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1.
Chinese Journal of School Health ; (12): 242-246, 2022.
Article in Chinese | WPRIM | ID: wpr-920606

ABSTRACT

Objective@#To explore the relationship and gender difference between family rearing styles with emotional and behavior problems in preschool children aged 3-6 years, so as to provide reference for early prevention and intervention of children s emotional and behavior problems.@*Methods@#Using the method of stratified cluster sampling, 9 647 children aged 3-6 years old from 36 kindergartens in Wuhu, Lu an and Fuyang of Anhui Province were selected in June 2021. Primary caregivers were investigated with self designed questionnaire, Strengths and Difficulties Questionnaire (parents version) and Parental Rearing Style Scale.@*Results@#The detection rate of elevated SDQ total difficulty score was 6.5%, with boys (7.1%) higher than that of girls (5.8%). The detection rate of abnormal emotional behavior were significantly higher in children with high scores on doting, laissez faire, autocracy and inconsistency of family rearing style, compared with those in the low score group ( χ 2=210.32, 203.87, 102.70, 212.69, P <0.01 ), and the detection rate increased with the increase of score. However, the detection rate of abnormal emotional behavior in the high score group of democracy was significantly lower than that in the low score group ( χ 2=156.24, P <0.01), and the detection rate decreased with the increase of score. Logistic regression analysis showed that high level doting ( OR =4.31), laissez faire ( OR = 4.16), autocracy ( OR =3.36) and inconsistency ( OR =4.76) of family rearing style were associated with high risk of children s emotional behavior problems, while high level of democracy ( OR =0.34) in family rearing style was associated with low risk of emotional behavior problems. The comparison between boys and girls showed that the risk of emotional and behavioral problems in the indulgent rearing style of boys was significantly higher than that of girls ( OR =1.90, 2.13) ( P <0.05).@*Conclusion@#Family rearing styles are associated with emotional and behavioral problems among preschool children. Boys are sensitive to the negative impact of doting rearing style. Good rearing styles is beneficial to the prevention and control of children s emotional and behavioral problems.

2.
Clinical Medicine of China ; (12): 79-84, 2021.
Article in Chinese | WPRIM | ID: wpr-884126

ABSTRACT

Objective:To compare the difference of human epididymis protein 4(HE4) and carbohydrate antigen 125(CA125) indexes before and after menopause in ovarian cancer patients, and to evaluate the efficacy of risk of ovarian malignancy algorithm(ROMA) index in early diagnosis.Methods:The clinical data of 236 patients with ovarian cancer (malignant ovarian tumor group) who were hospitalized in Cancer Hospital of China Medical University from April 2018 to September 2019 were retrospectively analyzed, and 312 benign patients treated at the same period were selected as the control group (benign ovarian tumor group). On the basis of clinical pathological section confirmation, the serum samples were collected to detect HE4 and CA125, and the ROMA index was calculated according to the formula.The differences of HE4, CA125 and ROMA indexes before and after menopause, as well as the diagnostic efficacy of ROC survival curve of the three were compared, and the relationship between the different clinical characteristics of ovocarcinoma patients was evaluated to comprehensively analyze the early diagnostic effect of ROMA index.Results:In the serum of patients with malignant ovarian cancer, HE4, CA125 and ROMA index were abnormally high expression, and the difference between HE4 before(263.2(128.4, 385.6) pmol/L) and after menopause(354.8(179.5, 554.2) pmol/L) was statistically significant( Z=2.09, P=0.037). Through fitting the ROC curve: the AUC of premenopausal ROMA index was 0.939, and the AUC of postmenopausal ROMA index was 0.933, which were higher than HE4 (0.937, 0.906) and CA125 (0.913, 0.924), and their corresponding Youden correct diagnostic indexes were 0.800 and 0.742 respectively, which were higher than HE4 (0.788, 0.653) and CA125 (0.498, 0.565). The two categories of HE4 were associated with the occurrence of peritoneal effusion (the percentage of postmenopausal and premenopausal HE4<140 nmol/L and premenopausal HE4<70 nmol/L were 25.77%, 74.23% and 74.23% respectively), and the difference was statistically significant (χ 2=10.155, P=0.006). CA125 was associated with the classification of the largest diameter of parenchymal tumor and the occurrence of peritoneal effusion (all P<0.05). ROMA index was associated with menopause or not, classification of maximum diameter of mass, classification of maximum diameter of parenchymal tumor and occurrence of ascites, and the differences were statistically significant (all P<0.05). Conclusion:ROMA index has a good diagnostic efficiency in the diagnosis of malignant ovarian cancer, especially premenopausal patients with good diagnostic efficiency, for early diagnosis of ovarian cancer has a certain guiding value, the follow-up will further carry out confirmatory research.

