Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 20 de 218
Filter
1.
Chinese Journal of Orthopaedics ; (12): 172-181, 2022.
Article in Chinese | WPRIM | ID: wpr-932820

ABSTRACT

Objective:To explore the clinical effects of combined medial and lateral approaches in treating of calcaneal fractures combined with sustentaculum tali fractures and/or dislocations of sustentaculum tali-talus joint.Methods:Four adult cadaver specimens (8 feet) were selected, of which two (4 feet) were dissected on the medial side of the calcaneus to observe the adjacency and exposure range of sustentaculum tali. The other two specimens were simulated as medial and lateral approaches to reduce and fix calcaneal fractures. Retrospective analysis of 9 cases (9 feet) of Sanders II-IV type calcaneal fractures with combined medial and lateral approaches in the treatment of fractures and/or dislocations of sustentaculum tali-talus joint was performed. The average age was 49.9±11.3 (25-58) years. During the operation, the medial incision was made first, and the sustentaculum tali fracture was temporarily reduced and fixed to the talus. Then the lateral incision was made to expose the lateral side of the calcaneus, and the fracture fragments were reduced and fixed; the sustentaculum tali was fixed laterally with screws, and 2 cases were additionally fixed medially with absorbable rods. At the same time, six cases (8 feet) of calcaneal fractures with sustentaculum tali fractures and/or dislocations of sustentaculum tali-talus were treated with lateral approach as a control group. The lateral sides of both groups were fixed with calcaneal locking plate and implanted with demineralized bone matrix into the cavity after articular surface reduction. The B?hler and Gissane angles of the two groups of patients were measured at 1 year after operation. The American Orthopaedic Foot and Ankle Society (AOFAS) scoring system was used to evaluate the clinical efficacy.Results:The sustentaculum tali-talus joint had a shape of an inverted "V" with two divided parts. The tip of the sustentaculum tali was exposed through the front window of the posterior tibial tendon. The sustentaculum tali and the medial side of the calcaneal body was completely exposed and fixed through the window between the posterior tibial tendon and the flexor digitorum longus tendon. The postoperative incision blood loss in the combined medial and lateral approach group was 73.6±4.3 ml, which was greater than that in the lateral approach group (70.6±7.1 ml) ( t=2.18, P=0.045). The lateral incision healed in both groups. The medial incision healed delayed in 1 patient in the combined medial and lateral approach group. The fractures in the combined medial-lateral approach group and the lateral approach group were both healed. The healing duration was 12.2±2.1 weeks and 12.8±2.8 weeks, respectively, without significant difference ( t=0.50, P=0.622). The B?hler angles of the combined medial-lateral approach group and the lateral approach group were 37.0°±5.7° and 27.9°±4.0° at 1 year after operation, respectively. These values were greater than the preoperative values of 4.7°±3.4° and 3.9°±2.9° ( P<0.05), with significant difference between groups ( t=3.76, P=0.002). The Gissane angles were 133.2°±9.8° and 139.1°±9.4° respectively, which were lower than those of 172°±7.3° and 175.6°±5.6° before operation ( P<0.05). There was no significant difference between the groups ( t=1.26, P=0.226). The AOFAS score of the combined medial and lateral approach group was 93.6±4.0 points, which was higher than that of the lateral approach group (84.3±8.2 points) ( t=3.03, P=0.008). Conclusion:Intra-articular calcaneal fractures combined with a high probability of sustentaculum tali fractures and/or dislocations of sustentaculum tali-talus joint. Compared with the simple lateral approach, the use of the combined medial-lateral approach and the medial-lateral surgical sequence is beneficial to restore the calcaneal alignment and anatomic shape, especially the alignment relationship of the medial calcaneus and talus, so as to obstain better early clinical outcomes.

2.
Article in Chinese | WPRIM | ID: wpr-931121

ABSTRACT

Objective:To investigate the influencing factors of headache degree in migraine patients with patent foramen ovale (PFO).Methods:The clinical data of 124 migraine patients with PFO from January 2013 to June 2019 in Dalian Central Hospital Affiliated to Dalian Medical University were retrospectively analyzed. The right-to-left shunt of PFO was assessed by contrast-enhanced transcranial Doppler (c-TCD); the diameter of PFO, length of PFO tunnel and the presence of atrial septal aneurysm (ASA) were detected by transesophageal echocardiography (TEE); the degree of migraine was assessed by headache impact test-6 (HIT-6) scale. The relations between right-to-left shunt volume of PFO, diameter of PFO and degree of migraine were analyzed by Goodman-Kruskal γ test; the relations between the length of PFO tunnel, ASA and degree of migraine were analyzed by Spearman rank correlation analysis.Results:Among the 124 migraine patients with PFO, the c-TCD test result showed that small shunt volume was in 20 cases, medium shunt volume in 31 cases, and large shunt volume in 73 cases. The TEE test result showed that small foramen ovale in 76 cases, medium foramen ovale in 47 cases, and large foramen ovale in 1 case; long tunnel in 57 cases, and short tunnel in 67 cases; without ASA in 91 cases, and with ASA in 33 cases. The HIT-6 score result showed that some influence in 9 cases, significantly influence in 22 cases, and serious influence in 93 cases. The Goodman-Kruskal γ test result showed that right-to-left shunt volume of PFO and diameter of PFO were positive correlation with degree of migraine ( γ = 0.66, P<0.01; γ = 0.38, P<0.05). The Spearman rank correlation analysis result showed that ASA was positive correlation with degree of migraine ( r = 0.18, P<0.05), while the length of PFO tunnel was negative correlation with degree of migraine ( r = -0.23, P<0.05). Conclusions:The right to left shunt amount of PFO, diameter of PFO and the presence of ASA are positive correlation with degree of migraine, while the length of PFO tunnel is negative correlation with degree of migraine.

