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Objective:To explore the effect of Helicobacter pylori(HP)eradication on development of metachronous gastric cancer(MGC)after endoscopic submucosal dissection(ESD)in elderly patients with early gastric cancer.Methods:From January 2014 to December 2019, 748 early gastric cancer patients aged 60 years or older, receiving ESD in Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, were included.According to the situation of HP infection and eradication efficacy within 1 year postoperatively, patients were divided into three groups.The patients with HP infection and successful HP-eradication were enrolled into successful eradication group, those without eradicating or with eradication failure were enrolled into eradication failure group, those with HP negative were enrolled into HP-negative group.And then the occurrence and risk factors of MGC after ESD among the three groups were statistically analyzed.Results:MGC were detected in 58 cases(7.7%)in elderly patients with early gastric cancer after ESD.The median follow-up time was 39 months.The multivariate regression analysis results of MGC showed that no HP-eradication or HP eradication of failure( HR=2.231, 95% CI: 1.054-4.722, P=0.036)and multiple lesions( HR=1.857, 95% CI: 1.076-3.204, P=0.026)were independent risk factors.Non-smoking was a protective factor for the occurrence of MGC( HR=0.409, 95% CI: 0.234-0.716, P=0.002). After adjusting for confounding factors, Cox proportional risk regression analysis showed that the incidence of MGC was significantly higher in group of no HP-eradicating or HP-eradicating of failure than in group of successful HP-eradicating group( χ2=37.877, P<0.001). Conclusions:HP eradication can effectively prevent MGC in elderly patients with early gastric cancer after ESD.Multiple lesions and smoking are independent risk factors for MGC.
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Objective:To study the safety and efficacy of endoscopic submucosal dissection (ESD) for early gastric cardia cancer (EGCC) in elderly patients.Methods:A retrospective analysis was performed on data of 499 EGCC patients who underwent ESD from January 2011 to June 2018 in Nanjing Drum Tower Hospital. The patients were divided into two groups by age, the young/middle-aged group (<65 years old) and the elderly group (≥65 years old). The baseline data, lesion features, postoperative complications, short-term efficacy and long-term efficacy of the two groups were compared.Results:The elderly group included 272 patients (283 lesions) and the young/middle-aged group included 227 patients (229 lesions). Except that there were significant differences in the age ( P<0.001) and body mass index ( P=0.002) between the elderly group and the young/middle-aged group, there were no significant differences in the baseline data or pathological features between the two groups. The rate of curative resection in the elderly group was 77.0%, lower than that in the young/middle-aged group (84.3%, P=0.045). No significant differences were found in en bloc resection rate (100.0% VS 99.6%, P=1.000), complete resection rate (94.7% VS 93.9%, P=0.705), postoperative complications incidence (6.4% VS 5.7%, P=0.747), operation time (64.02±39.24 min VS 66.16±44.62 min, P=0.566) or hospitalization time (6.76±2.06 d VS 6.47±1.74 d, P=0.092]. After the median follow-up of 47.9 months, 13.4% patients in the elderly group received additional surgery, which was slightly lower than that in the young/middle-aged group ( P=0.891). There were no significant differences in postoperative recurrence, lymph node metastasis, distant metastasis, overall mortality and disease-related mortality between the two groups. The survival analysis showed that five-year overall survival rates were 94.41% and 96.34% in the elderly group and the young/middle-aged group respectively ( P=0.156), and five-year disease-specific survival rate were 99.18% and 99.03% in the two groups respectively ( P=0.858). Conclusion:ESD is safe and effective for EGCC in elderly patients with satisfactory short-term and long-term efficacy.
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Objective To investigate the level about illness perception in patients with coronary heart disease. Methods From July to De-cember, 2015, 198 inpatients with coronary heart disease who were admitted into hospitals twice or more were enrolled. They were assessed with Illness Perception Questionnaire-Revised (IPQ-R). Results The score of common symptoms was (4.55±1.64). The symptoms, for exam-ple, chest pains, uncomfortable feeling in chest, cold sweat, flustered and breathlessness were most frequently experienced and most often identified. For the illness perception part, the scores on subscales of treatment control and consequences were higher than 3, which was the neutral point. For the cause dimension part, the highest scores was (3.38 ± 0.90) in diet or eating habits, followed by (3.38 ± 0.89) in aging. Among these factors, immune factors had the highest mean score, followed by stress factor. Conclusion The level of illness perception in pa-tients with coronary heart disease was in the middle level, and individual differences were obvious. The awareness of the disease and the in-tervention of the patient should be strengthened.
