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1.
Article in Chinese | WPRIM | ID: wpr-943039

ABSTRACT

Objective: To investigate the experience of patients in the implementation of enhanced recovery after surgery (ERAS) strategy after radical gastrectomy and the factors affecting the treatment experience. Methods: A prospective cohort study was carried out. Patients who were diagnosed with gastric cancer by pathology and underwent radical gastrectomy at the Xijing Digestive Disease Hospital from December 2019 to December 2020 were consecutively enrolled. Those who received emergency surgery, residual gastric cancer surgery, preoperative neoadjuvant chemotherapy, non-curative tumor resection, intraperitoneal metastasis, or other malignant tumors were excluded. Patients' expectation and experience during implementation were investigated by questionnaires. The questionnaire included three main parts: patients' expectation for ERAS, patients' experience during the ERAS implementation, and patients' outcomes within 30 days after discharge. The items on the expectation and experience were ranked from 0 to 10 by patients, which indicated to be unsatisfied/unimportant and satisfied/important respectively. According to their attitudes towards the ERAS strategy, patients were divided into the support group and the reject group. Patients' expectation and experience of hospital stay, and the clinical outcomes within 30 days after discharge were compared between the two groups. Categorical data were reported as number with percentage and the quantitative data were reported as mean with standard deviation, or where appropriate, as the median with interquartile range (Q1, Q3). Categorical data were compared using the Chi-squared test or Fisher's exact test, where appropriate. For continuous data, Student's t test or Mann-Whitney U test were used. Complication was classified according to Clavien-Dindo classification. Results: Of the included 112 patients (88 males and 24 females), aged (57.8±10.0) years, 35 patients (31.3%) were in the support group and 77 (68.7%) in the reject group. Anxiety was detected in 56.2% (63/112) of the patients with score >8. The admission education during the ERAS implementation improved the patients' cognitions of the ERAS strategy [M(Q1, Q3) score: 8 (4, 10) vs. 2 (0, 5), Z=-7.130, P<0.001]. The expected hospital stay of patients was longer than the actual stay [7 (7, 10) days vs. 6 (6, 7) days, Z=-4.800, P<0.001]. During the ERAS implementation, patients had low score in early mobilization [3 (1, 6)] and early oral intake [5 (2.25, 8)]. Fifty-eight (51.8%) patients planned the ERAS implementation at home after discharge, while 32.1% (36/112) preferred to stay in hospital until they felt totally recovered. Compared with the reject group, the support group had shorter expected hospital stay [7 (6, 10) days vs. 10 (7, 15) days, Z=-2.607, P=0.009], and higher expected recovery-efficiency score [9 (8, 10) vs. 7(5, 9), Z=-3.078, P=0.002], lower expected less-pain score [8 (6, 10) vs. 6 (5, 9) days, Z=-1.996, P=0.046], expected faster recovery of physical strength score [8 (6, 10) vs. 6 (4, 9), Z=-2.200, P=0.028] and expected less drainage tube score [8 (8, 10) vs. 8 (5, 10), Z=-2.075, P=0.038]. Worrying about complications (49.1%) and self-recognition of not recovery (46.4%) were the major concerns when assessing the experience toward ERAS. During the follow-up, 105 patients received follow-up calls. There were 57.1% (60/105) of patients who experienced a variety of discomforts after discharge, including pain (28.6%), bloating (20.0%), nausea (12.4%), fatigue (7.6%), and fever (2.9%). Within 30 days after discharge, 6.7% (7/105) of patients developed Clavien-Dindo level I and II operation-associated complications, including poor wound healing, intestinal obstruction, intraperitoneal bleeding, and wound infection, all of which were cured by conservative treatment. There were no complications of level III or above in the whole group after surgery. Compared with the support group, more patients in the reject group reported that they had not yet achieved self-expected recovery when discharged [57.1% (44/77) vs. 22.9% (8/35), χ2=11.372, P<0.001], and expected to return to their daily lives [39.0% (30/77) vs. 8.6% (3/35), χ2=10.693, P<0.001], with statistically significant differences (all P<0.05). Only 52.4% (55/105) of patients returned home to continue rehabilitation, and the remaining patients chose to go to other hospitals to continue their hospitalization after discharge, with a median length of stay of 7 (7, 9) days. Compared with the reject group, the support group had a higher proportion of home rehabilitation [59.7% (12/33) vs. 36.4% (43/72), χ2=4.950, P=0.026], and shorter time of self-perceived postoperative full recovery [14 (10, 20) days vs. 15 (14, 20) days, Z=2.100, P=0.036], with statistically significant differences (all P<0.05). Conclusions: Although ERAS has promoted postoperative rehabilitation while ensuring surgical safety, it has not been unanimously recognized by patients. Adequate rehabilitation education, good analgesia, good physical recovery, and early removal of drainage tubes may improve the patient's experience of ERAS.