3.
Chinese Journal of Endemiology ; (12): 263-267, 2021.
Article in Chinese | WPRIM | ID: wpr-883706

ABSTRACT

Objective:To analyze the genetic characteristics of Brucella strains isolated from a human brucellosis epidemic in Baoding City of Hebei Province, and to provide scientific basis for control and prevention of brucellosis. Methods:Brucella antibody was detected in a high-risk population ( n=22) of brucellosis in Baoding City in 2018 by using rose bengal plate test and tube agglutination test. Blood samples of patients with brucellosis were collected for Brucella isolation ( n=3). Conventional methods were used to identify the bacteria strains. Multiple locus variable-number tandem repeat analysis (MLVA) and multilocus sequence typing (MLST) were used to analyze the genetic characteristics of the strains. Results:The sero-prevalence of Brucella antibodies in high-risk populations was 4.55% (1/22). Three suspected Brucella strains were isolated from blood samples of three patients (No. BDY-1, BDY-2 and BDY-3) and were identified as Brucella melitensis biovar 3. The results of MLVA showed that strain BDY-1 and strain BDY-2 were the same genotype. Strain BDY-3 added two tandem repeats at the locus of Bruce04 and Bruce16, respectively, and lost three tandem repeats at the locus of Bruce30. The genotype of panel 1 (MLVA-8) and panel 1 + panel 2A (MLVA-11) were 42 and 116, respectively, which belonged to the "East Mediterranean group". They were closely clustered with Brucella melitensis biovar 3. MLST analysis showed that all isolated strains could be classified into a ST8 type. Conclusions:The isolated strains from the epidemic are Brucella melitensis biovar 3. In the future, the prevention and control of brucellosis in Baoding City should strengthen the health education and behavior intervention of the high-risk population.

4.
Article in Chinese | WPRIM | ID: wpr-883101

ABSTRACT

Objective:To investigate the feasibility of using anastomotic stoma as a long-term vascular access to maintain hemodialysis in patients who cannot establish an effective vascular access after ACUSEAL graft occlusion.Methods:A rare case of brachial artery-right atrium ACUSEAL artificial blood vessel fistula bypass to establish vascular access occlusion, the use of artificial blood vessel anastomosis stoma to establish buttonhole puncture as a long-term vascular access and the corresponding nursing methods.Results:At present, the patients were treated with regular dialysis for 32 months and blunt needle puncture for 23 months.Conclusions:Brachial artery-right atrium ACUSEAL graft is a rare vascular access surgery. As a new type of access with depleted autologous vascular resources, the efficacy is not certain. Because it is different from the traditional vascular prosthesis surgery, once the thrombotic occlusion of the graft fails, the risk and difficulty of reopening by interventional or surgical methods are great. Therefore, it is a challenging and reasonable method to use the limited residual cavity of the anastomosis as a long-term vascular access after occlusion to prolong the service life of the graft.

5.
Article in Chinese | WPRIM | ID: wpr-883000

ABSTRACT

Objective:To investigate the incidence of sarcopenia in maintenance hemodialysis (MHD) patients and analyze its influencing factors.Methods:Totally 441 non-hospitalized MHD patients in stable condition were selected,by bioelectrical impedance analysis (BIA) to test appendicular skeletal muscle mass(ASM), by testing grip strength of MHD patients, to assess Muscle strength, by gait speed test to measure the 4-m usual walking speed, to assess physical performance of MHD patients.Risk factors of sarcopenia were identified by Logistic regression analysis.Results:The total incidence of sarcopenia in 441 MHD patients was 16.55% (73/441) and the incidence of sarcopenia in patients over 60 years old was 28.91% (61/211).The results showed older age ( OR=0.213, 95% CI 0.099-0.458, P<0.01), Karnofsky ( OR=9.661, 95% CI 3.850-24.244, P<0.01), subjective global assessment ( OR=0.491, 95% CI 0.250-0.965, P=0.039), serum phosphorus ( OR=0.422, 95% CI 0.204-0.875, P=0.020) and body mass index ( OR=0.754, 95% CI 0.609-0.935, P=0.010) were risk factors of sacopenia. Conclusions:The incidence of sarcopenia in elder, performed less physical activity, malnutrition predisposed MHD patients was high, so to those patients we should be paid more attention and gave active interventions to reduce sarcopenia.

6.
Journal of Clinical Hepatology ; (12): 2324-2326, 2021.
Article in Chinese | WPRIM | ID: wpr-904941

ABSTRACT

Objective To investigate HBV RNA level in patients with HBV-related hepatocellular carcinoma after long-term antiviral therapy and its clinical significance. Methods A total of 60 patients with HBV-related hepatocellular carcinoma who were admitted to Tianjin Second People's Hospital from June 2019 to August 2020 were enrolled in this study. These patients received antiviral therapy with nucleos(t)ide analogues (NAs) for at least two years, and high-sensitivity HBV DNA detection showed a HBV RNA level of < 20 IU/mL at least twice at an interval of 3 months. Liver function, HBV serum markers, and HBV RNA level were measured for all patients. The Kruskal-Wallis H test was used for comparison between multiple groups, and the Wilcoxon rank-sum test was used for comparison between two groups; a Pearson correlation analysis was used to investigate the influencing factors for HBV RNA. Results Among the 60 patients with HBV-related hepatocellualr carcinoma who received long-term antiviral treatment, 9 (15%) tested positive for HBV RNA. According to the level of alpha-fetoprotein (AFP), the patients were divided into AFP positive group and AFP negative group, and there was no significant difference in HBV RNA level between the two groups [0(0-3.57) vs 0(0-2.00), Z =-1.474, P =0.141). According to Barcelona Clinic Liver Cancer (BCLC) stage, they were divided into BCLC stage A group and BCLC stage B+C+D group, and there was no significant difference in HBV RNA level between the two groups [0(0-2.0) vs 0(0-2.0), Z =-0.607, P =0.544]. According to HBeAg level, the patients were divided into HBeAg positive group and HBeAg negative group, and there was a significant difference in HBV RNA level between the two groups [2.99(0-4.80) vs 0(0-0.50), Z =-3.400, P =0.001]. According to the titer of HBsAg, they were divided into HBsAg≤100 IU/mL group, 100 IU/mL < HBsAg < 1500 IU/mL group, and HBsAg ≥1500 IU/mL group, and there was a significant difference in HBV RNA level between the three groups [0(0-0.0) vs 0(0-0.20) vs 2.00(0.0-4.54), H =-7.899, P =0.019]. A Pearson correlation analysis was performed for age, alanine aminotransferase, aspartate aminotransferase, gamma-glutamyl transpeptidase, alkaline phosphatase, alpha-fetoprotein, HBsAg, and HBeAg, and the results showed that HBsAg level was correlated with HBV RNA quantification ( r =0.292, P < 0.05). Conclusion In patients with HBV-related hepatocellualr carcinoma receiving long-term antiviral therapy with NAs, HBV RNA can still be detected after HBV DNA is lower than the lower limit of detection. HBsAg titer may be correlated with serum HBV RNA level.

