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@#Abstract: Objective To investigate the clinical outcomes and influencing factors of mild therapeutic hypothermia for influenza-associated encephalopathy/encephalitis (IAE) in children with different center temperatures, and to provide ideas and references for new mild therapeutic hypothermia scheme. Methods A total of 115 hospitalized children with IAE who were scheduled to receive mild therapeutic hypothermia in Zhongshan Hospital Affiliated to Xiamen University from January 2019 to February 2022 were collected as subjects. They were randomly divided into two groups, namely, the 33 ℃ group (n=60) and the 35 ℃ group (n=55). The clinical features and clinical outcomes of the two groups were analyzed. Univariate and multivariate logistic regression analysis was performed for 6-month to investigate the factors affecting neurological disability. Results The baseline indicators after treatment, such as Glasgow Coma Scale (GCS) score, cerebrospinal fluid total protein (CSF-TP), CSF lactate dehydrogenase (CSF-LDH), lymphocyte (Lym), creatine kinase-MB (CK-MB), LDH, and neuron-specific enolase (NSE), revealed no significant differences between the two groups before treatment or after treatment (P>0.05). There was no significant difference between the two groups after treatment in the clinical outcomes including GCS score D-value, time of hospitalization, 6-month neurological disability rate and mRS score, CSF-TP D-value, CSF-LDH D-value, Lym D-value, CK-MB D-value, LDH D-value, NSE D-value, improvement rate of EEG and MRI (P>0.05). Univariate and multivariate logistic regression analyses [OR=1.185, 95%CI (1.026~1.369), P=0.021] indicated that the delay of the onset of mild therapeutic hypothermia treatment was an independent risk factor for neurological disability in children with IAE after mild therapeutic hypothermia treatment of 6 months. Conclusion There was no significant difference in the clinical outcomes between 33 ℃ and 35 ℃ mild therapeutic hypothermia for children with IAE. Therefore, mild therapeutic hypothermia for children with IAE may not require a strict requirement. Timely receipt of mild therapeutic hypothermia is a key measrue to reduce the risk of neurological disability in children with IAE.
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SUMMARY A 71-year-old woman with recurrent papillary thyroid carcinoma (PTC) was referred to our hospital. A computed tomography scan revealed extensive recurrence in the neck, invading sternocleidomastoid muscle, internal jugular vein, sternal end of the clavicle, strap muscle and skin; and lateral compartment and subclavian lymph nodes were also involved. Multiple pulmonary micrometastases also noticed. The tumor was considered unresectable; however, the patient was unwilling to accept highly invasive surgery. Therefore, we initiated neoadjuvant therapy with anlotinib, 12mg p.o. daily with a 2-week on/1-week off regimen. The tumor shrunk to resectable state after 4 cycles of treatment, and after 3 weeks of withdrawal, successful surgical resection without gross tumor residual was performed. Pathology confirmed as classic PTC harboring coexistent TERT promoter and BRAFV600E mutations by NGS. After anlotinib therapy, apoptosis induction was observed, and proliferation increased, which was due to three weeks of anlotinib withdraw. Structual recurrence was recorded at 6 months after operation due to no further treatment was taken. Our finding suggests that anlotinib could represent as a good treatment option for patients with locally advanced (with or without distant metastasis) PTC; Anlotinib treatment resulted in sufficient reduction of the tumor mass to enable total thyroidectomy and radioactive iodine treatment, providing long-term control of the disease.
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ABSTRACT Introduction As college basketball continues to develop, more and more college students are joining the sport, and the resulting sports injuries have also gradually increased, affecting the quality of life and academic performance. Objective Analyze the most common sports injuries and offer solutions for the safe practice of college basketball. Methods This article studies, through interviews and literature review, the basketball injuries of college students, analyze the main causes of sports injuries, and presents corresponding countermeasures to promote the safe development of sports education in colleges. Results The main injuries were during training, excessive force, and inadequate preparation. Deficient muscle work is also associated with most of these injuries. Conclusion Basketball is highly competitive and popular on college campuses. It is a sport that can exercise and enrich the extracurricular life of college students, requiring from its practitioners greater attention in the pre-training warm-up phase and parallel muscle strengthening to reduce its major injuries in college students. Level of evidence II; Therapeutic studies - investigation of treatment outcomes
RESUMO Introdução Com o desenvolvimento contínuo do basquetebol universitário, cada vez mais estudantes universitários aderem ao esporte e as lesões esportivas resultantes também tem aumentado gradualmente, afetando a qualidade de vida e o desempenho nos estudos. Objetivo Analisar as lesões esportivas mais comuns e oferecer soluções visando a prática segura do basquetebol universitário. Métodos Este artigo estuda por meio de entrevistas e revisão literária as lesões no basquetebol dos estudantes universitários, analisa as principais causas das lesões no esporte e apresenta as contramedidas correspondentes para promover o desenvolvimento seguro do ensino esportivo em faculdades. Resultados As principais lesões encontradas foram durante o treino, excesso de força e preparo inadequado. O trabalho muscular deficitário também está associado a maior parte dessas lesões. Conclusão O basquetebol é um esporte altamente competitivo, muito popular nos campi universitários. É um esporte que pode exercitar e enriquecer a vida extracurricular dos estudantes universitários, requerendo de seus praticantes uma maior atenção na fase de aquecimento pré-treino e fortalecimento muscular paralelo para redução das suas principais lesões em universitários. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.
