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ObjectiveTo study the effect of Bushen Huoxuetang on the apoptosis and the expression of B-cell lymphoma （Bcl-2）-associated X protein （Bax）/ Bcl-2 and cleaved cysteine-containing aspartate proteolytic enzyme-3 （cleaved Caspase-3） in the nude mouse model of bone metastasis of breast cancer， and explore the mechanism of Bushen Huoxuetang in inhibiting bone destruction. MethodThirty BALB/c female nude mice were randomly assigned into blank group （n=6） and model group （n=24）. The suspension of 4T1 breast cancer cells was injected into the tibia of mouse right lower limb to establish model of bone metastasis of breast cancer. The successfully modeled nude mice were randomly assigned into model group， Bushen Huoxuetang group， zoledronic acid group， and combined drug group， with 6 mice in each group. Bushen Huoxuetang was administrated at a dose of 36.67 g·kg-1， once a day， and zoledronic acid was administrated by subcutaneous injection at a dose of 100 μg·kg-1， twice a week. The combined drug group was administrated with the same doses of Bushen Huoxuetang group by gavage and zoledronic acid by subcutaneous injection. The mice in the blank group and the model group were administrated with the same volume of distilled water by gavage for 14 days. On the next day at the end of drug administration， the mice were sacrificed by cervical dislocation. The general situation and weight changes of the mice were examined. The right lower limb was collected， and X-ray scanning and hematoxylin-eosin （HE） staining methods were used for observation of pathological changes in the bone. The terminal deoxynucleotidyl transferase dUTP nick-end labeling （TUNEL） was employed to detect the apoptosis of bone tissue in nude mice， and Western blot to determine the expression of Bax/Bcl-2 and cleaved Caspase-3 in the bone tissue. ResultCompared with the blank group， the modeling reduced the body weight （P<0.01） and increased the right lower limb weight of the nude mice （P<0.01）. Compared with the model group， Bushen Huoxuetang， zoledronic acid， and their combination increased the body weight （P<0.01） and decreased the right lower limb weight （P<0.01）. Compared with the blank group， the other groups showed obvious tumor cell atypia， deep nuclear staining， and clear bone metastasis， and the model group showed obvious osteolytic damage in right lower limb and loss of proximal tibia and knee joint. Compared with the model group， Bushen Huoxuetang， zoledronic acid， and their combination reduced the osteolytic lesions in the right lower limb and recovered part of the bone structure， demonstrating an inhibitory effect on bone destruction. The TUNEL assay showed that the model group had lower apoptosis rate of bone metastatic tumor cells than the blank group， Bushen Huoxuetang group， zoledronic acid group， and combined drug group （P<0.01）. Compared with the blank group， the modeling down-regulated the expression of Bax and cleaved Caspase-3 （P<0.01） and up-regulated the expression of Bcl-2 （P<0.01）. Compared with the model group， Bushen Huoxuetang， zoledronic acid， and their combination up-regulated the expression of Bax （P<0.01） and cleaved Caspase-3 （P<0.05， P<0.01） and down-regulated the expression of Bcl-2 （P<0.05， P<0.01）. ConclusionBushen Huoxuetang may inhibit bone destruction in the nude mouse model of bone metastasis of breast cancer by up-regulating the expression of Bax， down-regulating the expression of Bcl-2， activating cleaved Caspase-3， and further inducing apoptosis.
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In recent years,great progress has been achieved in the application of immune checkpoint inhibitors (ICI) in tumor immunotherapy.However,a variety of adverse reactions induced by ICI have been reported.Despite the high overall incidence of adverse reactions caused by ICI,some adverse reactions,such as immune-related pancreatitis,are rare in clinical practice.In this paper,a case of immune-related pancreatitis after treatment of advanced gastric cancer with nivolumab was identified.We analyzed the cause,treatment,incidence,and risk factors of the adverse reaction,aiming to improve the clinical diagnosis,treatment,and safe medication of rare adverse reactions associated with ICI.