7.
Journal of Clinical Hepatology ; (12): 2324-2326, 2021.
Article in Chinese | WPRIM | ID: wpr-904891

ABSTRACT

Objective To investigate HBV RNA level in patients with HBV-related hepatocellular carcinoma after long-term antiviral therapy and its clinical significance. Methods A total of 60 patients with HBV-related hepatocellular carcinoma who were admitted to Tianjin Second People's Hospital from June 2019 to August 2020 were enrolled in this study. These patients received antiviral therapy with nucleos(t)ide analogues (NAs) for at least two years, and high-sensitivity HBV DNA detection showed a HBV RNA level of < 20 IU/mL at least twice at an interval of 3 months. Liver function, HBV serum markers, and HBV RNA level were measured for all patients. The Kruskal-Wallis H test was used for comparison between multiple groups, and the Wilcoxon rank-sum test was used for comparison between two groups; a Pearson correlation analysis was used to investigate the influencing factors for HBV RNA. Results Among the 60 patients with HBV-related hepatocellualr carcinoma who received long-term antiviral treatment, 9 (15%) tested positive for HBV RNA. According to the level of alpha-fetoprotein (AFP), the patients were divided into AFP positive group and AFP negative group, and there was no significant difference in HBV RNA level between the two groups [0(0-3.57) vs 0(0-2.00), Z =-1.474, P =0.141). According to Barcelona Clinic Liver Cancer (BCLC) stage, they were divided into BCLC stage A group and BCLC stage B+C+D group, and there was no significant difference in HBV RNA level between the two groups [0(0-2.0) vs 0(0-2.0), Z =-0.607, P =0.544]. According to HBeAg level, the patients were divided into HBeAg positive group and HBeAg negative group, and there was a significant difference in HBV RNA level between the two groups [2.99(0-4.80) vs 0(0-0.50), Z =-3.400, P =0.001]. According to the titer of HBsAg, they were divided into HBsAg≤100 IU/mL group, 100 IU/mL < HBsAg < 1500 IU/mL group, and HBsAg ≥1500 IU/mL group, and there was a significant difference in HBV RNA level between the three groups [0(0-0.0) vs 0(0-0.20) vs 2.00(0.0-4.54), H =-7.899, P =0.019]. A Pearson correlation analysis was performed for age, alanine aminotransferase, aspartate aminotransferase, gamma-glutamyl transpeptidase, alkaline phosphatase, alpha-fetoprotein, HBsAg, and HBeAg, and the results showed that HBsAg level was correlated with HBV RNA quantification ( r =0.292, P < 0.05). Conclusion In patients with HBV-related hepatocellualr carcinoma receiving long-term antiviral therapy with NAs, HBV RNA can still be detected after HBV DNA is lower than the lower limit of detection. HBsAg titer may be correlated with serum HBV RNA level.

8.
Journal of Leukemia & Lymphoma ; (12): 658-664, 2021.
Article in Chinese | WPRIM | ID: wpr-907231

ABSTRACT

Objective:To investigate the effects of hemophagocytic syndrome also known as hemophagocytic lymphohistiocytosis (HLH) on the clinical features and therapeutic efficacy of patients with Epstein-Barr virus-positive T-cell lymphoma (EBV-TCL).Methods:The clinical data of patients with EBV-TCL diagnosed by pathological examination in the First Affiliated Hospital of Guangzhou Medical University from November 2015 to August 2020 were retrospectively analyzed. According to whether they were accompanied with HLH at the time of onset, patients were divided into HLH group (10 cases) and non-HLH group (13 cases), and the clinical features and prognosis of the two groups were compared. The curative effects of different treatment methods and patients with different plasma EBV-DNA titers were compared.Results:Among 23 patients, 3 cases (13.0%) were in Ann Arbor stage Ⅰ-Ⅱ, 20 cases (87.0%) were in stage Ⅲ-Ⅳ; the International Prognostic Index (IPI) score was 1 point in 3 cases (13.0%), 2 points in 4 cases (17.4%), 3 points in 8 cases (34.8%), 4 points in 8 cases (34.8%). In the HLH group, there were 2 cases of aggressive NK-cell leukemia and 3 cases of childhood systemic EBV-TCL. There were no cases of above two pathological types in the non-HLH group. In the HLH group, the proportions of patients with fever, bone marrow invasion, IPI score > 2 points, and EBV-DNA > 10 4 copies/ml were higher than those in the non-HLH group (all P < 0.05). The objective response rate (complete remission plus partial remission) of all patients after chemotherapy was 47.8% (11/23); there were 3 cases undergoing hematopoietic stem cell transplantation in both the HLH group and the non-HLH group, and all achieved objective remission. The objective remission of 7 patients and 10 patients who did not undergo hematopoietic stem cell transplantation in the HLH group and non-HLH group after lymphoma chemotherapy had 0 case and 5 cases, respectively, and the difference was statistically significant ( P = 0.044). In the chemotherapy alone group, 5 of 17 patients had objective remission, 6 patients in the chemotherapy plus transplantation group had objective remission, and the difference was statistically significant ( P = 0.039). Among 16 patients whose plasma EBV-DNA titers turned negative, 11 patients had objective remission, and 7 patients whose plasma EBV-DNA titers were continuously positive had no objective remission, and the difference was statistically significant ( P = 0.001). The 1-year overall survival rate of all patients was 69.3%, and the 2-year overall survival rate was 52.0%. In the HLH group, the 1-year and 2-year overall survival rates of 7 patients receiving chemotherapy alone and 3 patients receiving chemotherapy plus transplantation were 42.9% and 66.7%, respectively. In the non-HLH group, the 1-year overall survival rates of 10 patients receiving chemotherapy alone and 3 patients receiving chemotherapy plus transplantation were 80.0% and 100.0%, respectively; the 2-year overall survival rates were 26.7% and 100.0%,respectively. The overall survival of patients receiving chemotherapy plus transplantation was better than that of those receiving chemotherapy alone in both the HLH group and the non-HLH group, and differences were statistically significant (all P < 0.05). Conclusions:The general clinical stage of patients with EBV-TCL is later, and the prognosis of EBV-TCL patients with HLH is worse. The therapeutic efficacy may be related to plasma EBV-DNA titers. Hematopoietic stem cell transplantation can improve the remission rate.

