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1.
Article in English | WPRIM | ID: wpr-915749

ABSTRACT

Background/Aims@#Mean nocturnal baseline impedance (MNBI) is a new reflux metric for mucosal integrity. It remains unclear whether MNBI can help identify evidence against pathological reflux by the Lyon Consensus in patients with refractory gastroesophageal reflux disease (GERD) symptoms. @*Methods@#Three hundred and forty-nine patients with refractory GERD symptoms enrolled in this study were subjected to high-resolution manometry, 24-hour multichannel intraluminal impedance-pH (MII-pH) monitoring, and endoscopy. Conventional indexes (ie, reflux events and acid exposure time) and the novel index (MNBI) of MII-pH monitoring were extracted and analyzed. The value of MNBI in diagnosing patients with evidence against pathologic reflux was evaluated by receiver-operating-characteristic analysis. @*Results@#There were 102 (29.2%) patients with evidence against pathologic reflux, 149 (42.7%) with inconclusive or borderline evidence and 98 (28.1%) with conclusive evidence for pathologic reflux. The MNBI was significantly higher while the proportion of pathological MNBI was significantly lower in subjects with evidence against pathologic reflux than in patients with inconclusive or borderline evidence and in patients with conclusive evidence for pathologic reflux (2444.3 [1977.9-2997.4] vs 1992.8 [1615.5-2253.6] and vs 1772.3 [758.6-2161.3], both P < 0.001; 42.2% vs 79.7% and vs 80.0%, both P < 0.05). When identifying evidence against pathologic reflux in patients with refractory GERD symptoms, the MNBI yielded an area under the curve of 0.749 (P < 0.001) at a cutoff value of 1941.8 Ω. @*Conclusions@#The MNBI has a good diagnostic value for evidence against pathological reflux in patients with refractory GERD symptoms. For its simplicity and reproducibility, we believe that MNBI should be referred to in reports of impedance-pH tracings by physicians.

2.
Journal of Chinese Physician ; (12): 1192-1195, 2021.
Article in Chinese | WPRIM | ID: wpr-909686

ABSTRACT

Objective:To design a laparoscopic partial renal blood flow blocker (LPRB), and to explore the design rationality and effect of LPRB on blocking the blood flow of local renal tissue in rabbit kidney experiment.Methods:⑴ Design.According to the anatomical characteristics of the renal blood flow from the center to the periphery in the human, pig and rabbit, the blood flow at the distal part of the compression area could be blocked by the compression of the medial kidney tissue. LPRB included the first pressure arm, the second pressure arm and shaft. A built-in torsion spring made the two ends of the pressure arm to automatically close. The ends of pressure arm were provided with an arc-shaped compression component, on which, there were multiple adaptive compression plates. ⑵ Fabrication. 3D printer printed the finished product with titanium alloy material. ⑶ Animal experiments. Five New Zealand rabbits were anesthetized and fixed on the operating table in a semi-lateral position, with a lateral abdominal incision. Kidneys were exposed, only the renal pedicle vessels were retained. According to different methods of blocking blood flow, they were divided into conventional group and LPRB group for self-control. The effect of blocking blood flow was observed. The clamping force of LPRB was detected, and the degree of tissue damage at the clamping site was observed by naked eye and pathology.Results:LPRB had been licensed as a utility model and apperance patent. The device was successfully made from titanium alloy by 3D printer. In the experiment, the device was easily placed and removed. The two pressure arms were automatically closed and fixed under the action of torsion spring. The angle of the compression arm could be adjusted according to the position of clamping. The self-adaptive compression plates might be inclined in order to be consistent with the shape of the kidney; The pressure of LPRB was sufficient and the hemostasis was complete.Conclusions:LPRB is basicly rational and safe, and it can realize the partial hemostasis of the excised part and guarantee the blood flow of other parts at the same time. However, the larger size and harder adaptive component need to be improved in the future.

3.
Article in Chinese | WPRIM | ID: wpr-885892

ABSTRACT

Cytomegalovirus (CMV) retinitis (CMVR) is a common opportunistic infection of the eye after allogeneic hematopoietic stem cell transplantation in patients with hematological diseases. It often occurs within 3 months after the operation, with CMV activation and high blood CMV peaks. It often occurs on patients with long-term CMV viremia, human leukocyte antigen incompatible transplantation, unrelated donor transplantation, haploid transplantation, childhood hematopoietic stem cell transplantation, delayed lymphocyte engraftment, acute and chronic graft-versus-host disease after surgery. The visual prognosis of patients is related to the area of CMVR lesions on the retina, the number of quadrants involved, whether the macula is involved, and the CMV load of the vitreous body is involved, and it is not related to whether the Epstein-Barr virus infection is combined with blood and vitreous humor. The incidence of CMVR is increasing year by year. It is helpful that paying attention to systemic risk factors and epidemiology can provide more effective guidance for ophthalmologists during diagnosis and treatment, help patients improve the prognosis of vision, and reduce or even avoid the occurrence of blindness caused by CMVR.

