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BACKGROUND@#Lung cancer has been the leading cause of cancer-related deaths worldwide for many years. This study aimed to investigate the global patterns and trends of lung cancer.@*METHODS@#Lung cancer incidence and mortality were derived from the GLOBOCAN 2020 database. Continuous data from Cancer Incidence in Five Continents Time Trends were used to analyze the temporal trends from 2000 to 2012 using Joinpoint regression, and average annual percent changes were calculated. The association between the Human Development Index and lung cancer incidence and mortality was assessed by linear regression.@*RESULTS@#An estimated 2.2 million new lung cancer cases and 1.8 million lung cancer-related deaths occurred in 2020. The age-standardized incidence rate (ASIR) ranged from 36.8 per 100,000 in Demark to 5.9 per 100,000 in Mexico. The age-standardized mortality rate (ASMR) varied from 32.8 per 100,000 in Poland to 4.9 per 100,000 in Mexico. Both ASIR and ASMR were approximately twice higher in men than in women. The ASIR of lung cancer showed a downward trend in the United States of America (USA) between 2000 and 2012, and was more prominent in men. The age-specific incidence rates of lung cancer for ages of 50 to 59 years showed an upward trend in China for both men and women.@*CONCLUSIONS@#The burden of lung cancer is still unsatisfactory, especially in developing countries like China. Considering the effectiveness of tobacco control and screening in developed countries, such as the USA, there is a need to strengthen health education, accelerate the establishment of tobacco control policies and regulations, and improve early cancer screening awareness to reduce the future burden of lung cancer.
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Male , Humans , Female , Middle Aged , United States , Incidence , Lung Neoplasms/epidemiology , Linear Models , China/epidemiologyABSTRACT
Targeted therapy characterized with high specificity and low toxicity, is an important treatment method for human epidermal growth factor receptor 2 (HER2)-positive breast cancer, which can prolong the disease-free survival and the overall survival time of HER2-positive early breast cancer patients, and prolong the progression-free survival and the overall survival time of HER2-positive advanced patients with breast cancer. However, targeted drugs blocked the normal signaling pathway outside the target organs, and some patients experienced treatment-related adverse reactions, resulting in dose reduction, treatment delay and interruption, or even life-threatening consequences. Cardiotoxicity is one of the potentially serious side effects of targeted-HER2 drugs. Currently the targeted drugs for treatment of HER2-positive breast cancer patients include macromolecular monoclonal antibody drugs such as trastuzumab and pertuzumab, antibody-drug conjugates such as T-DM1 and T-DXd, and small-molecule tyrosine kinase inhibitors. This paper reviews the cardiotoxicity of HER2 targeted drugs including antibody-drug conjugates monoclonal antibody drugs in targeted therapy for breast cancer in order to provide references for clinical treatment.
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Objective:To evaluate the clinical effect of fibula flap in the repair of large segment of composite tissue defect in upper limb.Methods:From April, 2015 to June, 2019, 7 patients with large composite tissue defects in upper limbs were treated. All of them with various skin, vessel, nerve, tendon and other tissue defects. Repairing was well planned before surgery according to the type, location and size of defect. While in repairing of the bone and skin defect, fibula flap was taken from the shank and to repair the defects of nerve, tendon and vessels in upper limb. Regular followed-ups were made after surgery.Results:The 7 fibula flaps all survived. Postoperative follow-up ranged between 8 to 36 (averaged of 15) months. All the reconstructed limbs were in satisfactory appearance and function recovery. All the patients were able to manage their daily activities and live independently. The shape and function of donor sites were good. According to the Enneking system, the outcomes were graded as excellent in 4 cases and good in 3, with the average score was 25.9 points.Conclusion:Free grafting of vascularised fibula flap is especially feasible to be used in the repair of large bone tissue defect of upper limb. It repairs the defects of skin, vessel, nerve and tendon with the flap from a single donor site.
