion with a concordancy of 83.3％ (235/282)and the underestimation rate was 16.7％ (47/282).US-CNB identified 20 high-risk lesions.According to surgical results,15 were high-risk lesions and 5 were malignant lesions with a concordancy of 75％ (15/20) and the underestimation rate was 25％ (5/20).When it comes to malignant lesions,the excision results showed that 70 were malignant lesions and 1 was high-risk lesion with a concordancy of 98.6％ (70/71) and the overestimation rate was 1.4％ (1/71).The concordance of the histological type,calculated for 50 invasive carcinomas,was 92％ (46/50) with a kappa value of 0.77.The concordance of the histological grade could be calculated for 38 invasive ductal carcinomas with the Elston-Elllis Method.It was 89.5％ (34/38) with a kappa value of 0.57.Conclusions The pathology result of 14gUS-CNB is in good consistency with surgical excision for breast benign and malignant lesions.
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<p><b>OBJECTIVE</b>To observe the therapeutic effects on the postoperative analgesia after total knee arthroplasty (TKA) and functional rehabilitation with acupuncture at the distal points along the affected meridians and femoral nerve block.</p><p><b>METHODS</b>A total of 60 patients with knee prosthesis were collected and randomized into an observation group and a control group, 30 cases in each one. All of the patients received the femoral nerve block before operation. The analgesia pump was used for analgesia after operation and TKA postoperative rehabilitation was adopted. Additionally, in the observation group, acupuncture was applied to Taichong (LR 3), Kunlun (BL 60), Taixi (KI 3), Shenmai (BL 62), Sanyinjiao (SP 6) and Houxi (SI 3) unilaterally on the affected side, as well as Chize (LU 5), Quchi (LI 11) and Shousanli (LI 10) bilaterally. The needles were remained for 30 min, once a day, totally for 2 weeks. Separately, 4 h, 8 h, 12 h, 24 h and 48 h in resting after operation, as well as during the passive functional exercises 12 h, 24 h, 48 h, 7 d and 14 d after operation, the scores of visual analogue score (VAS) were recorded. HSS score, ROM before operation and 7 d and 14 d after operation, the analgesia satisfaction, the analgesic dose as well as the adverse reactions were recorded.</p><p><b>RESULTS</b>Regarding the VAS scores, 8 h, 12 h, 24 h and 48 h in resting after operation, the results in the observation group were lower than those in the control group (all <0.05). The VAS scores during the passive functional exercises 12 h, 24 h 48 h and 7 d after operation in the observation group were lower than those in the control group (all <0.05). The analgesia satisfaction in the observation group was higher than that in the control group (<0.05). 72 h, 7 d and 14 d after operation, HSS scores in the observation group were better than those in the control group (all <0.05) and the effects of ROM in the observation group were better than those in the control group (both <0.05). Regarding the safety, the adverse reaction rate in the observation group was lower than that in the control group (<0.05).</p><p><b>CONCLUSION</b>The combined treatment with acupuncture along the meridians and femoral nerve block achieves the remarkably analgesia effects after TKA and definite effects of the joint function recovery. This combined therapy is favorable in safety and adverse reactions.</p>
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Humans , Acupuncture Therapy , Analgesia , Arthroplasty, Replacement, Knee , Femoral Nerve , Nerve Block , Pain, Postoperative , TherapeuticsABSTRACT
Objective To observe the effects of naringin (Nar) on hemodynamics in myocardial ischemia-reperfusion(MI/R) injury rats for investigating its protective role on MI/R rats.Methods The ischemia-reperfusion(I/R) model was prepared by ligating the left anterior descending coronary artery,meanwhile different doses of Nar(10,20,40 mg/kg) were given.Then the electrocardiogram (ECG) was recorded after 7 d.The left ventricular end diastolic pressure (LVEDP),left ventricular systolic pressure (LVSP) and maximum ascending rate of left ventricular pressure/maximal descending rate of left ventricular pressure (±dp/dtmax) were measured.The activities of srum creatine kinase (CK) and lactate dehydrogenase (LDH) were measured by using the chemical colorimetry method.Results Compared with the MI/R group,Nar 20,40 mg/kg could decrease LVEDP,increased ±dp/ dtmax and LVSP,and decreased the activities of serum CK and LDH (P＜0.05),showing a dose-dependent manner.Conclusion Nar has the protective effect against MI/R injury rat and alleviates the myocardial damage extent,which may be related with improving the hemodynamics.