9.
Cancer Research and Clinic ; (6): 725-730, 2021.
Article in Chinese | WPRIM | ID: wpr-912957

ABSTRACT

Objective:To investigate the diagnostic value of serum miRNA-9-5p (miR-9-5p), miRNA-21-5p (miR-21-5p) and miRNA-3923 (miR-3923) in patients with cervical cancer.Methods:The data of 100 cervical cancer patients in Shanxi Provincial Cancer Hospital from July 2016 to June 2018 (the experimental group) and 100 healthy subjects (the healthy control group) during the same period were collected. The real-time fluorescent quantitative polymerase chain reaction (qRT-PCR) combined with probe hybridization was used to detect the expression levels of human papillomavirus (HPV) E6/E7 mRNA in paraffin-embedded tissues of patients with cervical cancer and in cervical exfoliated cells of the healthy control people. Ct value ≤ 40 cycles was considered as HPV E6/E7 positive. Serum samples from 3 patients with cervical cancer and 3 healthy people were taken out; microRNA (miRNA) Array was used to detect the expression level of 384 miRNA; the differential expression of miRNA was screened out and cluster analysis was performed, and then the screened miRNAs was verified by using qRT-PCR. Finally, the receiver operation characteristics (ROC) curves of screened miRNAs alone and HPV E6/E7 alone or the combination of three miRNAs and HPV E6/E7 in the diagnosis of cervical cancer were drawn to make comparison of diagnostic efficacy.Results:Among the paraffin-embedded tissues from 100 patients with cervical cancer, there were 65 cases (65%) HPV E6/E7 positive; in the healthy control group, HPV E6/E7 in cervical exfoliated cells of 100 people was negative. A total of 248 differentially expressed miRNAs were detected from the serum samples in 3 patients with cervical cancer and 3 healthy people. The cluster analysis finally identified 16 abnormally regulated miRNAs. qRT-PCR verification confirmed that differences in the expression levels of miR-9-5p, miR-21-5p and miR-3923 in the healthy control group and cervical cancer group were statistically significant (all P < 0.01), and then the three were selected to make diagnosis of cervical cancer. The expression levels of miR-9-5p, miR-21-5p and miR-3923 in HPV E6/E7 positive cervical cancer group were higher than those in the healthy control group (all P < 0.05), expression levels of miR-21-5p and miR-3923 in HPV E6/E7 negative cervical cancer group were increased ( P = 0.008, P = 0.038); expression levels of the three miRNAs in HPV E6/E7 positive group were higher than those in HPV E6/E7 negative group (all P < 0.05). ROC curve analysis showed that the area under the curve (AUC) of miR-3923 was the biggest (0.843), the specificity was the highest (82%, the cut-off value was 2.88) and the sensitivity of miR-21-5p was the highest (85%, the cut-off value was 4.08) when miR-9-5p, miR-21-5p and miR-3923 were respectively applied to diagnose the cervical cancer; AUC (0.924), the sensitivity and the specificity (85%, 94%; the cut-off value was 4.04) of the combination of the three indicators were higher than those of the single indicator in the diagnosis of cervical cancer. AUC was 0.766 when HPV E6/E7 was kused alone to diagnose. The diagnostic efficacy of HPV E6/E7 combined with miR-9-5p, miR-21-5p, miR-3923 respectively was further improved, the corresponding AUC was 0.914, 0.848, 0.932, respectively; the diagnostic efficacy of the combination of the four indicators was the highest (AUC was 0.942). Conclusion:miR-9-5p, miR-21-5p and miR-3923 may be helpful in the diagnosis of cervical cancer.

10.
Article in Chinese | WPRIM | ID: wpr-879940

ABSTRACT

The pathogenesis of endometriosis is not well understood at the moment, and the lack of effective biomarkers often leads to delayed diagnosis of the disease. Lipidomics provides a new approach for the diagnosis and prediction of endometriosis. Sphingomyelin, phosphatidylcholine and phosphatidylserine in peripheral blood, endometrial fluid, peritoneal fluid and follicular fluid have good diagnostic value for endometriosis and disease classification; the lipid metabolites in the eutopic endometrium tissue are expected to be biomarkers of early endometriosis; and the lipid metabolites in peripheral blood are also of great value for predicting endometriosis-related infertility. The development of lipidomics technique will further advance the progress on the pathogenesis, prediction, diagnosis and treatment of endometriosis.