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Objective:To investigate clinical features, diagnosis and treatment of angioimmunoblastic T-cell lymphoma(AITL)in middle and old age patients.Methods:This was a retrospective study.A total of 33 middle-aged and elderly patients(a median age of 64 years, range 47~85 years)with AITL admitted to our hospital from May 2008 to March 2017, including 54.5% male(18 cases), were enrolled in this study.Clinical manifestations, pathology, imaging and survival data of patients were collected.The objective response rate(ORR)of patients with different therapeutic regimens was analyzed.The survival analysis was conducted by using the Kaplan-Meier method, the survival rate was analyzed by using the Log-rank method, and multivariate analysis was conducted by using the proportional hazards regression model.Results:The median overall survival(OS)was 26.0 months(8.5-43.5 months). The 1-year, 3-year and 5-year OS rate was 66.7%(22 cases), 45.5%(15 cases)and 24.2%(8 cases), respectively.The ORR of first-line chemotherapy with CHOP-like regimens(cyclophosphamide, doxorubicin, vincristine, prednisone)was 65.5%(19/29)and the incidence of serious adverse reactions was 64.5%(20/31). Single-factor chi-square testing showed that age ≥60 years, Barthel score ≥90, Eastern Cooperative Oncology Group performance status score(ECOG-PS)≥2, anemia, International prognostic index(IPI)score of 4~5, receiving chidamide treatment were influncing factors for the prognosis in middle-aged and elderly patients with AITL( χ2=5.103, 4.306, 6.004, 4.030, 6.348 and 4.080, P<0.05). Cox multivariate analysis showed that age ≥60 years and receiving chidamide treatment were independent prognostic factors affecting the 5-year survival rate of middle-aged and elderly AITL patients( OR=0.313 and 4.964, P<0.05). That the OS was better in the group receiving chidamide treatment than in the group without chidamide treatment( P<0.05). Conclusions:Clinical features of AITL are diverse and lack of specificity.Most patients present with advanced stage AITL at the initial diagnosis.The 5-year OS rate is low.AITL patients aged over 60 years have a poor prognosis.Chidamide can improve the OS rate.
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Objective:To introduce an improved method for reconstruction of thumb by transplanting partial second toe combined with hallucis flap.Methods:Since April, 2015 to December, 2019, 12 thumbs were reconstructed by transplanting partial second toe combined with hallucis flap. The average age of the patients was 28.5 years old. The severity of thumb defect was grade III-V. The compound tissue flap of common vascular pedicle was obtained from the hallux and the partial second toe of the contralateral foot, according to the condition of the defect of thumb. The hallucis flap was rotated transversely and connected with the partial second toe. Make up the characteristics and defects for the reconstructed thumb. The remaining skin and soft tissue of the second toe and the donor area were tiled to cover the wound. The patients were followed-up regularly.Results:All of the 12 transplantations completely survived. Postoperative follow-up period ranged from 6 to 26 months, 14 months in average. Appearances of all reconstructed thumbs and the donor toes was satisfactory. According to the Functional Assessment Criteria of the Upper Limb set by the Hand Surgery Society of Chinese Medical Association, the outcomes were graded excellent in 9 cases and good in 3 cases. All patients were able manage daily activities and living independently. Shape and function of donor foot were good.Conclusion:Part of the second toe combined with the hallucis flap transfer for thumb reconstruction may effectively improve the appearance of the reconstructed thumb. The reconstructed thumb is symmetrical, good in shape and satisfactory in function.