3.
Chinese Journal of Hematology ; (12): 48-53, 2022.
Article in Chinese | WPRIM | ID: wpr-929529

ABSTRACT

Objective: To analyze the clinical manifestations and molecular pathogenesis of 18 patients with inherited protein S (PS) deficiency. Methods: Eighteen patients with inherited PS deficiency who were admitted to the Institute of Hematology & Blood Diseases Hospital from June 2016 to February 2019 were analyzed: activity of protein C (PC) and antithrombin (AT) , PS activity were measured for phenotype diagnosis; high throughput sequencing (HTS) was used for screening of coagulation disease-related genes; Sanger sequencing was used to confirm candidate variants; Swiss-model was used for three-dimensional structure analysis. Results: The PS:C of 18 patients ranged from 12.5 to 48.2 U/dL. Among them, 16 cases developed deep vein thrombosis, including 2 cases each with mesenteric vein thrombosis and cerebral infarction, and 1 case each with pulmonary embolism and deep vein thrombosis during pregnancy. A total of 16 PROS1 gene mutations were detected, and 5 nonsense mutations (c.134_162del/p.Leu45*, c.847G>T/p.Glu283*, c.995_996delAT/p.Tyr332*, c.1359G> A/p.Trp453*, c.1474C>T/p.Gln492*) , 2 frameshift mutations (c.1460delG/p.Gla487Valfs*9 and c.1747_1750delAATC/p.Asn583Wfs*9) and 1 large fragment deletion (exon9 deletion) were reported for the first time. In addition, the PS:C of the deep vein thrombosis during pregnancy case was 55.2 U/dL carrying PROC gene c.565C>T/p.Arg189Trp mutation. Conclusion: The newly discovered gene mutations enriched the PROS1 gene mutation spectrum which associated with inherited PS deficiency.


Subject(s)
Antithrombin III/genetics , Female , Genetic Testing , Humans , Mutation , Pregnancy , Protein C/genetics , Protein S/genetics , Protein S Deficiency/genetics
4.
Chinese Journal of Hematology ; (12): 26-30, 2022.
Article in Chinese | WPRIM | ID: wpr-929525

ABSTRACT

Objective: To analyze the clinical characteristics, laboratory examination, diagnosis, treatment, and outcome of hereditary factor Ⅹ (FⅩ) deficiency. Methods: Clinical data of 11 patients with congenital FⅩ deficiency were retrospectively analyzed from July 2009 to February 2021. Results: There were 3 males and 8 females. Median age was 39 (5-55) years. The media duration of follow-up was 81.67 (1.87-142.73) months. Of the 11 patients, 10 had bleeding symptoms, 7 had ecchymosis or hemorrhage after skin bump, 7 had nosebleed, 6 had gingival hemorrhage, and 1 had muscle hematoma. Among the female patients, 6 had menorrhagia and 1 experienced bleeding after vaginal delivery. Family history of FⅩ deficiency was found in one case. Eight patients had a history of surgery, and four had postoperative bleeding. Laboratory findings were characterized by significantly prolonged activated partial thromboplastin time, prothrombin time, and decreased FⅩ activity (FⅩ∶C) . Four cases underwent gene mutation analysis and five new mutations were found. Four cases were treated with prothrombin complex concentrates (PCC) and seven cases with fresh frozen plasma (FFP) . One female patient had significantly reduced menstrual volume after PCC prophylactic therapy. One patient received FFP for prophylactic infusion with no bleeding during and after the operation. Conclusion: Most patients with congenital FⅩ deficiency had bleeding symptoms and there was no significant correlation between severity of bleeding symptoms and FⅩ∶C. Prophylaxis should be applied in patients with severe bleeding tendencies. Gene mutation test is significant for screening, diagnosis, and prognosis prediction of congenital FX deficiency.


Subject(s)
Adolescent , Adult , Blood Coagulation Factors/therapeutic use , Blood Coagulation Tests , Child , Child, Preschool , Factor X Deficiency/genetics , Female , Hemorrhage/drug therapy , Humans , Male , Middle Aged , Plasma , Retrospective Studies , Young Adult
5.
Chinese Journal of Burns ; (6): 650-660, 2022.
Article in Chinese | WPRIM | ID: wpr-940971