Subject(s)
Enhanced Recovery After Surgery , Female , Gastrectomy , Humans , Length of Stay , Male , Pain , Patient Outcome Assessment , Postoperative Complications/surgery , Prospective Studies , Retrospective Studies , Stomach Neoplasms/surgery , Treatment Outcome
2.
Article in Chinese | WPRIM | ID: wpr-885792

ABSTRACT

Objective:To analyze and compare difference of ultrasonic blood flow of left internal mammary artery(LIMA) and right internal mammary artery(RIMA)as graft to left anterior descending artery(LAD) in patients undergoing off-pump coronary artery bypass grafting(OPCABG).Methods:From October 2017 to October 2019, a total of 363 patients who underwent OPCAB including 329 patients in LIMA-LAD group and 34 patients in RIMA-LAD group, were included in this study. Transthoracic ultrasound examination on IMA was performed before OPCABG. The blood flow , the value of PI(pulsation index) and diastolic flow(DF) of LIMA and RIMA to left anterior descending were measured and recorded by intraoperative TTFM. Patients underwent coronary artery CT examinations at 1 week after OPCABG to discover the patency of grafts.Results:The pre-operative diameter of RIMA was larger and the blood flow and pulsation index of RIMA was better than that of LIMA before OPCABG( P<0.001). But there was no significant difference in the flow, pulsation index and DF value of graft between the two groups after IMA were anastomosed to LAD( P>0.05). In situ skeletonized graft of RIMA did not show the advantage of increased blood flow. Compared with the preoperative parameters of flow of internal mammary artery, both the left and right grafts of IMA were significantly better in blood flow and pulsation index( P<0.001). Considering the remarkable difference in age between the two groups, Flow, PI and DF were compared again after propensity score matching, and there was still no statistical difference between the two groups( P>0.05). A total of 313 patients in LIMA-LAD group completed coronary CTA examination one week after surgery, among which 4 grafts had different degrees of problems. A total of 34 patients in RIMA-LAD group completed coronary CTA examination, one case indicated that the CTA imaging in distal segment was not clear, and the other results had no obvious abnormality. There was no significant difference in postoperative rate of coronary CTA completion( P=0.381) and rate of graft failure( P=0.405) between the two groups. Conclusion:Compared with the preoperative parameters of blood flow of internal mammary artery, both the left and right IMA grafts are significantly better in flow and pulsation index. The pre-operative diameter of RIMA is larger and the blood flow and pulsation index of RIMA is better than that of LIMA before OPCABG. But there is no significant difference in the flow, pulsation index and DF value of graft between the two groups after IMA are anastomosed to LAD. In situ skeletonized graft of RIMA do not show the advantage of increased blood flow.

3.
Article in Chinese | WPRIM | ID: wpr-942998

ABSTRACT

Objective: To observe the incidence and treatment of radiation rectal injury complicated with anxiety, depression and somatic symptom disorder. Methods: A cross-sectional survey research method was carried out. Patients with radiation rectal injury managed by members of the editorial board of Chinese Journal of Gastrointestinal Surgery were the subjects of investigation. The inclusion criteria of the survey subjects: (1) patients suffered from pelvic tumors and received pelvic radiotherapy; (2) colonoscopy showed inflammatory reaction or ulcer in the rectum. Exclusion criteria: (1) patient had a history of psycho-somatic disease before radiotherapy; (2) patient was unable to use a smart phone, unable to read and understand the questions in the questionnaire displayed on the phone; (3) patient refused to sign an informed consent form. According to the SOMA self-rating scale, PHQ-15 self-rating scale, GAD-7 and PHQ-9 self-rating scale, the electronic questionnaire of "Psychological Survey of Radiation Proctitis" was designed. The questionnaire was sent to patients with radiation rectal injury managed by the committee through the WeChat group. Observational indicators: (1) radiation rectal injury symptom assessment: using SOMA self-rating scale, radiation rectal injury symptom classification: mild group (≤3 points), moderate group (4-6 points) and severe group (> 6 points); (2) incidence of anxiety, depression and physical disorder: using GAD-7, PHQ-9 and PHQ-15 self-rating scales respectively for assessment; (3) correlation of radiation rectal injury symptom grading with anxiety, depression, and somatic symptom disorder. Results: Seventy-one qualified questionnaires were collected, of which 41 (56.9%) were from Guangzhou. Among the 71 patients, 6 were males and 65 were females; the mean age was (55.7±9.3) years old and 48 patients (67.6%) were less than 60 years old; the median confirmed duration of radiation rectal injury was 2.0 (1.0, 5.0) years. (1) Evaluation of symptoms of radiation rectal injury: 18 cases of mild (25.4%), 27 cases of moderate (38.0%), and 26 cases of severe (36.6%). (2) Incidence of anxiety, depression and somatic disorder: 12 patients (16.9%) without comorbidities; 59 patients (83.1%) with anxiety, depression, or somatic disorder, of whom 2 patients only had anxiety, 1 patient only had depression, 9 only had somatic disorder, 2 had anxiety plus depression, 4 had anxiety plus somatic disorder, 2 had depression plus somatic disorder, and 40 had all three symptoms. (3) correlation of radiation rectal injury grading with anxiety, depression, and somatic symptom disorder: as compared to patients in mild group and moderate group, those in severe group had higher severity of anxiety and somatic symptom disorder (Z=-2.143, P=0.032; Z=-2.045, P=0.041), while there was no statistically significant difference of depression between mild group and moderate group (Z=-1.176, P=0.240). Pearson correlation analysis revealed that radiation rectal injury symptom score was positively correlated with anxiety (r=0.300, P=0.013), depression (r=0.287, P=0.015) and somatic symptom disorder (r=0.344, P=0.003). Conclusions: The incidence of anxiety, depression, and somatic symptom disorder in patients with radiation rectal injury is extremely high. It is necessary to strengthen the diagnosis and treatment of somatic symptom disorder, so as to alleviate the symptoms of patients with pelvic perineum pain and improve the quality of life.