RESUMEN Introducción Con el continuo desarrollo del baloncesto universitario, cada vez más estudiantes universitarios se incorporan a este deporte y las lesiones deportivas resultantes también han aumentado gradualmente, afectando a la calidad de vida y al rendimiento en los estudios. Objetivo Analizar las lesiones deportivas más comunes y ofrecer soluciones orientadas a la práctica segura del baloncesto universitario. Métodos Este artículo estudia, mediante entrevistas y revisión de la literatura, las lesiones de baloncesto de los estudiantes universitarios, analiza las principales causas de las lesiones deportivas y presenta las correspondientes contramedidas para promover el desarrollo seguro de la enseñanza deportiva en los colegios. Resultados Las principales lesiones encontradas fueron durante el entrenamiento, la fuerza excesiva y la preparación inadecuada. El trabajo muscular deficiente también está asociado a la mayoría de estas lesiones. Conclusión El baloncesto es un deporte altamente competitivo, muy popular en los campus universitarios. Es un deporte que puede ejercitar y enriquecer la vida extraescolar de los universitarios, requiriendo de sus practicantes una mayor atención en la fase de calentamiento previo al entrenamiento y el fortalecimiento muscular paralelo para reducir sus principales lesiones en los universitarios. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento.
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Humans , Athletic Injuries/etiology , Basketball/injuries , Athletic Injuries/therapy , Severity of Illness Index , Interviews as TopicABSTRACT
SUMMARY OBJECTIVE: This study aimed to investigate the suboptimal health status or subhealth status and their relationship with mental health and smartphone addiction among Chinese medical students. METHODS: A cross-sectional survey was conducted at Wannan Medical College of China in Wuhu. RESULTS: A total of 2,741 students were surveyed in October 2020. Of 2,741 Chinese medical students who completed the survey, 904 (33%) participants reported to have had subhealth status. Anxiety status (p<0.001), depression status (p<0.001), and smartphone addiction status (p<0.001) have strong association with subhealth status. CONCLUSION: This survey shows that the detection rate of subhealth status in Chinese medical students was 33%. Anxiety, depression, and smartphone addiction students had a higher detection rate of subhealth status. The anxiety, depression, and smartphone addiction of Chinese medical students are associated with subhealth status.
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Students, Medical , China/epidemiology , Prevalence , Cross-Sectional Studies , Internet Addiction DisorderABSTRACT
Objective@#To explore age, gender, and regional differences in physical activity among children and adolescents in China, and to provide a scientific reference for enhancing physical activity promotion.@*Methods@#A total of 4 269 children and adolescents aged 7 to 18 years were selected from six administrative regions of China (East China, Northwest China, North China, Central China, Southwest China and South China) using a stratified random cluster sampling method from September to December 2018. A questionnaire was administered to evaluate the physical activity level of Chinese children and adolescents aged 7 to 18.@*Results@#The overall detection rate of MVPA insufficiency in children and adolescents in China was 53.8%, of which the detection rate of MVPA insufficiency was 50.8% among boys and 57.1% among girls. Gender differences were statistically significant ( χ 2= 17.10 , P <0.05). Among the different age groups, the lowest detection rate of MVPA among 10-12 year olds was 43.6%, whereas the highest rate among 16-18 year olds was 63.0%, with significant differences between gender ( χ 2=4.33, 30.79, P <0.05). The P 50 values of total physical activity(TPA), light intensity physical activity(LPA), moderate intensity physical activity(MPA), vigorous intensity physical activity(VPA), moderate to vigorous physical activity(MVPA) were 92.9,24.3,41.4,7.1 and 55.7 min/d , respectively. The P 50 values of physical exercise, housework activities, entertainment activities and transportation activities were 34.3 , 2.1, 2.3 and 30.0 min/d, respectively, and the difference in age groups was statistically significant( H =95.03, 74.99, 300.26 , 64.16, P <0.05). There was a statistically significant difference in the detection rate of insufficient MVPA among children and adolescents in different regions ( χ 2=83.91, P <0.05). The lowest rate was 44.0% in North China, and the highest was 65.9% in East China.@*Conclusion@#The detection rate of MVPA insufficiency among Chinese children and adolescents firstly decreased and then increased with age. Boys participated in higher levels of physical activity than girls.
