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1.
China Journal of Chinese Materia Medica ; (24): 2260-2264, 2023.
Article in Chinese | WPRIM | ID: wpr-981357

ABSTRACT

With the effects of activating blood and resolving stasis, and moving Qi to relieve pain, Jingtong Granules is widely used in the treatment of cervical radiculopathy in China. Long-term clinical application and related evidence have shown that the prescription has ideal effect in alleviating the pain in neck, shoulder, and upper limbs, stiffness or scurrying numbness, and scurrying pain caused by this disease. However, there is a lack of consensus on the clinical application of Jingtong Granules. Therefore, clinical first-line experts and methodology experts from all over the country were invited to compile this expert consensus. This expert consensus is expected to guide clinicians to use Jingtong Granules in a standardized and reasonable way, improve clinical efficacy, reduce medication risks, and benefit patients. First, according to the clinical experience of experts and the standard development procedures, the indications, syndrome characteristics, clinical advantages, and possible adverse reactions of Jingtong Granules were summarized. Then, through face-to-face interview of clinical doctors in traditional Chinese medicine and western medicine and survey of the clinical application, the clinical problems were summed up, and the consensus was reached with the nominal group method to form the final clinical problems. Third, evidence retrieval was carried out for the clinical problems, and relevant evidence was evaluated. The GRADE system was employed to rate the quality of evidence. Fourth, 5 recommendation items and 3 consensuses items were summarized with the nominal group method. Opinions and peer reviews on the consensus content were solicited through expert meetings and letter reviews. The final consensus includes the summary of evidence on the clinical indications, effectiveness, and safety of Jingtong Granules, which can serve as a reference for clinicians in hospitals and primary health institutions.


Subject(s)
Humans , Drugs, Chinese Herbal/adverse effects , Consensus , Radiculopathy/drug therapy , Medicine, Chinese Traditional , Pain/drug therapy
2.
China Journal of Orthopaedics and Traumatology ; (12): 982-989, 2023.
Article in Chinese | WPRIM | ID: wpr-1009172

ABSTRACT

OBJECTIVE@#To investigate whether Salvianolic acid A (SAA) can restore cartilage endplate cell degeneration of intervertebral discs and to identify the mechanism via regulation of micro-RNA.@*METHODS@#Cartilage endplate cells were isolated from lumbar intervertebral disc surgical samples and were treated with serum containing a series of concentrations of SAA (2, 5, and 10 ?M) for 24, 48, and 72 h to identify a proper dose and treatment time of SAA. The effect SAA on interlenkin-1β (IL-1β)-induced extracellular matrix degradation of cartilage endplate cells were analyzed by Alcian blue staining and assessment of the expression levels of ADAMTS-5, MMP3 and Col2a1. Further, the potential target miRNAs were preliminarily screened by micro-RNA sequencing combining qRT-PCR and Western blot, and then, the miRNAs mimics and inhibitors were used to verify the regulatory effect of SAA on potential target miRNAs.@*RESULTS@#The 10 μM SAA treatment for 48 h significantly enhanced the viability of cartilage endplate cells, and increased Col2a1 expression and glycosaminoglycan accumulation that were repressed by IL-1β, and reduced the effect of IL-1β on ADAMTS-5, and MMP3. Screening analysis based on micro-RNA sequencing and Venny analysis identified the downstream micro-RNAs, including miR-940 and miR-576-5p. Then, the miR-940-mimic or miR-576-5p-mimic were transfected into CEPCs. Compared with the SAA group, the expression of ADAMTS-5 and MMP3 increased significantly and the expression of COL2A1 obviously decreased after overexpression of miR-940 or miR-576-5p in CEPCs.@*CONCLUSION@#Salvianolic acid A attenuated the IL-1β-induced extracellular matrix degradation of cartilage endplate cells by targeting regulate the miR-940 and the miR-576-5p.


Subject(s)
Humans , Apoptosis , Cartilage/metabolism , Chondrocytes/metabolism , Interleukin-1beta/metabolism , Matrix Metalloproteinase 3/metabolism , MicroRNAs/metabolism
3.
China Pharmacy ; (12): 1622-1626, 2023.
Article in Chinese | WPRIM | ID: wpr-977853