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Objective@#To introduce the method for reconstruction of thumb defect by transplanting free flap of second toe combined with the hallucis flap.@*Methods@#From June, 2012 to February, 2017, a total of 9 cases of thumb defect were treated. The average age of these 9 patients was 26 years. The plane of thumb defect was class II area A to class III area A. According to the condition of thumb defect, designed the incision on the hallux and the second toe of the contralateral foot, and cut the 2nd digit and big-toe nail flap with a common arterial trunk. The nail of hallucis flap was rotated 90 degree and connected to the distal end of the 2nd toe. The hallucis flap covered the narrow neck of the 2nd toe. Thus, the circumference of the reconstructed finger and the length of the toenail were increased. Regular followed-up was made after operation.@*Results@#All 9 transplantation flaps survived, and donor sites healed primarily. Postoperative followed-up period ranged from 4 to 12 (averge,7) months. All the reconstructed thumbs survived and donor toes were in satisfactory appearances. According to the Functional Assessment Criteria of the Upper Limb Formulated by the Hand Surgery Society of Chinese Medical Association, the outcomes were graded as excellent in 6 cases and good in 3 cases. All the patients were able to manage their daily activities independently. Donor toe injury was small, and their shape and function was good.@*Conclusion@#Free flap of second toe combined with hallucis can effectively improve the appearance of the reconstructed thumb. The appearance of the reconstructed thumb is symmetrical, beautiful, and the function is good.
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Objective To introduce the method for reconstruction of thumb defect by transplanting free flap of second toe combined with the hallucis flap. Methods From June, 2012 to February, 2017, a total of 9 cases of thumb defect were treated. The average age of these 9 patients was 26 years. The plane of thumb defect was class II area A to class III area A. According to the condition of thumb defect, designed the incision on the hallux and the second toe of the contralateral foot, and cut the 2nd digit and big-toe nail flap with a common arterial trunk. The nail of hallucis flap was rotated 90 degree and connected to the distal end of the 2nd toe. The hallucis flap covered the narrow neck of the 2nd toe. Thus, the circumference of the reconstructed finger and the length of the toenail were in鄄creased. Regular followed-up was made after operation. Results All 9 transplantation flaps survived, and donor sites healed primarily. Postoperative followed-up period ranged from 4 to 12 (averge,7) months. All the reconstructed thumbs survived and donor toes were in satisfactory appearances. According to the Functional Assessment Criteria of the Upper Limb Formulated by the Hand Surgery Society of Chinese Medical Association, the outcomes were graded as excellent in 6 cases and good in 3 cases. All the patients were able to manage their daily activities independently. Donor toe injury was small, and their shape and function was good. Conclusion Free flap of second toe combined with hallucis can effectively improve the appearance of the reconstructed thumb. The appearance of the reconstructed thumb is symmetrical, beautiful, and the function is good.
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Objective To investigate the distribution,treatment and prognosis of cancer among elderly male patients.Methods Clinical data of 898 male subjects aged 60-105 years with a median age of 82 years who participated in cancer screening in gerontology center of Beijing Hospital from January 1995 to January 2015 were collected in this retrospective study.Low-dose computed tomography,gastroenterological endoscope,alpha fetoprotein plus abdominal ultrasonography,and prostate specific antigen were used to screen lung cancer,gastroenteric cancer,liver cancer,and prostate cancer respectively.The incidences of malignant tumors,treatments and efficacies were collected during the study period.Results The 136 cases(85.0％)were diagnosed as malignant tumors by screening and 24 cases(15.0 ％)by clinical symptoms.Three of the most common cancers were lung cancer(46 cases,28.8 ％),prostate cancer(33 cases,20.6 ％),and colorectal cancer(15 cases,9.4 ％).The median age of cancer diagnosis was 73 years.The prevalence of cancer was higher in males aged over 70 years than in males aged under 70 years(18.1％ or 112/620 vs.7.2％,20/278,P ＜ 0.01).The median survival time after cancer diagnosis was 5 years (range of 1-20 years).Compared with patients diagnosed by clinical symptoms,patients diagnosed by screening had higher early detection rate of cancer(97.8％ or 133/136 vs.54.2％ or 13/24,P ＜0.01),higher definitive therapy rate(79.4％ or 108/136 vs.58.3％ or 14/24,P＜0.05),and lower recurrence rate(6.5％ or 7/108 vs.28.6％ or 4/14,P＜0.01).Conclusions The positive rate of cancer screening is high in males over 70 years old.Elderly males could benefit from early diagnosis and treatment by cancer screening.