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SUMMARY OBJECTIVE: This study aimed to assess the attitudes of Chinese residents toward COVID-19 vaccines and explore the potential drivers for Chinese residents' vaccine hesitancy. METHODS: A cross-sectional survey was conducted from February 16 to March 16, 2021, by administering an online questionnaire to the Chinese residents. RESULTS: Of 5240 residents who completed the survey, 464 (8.9%) participants reported to have had one shot, and 348 (6.6%) reported to have had 2 shots. At the time the questionnaire was administered, 2298 (43.9%) participants reported they wanted to get vaccinated, while 2255 (43.0%) declared that they still did not know, and 687 (13.1%) respondents declared vaccine refusal. Overall, 2255 (43%) participants were categorized as vaccine hesitancy. Female participants (p=0.000), <20 years old (p=0.000), have low risk of COVID-19 (p=0.000) infection and strong associations of vaccine hesitancy. eHealth literacy was a protective factor. CONCLUSIONS: The results of this study show high rates of vaccine hesitancy in China. This could pose a serious threat to the preventive measures that aimed at controlling COVID-19 spread in the country. The government and different media platforms should encourage the dissemination of correct information about vaccines, the communities and medical staff to improve residents' knowledge about vaccines, and strive to improve residents' electronic health literacy.
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Humans , Female , Adult , Young Adult , Vaccines , COVID-19 , China , Cross-Sectional Studies , Vaccination , Policy , COVID-19 Vaccines , SARS-CoV-2ABSTRACT
Objective@#To learn the prevalence and drug resistance of nontuberculous mycobacteria ( NTM ) in Zhejiang Province, so as to provide evidence for NTM prevention and control.@*Methods@#A total of 2 878 clinical mycobacterium isolates in Zhejiang Province were collected from the drug resistance surveillance in 2008-2009, 2013-2014 and 2018-2019, PNB/TCH growth tests were used to preliminarily identify the NTM in these mycobacterium-positive isolates. 16SrRNA, rpoB, ITS and hsp65 gene sequencing analysis were used to confirm strains initially identified as NTM. Proportional method was applied to detect drug susceptibility of NTM isolates.@*Results @# Finally, 135 strains were confirmed as NTM and the isolation rate was 4.69%. The isolation rates of NTM in 2008-2009, 2013-2014 and 2018-2019 were 1.85%, 4.56% and 7.84%, respectively, with an increasing trend ( P<0.05 ). Thirteen species were identified and the top two species were M. intracellulare ( 82, 60.74% ) and M. kansassi ( 18, 13.33% ). The NTM isolates showed the highest drug resistance rate to isoniazid ( 97.78% ), followed by p-aminosalicylic acid ( 94.87% ) and streptomycin ( 94.81% ).@*Conclusions@#The isolation rates of NTM showed an upward trend in the drug resistance surveillance in 2008-2019,2013-2014 and 2018-2019 in Zhejiang Province. M. intracellulare and M. kansassi were the main strains isolated. The NTM isolates showed high resistance against both first and second-line antituberculosis drugs.