ABSTRACT

Objective: To explore the feasibility on the preparation of novel negative pressure materials for constructing new matrix of full-thickness skin defect wounds in rats. Methods: The experimental research method was applied. The microstructure of polyurethane foam dressing which was commonly used in negative pressure treatment was observed under scanning electron microscope, and its pore diameter was detected (n=5). Polycaprolactone (PCL) and polybutylene succinate (PBS) were used respectively as raw materials for the preparation of PCL and PBS negative pressure materials by melt spinning technology, with the measured pore diameter of polyurethane foam dressing as the spinning spacing at the spinning rates of 15, 25, and 35 mm/s, respectively. The microstructures of the prepared negative pressure materials were observed under scanning electron microscope, and their fiber diameters were measured. The tensile strength and tensile modulus of the prepared negative pressure materials and polyurethane foam dressing were measured by tensile testing machine and composite testing machine, respectively (n=5), to screen the spinning rate for subsequent preparation of negative pressure materials. Human skin fibroblasts (Fbs) in logarithmic growth phase were co-cultured with PCL negative pressure material and PBS negative pressure material prepared at the selected spinning rate, respectively. After 1, 4, and 7 day (s) of co-culture, the cell activity and adhesion in the materials was detected by living/dead cells detection kit, and the cell proliferation level in the materials was detected by cell counting kit 8 method (n=5). A full-thickness skin defect wound was prepared on the back of 18 5-6 weeks old Sprague-Dawley rats (gender unlimited). Immediately after injury, the injured rats were divided into PCL+polyurethane group, PBS+polyurethane group, and polyurethane alone group according to the random number table (with 6 rats in each group). The wounds were covered with materials containing corresponding component and performed with continuous negative pressure suction at the negative pressure of -16.7 kPa. The wound tissue along with materials directly contacted to the wound (hereinafter referred to as wound specimens) were collected from 3 rats in each group after 7 and 14 days of negative pressure treatment (NPT), respectively. The growth of granulation tissue and the attachment of material to wound surface were observed after hematoxylin-eosin staining, the collagen fiber deposition was observed after Masson staining, and CD34 and interleukin-6 (IL-6) positive cells were detected and counted by immunohistochemical staining. Data were statistically analyzed with one-way analysis of variance, analysis of variance for factorial design, least significant difference-t test, Kruskal-Wallis H test, Mann-Whitney U test, and Bonferroni correction. Results: The microstructure of polyurethane foam dressing was loose and porous, with the pore diameter of (815±182) μm. The spinning spacing for the subsequent negative pressure material was set as 800 μm. The microstructures of PBS negative pressure material and PCL negative pressure material were regular, with vertically interconnected layers and continuous fibers in even thickness, but the fibers of PBS negative pressure material were straighter than those of PCL negative pressure material. There was no obvious difference in the microstructure of negative pressure materials prepared from the same raw material at different spinning rates. The fiber diameters of PCL negative pressure materials prepared at three spinning rates were similar (P>0.05). The fiber diameters of PBS negative pressure materials prepared at spinning rates of 25 mm/s and 35 mm/s were significantly smaller than the fiber diameter of PBS negative pressure material prepared at the spinning rate of 15 mm/s (with t values of 4.99 and 6.40, respectively, P<0.01). Both the tensile strength and tensile modulus of PCL negative pressure materials prepared at three spinning rates were similar (P>0.05). The tensile strength of PBS negative pressure materials prepared at spinning rates of 15 mm/s and 25 mm/s was significantly lower than that of PBS negative pressure materials prepared at the spinning rate of 35 mm/s (with t values of 9.20 and 8.92, respectively, P<0.01), and the tensile modulus was significantly lower than that of PBS negative pressure materials prepared at the spinning rate of 35 mm/s (with t values of 2.58 and 2.47, respectively, P<0.05). Subsequently, PCL negative pressure material was prepared at the spinning rate of 35 mm/s, and PBS negative pressure material was prepared at the spinning rate of 15 mm/s. After 1, 4, and 7 day (s) of co-culture, the number of human skin Fbs that adhered to PCL negative pressure material and PBS negative pressure material increased with time, and there was no significant difference between the two materials. After 1 and 7 day (s) of co-culture, the proliferation levels of human skin Fbs between the two negative pressure materials were similar (P>0.05). After being co-cultured for 4 days, the proliferation level of human skin Fbs in PBS negative pressure material was significantly higher than that in PCL negative pressure material (t=6.37, P<0.01). After 7 days of NPT, the materials were clearly identifiable and a small amount of collagen fibers were also observed in the wound specimens of rats in the three groups; a small amount of granulation tissue was observed in the wound specimens of rats in polyurethane alone group. After 14 days of NPT, a large number of granulation tissue and collagen fibers were observed in the wound specimens of rats in the three groups; the materials and wound tissue in the wound specimens of rats in PCL+polyurethane group could not be clearly distinguished. After 7 and 14 days of NPT, the collagen fibers in the wound specimens of rats in polyurethane alone group were denser than those in the other two groups. After 7 days of NPT, the number of CD34 positive cells in the wound specimens of rats in PBS+polyurethane group was 14.8±3.6 per 400 times visual field, which was significantly less than 27.8±9.1 in polyurethane alone group (t=3.06, P<0.05); the number of IL-6 positive cells was 60 (49, 72), which was significantly more than 44 (38, 50) in polyurethane alone group (Z=2.41, P<0.05). After 14 days of NPT, the number of IL-6 positive cells in the wound specimens of rats in PBS+polyurethane group was 19 (12, 28) per 400 times visual field, which was significantly more than 3 (1, 10) in PCL+polyurethane group and 9 (2, 13) in polyurethane alone group (with Z values of 2.61 and 2.40, respectively, P<0.05). Conclusions: The prepared PCL negative pressure material and PBS negative pressure material have good biocompatibility, and can successfully construct the new matrix of full-thickness skin defect wounds in rats. PCL negative pressure material is better than PBS negative pressure material in general.