ABSTRACT

OBJECTIVE To provide reference for clinically safe application of avapritinib. METHODS The adverse drug event (ADE) reports of avapritinib from January 9th,2020,to September 30th,2022 were collected from FDA Adverse Event Reporting System (FAERS) database. For data mining and analysis,reporting odds ratio (ROR) method and proportional reporting ratio (PRR) method in the proportional imbalance method were utilized. RESULTS A total of 10 895 ADE reports with avapritinib as the main suspect drug were gathered,and 201 ADE signals involving 19 systematic organ classifications were found after eliminating invalid signals. The instruction of the drugs did not mention any of the ADE,including tinnitus,dementia,chilly limbs, the reduction of blood iron,the reduction of blood sugar,fever,the reduction of vitamin D and vitamin B12,as well as all ADE in the 2 SOCs of musculoskeletal and connective tissue illnesses,diseases of the reproductive system,and diseases of the breast. The majority of the ADE reports 670 cases with complete drug information were for the nervous system (230 cases,accounting for 34.33%) and ocular organ (277 cases,accounting for 41.34%). Compared with other systems,daily dose and treatment course showed significant effects on ADE of neurological system and ocular organ (P<0.05),and the patient’s age had a significant impact on the ADE of the nervous system (P<0.05). CONCLUSIONS A greater incidence of ADE after using avapritinib is present in patients older than 65 with a daily dose of 300 mg/d and a treatment period lasting between 31 and 90 days; patients receiving a daily dose of 300 mg/d and a treatment regimen lasting 31 to 90 days are more likely to experience ADE of the ocular organ. Attention should be given to the aberrant symptoms of the patient’s eyes and nervous system throughout clinical use of avapritinib,and prompt intervention should be given.

4.
Chinese Journal of Surgery ; (12): 381-388, 2023.
Article in Chinese | WPRIM | ID: wpr-970219

ABSTRACT

Objective: To investigate surgical strategies and the corresponding benefits for patients with perihilar cholangiocarcinoma(pCCA). Methods: A total of 81 patients with pCCA who underwent radical excision in the Department of Biliary and Pancreatic Surgery of Sun Yat-Sen Memorial Hospital between January 2014 and December 2021 were retrospectively collected.The cohort consisted of 50 male and 31 female patients,with an age of (62.5±11.5)years(range:26 to 83 years).Seventy-five cases were diagnosed with jaundice,60 of whom received preoperative biliary drainage,while 20 patients received portal vein embolization.Their serum bilirubin level within one week before the operation(M(IQR)) was 44.3 (41.9) μmol/L(range:8.0 to 344.2 μmol/L).Preoperative imaging examinations were performed to evaluate the Bismuth-Corlette type of pCCA,showing 3,6,21,27,and 24 cases of Bismuth-Corlette type Ⅰ,Ⅱ,Ⅲa,Ⅲb,and Ⅳ,respectively.The primary outcome was overall survival (OS),and the secondary outcomes were relapse-free survival (RFS),90-day postoperative morbidity and 90-day postoperative mortality.OS and RFS were estimated using the Kaplan-Meier method and compared by the Log-rank test.Significant prognostic factors were determined using univariate and multivariable Cox proportional hazard regression analyses. Results: In the cohort of 81 pCCA patients,67 cases(82.7%) underwent major hepatectomy while 3 cases received major hepatectomy combined with pancreaticoduodenectomy.Thirty-four patients underwent hepatectomy combined with vascular resection and reconstruction(18 cases of portal vein resection and reconstruction alone;9 cases of hepatic artery resection and reconstruction alone;7 cases of combination of portal vein and hepatic artery resection and reconstruction).Margin negative(R0 excision) were achieved in 53.1%(43/81) of these patients.The operation duration was (627±136)minutes(range:565 to 940 minutes),and the intraoperative blood loss was 400(455)ml(range:200 to 2 800 ml).The 90-day postoperative mortality was 3.7%(3/81).Grade 3-4 postoperative morbidity was 23.4% (19/81) according to the Clavien-Dindo classification of surgical complications.Up to the last follow-up at September 2022,the follow-up time was 34.0(24.2)months (range:0.4 to 103.6 months).Three patients who died within 90 days after surgery were excluded from the survival analysis.The median OS was 36.10 months (95%CI:18.23 to 42.97 months) and the 1-,3-and 5-year OS rates were 85.3%,46.8% and 27.3%,respectively.The median OS of 41 patients with negative margins was 47.83 months(95%CI:36.90 to 58.80 months) and that of 37 patients with positive margins was 20.47 months(95%CI:10.52 to 30.58 months).The median RFS of 70 patients with R0 and R1 resection was 24.50 months(95%CI:12.15 to 31.85 months)and the 1-,3-and 5-year RFS rates were 65.2%,45.7% and 29.9%,respectively.The median RFS of 41 patients with R0 resection was 38.57 months(95%CI:21.50 to 55.63 months) and that of 29 patients with R1 resection was 10.83 months(95%CI:2.82 to 19.86 months). Conclusions: The primary therapy for pCCA is radical surgical resection.A precise preoperative evaluation and sufficient preparation can reduce postoperative morbidity.Surgical treatment can achieve a better survival outcome by increasing the radical resection rate.