Subject(s)
Biomarkers/blood , Blood Chemical Analysis/trends , Body Fluids/chemistry , Endometriosis/diagnosis , Female , Humans , Lipidomics/trends
11.
Article in Chinese | WPRIM | ID: wpr-864520

ABSTRACT

Objective:To analyze the effect of time-division appointment mode on patients undergoing PICC dressing change.Methods:Totally 50 patients who did not implement the time-sharing appointment mode from June 2017 to August 2017 were randomly selected as the control group, 50 patients who implemented the time-sharing appointment mode from April 2018 to June 2018 were randomly selected as the observation group. Comparison of waiting time, satisfaction and mastery of catheter nursing knowledge between the two groups.Results:The waiting time of observation group was (0.26±0.22) h, while (0.80±0.76) h of control group, the difference between the two groups was statistically significant ( Z value was -3.537, P<0.05) ; The mastery rate of catheter nursing knowledge of observation group was 84.00% (42/50), while 62.00% (31/50) of control group, the difference between the two groups was statistically significant ( χ2 value was 7.324, P<0.05) . The satisfaction of observation group was 74.00%(37/50), while 46.00%(23/50) of control group, the difference between the two groups was statistically significant ( χ2 value was 8.569, P<0.05) . Conclusions:The time-sharing appointment mode can shorten the waiting time of patients, help patients to master the relevant knowledge of catheter care, improve patients′ satisfaction, and improve patients ′ medical experience.

12.
Cancer Research and Clinic ; (6): 174-177, 2020.
Article in Chinese | WPRIM | ID: wpr-872473

ABSTRACT

Objective:To analyze the influencing factors of prognosis of early mixed signet ring cell carcinoma (SRCC) of the stomach with signet ring cell ratio less than 50%.Methods:The clinical data of 110 patients with SRCC who underwent radical resection of gastric cancer in the First People's Hospital of Ziyang from January 2014 to December 2016 were retrospectively analyzed. The postoperative pathology was confirmed as mixed SRCC of the stomach with signet ring cell ratio less than 50%. The patients were followed up, and the end point of the follow-up was all-cause death. The prognostic influencing factors of SRCC patients were analyzed.Results:The median follow-up time was 32.5 months (0.9-70.0 months), with the median overall survival (OS) time of 40.0 months (7.0-61.0 months) and the 3-year OS rate of 46.5%. Kaplan-Meier survival analysis showed that the 3-year OS rate of age ≥60 years, male, upper stomach, tumor diameter ≥5 cm, invasion of the gastric wall, lymph node metastasis, and vascular invasion of mixed SRCC of the stomach patients was 34.3%, 31.1%, 30.0%, 33.3%, 40.7%, 28.9%, 37.5%, respectively, which was all lower than that of those with age <60 years old, female, lower stomach, tumor diameter <5 cm, non-invasive whole stomach wall, no lymph node metastasis, no vascular invasion (57.6%, 57.5%, 52.9%, 57.6%, 56.7%, 74.6%, 62.3%), and there was no statistically significant difference (all P < 0.05). Cox multivariate results showed that age ≥60 years old ( OR = 1.225, 95% CI 1.089-3.481, P = 0.003), lymph node metastasis ( OR = 1.077, 95% CI 1.059-2.674, P = 0.034), invasion of the whole stomach wall ( OR = 1.342, 95% CI 1.117-7.225, P = 0.002), and vascular invasion ( OR = 1.104, 95% CI 1.087-2.541, P = 0.018) were independent factors affecting OS of mixed SRCC of the stomach. Conclusion:Mixed SRCC of the stomach patients with signet ring cell ratio less than 50% featured by advanced age, lymph node metastasis, invasion of the full thickness of the stomach wall, and vascular invasion have a poor prognosis.

13.
Article in Chinese | WPRIM | ID: wpr-871390

ABSTRACT

Objective:To evaluate the safety and efficacy of circulating tumor cells(CTCs)measurement in patients with pancreatic cancer by endoscopic ultrasonography-guided fine needle aspiration (EUS-FNA).Methods:This prospective, single-center clinical study recruited 5 patients with pancreatic cancer, who underwent EUS-FNA for portal vein blood collection to detect CTCs in portal vein blood and CTCs in peripheral blood as control. CTCs were determined using negative immunomagnetic beads combined with FISH and a folate receptor positive circulating tumor cells detection kit.Results:All 5 patients underwent EUS-FNA portal vein blood collection successfully. One sample developed blood agglutination and failed to perform CTCs test. Four others were tested, and CTCs in portal vein samples and peripheral blood samples were obtained from 3 patients. The mean CTCs in portal vein blood was 10.5±4.0 FU/3.7 mL, and the mean CTCs in peripheral blood was 11.4±4.2 FU/3.7 mL. There was no significant difference between the two groups ( P >0.05). There were no complications such as infection, abdominal bleeding or shock during operation. Conclusion:It is a safe and feasible method to collect and determine the CTCs in portal venous blood from patients with pancreatic cancer under EUS, which helps prediction and treatment of early metastasis of pancreatic cancer.