4.
Article in Chinese | WPRIM | ID: wpr-885577

ABSTRACT

Objective:To investigate the pathogenic gene locus and prenatal genetic diagnosis of 54 families with oculocutaneous albinism (OCA).Methods:This retrospective study enrolled 54 OCA probands and their families from Gansu Province Maternal and Child Health Care Hospital from May 2014 to May 2020. TYR gene variation screening was performed on the probands by Sanger sequencing. Those with negative results were analyzed by high-throughput sequencing, and further verification was performed on their parents by Sanger sequencing. Among the 54 families, 15 ml amniotic fluid were collected from 16 women at 18-21 gestational weeks in their subsequent pregnancy. Sanger sequencing combined with short tandem repeats sequence for linkage analysis were performed for genetic analysis. All data were analyzed using descriptive statistical analysis. Results:Out of the 54 OCA probands, 48 were diagnosed as OCA1, five were OCA2 and one was OCA4 based on the Sanger sequencing and high-throughput sequencing detection. A total of 26 different variation sites were involved in the 48 OCA1 probands, including 15 missense mutations, five nonsense mutations, three splicing mutations, and three frame-shift mutations, among which, c.929insC (29%, 28/96) was the most frequent mutation, followed by c.896G>A (11%, 11/96), c.832C>T (8%, 8/96) and c.703T>C (5%, 5/96). The diagnosis was confirmed in all 16 fetuses in the 16 families that underwent prenatal diagnosis. Five of them were affected and their mothers chose to terminate the pregnancies, the other 11 pregnancies continued to delivery, including seven heterozygous carriers and four fetuses without the same pathogenic allele as the proband. Maternal contamination was excluded in all prenatal samples using short tandem repeat for linkage analysis. All 11 children were in good health during telephone follow-up one month after birth. Postnatal validations were consistent with the prenatal tests.Conclusions:Genetic diagnosis could accurately identify various types of OCA and help to provide prenatal diagnosis and fertility consultation for subsequent pregnancies.

5.
Article in Chinese | WPRIM | ID: wpr-921935

ABSTRACT

OBJECTIVE@#To investigate the efficacy of self-made arthroscopic single channel in the treatment of carpal tunnel syndrome.@*METHODS@#Sixty patients with primary carpal tunnel syndrome treated from January 2014 to December 2019 were divided into arthroscopic group and traditional open operation group. There were 30 cases in arthroscopic group, including 12 males and 18 females, aged (47.5±4.5) years and the course of disease was (6.6±4.2) months. There were 30 cases in the traditional operation group, including 10 males and 20 females, aged (48.5±3.5) years, and the course of disease was (5.6±4.4) months. Both groups were unilateral. According to the anatomy of wrist joint and the characteristics of transverse carpal ligament and arthroscopy, the instruments including cannula, inner heart and hook knife were designed. The patients in two groups were treated with decompression of transverse carpal ligament using arthroscopy combined with self-made instruments and traditional open sergery. The incision length, operation time, intraoperative bleeding, hospitalization cost, hospitalization time and recovery time of the two groups were observed and compared. Boston Carpal Tunnel Questionnaire (BCTQ) score was used to evaluate the clinical efficacy of arthroscopy combined with self made instruments in the treatment of carpal tunnel syndrome.@*RESULTS@#Compared with the traditional group, the arthroscopic group had significant advantages in incision length, operation time, intraoperative bleeding and hospital stay, but the total cost of hospitalization was increased. The Boston score was significantly higher in the arthroscopic group than that in the traditional group at 1 month after operation, but not at 3 and 6 months after operation.@*CONCLUSION@#Arthroscopy combined with self-made instruments in the treatment of carpal tunnel syndrome is more reliable, minimally invasive and simplified than open surgery, but the patients should be clearly diagnosed and appropriately selected before operation to achieve satisfactory clinical effect.


Subject(s)
Carpal Tunnel Syndrome/surgery , Decompression, Surgical , Female , Humans , Ligaments, Articular , Male , Treatment Outcome , Wrist/surgery , Wrist Joint/surgery
6.
Article in Chinese | WPRIM | ID: wpr-921682

