ABSTRACT
Objective:To establish and evaluate a nomogram for long-term survival of patients with intrahepatic cholangiocarcinoma (ICC) after radical resection.Methods:The data of ICC patients who underwent radical resection for the first time at Zhongshan Hospital, Fudan University from January 2014 to December 2017 were retrospectively analyzed. Of 167 patients who were enrolled, there were 104 males and 63 females, with the age of (60.3±10.9) years. Tumor tissues were collected for immunohistochemical staining and interpretation. Univariate Cox regression, LASSO regression and multivariate Cox regression were used to analyze influencing factors of postoperative long-term survival after ICC. R software was used to construct a nomogram in predicting ICC prognosis.Results:Cox regression analysis showed that TNM staging, poorly differentiated tumor, positive resection margin, positive mucin 5 expression and abnormal P53 expression to be independent risk factors associated with poor long-term survival after radical resection. The prognostic nomogram model of ICC was constructed based on these factors. The C-index was 0.821. The nomogram model consistency index had a high degree of prognostic differentiation. The 45° diagonal of the 3-year postoperative calibration curve which represented the actual survival fitted well with the segmented line which represented the predicted survival of the nomogram. The area under the receiver operating characteristic curve of the nomogram model was higher than that of AJCC TNM staging (0.894 vs. 0.803, z=4.10, P<0.001). The nomogram model was more effective in predicting postoperative survival of ICC patients than the TNM staging. Conclusion:TNM staging, poorly differentiated tumor, positive resection margin, positive mucin 5 expression and abnormal P53 expression were independent risk factors for postoperative survival of ICC. The nomogram model could better evaluate long-term prognosis of ICC patients after radical resection than the traditional TNM staging system.
ABSTRACT
Objective To explore the effect and significance of electronic account books on the management of anesthesia and psychotropic drugs. Methods The data of electronic account books from January 2020 to June 2020 in the inpatient pharmacy of the hospital (observation group), and manual account books from July 2019 to December 2019 (control group) were collected respectively. The data of daily accounting time, monthly settlement accounting time and accounting accuracy between the two groups were compared and analyzed. Results The daily average time for pharmacists to manually accounting was (162.8±22.5) min, and the daily average time for pharmacists to make accounts electronically was (33.2±7.0) min. It took (245.5±7.2) min for manual accounting of monthly settlement and (46.8±2.5) min for electronic accounting of monthly settlement. The accuracy rate of daily counting records, special account books, special register and empty ampoule waste paste recovery records included in electronic accounting is up to 100%. Conclusion The implementation of electronic account books not only significantly improved the work efficiency of pharmacists, but also strengthened drug supervision, formed a comprehensive traceability system, which could ensure the safety of clinical medication, and make the management of narcotic psychotropic drugs more efficient and standardized.
ABSTRACT
Objective:The medical-related patent transformation level is relatively low in China for a long time. However, with the support and advancement of a series of national policies, domestic patents and other medical intellectual property projects are increasing year by year, and medical transformation is also receiving more and more attention. Zhongshan Hospital affiliated to Fudan University actively promotes the transformation of hospital patents through various channels, and actively explores how to carry out patent transformation and how to improve the success rate of transformation. This article aims to analyze and explore the feasibility of multi-channel promotion of patents, and to open up a new path for the use of new media to promote patent conversion.Methods:Through Excel analysis of " Zhongshan Patent Hero Post" WeChat public account and official Weibo platform weekly page views data and patent salon project data, as well as the patent application and transformation of Zhongshan Hospital in the past 6 years, and analyze the effect of patent promotion.Results:Through multiple channels and various links of effective promotion methods, the patent application and conversion situation of Zhongshan Hospital has doubled in the past 6 years.Conclusions:The hospital will further actively explore the patent application and transformation process, the full-cycle promotion method of each link, and provide a transfer and transformation consulting docking and promotion platform for the scientific research results or patent technologies related to hospitals and enterprises, and help the transformation of medical patents.