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Objective To investigate Treg and Th17 cell numbers in the peripheral blood of patients with unexplained recurrent spontaneous abortion (URSA),with an aim to elevate their potential for predicting pregnancy outcomes.Methods Peripheral blood was collected from 60 URSA pregnant women and 56 healthy pregnant women during their first trimester in the Department of Reproductive Endocrinology of the Second Affiliated Hospital of Soochow University from January 2014 to June 2015.The counts of regulatory T cell (Treg),T helper cell 17 (Th17),CD4 positive T cell (CD4+ T cell) and total lymphocytes in the peripheral blood were determined by flow cytometry.Calculated the ratios of Treg/CD4+ T cells,Treg/total lymphocytes,Th17/CD4+ T cells,Th17/total lymphocytes and Treg/Th17,then the pregnancy outcomes were followed up.According to the different pregnancy outcomes,the patients were divided into three groups: URSA successful delivery group (23 cases),URSA re-miscarriage group (37 cases) and normal successful delivery group (44 cases).Non-parametric test were used to compare the differences between groups.Results There were no difference between the URSA re-miscarriage group and URSA successful delivery group in the CD4+ T cell counts[(1 570.16±519.56) vs (1 571.83±450.37),t=0.01,P=0.99]and total lymphocytes[(4 497.11±975.48) vs (4 558.52±1 032.54),t=0.23,P=0.82].However,the ratios of Treg/CD4+ T cells[(1.09±0.62) vs (3.32±2.30),t=4.55,P=0.000 1],Treg/total lymphocytes[(0.42±0.24) vs (1.31±1.14),t=3.67,P=0.001 3]and Treg/Th17[(0.56±0.41) vs (2.51±2.38),t=3.89,P=0.000 8]in the URSA miscarriage again group were significantly lower whereas the ratios of Th17/CD4+ T cells[(1.85±0.92) vs (0.93±0.36),t=5.40,P<0.001]and Th17/total lymphocytes[(0.64±0.31) vs (0.31±0.14),t=5.52,P<0.001]were significantly higher.Similarly,There were no difference between the URSA re-miscarriage group and normal successful delivery group in the CD4+ T cell counts[(1 570.16±519.56) vs (1 566.86±651.36),t=0.03,P=0.98]and total lymphocytes[(4 497.11±975.48) vs (4 720.91±1 572.92),t=0.78,P=0.44].However,the ratios of Treg/CD4+ T cells[(1.09±0.62) vs (3.17±1.81),t=7.16,P<0.001],Treg/total lymphocytes[(0.42±0.24) vs (1.03±0.51),t=7.08,P<0.001]and Treg/Th17[(0.56±0.41) vs (1.87±1.68),t=4.98,P<0.001]in the URSA re-miscarriage group were significantly lower whereas the ratios of Th17/CD4+ T cells[(1.85±0.92) vs (1.12±0.50),t=4.29,P<0.001]and Th17/total lymphocytes[(0.64±0.31) vs (0.36±0.15),t=5.01,P<0.001]were significantly higher.Conclusions Treg and Th17 cell counts in the peripheral blood of patients with URSA might be useful in predicting their pregnancy outcomes.The decrease of Treg cell counts and the increase of Th17 cell counts might imply another abortion.