Subject(s)
Aged , Anxiety , Cross-Sectional Studies , Depression , Female , Humans , Male , Middle Aged , Quality of Life , Rectum , Surveys and Questionnaires
4.
Article in Chinese | WPRIM | ID: wpr-871643

ABSTRACT

Objective:To investigate the early clinical outcomes and experience of minimally invasive coronary surgery-bilateral internal mammary artery(MICS-BIMA) through the left anterior small incision.Methods:132 consecutive patients with 2-vessel disease receiving off-pump coronary artery bypass surgery from October 2015 to June 2019 were enrolled in this study, 20 of which performed MICS-BIMA while 112 cases the routine OPCAB through median sternal incision. Propensity Score Match was used to balance the two groups with the ratio of 1∶3, 60 cases selected as the control group from OPCAB in consequence. After the match, two groups were compared in terms of the baseline and the perioperative data. The conduit patency was evaluated in MICS-BIMA group.Results:No statistically significant difference was shown in the baseline between the two groups( P>0.05). The operation time in MICS-BIMA group was longer than that in OPCAB group[(256.0±57.7)min vs.(227.8±46.8) min, t=2.20, P=0.03)], and the postopende hospital stag nas colso short(nedim 7 days vs. medion 10 ays, P=0.002), the differences were statistically signific cint.. The perioperative blood transfusion in MICS-BIMA group seemed less, though no significant difference was performed between the two groups[(0.5±1.2)U vs.(1.1±2.0)U, t=10.0, P=0.072]. There were no differences in MACCE, perioperative IABP use and wound infection between the two groups( P>0.05). In MICS-BIMA group, 40 IMA grafts from 20 patients were performed, with 8 in-situ grafts and 12 Y-graft. Except from LAD in all cases, 10 Diagonals, 4 RAMUSs, 4 OM/LCXs, 1 RCA and 1 PDA were bypassed. Operative angiography by CT scan showed a good patency of BIMA in MICS-BIMA group. Conclusion:Minimally invasive coronary surgery with bilateral internal mammary artery is a safe and effective approach for 2-vessel disease. Satisfied early clinical outcomes were shown in the study.

5.
Article in Chinese | WPRIM | ID: wpr-871598

ABSTRACT

Objective:To observate the changing trend of flow of in-situ bilateral internal mammary artery as grafts during perioperative period in patients undergoing coronary artery bypass grafting(CABG), and to compare the parameters of flow between LIMA and RIMA.Methods:A total of 57 patients , 50 males and 7 femails, mean aged(57.8±10.1) years, underwent bilateral IMA CABG in our hospital from August 2016 to January 2019. Transthoracic ultrasound of IMA examination was performed before CABG. The blood flow, the PI(pulsation index) and other parameters were measured and recorded by intraoperative TTFM.Results:There was no significant difference of the average diameter and PI between LIMA and RIMA, but the preoperative flow of RIMA is higher( P=0.026) in our study. There was no significant difference of the average flow and PI between LIMA and RIMA recorded by TTFM( P>0.05), but the higher diastolic flow(DF) in LIMA grafts( P=0.022) compared with RIMA grafts may be associated with the different target sites( P<0.05). Compared with the preoperative flow and PI of IMA, the intraoperative flow and PI of both LIMA and RIMA grafts were better( P<0.001). Conclusion:Compared with the preoperative flow of IMA, both flow of LIMA and RIMA are better. In spite of the targets exist difference , there are no significant difference of the average flow and PI between LIMA graft and RIMA graft recorded by TTFM.

6.
Article in Chinese | WPRIM | ID: wpr-867038

ABSTRACT

Major depressive disorder is a mental illness characterized by depressed mood, lack of engagement in pleasurable activities, anhedonia, and cognitive-behavioral disorders. Currently, traditional pharmacological treatments for depression have a delayed therapeutic onset and low treatment effectiveness. (2R, 6R)-HNK, as a key metabolite of ketamine, can not only exert rapid and lasting antidepressant effects but also has no side effects such as hallucination and addiction caused by ketamine, which has potential clinical application values. Studies have found that the antidepressant effect of (2R, 6R)-HNK is closely related to the regulation mechanism of glutamate receptor and synaptic plasticity. Besides, the changes of downstream signaling pathways include the upregulation of brain-derived neurotrophic factor (BDNF) expression, dephosphorylation of eukaryotic elongation factor 2 (eEF2), and activation of the mammalian target of rapamycin (mTOR) play a key role in the antidepressant process of the drug. Understanding the molecular mechanisms underpinning (2R, 6R)-HNK's antidepressant effects will be invaluable for the identification of targets, which will drive the development of novel, effective, next-generation pharmacotherapies for the treatment of depression.

7.
International Journal of Surgery ; (12): 255-261,290, 2020.
Article in Chinese | WPRIM | ID: wpr-863311

ABSTRACT

Objective:To compare the application of epidural analgesia (EA) with intravenous analgesia (IA) in radical gastrectomy for gastric cancer.Methods:A systematic review and meta-analysis of randomized controlled trials of EA and IA in radical gastrectomy was conducted. Primary outcome was pain scores at 24 h after surgery, while the secondary outcomes included incidence of postoperative complications, first flatus time and (LOS).Results:A total of 6 randomized controlled studies was identified and 393 patients were enrolled in this review, 4 published in English and 2 in Chinese. Meta-analysis revealed that, the EA group had lower pain score at 24h either pain at rest ( WMD=-0.74, 95% CI: -1.35~-0.13, P=0.02) or pain on movement or coughing( WMD=-1.5, 95% CI: -1.95~-1.05, P<0.001) than that of the IA group. In terms of complications, postoperative nausea and vomiting ( RR=0.32, 95% CI: 0.18~0.58, P<0.001) and respiratory complications ( RR=0.50, 95% CI: 0.29~0.85, P=0.01) in EA group were obviously lower than those of the IA group. No difference was observed in postoperative urinary complications between the two groups ( RR=0.87, 95% CI: 0.38~1.96, P=0.73). However, the incidence of hypotension was obviously higher than that of IA group ( RR=3.27, 95% CI: 1.28~8.32, P=0.01). Time of first exhaust time after operation ( WMD=-14.01, 95% CI: -22.85~-5.17, P=0.002), postoperative length of hospital stay ( WMD=-0.69, 95% CI: -0.90~-0.49, P<0.001) were shorter than IA group. Conclusions:For patients who undergoing radical gastrectomy for gastric cancer, epidural analgesia could provide better pain control either pain at rest or on movement, although a rising incidence of hypotension was leaded, reduced pulmonary complications, nausea and vomiting were found, and promote the bowel function and shorten the duration of hospital stay.