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Objective To explore the function of losartan on heat-stress induced high-mobility group protein B1 (HMGB1) mediated inflammatory damage in the hepatocytes. Methods Rats were randomized into three groups: sham group (without heat stress), heatstroke group (heatstroke induction followed by i.p. injection of normal saline) and heatstroke+losartan group (heatstroke induction followed by i.p. injection of 50 mg/kg losartan). The serum and liver tissue were harvested nine hours after heatstroke to invest the serum alanine aminotransferase (ALT) levels, liver myeloperoxidase (MPO) levels, liver pathological morphology, serum HMGB1 levels as well as the expression of interleukin(IL)-1β and IL-18 in the liver. In vitro, the HBL3A hepatocyte cell lines were divided into the sham group (without heat stress), heat stress group and heat stress +losartan group (10 μmol/L losartan added into the supernatant after heat stress). Nine hours after heat stress, the cell viability and the levels of supernatant lactate dehydrogenase, supernatant HMGB, cytoplasm and total HMGB1 were all examined. Besides, the level of activated caspase-1 in hepatocytes, supernatant IL-1β and IL-18, as well as the cellular level of reactive oxygen species (ROS), were detected. The effects of recombinant HMGB1 with concentration gradients and 0.2 mmol/L hydrogen peroxide on the levels of IL-1β, IL-18 and HMGB1 in the heat stress hepatocytes treated by losartan were observed. Results In vivo, liver damage occurred in the rats of the heatstroke group. Compared with the heatstroke group, the levels of serum ALT, liver MPO, serum HMGB1, liver tissue IL-1β and IL-18 decreased in the heatstroke+losartan group (P<0.05). In vitro, hepatocytes in the heat stress group were apparently damaged. Compared with the heat stress, the levels of cytoplasmic HMGB1, supernatant HMGB1, IL-1β and IL-18 decreased in the heat stress+losartan group, and the cell survival rate increased (P<0.05). In addition, the HMGB1 inhibitor also reduced the levels of IL-1β and IL-18 in heat stress group hepatocytes. And the supplementation with HMGB1 increased the levels of IL-1β and IL-18 in heat stress hepatocytes treated by losartan (P<0.05). Losartan reduced the level of reactive oxygen species in heat stress hepatocytes, and the supplementation with hydrogen peroxide increased the level of HMGB1 in heat stress hepatocytes treated by losartan (P<0.05). Conclusion Losartan decreased the heat-stress induced HMGB1 mediated inflammatory damage in the hepatocytes.
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[Abstract] Objective To monitor the hyporesponsiveness to norepinephrine in heatstroke rats and the improvement of the responsiveness and inflammation by hydrocortisone. Methods Rats were randomized into 4 groups, saline control group, saline heatstroke group, hydrocortisone control group, and hydrocortisone heatstroke group. The carotid blood pressure was monitored in the four groups of rats under anesthesia. The following three parts of experiments were conducted with the sample size 8 in each part of the experiment. (1) The experiment of noradrenaline at two loading doses (1 μg/kg) i.v.. The mean arterial pressure (MAP) and interval time between blood pressure rising and dropping to the baseline were observed in groups of rats after receiving two loading doses of noradrenaline. (2) The experiment of constant low-dose norepinephrine [25 μg/(kg.h)] by continuous pumping injection. The blood pressure level and survival time were observed. (3) The experiment to detect biochemical indicators related to responsiveness. Four groups of rats receiving constant low-dose norepinephrine were sacrificed, and the serum and aortic tissues were collected to measure serum vasodilators (nitric oxide and prostaglandin E2), hormones (cortisol and adrenocorticotropic hormone), pro-inflammatory factors (nuclear factor κB, tumor necrosis factor α, and interleukin 1β) and α1 adrenergic receptor mRNA expression levels in aortic tissues. Results (1) Compared with the saline control group, the mean arterial pressure and interval time between blood pressure rising and dropping to the baseline were significantly decreased in the saline heatstroke group after receiving noradrenaline injection at a loading dose compared with the normal saline control group, especially after the second dose. The hydrocortisone heatstroke group had higher MAP and longer interval time than the saline heatstroke group. The difference was statistically significant (P<0.05). (2) The mean arterial pressure level of the saline heatstroke group was significantly lower than that of the saline control group after receiving a constant low dose of norepinephrine. The mean arterial pressure in the hydrocortisone heatstroke group was increased compared with the saline heatstroke group, and the survival time was prolonged. The difference was statistically significant (P<0.05). (3) The serum nitric oxide, prostaglandin E2, cortisol, and adrenocorticotropic hormone of the saline heatstroke group were not significantly different from those of the saline control group. The levels of pro-inflammatory factors were significantly increased, and the mRNA levels of α1 adrenergic receptors in the aorta were significantly reduced in the saline heatstroke group compared with the saline control group. The decreased pro-inflammatory factors and increased mRNA of α1 adrenergic receptors in the aorta were observed in the hydrocortisone heatstroke group compared with the saline heatstroke group. The difference was statistically significant (P<0.05). Conclusions The hyporesponsiveness to norepinephrine was demonstrated in the heatstroke rats with circulatory failure. Hydrocortisone could increase MAP and survival time, improve the hyporesponsiveness, reduce the inflammatory cytokines and increase the aortic adrenergic receptor expression.