Subject(s)
Humans , Nivolumab/adverse effects , Immune Checkpoint Inhibitors/adverse effects , Antineoplastic Agents, Immunological/adverse effects , Pancreatitis/drug therapy , Stomach NeoplasmsABSTRACT
OBJECTIVES@#To thoroughly understand the current dental chair equipment status of dental clinics in Sichuan Province and provide a reference for administrative departments.@*METHODS@#Data were collected from a health administrative department and a regional social development yearbook. The number of existing dental clinics and dental chairs in Sichuan Province was investigated.@*RESULTS@#In Sichuan Province, 7 103 dental clinics were determined to be equipped with 21 760 dental chairs. The Gini coefficients of per capita dental clinics in the province were 0.50, 0.22, and 0.06, and the Gini coefficients of per capita dental chairs were 0.68, 0.31, and 0.15; these coefficients had the same distribution as that reflected by the Lorenz curve. In consideration of geographic distribution, the Theil index for the distribution of dental clinics and dental chairs among cities and states were 0.690 7 and 0.822 3, respectively. The overall Theil index va-lues for the distribution of dental clinics and dental chairs in the province were 0.902 4 and 1.079 4, respectively. The difference in the distribution of dental clinics and dental chairs among cities and states in the province contributed 0.765 4 and 0.761 8 to the total difference, respectively.@*CONCLUSIONS@#The allocation of oral health resources in Sichuan Pro-vince is relatively equitable in terms of population and economic distribution but uneven in geographical distribution.
Subject(s)
Dental Clinics , Oral Health , ChinaABSTRACT
@#Chalcones are polyphenolic flavonoid substances with various pharmacological effects and low toxicity.In this study, 15 novel trifluoromethyl chalcone derivatives (3a-3o) were designed and synthesized using the chalcone nucleus of natural licorice chalcone as the lead compound skeleton in order to find the candidate drugs with high efficiency and low toxicity against cervical cancer.The structures of the target compounds were confirmed by 1H NMR, 13C NMR and HRMS. The inhibitory activities of compounds 3a-3o, licorice chalcone, cisplatin and Nutlin3a on SiHa, HeLa and C-33A human cervical cancer cells and H8 and HaCaT normal cells were determined by MTT assay, and the structure-activity relationship was analyzed.Transwell and flow cytometry methods were used to assess the target compounds'' ability to inhibit cell migration and invasion, promote apoptosis, and arrest the cell cycle.Molecular docking technology was used to further study the binding characteristics of the target compound with MDM2 protein.The results showed that the compounds had different degrees of inhibitory activity against the three types of cervical cancer cells.Compound 3n showed the strongest activity against HeLa cells (IC50 = 11.69 μmol/L), which was superior to the lead compound, and had lower toxicity against the two normal cells.Compound 3n was found to significantly inhibit the migration and invasion of HeLa cells, induce apoptosis and arrest the cell cycle at G2/M phase.The results of molecular docking showed that the effective binding of compound 3n to MDM2 protein may be one of its anti-tumor mechanisms.This study provides an experimental basis for the screening of new anti-cervical cancer candidate drug from chalcone derivatives.
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Objective:To explore the effectiveness of medial malleolus screw epiphyseodesis for pediatric ankle valgus correction and calculate the correction rate, and analyse the influence factors on deformity correction and the risk factors of deformity recurrence after screw removal.Methods:Medical records and radiographs of patients undergoing screw hemiepiphyseodesis of the medial physis of the distal tibia for ankle valgus between Jan 2011 and Dec 2020, at a single pediatric orthopedic department were retrospectively analyzed. A total of 41 patients (49 ankles) were included in following study, including 28 male patients and 13 female patients; with 24 left sides and 25 right sides. Median age at surgery was 10.75 (4.5, 13.9) years, and median follow-up time was 27 (12, 64) months. According to the clinical diagnosis: hereditary multiple exostoses were 23 ankles, fibula hemimelia were 5 ankles, tibia hemimelia were 2 ankles, endochondromatosis were 5 ankles, neurofibromatosis were 5 ankles, traumatic fracture were 6 ankles, and fibrous dysplasia were 3 ankles. The lateral distal tibial angle (LDTA) was measured on ankle weight-bearing X-ray to evaluate the deformity correction. Malhotra classification was used to describe shortening of the fibula at the ankle.Results:Eventually effective correction were obtained in 36 ankles, with an overall effective rate of 73.5%. Screw type (partial-thread or full-thread), screw length (whether to the contralateral cortex), washer used, clinical diagnosis, and age are not independent risk factors for effective correction. Multiple linear regression analysis ( R 2=0.67) was applied for postoperative correction amplitude in effective correction cases, and the length of correction time ( P<0.001), clinical diagnosis ( P=0.013) and preoperative LDTA ( P=0.002) were significant predictive factors after adjusting for age differences. One-way ANOVA were used to compare data between different clinical diagnosis, showed a significant difference in the mean postoperative correction rate ( F=5.05, P=0.003). Conclusion:Medial malleolus screw epiphyseodesis is an effective and reliable method for the treatment of ankle valgus deformity in children; different clinical diagnosis can produce significant differences in the correction rate of ankle valgus deformity.