Subject(s)
Animals , Collagen , Feasibility Studies , Humans , Interleukin-6 , Polyurethanes , Rats , Rats, Sprague-Dawley , Skin Abnormalities , Soft Tissue Injuries , Wound Healing
6.
Article in Chinese | WPRIM | ID: wpr-940642

ABSTRACT

Autophagy and tumor immune escape are important biological mechanisms in the process of tumor cell proliferation and metastasis, involving multiple signaling pathways. The interaction of autophagy and tumor immune escape seriously affects the treatment and prognosis of tumor diseases. However, the correlation between autophagy and tumor immune escape is still not fully elucidated. Recent studies have shown that autophagy can affect the activity of immune cells by regulating the presentation of antigens in tumor cells, the release of cytokines, and the degradation of immune checkpoint proteins, thereby positively or negatively regulating tumor cell immune escape. The activation of autophagy in tumor cells can inhibit the activation of the innate immune sensing pathway of stimulator of interferon genes (STING)-type Ⅰ interferon (IFN-Ⅰ) to inhibit its immunogenicity and cytotoxic T lymphocytes (CTLs), which promotes tumor immune escape. While autophagy suppression can reduce the infiltration of M2 macrophages, promote the binding of natural killer group 2, member D (NKG2D) to its ligand, and inhibit the recognition of immune checkpoint proteins, thereby exerting an immune-killing effect and inhibiting tumor immune escape. Traditional Chinese medicine (TCM) has unique advantages in anti-tumor research, especially in the unilateral regulation of autophagy or improvement of tumor immunity, but the research based on the regulation of autophagy and tumor immunity by TCM is insufficient. A few studies have shown that Chinese medicine monomers and compounds can exert an anti-tumor effect by regulating cell autophagy and interfering with tumor immune escape, but there is still a lack of systematic elaboration. The present study reviewed correlation between autophagy and tumor immune escape and regulation of autophagy by Chinese medicine to interfere with tumor immune escape to provide new ideas for research on mechanism of TCM against tumor diseases and development of innovative TCM drugs against tumors.

7.
Article in English | WPRIM | ID: wpr-928474

ABSTRACT

Chronic wounds have always been a tough fight in clinical practice, which can not only make patients suffer from pain physically and mentally but also impose a heavy burden on the society. More than one factor is relevant to each step of the development of chronic wounds. Along with the in-depth research, we have realized that figuring out the pathophysiological mechanism of chronic wounds is the foundation of treatment, while wound infection is the key point concerned. The cause of infection should be identified and prevented promptly once diagnosed. This paper mainly describes the mechanism, diagnosis and therapeutic strategies of chronic wound infection, and will put an emphasis on the principle of debridement.


Subject(s)
Chronic Disease , Debridement , Humans , Wound Infection/therapy
8.
Chinese Journal of Biotechnology ; (12): 1183-1196, 2022.
Article in Chinese | WPRIM | ID: wpr-927773

ABSTRACT

Mesenchymal stem cells (MSCs) have broad application potentials in regenerative medicine and translational medicine. Obtaining large quantities of primary-cultured MSCs and select the most suitable cell origin for targeted diseases are critical to research. To select the most suitable seed cells of MSCs from different origins for clinical treatment and research, biological characteristics of MSCs from human umbilical cord and placenta were compared. These include cell morphology, surface marker expression, differentiation and karyotype. Transcriptome sequencing of four MSCs from fetus were performed and the results were analyzed from the perspective of proliferation and cytokine secretion. The results revealed that MSCs from umbilical cord (UC), amniotic membrane (AM), chorionic membrane (CM), chorionic villi (CV) and deciduae (DC) met the minimum standards of the International Society of Cell Therapy (ISCT) in 2006 and had the general characteristics of stem cells. Karyotype analysis showed that MSCs derived from UC, AM, CM and CV were all from fetus except that the DC-MSCs were from mother. Transcriptome sequencing analysis showed that hMSCs from umbilical cord and placenta had similar gene expression patterns, while different expression patterns were observed in specific genes involved in cell cycle, cell division, cell death, cell growth and development. These genes play important roles in transcriptional regulation, DNA repair, DNA replication and chromosome stability, which were momentous components of cellular or subcellular fraction movement, cell communication, cell tissue protrusions, cytokine secretion and hormone metabolism. Transcriptome sequencing analysis explained the differences in biological characteristics among MSCs from different sources, while verification experiments based on the transcriptome sequencing results showed that the proliferation and cytokine secretion capabilities of MSCs from different sources were significantly different. In all, UC-MSCs and CV-MSCs with stronger proliferation and higher levels of paracrine factors secretion may show their respective advantages in treating diseases.


Subject(s)
Cell Differentiation , Female , Fetus , Humans , Mesenchymal Stem Cells , Placenta , Pregnancy , Umbilical Cord
9.
Chinese Critical Care Medicine ; (12): 967-972, 2021.
Article in Chinese | WPRIM | ID: wpr-909436