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@#Music has a powerful influence on people’s psychology and emotions. Many clinical research reports confirm that music therapy can directly affect and improve people’s psychological and physiological status, alleviate patients’anxiety and other adverse physiological emotions, improve the effectiveness of surgical treatment, and promote rapid recovery. Lung cancer surgery has the characteristics of great trauma, high incidence of postoperative complications and poor prognosis. Therefore, music therapy has its unique advantages for lung cancer. With the rapid development of thoracic surgery (ERAS), as an important part of psychological intervention, music therapy plays an irreplaceable role in the surgical treatment of lung cancer. This article reviews the impact of music therapy on anxiety in lung cancer surgery.
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This study aimed to evaluate the feasibility and repeatability of the flash-replenishment method in contrast-enhanced ultrasound (CEUS) perfusion imaging and assess quantitatively microvascular perfusion in the liver. Twenty healthy New Zealand rabbits were submitted to CEUS perfusion imaging with continuous intravenous infusion. Using flash-replenishment kinetics, the dynamic process of depletion and refilling of microbubble contrast agent was recorded. The hepatic microvascular perfusion parameters were calculated, including region of interest, peak intensity (PI), area under the curve (AUC), and hepatic artery to vein transit time (HA-HVTT). A consistency test was performed for multiple measurements by the same operator and blind measurements by two different operators. The hepatic perfusion imaging of 3×108 bubbles/min had minimal error and the best imaging effect and repeatability. The variability of the perfusion parameter measured at 3 cm depth under the liver capsule was at a minimum with coefficient of variation of 3.9%. The interclass correlation coefficient (ICC) of measurements taken by the same operator was 0.985, (95% confidence interval, CI=0.927-0.998). Measurements taken by two operators had good consistency and reliability, with the ICC of 0.948 (95%CI=0.853-0.982). The PI and AUC of liver parenchyma after reperfusion were lower than before blocking; and HA-HVTT was significantly longer than before blocking (P<0.05). The flash-replenishment method in CEUS perfusion imaging showed good stability and repeatability, which provide a valuable experimental basis for the quantitative assessment of hepatic microvascular perfusion in clinical practice.
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Animals , Male , Female , Rabbits , Reperfusion Injury/diagnostic imaging , Ultrasonography/methods , Ischemia/physiopathology , Liver/blood supply , Liver Circulation/physiology , Blood Flow Velocity , Image Enhancement/methods , Random Allocation , Feasibility Studies , Reproducibility of Results , Contrast Media , Disease Models, Animal , Liver/diagnostic imaging , MicrocirculationABSTRACT
@#Objective To explore the effect of aortic root perfusion of amiodarone when intractable ventricular fibrillation occurs during valve replacement. Methods Totally 42 patients were selected as a drug group, who underwent intractable ventricular fibrillation following ascending aortic opening in valve replacement in Beijing Anzhen Hospital from October 2006 to October 2016. There were 26 males and 16 females with an average age of 56.31±12.56 years. The aorta was re-blocked when intractable ventricular fibrillation occured, amiodarone (150 mg diluted to 20 ml) through the aortic root perfusion tube was applicated, and suction was repeated 8-10 times with the cumulative amount of 150-200 ml, and then the ascending aorta was opened and fast compressed with a frequency of 200 times/min. While 53 patients with the same condition during the same period were selected as a control group. There were 35 males and 18 females with an average age of 58.79±19.81 years. The commonly used clinical treatment method of intractable ventricular fibrillation was adopted, such as continuous intravenous injection of 1 mg/kg lidocaine, while ascending aortic was re-blocked. The warm blood perfusion was given until the heart re-beated. The clinical outcomes were compared between the two groups. Results There was one perioperative death in the drug group and two deaths in the control group during perioperative period. Defibrillation frequency (3.11±0.59 times vs. 4.91±1.34 times, t=–2.917, P=0.000), heart rate 5 min after re-beating (91.65±9.81 beats/min vs. 98.32±10.21 beats/min, t=–2.019, P=0.032), cardiopulmonary bypass time (71.68±10.21 min vs. 81.59±12.93 min, t=–2.512, P=0.032), dopamine dosage (4.32±1.28 μg·kg–1·min–1 vs. 5.79±1.98 μg·kg–1·min–1, t=–2.781, P=0.015), epinephrine dosage (0.03±0.01 μg·kg–1·min–1 vs. 0.06±0.02 μg·kg–1·min–1, t=–3.996, P=0.000) and norepinephrine dosage (0.01±0.01 μg·kg–1·min–1 vs. 0.03±0.01 μg·kg–1·min–1, t=–4.163, P=0.000) of the drug group were significantly shorter or lower than those of the control group. The rate of cardiac rhythm 5 min after re-beating (42.8% vs. 9.4%, χ2=11.211, P=0.000) of the drug group was higher than that of the control group. Conclusion During intractable ventricular fibrillation following ascending aortic opening in valve replacemen, re-blocking the aorta and amiodarone reperfusion of the aortic root can significantly improve the heart re-beating rate and avoid ventricular re-fibrillation, shorten the cardiopulmonary bypass time and reduce the dosage of inotropic drugs.