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Objective@#Evaluate GII.4 norovirus infection and blocking effects of serum antibodies against HBGAs binding to GII.4 norovirus of population in oyster culture area, provide references for screening of fully human monoclonal antibody.@*Methods@#Using a random survey method to collect blood and saliva samples in oyster culture area, select serum samples from the inland region of Guangdong as control group. Identification of salivary HBGA receptor phenotype and detection of serum antibody levels between two areas by ELISA. A vitro neutralization model was to determine the efficiency of serum antibodies blocking GII.4 norovirus and HBGA receptors binding.@*Results@#The age were (50.68 ± 15.17), (52.52 ± 15.90) and (51.37 ± 13.32) years old of 2015, 2016 in experimental group, and in control group, respectively. Males accounted for 5.9% (70/195), 36.6%(60/164), 40.8% (69/169) (χ2=0.93, P=0.334). The mean value of serum antibodies Absorbance value was 2.521±0.05 of 2015 and was 2.583±0.045 of 2016 in oyster culture area, the mean value was 2.249±0.05 in control group, there was a statistical difference among three group (F=13.28, P<0.001). The antibody prevalence in the three groups was 100%. BT50 geometric mean titer (GMT) of oyster culture area in 2015 was 423.1±40.11, culture group was 248.2±25.63, there was a statistical difference (t=3.73, P<0.001).@*Conclusion@#The population in oyster culture area does have more chance of exposure and infection GII.4 norovirus, Serum antibody of blocking ability in oyster culture areas is better than the general population in inland city. Suggesting that the population is more immunity resistant infected GII.4 norovirus.
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Objective To investigated the etiologic characteristics of Shigella (S.) sonnei strains causing outbreaks and sporadic cases in some areas of Guangdong province and Guangxi Zhuang Autonomous Region during 2014-2016. Methods Fourteen S. sonnei strains isolated from outbreaks and 6 S. sonnei strains from sporadic cases from Guangdong and Liuzhou of Guangxi Zhuang Autonomous Region were tested for antimicrobial resistance and analyzed by pulsed-field gel electrophoresis (PFGE). Six typical strains were selected for whole genome sequencing typing and compared with 51 strains isolated both at home and abroad from NCBI genome database. Results The antibiotic resistance test indicated the isolates had high resistance rate to ampicillin, tetracycline, gentamicin, trimethoprim/sulfamethoxazole and nalidixic acid, while sensitive to azithromycin, chloromycetin and imipenem. PFGE showed high similarity (93.2%) among the strains isolated from different areas. The whole genome sequencing analysis also revealed that all the typical strains wereclustered into a same evolution branch, close to some strains from Korea. Conclusions The S. sonnei strains isolated from some areas of Guangdong and Guangxi Zhuang Autonomous Region showed high resistance to commonly used antibiotics, but they were sensitive to azithromycin, chloramphenicol and imipenem. The isolates in this study also showed similar PFGE patterns and close phylogenic evolution.
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Objective To investigate the incidence and risk factors of the complications in perioperative intra-aortic balloon pump (IABP) supported cardiac surgical patients. Methods The clinical data of adult cardiac surgery patients undergoing IABP in Fuwai Hospital from January 2005 to January 2017 were enrolled. The patients were divided into complications group and no complications group. Demographic characteristics, diagnosis, perioperative clinical parameters, IABP related data, and IABP complications (including ischemia, bleeding, vascular injury and mechanical problems) were collected. The incremental risk factors of complications related IABP were analyzed by logistic regression. Results During the 12-year period, 522 patients received IABP support, with 388 male and 134 female; the mean age was (61.79±9.35) years; the complications related to IABP occurred in 25 patients, and overall complication rate was 4.79%; 87 IABP patients were dead in-hospital, the overall mortality was 16.67%, no patient died due to complications. The complications rate was higher in the female patients (40.00% vs. 24.95%), and was more in patients with age ≥ 65 years old (80.00% vs. 38.03%), more with higher body mass index [BMI (kg/m2): 25.45±13.71 vs. 22.95±3.45], diabetes mellitus (44.00% vs. 26.76%), combination treatment with extra-corporeal membranous oxygenation (ECMO: 20.00% vs. 5.03%) and prolonged IABP support time (hours: 134.4±90.3 vs. 109.8±89.1, all P < 0.05). There was no significant difference in the incidence of complications among preoperative IABP support, intra-operative IABP support and post-operative IABP support [3.30% (3/91), 5.46% (10/183), 4.84% (12/248), χ 2 =0.629, P = 0.730]. Bleeding from puncture site occurred in 14 cases (2.68%) without severe bleeding. Limb ischemia occurred in 9 cases (1.72%). One patient (0.19%) was under another surgery because of retroperitoneal hemorrhage caused by vascular injury. One patient (0.19%) was unsuccessful due to a balloon leak. It was shown by logistic regression analysis that presence of age ≥ 65 years [odds ratio (OR) = 2.320, 95% confidence interval (95%CI) = 1.011-1.806, P = 0.047], diabetes mellitus (OR = 2.281, 95%CI = 1.016-5.120, P = 0.026) and combination treatment with ECMO (OR = 4.341, 95%CI = 1.240-15.196, P = 0.040) were found to be the risk factors of complications related to IABP. Conclusions IABP complication rates are generally low. The frequent complications during IABP support is bleeding from site of catheterization and limb ischemia. When patients were treated with IABP, those with older age, diabetes mellitus and combination with ECMO should be monitored closely in order to reduce complications.