ABSTRACT
Objective To explore the role of clinical pharmacists in rational drug use through the pharmacy care of an elderly pneumonia patient with Chlamydia psittaci infection and drug-induced liver injury. Methods The clinical pharmacists participated in the treatment of one patient with Chlamydia psittaci pneumonia and drug-induced liver injury. Based on the results of second-generation gene sequencing, the characteristics of the pathogen were learned by literature search. The clinical pharmacists monitored the patient’s liver and kidney function, provided a new medication treatment plan to Doctors, and performed patient education during the treatment. Results The initial empirical anti-infective treatment with teicoplanin and imipenem-cilastatin was not effective. After the diagnosis of Chlamydia psittaci and Candida albicans infection, the combination of doxycycline with azithromycin and fluconazole was administered. Drug-induced liver injury was found with this treatment. The clinical pharmacist proposed to switch to doxycycline and clarithromycin with co-administration of magnesium isoglycyrrhizinate and polyene phosphatidylcholine to protect the liver. With this new regime, patient's liver function was improved and the infection was under control. Conclusion Individualized pharmaceutical cares provided by clinical pharmacists helped the safe, rational and effective use of medications.
ABSTRACT
To conduct research and stipulate international standards of Chinese herbal medicine under the guildance of International Organization for Standardization (ISO) has become a new hot spot of internationalization and standardization of traditional Chinese medicines. International organization for standardization/technical committee of traditional Chinese medicine (ISO/TC249) provides a international platform to develop the standards of Chinese herbal medicine. Sinomenii Caulis, as a traditional Chinese medicine with obvious clinical effect which is used internationally, it’s necessary to establish a unified quality and safety control standards at international level. The current literature showed that there are many aliases of Sinomenii Caulis, and the problem of its variety confusion and adulteration is serious. Sinomenine-based alkaloids were the main pharmacological active components of Sinomenii Caulis. By analyzing the pharmacopoeias of China, Japan, South Korea and Europe, it was found that both Chinese and European Pharmacopoeias take sinomenine as the quality control indicator of Sinomenii Caulis. The Japanese and South Korean pharmacopoeias had similar quality control requirements of Sinomenii Caulis, and the South Korean pharmacopoeia pays more attention on safety requirements. Thus, it is suggested that setting ISO standards of Sinomenii Caulis requires the collection of global trade data and samples of Sinomenii Caulis for future quality and safety research.
ABSTRACT
OBJECTIVE@#To carry out single nucleotide polymorphism (SNP)-based chromosome microarray analysis (CMA) for a boy featuring global developmental delay.@*METHODS@#The SNP array was conducted for the child, and real-time PCR was used to validate its result and identify the origin of pathological copy number variants.@*RESULTS@#SNP array revealed that the patient has carried a de novo 2.5 Mb duplication at 2q22.3q23.3, which encompassed ACVR2A, KIF5C, MBD5, EPC2, LYPD6, LYPD6, MMADHC and ORC4 genes. Literature review suggested that the MBD5 gene from the duplicated region may have predisposed to the global developmental delay shown by the girl.@*CONCLUSION@#The patient's clinical phenotype was consistent to that of 2q23 duplication, for which the MBD5 gene may play a key role. CMA has provided an important tool for the diagnosis of patients with global developmental delay.
Subject(s)
Child , Female , Humans , Chromosome Deletion , Chromosomes, Human, Pair 2 , DNA Copy Number Variations , DNA-Binding Proteins , Genetics , Genotype , Kinesins , PhenotypeABSTRACT
OBJECTIVE@#To carry out genome-wide copy number variations (CNVs) analysis for a boy with autism by using single nucleotide polymorphism array (SNP array).@*METHODS@#SNP array analysis was conducted for the boy and his parents, and the data was validated by real-time PCR. Correlation between the deleted genes and the phenotype was analyzed by reviewing the literature.@*RESULTS@#The patient was found to carry a terminal deletion of 18q22.3q23 (7.1 Mb), which involved FBXO15, ZNF407, ZADH2, TSHZ1, MBP and ADNP2 genes. No pathogenic CNVs were found in the parents. Comparison of the patient with cases reported in the literature suggested that the ZNF407 gene probably accounts for the autistic phenotype in these patients.@*CONCLUSION@#The autistic phenotype of the patient may be attributed to the 18q deletion, for which ZNF407 may be a critical candidate. SNP array has provided an useful tool for the study of molecular mechanism underlying autism.