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Objective To investigate the effects of butylphthalide soft capsules on cognitive function and daily living ability in patients with Parkinson's disease dementia(PDD). Methods From January 2016 to January 2017, 90 patients with PDD in the First People's Hospital of Wenling were divided into control group and study group by random number table method,with 45 cases in each group. The patients in the two groups were treated with conventional symptomatic treatment, and the control group was treated with donepezil, the study group was treated with butylphthalide soft capsules on this basis. The treatment time was 12 weeks. The clinical efficacies of the two groups were compared. Before treatment and 12 weeks after treatment,the cognitive functions of patients were assessed by Montreal cognitive assessment scale (MoCA) and mini - mental state examination (MMSE),and the daily living abilities of patients were assessed by Barthel index scale. Results The total effective rate of the study group was 93. 33％ ,which was higher than 75. 56％ of the control group (χ2 = 5. 414,P < 0. 05). 12 weeks after treatment,the scores of MoCA and MMSE scales in the two groups were (20. 54 ±2. 53)points,(18. 95 ± 2. 63)points,(23. 53 ± 2. 87)points,(22. 53 ± 2. 62)points,respectively,which were significantly higher than those before treatment[(16. 78 ±2. 34)points,(16. 03 ± 2. 24)points,(16. 23 ± 2. 78)points,(15. 23 ± 2. 34)points](t = 2. 863,2. 735,3. 062,3. 178,all P < 0. 05),and the scores of MoCA and MMSE scales in the study group were higher than those in the control group (t = 2. 798, 2. 753,all P < 0. 05). 12 weeks after treatment,the Barthel scores of the two groups were (64. 43 ± 5. 89) points, (76. 33 ± 5. 23 ) points, respectively, which were significantly higher than those before treatment [( 59. 34 ± 4. 83)points,(58. 26 ± 6. 65)points](t = 2. 916,3. 203,all P < 0. 05),and the Barthel score in the study group was higher than that in the control group (t = 2. 835,P < 0. 05). The incidence rate of adverse reaction in the control group was 6. 67％ ,which in the study group was 8. 89％ ,there was no statistically significant difference between the two groups (χ2 = 0. 155,P > 0. 05). Conclusion Butylphthalide soft capsules can significantly improve the cognitive function and daily living ability of patients with PDD,which is suitable for clinical application and promotion.
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Objective To observe the tolerance and prognosis of chemotherapy in patients aged 80 year and over with lung cancer in China.Methods This retrospective study was performed on 30 patients aged 80 year and over with lung cancer who received chemotherapy at our hospital from 2012 to 2017.We collected basal clinical and laboratory data before chemotherapy,recorded the treatment regimens,side effects,and outcome of chemotherapy,and analyzed the overall survival of patients with stage Ⅳ lung cancer.Results The patients aged 80 90 years were mainly males (63.3％,19/30),and most of them had good performance status (PS) with PS 0-1 in 22 patients (73.3％) and activity of daily living (ADL) score ≥90 in 18 patients (60.0％).Patients were treated with a median of 4 chemotherapy courses,and half of them had adverse reactions of degree ⅢI or above.A total of 21 patients (70.0 ％) had myelosuppression and 3 (10.0 ％) had weakness,while clinical efficacy occurred in 17 (68.0％) patients.The median of overall survival was 8.5 months (95％CI:2.396-14.604) in 25 patients with stage IⅣ lung cancer.Conclusions Some patients with lung cancer aged 80 years and over can benefit from chemotherapy.The patients with better PS and ADL may be more suitable for chemotherapy.The adverse reactions of chemotherapy need to be closely monitored.