5.
Chinese Journal of Radiation Oncology ; (6): 1133-1139, 2022.
Article in Chinese | WPRIM | ID: wpr-956962

ABSTRACT

Objective:To investigate the workflow, feasibility and advantages of respiratory navigator-guided stereotactic body radiation therapy (SBRT) of liver malignancies on the magnetic resonance linear accelerator (MR-linac).Methods:Clinical data of 10 patients with liver cancer treated with respiratory navigator-guided SBRT on the MR-linac from September to December 2021 were analyzed retrospectively. All patients underwent CT and MR simulated localization, and plain, enhanced and 4D CT scan, and T 1 3D MR and T 2 3D MR images were collected. The expiratory 4D CT was chosen to design the reference plan. The T 2 3D navigator MR image (end-exhalation) was collected before treatment, the target position was adjusted or the target shape was modified in combination with the real-time monitoring 2D MR image and appropriate online adaptive planning process was selected. Then, the ability of CT, T 2 3D and T 2 3D navigator MR images to display the tumor was evaluated by naked eye. The changes of target volume were calculated. Dosimetric differences between the adaptive and reference plans were compared. The efficacy and adverse reactions of patients were evaluated. Results:In the free breathing state, the T 2 3D navigator MR image was significantly better than T 2 3D MR image to clearly display the tumor and its boundary. The adaptive plans of adapt-to-position (ATP) and adapt-to-shape (ATS) adopted by 10 patients was 37 times and 22 times respectively. The tumor subsided significantly in 3 patients. The average target conformal index (CI) of the adaptive plans was no different from that of the reference plans, but the gradient index (GI) was higher ( P<0.05), especially in the ATS plans. Compared to the reference plans, the normal liver V 5 Gy, V 10 Gy and D mean were almost the same, but the average MU was increased with a significant difference in the ATP adaptive plans ( P<0.05). The average of MU, segments and normal liver D mean and V 10 Gy in the ATS adaptive plans were lower than those in the reference plans, and the liver V 5 Gy was slightly increased. Seven patients were evaluated after 1 month and 3 months. The local control of lesions was promising. Toxicities were mild and no grade 3 or higher toxicities were observed. Conclusion:Respiratory navigator on MR-linac improves the visual clarity of tumors and online MR images, and shows its advantages to guide the adaptive precision radiotherapy of liver tumors, especially in SBRT.

6.
Chinese Journal of Radiological Medicine and Protection ; (12): 678-684, 2022.
Article in Chinese | WPRIM | ID: wpr-956844

ABSTRACT

Objective:To compare the effects of parameters, such as planning target volume (PTV), calculation grid size, and dose threshold, on the dosimetric verification result of three dosimetric verification systems ArcCHECK, SRS MapCHECK, and 3DMap for stereotactic body radiation therapy (SBRT).Methods:Based on the dosimetric verification result of the SBRT plans of 50 patients, this study compared the effects of PTV (<25 cm 3 and ≥25 cm 3), calculation grid size (1.0, 1.5, and 2.0 mm), and dose threshold (5%, 10%, and 15%) on the γ passing rates of the three dosimetric verification systems at five criteria, i. e., 3 mm/3%, 3 mm/2%, 3 mm/1%, 2 mm/3%, and 2 mm/2%. Results:The changes in PTV affected 3DMap more significantly. With an increase in PTV, the γ passing rates of 3DMap at the criteria of 3 mm/3%, 3 mm/2%, 2 mm/3%, and 2 mm/2% increased by 2.2%, 2.2%, 4.4%, and 4.7% ( t=-2.76, -2.17, -4.72, -3.86, P<0.05), respectively. The increase in the calculation grid from 1.0 mm to 1.5 mm had greater effect on MapCHECK, with the γ passing rates at the criteria of 3 mm/3%, 3 mm/2%, 3 mm/1%, 2 mm/3% and 2 mm/2% decreased by 0.7%, 1.1%, 1.7%, 0.9%, 1.5% ( t=-6.15, -6.23, -5.98, -5.11, -8.34, P<0.05), respectively. The increases in the calculation grid from 1.0 mm to 2.0 mm had greater impact on ArcCHECK, with the γ passing rates at the criteria of 3 mm/3%, 3 mm/2%, 3 mm/1%, 2 mm/3%, 2 mm/2% decreased by 1.0%, 1.7%, 2.4%, 1.7%, 2.7% ( t=-4.75, -7.3, -8.63, -7.11, -8.26, P<0.05), respectively. The increase in the dose threshold from 5% to 10% had greater impact on ArcCHECK, with the γ passing rates at the criteria of 3 mm/3%, 3 mm/2%, 2 mm/3% and 2 mm/2% decreased by 1.1%, 1.4%, 2.5%, and 3.0% ( t=5.20, 5.68, 8.17, 9.99, P<0.05), respectively. Moreover, the increase in the dose threshold from 5% to 15% had more impact on 3DMap, with the γ passing rates at the criteria of 3 mm/3%, 3 mm/2%, 2 mm/3%, and 2 mm/2% decreased by 1.6%, 1.7%, 2.8%, and 3.2% ( t=3.25, 2.98, 4.40, 4.21, P<0.05), respectively. Conclusions:Target volume, calculation grid, and dose threshold are influencing factors in the dosimetric verification of three dosimetric verification systems for SBRT. Therefore, the effects of these parameters should be considered for different verification systems in clinical applications.

