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Objective To evaluate the influence of 125I seed implantation brachytherapy on QOL of patients with salivary gland malignant tumor which couldn't be treated by conventional surgery and its influence factors. Methods 23 patients with malignant salivary gland cancer which couldn't be treated by conventional surgery were selected from Peking University School of Stomatology from 2013 to 2017. The patients were treated by 125I seed implantation brachytherapy. EORTC QLQ-C30 ( V3. 0 ) as well as QLQ-H&N35 QOL scale ( Chinese version) were used for the assessment of post-treatment QOL. Results The survival rate of one year and three years after treatment in 23 patients was 100％ and 67％, respectively. The score of the quality of life before and after treatment was 201. 48 and 199. 48, respectively. The difference was not significant after the test ( P>0. 05 ) . The level of total QOL and function score were relatively high. Among the influence factors, location of tumor significantly influenced QOL( F=9. 127,P<0. 05). Other factors still needed research based on larger sample. Conclusions 125I seed implantaion brachytherapy can better protect the head and neck function and maintain the quality of life of patients with salivary gland malignant tumor.
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Objective@#To study the clinical value of serum cystatin C, neutrophil gelatinase-associated lipocalin (NGAL) and matrix metalloproteinase (MMP)-9/NGAL-1 measurements for early diagnosis of acute kidney injury (AKI) in patients with acute-on-chronic liver failure (ACLF).@*Methods@#This study included 102 patients with hepatitis B virus related ACLF and 31 patients with chronic hepatitis B (CHB) were enrolled as controls. Biomarkers including serum cystatin C, NGAL and MMP-9/NGAL-1 were measured twice in the patients with ACLF at admission and at the time progressed to AKI and once in the controls.@*Results@#In patients with ACLF, serum cystatin C levels was higher than that of the CHB control (t=3.609, P=0.000), whereas NGAL and MMP-9/NGAL-1 levels were lower in patients with ACLF than that of CHB controls (t=3.016, P=0.003; t=7.514, P=0.000, respectively). Thirty-three patients (32.4%) progressed to AKI during hospitalization period. In AKI group of the patients serum cystatin C levels was higher than that of non-AKI group of the patents (t=4.543, P=0.000). MMP-9/ NGAL-1 and NGAL levels were not different in patients with and without AKI (t=0.905, P=0.368; t=0.061, P=0.952). Serum cystatin C in patients with mild AKI (serum creatinine<1.5 mg/dl) and AKI serum creatinine>1.5 mg/dl were 33.59± 9.19 ng/ml and 43.32±9.02 ng/ml respectively. That was higher than that of non-AKI patients (27.94±7.93 ng/ml, P=0.022, 0.000, respectively). Serum cystatin C was the independent risk factors associated with development of AKI by a multivariate logistic regression in patients with ACLF.@*Conclusions@#Serum cystatin C measurement may contribute to more earlier diagnosis of AKI even in patients with S. creatinine<1.5 mg/dl. NGAL and MMP-9/NGAL-1 may be the biomarker of progress for ACLF.
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Objective To investigate the predictive value of preoperative Aspartate Transaminase and Platelet Ratio Index (APRI) for postoperative complications in patients with hepatocellular carcinoma after liver resection.Methods The clinical data of 278 patients who underwent hepatic resection for hepatocellular carcinoma from January 2010 to December 2013 were retrospectively analyzed.The receiver operating characteristic (ROC) curve was used to determine the cutoff value of APRI.Based on this preoperative APRI,patients were divided into the low-risk group (APRI ≤ 0.37) and the high-risk group (APRI ＞ 0.37).Using univariate analysis and multivariate logistic regression,21 risk factors that might be relevant to postoperative complications were analyzed.Results 159 patients (57.2％) developed postoperative complications.The AUC for APRI in predicting complications was 0.677 (0.615-0.740,P ＜ 0.05).At a cutoff value of APRI at 0.37,the sensitivity was 0.616 and the specificity was 0.697.Univariate analysis and logistic regression analysis showed that APRI (P ＜ 0.05,OR =2.138),degree of ASA (P ＜ 0.05,OR =1.864),prognostic nutritional index (PNI) (P ＜ 0.05,OR =0.354) and volume of blood loss during operation (P ＜ 0.05,OR =2.836) were independent risk factors of postoperative complications.Conclusions A high APRI (＞ 0.37) was a simple and practicable preoperative index to predict postoperative complications in patients with hepatocellular carcinoma after hepatectomy.