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Objective To prepare the frozen human serum pools for AFP reference materials through quantity value transmission from several analysis systems . Methods Method establishment. According to the requirement of preparation for the national standard materials , the studies of homogeneity and stability of frozen human serum pools for AFP reference materials were carried out .The commutability of prepared AFP reference materials and WHO AFP 72/225 reference material were assessed .By use of four automated chemiluminescence analysis systems , the prepared reference materials and different dilutions of WHO reference material 72/225 were tested in the same run.The values of prepared AFP reference materials were assigned by comparing these results and the uncertainty was evaluated .Results The three levels of AFP reference materials were tested to be homogeneous .The long term stability had been observed at -80℃for 14 months.The different dilutions of WHO AFP 72/225 reference material and three levels of prepared reference materials were commutable with patient serum samples among the four analysis systems .Through multiple system quantity value transmission and total uncertainty evaluation , the assigned values ( IU/ml) of three levels of AFP reference materials were 23.0 ±3.0, 93.2 ±7.2, ( 26.1 ±2.4 ) ×102 respectively.Conclusions The three levels of AFP reference materials were homogeneous and stable in accordance with requirement of preparation for national standard materials .The assigned values were reliable.The materials showed accepted commutability across 4 analytical systems.These materials had been approved as the national certified reference materials .These reference materials could be applied for the calibration or calibration verification of clinical analytical systems and the external quality assessment schemes for clinical laboratories.
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Objective To discuss the influence of high-quality rehabilitation model intervention on postoperative anxiety,depression and quality of life in patients with colorectal cancer.Methods 60 patients with colorectal cancer in our hospital were randomly divided into the observation group and the control group,30 cases in each group.The control group was given routine nursing measures.The observation group received high-quality rehabilitation model intervention on the basis of routine nursing measures.SAS and SDS were used to observe the psychological status of the patients,SF-36 was used to observe the quality of life of patients.Results Two weeks after operation,SAS,SDS scores of the observation group were (47.5 ± 5.2) points,(49.7 ± 5.7) points,which were significantly lower than (55.2 ± 6.3) points,(53.4 ± 5.8) points of the control group (t =5.163,2.492,all P ＜ 0.01).Two weeks after operation,the general health,physiological function,physical function,body pain,activity,social function,emotional function,mental health,quality of life score in the observation group were (79.06 ± 3.78)points,(79.57 ±3.96)points,(78.39 ± 3.71) points,(76.98 ± 3.52) points,(77.59 ± 4.16) points,(75.52 ± 4.85) points,(79.28 ±4.91) points,(78.31 ± 4.27) points,which were significantly higher than those of the control group (74.19 ±4.07)points,(75.24 ± 4.12) points,(71.92 ± 4.38) points,(73.25 ± 3.47) points,(74.06 ±4.13)points,(72.17 ±4.21) points,(74.65 ± 4.35) points,(73.87 ± 3.92) points(t =4.802,4.150,6.174,4.133,3.298,2.857,3.866,all P ＜ 0.01).Conclusion High-quality rehabilitation model can significantly improve the postoperative anxiety and depression,and improve the quality of life of patients with colorectal cancer.
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OBJECTIVE:To study the effects of different extraction methods on the content of cholalic acid from Artificial Bezoar. METHODS: Artificial Bezoar from 3 different habitats was used to extract cholalic acid by hydrolization vs. hydrolization-free method, and the content of cholalic acid was determined by HPLC-ELSD(high performance liquid chromatography with evaporative light scattering detection). RESULTS: The content of cholalic acid in the hydrolyzed sample was higher than that in the non-hydrolyzed sample of the same batch. CONCLUSION: Through hydrolization, the binding cholalic acid in the artificial bezoar was transformed into free cholalic acid so that the content of cholalic acid was increased. Therefore, it is more reasonable to control the quality of Artificial Bezoar by taking the contents of total cholalic acid and free cholalic acid as indexes.
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Although reports on the diagnosis of CHD angina pec-toris are plenty, yet studies on nature and typing of Zheng on its two main types, spontaneous and overworked, of anginal attacks are scarce. During the period Jan. 1985 -July 1994. we treated 92 cases of spontaneous angina pectoris and 303 cases of overworked angina on the basis of TCM syndrome typing, in the hope of giving assistance to the correcttherapy of this disease.
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AIM:To determine the optimal extraction of effective component from Swertia chirayita(Roxb.ex Flemi) Karsten in Tibet. METHODS: HPLC method was used to determine the yield rate and mango glucoside content,the preference extract methods,extraction solvents and extraction method of Swertia chirayita(Roxb.ex Flemi) Karsten were chose by parallel comparative method. RESULTS: 75% ethanol was used to extract medicine materials by Percolate,the flow rate was 4 mL/min/kg,collecting 6 times liquor after percolate. CONCLUSION: The extraction method is simple and convenient,furthermore the extract stability is good too.