ABSTRACT

Objective:To establish a nomogram model for predicting the risk of coronary artery disease in elderly patients with acute myocardial infarction (AMI).Methods:The clinical data of elderly patients with AMI who underwent coronary angiography in the department of cardiology of Cangzhou Central Hospital from July 2015 to March 2020 were analyzed, including age, gender, smoking history, underlying diseases, family history, blood pressure, left ventricular ejection fraction (LVEF), and several biochemical indicators at admission, such as total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), lipoprotein [Lp(a)], apolipoproteins (ApoA, ApoB), ApoA/B ratio, total bilirubin (TBil), direct bilirubin (DBil), indirect bilirubin (IBil), fasting blood glucose (FBG) and uric acid (UA). Patients were divided into model group (2 484 cases) and validation group (683 cases) according to the ratio of 8∶2. According to Gensini score, the model group and validation group were divided into mild lesion group (0-20 points) and severe lesion group (≥81 points). The differences of each index between different coronary lesion degree groups were compared. Lasso regression and Logistic regression were used to analyze the risk factors of aggravating coronary lesion risk in elderly patients with AMI, and then the nomogram prediction model was established for evaluation and external validation.Results:① In the model group, there were significant differences in the family history of coronary heart disease, FBG and HDL-C between the mild lesion group (411 cases) and the severe lesion group (417 cases) [family history of coronary heart disease: 3.6% vs. 7.7%, FBG (mmol/L): 5.88±1.74 vs. 6.43±2.06, HDL-C (mmol/L): 1.48±0.69 vs. 1.28±0.28, all P < 0.05]. In the validation group, there were significant differences between the mild lesion group (153 cases) and the severe lesion group [132 cases; FBG (mmol/L): 5.58±0.88 vs. 6.85±0.79, HDL-C (mmol/L): 1.59±0.32 vs. 1.16±0.21, both P < 0.05]. ② Lasso regression analysis showed that family history of coronary heart disease, FBG, and HDL-C were risk factors of coronary artery disease in elderly patients with AMI, with coefficients 0.118, 0.767, and -0.558, respectively. Logistic regression analysis showed that FBG [odds ratio ( OR) = 1.479, 95% confidence interval (95% CI) was 1.051-2.082, P = 0.025] and HDL-C ( OR = 0.386, 95% CI was 0.270-0.553, P < 0.001] were independent risk factors of coronary artery disease in elderly patients with AMI. ③ According to the rank score of FBG and HDL-C, the nomogram prediction risk model of aggravating coronary artery disease degree was established for each patient. It was concluded that the risk of coronary artery disease in elderly people with higher FBG level and (or) lower HDL-C level was significantly increased. ④ The nomogram model constructed with the model group data predicted the risk concordance index (C-index) was 0.689, and the C-index of the external validation group was 0.709. Conclusions:FBG and HDL-C are independent risk factors for aggravating coronary artery disease in elderly patients with AMI. The nomogram model of aggravating coronary artery disease in elderly patients with AMI has good predictive ability, which can provide more intuitive research methods and clinical value for preventing the aggravation of coronary artery disease in elderly patients.

10.
Article in English | WPRIM | ID: wpr-878338

ABSTRACT

Objective@#Exposure to microgravity results in postflight cardiovascular deconditioning in astronauts. Vascular oxidative stress injury and mitochondrial dysfunction have been reported during this process. To elucidate the mechanism for this condition, we investigated whether mitochondrial oxidative stress regulates calcium homeostasis and vasoconstriction in hindlimb unweighted (HU) rat cerebral arteries.@*Methods@#Three-week HU was used to simulate microgravity in rats. The contractile responses to vasoconstrictors, mitochondrial fission/fusion, Ca @*Results@#An increase of cytoplasmic Ca @*Conclusion@#The present results suggest that mitochondrial oxidative stress enhances cerebral vasoconstriction by regulating calcium homeostasis during simulated microgravity.


Subject(s)
Animals , Calcium/metabolism , Cerebral Arteries , Homeostasis , Male , Mitochondria/physiology , Myocytes, Smooth Muscle/physiology , Oxidative Stress , Rats , Rats, Sprague-Dawley , Vasoconstriction/physiology , Weightlessness Simulation
11.
Article in Chinese | WPRIM | ID: wpr-880115

ABSTRACT

OBJECTIVE@#To investigate the factors affecting the chronicity of childhood primary immune thrombo-cytopenia (ITP) and compare the efficiency of different first-line treatment regimens.@*METHODS@#Children with ITP hospitalized in our hospital from September 2013 to October 2018 were retrospectively analyzed.@*RESULTS@#Three hundred and one children (150 males and 151 females) were included in this study, with a median age of 8 (0.17-17) years old, and 110 (36.5%), 92 (30.6%), and 99 (32.9%) cases were grouped into newly diagnosed, persistent, and chronic ITP, respectively. The median of follow-up was 41.92 (1.07-74.03) months. At the end of the follow-up (October 2019), among the 202 newly diagnosed/persistent ITP children, 79 cases (59 newly diagnosed and 20 persistent ITP) achieved remission within 1 year after initial diagnosis, with a remission rate of 39.3%; 122 cases (50 newly diagnosed and 72 persistent ITP) developed chronic disease, with a chronicity rate of 60.7%; one case underwent splenectomy. In 99 cases with chronic ITP, 5 cases underwent splenectomy. Multivariable logistic regression analysis showed that, the insidious onset of symptoms (OR=3.754, 95%CI: 1.882-7.488, P=0.000) increased the risk of chronicity, while the positive antibody to anti-platelet membrane glycoprotein (OR=0.446, 95%CI: 0.224-0.888, P=0.021) might reduce the risk of chronicity. And no difference was found by the analysis of subtype of anti-platelet membrane glycoprotein (P=0.305). The efficacy of the first-line treatment of intravenous immunoglobulin (IVIG) alone or combined with steroid was better than that of steroid alone (P=0.028, 0.028), however, the efficiency was not significantly different between IVIG alone and combined with steroid (P=0.086).@*CONCLUSION@#Insidious onset of symptoms in pediatric ITP increases the risk of chronicity, while the positive titer of anti-platelet membrane glycoprotein may reduce the risk. In the first-line treatment for the newly diagnosed/persistent children. The efficacy of IVIG alone or combined with steroid is better than that of steroid alone.