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Objective:To evaluate the safety and clinical efficacy of transphyseal anterior cruciate ligament (ACL) reconstruction with hamstring autograft in skeletally immature pubescent adolescents.Methods:Retrospectively reviewed 10 skeletally immature pubescent patients (10 knees) who underwent transphyseal ACL reconstruction with hamstring autograft between May 2015 and May 2020 in our center. Out of the 10 patients, 6 were males aged 14.2±1.4 years (range, 13-15 years) with bone age 13-15 years, 4 were females aged 12.4±1.2 years (range, 11-13 years) with bone age 11-13 years. The average duration from injury to surgery was 8.3±5.3 months (range, 3-48 months). Before operation, left hand and wrist plain film were done to assess bone age. Before operation and at follow up, physical examination, KT-1000 measurements and functional outcome instruments (the Lysholm score, and the Tegner score) were done. Radiographs were performed for angular deformity and leg-length measurements. The surgery was conducted via arthroscopically assisted transphyseal reconstruction of the ACL with use of an autogenous quadrupled hamstring tendon graft and fixation devices that did not cross the physes. A protective knee brace was used for 1 month postoperatively. Comparison of Lysholm score and Tegner score before and after surgery was performed using t test. Results:Arthroscopy confirmed ACL rupture in 10 knees. Concurrent meniscal surgery was performed in 3 knees. The follow-up duration was 3.2±2.3 years (range 2-5 years), one of 10 patients had ligament reinjury 1 year after surgery with positive anterior drawer test and Lachman test. As for the remaining 9 patients, the mean Lysholm knee score improved from preoperative 76.1±8.2 to 95.8 ±3.5, and the mean Tegner score improved from preoperative 4.3±0.9 to 8.3±0.6, both of the two outcomes had statistically significant difference ( t=6.43, P=0.024; t=4.41, P=0.033). One patients was weakly positive for anterior drawer test and Lachman test, with KT-1000 side difference >3 mm, the remaining eight were negative for anterior drawer test and Lachman test, and KT-1000 side difference was mean 1.7±0.7 mm. All patients had no more than 5° restriction in knee range of motion compared with the healthy side. The full-length X-ray of the standing lower limbs showed no length and angle deformity in both lower limbs. Conclusion:Transphyseal ACL reconstruction with autogenous quadrupled hamstring graft in treating skeletally immature pubescent patients (bone age over 13 years in male and 11 years in female) yields satisfied functional outcomes without growth disturbance.
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OBJECTIVE@#Review and analyze the characteristics of bone marrow cell morphology in patients with Epstein-Barr virus (EBV) infection, and explore the diagnostic value of bone marrow cell morphology for the early identification of EBV infection.@*METHODS@#A total of 33 patients with EBV-DNA positive detection in the First Affiliated Hospital of Guangxi Medical University from January 2018 to May 2021 were collected as the research objects. Bone marrow cell morphology and peripheral blood cell analysis were performed, and the significance in disease diagnosis was analyzed by statistical methods.@*RESULTS@#The sampling satisfaction of 33 patients with EBV infection was 100%. In the clinical diagnosis of all cases, 7 cases were IM, 17 cases were EBV-HLH, 3 cases were lymphoma, 2 cases were EBV-associated lymphoid hyperplasia, and 4 cases were not diagnosed. Among them, 31 patients had active bone marrow hyperplasia or above, 26 patients had active granulocytic hyperplasia or above, 21 patients had active erythroid hyperplasia or above, and 17 cases of megakaryocyte production platelet function decreased. The abnormal components of bone marrow mainly indude atypical lymphocyte cells (33 cases), hemophagocytic cells (22 cases), abnormal histiocyte (10 cases).@*CONCLUSION@#According to the proliferation of granulocytes, erythrocytes and megakaryocytes in the bone marrow, and the emergence of abnormal components such as atypical lymphocytes, hemophagocyte, abnormal histiocyte. Bone marrow cell morphological examination can indicate the possibility of EBV infection, which is certain diagnostic value for early identification of EBV infection.