14.
Journal of Clinical Hepatology ; (12): 551-555, 2020.
Article in Chinese | WPRIM | ID: wpr-819212

ABSTRACT

ObjectiveTo investigate the correlation between plasma D-dimer level and severity of hepatitis B cirrhosis and its value in the diagnosis of portal vein thrombosis (PVT). MethodsA retrospective analysis was performed for the clinical data of 500 patients with hepatitis B cirrhosis who were hospitalized in The Fifth Medical Center of Chinese PLA General Hospital from January to December, 2018, and according to the plasma level of D-dimer, they were divided into normal group with 217 patients and elevated group with 283 patients. The correlations of plasma D-dimer level with Child-Pugh class and Model for End-Stage Liver Disease (MELD) score were compared between the two groups. The t-test was used for comparison of normally distributed continuous data between two groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups; the Kruskal-Wallis H test was used for multiple groups comparison and further pairwise comparison. The chi-square test was used for comparison of categorical data between two groups. A Spearman correlation analysis was used to investigate correlation. The receiver operating characteristic (ROC) curve was used to evaluate the early warning performance of D-dimer level for PVT in patients with hepatitis B cirrhosis. ResultsThere were significant differences between the two groups in D-dimer level, alanine aminotransferase, aspartate aminotransferase, total bilirubin, albumin, Child-Pugh class, MELD score, and incidence rate of PVT (all P<0.05). The correlation analysis showed that plasma D-dimer level was positively correlated with Child-Pugh class and MELD score in both groups (r=0.463, 0.455, 0.214, and 0.756, all P<005). A total of 50 patients with hepatitis B cirrhosis were found to have PVT; the patients with PVT had a significantly higher D-dimer level that those without PVT [1.96 (0.82-4.91) mg/L vs 0.61 (0.19-1.54) mg/L, Z=-6.02, P<0.001]. The ROC curve analysis showed that D-dimer level had an area under the ROC curve of 0.758 (95% confidence interval: 0.719-0.796) at the optimal cut-off value of 0.76 mg/L. ConclusionPlasma D-dimer level is correlated with the severity of hepatitis B cirrhosis and can be used to predict the prognosis of patients with hepatitis B cirrhosis. The possibility of PVT should be considered in patients with an elevated D-dimer level.

15.
Journal of Clinical Hepatology ; (12): 2473-2477, 2020.
Article in Chinese | WPRIM | ID: wpr-829635

ABSTRACT

ObjectiveTo investigate the association of liver stiffness measurement (LSM) and serum biochemical parameters with hepatic steatosis, liver inflammation, and liver fibrosis in patients with nonalcoholic steatohepatitis (NASH). MethodsA total of 520 patients with NASH who were treated in The Fifth Medical Center of Chinese PLA General Hospital from January 2007 to December 2018 were enrolled, and according to body mass index (BMI) with a cut-off value of 28 kg/m2, the patients were divided into obese group with 151 patients and non-obese group with 369 patients. All patients underwent liver biopsy, and LSM was measured within 3 days before biopsy. Serum biochemical parameters and general clinical data were collected before liver biopsy, and the noninvasive indices aspartate aminotransferase to platelet ratio index (APRI) and fibrosis-4 (FIB-4) were calculated. The t-test was used for comparison of normally distributed continuous between groups, the nonparametric Mann-Whitney U test was used for comparison of non-normally distributed continuous between groups; the chi-square test was used for comparison of categorical data between groups. A Spearman rank correlation analysis was also performed. ResultsAlanine aminotransferase (ALT), aspartate aminotransferase, LSM, controlled attenuation parameter (CAP), spleen length, and APRI gradually increased with the increase in BMI (all P<0.05). The Spearman correlation analysis showed that LSM, ALT, BMI, and CAP were positively correlated with the degree of hepatic steatosis (r=0.263, 0.327, 0.184, and 0.452, all P<0.05); LSM, ALT, and CAP were positively correlated with the degree of liver inflammation (r=0.357, 0.278, and 0.121, all P<0.05); LSM, ALT, BMI, and CAP were positively correlated with the degree of liver fibrosis (r=0.500, 0.216, 0.248, and 0.101, all P<0.05); age was negatively correlated with the degree of hepatic steatosis, liver inflammation, and liver fibrosis (r=-0.344, -0.129, and -0.163, all P<0.05). ConclusionLSM, CAP, ALT, and age are significantly correlated with the degree of liver inflammation, liver fibrosis, and hepatic steatosis in NASH patients, and therefore, they can be used in noninvasive diagnostic and predictive models to access the severity of liver injury.