Subject(s)
Humans , Male , Autistic Disorder , Genetics , DNA Copy Number Variations , Microarray Analysis , Polymorphism, Single NucleotideABSTRACT
<p><b>OBJECTIVE</b>To explore the clinical features and genomic abnormality of a patient with Coffin-Siris syndrome.</p><p><b>METHODS</b>Microdeletion and microduplication were detected with chromosomal microarray analysis (CMA) and verified with real-time quantitative PCR.</p><p><b>RESULTS</b>The patient, a 6-month-old boy, featured global development delay, thick eyebrows, low frontal hairline, long eyelash, flat nasal bridge, hypotonia, difficulty in turning over, over stretching of head, and hypoplatic nails. He could not stand stability or actively grasp. He also has characteristics of rickets. Chromosome karyotype of the patient was normal. Genomic analysis has detected a 1.3 Mb deletion in 6q25.3 region encompassing the ARID1B gene. Neither of his parents was found to harbor the same deletion.</p><p><b>CONCLUSION</b>The 6q25.3 microdeletion probably underlies the Coffin-Siris syndrome in this patient, and rickets may be part of its clinical spectrum.</p>
ABSTRACT
Objective To determine the content of paeoniflorin in Fuzhengpingxiao capsule by HPLC method .Methods The content of paeoniflorin were determined by HPLC ,and the column was an Agilent Zorbax SB-C18 column (150 mm × 4 .6 mm ,5 μm);The mobile phase was acetonitrile and 5 mmol/L sodium dihydrogen phosphate (10:90) ,and the flow rate was set at 1 ml/min .Column temperature was 25°C ,detection wavelength was 230 nm ,injection volume was 10 μl ,and running time was 25 min .Results Paeoniflorin was linear (r=0 .9999) in the concentration of 25 .0-500 .0 μg/ml ,the linear equation was Y=12 .65 X +43 .54 ,and the average recovery was 92 .69％ with RSD value was 1 .77％ .Conclusion The method was easy to operate ,reliable and reproducible ,which could be used in the determination of paeoniflorin in FuzhengPingxiao capsule .
ABSTRACT
Objective The effect of different doses of ethylnitrosourea(ENU)and cyclophosphamide(CP)on the loss rate of CD59 on peripheral blood erythrocytes was explored to optimize the detection method of Pig-a gene mutation. Methods According to the weight and loss rate of CD59 on peripheral blood erythrocytes,rats were divided into 4 groups:the control group,CP 40 mg/kg group,ENU 10 mg/kg group and ENU 40 mg/kg group(n=6). The control group was injected i.p. with PBS,other groups were injected i.p. with corresponding solutions. The body weight of rats on days 0,7,14,21, 28, 42 and 56 were recorded. At the same time, blood samples were collected and incubated with antibodies,and the loss rate of RBCCD59-was detected by flow cytometry. Results Compared with the control group, at different time points, the body weight and weight gain of ENU 10 mg/kg group and ENU 40 mg/kg group had no statistically significant difference(P > 0.05),while those in the CP 40 mg/kg group were significantly decreased(P <0.05). The loss rate of RBCCD59-was significantly increased in the CP 40 mg/kg group at 28,42 and 56 days, ENU 10 mg/kg group at 42 and 56 days,and ENU 40 mg/kg group at 7,14,21,28,42 and 56 days,(P < 0.05). The results showed a dose-response relationship. Conclusions Under the conditions of this Pig-a mutation detection method,ENU is superior to CP on raising loss rate of RBCCD59-,ENU 40 mg/kg is better than 10 mg/kg,and 28 days is suitable as the test period.