Subject(s)
Humans , Bone Marrow Cells , Bone Marrow Diseases/pathology , China , Epstein-Barr Virus Infections , Herpesvirus 4, Human , Hyperplasia/pathologyABSTRACT
In this study, a method for simultaneous quantitative analysis of 6 salvianolic acids and 4 tanshinones in extracts of Salviae Miltiorrhizae Radix et Rhizoma was established by ultra-high performance liquid chromatography (UHPLC). The semi-biomimetic method was applied to simulate digestion process in vitro, to explore the digestion and transport characters of oral administration through the gastrointestinal tract, and to explain the content ratio changes and bioaccessibility of active ingredients in Salviae Miltiorrhizae Radix et Rhizoma. The results showed that the 10 index components have a good linear relationship in the corresponding concentration range, and the average recovery rate was 91.35% to 105.65%. After simulated digestion in vitro, types of chemical composition in simulated gastric fluid and simulated intestinal fluid digested extracts of Salviae Miltiorrhizae Radix et Rhizoma did not change significantly. While the content ratio of salvianolic acid B and rosmarinic acid decreased, and the content ratio of protocatechuic aldehyde and danshensu increased. In the simulated gastric fluid digestion extract of Salviae Miltiorrhizae Radix et Rhizoma, the order of bioaccessibility was: danshensu (50.19%) > salvianolic acid B (33.44%) > lithospermic acid (27.34%) > salvianolic acid A (21.71%) > rosmarinic acid (12.31%). In the simulated intestinal fluid digestion extract of Salviae Miltiorrhizae Radix et Rhizoma, the order of bioaccessibility was: 15,16-dihydrotanshinone Ⅰ (5.45%) > tanshinone Ⅰ (3.67%) > cryptotanshinone (3.29%) > tanshinone ⅡA (3.01%) > salvianolic acid A (2.39%) > lithospermic acid (1.57%) > salvianolic acid B (1.02%) > danshensu (0.41%) > rosmarinic acid (0.34%). In conclusion, the UHPLC method established in this study can be applied for accurately and sensitively detecting the contents of 6 salvianolic acids and 4 tanshinones in Salviae Miltiorrhizae Radix et Rhizoma. The results of semi-biomimetic extraction showed that not all components were extracted with simulated gastric fluid and simulated intestinal fluid, especially rosmarinic acid and salvianolic acid B. Therefore, in the quality study of Salviae Miltiorrhizae Radix et Rhizoma and its extract, bioavailability should be considered at the same time when select quality markers and determine their content limits.
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Objective: To investigate the prevalence of tonsil hypertrophy in patients with different sagittal skeletal craniofacial patterns, as well as the correlation between tonsil hypertrophy and the type of skeletal pattern. Methods: Lateral cephalograms of patients who visited the Department of Orthodontics Division 1, School of Stomatology, Wuhan University during January to August, 2019 were retrospectively collected. Patients (children: age≥6 and ≤12 year; adults: age≥18 year) were divided into three groups according to the ANB (subspinale-nasion-supramental) angle: the skeletal class Ⅰ group (0°≤ANB≤4°), skeletal class Ⅱ group (ANB>4°) and skeletal class Ⅲ group (ANB<0°). Tonsil hypertrophy was diagnosed with lateral cephalogram by two specifically trained orthodontists independently, according to the Baroni's method. The between-group differences in tonsil hypertrophy prevalence were analyzed using chi-square tests with Bonferroni correction (α=0.017). Results: A total of 1 776 patients (593 children and 1 183 adults) were included, among which 672 (37.8%) were with class Ⅰ, 849 (47.8%) with class Ⅱ, and 255 (14.4%) with class Ⅲ skeletal pattern. The prevalence of tonsil hypertrophy in children was 66.3% (393/593). The proportion of children with tonsil hypertrophy in class Ⅲ group [87.0% (60/69)] were significantly higher than that in class Ⅰ [65.6% (145/221), χ²=11.56, P<0.017] and class Ⅱ [62.0% (188/303), χ²=15.69, P<0.017] groups. The prevalence of tonsil hypertrophy in adults was 23.2% (275/1 183). The proportion of adults with tonsil hypertrophy in class Ⅲ group [42.5% (79/186)] was significantly higher than that in class Ⅰ [19.1% (86/451), χ²=36.50, P<0.017] and class Ⅱ [20.2% (110/546), χ²=35.00, P<0.017] groups. However, there was no significant difference in the prevalence of tonsil hypertrophy between class Ⅰ and class Ⅱ groups for both children (χ²=0.70, P>0.017) and adults (χ²=0.18, P>0.017). Conclusions: The prevalence of tonsil hypertrophy in skeletal class Ⅲ patients was significantly higher than that in patients with skeletal class Ⅰ and Ⅱmalocclusion. Tonsil hypertrophy could be an important risk factor for skeletal class Ⅲ patients.