16.
Chinese Journal of Hematology ; (12): 149-156, 2020.
Article in Chinese | WPRIM | ID: wpr-799584

ABSTRACT

Objective@#To improve the clinical understanding of Castleman disease (CD) with different types of thoracic involvement, including their clinical features, radiological and pathological findings, diagnosis and current treatment strategies.@*Methods@#Retrospective analysis of 30 patients diagnosed with CD with thoracic involvement and hospitalized between June 2009 and May 2019 in The First Affiliated Hospital of Guangzhou Medical University was performed. Patients were divided into three groups for subsequent analysis based on the clinical data: CD with bronchiolitis obliterans (BO) , unicentric Castleman disease (UCD) without BO, and multicentric Castleman disease (MCD) without BO.@*Results@#Among the 30 patients, there were 5 (16.7%) patients diagnosed with BO, 18 (60.0%) patients had UCD without BO and 7 (23.3%) patients had MCD without BO. The average age of MCD without BO patients was significantly older than that of BO and UCD without BO patients[ (49.29±5.39) ys vs (27.20±3.76) ys and (37.17±2.87) ys; P=0.005 and 0.034, respectively) ]. Pulmonary symptoms were commonly seen in BO group (100%) and MCD without BO group (71.4%) . while no pulmonary symptoms were seen in UCD without BO group. Key abnormal laboratory findings were erythrocyte sedimentation rate (ESR) increase (40%in BO group and 57.1% in MCD without BO group) and hypoxia (60% in BO group and 28.6% in MCD without BO group) . Other abnormal laboratory findings seen in MCD without BO group included anemia and IgG increase (both 57.1%) . Notably, all patients in BO group had extremely severe mixed ventilation dysfunction in the lung function test. CT scan showed lung parenchyma involvement in BO group (100%) , in UCD without BO group (11.1%) featured by solitary pulmonary nodule and in MCD without BO group (57.1%) featured by diffuse lesions in bilateral lungs. The size of lymph nodes was significantly smaller in MCD without BO group comparing to that in BO group and UCD without BO group[short diameter (1.83±0.51) cm vs (4.73±1.63) cm and (3.62±0.26) cm; P=0.006 and 0.011, respectively]. All patients (100%) in the BO group had a pathological type of transparent vascular variant while the same pathological type accounts for 88.9% in UCD without BO patients. The predominantly pathological type (57.1%) was plasma cell variant in the MCD without BO group. Oral ulcers presented in all patients in BO group but were relieved after the mass resection and immunomodulatory therapy, but the pulmonary symptoms were still progressively aggravated. Thoracoscopic mass excision was the main treatment for UCD without BO patients while chemotherapy, immunomodulatory and targeted therapy were commonly used for MCD without BO treatment.@*Conclusion@#The age, clinical symptom, laboratory finding, lung function, imaging manifestation, pathology, treatment and prognosis were different among the three groups. This classification could improve clinical understanding of the disease.

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Chinese Journal of School Health ; (12): 1031-1035, 2019.
Article in Chinese | WPRIM | ID: wpr-818645

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Objective@#To evaluate adolescents’ self-esteem and explore its influencing factors in order to provide basic evidence for improving self-esteem level and mental health of adolescents.@*Methods@#A total of 5 709 adolescents of different characteristics from both urban and rural areas in six provinces were investigated anonymously with the method of computer-assisted self-interview (CASI). Self-esteem was evaluated by Self-Esteem Scale (SES, scored 10-40 points).@*Results@#The average score of self-esteem was 28.15,28.40, 28.97 and 27.45 point for junior high students, senior high students, college students and out-of-school adolescents, respectively. The difference of the scores among the four groups was statistically significant(F=27.64, 14.41, P<0.01). More than 80% adolescents felt they were people of worth, were able to do things as most other people, took a positive attitude toward themselves and were satisfied with themselves. About 50% of adolescents thought they were no good at all at times. Less than 20% adolescents thought they had enough respect for themselves. About 11.57% to 22.22% of adolescents felt sad about their own gender, about 37.56% to 61.49% of adolescents often or sometimes felt sad about their body image. The multiple linear regression analysis showed that those who had a good overall feeling of family, satisfied with their own gender, and less worried about their body image tended to have a higher self-esteem scores among 4 groups(P<0.01). Other related influencing factors included parental education level, family economic status, only-child or not, birth place and parental preference for gender of their child.@*Conclusion@#Adolescents’ self-esteem was fair, and many factors were associated with it. It is necessary to strengthen the education on gender equality among parents and adolescents and to pay more attention to mental health of the adolescents, who were in rural areas, with poor family atmosphere and economic status.

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Chinese Journal of Hepatology ; (12): 615-620, 2019.
Article in Chinese | WPRIM | ID: wpr-810838

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Objective@#To investigate the diagnostic value of endoscopic ultrasonography (EUS), Fibroscan, acoustic radiation force impulse (ARFI), and aspartate aminotransferase-to-platelet ratio (APRI) and their combination for early stage liver cirrhosis.@*Methods@#Three hundred and twenty-two hospitalized patients who had been diagnosed with chronic viral liver disease from March 2016 to April 2018 were included. According to the clinical diagnosis, patients were divided into chronic hepatitis and the early stage liver cirrhosis group (Child-Pugh A grade). All patients were examined by Fibroscan to detect liver stiffness measurement (LSM), ARFI to detect liver virtual touch tissue quantification (VTQ) value, esophagogastroduodenoscopy and EUS to detect esophagogastric varices, laboratory and imaging examination. The index of EUS, Fibroscan, ARFI, and APRI was analyzed and the regression model was established by binary logistic regression, and the diagnostic efficacy of the above index and regression model for early stage of cirrhosis was evaluated by the area under a receiver operating characteristic curve (AUROCs).@*Results@#An early stage cirrhosis group had significantly higher detection rate with EUS (esophagogastric varices), Fibroscan (LSM), ARFI (VTQ) and APRI than chronic hepatitis group [76.7% vs. 10.7%, 10.4 (7.8, 17.3) vs. 6.1 (5.2, 8.4) kPa, 1.71(1.48, 2.07) m/s vs. 1.25(1.14, 1.43) m/s and 0.65 (0.38, 1.15) vs. 0.38(0.26, 0.62), respectively]. The corresponding chi-square test were 140.86, Z = -9.069, Z = -9.948 and Z = -5.764, respectively and the differences were statistically significant (P < 0.01). The areas under the receiver operating characteristic curve and regression model were 0.830 (0.783 ~ 0.877), 0.793 (0.744 ~ 0.841), 0.821 (0.775 ~ 0.868), 0.686 (0.628 ~ 0.744) and 0.947 (0.925 ~ 0.969) for the diagnosis of early stage cirrhosis, respectively. Among them, the regression model of three indices (EUS, LSM and VTQ) had the largest AUROCs (0.947) and the corresponding sensitivity and specificity were 0.878 and 0.867, respectively.@*Conclusion@#The combination of EUS, LSM and ARFI had a superior diagnostic value for early stage liver cirrhosis, and may improve the diagnosis rate and reduce the misdiagnosis rate.