ABSTRACT

This study aims to predict the material basis and mechanism of Dachengqi Decoction in the treatment of sepsis based on network pharmacology. The chemical constituents and targets of Dachengqi Decoction were retrieved from TCMSP, UniPot and DrugBank and the targets for the treatment of sepsis from OMIM and GeneCards. The potential targets of Dachengqi Decoction for the treatment of sepsis were screened by OmicShare. STRING database and Cytoscape 3.7.2 were used to construct the Chinese medicinal-active component-target-disease, active component-key target-key pathway, and protein-protein interaction(PPT) networks. The gene ontology(GO) term enrichment analysis and Kyoto encyclopedia of genes and genomes(KEGG) pathway enrichment analysis were performed by DAVID(P<0.05). Finally, the animal experiment was conducted to verify some targets and pathways. A total of 40 active components and 157 targets of the Dachengqi Decoction, 2 407 targets for the treatment of sepsis, and 91 common targets of the prescription and the disease were also obtained. The key targets were prostaglandin G/H synthase 2(PTGS2), prostaglandin G/H synthase 1(PTGS1), protein kinase cAMP-dependent catalytic-α(PRKACA), coagulation factor 2 receptor(F2 R), phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic gamma subunit(PIK3 CG), dipeptidyl peptidase 4(DPP4), etc. A total of 533 terms and 125 pathways were obtained for the 91 targets. The main terms were the response to drug, negative regulation of apoptotic process, positive regulation of nitric oxide biosynthetic process and lipopolysaccharide-mediated signaling pathway, and the pathways included pathways in cancer, hepatitis B, and phosphatidylinositol 3-kinase and protein kinase B(PI3 K/Akt) signaling pathway. The animal experiment confirmed that Dachengqi Decoction can down-regulate inflammatory cytokines interleukin-1β(IL-1β), IL-6 and tumor necrosis factor α(TNF-α)(P<0.01). It could also reduce the wet/dry weight ratio of lung tissue, the level of myeloperoxidase(MPO) and the phosphorylation of PI3 K and Akt(P<0.01). These results indicated that Dchengqi Decoction could act on inflammation-related targets and improve sepsis by inhibiting PI3 K/Akt signaling pathway. The animal experiment supported the predictions of network pharmacology. Dachengqi Decoction intervenes sepsis via multiple components, multiple targets, and multiple pathways. The result lays a foundation for further research on the mechanism of Dachengqi Decoction in the treatment of sepsis.


Subject(s)
Animals , Drugs, Chinese Herbal , Gene Ontology , Plant Extracts , Sepsis/genetics
7.
Article in Chinese | WPRIM | ID: wpr-879540

ABSTRACT

OBJECTIVE@#To explore the genetic basis for a child with unexplained global developmental delay (GDD), seizure, and facial deformity.@*METHODS@#Whole exome sequencing (WES) was carried out for the patient. Candidate variants were verified by Sanger sequencing of the patient and his parents.@*RESULTS@#WES revealed that the patient has carried a previously unreported de novo heterozygous nonsense c.4906C>T (p.Arg1636Ter) variant of the KMT2A gene, Based on the American College of Medical Genetics and Genomics standards and guidelines, the c.4906C>T variant of KMT2A gene was predicted to be pathogenic (PVS1+ PS2+ PM2+PP3).@*CONCLUSION@#The heterozygous nonsense c.4906C>T (p.Arg1636Ter) variant of the KMT2A gene probably underlay the disease in the child. Above finding has enriched the spectrum of pathogenic variants of the KMT2A gene.


Subject(s)
Abnormalities, Multiple/genetics , Child , Histone-Lysine N-Methyltransferase/genetics , Humans , Intellectual Disability/genetics , Male , Myeloid-Lymphoid Leukemia Protein/genetics , Syndrome
8.
Chinese Journal of Digestion ; (12): 595-600, 2020.
Article in Chinese | WPRIM | ID: wpr-871494

ABSTRACT

Objective:To explore the quality of life and psychological factors of patients with refractory gastroesophageal reflux disease (rGERD).Methods:From September 2016 to March 2019, 159 rGERD patients visiting the Department of Gastroenterology, Beijing Tongren Hospital Affiliated to Capital Medical University were retrospectively selected. According to the presence or absence of distal esophageal mucosal injury under gastroscopy, the patients were divided into refractory reflux esophagitis (RE) group (58 cases) and refractory non-erosive reflux disease (NERD) group (101 cases). The general data, the results of 24 h esophageal impedance pH, esophageal high-resolution manometry (HRM) and the scores of gatroesophageal reflux disease-questionnaire (GerdQ), 36-item short-form health survey (SF-36), self-rating anxiety scale(SAS) and self-rating depression scale (SDS) were recorded and compared between the two groups. Independent sample t test, rank sum test, chi-square test and multiple linear regression analysis were used for statistical analysis. Results:There were no significant differences in gender, age, abdominal circumference or body mass index between the two groups (all P>0.05). The incidence of extraesophageal symptoms of refractory NERD group was higher than that of refractory RE group (45.5%, 46/101 vs. 24.1%, 14/58), and the difference was statistically significant ( χ2=7.185, P=0.010). The episodes of gas reflux, weak-acid reflux and non-acid reflux were all more than those of refractory RE group (66.20 times, 45.20 times to 111.60 times vs. 38.40 times, 23.50 times to 59.63 times; 34.70 times, 9.05 times to 52.75 times vs. 6.35 times, 3.10 times to 24.00 times; 12.60 times, 2.15 times to 24.20 times vs. 2.15 times, 0 times to 10.30 times), GerdQ score of refractory NERD group was higher than that of refractory RE group (8.9±2.5 vs. 7.8±2.3), and DeMeester score, the symptom index and symptom association probability of refractory NERD group were all lower than those of refractory RE group (5.16, 1.75 to 14.48 vs. 15.19, 2.78 to 45.96; 33.3%, 0 to 60.0% vs. 57.5%, 40.5% to 78.0%; 87.8%, 0 to 97.8% vs. 94.0%, 82.7% to 98.2%); and the differences were statistically significant ( Z=-5.548, -5.384 and -4.338, t=3.306, Z=-2.607, -4.313 and -2.468; all P<0.05). The esophageal distal contractile integral of refractory NERD group was lower than that of refractory RE group (334.0 mmHg·s·cm, 182.5 mmHg·s·cm to 492.0 mmHg·s·cm vs. 399.0 mmHg·s·cm, 216.5 mmHg·s·cm to 756.3 mmHg·s·cm, 1 mmHg=0.133 kPa), and the difference was statistically significant ( Z=-2.204, P=0.030). There were no significant differences in lower escophageal sphincter or the length of peristaltic interruption between the two groups (both P>0.05). There were no significant differences in physical functioning, role-physical, bodily pain, general health, vitality, social functioning, role-emotional, mental health or reported health transition of SF-36 score between refractory NERD group and refractory RE group (all P>0.05). Among 159 patients with rGERD, 98 patients (61.6%) had anxiety and 55 patients (34.6%) had depression. The SAS score of refractory NERD group was higher than that of refractory RE Group (52.6±5.8 vs. 47.0±8.8), and the difference was statistically significant ( t=4.794, P<0.05), however there was no significant difference in SDS score between the two groups ( P>0.05). The results of multiple linear regression analysis showed that GerdQ score in rGERD patients was positively correlated with DeMeester score, gas reflux, weak acid reflux, SAS score and SDS score ( r=0.201, 0.228, 0.171, 0.229 and 0.276; all P<0.05). Conclusions:Among the patients with rGERD, the reflux symptoms are more severe in refractory NERD patients, which may be related to non-acid reflux, gas reflux, esophageal motor disorders, and psychological abnormalities, especially anxiety.