Subject(s)
Adolescent , Adult , Child , Humans , Cephalometry/methods , Hypertrophy , Malocclusion , Palatine Tonsil , Retrospective StudiesABSTRACT
OBJECTIVE@#To investigate the effect of suture of pronator muscle on forearm function after modified Henry approach for distal radius fractures.@*METHODS@#from January 2018 to December 2020, 220 patients with distal radius fractures were treated with open reduction and locking plate internal fixation through the modified Henry approach. They were divided into two groups according to different suture methods. There were 112 cases in the intraoperative suture group, including 35 males and 77 females;The age ranged from 37 to 65(48.5±7.4) years;AO classification of fracture, 46 cases of type B and 66 cases of type C;After fracture reduction and locking plate fixation, the pronator muscle was opened and sutured. There were 108 cases in the non suture group, 32 males and 76 females;The age ranged from 34 to 67(47.6±7.8) years;There were 41 cases of fracture type B and 67 cases of fracture type C;After fracture reduction and locking plate fixation, the open pronator muscle was not sutured, and it was laid on the surface of the plate in situ. The range of wrist motion (pronation, supination, palmar inclination and dorsiflexion), the score of disability of arm shoulder and hand dash and visual analog scale(VAS) were compared between the two groups at 6 weeks and 6 months after operation.@*RESULTS@#All 220 patients were followed up for 6 to 18 (8.5±1.3) months. There was no significant difference in the range of motion and DASH score of forearm and wrist between the two groups 6 weeks after operation (P>0.05);There was significant difference in VAS score between suture group (2.6±1.2) and non suture group (5.8±2.3)(P<0.05). Six months after operation, there was no significant difference in the range of motion, DASH score and VAS score of forearm and wrist between the two groups(P>0.05).@*CONCLUSION@#The modified Henry approach has no obvious advantages in the range of wrist movement and upper limb function, but the intraoperative suture of pronator can reduce the early postoperative pain. It is suggested that the pronator should be sutured during the operation.
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Bone Plates , Forearm , Fracture Fixation, Internal , Muscle, Skeletal/surgery , Radius Fractures/surgery , Range of Motion, Articular , Sutures , Treatment OutcomeABSTRACT
Objective:In this study, the feasibility of this method was evaluated in children with large distance femoral lengthening cases, and the acute correction and staging surgeries were compared at healing speed. At the same time the key points of surgical techniques would be summarized, so as to clarify the application value of this technology in children patients.Methods:Since July 7 of 2014 to January 16 of 2018, a total of 10 cases of Lengthening Over Retrograde Nail (LORN) surgery have been formulated and carried out, including 9 males and 1 females.The average age of the operation was 13.10±2.18 y. In all cases, the osteotomy point was located in the metaphysis of the distal femur, and the records from the first meeting to the end of follow-up included gender, date of birth, reason of discrepancy and treatment history, age at surgery, lengthing distance, the length of duration with frame, healing time, ROM of the knee joint, complications, et al. To compare the healing time of acute correction and staging surgery. Statistical analysis was made by SPSS 22.0 software, and then reasonable treatment strategies were proposed.Results:The average lengthing distance of 7.07±1.01 cm. The median time of the duration with frame was 8.5 (4,16) months, and the median follow-up time was 39 (34, 54) months. All cases obtained good clinical and imaging healing (1.70±1.10 month/cm vs. 1.16±0.54 month/cm), and all regained to normal walking function (136.67°±20.82° vs. 125.71°±26.37°), without the occurrence of fracture after therapy. There were no statistically significant differences in the speed of healing, range of joint motion or complication rate between acute correction and staging treatment. Conclusion:It is feasible for femoral lengthening surgery assisted by retrograde intramedullary nail in the treatment of femoral shortening deformityin children. The correction of mild angular deformity and lengthening surgery can be performed simultaneously. The osteotomy site was proposed at distal metaphysealof the femur for better quality of osteogenesis and shorter duration for fixator. It is safe to osteotomy and lengthening in the area of enchondroma.