8.
Article in English | WPRIM | ID: wpr-773396

ABSTRACT

OBJECTIVE@#To explore the protective effect of NANOG against hydrogen peroxide (H2O2) -induced cell damage in the human hair follicle mesenchymal stem cells (hHF-MSCs).@*METHODS@#NANOG was expressed from a lentiviral vector, pLVX-IRES-ZsGreen. NANOG hHF-MSCs and vector hHF-MSCs were treated with 400 μmol/L hydrogen peroxide (H2O2) for 2 h, the cell survival rate, cell morphology, ROS production, apoptosis and expression of AKT, ERK, and p21 were determined and compared.@*RESULTS@#Our results showed that NANOG could activate AKT and upregulate the expression of p-AKT, but not p-ERK. When treated with 400 μmol/L H2O2, NANOG hHF-MSCs showed higher cell survival rate, lower ROS production and apoptosis, higher expression of p-AKT, higher ratio of p-AKT/AKT.@*CONCLUSION@#Our results suggest that NANOG could protect hHF-MSCs against cell damage caused by H2O2 through activating AKT signaling pathway.


Subject(s)
Cell Survival , Drug Evaluation, Preclinical , Hair Follicle , Cell Biology , Humans , Hydrogen Peroxide , Lentivirus , Mesenchymal Stem Cells , Metabolism , Nanog Homeobox Protein , Metabolism , Pharmacology , Oxidative Stress , Phosphatidylinositol 3-Kinases , Metabolism , Proto-Oncogene Proteins c-akt , Metabolism , Signal Transduction
9.
Article in Chinese | WPRIM | ID: wpr-941898

ABSTRACT

OBJECTIVE@#To investigate and analyze the relationship between intraoperative graft flow measurements and the early mid-term outcomes after off-pump coronary artery bypass grafting (OPCAB).@*METHODS@#Patients who underwent isolated OPCAB in the Department of Cardiac Surgery of Peking University People's Hospital from January 2013 to June 2016 were included. Perioperative characteristics, graft flow measurements and postoperative follow-up outcomes were retrospectively collected. Comparison was made between flow measurements of grafts and the early mid-term outcomes. Flow measurements of grafts included the mean flow (MF) and the pulsatility index (PI). The early outcomes included peri-operative myocardial infarction (PMI), use of an intra-aortic balloon pump (IABP), reoperation for all causes, new-onset atrial fibrillation and in-hospital or 30-day mortality.@*RESULTS@#A total of 463 patients were included in the study. Mean age was (62.80±8.36) years, and 24.8% were females. The total number of grafts was 1 435, which averaged 3.10 grafts per patient. The MF and PI were separately (32.34±14.45) mL/min and 2.87±0.92. Of all the patients, 23(5%) had PMI, and 11 used IABP. Observed in-hospital or 30-day mortality was 0.86% (4 patients). Compared with non-PMI group, the MF was lower and the PI was higher in the PMI group (P<0.05). However, the differences of other early outcomes had no statistical significance between the PMI group and the non-PMI group. The lower MF (Wald=5.684, P=0.017, 95%CI: 0.894-0.989) and the higher PI (Wald=9.040, P=0.003, 95%CI: 1.252-2.903) were risk factors of PMI in multivariable Logistic regression modeling. The longest follow-up time was 37 months, and 7 patients died. The differences of graft flow measurements between the surviving group and the nonsurvivors had no statistical significance, but overall mid-term survival was lower in patients with poor left internal mammary artery (LIMA) to left anterior descending artery (LAD) graft flow (MF<10 mL/min; OR=9.6, P<0.05).@*CONCLUSION@#Intraoperative graft flow parameters during OPCAB can predict the early mid-term outcomes. The lower MF and the higher PI should increase the rate of PMI. A lower flow of LIMA to LAD graft (<10 mL/min) should increase the rate of midterm mortality, but further research will be needed to confirm and explore the findings.


Subject(s)
Aged , Coronary Artery Bypass , Coronary Artery Bypass, Off-Pump , Female , Humans , Male , Mammary Arteries , Middle Aged , Retrospective Studies , Treatment Outcome
10.
Chinese Pharmacological Bulletin ; (12): 706-712, 2018.
Article in Chinese | WPRIM | ID: wpr-705112