7.
Chinese Acupuncture & Moxibustion ; (12): 669-672, 2022.
Article in Chinese | WPRIM | ID: wpr-939512

ABSTRACT

Professor YANG Jun's clinical experience of acupuncture and moxibustion for oculomotor paralysis is summarized. Professor YANG Jun pays attention to disease differentiation and syndrome differentiation in the treatment of this disease. According to the characteristics of oculomotor paralysis, "early diagnosis and seeking treatment from the source" is advocated. According to the etiology and pathogenesis, professor YANG divides oculomotor paralysis into three types: the syndrome of wind-evil attacking collaterals, the syndrome of spleen-stomach weakness and the syndrome of qi-deficiency and blood-stasis. As such, the acupoints are selected according to syndrome differentiation, and several different acupuncture methods (pricking needling at eyelids, penetrating needling and lifting eyelids and contralateral- balance needling on the healthy side) are adopted to improve the symptoms of oculomotor paralysis. It is also suggested to use the combination of scalp acupuncture and electroacupuncture to achieve the best dose-effect state. Moreover, local stimulation around the eyes is important to achieve the effects of "qi reaching affected area".


Subject(s)
Humans , Acupuncture , Acupuncture Points , Acupuncture Therapy , Moxibustion , Ophthalmoplegia , Syndrome
8.
Chinese Journal of Burns ; (6): 408-414, 2022.
Article in Chinese | WPRIM | ID: wpr-936027

ABSTRACT

Objective: To investigate the clinical characteristics and risk factors of postoperative atrial fibrillation (POAF) in patients with critical burns. Methods: A retrospective case series study was conducted. From January 2017 to December 2021, two hundred and twenty-seven critically burned aldult patients who met the inclusion criteria were admitted to Guangzhou Red Cross Hospital of Jinan University, including 173 males and 54 females, aged 19-83 (43±14) years. The admission years of patients were collected, and the percentage of patients complicated with POAF in each year was calculated. According to whether the patients were complicated with POAF or not, they were divided into POAF group (n=17) and non-POAF group (n=210). Following data were collected in patients in POAF group, including operation methods, duration of operation, intraoperative blood loss before occurrence of POAF each time, occurrence time and times of POAF, postoperative body temperature, blood pressure, hemoglobin, blood glucose, blood lactate, sepsis, and electrolyte, and type, duration, and treatment of POAF. General data of patients in the two groups including age, gender, burn reason, total burn area, full-thickness burn area, acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) and sepsis-related organ failure evaluation (SOFA) scores on admission, combined with underlying diseases (hypertension, diabetes, and other types of arrhythmias), and sepsis were collected and analyzed. The mortality and factors influencing the prognosis of patients in the two groups such as mechanical ventilation time, operations times, and burn intensive care unit (BICU) length of stay were also collected and analyzed. Data were statistically analyzed with independent sample t test, Mann-Whitney U test, chi-square test or Kruskal-Wallis H test. The multivariate logistic regression analysis was performed on the general data with statistically significant differences between the two groups, and the independent risk factors influencing the onset of POAF in 227 patients with critical burns were screened. Results: From 2017 to 2021, the percentage of critically burned patients complicated with POAF increased year by year. In POAF group, eschar debridement in limbs was the main surgical procedure prior to POAF complication, with the operation time of (3.5±1.2) h and the intraoperative blood loss volume of (365±148) mL.The POAF occurred 25 times in total in patients of POAF group, mostly within one week after the injury and within 6 hours after the operation with most of these patients having POAF only once. When POAF happened, the patients were often complicated with hypothermia, anemia, hyperglycemia, high blood lactate, sepsis, and electrolyte disturbance, and few patients had complications of hypotension. The POAF lasted (5±3) h, with all being paroxysmal atrial fibrillation, and most of POAF patients were reverted to sinus rhythm after amiodarone intervention. Most patients in the two groups suffered from flame burn, and the gender, age, and SOFA score on admission of patients in the two groups were similar (P>0.05); the APACHEⅡ score on admission, total burn area, full-thickness burn area, incidence proportion of sepsis, combined with diabetes and hypertension and other types of arrhythmias of patients in POAF group were significantly higher or larger than those in non-POAF group (t=3.47, with χ2 values of 7.44, 10.86, 12.63, 14.65, 6.49, and 7.52, respectively, P<0.05 or P<0.01). The full-thickness burn area, combined with other types of arrhythmias, and sepsis were the independent risk factors for POAF in 227 critically burned patients (with odds ratios of 4.45, 0.04, and 3.06, respectively, with 95% confidence intervals of 2.23-8.87, 0.01-0.22, and 1.77-5.30, respectively, P<0.01). Compared with those in non-POAF group, the mechanical ventilation time, BICU length of stay, number of operations, and mortality rate of patients in POAF group were significantly increased (Z=3.89, Z=2.57, t=3.41, χ2=3.72, P<0.05 or P<0.01). Conclusions: POAF is a common postoperative complication in critically burned patients, and the incidence is increasing year by year, which seriously affects the prognosis of patients. The full-thickness burn area together with other types of arrhythmias and sepsis are the high-risk factors for POAF complication in patients with critical burns.