9.
Article in English | WPRIM | ID: wpr-834371

ABSTRACT

Purpose@#This study was conducted to evaluate the hypothesis that an enlarged prostate in old rats may lead to complications associated with voiding dysfunction involving ionotropic P2X2/3-type purinergic receptors @*Methods@#Intact animals were divided into male young (MYR; 8–10 weeks old) and male old (MOR; 20 months old) rats. The animals underwent simultaneous detrusor electromyography (EMG) and suprapubic cystometry (CMG) under urethane anesthesia. Immunofluorescence techniques were used to evaluate prostatic autonomic innervation and P2X3R expression in bladder urothelial cells. The functional role of P2X3R was characterized by intramuscular application of AF-353, a selective P2X2/3R antagonist. @*Results@#The prostate index significantly increased in MOR, suggestive of an enlarged prostate affecting micturition patterns. Significant EMG and CMG differences were found between MYR and MOR. Higher immunoreactivity for P2X2/3R in the urothelial layer and for prostatic neurofilaments was seen in MOR. Systemic inhibition of P2X2/3R had minimal effects on MYR responsiveness, but improved voiding function in MOR with a marked decrease of intravesical pressure and bladder contractile responses. @*Conclusions@#The data support the hypothesis that an enlarged prostate in MOR may contribute to voiding dysfunction involving activation of P2X2/3R, which enhances a prostate-bladder reflex. This reflex may increase bladder afferent transmission and activation of increased prostate innervation, leading to voiding dysfunction.

10.
Article in Chinese | WPRIM | ID: wpr-826477

ABSTRACT

OBJECTIVE@#To explore the genetic basis for a child with concomitant spinal muscular atrophy (SMA) and Citrin protein deficiency.@*METHODS@#The child was subjected to whole exome sequencing by using target sequence capture high-throughput sequencing. Candidate variants were verified by Sanger sequencing. The SMN genes of the patient were also analyzed through multiplex ligation-dependent probe amplification (MLPA).@*RESULTS@#The patient was found to carry homozygous deletion of exons 7 and 8 of the SMN1 gene, for which his parents were both carriers. The patient also carried compound heterozygous variants c.1737G>A and IVS16ins3kbof the SLA25A13 gene, in addition with compound heterozygous variants c.948G>A and c.2693T>C of the POLG gene, for which his parents were carriers, too.@*CONCLUSION@#Variants of the SLC25A13 gene probably underlay the deficiency of Citrin protein, which may lead to neonatal intrahepatic cholestasis (NICCD). The patient also had SMA. The compound heterozygous variants c.948G>A and c.2693T>C of the POLG gene are likely to cause mitochondrial DNA deletion syndrome type 4A, though other types of mitochondrial disease cannot be excluded.

11.
Article in Chinese | WPRIM | ID: wpr-821474

ABSTRACT

Objective To investigate the effect of tetrahydrobiopterin (BH4), superoxide dismutase-polyethylene glycol (PEG-SOD) and N(G)-nitro-L-arginine (L-NNA) on impaired endothelial progenitor cell (EPC) functions in DOCA-salt hypertensive mice. Methods DOCA-salt hypertension was created and systolic blood pressure was measured by tail-cuff methods. EPC was isolated from bone marrow of mice and characterized by flow cytometry and fluorescence microscopy. EPC of DOCA-salt mice was incubated with BH4, PEG-SOD, and L-NNA for 24 h, then in vitro EPC function assays were performed. Results Compared with control group, systolic blood pressure was significantly increased in DOCA-salt mice. Both EPC adhesion and angiogenesis functions were impaired in DOCA-salt mice compared to control animals, which were reversed by incubation with BH4, PEG-SOD and L-NNA. Conclusion BH4, PEG-SOD and L-NNA rescued the impairments from EPC functions in DOCA-salt hypertensive mice.