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Objective To analyze the effect and possible mechanism of propofol on proliferation and inva-sion of lung cancer cells. Methods Lung cancer cells were cultured and divided into experimental control group, groupL,group M and group H.The optical density of cancer cell was detected by CCK-8.Meanwhile,the difference of the proliferation of cancer cells in each groupwas determined after down-regulation gene.The change of inhibition rate in four groups was analyzed by Transwell test. The expression of MMP-2 and mRNA in different groups were compared by Western blot and Q-PCR. Results the results of CCK-8 test showed the cancer cell viability in H group was lowest and the inhibition ability increasedafter silencing MMP-2 gene(P<0.05); the invasion inhibition rate of the lung cancer cells treated with propofol was higher(P<0.05), and invasion inhibition rate in each group also rise after silencing MMP-2; Western blot and Q-PCR show that the MMP-2 expression level in group Mand group H were lowest(P<0.05).Conclusion Propofol may inhibit the proliferation and invasion of lung cancer cells and its mechanism may be associated with down-regulation MMP-2,which is expected to inhibit the proliferation of lung cancer invasion.
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Objective This study explored two methods of predicting the initial dose of heparin by heparin dose response curve(HDR)and in vitro heparin concentration progressive(HCP),and evaluated the predictive value of HCP for precise heparin dosage in patients undergoing cardiac surgery. Method Include 18-65 years old undergoing elective cardiac surgery patients,Before the start of the surgery internal jugular vein blood was taken in-to the HCP(2.5 mg/kg,3.0 mg/kg)test;The first injection of heparin 2 mg/kg via the internal jugular vein, then every 5 minutes each additional heparin 0.5 mg/kg to amount to 2.5 mg/kg,3.0 mg/kg,and measurement ACT and until ACT value≥480 s;According to HDR calculated per patient 2.5,3.0 mg/kg of ACT value;Respective-ly according to the HCP and HDR ACT values obtained by two methods with the actual measured by the correspond-ing value in the body. Results Comparing the ACT values measured by HDR and HCP with the corresponding ACT values in vivo:There are good similarity for heparinization ACT value between HCP and the actual body corresponding concentrations(r was 0.62 and 0.74,respectively),P<0.05;HDR results also have better similar-ity(r was 0.66 and 0.54,respectively),P < 0.05;However,HDR and HCP compared with the actual results in vivo found that in vitro HCP prediction results especially 3.0 mg/kg is more similar with the actual values.Conclu-sions HCP for predicting heparin dosage to meet extracorporeal circulation is more accurate.
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Objective To explore the clinical effect of the high frequency transcranial magnetic stimulation in the treatment of Parkinson's non motor symptoms. Methods 80 patients with Parkinson's disease were randomly divided into observation group and control group by using random number table,40 cases in each group. The patients in the observation group received high-frequency repetitive transcranial magnetic stimulation treatment based on the conventional anti-Parkinson's disease drugs. The patients of the control group were treated with conventional anti-Parkinson's disease drugs. The therapeutic effect of the two groups was compared, The test results of the unified Parkinson's disease,Hamilton depression scale,scores of Pittsburgh sleep quality index before and after treatment were analyzed in the two groups . Results After treatment for 7 days and 1 month , the unified Parkinson ' s disease rating scale test results of the observation group were (29. 1 ± 7. 3) points,(29. 5 ± 6. 9) points,respectively,which were significantly lower than (38. 6 ± 9. 8) points before treatment,the difference was statistically significant( F=4. 881, P<0. 05). After treatment for 7 days,the Hamilton depression scale score of the observation group was (8. 33 ± 4.01)points,which was significantly lower than (13.55 ±8.27)points of the control group (t=2.356,P<0.05). After treatment for 1 month,the Hamilton depression scale score of the observation group was (8. 01 ± 3. 87)points, which was significantly lower than ( 12. 98 ± 8. 34 ) points of the control group , the difference was statistically significant(t=3. 018,P<0. 05). After treatment for 7 days,the Pittsburgh sleep quality index between the two groups had statistically significant difference [(19. 7 ± 2. 2) points in the observation group,(16. 1 ± 1. 1) points in the control group,t=2. 371,P<0. 05]. After treatment for 1 month,the Pittsburgh sleep quality index of the observation group was (26. 5 ± 1. 3) points,which was significantly higher than (17. 2 ± 1. 2) points of the control group ,the difference was statistically significant(t=3. 004,P<0. 05). Conclusion The high frequency transcranial magnetic stimulation in the treatment of non motor symptoms of Parkinson's disease can significantly improve the patients ' movement,speech,consciousness,emotion,sleep quality,and the effect is good.