Subject(s)
Female , Humans , Male , Atrial Fibrillation/etiology , Blood Loss, Surgical , Hypertension , Lactates , Prognosis , Retrospective Studies , Risk Factors , Sepsis
9.
Chinese Journal of Industrial Hygiene and Occupational Diseases ; (12): 216-218, 2022.
Article in Chinese | WPRIM | ID: wpr-935779

ABSTRACT

The Second Affiliated Hospital of Shandong First Medical University treated a patient with oral sulfur mixture poisoning on January 14, 2020. The patient presented with cyanosis and disturbance of consciousness as the first manifestations, accompanied by metabolic acidosis, shock, hypercalcemia and severe liver function and myocardial damage. The patient was given active treatment, including gastric lavage, blood purification, methylene blue application, correction of shock, organ support and other therapies. However the treatment was poor. Finally, the patient's family chose to give up and requested to be discharged from the hospital, and the patient died on the same day after follow-up.


Subject(s)
Humans , Calcium Compounds , Poisoning/therapy , Sulfides
10.
China Journal of Orthopaedics and Traumatology ; (12): 333-337, 2022.
Article in Chinese | WPRIM | ID: wpr-928318

ABSTRACT

OBJECTIVE@#To investigate the clinical effect of using lengthened trochanteric osteotomy wire fixation combined with autologous bone graft in patients undergoing revision total hip arthroplasty.@*METHODS@#From December 2010 to December 2018, 18 patients underwent revision of total hip arthroplasty with extended trochanteric osteotomy wire fixation and autogenous bone graft, including 8 males and 10 females with an average age of (78.89±3.32) years old ranging from 68 to 82 years. The time from the initial replacement to the revision was 9 to 22 (16.33±2.93) years. The patients were followed up regularly after operation. The healing time of osteotomy, the time of full weight-bearing activity, Harris score of hip joint and complications were recorded.@*RESULTS@#All 18 patients were followed up for 16 to 38 months with an average of (25.78±6.65) months. The incision length was 16 to 21 cm with an average of (18.89±1.32) cm; the operation time was 105 to 128 min with an average of (115.44±6.59) min, the bleeding volume was 240 to 285 ml with an average of (267.44±13.77) ml. The healing time of osteotomy was 12 to 18 weeks with an average of (15.61±1.75) weeks. Harris score of hip joint was (47.11±5.04) before operation, (76.39±3.85) during full weight-bearing activities, and (82.22±2.76) at the final follow-up(P<0.05). During the follow-up period, there were no complications such as limb shortening, infection, poor incision healing, prosthesis loosening and sinking, and periprosthetic fracture.@*CONCLUSION@#In revision total hip arthroplasty, the use of extended trochanteric osteotomy wire fixation combined with autologous bone graft can achieve satisfactory clinical results, but the surgeon needs to make a systematic plan for the pre-revision, intraoperative and postoperative recovery.


Subject(s)
Aged , Aged, 80 and over , Female , Humans , Male , Arthroplasty, Replacement, Hip/methods , Bone Transplantation , Bone Wires , Femur/surgery , Osteotomy/methods
11.
Journal of Clinical Hepatology ; (12): 2435-2438, 2021.
Article in Chinese | WPRIM | ID: wpr-904965

ABSTRACT

Liver cirrhosis is the end stage of various chronic liver diseases, and portal hypertension is a main complication of liver cirrhosis. In this pathological state, spontaneous portosystemic shunt (SPSS), as the collateral circulation of the portal venous system, has not attracted enough attention in terms of occurrence mechanism and clinical value. The analysis shows that although SPSS is a natural shunt channel, further studies are still needed to clarify whether it can be used as a decompression method for portal hypertension, and a deeper understanding of SPSS will provide important guiding significance for the diagnosis and treatment of portal hypertension.

12.
Journal of Clinical Hepatology ; (12): 2435-2438, 2021.
Article in Chinese | WPRIM | ID: wpr-904915

ABSTRACT

Liver cirrhosis is the end stage of various chronic liver diseases, and portal hypertension is a main complication of liver cirrhosis. In this pathological state, spontaneous portosystemic shunt (SPSS), as the collateral circulation of the portal venous system, has not attracted enough attention in terms of occurrence mechanism and clinical value. The analysis shows that although SPSS is a natural shunt channel, further studies are still needed to clarify whether it can be used as a decompression method for portal hypertension, and a deeper understanding of SPSS will provide important guiding significance for the diagnosis and treatment of portal hypertension.