ABSTRACT

Aim To prepare hyaluronic acid nanoparti-cles(Ade/GA-HA) using glycyrrhetinic acid modified hyaluronic acid as the carrier and adenine as a model drug, and analyze their physicochemical property and proliferation effect on Bel-7402 cells. Methods Gly-cyrrhetinic acid and hyaluronic acid were combined by chemical cross-linking method, dialysis and freeze-dr-ying,based on which Ade/GA-HA was prepared using ultrasonic method, and the particle size and Zeta po-tential were determined by Malvern laser particle analy-zer,and the morphology was observed by transmission electron microscopy, and the absorbance was deter-mined by ultraviolet-visible spectrophotometer, high performance liquid chromatograph and microplate read-er to caculate drug load, encapsulation efficiency and in vitro release. MTT assays were utilized to determine the proliferation of nanoparticles treated Bel-7402 cells. Results GA-HA nanoparticles had spherical shape with a good dispersion, at diameters of 398.1 nm, of which Zeta potential was - 34.2 mV, and presented good short term stability. The drug load and encapsulation efficiency of Ade/GA-HA nanoparticles were (22.5 ± 5.8)% and (87.27 ± 0.33) %, re-spectively. Burst release was observed in Ade/GA-HA nanoparticles within 4 h, while controlled release 4 h later. Compared with free adenine,Ade/GA-HA nano-particles had a stronger inhibitory effect on cell prolif-eration with statistically significant difference. Conclu-sion GA-HA nanoparticles has excellent physico-chemical properties and meet the design requirement.

11.
Article in Chinese | WPRIM | ID: wpr-704061

ABSTRACT

Objective To explore the effect of expressive writing intervention on social support,resilience and school maladjustment in university freshman.Methods Selecting the freshmen volunteer of 600 university freshmen of Shandong,through the scale before the test recovery and comprehensive scoring chosen the part of low grade college students as the intervention object and were divided into writing expression(n=60) person and control group(n=60).The intervention group received a positive subject writing expression and the control group in the normal writing.Before and after the intervention tested the social support rating scale,the resilience scale for Chinese adolescents and the the student adaptation to college questionnaire were tested to evaluate the effect of active writing expression intervention.Results (1)After intervention,the intervention group and the control group had significant differences among the scales,objective support (t =-2.36,P<0.05),learning adaptation(t=-1.98,P<0.05) and subjective support (t=-2.56,P<0.05),target focus(t=-2.66,P<0.01),emotional control(t=-2.81,P<0.01),family support (t=-3.46,P<0.01),adaptation (t=-2.73,P<0.01),support utilization (t=-5.91,P<0.01) and social support score (t =-4.04,P< 0.01),positive cognition (t=-2.73,P<0.01),interpersonal assistance (t=-3.13,P<0.01),resilience score (t=-7.40,P<0.01),life adaptation (t=-3.83,P< 0.01),emotional state (t =-3.39,P< 0.01),and school adaptation score (t=-3.46,P<0.01).(2)There was no significant difference in objective support between the control group before intervention and after intervention.In addition,the remaining dimensions such as subjective support (20.72±2.46,22.96±2.81,t=4.54,P<0.01),support utilization (7.49± 1.40,9.86± 1.90,t =7.56,P<0.01) and social support score (36.79±4.24,41.89±5.18,t=5.76,P<0.01) were significantly increased.The intervention group had significant difference among target focus (15.98±2.86,17.89±3.35,t=3.28,P<0.01),emotional control (14.98±2.77,15.70±2.71,t=3.35,P<0.01),positive cognition (14.61 ± 2.04,16.26±3.09,t=3.36,P<0.01),interpersonal assistance (15.30±2.44,17.49±2.73,t=4.52,P<0.01),resilience score(77.65±6.01,88.25±5.74,t=9.63,P<0.01) and family support(16.77±2.28,19.58± 2.44,t =6.35,P< 0.01).In the intervention group of school adaptation scale,life adaptation (40.44± 6.36,45.12± 7.21,t=3.68,P<0.01),emotional state (34.04±6.99,38.84±5.95,t=3.95,P<0.01) and school adaptation score (145.21 ±22.86,160.51±21.78,t=3.66,P<0.01),interpersonal assistance (32.30±5.34,35.23±5.18,t=2.98,P<0.01),learning adaptation (38.44±7.06,41.32± 5.92,t=2.36,P<0.05) were significantly increased.Conclusion Written expression intervention has a positive effect on improving the low level of social support,the poor resilience and freshman's adaptation to college.

12.
Chinese Circulation Journal ; (12): 380-384, 2018.
Article in Chinese | WPRIM | ID: wpr-703869

ABSTRACT

Objectives: To observe the impact of cannulation strategies on veno-arterial extracorporeal membrane oxygenation (VA-ECMO) complications. Methods: A total of 37 patients with refractory heart failure (HF) treated in our hospital from 2007 to 2016 were enrolled. All patients received VA-ECMO with ipsilateral femoral artery and vein cannulation and they were divided into 2 groups: Direct cannulation group, patients received open surgery for femoral artery and vein cannulation directly, based on downstream leg ischemia condition, ARROW sheath was used in ECMO pipeline to establish collateral circulation, n=21 and "Chimney technique" group, patients received femoral vessel cannulation as a graft of 8 mm Dacron artificial vessel was end-to-side anastomosed to the host femoral artery, then was connected to the host femoral vein directly, n=16. Prior ECMO clinical condition, time of cannulation, duration of VA-ECMO, the mean amounts of daily bleeding and transfusion, downstream leg ischemia condition and in-hospital mortality were observed and compared between 2 groups. Results: Compared with Direct cannulation group, "Chimney technique" group showed the longer time of cannulation (83.54±13.2) min vs (67.33±22.4) min, P<0.05, less patients with downstream leg ischemia (6.2% vs 23.8%), less amounts of daily bleeding (210.78±180.22) ml vs (560.76±220.23) ml and transfusion (3.11±1.65) U vs (6.37±2.44) U, all P<0.01; the in-hospital mortality was similar between 2 groups (62.5% vs 61.9%), P>0.05. Conclusions: "Chimney technique" of VA-ECMO improved the downstream leg ischemia and bleeding, while the in-hospital mortality was similar to direct cannulation in relevant patients.