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Objective To evaluate the efficacy and safety of combined use of insulated-tip knife, titanium clips and transparent caps in the resection of large pedunculated colorectal polyps. Methods Therapeutic method: with the assistance of transparent cap, 1~3 titanium clip(s) were applied to the base of the stalk to block blood supply of large polyps and then insulated-tip knife was utilized to resect polyps by cutting the stalk. Research method: retrospectively analyze the clinical data of 45 large pedunculated colorectal polyps (head ≥ 2.0 cm) which were treated by the method mentioned above from January 2014 to December 2015. Statistics of procedure time, clip numbers, complication rates were used to assess the effect of the treatment. Results 45 large polyps were successfully removed one time without any severe complications of bleeding or perforation during procedure except a very small amount of blood were oozing from the cutting edge in 3 cases. There were also no delayed complications of bleeding or perforation after procedure. The average number of titanium clip was 2.7 and the average operating time was (5.7 ± 1.2) min (range 3 ~ 12 min). Conclusion Combined application of insulated-tip knife, titanium clips and transparent cap inthe resection of large pedunculated colorectal polyps is safe, effective and convenient to conduct.
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Objective To evaluate the efficacy and safety of combined use of insulated-tip knife, titanium clips and transparent caps in the resection of large pedunculated colorectal polyps. Methods Therapeutic method: with the assistance of transparent cap, 1~3 titanium clip(s) were applied to the base of the stalk to block blood supply of large polyps and then insulated-tip knife was utilized to resect polyps by cutting the stalk. Research method: retrospectively analyze the clinical data of 45 large pedunculated colorectal polyps (head ≥ 2.0 cm) which were treated by the method mentioned above from January 2014 to December 2015. Statistics of procedure time, clip numbers, complication rates were used to assess the effect of the treatment. Results 45 large polyps were successfully removed one time without any severe complications of bleeding or perforation during procedure except a very small amount of blood were oozing from the cutting edge in 3 cases. There were also no delayed complications of bleeding or perforation after procedure. The average number of titanium clip was 2.7 and the average operating time was (5.7 ± 1.2) min (range 3 ~ 12 min). Conclusion Combined application of insulated-tip knife, titanium clips and transparent cap inthe resection of large pedunculated colorectal polyps is safe, effective and convenient to conduct.