ABSTRACT
Objective To investigate the clinical manifestations and motor neuron and pancreas homeobox 1 (MNX1) gene mutation features of Currarino syndrome.Methods Microdeletion and microduplication of the patients were detected by chromosomal microarray analysis (CMA),and literature review was performed for the clinical syndrome of Currarino syndrome with similar genotype.Results Two patients with Currarino syndrome were recruited in this study.Patient 1,a 7-day girl,came to hospital because of recurrent vomiting.Physical examinations showed coarse facial features,vision problems,serious abdominal flatulence and anal stenosis.Bowel imaging revealed malrotation of the midgut;and the magnetic resonance imaging (MRI) showed tethered spinal cord and malformation of sacrococcygeal vertebra.A 7.89 Mb deletion in chromosome 7 q36.lq36.3 region including MNX1 gene and a 2.20 Mb duplication in 14q32.33 area was found by using CMA.Patient 2,a 1 year and 3 months girl,came to hospital with global development delay.Clinical examination showed facial dysmorphic,growth retardation,intellectural disability,ptosis in right eye and anal stenosis.This patient had developmental retardation in language and movement.MRI showed spina bifida occulta.And a 15.00 Mb deletion in chromosome 7 q35q36.3 region was found including MNX1 gene.Literature review revealed that deletions in MNX1 gene led to Currarino syndrome with coarse facial features,growth retardation and intellectural disability,and this type of Currarino syndrome had not been reported in China.Conclusions Two cases of Currarino syndrome caused by microdeletion in 7q36 are reported for the first time in China,and this study can help clinicians to have a better understanding of this disease.
ABSTRACT
Objective To investigate clinical features of Peutz-Jeghers syndrome(PJS)and genetic change in STK11. Methods Clinical data and genetic change in STK11 gene of four PJS children were retrospectively analyzed.Results Four patients have hyperpigmentation on their lips, buccal mucosa or fingers. Intestinal polyposis was found at different locations of gastrointestinal tract. Polypectomy was performed in four patients and pathological section displayed the muscle fibers of the muscularis mucosae form a dendritic structure. And we found 4 heterozygous mutations (c.582C>A,c.580G>A,c.719C>G and c.879insA)on STK11 gene in these patients.Conclusions The PJS patients have typical clinical features;gene detection is helpful to early diagnosis,and we found a novel mutation(c.879insA) in STK11 gene.
ABSTRACT
Objective To explore the relationships between the alterations of cervical sagittal parameters and clinical outcomes after anterior cervical discectomy and fusion (ACDF).Methods From January 2010 to December 2015,a total of 227 patients with cervical spondylosis who undelwent ACDF in Dongfang Hospital affiliated Tongji University were analyzed in this study.There were 109 male and 118 female,with an average age of 52.2± 10.7 years (ranged from 34 to 78 years).The average duration of follow-up after revision surgery was (21.1 ±9.0) months (12-60 months).Comparing with Japanese 0rthopaedic Association (JOA) score and its improvement rate (IR),visual analogue scale (VAS) scores and neck disability index (NDI) between preoperation and 1 year follow-up.Cervical alignment was assessed with the following 3 parameters:T1 slope (T1S),Cobb's angle of C2 to C7 and C2-7 sagittal vertical axis (SVA).And compared the changes of sagittal parameters and clinical efficacy.Results At 1 year follow-up,T1S was increased from 25.4°±8.5° to 27.9°±8.2°,Cobb's angle was increased from 12.7°±8.5° to 15.3°±9.5°,SVA was increased from (21.0± 12.3) mm to (24.30± 11.4) mm,and the differences were statistical significant (P＜ 0.001).JOA score was increased from (8.5±4.0) points to (13.0±2.4) points at 1 year follow-up,however,VAS score was decreased from 2.7± 1.8 points to 0.2±0.4 points,and NDI was decreased from 48.2％±8.2％ to 27.1％± 11.1％,and the differences were statistical significant (P ＜ 0.001).Preoperatively,T1S had positive correlations with both Cobb's angle and SVA before operation (r=0.311,0.213;P=0.000,0.001),but Cobb's angle had negative correlation with SVA (r=-0.246,P=0.000).At 1 year follow-up,T1S had positive correlations with Cobb's angle and SVA (r=0.390,0.392;P=0.000,0.000),and Cobb's angle had negative correlation with SVA (r=-0.131,P=0.048).At 1 year after operation,the change value of Cobb's angle had positive correlation with the change of JOA (r=0.294,P=0.000),but negative correlation with the change of NDI (r=-0.141,P=0.034).Conclusion ACDF is effective in the treatment of cervical spondylosis which the cervical sagittal alignment remains relatively stable,and there were significant correlation between the alteration of cervical sagittal parameters and clinical outcomes after ACDF.