12.
Article in Chinese | WPRIM | ID: wpr-753121

ABSTRACT

Objective :To explore influence of dual-and triple-anticoagulant therapy on hemorrhage events ,laboratory in-dexes and cardiovascular events after percutaneous coronary intervention (PCI) in patients with atrial fibrillation (AF) complicated coronary heart disease (CHD).Methods : Clinical data of 100 AF + CHD patients were analyzed .All subjects received PCI and anticoagulant therapy after PCI .Dual-therapy group (n= 50) received dual-anticoagulant program and triple-therapy group (n=50) received triple-anticoagulant program.Levels of blood C reactive protein (CRP) ,fibrinogen (Fg) ,D-dimer (D-D) and platelet count (PLT) before and after treatment ,incidence of hemorrhage events and adverse cardiovascular events during treatment were compared between two groups .Results : Compared with dual-therapy group af-ter 12-month treatment ,there were significant reductions in blood levels of CRP [(16-81 ± 4-49) mg/L vs.(7-86 ± 1-64) mg/L] ,PLT [ (298-47 ± 54-33)×109/L vs.(148-89 ± 23-11)×109/L] ,Fg [ (5-59 ± 1-41) g/L vs.(2-14 ± 0-56) g/L] and D-D [(0-37 ± 0-08) mg/L vs.(0-21 ± 0-06) mg/L] in triple-therapy group ,P=0-001 all.Incidence rate of ad-verse cardiovascular events in triple-therapy group was significantly lower than that of dual-therapy group (6-00% vs. 22-00%, P=0-021) ,there was no significant in incidence rate of hemorrhage events between two groups , P=0-182-Conclusion : Triple-anticoagulant therapy can significantly improve therapeutic effect with high safety in AF + CHD pa-tients after PCI ,which is worth extending .

13.
Article in Chinese | WPRIM | ID: wpr-753012

ABSTRACT

Objective To investigate the application value of superior mesenteric artery (SMA)-oriented complete mesocolic excision (CME) in the treatment of right colon cancer.Methods The retrospective cohort study was conducted.The clinicopathological data of 955 patients with right colon cancer who were admitted to the First Affiliated Hospital of Nanjing Medical University from January 2013 to June 2018 were collected.There were 514 males and 441 females,aged from 18 to 96 years,with a median age of 65 years.Of the 955 patients,377 undergoing SMA-oriented CME of right colon with the lymph node dissection along the left boundary of SMA were allocated into SMA-oriented group,and 578 undergoing superior mesenteric vein (SMV)-oriented CME of right colon with the lymph node dissection along the left boundary of SMV were allocated into SMV-oriented group.Observation indicators:(1) intraoperative and postoperative conditions;(2) postoperative complications;(3) postoperative pathological examinations;(4) follow-up and survival situations.Follow-up was performed by telephone interview and outpatient examination once every 3-6 months within 2 years after surgery and once a year after 2 years up to January 2019,using tumor recurrence and metastasis or death as the end point.Follow-up included physical examination and tumor marker test,including carcino embryonic antigen,CA19-9,chest and abdomen CT examination and enteroscopy.Measurement data with skewed distribution were described as M (P25,P75),and comparison between groups was done using the Mann-Whitney U test.Count data were described as absolute numbers or percentages,and comparison between groups was analyzed using the chi square test.Ordinal data were analyzed using the rank sum test.Kaplan-Meier method was used to calculate survival time and rate,and draw survival curve.Log-rank test was used for survival analysis.Patients with loss to follow-up were involved in survival analysis as censored data.Results (1) Intraoperative and postoperative conditions:the operation time,volume of intraoperative blood loss,duration of postoperative hospital stay were 100 minutes (90 minutes,110 minutes),50.0 mL (50.0 mL,70.0 mL),8 days (8 days,10 days) in the SMA-oriented group,and 110 minutes (90 minutes,135 minutes),50.0 mL (50.0 mL,122.5 mL),10 days (8 days,12 days) in the SMV-oriented group,showing significant differences between the two groups (Z=-5.400,-5.799,-7.461,P<0.05).After the exclusion of 47 patients unsuitable for defecation analysis because of postoperative complications,365 in the SMA-oriented group and 543 in the SMV-oriented group were analyzed.The time to first defecation,the maximum number and the median number of daily defecation postoperatively were 5 days (3 days,5 days),2.0 (1.0,2.5),1.0 (1.0,1.0) in the SMA-oriented group,which showed no significant difference from 4 days (3 days,5 days),2.0 (1.0,3.0),1.0 (1.0,1.0) in the SMV-oriented group (Z=-1.622,-1.541,-1.024,P> 0.05).(2) Postoperative complications:cases with postoperative complications,cases with incisional liquefaction or infection,cases with anastomostic leakage,cases with delayed gastric emptying,cases with intra-abdominal bleeding,cases with complete or incomplete ileus,cases with anastomostic bleeding,cases with intra-abdominal infection,cases with disruption of wound,the number of death were 55,10,3,3,2,2,1,1,1,1 in the SMA-oriented group,which showed no significant difference from 83,30,13,4,3,8,3,6,2,3 in the SMV-oriented group,respectively (x2 =0.045,3.662,2.926,0.034,0.001,1.604,0.352,1.873,0.048,0.352,P>0.05).There were 32 of 377 patients in the SMA-oriented group and 14 of 578 in the SMV-oriented group with chylous leakage,showing a significant difference between the two groups (x2 =18.312,P< 0.05).Patients with chylous leakage were improved after conservative treatment,without reoperation.Patients with other complications were improved after anti-infection,fluid infusion,and reoperation.Four of 955 patients died after surgery.(3) Postoperative pathological examinations:patients with stage Ⅰ,stage Ⅱ,and stage Ⅲ (pathological TNM staging),patients with high-differentiation,mid-differentiation,and low-differentiation (tumor differentiation degree),length of intestine specimen,number of positive lymph nodes,maximum tumor diameter,patients with cancer nodules,patients with vascular invasion,patients with perineural invasion were 57,174,146,30,174,173,23 cm (21 cm,26 cm),0 (0,2),5.0 cm (3.0 cm,6.0 cm),37,81,53 in the SMA-oriented group,which showed no difference from 66,280,232,33,303,242,23 cm (21 cm,25 cm),0 (0,2),5.0 cm (3.5 cm,6.0 cm),80,108,82 in the SMV-oriented group (Z=-1.020,-0.216,-0.243,-0.220,-0.814,x2=3.441,1.127,0.003,P>0.05).The number of harvested lymph nodes was 22.0 (17.0,27.0) and 18.0 (15.0,22.0) in the SMA-oriented group and SMV-oriented group,respectively,with a significant difference between the two groups (Z=-7.800,P<0.05).There were 202 patients extracted for further analysis.The number of harvested lymph nodes and harvested central lymph nodes was 25.0 (20.0,31.3),5.0 (3.0,8.0) of 166 patients in the SMA-oriented group,and 21.5 (18.0,28.8),1.5 (0,4.5) of 36 patients in the SMV-oriented group,respectively,showing significant differences between the two groups (Z =-1.995,-4.309,P<0.05).(4) Follow-up and survival situations:840 of 955 patients including 346 in the SMA-oriented group and 494 in the SMV-oriented group were followed up for 1.0-73.2 months,with a median time of 31.5 months.SMA-oriented group had a higher 5-year overall survival rate than SMV-oriented group (91.8% vs.84.9%,x2 =4.384,P<0.05),but had no significant difference in the 5-year tumor-free survival rate compared with the SMV-oriented group (84.4% vs.78.2%,x2=2.158,P>0.05).Conclusion Compared with SMV-oriented CME of right colon,SMA-oriented CME of right colon is safe and feasible,with larger number of harvested lymph nodes,which can achieve complete lymph node dissection.