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The effect and underlying mechanism of Bu-Shen-An-Tai recipe on ovarian apoptosis in mice with controlled ovarian hyperstimulation (COH) implantation dysfunction were studied.The COH implantation dysfunction model in mice was established by intraperitoneal injection of 7.5 IU pregnant mare's serum gonadotrophin (PMSG),followed by 7.5 IU human chorionic gonadotrophin (HCG) 48 h later.Then the female mice were mated with male at a ratio of 2:l in the same cage at 6:00 p.m.The female mice from normal group were injected intraperitoneally with normal saline and mated at the corresponding time.Day 1 of pregnancy was recorded by examining its vaginal smears at 8:00 a.m.of the next day.Fifty successfully pregnant mice were equally randomly divided into 5 groups:normal control pregnant group (NC),COH implantation dysfunction model group (COH),low dosage of Bu-Shen-An-Tai recipe group (LOW),middle dosage of Bu-Shen-An-Tai recipe group (MID) and high dosage of Bu-Shen-An-Tai recipe group (HIGH).Then from day 1,the mice in different groups were respectively intragastrically given corresponding treatments at 9:00 a.m.for 5 consecutive days.The concentrations of 17β-estradiol (E2) and progesterone (P4) were determined by radioimmunoassay (RIA).The ultrastructural changes of ovarian tissues were observed by transmission electron microscope (TEM).The histopathological changes of ovarian tissues were observed by HE staining.The number of atretic follicles and pregnant corpus luteum were also recorded.TUNEL was applied to measure apoptotic cells of ovarian tissues.Western blotting was used to detect the protein expression of apoptosis-related factors like Bax,Bcl-2 and cleaved-caspase-3 in ovarian tissue of mice.The results showed that ovarian weight,the concentrations of E2 and P4,the number of atretic follicles and pregnant corpus luteum,as well as the apoptosis of granulosa cells were significantly increased in the COH group.The ultrastructures of ovarian tissues in the COH group showed that chromatin in granulosa cells was increased,agglutinated,aggregated or crescent-shaped.The focal cavitation and the typical apoptotic bodies could be seen in granulosa cells in the late stage of apoptosis.After the treatment with different doses of Bu-Shen-An-Tai recipe,the ultrastructural changes of ovarian granulosa cells apoptosis were dramatically improved and even disappeared under TEM.Visible mitochondria and mitochondrial cristae were increased and vacuoles were significantly reduced.The lipid dropltes were shown in a circluar or oval shape.The protein expression levels of Bax and cleaved-caspase-3 were decreased,and the expression of Bcl-2 protein was increased after treatment.It was concluded that Bu-Shen-An-Tai recipe can inhibit the apoptosis of ovarian granulosa cells,probably by up-regulating the protein expression of Bcl-2 and down-regulating Bax and cleaved-caspase-3,which contributes to the formation and maintenance of ovarian corpus luteum.It's helpful to promote the embryonic implantation,to reduce embryo loss and ultimately to improve the success rate of pregnancy.
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To investigate the clinical course and management of congenital vaginal atresia.This retrospective analysis included patients with congenital vaginal atresia treated from March 2004 to August 2014 at the Obstetrics and Gynecology Hospital of Fudan University.Thirty-nine patients were included in this study.Their average age was 16.87±2.2 years when they came to our hospital.Totally,51％ of the patients had isolated congenital vaginal atresia with a normal cervix,whereas the others had either cervical atresia or imperforate hymen.The primary presenting signs and symptoms included primary amenorrhea (71.8％),periodic abdominalgia (41.0％),abdominal pain (36.0％),dyspareunia (10.3％),menstrual disorders (5.1％),and pelvic mass (5.1％).Ultrasound and magnetic resonance imaging (MRI) were effective inspection methods for the screening of urogenital tract-associated anomalies.Vaginoplasty mainly included simple vagina reconstruction with insertion of a mold (n=22) and split-thickness skin grafting (n=4).In 64％ of surgical patients,normal menstrual bleeding was achieved.Four of the patients subsequently became pregnant and delivered at term.Primary amenorrhea,periodic abdominalgia and abdominal pain are the main reasons for the post pubertal patients to visit doctors.Surgical methods can successfully provide these patients an opportunity for subsequent conservative management,can result in normal menstrual bleeding,resolve cyclic pelvic pain,and provide some potential for fertility.
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The present study aimed to examine the value of ultrasonic soft markers in prenatal screening by analyzing the clinical outcome of fetuses with ultrasonic soft markers during the second trimester of pregnancy.A retrospective analysis was performed to evaluate the outcome of 591 fetuses with ultrasonic soft markers from January 2015 to August 2016 in Zhongnan Hospital of Wuhan University,China.It was found that 591 fetuses showed ultrasonic soft markers in 4927 cases with the occurrence rate being 12.0％.Among them,564 fetuses (95.4％) were delivered and the remaining 27 cases (4.6％) were aborted.Five hundred and sixty-seven cases had single ultrasonic soft marker,including echogenic intracardiac focus (n=343),mild renal pelvis dilatation (n=116),short long bones (n=72),single umbilical artery (n=31),mild lateral ventriculomegaly (n=21),choroid plexus cysts (n=19),and echogenic bowel (n=13),with the disappearing rates in pregnancy being 97.1％ (333/343),77.6％ (90/116),0％ (0/72),0％ (0/31),57.1％ (12/21),89.5％ (17/19) and 61.5％ (8/13) respectively.The rate of pregnancy termination due to single ultrasonic soft marker was 3.4％ (19/567),and that was 33.3％ (8/24) due to two ultrasonic soft markers with the difference being statistically significant (P＜0.05).The reasons of pregnancy termination included malformations (polycystic kidney,cleft lip and palate,congenital heart diseases,pcromphalus,hypospadias,hydrocephalus),chromosome abnormality,and stillbirth.It was concluded that single ultrasonic soft marker is usually transient manifestation in pregnancy.Without the other structural defects,single ultrasonic soft marker usually disappears spontaneously with favorable prognosis in a low-risk population.It is suggested that ultrasonic soft markers should be appropriately interpreted to avoid unnecessary invasive examination.
