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1.
Braz. j. otorhinolaryngol. (Impr.) ; 87(4): 402-409, July-Aug. 2021. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1285714

ABSTRACT

Abstract Introduction Ultrasound sonography provides a quick method for determining which nodule to sample for fine needle aspiration biopsy in thyroid nodules. On the other hand, the computed tomography examination is not restricted by echo attenuation and distinguishes between benign and malignant nodules. Objective To compare computed tomography examinations against ultrasound/fine needle aspiration biopsy in the differential diagnosis of thyroid nodules. Methods Data regarding computed tomography examinations, sonographic finding following fine needle aspiration biopsy, and tumor histology of 953 nodules from 698 patients who underwent thyroidectomy were collected and analyzed. The beneficial score for detection of the malignant tumor for each adopted modality was evaluated. Results Ultrasound images did not show a well-circumscribed solid mass in 89 nodules, and ultimately did not detect nodules in fine needle aspiration biopsies (false positive non-malignant nodules). Ultrasound images showed parenchymatous disease (false positive malignant nodules) in several nodules. Computed tomography examinations demonstrated higher difficulty in detection of malignant nodules of 1.0-2.0 cm size than ultrasound examination following fine needle aspiration biopsies; compared to tumor histological data, computed tomography examinations had a sensitivity of 0.879. Conclusion Computed tomography examinations are a more reliable method for differential diagnosis of thyroid nodules than ultrasound examinations followed by fine needle aspiration biopsy. Level of Evidence III.


Resumo Introdução A ultrassonografia é um método rápido para determinar de qual nódulo se deve coletar uma amostra para biópsia por aspiração com agulha fina. Por outro lado, o exame de tomografia computadorizada não é restringido pela atenuação do eco e distingue entre nódulos benignos e malignos. Objetivo Comparar exames tomográficos versus biópsia por ultrassonografia/aspiração por agulha fina no diagnóstico diferencial de nódulos tireoidianos. Método Dados sobre exames tomográficos, achados ultrassonográficos após biópsia por aspiração com agulha fina e histologia tumoral de 953 nódulos de 698 pacientes submetidos à tireoidectomia foram coletados e analisados. O escore de benefício para detecção do tumor maligno para cada modalidade adotada foi avaliado. Resultados As imagens de ultrassom não mostraram uma lesão sólida bem circunscrita em 89 nódulos; e na análise final não foram detectados nódulos nas biópsias por aspiração com agulha fina (nódulos não malignos falsos positivos). As imagens ultrassonográficas mostraram doença parenquimatosa (nódulos malignos falsos positivos) em vários nódulos. Os exames de tomografia computadorizada apresentaram grandes dificuldades na detecção de nódulos malignos de 1,0-2,0 cm de tamanho em comparação com o exame de ultrassonografia após biópsias por aspiração com agulha fina; comparados aos dados histológicos do tumor, os exames de tomografia computadorizada apresentaram sensibilidade de 0,879. Conclusão Os exames de tomografia computadorizada são um método mais confiável para o diagnóstico diferencial de nódulos tireoidianos do que os exames de ultrassonografia, seguidos por biópsia por aspiração com agulha fina.

2.
Article in Chinese | WPRIM | ID: wpr-879565

ABSTRACT

OBJECTIVE@#To report on the clinical features and result of genetic testing for a child featuring immune dysregulation, polyendocrinopathy, enteropathy, X-linked (IPEX) syndrome.@*METHODS@#Clinical records, genetic testing, laboratory investigation and treatment of the child were summarized in addition with a comprehensive review of the literature.@*RESULTS@#The 3-year-old boy was administered due to intractable diarrhea, recurrent infections, liver dysfunction and failure to thrive, though no diabetes or skin disorder was observed. Laboratory testing showed elevated liver enzymes and total IgE, decreased albumin and electrolyte imbalance. Gastrointestinal endoscopy revealed erosion and granules in the duodenum, and edema in the terminal ileum and colon. Biopsies showed villous atrophy in the duodenum and terminal ileum. Genetic testing revealed that the patient has carried a missense c.1087A>G (p.I363V) variant in the exon 10 of the FOXP3 gene. He was treated with enteral and parenteral nutrition, anti infection and Sirolimus, and was waiting for hemopoietic stem cell transplantation.@*CONCLUSION@#Although IPEX syndrome usually occur during infancy, it should not be ruled out solely based on the age, and its presentation can be variable. For male children with refractory diarrhea, autoimmune disorder and growth retardation, the diagnosis should be suspected and confirmed by genetic testing.