ABSTRACT
Objective To investigate the clinical features of a patient diagnosed with Jacobsen syndrome (JBS) and Paris-Trousseau syndrome (PTS) using chromosomal microarray analysis. Method A retrospective analysis including the patients' clinical manifestations, laboratory examination and genetic analysis was carried out and related literature were reviewed. Results A 14 month-old girl with global development retardation was reported. The patient can sit but cannot walk independently. The patient also presented hypsicephaly, ocular hypertelorism, palpebral ptosis, flat nasal bridge, sparse eyebrows, and speech delay. Gesell development scale showed that the patient was global development retarded with a development level of 40 weeks. No o bvious abnormality was found in EEG but the MRI showed cerebral white matter abnormality. This patient was also diagnosed with neonatal thrombocytopenia in other hospital. Genomic CNVs were detected in this girl, and a 15.7Mb loss was found in the 11q23.3q25 region that covers JBS and PTS region. Conclusions Patient diagnosed with JBS and PTS often present with craniofacial abnormalities, cerebral white matter abnormality and neonatal thrombocytopenia. Chromosomal microarray analysis can help diagnosis.
ABSTRACT
Objective To study the irrational intravenous (IV) medication orders and promote rational medication applications.Methods A retrospective analysis was conducted to analyze the irrational prescriptions from January to December 2016.Results Among 39 948 IV medication orders reviewed, there were 134 irrational prescriptions of cytotoxic drugs (0.33％) and 222 irrational prescriptions of total parenteral nutrition(TPN)(0.56％).Within 356 irrational prescriptions, 19 had improper amount of diluent(5.34％), 95 inappropriate dosage(26.69％), 12 drug incompatibility(3.37％), 8 wrong diluent (2.24％) and 222 inappropriate TPN orders (62.36％).Conclusion The interventions of the clinical pharmacists are needed to reduce medication errors and improve the drug safety and effectiveness.
ABSTRACT
Objective To explore method for determination of calycosin contents in Wujin capsule by HPLC .Methods The sample was studied on ZORBA Bonus‐RP (4 .6 mm × 260 mm ,5 μm) column ,the mobile phase consisted of acetonitrile and H2O‐0.1% HCOOH (gradient elution) ,the temperature of column was 25 ℃ ,the UV detection wavelength was set at 260 nm , flow speed was 1 .0 ml/min and injection volume was 10 μl .Results The calycosin calibration curve was at the range of 7 .4‐117 .6 μg/ml (r=1 .000) ,with their regression function being Y=34 .002 X-3 .451 2 .The recovery of calycosin was 95 .24%(RSD=2 .10% ) .6 batches of Wujin capsule calycosin contents were 9 .26‐23 .14μg/g .Conclusion HPLC was an accuracy and simple method for determining the content of calycosin in Wujin capsule .