13.
Chinese Journal of Radiation Oncology ; (6): 387-391, 2021.
Article in Chinese | WPRIM | ID: wpr-884575

ABSTRACT

Objective:To evaluate the application value of robost optimization of brachytherapy for cervical cancer.Methods:Twenty patients who completed radical treatment were recruited in this study. The dose volume histogram (DVH) parameters were statistically compared between the conventional and robust optimization plans, and the robustness between the conventional and robust optimization plans was evaluated using DVH and DVH bands. The robust optimization method utilized the worst dose distribution to consider the dose in the presence of uncertainties. In each optimization iteration, the dose distributin when the radioactive source shifted along the X, Y, and Z directions (±2 mm), and the dose distribution when the radioactive source was not shifted were calculated. The worst dose distribution for each voxel was the lowest dose in the target and the highest dose outside the target under all circumstances. The iterative objective function was calculated by the worst dose distribution.Results:In the scenario of no shifting of radioactive source position, the mean value of robust optimization was significantly lower and that of V 150% was significantly higher than those of conventional optimization (both P<0.05). When considering the shifting of radioactive source position, the worst dosimetric parameters of multiple dose distributions were statistically compared. The mean HR-CTV D 100% values did not significantly differ between the robust and conventional optimization plans, whereas the mean D 90% value (range: 0.02-0.03 Gy) of robust optimization was significantly higher than that of conventional optimization ( P<0.05). Robust optimization increased the D 2cm 3 of the bladder and small intestine, and the rectum dose was increased with the shifting of the radioactive source position in the robust optimization. The DVH bands did not significantly differ between the conventional and robust optimization plans for all patients. Conclusions:Robust optimization based on the worst dose distribution fails to significantly improve the robustness of brachytherapy for cervical cancer. Alternative methods are required to minimize the dosimetric effect of uncertainties in brachytherapy.

14.
China Journal of Orthopaedics and Traumatology ; (12): 1165-1170, 2021.
Article in Chinese | WPRIM | ID: wpr-921943

ABSTRACT

OBJECTIVE@#To investigate the short-term effect of suprapatellar interlocking intramedullary nail in the treatment of tibial fractures.@*METHODS@#Eighty patients with tibial fractures treated from January 2016 to June 2018 were treated with interlocking intramedullary nail, who were divided into observation group (suprapatellar approach) and control group (patellar ligament approach) according to different surgical approaches. There were 40 cases in the observation group, including 28 males and 12 females, aged 28 to 67 years with a mean of (46.70±10.34) years. There were 40 cases in the control group, including 30 males and 10 females, aged 31 to 69 years with a mean of(49.38±10.74) years. The operation time, incision length, intraoperative C-arm X-ray fluoroscopy times, intraoperative blood loss, fracture healing time, postoperative active straight leg raise (SLR) time, hospital stay, visual analogue scale (VAS), knee pain rate and postoperative Hospital for Special Surgery (HSS) score were recorded and compared between two groups.@*RESULTS@#All the patients were followed up, and the duration ranged from 19 to 38 months, with an average of(24.60±4.52) months. In the observation group, the operation time was(53.83± 7.01) min;the incision length was (3.98±0.83) cm;the number of intraoperative C-arm X-ray fluoroscopy was (18.90±1.75) times;the fracture healing time was (10.03±0.89) weeks;the postoperative active SLR time was (1.19±0.25) days;and the hospital stay was(6.73±1.06) days. The above indexes were better than those in the control group (@*CONCLUSION@#The treatment of tibial fractures with suprapatellar interlocking intramedullary nail has the advantages of less trauma and better recovery of knee function. It can obtain more satisfactory clinical results and can be further widely used.


Subject(s)
Female , Humans , Male , Bone Nails , Follow-Up Studies , Fracture Fixation, Intramedullary , Fracture Healing , Tibial Fractures/surgery , Treatment Outcome
15.
Chinese Journal of Radiological Medicine and Protection ; (12): 873-876, 2020.
Article in Chinese | WPRIM | ID: wpr-868528

ABSTRACT

Objective:To report an implementation method and result of an inverse dose optimization algorithm (GBPO) that can control the dwell time variation in three-dimensional brachytherapy.Methods:The GBPO used a quadratic objective function. A dwell time modulation item was added to the objective function to restrict the dwell time variation, and a DTMF (dwell time modulation factor) was used to adjust the dwell time variation. A retrospective study was made of 15 cervical cancer patients treated using the Fletcher applicator. The relationship between the DTMF and dwell time deviation was analyzed. Dose-volume histogram (DVH) parameters of HR-CTV ( D100%, V150%) and organs at risk (OARs) ( D0.1 cm 3, D1 cm 3, D2 cm 3) were used to evaluate the difference between the GBPO plans and the commercial treatment plan system (using the IPSA algorithm) plans. Results:When the DTMF was less than 20, the dwell time deviation decreased quickly. However, after the DTMF increased to 100, and the dwell time deviation had no remarkable change. The D100% of GBPO plan was higher than that of IPSA plan (3.63±0.36 vs. 3.53±0.34, t=2.45, P<0.05), and the difference in other dosimetric parameters between the GBPO plans and the IPSA plans was not statistically significant ( P>0.05). Conclusions:The method reported in this study to control the dwell time variation was feasible. The GBPO plans have a comparable quality as the IPSA plans for the studied cervical cancer cases. The GBPO algorithm could be integrated into a three-dimensional brachytherapy treatment planning system.