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BACKGROUND: Studies have shown that propofol enables a reduction in the number of adult rat mesenchymal stem cells, while the cell differentiation is also significantly inhibited. OBJECTIVE: To explore whether liver X receptors (LXRs) can reverse the inhibitory effects of propofol on bone marrow mesenchymal stem cells. METHODS: Fifteen healthy C57/BL6 mice were randomized into three groups, 5 of which served as blank control group (intraperitoneally treated with normal saline), 5 as propofol treatment group (intraperitoneally treated with 60 mg/kg propofol), and 5 as propofol + LXRs agonist treatment group (intraperitoneally injected with 10 μL/g LXRs at the 1st day, and then injected with 60 mg/kg propofol at the 2nd day). The mice in the three groups were killed at 1-3 hours after treatment to isolate and culture bone marrow mesenchymal stem cells. Cell counting kit-8 and cloneformation assay were used to evaluate the abilities of cell proliferation and self-renewal; induced differentiation experiments in vitro were used to evaluate the differentiation ability of cells into adipocytes, osteoblasts and chondrocytes; real-time quantitative PCR was used to detect the expression of differentiation related molecules andNotch signal. RESULTS AND CONCLUSION: In the propofol-treated mice, cell viability and clone forming ability as well as adipogenic, osteogenic and chondrogenic differentiation of cells decreased significantly compared with the blank control group (P <0.05), while LXR agonists could reverse these effects significantly (P < 0.05). Notch signal expressions showed no difference among three groups prior to induced differentiation. The expression levels differentiation related molecules downregulated significantly after propofol treatment (P < 0.05), but upregulated significantly after treatment with LXR agonists (P < 0.05). Notch signaling inhibitor treatment could significantly inhibit the multi-directional differentiation of bone marrow mesenchymal stem cells in the three groups. All these findings indicate that activated LXRs can reverse the inhibitory effects of propofol on bone marrow mesenchymal stem cells.
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Objective To explore the clinical effect of the high frequency transcranial magnetic stimulation in the treatment of Parkinson's non motor symptoms. Methods 80 patients with Parkinson's disease were randomly divided into observation group and control group by using random number table,40 cases in each group. The patients in the observation group received high-frequency repetitive transcranial magnetic stimulation treatment based on the conventional anti-Parkinson's disease drugs. The patients of the control group were treated with conventional anti-Parkinson's disease drugs. The therapeutic effect of the two groups was compared, The test results of the unified Parkinson's disease,Hamilton depression scale,scores of Pittsburgh sleep quality index before and after treatment were analyzed in the two groups . Results After treatment for 7 days and 1 month , the unified Parkinson ' s disease rating scale test results of the observation group were (29. 1 ± 7. 3) points,(29. 5 ± 6. 9) points,respectively,which were significantly lower than (38. 6 ± 9. 8) points before treatment,the difference was statistically significant( F=4. 881, P<0. 05). After treatment for 7 days,the Hamilton depression scale score of the observation group was (8. 33 ± 4.01)points,which was significantly lower than (13.55 ±8.27)points of the control group (t=2.356,P<0.05). After treatment for 1 month,the Hamilton depression scale score of the observation group was (8. 01 ± 3. 87)points, which was significantly lower than ( 12. 98 ± 8. 34 ) points of the control group , the difference was statistically significant(t=3. 018,P<0. 05). After treatment for 7 days,the Pittsburgh sleep quality index between the two groups had statistically significant difference [(19. 7 ± 2. 2) points in the observation group,(16. 1 ± 1. 1) points in the control group,t=2. 371,P<0. 05]. After treatment for 1 month,the Pittsburgh sleep quality index of the observation group was (26. 5 ± 1. 3) points,which was significantly higher than (17. 2 ± 1. 2) points of the control group ,the difference was statistically significant(t=3. 004,P<0. 05). Conclusion The high frequency transcranial magnetic stimulation in the treatment of non motor symptoms of Parkinson's disease can significantly improve the patients ' movement,speech,consciousness,emotion,sleep quality,and the effect is good.