14.
Article in Chinese | WPRIM | ID: wpr-734450

ABSTRACT

Objective To investigate the safety and efficacy of 177Lu-prostate specific membrane antigen (PSMA)-617 in the treatment of metastatic castration-resistant prostate cancer (mCRPC).Methods From August 2017 to September 2018,11 patients(average age 70.6 years) with mCRPC who underwent 177Lu-PSMA-617 therapy in Nanjing First Hospital were studied.All patients underwent 68Ga-PSMA-11 PET/CT before therapy to assess the tumor radioactive uptake.Blood routine examination and renal function test results were documented before and after therapy to assess the safety.The efficacy was reflected by the changes of prostate specific antigen (PSA) levels and maximum standardized uptake value (SUVmax) on 68Ga-PSMA-11 PET/CT imaging.Paired t test and Wilcoxon's sign rank test were used to analyze the data.Results No acute side effects were observed after therapy of 177Lu-PSMA-617.There were no statistically significant differences after therapy in WBC counts,RBC counts,and PLT,as well as Hb levels (t values:-0.28-1.11,all P> 0.05).No kidney toxicity was found.The PSA level after 177Lu-PSMA-617 therapy was significantly lower than that before therapy (80.70 (14.29,1 538.00) μg/L vs 604.60 (88.41,3 980.00) μg/L;u =59,P =0.023).Of the 11 patients,only 2 had elevated PSA levels and disease progression,while the other 9 patients had varying decreases,of which 2/11 decreased by >30% and 7/11 decreased by >50%.After therapy,SUVmax of metastatic lesions and metastatic lymph nodes were decreased in 9 and 2 patients respectively.Conclusions 177Lu-PSMA-617 has a good therapeutic value for mCRPC.It is safe and has no obvious side effects.