ABSTRACT
BACKGROUND:Numerous studies have shown that local lumbar stenosis can cause immunological abnormalities and local chronic inflammation, which is the main cause of pain. At present, studies on inflammatory factors and lumbar spinal stenosis mainly focused on intervertebral discs, facet joint and ligamenta flava. No reports addressed the relationship between inflammatory factor in vein of lumbar spinal canal and lumbar spinal stenosis. OBJECTIVE:To analyze the correlation of serum interleukin-1αand tumor necrosis factor-αlevels with lumbar spinal stenosis. METHODS:A total of 51 patients with lumbar spinal stenosis or lumbar vertebral burst fracture, who underwent posterior lumbar decompression in the Department of Spine Surgery, Shanghai East Hospital, Tongji University in China from September 2011 to December 2013, were enrol ed in this study. Visual analogue scale score of low back pain and Oswestry disability index were evaluated before treatment. Peripheral vein blood and venous blood in the vertebral canal were col ected from patients with lumbar spinal stenosis or lumbar vertebral burst fracture. The concentrations of serum interleukin-1αand tumor necrosis factor-αwere determined using enzyme-linked immunosorbent assay. RESULTS AND CONCLUSION:The concentration of interleukin-1αin degenerative lumbar stenosis group was significantly higher than that in the lumbar burst fracture group and peripheral veins (P<0.05). The more segments of lumbar spinal stenosis, the higher the venous serum interleukin-1αlevels were in the degenerative lumbar stenosis group, but the statistical difference was not significant. Linear correlation analysis results displayed that interleukin-1αlevels were positively associated with low back pain and disability scores in the degenerative lumbar stenosis group (r2=0.359 3, P<0.05;r2=0.526 4, P<0.05). These results indicated that the lumbar spinal venous inflammatory factors may be one of the reasons of low back pain and dysfunction in patients with degenerative lumbar spinal stenosis.
ABSTRACT
<p><b>OBJECTIVE</b>To obtain the cDNA sequence encoding fibrinolytic enzyme from Eupolyphaga sinensis and express it in prokaryotic and eukaryotic expression system.</p><p><b>METHOD</b>The primers were designed according to the cDNA of other animals'fibrinolytic enzyme. The cDNA sequence was cloned by RT-PCR and 3 RACE.</p><p><b>RESULT</b>Sequence analysis revealed that the length of the cDNA fragment was 672 bp and encoded a protein of 224 amino acid residues, the N end amino acid sequence residues was IVGG in accordance with other fibrinolytic enzyme. The cDNA sequence was expressed in E. coli, inactive protein was obtained. While expressed in Pichia pastoris, recombinant protein had fibrinolytic activity.</p><p><b>CONCLUSION</b>The cDNA sequence of fibrinolytic enzyme from E. sinensis Walker was cloned and expressed for the first time and it proved a good basis for further functional study of the enzyme.</p>
Subject(s)
Animals , Amino Acid Sequence , Base Sequence , Cloning, Molecular , Cockroaches , Chemistry , Genetics , DNA, Complementary , Chemistry , Genetics , Fibrinolysin , Chemistry , Genetics , Metabolism , Gene Expression , Insect Proteins , Chemistry , Genetics , Metabolism , Molecular Sequence Data , Sequence AlignmentABSTRACT
In conventional ear implantation surgery, clinical physicians usually make a surgery planning based on their observation on series of 2D X-ray images or CT images. Such a planning method requires the physicians to have a high level of clinical experience. Besides, the whole operation is unintuitive, and might have certain risk. Considering these facts, we have developed a computer-aided system for the surgery planning of the implantation of artificial ear based on CT imaging and 3D reconstruction techniques. The system effectively overcomes the main drawbacks in conventional surgery planning techniques, and it makes the surgery planning procedure more precise, safe, and intuitive.
Subject(s)
Humans , Artificial Organs , Ear , Congenital Abnormalities , Imaging, Three-Dimensional , Prosthesis Implantation , Methods , Surgery, Computer-Assisted , Methods , Tomography, X-Ray ComputedABSTRACT
Objective To purify ?-glutamyltranspeptidase (GGT) strongly combined to datura stramonim (DSA) lectin from human liver cancer tissue,which will be used as the antigen to produce antibodies for early diagnosis of liver cancer.Methods The GGT strongly combined to DSA lectin in human liver cancer tissue was purified by lectin affinity chromatography from human liver cancer tissue, including rough extraction,dialysis,ion-exchange chromatography and lectin affinity chromatography.Results The catalysis units per milligram protein of GGT increased about 84.9 times.The yield of the GGT was 1.60%.Conclusion The protocol in this study is efficient to purity GGT from human liver cancer tissue.