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Objective To discuss the risk factors of progressive hemorrhagic injury(PHI)in patients with craniocerebral injury.Methods Clinical data of 149 patients with closed craniocerebral injury were retrospectively analyzed,and the patients were divided into PHI group (42 cases)and non -PHI group (107 cases)according to PHI appeared or not.The patients were immediately given CT scan after admitted,the first CT review was given in the non -PHI group within routine 4 -8h after first CT scan,and due to deterioration of clinical symptoms,the PHI group was given CT review in advance.The intracranial hematoma volume changes between first CT and first CT review in the two groups were observed,then clinical symptoms,signs,biochemical indicators and CT performance in the two groups were compared,and analyzed risk factors of PHI.Results The intracranial hematoma volume showed in CT scan,first CT review and increment volume of the PHI group were significantly higher than the non -PHI group [(14.59 ±4.60)mL vs.(7.28 ±2.94)mL,(25.92 ±8.84)mL vs.(8.35 ±3.41)mL,(10.20 ±3.45)mL vs. (2.10 ±0.65)mL],the differences were significant (t =6.796,11.894,9.367,all P 10mL were major risk factors of PHI (P 50 years old,mydriasis,conscious disturbance,intracranial hematoma volume >10mL in first CT scan.
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Objective:To investigate the effects of chronic exposure to low concentration sevoflurance on hippocampus in SD fetal rats.Methods:Totally sixty female SD rats at clean grade weighing 240-260 g were randomly divided into four groups , the control group and sevoflurane groups (n=15).The three experimental groups were respectively treated with 30 mg· L-1(parts permillion1 × 10 -6), 100 mg· L-1 and 300 mg· L-1 sevoflurane with 6-hour inhalation, qd for 2 weeks, while the control group breathed fresh air with the same volume .After mating conception , the rats inhaled the same concentration sevoflurane or air till scarification on the 19 th day.Half of brain in the fetal rats was withdrawn to prepare the paraffin specimens , and immunohistochemistry was used to detect the apoptosis in hippocampal CA 1 region associated with protein Bcl-2 and Bax.The hippocampus was stripped from the other half of brain and 10%homogenate was prepared, and the activity level of superoxide dismutase (SOD) and the content of malondialdehyde (MDA) were detected.Results:Bcl-2 in hippocampus CA1 region in 300 mg· L-1 group was lower than that in the control group , while Bax was higher than that in the control group (P0.05).Conclusion:Low concentration inhalation of sevoflurane above 300mg· L-1 can enhance the cell apoptosis in hippocampus through increasing the oxidative stress reaction in embryonic brain of SD rat resulting in excessive MDA and reduced SOD.
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This retrospective case-control study explored the factors associated with anaphylactic shock during surgery for cystic echinococcosis (CE) at the First Affiliated Hospital of Xinjiang Medical University between October 2008 and September 2013. Patients who suffered from anaphylactic shock (n=16) were age-matched 3:1 to patients who did not (n=43). Multivariate analysis suggested that IL-4 levels (odds ratio=1.096; 95% confidence interval=1.015–1.185; P=0.02) and cyst size (odds ratio=3.028, 95% confidence interval=1.259–7.283, P=0.013) were independently associated with CE-induced perioperative anaphylactic shock. Using the receiver operating characteristic (ROC) curves and a cut-off value of 415.7 ng/ml, IL-4 showed an area under the ROC (AUC) of 0.926, sensitivity of 75.0%, and specificity of 97.7%. Using a cut-off value of 7.8 cm, cyst size showed an AUC of 0.828, sensitivity of 81.3%, and specificity of 76.7%. In conclusion, results suggest that levels of IL-4 and cyst size were independently associated with echinococcosis-induced perioperative anaphylactic shock. These results could help identifying patients with echinococcosis at risk of anaphylactic shock in whom appropriate prophylaxis could be undertaken.