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Article in Chinese | WPRIM | ID: wpr-753770

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Objective To investigate the effects of compound Haishe capsule combined with rivastigmine capsule on serum thyroid hormone ,inflammatory factors and coagulation function in patients with Alzheimer's disease (AD).Methods From January 2016 to January 2018,74 patients with AD in the Seventh People's Hospital of Hangzhou were randomly divided into control group and observation group according to the digital table ,with 37 cases in each group.The control group was treated with rivastigmine capsule ,while the observation group was treated with compound Haishe capsule on the basis of the control group.The two groups were treated for 6 months.The therapeutic effects of the two groups were compared.The changes of BEHAVE-AD and ADAS-Cog scores,thyroid hormones,inflammatory factors and coagulation function were compared before and after treatment.Results The total effective rate of the observation group was 94.59%(35/37),which was higher than 72.97%(27/37) of the control group(u=6.366,P<0.05).After treatment, the scores of BEHAVE -AD and ADAS -Cog in the observation group were (4.87 ± 0.64)points,(14.28 ±1.82 ) points, respectively, which were lower than those in the control group [( 8.91 ± 1.07)points,(18.93 ±1.25)points] ( t=19.710,12.811,all P<0.05).After treatment,the level of FT4 in the observation group was (13.09 ±0.71) pmol/L,which was higher than (12.30 ±0.52) pmol/L in the control group (t=5.460,P<0.05).After treatment,the levels of CRP and IL-6 in the observation group were (2.13 ±0.38)mg/L, (31.32 ±5.64)ng/L,respectively,which were lower than those in the control group [(3.47 ±0.61) mg/L,(58.93 ± 12.15)ng/L](t=11.342,12.538,all P<0.05).After treatment,the levels of D-dimer and Fib in the observation group were (519.82 ±10.29) μg/L,(3.21 ±0.32) ng/L,respectively,which were lower than those in the control group[(552.31 ±8.31) μg/L,(4.12 ±0.49) ng/L] ( t=14.942,9.458,all P<0.05).Conclusion Compound Haishe capsule combined with rivastigmine capsule is effective in the treatment of AD , and can improve thyroid hormone and coagulation function ,and reduce the level of inflammatory factors.

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Article in Chinese | WPRIM | ID: wpr-755582

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Objective To evaluate the relationship between remifentanil-induced hyperalgesia and Antamins family member membrane protein 16C ( TMEM16C) and Slack channel in the spinal dorsal horn of rats with incisional pain. Methods Forty-eight male Sprague-Dawley rats, aged 1 month, were studied. The study was performed in two parts. Experiment Ⅰ Twenty-four rats were divided into 4 groups ( n=6 each) using a random number table method: normal saline group ( S group ) , virus vector group ( V group) , virus vector plus remifentanil plus incisional pain group ( VRI group) , and AAV5-TMEM16C o-ver-expression plus remifentanil plus incisional pain group (ORI group). Normal saline (S group), virus vector (V group and VRI group) or AAV5-TMEM16C (ORI group) 1 μl was injected via the L4,5 spinal dorsal horn. Remifentanil 1 μg ·kg-1 ·min-1 was infused for 60 min via the caudal vein at 30 days, and the incisional pain model was simultaneously established in VRI and ORI groups. The thermal paw withdrawal latency ( TWL) and mechanical paw withdrawal threshold ( MWT) were measured at 24 h before remifen-tanil infusion ( T0 ) and 2, 6, 24, and 48 h after stopping infusion ( T1-4 ) . The L4,5 segments of spinal dorsal horns were obtained at the end of the behavioral testing, and the expression of TMEM16C and Slack in total and membrane proteins was determined by Western blot. ExperimentⅡ Twenty-four rats were di-vided into 4 groups ( n=6 each) using a random number table method: normal saline plus artificial cerebro-spinal fluid (ACSF) group (SA group), virus vector plus ACSF group (VA group), virus vector plus remifentanil group ( VR group ) , and AAV5-TMEM16C over-expression plus remifentanil group ( OR group). Normal saline (SA group), virus vector (VA group and VR group) or AAV5-TMEM16C (OR group) 1μl were injected via the spinal dorsal horn at the level of L4,5 . L4,5 spinal cord slices were obtained at 30 days and incubated for 60 min in ACSF ( SA and VA groups ) or in ACSF containing 4 nmol∕L remifentanil ( VR group and OR group) . The whole-cell patch-clamp was used to measure the frequency and amplitude of the Slack channel current after the end of incubation in each group. Results ExperimentⅠCompared with S group, the TWL was significantly shortened and the MWT was decreased at T1-4 , and the expression of TMEM16C and Slack in total and membrane proteins was down-regulated in VRI group ( P<0. 05) . Compared with VRI group, the TWL was significantly prolonged and the MWT was increased at T1-4 , and the expression of TMEM16C and Slack in total and membrane proteins was up-regulated in ORI group ( P<0. 05) . Experiment Ⅱ Compared with SA group, the amplitude and frequency of Slack chan-nel current in spinal dorsal horns were significantly decreased in VR group ( P<0. 05) . Compared with VR group, the amplitude and frequency of the Slack current were significantly increased in OR group ( P<0. 05) . Conclusion The mechanism of remifentanil-induced hyperalgesia is related to down-regulating the expression of TMEM16C and further down-regulating the expression of the Slack channel in the spinal dorsal horn of rats with incisional pain.

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