16.
Chinese Journal of Radiological Medicine and Protection ; (12): 32-35, 2020.
Article in Chinese | WPRIM | ID: wpr-868395

ABSTRACT

Objective To compare the dosimetric differences of volumetric modulated arc therapy (VMAT) plans optimized with 3 different fluence smoothing parameters using Monaco treatment planning system.Methods A total of 15 patients with middle and upper esophageal carcinoma were planned with Low fluence smoothing (Low),Medium fluence smoothing (Medium) and High fluence smoothing (High) during VMAT optimization.The dosimetric differences in D95,D conformity index (CI),homogeneity index (HI) of targets,dose volume histogram (DVH) of organs at risk (OARs),and monitor unit (MU) were compared.Results There were no significant differences in D95,D CI and HI of targets,as well as in V40 and D of the heart,V10,V20 and D of the lung,and segment number among plans optimized with different fluence smoothing techniques (P>0.05).Plans with high fluence smoothing achieved less V30 of heart,Dmax of cord PRV (t=-2.167,-0.999,P<0.05),lower MU (t=-3.148,-6.692,P<O.05),but increased V5 of both lungs (t=1.306,-2.027,P<O.05)compared with plans with Medium and Low fluence smoothing.Plans with low fluence smoothing irradiated higher dose to the V30 and D to heart (t=O.411,0.589,0.013,P<0.05),but less V5 of the lungs (t=O.423,P<0.05) compared with plans with medium fluence smoothing.Conclusions All VMAT plans with 3 different fluence smoothing can meet the clinical requirements.VMAT plans optimized with high fluence smoothing are recommended in the treatment of patients middle and upper thoracic esophageal carcinoma.

17.
Shanghai Journal of Preventive Medicine ; (12): 821-2020.
Article in Chinese | WPRIM | ID: wpr-862461

ABSTRACT

Objective To evaluate the effect of increasing sunshine time or 1, 25(OH)2D3 supplement on improving Vitamin D blood level and reduction of microalbuminuria in early stage diabetic nephropathy (DN) patients. Methods A total of 150 early stage type 2 DN patients with serum 25(OH)D3 lower than 15 mg/L were included.The patients were divided into sunshine group (n=50), 1, 25(OH)2D3 supplement group (n=50), and control group (n=50).After three-month treatment, serum 25(OH)D3 level and urinary albumin to creatinine ratio(ACR)were compared among these three groups. Results Before treatment, there were no differences in serum 25(OH)D3, ACR, HbA1c among the three groups.After three-month treatment, serum 25(OH)D3 level was significantly improved in sunshine group, and ACR was reduced significantly in both sunshine group and 1, 25(OH)2D3 group. Conclusion Increasing sunshine time can improve Vitamin D level and reduce microalbuminuria in early stage diabetic nephropathy patients.

18.
China Journal of Orthopaedics and Traumatology ; (12): 916-921, 2020.
Article in Chinese | WPRIM | ID: wpr-879324

ABSTRACT

OBJECTIVE@#To investigate the relevance ratio of osteoporosis and bone mass of middle aged and elderly people in Beijing communities, in order to understand occurrence and development trend of abnormality of bone mass in high-risk population from community.@*METHODS@#Based on the method of cross-sectional investigation, the information data of 1 540 middle-aged and elderly people from 10 communities were collected, including 415 males and 1 125 females, aged from 45 to 80 years old with the average of (63.02±7.15) years old; the height was (161.34±7.24) cm, the weight was (65.90±10.19) kg, body mass index was (25.29±3.32) kg /m2. Bone mineral density (BMD) of lumbar vertebrae (L@*RESULTS@#The level of β-CTX was(0.27±0.12) ng /ml, procollanen type 1 N-terminal propeptide(P1NP) was(51.03± 22.36) ng /ml, 25(OH) D3 was (16.68±6.24) ng /ml, serum calcium was(2.34±0.09) mmol / L, blood phosphorus was (1.43± 0.37) mmol / L, and blood magnesium was (0.94±0.07) mmol / L, alkaline phosphatase was (79.28±20.48) U/ L, parathyroid hormone was (3.09±1.60) pmol / L, osteocalcin was (13.29±6.65) ng /ml. Except for blood magnesium, the other indexes had significant differences between different sex groups(@*CONCLUSION@#There are obvious differences in relevance ratio of osteoporosis and low bone mass among different sites. It is suggested that the clinical diagnosis of osteoporosis should be combined with bone mineral density and bone metabolic markers. With the increasing prevalence of osteoporosis among middle aged and elderly people in Beijing community, continuous follow-up research based on community primary health care units could promote early examination, early diagnosis, and early treatment of middle aged and elderly people at high risk of osteoporosis in community.