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Humans , Anaphylaxis , Area Under Curve , Case-Control Studies , Echinococcosis , Echinococcus granulosus , Interleukin-4 , Multivariate Analysis , Retrospective Studies , ROC Curve , Sensitivity and Specificity , ZoonosesABSTRACT
Objective To evaluate the application of three dimensional time-of-flight (3D-TOF) MRA in screening intracranial aneurysms in the population of Wenling community. Methods A total of 2 124 patients with suspicious intracranial aneurysm in Wenling community, who received 3D-TOF MRA and three dimensional digital subtraction angiography(3D-DSA) during the period from September 2011 to August 2012, were enrolled in this study. The epidemic data of intracranial aneurysm in Wenling community were analyzed, the effectiveness of 3D-TOF MRA in detecting intracranial aneurysm was assessed, and the consistency between 3D-TOF MRA and 3D-DSA (regarded as the golden standard) in detecting intracranial aneurysm was statistically analyzed. Results The results of 3D-TOF MRA showed that the morbidity of intracranial aneurysm in the population of Wenling community was 6.87% (146/2 124), among which the morbidities in males and females were 48.63% (n=71) and 51.37% (n=75) respectively; the mean age of patients was (41.2±11.6) years old. The accompanying diseases included hypertension, diabetes mellitus, arteriosclerosis and cerebrovascular lesions. 3D-TOF MRA examination revealed 149 intracranial aneurysms, among which misdiagnosis was made in 5 patients and missed diagnosis in 2 patients. The sensitivity, specificity and accuracy of 3D-TOF MRA in diagnosing intracranial aneurysm were 98.63% (144/146), 99.72%(1 773/1 778) and 99.67%(2 117/2 124) respectively. No statistically significant difference in measuring the longitudinal diameter and neck width of intracranial aneurysms existed between 3D-TOF MRA and 3D-DSA examinations (P>0.05). Conclusion In detecting intracranial aneurysm, 3D-TOF MRA carries higher sensitivity, specificity and accuracy, and its non-invasive advantage is more suitable for the screening of intracranial aneurysms.
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Objective To investigate the clinicopathological features,diagnosis and treatment experience,in order to improve the recognition of male breast cancer and prepare for the study of standardized treatment of breast cancer.Methods Data of epidemiological characteristics,clinical and pathological parameters,treatment and outcome from 43 male breast cancer patients were collected and analyzed in Peking University Cancer Hospital and Beijing Hospital from January 2009 to December 2014.Results Of these patients,42 (97.6％) cases presented with located tumors,11 (25.5％) cases were on pathological stage Ⅲ or stage Ⅳ,and 40 (93.0％) cases were with hormone receptor positive breast cancer and 3 (6.9％) cases were with human epidermal growth factor receptors (HER)-2 positive breast cancer.Patients were stratified according to more or less than 70 years of age,and there were no significant differences in clinicopathological features between the two year groups.But 3 cases with HER-2 over-expressed were all less than 70 years old.38 (88.4％) patients underwent surgical treatment,among which 32 HR-positive patients (74.4％) received tamoxifen as adjuvant endocrine therapy.The median follow-up periods was 31 months (6.1-55.4 months),7 (16.3％) patients developed local recurrence or distant metastasis.Conclusions Male breast cancer is often diagnosed at a later stage and has inferior outcome.Majority of male breast cancer are found to be HR positive,hence hormonal therapy should be strongly considered.