Subject(s)
Adolescent , Child , Child, Hospitalized , Female , Humans , Immunoglobulins, Intravenous , Male , Purpura, Thrombocytopenic, Idiopathic , Retrospective Studies , Splenectomy
12.
Article in Chinese | WPRIM | ID: wpr-880082

ABSTRACT

OBJECTIVE@#To investigate the effect of Bmi-1 expression on the chemosensitivity of THP-1 cells and its relative mechanism.@*METHODS@#The pGenesil-2-Bmi-1 1 siRNA, p-MSCV-Bmi-1 plasmid was transfected into THP-1 cells to reduce or increase the expression of Bmi-1. The expression of Bmi-1 mRNA and protein was verified by PCR and Western blot. The effect of camptothecin (CPT) on the proliferation and chemosensitivity of THP-1 cells affected by Bmi-1 gene were detected by MTT assay. The expression of DNA double-strand breaks marker-γ-H2AX was detected by immunofluorescence assay. Mitochondrial membrane potential and apoptosis were observed by flow cytometry. The expression of Cytochrome C, Caspase 3, Bax and BCL-2 was detected by Western blot.@*RESULTS@#Silencing Bmi-1 could inhibit proliferation and enhance the sensitivity of THP-1 cells to CPT, while overexpressed Bmi-1 could promote the cell proliferation and attenucate sensitivity of THP-1 cells to CPT. Silencing Bmi-1 could enhance CPT-induced DNA double-strand breaks, decrease mitochondrial membrane potential and promote CPT-induced apoptosis. While increasing Bmi-1 gene expression could attenuate CPT-induced DNA double-strand breaks, enhamce mitochondrial membrane potential and significantly reduce CPT-induced apoptosis of cells.@*CONCLUSION@#Bmi-1 expression could influence the sensitivity of THP-1 cells to CPT, and its relative mechanism may relate to DNA double-strand breaks and endogenous apoptotic pathways.


Subject(s)
Apoptosis , Camptothecin/pharmacology , Cell Line, Tumor , Cell Proliferation , THP-1 Cells
13.
Article in Chinese | WPRIM | ID: wpr-879560

ABSTRACT

OBJECTIVE@#To explore the clinical characteristics and genetic basis for a pair of twins affected with hyaline fibromatosis syndrome (HFS).@*METHODS@#Clinical data of the twins were retrospectively analyzed. High-throughput sequencing was carried out to detect potential pathogenic variants. CLUSTALX was employed to analyze cross-species conservation of the mutant amino acids. Impact of the mutations was predicted by using software including PolyPhen-2 and Mutation taster.@*RESULTS@#The pair of twins have featured growth and intelligence retardation, and were found to carry compound heterozygous variants of the ANTXR2 gene including c.1214G>A and c.1074delT, among which c.1214G>A was unreported previously. Both variants were predicted to be pathogenic. In addition to growth and mental delay, the pair of twins also featured hyperplasia of the gum and soft tissue-like masses of the auricle. The younger brother had rupture of the auricle mass during follow-up.@*CONCLUSION@#The patients' condition can probably be attributed to the compound heterozygous variants of the ANTXR2 gene. Above finding has facilitated molecular diagnosis of the patients.


Subject(s)
Asians/genetics , China , Humans , Hyalinosis, Systemic/genetics , Male , Mutation , Pedigree , Receptors, Peptide/genetics , Retrospective Studies
14.
Journal of Medical Biomechanics ; (6): E877-E882, 2021.
Article in Chinese | WPRIM | ID: wpr-920697

ABSTRACT

Objective To study urodynamic changes of urine at different degrees of hydronephrosis based on computational fluid dynamics (CFD) method, so as evaluate the influence of hydronephrosis degree on kidneys’ ability to discharge stones. Methods Twelve models, including the branched pelvis Model A (normal hydronephrosis A1, mild hydronephrosis A2, medium hydronephrosis A3, severe hydronephrosis A4 models), mature ampullary pelvis Model B (normal hydronephrosis B1, mild hydronephrosis B2, medium hydronephrosis B3, severe hydronephrosis B4 models), and embryo pot abdominal pelvis Model C (normal hydronephrosis C1, mild hydronephrosis C2, medium hydronephrosis C3, severe hydronephrosis C4 models) were established. The urine flow velocity and velocity vector at the neck of the kidney, the outlet of the renal pelvis were calculated by CFD method. Results As the degree of hydronephrosis increased, the flow velocity of urine at the neck of the kidney and the outlet of the renal pelvis decreased. The urinary shearing force of the stones and the kidney’s ability to discharge stones gradually decreased, whereas the circulatory stagnation zone and the velocity boundary layer in kidney aggregate system gradually increased. Conclusions Hydronephrosis can cause changes in urodynamics of the urine. Therefore, the effect of hydronephrosis with different degrees on the patient’s ability to discharge stones after surgery should be fully considered, so as to choose an appropriate treatment method for kidney stones in clinic.

15.
Article in Chinese | WPRIM | ID: wpr-942897

ABSTRACT

Straight coloanal anastomosis (SCA), colonic J-pouch anastomosis (CJP), transverse coloplasty pouch anastomosis (TCP), and side-to-end anastomosis (SEA) are the most commonly used procedures of bowel reconstructions in the low anterior resections (LAR) of rectal cancer. Different bowel reconstruction procedures greatly affect postoperative bowel function, urinary function and sexual function. SCA is the most traditional procedure. CJP has been studied extensively and well-developed reconstruction method; however, recent studies have shown that CJP has the highest morbidity of complications, so the clinical application of CJP is limited. SEA is not inferior to CJP and SCA in the short-term and long-term defecation function, urination function, and sexual function, with reliable operational safety, so it is expected to become an alternative to SCA and CJP. The research on TCP is lacking, but there are some related clinical trials currently underway, and the results are worth expecting. The improvement and innovation of bowel reconstructions provide a bright prospect for better functional prognosis in patients with rectal cancer.