15.
Chinese Journal of Digestion ; (12): 217-222, 2019.
Article in Chinese | WPRIM | ID: wpr-746120

ABSTRACT

Objective To analyze the relationship between body type,age,gender,esophageal motility function,lower esophageal sphincter pressure (LESP) and clinical classification and type of reflux contents of patients with gastroesophageal reflux disease (GERD).Methods From September 2015 to July 2016,at Beijing Tongren Hospital of China Capital Medical University,the results of 24-hour esophageal impedance-pH monitoring of 141 patients with GERD were retrospectively analyzed.The differences of reflux contents were compared in patients with GERD among different body type,age,gender,esophageal motility function,LESP and clinical classification.Mann-Whitney test was performed for comparison between groups.Results Acid reflux was more common in obese patients (body mass index more than 23.9 kg/m2) compared with patients with normal body type (body mass index from 18.5 to 23.9 kg/m2) (18.5,7.0 to 45.3 vs.10.0,2.0 to 32.0),and the difference was statistically significant (Z =-2.320,P =0.020).Patients under 65 years old had more numbers of weak acid reflux,non-acid reflux and gas reflux than patients over 65 years old (58.5,32.8 to95.0 vs.40.0,24.0to71.0;19.5,6.0to47.5 vs.8.0,3.0 to19.0;46.0,23.8to79.3 vs.35.0,11.0 to 56.0),and the differences were statistically significant (Z =-2.690,-3.286 and-2.091,all P<0.05).Male patients had more gas and mixed reflux compared with female patients (53.5,24.0 to 122.8 vs.36.0,19.0 to 67.0;34.0,20.8 to 50.0 vs.27.0,14.0 to 43.0),and the differences were statistically significant (Z =-2.424 and-1.961,both P < 0.05).There was no statistically significant difference in reflux contents between patients with normal esophageal motility and patients with esophageal motility disorder (weak or interrupted peristalsis) (all P > 0.05).Patients with reflux esophagitis(RE) and/or Barrett's esophagus (BE) had more weak acid reflux,non-acid reflux and gas reflux compared with patients with non-erosive reflux disease (NERD) (61.0,31.3 to 102.5 vs.44.0,24.5 to 66.5;18.0,8.0 to 36.5 vs.8.0,2.0 to 22.0;49.5,27.5 to 86.5 vs.26.0,11.0 to 47.0),and the differences were statistically significant (Z =-2.585,-2.942 and-3.278,all P < 0.05).Patients with lower esophageal sphincter (LES) relaxation were more likely to have weak acid reflux than patients with normal LES function (57.0,32.3 to 87.0 vs.40.0,21.0 to 73.0),the difference was statistically significant (Z =-2.065,P =0.039).Conclusion Body type,age,gender,LESP and clinical classification are related to type of reflux contents in GERD patients,while esophageal peristalsis is irrelevant.

16.
Article in Chinese | WPRIM | ID: wpr-743344

ABSTRACT

Purpose To investigate the pathological features and prognostic value of tertiary lymphoid structure (TLS) formation in gastric cancer (GC) . Methods HE staining slides were reviewed to evaluate the TLS in 163 specimens from patients with GC in the Third Affiliated Hospital of Soochow University from 2006 to 2008. The validation cohort contained 63 randomly selected cases and immunohistochemical staining of MECA-79 was used to verify the accuracy of pathological assessment of TLS. Results TLS score and MECA-79 immunohistochemical staining showed significant correlation (P = 0. 002) and agreement (P = 0. 024) . The TLS was not significantly correlated to clinical pathological parameters. The patients with high level of TLS had better prognosis (P = 0. 025) with the mean survival time of 48. 54 months. In multivariate Cox regression analysis, TLS was an independent prognostic factor (P = 0. 031) . Conclusion The pathological evaluation of TLS is accurate. The formation of TLS is an important positive prognostic factor for GC patients.

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Article in Chinese | WPRIM | ID: wpr-743284

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Objective To explore the clinical features, cytogenetic and molecular genetics characteristics of trisomy 12 p in neonates. Method The clinical data were reviewed in a neonate with trisomy 12 p confirmed by routine G-banding chromosome karyotype analysis, high throughput sequencing chromosome copy number variation analysis (CNV) and lymphocyte interphase fluorescence in situ hybridization (FISH) . Results The chromosome karyotype in peripheral blood of the neonate was 47, XX, +mar, and the karyotypes of her parents were normal. CNV detected a regional duplication of 12 p13.33-p11.1 (160001-34860000) with a fragment size of 34.7 Mb. Peripheral blood lymphocyte interphase FISH showed that there were 3 signals in the short arm of chromosome 12 in all interphase nuclei of the neonate, and no chimera existed. It was finally confirmed to be trisomy 12 p. Conclusion The combination of clinical features, peripheral blood karyotype analysis, CNV and FISH techniques can effectively confirm the diaganosis of trisomy 12 p.