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For patients with chronic hepatitis C who undergo liver transplantation, recurrence of hepatitis C virus (HCV) infection after liver transplantation has always been a great challenge in the medical field. With our increased understanding of HCV replication cycle, the appearance of direct-acting antiviral agents (DAAs) has brought new hope to patients who have failed interferon therapy. Based on the latest research advances at home and abroad, this article retrospectively introduces the mechanism of action and the development of DAAs, focuses on the clinical application, therapeutic effects, and potential risks of various regimens with DAAs before and after liver transplantation, and systematically reviews the application of DAAs in the perioperative period of liver transplantation for patients with hepatitis C. The results show that DAAs are safe and effective as perioperative antiviral therapies, and a combination of drugs with different targets is recommended as the antiviral therapy in the perioperative period of liver transplantation for patients with chronic hepatitis C.
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Objective:To explore safety and therapeutic effect of aerobic rehabilitative exercise in patients with chro-nic heart failure (CHF).Methods:A total of 118 aged CHD patients were selected.According to random number table method,patients were randomly divided into routine treatment group and aerobic exercise group.Patients were followed up for six months,and cardiac function and related indexes were compared between two groups.Re-sults:Compared with before treatment,after six-month intervention,there were significant improvements in NY-HA class,left ventricular ejection fraction (LVEF)and left ventricular end-diastolic dimension (LVEDd)in both groups,P 0.05).Conclusion:Aerobic training can significantly improve cardiac function of CHF patients,it's safe and effec-tive,and suitable for secondary prevention of CHF patients.
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Objective To develop a quantitative immunohistochemistry assay for duck hepatitis B virus core antigen (DHB-cAg)in duck liver tissue.Methods By comparison with no repair antigen and repair antigen with high pressure,microwave and trypsin,the best solution of antigen retrieval was determined.By optimizing the parameter of image acquisition and de-ducting blank area,mean density of yellow areas was calculated using Image-Pro Plus 6.0 software.Using the assay devel-oped to determine the level of DHBcAg in liver tissue from duck infected by DHBV,anti-DHBV activity of DHBcMAb-TAT PTD conj ugate was examined.Results SABC method with no repair antigen was selected,which was better than other methods.DHBcAg expression in duck liver tissue could be objectively and accurately quantified by setting Image-Pro Plus 6.0 software parameters and calculating mean density of yellow areas.By comparison with the differences between mean densityat baseline of treatment and end of treatment,it was showed that DHBcMAb-TATPTD conjugate treatment dose-de-pendently reduced the levels of DHBcAg in liver tissue,which show that the assay developed could effectively evaluate the anti-DHBV activity of agent.Conclusion The immunohistochemistry assay developed in this study can objectively and accu-rately evaluate the level of DHBcAg in duck liver tissue.
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Objective To explore the roles of cytokines in the pathogenesis of hemorrhagic fever with renal syndrome(HFRS). Methods Double-antibody sandwich ELISA was used to determine serum interleukin (IL)-6, urine tumor necrosis factor (TNF), IL-6 and IL-8 levels in 56 patients with HFRS. Results Serum IL-6, urine TNF, IL-6 and IL-8 concentrations in HFRS patients were significantly higher than those in control group, respectively (P＜0.001). The concentrations increased at fever stage, then continued to increase during hypotension stage and peaked at oliguria stage. The concentrations of serum IL-6, urine TNF, IL-6 and IL-8 increased in accord with the severity of the disease and differed greatly among different types of the disease. Serum IL-6 had remarkable relationships with serum specific antibodies. It was positively related to serum β2-microglobulin (β2-MG), blood ureanitrogen (BUN) and creatinine (Cr). Significant positive relationships were also found both between urine IL-6 and TNF, and between IL-6 and IL-8 (r=0.5768, P＜0.05; r=0.3760, P＜0.01). Conclusion TNF, IL-6 and IL-8 activated during the course of the disease. IL-6 is associated with the immunopathological lesions caused by the hyperfunction of humoral immune response. IL-6, IL-8 and TNF are involved in the renal immune impairment. Determining them might, in certain extent, be used in predicting the prognosis and outcome of patients with HFRS.