Subject(s)
Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Absorptiometry, Photon , Beijing/epidemiology , Bone Density , Cross-Sectional Studies , Osteoporosis/epidemiology
19.
Chinese Medical Journal ; (24): 2928-2939, 2020.
Article in English | WPRIM | ID: wpr-877928

ABSTRACT

BACKGROUND@#Natural killer (NK) cells play a critical role in suppressing human immunodeficiency virus-1 (HIV-1) infection, but knowledge on whether and how NK cells affect immune reconstitution in HIV-1-infected individuals who receive antiretroviral therapy (ART) is limited.@*METHODS@#We performed a case-control study with 35 healthy individuals and 66 HIV-1-infected patients including 32 immunological non-responders (INRs) with poor CD4+ T-cell recovery (500 cells/μL after 4 years of ART). NK cell phenotype, receptor repertoire, and early activation in INRs and IRs were investigated by flow cytometry.@*RESULTS@#A significantly higher proportion of CD56dimCD16dim/- NK cells was observed in INRs than IRs before ART and after 4 years of ART. The number of CD56dimCD16dim/- NK cells was inversely correlated with CD4+ T-cell counts in INRs before ART (r = -0.344, P = 0.050). The more CD69-expressing NK cells there were, the lower the CD4+ T-cell counts and ΔCD4, and these correlations were observed in INRs after ART (r = -0.416, P = 0.019; r = -0.509, P = 0.003, respectively). Additionally, CD69-expressing CD56dimCD16dim/- NK cells were more abundant in INRs than those in IRs (P  = 0.018) after ART, both of which had an inverse association trend towards significance with CD4+ T-cell counts. The expression of the activating receptors NKG2C, NKG2D, and NKp46 on CD56dimCD16dim/- NK cell subsets were higher in IRs than that in INRs after 4 years of ART (all P < 0.01). Strong inverse correlations were observed between CD69 expression and NKG2C, NKG2A-NKG2C+, NKG2D, and NKp46 expression on CD56dimCD16dim/- NK cells in INRs after ART (NKG2C: r = -0.491, P = 0.004; NKG2A-NKG2C+: r = -0.434, P = 0.013; NKG2D: r = -0.405, P = 0.021; NKp46: r = -0.457, P = 0.008, respectively).@*CONCLUSIONS@#INRs had a larger number of CD56dimCD16dim/- NK cells characterized by higher activation levels than did IRs after ART. The increase in the CD56dimCD16dim/- NK cell subset may play an adverse role in immune reconstitution. Further functional studies of CD56dimCD16dim/- NK cells in INRs are urgently needed to inform targeted interventions to optimize immune recovery.


Subject(s)
Humans , CD4 Lymphocyte Count , CD4-Positive T-Lymphocytes , Case-Control Studies , HIV Infections/drug therapy , HIV-1 , Killer Cells, Natural
20.
Biomedical and Environmental Sciences ; (12): 396-402, 2020.
Article in English | WPRIM | ID: wpr-829000

ABSTRACT

Objectives@#To evaluate the distribution by age and sex of serum high-sensitivity C-reactive protein (hsCRP) in an urban Chinese population and to provide a profile prediction for the risk of bacterial infection, inflammatory diseases, or tissue damages in the body.@*Methods@#Serum hsCRP was determined using the Roche Tina-quant immuno-turbidimetric assay on a Hitachi 7600-010 automatic biochemical analyzer (Roche Diagnostics) in 1,572 males and 1,800 females, including 78 pregnant women, who were derived from the National Health and Nutrition Survey in 2010-2012.@*Results@#The average hsCRP concentration in urban China was 0.68 mg/L for males and 0.65 mg/L for females. Significant differences in hsCRP were found among different age groups ( < 0.05). Monitoring results showed no significant differences among the 6-11, 45-59, and ≥ 60-year-old groups in the comparison of hsCRP between males and females in large cities. However, hsCRP concentration was significantly higher in men aged 12-17 and 18-44 years than in women.@*Conclusion@#The distribution of the hsCRP status of residents in large cities in China was influenced by age and gender, and the hsCRP levels of both sexes increased gradually with age. In addition, hsCRP concentration was higher in healthy pregnant women than in non-pregnant women. Basing on our results, we recommend that this parameter be included in future national and international screening for early detection of various illnesses.


Subject(s)
Adolescent , Adult , Aged , Child , Female , Humans , Male , Middle Aged , Pregnancy , Young Adult , Biomarkers , Blood , C-Reactive Protein , Metabolism , Cardiovascular Diseases , Epidemiology , China , Epidemiology , Inflammation , Epidemiology , Prevalence , Urban Population
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