Subject(s)
Anal Canal , Anastomosis, Surgical , Colon/surgery , Colonic Pouches , Digestive System Surgical Procedures , Humans , Proctectomy , Proctocolectomy, Restorative , Rectal Neoplasms/surgery , Treatment Outcome
16.
Article in Chinese | WPRIM | ID: wpr-942889

ABSTRACT

Objective: To understand the current status of diagnosis and treatment regarding the protection of defecation function in Chinese surgeons performing sphincter-preserving resections (SPR) for rectal cancer in order to discover the problems existing in the function protection during SPR and provide support and reference for the standardized clinical management of rectal cancer. Methods: A cross-sectional survey was performed. Colorectal surgeons who obtained the medical qualifications and volunteered to participate in this study were included, and respondents with incomplete information were excluded. From October 18 to 22, 2020, randomized sampling was conducted among Chinese colorectal surgeons from Chinese Association of Colorectal Surgeons, Chinese Colorectal Cancer Committee, Chinese Sexology Association Anal functional Surgery Committee and National Health Commission Capacity Building and Continuing Education Committee. The questionnaire included basic information of the respondents, assessment of defecation function before SPR, intraoperative details, postoperative follow-up, evaluation and intervention of patients with low anterior resection syndrome (LARS). Observation indicator: results of the questionnaire survey. Result: A total of 231 questionnaires were collected, and 230 were effective, with an effective rate of 99.6%. Among these participants, 217 (94.3%) were males; 107 (46.5%) had medical doctor degrees; 129 (56.1%) were national commission members in colorectal surgery; 137 (59.6%) performed more than 50 SPR operations per year; 211 (91.7%) assessed defection function by auxiliary examinations before SPR. Rigid sigmoidoscopy (n=116, 55.0%) and anorectal manometer (n=81, 38.4%) were the most commonly used method. Among the 230 respondents, 64.8% (n=149) of surgeons used 2D laparoscopy for SPR surgery most commonly, and 51.3% (n=118) of surgeons performed direct colorectal anastomosis for reconstruction, and 98.3% (n=226) used staplers during anastomosis. All the surgeons indicated that they would follow up patients after SPR, and outpatient clinic was the most common method (84.4%, 184/230). When LARS occurred, 50.0% (115/230) of surgeons chose defecation function scale and 78.7% (181/230) actively provided guidance and intervention for patients. Conclusions: Chinese colorectal surgeons still have shortcomings in the protection of defecation function during SPR for rectal cancer. They do not make enough preoperative functional evaluation and postoperative functional recovery estimate for patients. The knowledge and use of defecation function scales and interventions on LARS are expected to be standardized.


Subject(s)
Anal Canal/surgery , China , Cross-Sectional Studies , Defecation , Humans , Male , Postoperative Complications/prevention & control , Rectal Neoplasms/surgery , Surgeons , Surveys and Questionnaires , Syndrome
17.
Article in Chinese | WPRIM | ID: wpr-870581

ABSTRACT

Objective:To explore the efficacy and safety of low-dose valganciclovir for preventing CMV infection after renal transplantation.Methods:Patients undergoing the first renal transplantation from January 2015 to January 2017 were selected. Recipients were divided into two groups according to anti-CMV prophylactic strategy. Recipients in test group (valganciclovir group, n=85) received oral valganciclovir 450 mg once daily and those in control group (ganciclovir group, n=81) had oral ganciclovir 1g thrice daily. Both drugs were prescribed within 10 days after transplantation and maintained for 3 months. Dose adjustments were based upon renal function. All recipients were followed up for 12 months posttransplantation. CMV-DNA, renal function, blood routine and liver function were regularly monitored. The incidence of CMV infection/disease, the median time to CMV infection onset, the incidence of opportunistic infections (OI) and acute rejection, graft or recipient survival and drug safety were evaluated.Results:A total of 166 renal recipients were admitted. Fewer recipients in test group (12, 14.1 %) than in control group (26, 32.1 %) had CMV infection ( P=0.006). The median time to CMV infection onset was longer in test group than in control group: 140.5 days (interquartile range [IQR]: 77.3-198.5 days) versus 47.5 days (IQR: 36.8-67.8 days) respectively ( P=0.014). The CMV disease rate was lower in test group ( P=0.080). The incidence of OI decreased significantly in test group (10.6 % vs 21.0 %, P=0.037). No patients in test group suffered allograft loss while 6 recipients (7.4 %) in control group ( P=0.032). Other adverse and side effects of both regimens were comparable. Conclusions:Low-dose valganciclovir regimen is both safe and efficacious in preventing CMV infection among kidney transplant recipients during the first year posttransplantation.