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The discussion about the relationship between doctors and patients has been a hot topic in China for a long time and there are some biased views and even hostility to the doctors. Deep and multiple thoughts on this issue have been induced by the severe acute respiratory syndrome (SARS) event happened during the winter of 2002 and the spring of 2003. After the experience of SARS episode, most people believed that the selfless contribution and dedicated spirit and the brave and fearless behavior that the doctors and nurses manifested and practiced in front of SARS merit great respect. Since the work of medical care has high risk and is very tremendous to the strength of the body of the doctors and nurses, people should deeply understand and support their work. The cbjective report and appropriate focuses by the media constructed an important bridge for the good communication between doctors and patients. The understanding and support from the public and the media have been converted to powerfully spiritual energy for the doctors and nurses to combat SARS. SARS makes a specific expression of the "go through thick and thin together" spirit of the national spirits between doctors and patients and the dedicated contribution and sacrifice by the doctors and nurses created a harmony social environment for the improvement of doctor- patient relationship.
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Objective To investigate the correlation between gene polymorphisms in IL-10 promoter region and the susceptibility and clinical phenotypes of HCV infection. Methods Two groups of subjects were studied. Group 1 included 85 treatment naive patients with chronic HCV infection, and group 2 included 75 healthy blood donors. Genotyping of IL-10 promoter-592 was performed by PCR-RFLP. Results No significant difference was found in IL-10 promoter-592 genotypes between the healthy individuals and HCV-infected patients. However, IL-10 promoter-592 genetype A/A appeared more frequently in patients with ALT≥80U/L than in those with ALT
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Serum specific IgG (SIgG) antibodies of 32 patients with epidemic hemorrhagic fever (EHF) were sequentially determined by indirect immunofluorecent antibody test and their relationship to the types of the disease were analyzed in the present paper. The SIgG antibodies appeared practically on day 3 after the onset of the disease. Thereafter,the positive rates and the SIgG titres increased with the prolongation of the illness days and reached 100% positive rates and stable high titres till day 11 to day 12 after the onset of the disease. Furthermore, different types of the disease had.different SIgG response curves ,and there was a significant difference between the SIgG titres of different illness types statistically from day 7 to day 8 after the onset of the disease. These results suggest that the SIgG might be responsible for the immunopathogenesis of EHF.
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The specific IgM (SIgM) antibodies in serum samples from 32 patients with epidemic hemorrhagic fever (EHF) were sequentially determined by IgM antibody capture ELISA (MacELISA) and indirect immunofluorescence technique (IFA) sitnultaneously. Of the samples detected by the two methods, 99.46% had the same positive or negative results. The response curves of SIgM titres separately determined by MacELISA or IFA were parellel, whereas, the SIgM titres detected by MacELISA were comparatively higher than those detected by IFA. During the course of the disease, no significant defference was found between the SIgM titres of defferent illness types at the same illness day.
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The specific IgM(SIgM) antibodies in 84 urine specimens from 52 patients with epidemic hemorrhagie fever (EHF) were detected by an IgM antibody capture ELISA technique with mixed monoclonal antibodies against multiple EHF virus strains. The total positive rate and the positive rate from day 7 to day 9 of illness were 72.62% and 83.87% respectively. The SIgM positive urine specimens oecured on day 3 of illness. The urine specimen, from healthy persons and the persons with other diseases were all negative. Therefore, high specificity and sensitivity were observed. No significant correlations were found both between the positive rates and drays of illness and between p(?)sitive rates and protein levels in urine specimens. The SIgM antibody titres were related with the days of illness rather than the protein levels in urine specimens. Furthermore, the positive rates were increased positively with the SIgM antibody titres.