13.
Clinical Medicine of China ; (12): 9-14, 2018.
Article in Chinese | WPRIM | ID: wpr-663926

ABSTRACT

Objective To observe the proliferation and apoptosis of oxaliplatin-resistant colon cancer cell lines and the expression of estrogen receptor related receptor(ERR)α when tetrasoanin was down-regulated. Methods Western blot and quantitative real-time polymerase chain reaction(qRT-PCR)were used to detect the expression of tetrasoanin and ERRα of colon cancer cells and oxaliplatin resistant cells in mRNA and protein levels. ERRα inhibitor XCT790 was used to down-regulate ERRα expression, The expression of ERRα was down regulated by ERR α inhibitor XCT790,and the level of tetrasoanin,apoptosis and proliferation of L-OHP-SW620 cells were detected by Western blot, flow cytometry and MTT.Tetrasoanin expression was down regulated by siRNA, the expression, apoptosis and proliferation of L-OHP-SW620 cells AKT, p-AKT, tetrasoanin and ERRα were detected by Western blot,qRT-PCR,flow cytometry and MTT assay.Results The expression of tetrasoanin and ERRα protein in L-OHP-SW620 cell lines were higher than those in SW620 cells (t=6.127,P<0.01,t=12.579,P<0.01),The expression of tetrasoanin mRNA in L-OHP-SW620 cell line was higher than that in SW620 cell line(t=9.085,P< 0.01). The early apoptosis rate of L-OHP-SW620 cells in XCT790 group after XCT790 inhibited ERR -αexpression was higher than that in NC group(t=3.297, P< 0.01). The survival rate of XCT790 group after 72 h culture was(45.264±6.249)%,lower than that of NC group((63.364 ± 9.472)%)(t=4.537, P<0.01). Compared with NC group,p-AKT protein was up-regulated(t=8.139,P<0.01),ERRα protein was down-regulated(t=6.452,P<0.01),the apoptosis rate was(17.541±2.317)%,lower than that in the sitetrasoanin group((32.892±3.296)%)(t=4.526,P<0.01), the survival in sitetrasoanin group after 72 h culture was(49.653 ± 5.945)%, lower than that in NC group ((67.376±7.934)%)(t=3.109,P<0.05).Conclusion Tetrasoanin down-regulation and p-AKT protein up-regulation decreases ERRα protein and OHP-resistant colon cell proliferation is decreased, apoptosis is increased and drug resistance is decreased.

14.
Clinical Medicine of China ; (12): 865-869, 2017.
Article in Chinese | WPRIM | ID: wpr-659599

ABSTRACT

Objective To observe the changes of proliferation and apoptosis of colon cancer cell line treated with oxaliplatin after the downregulation of ERRα and to investigate the mechanism.Methods Colon cancer cell lines Colo-205,HCT-116,SW620 and HT-29 were cultured by adherent cells and in accordance with the given intervention,they were divided into group XCT790-OHP-HCT-116(after oxaliplatin treatment,ERR αinhibitor XCT790 was administered),group siERRα-OHP-HCT-116(after oxaliplatin treatment,siERR α was transfected into HCT-116 cells and downregulated ERR αexpression),oxaliplatin intervention group(group OHP-HCT-116)and the control group(NC group)which was given no intervention.The experiment was divided into siERR αgroup with siERR α transfected with HCT-116 cells,downregulated ERR αexpression and the negative control group(siNC group)transfected with siNegative Control.Using Western blot method and real-time quantitative(qRT)-PCR for the detection of colorectal cancer cell ERRαprotein and mRNA expression,the expression of ERR αwas downregulated by ERR αinhibitors XCT790 and siERR,and apoptosis and proliferation of colon cancer cells were detected by flow cytometry and MTT.Western blot and qRT-PCR were used to detect apoptosis and proliferation-related gene proteins and mRNA expression.Results ERR αand mRNA protein in HCT-116 were higher than those of Colo-205,SW620 and HT-29 cell lines(P<0.05); in the XCT790-OHP-HCT-116 group,the early apoptosis rate was higher than those of the NC group and OHP-HCT-116 group(P<0.05),the survival rate of cell culture in 72 and 96 h in the XCT790-OHP-HCT-116 group was lower than those in the NC group and OHP-HCT-116 group(P<0.05).The siERR α HCT-116 cells transfected with down-regulation of ERR expression,siERR α -OHP-HCT-116 group early apoptosis rate was lower than those of NC group and OHP-HCT-116 group(P<0.05),siERR -OHP-HCT-116 group cells cultured for 72 and 96 h after the survival rate was lower than the NC group and OHP-HCT-116 group(P<0.05);After the downregulation of ERRαby siERR alpha transfected with HCT-116 cells,the early apoptotic rate in the group siERRα-OHP-HCT-116 was lower than that in the group NC and group OHP-HCT-116(P<0.05),the survival rate of the group siERRα-OHP-HCT-116 after 72 and 96 h were lower than those in the group NC and group OHP-HCT-116(P<0.05),siERR α was transfected into HCT-116 cells,compared with the siNC group,YAP1,p73,p63,MDM2, Capase 8,Capase 9 protein in the siERR group decreased(P<0.01),there was no significant difference in the level of mRNA(P>0.05).Conclusion The downregulation the expression of ERRαcan promote colon cancer cell apoptosis,inhibit proliferation,and enhance the killing effect of oxaliplatin on colon cancer cells.