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Objective:To observe the clinical efficacy of Erchentang combined with Sanzi Yangqintang in the treatment of cough variant asthma （CVA） in children with phlegm-evil accumulation lung syndrome and its influence on airway inflammation and airway hyperresponsiveness （AHR）. Method:A total of one hundred and sixteen children were randomly divided into observation group and control group 58 cases in each group. Patients in both groups took montelukast sodium chewable tablets orally， 5 mg/time， once daily， at night before bedtime. In observation group， patients took Erchentang and Sanzi Yangqintang modified granules orally. While patients in control group took Erchentang and Sanzi Yangqintang placebo granules orally. Treatment course continued six weeks for two groups. Before and after treatment， the cough symptom scores and phlegm evil accumulating lung syndrome scores were recorded every week. The cough remission time and cough disappearance time were recorded， followed up for 24 weeks to record cough recurrence. Leicester Cough quality of life questionnaire （LCQ） was scored before and after treatment. The ratio of induced sputum eosinophils （EOS） and the levels of interleukin-4 （IL-4）， IL-5， IL-12， IL-13 were measured before and after treatment. The cumulative doses of exhaled nitric oxide （FeNO） and methacholine （PD20） were measued before and after therapy. Safety evaluation was conducted. Result:The scores of cough symptom and phlegm-evil accumulation lung syndrome at different time points were decreased gradually in two groups of children after treatment （<italic>F</italic><sub>control group</sub>=5.277， <italic>F</italic><sub>observation group</sub>=7.636，<italic>P</italic><0.01）. The scores of cough symptom and phlegm-evil accumulation in the lung syndrome of observation group were lower than those in control group （<italic>P</italic><0.01） at the same period. The durations of cough relief and cough disappearance in observation group were shorter than those in control group （<italic>P</italic><0.01）. Within 24 weeks of follow-up， the recurrence rate of children in observation group was 68.97% （40/58）， lower than 84.48% （49/58） in control group （<italic>χ</italic><sup>2</sup>=3.917，<italic>P</italic><0.05）. Children in observation group had fewer relapses than those in control group （<italic>P</italic><0.01）. The total LCQ scores and scores of all dimensions in observation group were higher than those in control group （<italic>P</italic><0.01）. The EOS， IL-4， IL-5 and IL-13 levels in observation group were lower than the data in control group， and IL-12 level was higher than that in control group （<italic>P</italic><0.01）. FeNO of children in observation group was lower than that in control group （<italic>P</italic><0.01）， while PD20 was more than that of control group （<italic>P</italic><0.01）. The total effective rate of clinical curative effect of children in observation group was 96.55% （56/58）， which was higher than 82.76% （48/58） in control group （<italic>χ</italic><sup>2</sup>=5.948，<italic>P</italic><0.05）. Conclusion:Erchentang combined with Sanzi Yangqintang for children with CVA phlegm evil accumulation lung syndrome can further control the symptoms of cough， shorten the course of cough， improve the quality of life， and reduce airway inflammation and AHR， reduce the recurrence rate. The clinical efficacy is better than using montelukast only， and it is safe and has good clinical value.
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Objective To investigate the effects of Nicotinamide mononucleotide (NMN) on ulcerative colitis induced by dextran sulfate sodium (DSS) in mice. Methods DSS-induced ulcerative colitis mice were used to evaluate the effects of NMN. After NMN administration, the survival time, weight, disease activity index (DAI), colon tissue length and pathological changes of colon tissue slices were observed. Results NMN did not cause significant changes in the survival time, weight, DAI, and intestinal morphology of ulcerative colitis mice. Conclusion NMN has no significant effect on DSS-induced ulcerative colitis mice.
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Objective:To investigate the short-term effect of thoracoscopic and laparoscopic surgery in the treatment of esophageal cancer and its impact on stress response and inflammatory response.Methods:The clinical data of 124 patients with esophageal cancer admitted to Huai′an Cancer Hospital from March 2018 to March 2020 were analyzed. The patients in observation group (62 cases) were treated with thoracoscopic esophagectomy and the patients in control group (62 cases) were treated with traditional open esophagectomy. The changes of perioperative indexes, postoperative complications, stress response, inflammatory response indexes before and 3 d after operation, and pulmonary function before and 1 month after operation were compared between the two groups.Results:The intraoperative blood loss in the observation group was less than that in the control group: (189.52 ± 37.28) ml vs. (258.94 ± 32.14) ml; the operation time in the observation group was longer than that in the control group: (271.92 ± 25.43) min vs. (231.09 ± 23.16) min, and the differences were statistically significant ( t = 11.105, 9.347, P<0.05). But there was no significant difference in the total number of lymph node dissection between the two groups ( t = 1.295, P>0.05). The postoperative complications in the observation group was less than that in the control group: 9.68%(6/62) vs. 24.19%(15/62), χ2 = 4.644, P<0.05. The serum levels of cortisol and norepinephrine at 3 d after operation in the observation group were lower than those in the control group: (145.32 ± 12.39) μg/L vs. (197.56 ± 18.78) μg/L, (84.54 ± 5.98) μg/L vs. (98.93 ± 7.26) μg/L, and the differences were statistically significant ( t = 18.283, 12.047, P<0.05). The serum levels of interleukin 6, C-reactive protein and tumor necrosis factoralpha at 3 d after operation in the observation group were lower than those in the control group: (101.31 ± 6.56) μg/L vs. (149.09 ± 12.31) μg/L, (18.94 ± 4.53) mg/L vs. (29.95 ± 4.16) mg/L, (84.52 ± 5.89) ng/L vs. (109.32 ± 8.64) ng/L, and the differences were statistically significant ( t = 26.972, 14.096, 18.675, P<0.05). The levels of the first second forced expiratory volume (FEV 1) as a percentage of the estimated value and the ratio of FEV 1 and forced vital capacity at 1 month after operation in the observation group were higher than those in the control group: (8.79 ± 4.50)% vs. (72.16 ± 3.64)%, (67.84 ± 3.24)% vs. (60.39 ± 4.15)%, and the differences were statistically significant ( t = 9.020, 11.142, P<0.05). Conclusions:The short-term effect of thoracoscopic and laparoscopic surgery in the treatment of esophageal cancer is obvious, and the stress response, inflammatory response and lung function are less affected.