18.
Article in Chinese | WPRIM | ID: wpr-867905

ABSTRACT

Objective:To compare clinical outcomes of arthroscopic double-row anchor suture bridge fixation versus open reduction and internal plating in the treatment of simple humeral fracture of the greater tuberosity.Methods:From March 2013 to March 2017 at Department of Orthopaedics, Jianhu Hospital Affiliated to Nantong University, 40 patients were treated for simple humeral fracture of the greater tuberosity. They were 23 men and 17 women, aged from 25 to 70 years (mean, 53.2 years). All the fracture displacements were larger than 5 mm and the fracture blocks smaller than 3 cm × 3 cm. They were complicated with no other injuries like rotator cuff tear, superior labrum anterior posterior (SLAP) injury or Bankart injury. Of them, 18 were treated by arthroscopic double-row anchor suture bridge fixation and 22 by open reduction and internal plating. The 2 groups were compared postoperatively in terms of joint activity, visual analogue scale (VAS) pain score, American Shoulder and Elbow Surgeon (ASES) score at the last follow-up.Results:There were no significant differences in the preoperative general data between the 2 groups ( P>0.05), indicating they were comparable. The arthroscopy and open reduction groups were followed up for an average of 19 and 20 months, respectively. All the patients obtained bony union within 3 months after surgery. At the last follow-up for the arthroscopy and open reduction groups, respectively, the shoulder flexion was 152.7°±13.3° and 137.7°±19.2°, the abduction 146.0°±16.4° and 132.4°±20.5°, the VAS score 0.8±0.4 and 1.3±0.6 and the ASES score 91.8±4.1 and 87.4±5.8, showing significant differences in the above items between the 2 groups ( P<0.05). In the open reduction group, 2 patients developed subacromial impingement syndrome which was relieved after removal of the plate following fracture union. Shoulder stiffness was observed in one case but improved after manipulative release under anesthesia. Conclusion:In the treatment of simple humeral fracture of the greater tuberosity, arthroscopic double-row anchor suture fixation has advantages over open reduction and internal plating because it can lead to less invasion, quicker recovery and better functional recovery of the shoulder after operation.

19.
Article in Chinese | WPRIM | ID: wpr-866459

ABSTRACT

Objective:To compare the efficacy and safety between biphasic insulin aspart 30 injection and insulin glargine combined with repaglinide in the newly diagnosed type 2 diabetes in the elderly patients.Methods:A total of 60 elderly patients with type 2 diabetes who were newly diagnosed in the First Hospital Affiliated to Hebei Medical University were selected as study objects, and they were divided into group A and group B according to the random digital table method, with 30 cases in each group.Group A was treated with aspart 30 injection, and group B was treated with glargine combined with repaglinide tablets for 2 weeks.The BMI, FPG, 2hPG, HbA1c, 1, 5-AG were detected after treatment for 1 and 2 weeks, and the FCP, PCP were detected before and after treatment.Results:The FPG and 2hPG of the two groups decreased significantly after treatment for 1 week and 2 weeks, and the blood glucose of group A decreased significantly after 1 week of treatment compared with group B, and the difference was statistically significant(FPG t=2.58, 2hPG t=2.46, all P<0.05).1, 5-AG increased significantly at 1 week and 2 weeks after treatment.At 1 weekafter treatment, the increase was more significant in group A than group B, and the difference was statistically significant( t=8.93, P<0.05). After 2 weeks of treatment, the levels of FCP and 2hCP of both two groups were increased compared with before treatment, and the differences were statistically significant(FCP t=3.72, 3.45, 2hCP t=4.14, 3.54, all P<0.05). The time of blood glucose reaching the standard in group A was(10.35±4.10)d, which was shorter than that in group B [(12.38±4.22)d], and the difference was statistically significant( t=8.32, P<0.05). The dosage of insulin required by the patients in group A was(45.14±8.42) U·kg -1·d -1, which was higher than that in group B [(24.88±7.36)U·kg -1·d -1], and the difference was statistically significant( t=9.06, P<0.01). Conclusion:Both BIAsp30 and IG combined with repaglinide can effectively reduce FPG and 2hPG of patients with type 2 diabetes newly diagnosed in the elderly.Besides, the occurrence of hypoglycemia in the glargine group is lighter than that in the BIAsp30 group, and the time of blood glucose reaching the standard is longer than that in the aspart 30 injection group.Monitoring 1, 5-AG can be used as a reference for timely adjustment of hypoglycemia programs.

20.
Article in Chinese | WPRIM | ID: wpr-865521

ABSTRACT

Objective:To explore the effect of improved urethral irrigation on urethral stricture in patients with closed bulbar urethral injury.Methods:The clinical data of 65 male patients with closed bulbar urethral injury complicated with difficult catheterization from January 2014 to January 2018 in the First Hospital of Shanxi Medical University were retrospectively analyzed. Among them, 30 cases were treated with flexible cystoscope-guided catheterization and external urethral orifice nursing (routine group), and 35 cases were treated with flexible cystoscope-guided catheterization and urethral drug flushing (improved group). The incidence of urethral stricture 1 and 6 months after catheter removal, number of urethral dilatation and maximum urinary flow rate 6 months after catheter removal, visual analogue score (VAS) during indwelling catheter were compared between 2 groups.Results:Both groups indwelled the catheters successfully. During indwelling catheter, the inflammatory secretion in improved group was less and thinner than that in routine group. There was no significant difference in the incidence of urethral stricture 1 month after catheter removal and VAS during indwelling catheter between 2 groups ( P>0.05); the incidence of urethral stricture and number of urethral dilatation 6 months after catheter removal in improved group were significantly lower than those in routine group: 5.7% (2/35) vs. 26.7% (8/30) and (7.1±1.0) times vs. (11.4±1.8) times, the maximum urinary flow rate 6 months after catheter removal was significantly higher than that in routine group: (19.8 ± 2.9) ml/s vs. (16.3±2.3) ml/s, and there were statistical differences ( P<0.05 or <0.01). Conclusions:The system of improved urethral irrigation can be easily fabricated and can achieve convenient application. This improved treatment can facilitate the discharge of urethral secretions, alleviate the urethral inflammation, reduce the urethral scar formation, and can prevent the incidence of bulbar urethral stricture effectively.

SELECTION OF CITATIONS
SEARCH DETAIL