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This meta-analysis aimed to comprehensively assess the efficacy and safety of hepatic resection combined with radiofrequency ablation versus hepatic resection (HR) alone for the treatment of multifocal hepatoeellular carcinomas (HCC).A literature search was conducted from the database including MEDLINE,Embase,Cochrane Central Register of Controlled Trials (CENTRAL) and China Biology Medicine (CBM) disc.The primary outcomes included the 1-,3-,5-year overall survival (OS) and disease-free survival (DFS) rate.The secondary outcomes contained the intraoperative parameters and postoperative adverse events (AEs).These parameters were all analyzed by RevMan 5.3 software.After carefully screening relevant studies,four retrospective studies of high quality involving 466 patients (197 in the combined group and 269 in the HR group) were included in this study.The pooled results showed that the 1-,3-,5-year OS rate in the combined group were comparable with those in the HR group (OR=0.77,0.96,0.88;P=0.33,0.88,0.70,respectively).Similarly,there was no significant difference in 1-,3-,5-year DFS rate between the combined group and the HR alone group (OR=0.57,0.83,0.72;P=0.17,0.37,0.32,respectively).And the intraoperative parameters and postoperative AEs were also comparable between the above two cohorts.However,two included studies reported that tumor often recurred in the ablation site in the combined group.The present meta-analysis indicated that the HR combined with RFA could reach a long-term survival outcome similar to curative HR for multifocal HCC patients.And this therapy may be a promising alternative for these patients with marginal liver function or complicated tumor distribution.Furthermore,high quality randomized controlled trials (RCTs) are imperative to verify this conclusion.
ABSTRACT
Spinal cystic schwannomas are a very rare entity and have been reported in only a few case reports in literature; its diagnosis and management has remained a challenge. This study reviewed the results of magnetic resonance imaging [MRI] of 12 patients [7 men and 5 women; aged 37 - 67 years; mean age: 52.75 years] with pathologically proven cystic schwannoma of the spine and discussed their differential diagnosis. All patients underwent surgery at our institutions between June 2000 and April 2012. MRI showed well-delineated intradural and extramedullary lesion of iso- to low signal intensity on T1 weighted images, high signal intensity on T2 weighted images, and rim enhancement on contrastenhanced images. A precise understanding of the MRI features of spinal schwannomas, especially the typical characteristic of enhancement, may help clinicians in their pre-operative diagnoses and surgical planning
ABSTRACT
Objective: We conducted a cohort study to investigate the association of three common SNPs of vascular endothelial growth factors [VEGF] gene [+1612G/A, -634C/G and +936G/C] with clinical outcome of osteosarcoma in a Chinese population
Methods: A prospective study was conducted. Genotyping analyses of VEGF -2578C/A, +1612G/A, -634C/G and +936G/C were conducted using polymerase chain reaction-restriction fragment length of polymorphism. Multivariate Cox proportional hazards models were used to calculate hazard ratio [HR] and 95% Cl of effect of each genotype of VEGF+1612G/A, -634C/G and +936G/C on PFS and osteosarcoma of osteosarcoma
Results: The good response rate was 52.29%, and 116 [68.7%] died during the follow-up period
Patients carrying the +936 CC genotype and C allele showed a significantly more response to chemotherapy than those carrying the wild-type genotype. In the Cox proportional hazards model, patients carrying the VEGF -634 T allele was associated with a significantly decreased risk of PFS and Osteosarcoma [OS]
Patients carrying the +936 CC genotype and C allele were associated with a significantly decreased risk of presenting progressive disease or death from osteosarcoma when compared with those carrying the wild-type genotype. However, we observed no significant association between the VEGF -2578C/Aand +1612A/G polymorphisms and PFS and Osteosarcoma [OS] in gastric cancer patients
Conclusions: We found that VEGF -634G/C and +936T/C polymorphisms may affect the prognosis of osteosarcoma patients. These finding may be useful for predicting the clinical outcome of patients with Osteosarcoma [OS]
Further studies are greatly needed to confirm the clinical significance of these results