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Objective: To compare the clinical application results of the FPTF (free posterior tibial artery perforator flap) and RFFF (radial forearm free flap) for reconstruction of head and neck defects. Methods: A retrospective analysis of 27 cases treated with FPTF (19 males and 8 females, aged 14-69 years) and 24 cases with RFFF (11 males and 13 females, aged 22-69 years) for head and neck defect reconstruction at Beijing Tongren Hospital of Capital Medical University from January 2015 to December 2020 was conducted. Flap size, vascular pedicle length, matching degree of recipient area blood vessels, preparation time, total operation time, hospital stay, recipient area complications, donor area complications and scale-based patient satisfaction were compared between two groups of patients with FTPF and RFFF. SPSS 26.0 statistical software was used for statistical analysis. Results: There was no statistically significant difference between the two groups of patients in tumor T staging (P=0.38), primary sites (P=0.05) and mean flap areas ((53.67±29.84) cm2 vs. (41.13±11.08) cm2, t=-1.472, P=0.14). However the mean vascular pedicle length of FPTF was more than that of RFFF ((11.15±2.48)cm vs. (8.50±1.69)cm, t=-4.071, P<0.01). The donor sites of 4 patients in FPTF group could be sutured directly, while all the 24 patients in RFFF group received skin grafts from the donor sites. There was no statistically significant difference in the recipient area arteries between two groups of flaps (P=0.10), with more commonly using of the facial artery (RFFF: FPTF=21∶27), but there was significant difference in the recipient area veins (P<0.01), with more commonly using of the external jugular vein in RFFF (14/24) than FPTF (4/32) and the posterior facial vein in FPTF (27/32) than RFFF (9/24). There were 10 recipient complications and 3 donor complications in RFFF group; no recipient complication and 3 donor complications occurred in FPTF group. With patient's subjective evaluation of the donor site at 12 months after surgery, FPTF was better than RFFF (χ²=22.241, P<0.01). Conclusions: FPTF is an alternative to RFFF in head and neck reconstruction and has unique advantages in aesthetics and clinical application.
Subject(s)
Female , Humans , Male , Forearm/surgery , Free Tissue Flaps , Perforator Flap , Plastic Surgery Procedures , Retrospective Studies , Skin Transplantation , Tibial Arteries/surgeryABSTRACT
Objective:In this study, lengthening over nail (LON) and plating after lengthening (PAL) were compared by the process of treatment and therapeutic effect in the children's femoral lengthening cases,to guide treatment choices; and in the PAL group there was another comparison between different timeline of plate fixation after lengthening to formulate reasonable technical route.Methods:Since January 7, 2014 to September 10, 2018, a total of 21 cases of LON and PAL surgery had been carried out, including 12 males and 9 females. The average age at their operation was 12.43±3.12 years. There were 10 patients in the LON group and 11 patients in the PAL group, in the PAL group 5 cases was synchronous fixation, which means removal of the external fixator and plate fixation would be performed in the same surgery, 6 cases was asynchronous fixation, which means plate fixation would be performed at least 2 weeks later after the removal offixator to reduce the risk of infection. The recorded data includesgender, date of birth, reason of discrepancy and treatment history, age at surgery, lengthening distance, the length of duration with frame, healing time, total duration time and total blood loss of seriesoperations, ROM of the knee joint, complications, etc.Statistical analysis was made by SPSS 22.0 software, and then reasonable treatment strategies were proposed.Results:In the LON group, the medianlengthening distance was 7.10 (6.63, 7.70) cm, the median total duration time was 300 (240, 330) min, the medianspeed of healing was 1.12 (0.78, 1.72) month/cm, complications were found in 3 cases, the median ROM of knee joint was 125.00° (117.50°, 150.00°); in the PAL group, the data respectively were 6.00 (5.00, 8.00) cm, 260 (230, 465) min, 1.00 (0.75,1.71) month/cm, 3 cases, 100.00° (90.00°, 150.00°), the difference between them was not statistically significant (all P>0.05). 2. In the PAL group, the difference of number of surgeries, total duration time, total blood loss, complication rate, healing speed and postoperative function between synchronous and asynchronous fixation was not statistically significant (all P>0.05). Conclusion:They are similarbetween LON and PAL techniques in the process of treatment and therapeutic effect. The surgeons could make choices according to the growth potential of the patients and their own custom operation methods. In the case of the current sample size, there is no statistical difference in the therapeutic effect between the synchronous and asynchronous plate fixation in the PAL method, but the sample size needs to be increased for further study.