15.
Chinese Traditional Patent Medicine ; (12): 2231-2235, 2017.
Article in Chinese | WPRIM | ID: wpr-668888

ABSTRACT

AIM To explore the effects of ligustrazine on blood rheology,aldose reductase (AR) and renal function in diabetic nephropathy (DN) rats.METHODS The DN rat model was established by intraperitoneal injection of streptozotoein (55 mg/kg),rats were randomly divided into five groups,model group,irbesartan [50 mg/(kg · d)] group,high-,middle-and low-dose of ligustrazine [200,100,50 mg/(kg · d)] groups,together with normal control group.All the rats received daily garage for eight successive weeks.At the end of experiment,blood rheology,blood glucose,aldose reductase in erythrocyte and kidney tissue,24 h urinary protein,blood urea nitrogen,creatinine,creatinine clearance and renal function were observed.RESULTS Compared with the model group,blood rheology,blood glucose and renal function in various treatment groups were effectively improved,and aldose reductase activity was significantly decreased (P < 0.05).HE staining and PAS staining showed that the pathological changes in kidney were significantly alleviated.CONCLUSION Ligustrazine can protect kidney of DN rats by ameliorating blood rheology,decreasing blood glucose and inhibiting aldose reductase activity.

16.
Clinical Medicine of China ; (12): 865-869, 2017.
Article in Chinese | WPRIM | ID: wpr-662225

ABSTRACT

Objective To observe the changes of proliferation and apoptosis of colon cancer cell line treated with oxaliplatin after the downregulation of ERRα and to investigate the mechanism.Methods Colon cancer cell lines Colo-205,HCT-116,SW620 and HT-29 were cultured by adherent cells and in accordance with the given intervention,they were divided into group XCT790-OHP-HCT-116(after oxaliplatin treatment,ERR αinhibitor XCT790 was administered),group siERRα-OHP-HCT-116(after oxaliplatin treatment,siERR α was transfected into HCT-116 cells and downregulated ERR αexpression),oxaliplatin intervention group(group OHP-HCT-116)and the control group(NC group)which was given no intervention.The experiment was divided into siERR αgroup with siERR α transfected with HCT-116 cells,downregulated ERR αexpression and the negative control group(siNC group)transfected with siNegative Control.Using Western blot method and real-time quantitative(qRT)-PCR for the detection of colorectal cancer cell ERRαprotein and mRNA expression,the expression of ERR αwas downregulated by ERR αinhibitors XCT790 and siERR,and apoptosis and proliferation of colon cancer cells were detected by flow cytometry and MTT.Western blot and qRT-PCR were used to detect apoptosis and proliferation-related gene proteins and mRNA expression.Results ERR αand mRNA protein in HCT-116 were higher than those of Colo-205,SW620 and HT-29 cell lines(P<0.05); in the XCT790-OHP-HCT-116 group,the early apoptosis rate was higher than those of the NC group and OHP-HCT-116 group(P<0.05),the survival rate of cell culture in 72 and 96 h in the XCT790-OHP-HCT-116 group was lower than those in the NC group and OHP-HCT-116 group(P<0.05).The siERR α HCT-116 cells transfected with down-regulation of ERR expression,siERR α -OHP-HCT-116 group early apoptosis rate was lower than those of NC group and OHP-HCT-116 group(P<0.05),siERR -OHP-HCT-116 group cells cultured for 72 and 96 h after the survival rate was lower than the NC group and OHP-HCT-116 group(P<0.05);After the downregulation of ERRαby siERR alpha transfected with HCT-116 cells,the early apoptotic rate in the group siERRα-OHP-HCT-116 was lower than that in the group NC and group OHP-HCT-116(P<0.05),the survival rate of the group siERRα-OHP-HCT-116 after 72 and 96 h were lower than those in the group NC and group OHP-HCT-116(P<0.05),siERR α was transfected into HCT-116 cells,compared with the siNC group,YAP1,p73,p63,MDM2, Capase 8,Capase 9 protein in the siERR group decreased(P<0.01),there was no significant difference in the level of mRNA(P>0.05).Conclusion The downregulation the expression of ERRαcan promote colon cancer cell apoptosis,inhibit proliferation,and enhance the killing effect of oxaliplatin on colon cancer cells.

17.
Article in Chinese | WPRIM | ID: wpr-619533

ABSTRACT

Attentional set-shifting tasks are used as a measure of human fronto-executive function.the cognitive processes involved in forming an attentional set,maintaining an attentional set and shifting an attentional set are vulnerable to dysfunction arising from a number of human neurological disorders (such as attentional deficit/hyperactivity disorder,depression,schizophrenia) and neurodegenerative diseases (such as Parkinson's,Huntington's,Alzheimer's diseases).Recently,researches on rodents mainly continue to illustrate normal rats which are caused by different operating different performance in the attentional set-shifting tasks.And also there are few studies committed to observe the adaptability of the rats in attentional set-shifting tasks as well as different performance between species of rodents in attentional set shifting tasks.In addition,these results have elucidated the roles of multiple neurotransmitters in the manifestation of cognitive processes.This review focuses on the methodology of the attentional set-shifting tasks and the role of the neurotransmitter in cognitive processes.