18.
International Journal of Surgery ; (12): 226-231,封4, 2019.
Article in Chinese | WPRIM | ID: wpr-743026

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Objective To analyze the risk factors for anastomotic leakage after low anterior resection(LAR) for rectal cancer.Methods The retrospective study of 1 336 patients with rectal cancer who underwent LAR from Jan.2013 to Dec.2017 in the Department of Colorectal Surgery,First Affiliated Hospital of Nanjing Medical University was conducted.There were 838 male and 498 female patients.The median age was 62 (53,70) years.Observation indicators:①intraoperative conditions,including the performance of preventive enterostomy,the preservation of left colic artery,the placement of transanal decompression tube;②postoperative conditions,for example,postoperative clinical symptoms and physical examination,postoperative hospital stay.Anastomotic leakage patients were graded according to the grading system of anastomotic leakage following anterior resection of the rectum proposed by the International Study Group of Rectal Cancer in 2010.Measurement data with non-normal distribution were described as median,and comparison between groups was done using Mann-Whitney U test.Ranked data were compared with rank sum test.Comparison of count data between groups were analyzed using the Chi-square test or Fisher exact test.Potential risk factors for anastomotic leakage were further analyzed with multiple logistic regression.Results Anastomotic leakage was noted in 138 (10.4%) of 1 336 patients with 93 patients (7.0%) of Grade B and 46 patients (3.4%) of Grade C respectively.The occurrence of Grade C anastomotic leakage was on the 3th day postoperatively,which was earlier than Grade B anastomotic leakage [5 (3,7) d,Z =2.746,P =0.006].There were significant differences in sex,BMI,placement of transanal decompression tube and tumor location between anastomotic leakage cases and non-anastomotic leakage cases by Chi-squared test (x2 =10.897,9.033,6.343,6.34,Z =-2.380,P <0.05).On multiple logistic regression analysis,male sex (OR =1.840,95 % CI:1.210-2.799,P =0.004),BMI ≥ 24 kg/m2 (OR =1.573,95 % CI:1.088-2.274,P =0.016),placement of transanal decompression tube(OR =2.418,95% CI:1.196-4.888,P =0.014),middle rectal cancer (OR =1.536,95% CI:O.836-2.822,P =0.167),low rectal cancer(OR =1.989,95% CI:1.068-2.822,P =0.03),ultralow rectal cancer (OR =2.908,95% CI:1.289-6.560,P =0.01) were independent risk factors of anastomotic leakage.Conclusion Male sex,high BMI,placement of transanal decompression tube and low rectal tumor were independent risk factors of anastomotic leakage for patients receiving LAR.

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Chinese Medical Journal ; (24): 1639-1644, 2019.
Article in English | WPRIM | ID: wpr-802620

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Background@#Unprotected anal intercourse (UAI) has previously been associated with human immunodeficiency virus (HIV) infection. Male students who have sex with men (SMSM) are at increased exposure to experience UAI. The aim of this study was to investigate the status of UAI and related factors among SMSM in three northern regions of China.@*Methods@#From November 2018 to January 2019, SMSM, 18 years or older, studying or living in Beijing, Tianjin, or Shijiazhuang, who had anal sex in the past 6 months were recruited by community-based organizations to participate in an unmatched, casecontrol study. Detailed demographic and behavioral information were collected via self-administrated electronic questionnaires and factors related to UAI were assessed using uni- and multivariate logistic regression analyses.@*Results@#Among the 511 SMSM included in the study, 210 (41.1%) reported UAI in the past 6 months. SMSM who had sexual partners at least 10 years older than themselves (odds ratio [OR] = 2.277, 95% confidence interval [CI]: 1.380–3.756), used vacant capsules before sexual activity (OR = 3.858, 95% CI: 1.472–10.106), had a self-perceived moderate-HIV risk (OR = 2.128, 95% CI: 1.403–3.227), and unprotected, first anal intercourse (OR = 2.236, 95% CI: 1.506–3.320) had increased odds of UAI.@*Conclusions@#Factors associated with increased odds of engaging in UAI in the past 6 months among SMSM included having older sexual partners, using vacant capsules, having a self-perceived moderate risk of HIV, and unprotected, first anal intercourse. Continuing education on risk reduction, including improving condom decision making in age-discordant relationships could help address the sexual risk behaviors among SMSM.

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Article in Chinese | WPRIM | ID: wpr-801860

ABSTRACT

Objective:To observe the effect of Linggui Zhugan Tang on gut microbiota in ob/ob mice, in order to explore whether its bone protective effect is related to its regulatory effect of gut microbiota. Method:The ob/ob mice were divided into control group, model group, Linggui Zhugan Tang group, and Atorvastatin group. After administration for 4 weeks, morphological changes in intestine and bone were observed by htoxylin eosin(HE) staining. The protein expression of alkaline phosphatase(ALP) was detected by Western blot in bone. The expression of farniol X receptor(FXR) was detected by in immunofluorescence staining. And the content of interleukin-6(IL-6) in serum was analyzed by the enzyme-linked immunosorbent assay(ELISA) method. Gut microbiota was analyzed by 16S rRNA. Result:Compared with control group, the trabecular bone of the femur became thinner, the bone marrow cavity was infiltrated with fat, and the epithelium of the small intestine was damaged in the model group. The protein expressions of ALP and FXR decreased, while the content of IL-6 in serum was increased in the model group. Compared with model group, the protein expressions of ALP and FXR increased, while the content of IL-6 in serum was decreased in the Linggui Zhugan Tang group. At the genus level, compared with control group, the abundance of Lachnospiraceae_UCG-001 increased (PBacteroidales_S24-7_group decreased in model group (PLachnospiraceae_UCG-001 was positively correlated with the weight of body (r=0.661), while norank_f__Bacteroidales_S24-7_group was negatively correlated with the weight of body (r=-0.622). Conclusion:Linggui Zhugan Tang has a protective effect on bone injury in ob/ob mice, and its mechanism may be related to its regulation of gut microbiota.

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