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【Objective】 To explore the optimal sampling scheme for functional indexes of blood components, so as to ensure the accuracy of sampling. 【Methods】 The operation characteristic curves of 5 sampling schemes as (4, 1), (6, 1), (8, 2), (10, 2) and (12, 3) were drawn based on the characteristic curve theory of sampling inspection, the discriminability of those 5 sampling schemes was compared, and the risk of misjudgment and omission of sampling schemes was analyzed. 【Results】 The discriminability of 5 sampling schemes from high to low were (10, 2), (6, 1), (12, 3), (8, 2) and (4, 1), ; the operation characteristic curves of scheme (10, 2) were in basic concordance with (6, 1), (12, 3) and (8, 2) as the percent defective was <0.25. The risk of misjudgment of the 5 sampling schemes was low, and the risk of omission was high in scheme (4, 1)(0.738, 3), and low in (10, 2) and (6, 1) (0.525 6 and 0.533 9, respectively). 【Conclusion】 On the premise of strictly controlling the process of blood collection and supply and ensuring the quality of blood preparations, the sampling scheme (4, 1) can effectively monitor the stability of the whole process. However, for blood preparations with high nonconforming rate, sampling scheme (6, 1) or (10, 2) was recommended as the sampling amount should be elevated appropriately.
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RNA N6-methyladenosine (m6A) modification is one of the most pervasive epigenetic modifications that correlate with gene expression, regulated by a variety of methylases, demethylases and reader proteins. m6A has been found crucial during cancer progression, aberrant changes of which contribute to tumorigenesis and metastasis. It's also been reported to be influential on chemotherapy and radiotherapy resistance of malignant tumors by inducing cancer stem cells (CSC) generation and enhancing post-therapy damage resistance, thus causing the progression or recurrence. In this review, we review the regulation of RNA m6A modification and focus on recent advances in functions of dysregulated m6A modification in the pathogenesis of cancer progression and recurrence. In addition, we also discuss the possible participation of CSC in this process combining current perspectives on the chemotherapy and radiotherapy resistance mechanism of CSC.
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The outbreak of corona virus disease (COVID-19) has raised concerns among dentists to develop strategies to prevent infection of dental equipment, materials, and patients during an epidemic period. Strategies following the National Laws and Standards of China and local standards of several provinces for controlling cross-infection and instituting protective measures for medical staff in dental clinics during an epidemic period are discussed. A proposal is put forth for dental clinics that will face similar situations in the future. Further research is warranted to address potential problems that will be encountered under such dire circumstances.
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Objective:To present briefly introductions and evaluations on the constructs, psychometric properties (reliability, validity, reactivity etc.) and applications of the system of Quality of Life Instruments for Cancer Patients QLICP(V1.0) including 12 kinds of scales for patients with head and neck cancer, brain cancer, lung cancer, breast cancer, esophageal cancer, gastric cancer, colorectal cancer, liver cancer, cervical cancer, ovarian cancer, leukemia and lymphoma.Methods:Based on our measuring data from relevant patients at hospitals, the constructs, characteristics and psychometrics of the system above were analyzed and presented. Internal consistency reliability for each domain and the overall scale was assessed using Cronbach's alpha coefficient, and test-retest reliability through calculating the Pearson correlation coefficient between the first and second assessments. The criterion-related validity was evaluated by correlating corresponding domains of two instruments. Responsiveness was assessed through comparing the mean difference between the pre-treatment and post-treatments with standardized response mean (SRM). The use agreements and literature reviews of this system were used to understand the applications of 12 kinds measurement scales.Results:The quality of life scales for 12 kinds of cancer patients of the system QLICP(V1.0) have good construct( 5 domains, 11-15 facets), reliability, validity and a certain degree of responsiveness. The internal consistency reliability Cronbach's α coefficients for the overall scale of QLICP in different cancers was from 0.67 to 0.92, and the test-retest reliability (correlation coefficient) was from 0.61 to 0.99. The criterion-related validity (correlation coefficient) was for the overall scale of QLICP in different cancers was from 0.28 to 0.89, and the responsiveness SRM was from 0.25 to 1.28. And also they were widely used in clinical practice and relevant studies for the corresponding cancers.Conclusion:The system QLICP(V1.0) is of outstanding characteristics with all psychometrics meeting requirements and better construct (clear hierarchical structure with items→ facets→ domains→ overall ), and can be used widely in clinical practice further.