18.
Parenteral & Enteral Nutrition ; (6): 150-154, 2017.
Article in Chinese | WPRIM | ID: wpr-618396

ABSTRACT

Objective:To investigate the influence of clinical outcomes and the risk factors of poor prognosis for preoperative nutritional risk in gastric cancer patients.Methods:A prospective study was performed in 140 patients with gastric cancer and the nutritional risk screening 2002 (NRS 2002) was done.The influence of preoperative nutritional risk on postoperative complications,hospital stay,ICU stay,hospital expenses,60 days readmission and mortality was analyzed,and the risk factors of perioperative complication were identified by univariate and multivariate analysis.Results:The significant difference (NRS 2002 ≥ 3 group vs.NRS 2002 < 3 group) was observed in the rates of overall postoperative complications,pulmonary infection,overall hospital stay and postoperative hospital stay (P < 0.05).The rates of anastomotic fistula,pleural effusion,60 days readmission,60 days mortality and hospitalization expenses in NRS 2002 ≥ 3 group were higher than that of NRS 2002 < 3 group,but there were no differences between the two groups (P > 0.05).By univariate and multivariate analysis,preoperative high cholesterol levels and preoperative nutritional risk are the risk factors of poor prognosis and postoperative complications.Conclusion:Preoperative high cholesterol levels and preoperative nutritional risk are independent risk factors of postoperative complications.

19.
Chinese Journal of Surgery ; (12): 436-441, 2015.
Article in Chinese | WPRIM | ID: wpr-308541

ABSTRACT

<p><b>OBJECTIVE</b>To describe the long-term survival of off-pump coronary artery bypass grafting (CABG) and to analysis the risk factors of operative mortality and long-term survival.</p><p><b>METHODS</b>From January 2001 to December 2012, 2 831 patients undergoing off-pump CABG in Peking University People's Hospital, 2 099 cases (74.1%) of them were male, the average age was (63±9) years. The perioperative data was retrospectively collected. Binary Logistic regression was used to find the risk factors which affect the operative mortality. Follow-up evaluation was completed regularly. Kaplan-Meier survival curve, Log-rank test and Cox regression model were used to find out factors which affect the long-term result.</p><p><b>RESULTS</b>Totally 2 831 patients underwent isolating off-pump CABG, in whom 45 patients died perioperative, 2 786 patients discharged successfully. Binary Logistic regression showed that sex (female) (χ2=4.4, OR=2.307, P=0.035), peripheral vascular disease (χ2=17.4, OR=6.616, P=0.000), New York Heart Association (NYHA) class grade≥3 (χ2=10.5, OR=3.491, P=0.001), ejection fraction≤40% (χ2=16.9, OR=5.230, P=0.000), emergency surgery (χ2=11.9, OR=5.127, P=0.001) are risk factors of operative mortality. The follow-up time was (74±44) months. Totally 107 patients were lost from follow-up, 109 patients died in follow-up. The survival rate at 1, 3, 5 , 8 and 10 years was 97.2%, 95.5%, 94.3%, 93.6%, 92.1%, respectively. Univariate analysis showed that age (>65 years), hypertension, renal insufficiency, peripheral vascular disease, history of myocardial infarction, NYHA class grade≥3 and emergency surgery were risk factors of the long-term survival (χ2=8.150 to 88.241, P<0.05). Cox regression analysis showed that age (>65 years) (χ2=12.1, RR=2.295, P=0.000), renal insufficiency (χ2=12.3, RR=3.160, P=0.000), peripheral vascular disease (χ2=42.5, RR=5.626, P=0.000), NYHA class grade≥3 (χ2=9.1, RR=1.994, P=0.002) and emergency surgery (χ2=5.5, RR=2.247, P=0.019) were independent risk factors that affect the long-term survival.</p><p><b>CONCLUSIONS</b>Sex (female), peripheral vascular disease, NYHA class grade≥3, ejection fraction≤40%, emergency surgery are risk factors of operative mortality. Age (>65 years), renal insufficiency, peripheral vascular disease, NYHA class grade≥3 and emergency surgery are independent risk factors that affect the long-term survival. Off-pump CABG has favorable perioperative and long-term outcome, and it definitely is a very safe and effective technique for coronary artery revascularization.</p>


Subject(s)
Aged , Cardiovascular Diseases , Coronary Artery Bypass, Off-Pump , Mortality , Coronary Artery Disease , General Surgery , Female , Humans , Kaplan-Meier Estimate , Logistic Models , Male , Middle Aged , Myocardial Infarction , Peripheral Vascular Diseases , Retrospective Studies , Risk Factors , Treatment Outcome
20.
Article in Chinese | WPRIM | ID: wpr-603135

ABSTRACT

Objective To explore an optimal method of producing STZ-induced type 1 diabetic KM mice model by investigating the molded rate of single high dose and multiple low dose of STZ injection.Methods Sixty KM mice were randomly divided into 4 groups(n=15), two control groups and two model groups.In the two control groups, one was blank control and the other was negative control.Mice in the blank control group treated with no injection, but mice in the negative control group were treated with injection of citric acid salt buffer.For the two model groups, one was single high-dose group, 150 mg/kg STZ was injected only once.The other was multiple low-dose group, 50 mg/kg STZ was injected for 5 consecutive days.After the last injection, daily food and water intake were tested, blood glucose level and body weight were examined once a week for 4 consecutive weeks. Results Mice in the two model groups showed typical features of diabetes.The blood glucose levels in the two model groups were significantly higher than in the two control groups ( P <0.05 ) .For the two model groups, the molded rate of 150 mg/kg and 50 mg/kg group were 60% and 53.33%respectively at 1st week, but at the 4th week, they were 60% and 80% respectively.The mortality of these two groups at the 4th week was 33.33% and 20% respectively.Moreover, the blood glucose level in multiple low-dose group increased stably from the 2nd week to the 4th week.Conclusion The multiple low-dose STZ injection (50 mg/kg for 5 consecutive days) is an optimal method for producing KM mice model of type 1 diabetes mellitus.

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