Subject(s)
Child, Preschool , Diabetes Mellitus, Type 1/genetics , Diarrhea/genetics , Forkhead Transcription Factors/genetics , Genetic Diseases, X-Linked/genetics , Genetic Testing , Humans , Immune System Diseases/genetics , Male , Mutation , Polyendocrinopathies, Autoimmune/genetics
3.
Chinese Journal of Urology ; (12): 830-833, 2021.
Article in Chinese | WPRIM | ID: wpr-911128

ABSTRACT

Objective:To evaluate the feasibility and clinical efficiency of robot-assisted laparoscopic radical prostatectomy (RARP) via extraperitoneal PORT-free single incision approach.Methods:The data of 33 patients with prostate cancer underwent the extraperitoneal PORT-free single incision RARP from November 2020 to January 2021 in Sichuan Provincial People's Hospital was retrospectively reviewed. The average age was 66.7 (58-78) years, the median PSA was 20.77 (2.89, 56.44) ng/m, and the mean Gleason score was 7.0 (6.0-9.0). The mean prostate volume was 48.4 (25.0-220.0) ml. Clinical stage: 32 cases was in cT 2a-2cN 0M 0, 1 case in cT 3aN 0M 0. 16 cases had a history of operation. All 33 operations were performed by the same operator. All operations were performed by extraperitoneal PORT-free single-incision approach. The surgical condition, postoperative complication, pathology, and follow-up results were observed. Results:In this study, 33 operations were successfully completed without conversion to open or additional single hole channel instruments. The average operation time was 61.3 (38.0-120.0) min, with the mean intraoperative bleeding volume of 72.2 (45.0-220.0) ml and the mean bladder neck urethral anastomosis time of 11.7 (8.5-15.7) min. The mean postoperative hospital stay was 7.9 (6.0-15.0) d, the mean postoperative indwelling time of urinary catheter was 6.8 (6.0-14.0) d, and the mean postoperative evacuation time was 1.0 (0.5-3.0) d. The average incision length was 5.2 (4.6-5.8) cm. There was no obvious complications. The postoperative pathological stage: 21 cases were in < pT 3a, 12 cases were in ≥ pT 3a, and 6 cases (18.8%) had positive resection margin. 29 cases (88.9%) acquired satisfactory urinary continence after operation, and the frequency of urinary pad use was ≤ 1 tablet/day. Conclusions:The extraperitoneal single-incision RARP surgical channel without PORT is safe and feasible with a satisfying cosmetic effect, which saves costs and requires less specific channel device. Simultaneously, the new approach has strong replicability, short-term tumor control and urinary control effect with rapid postoperative recovery. However, the sample size of this study is relatively small, which needs further research and demonstration

4.
Article in Chinese | WPRIM | ID: wpr-910037

ABSTRACT

Objective:To compare the short-term outcomes of femoral neck system (FNS) and dynamic hip screw (DHS) in the treatment of femoral neck fractures.Methods:A retrospective analysis was performed of the 105 patients with fresh femoral neck fracture who had been treated by FNS fixation from September 2019 to October 2020 or by DHS fixation from January 2018 to October 2020 at Department of Orthopaedics, The Third Hospital Affiliated to Peking University. In the FNS group of 54 cases, there were 18 males and 36 females with a mean age of (60.7±15.2) years; in the DHS group of 51 cases, there were 14 males and 37 females with a mean age of (63.3±13.2) years. The 2 groups were compared in terms of hospital stay, operation time, intraoperative blood loss, incision length, intraoperative fluoroscopy frequency, qualify of reduction, and femoral neck shortening length, Harris hip score and complications at the last follow-up.Results:The 2 groups were comparable due to insignificant differences in their preoperative general data or follow-up time ( P>0.05). In the FNS group, the median operation time [45.0 (40.0, 59.0) min], intraoperative blood loss [30.0 (20.0, 50.0) mL], incision length [4.0 (4.0, 5.0) cm], intraoperative fluoroscopy frequency [10.5 (9.0, 12.0) times] and hospital stay [2.0 (2.0, 4.0) d] were significantly superior to those in the DHS group [72.0 (55.0, 89.0) min, 50.0 (30.0, 50.0) mL, 7.0 (6.0, 8.0) cm, 18.0 (15.0, 19.0) times, and 3.0 (3.0, 6.0) d] (all P<0.05). There were no statistical differences between the 2 groups in quality of reduction, length of femoral neck shortening, failure rate of internal fixation or Harris hip score at the last follow-up ( P>0.05). There were no such surgical complications as deep infection or femoral head necrosis in either of the 2 groups. Conclusions:In the fixation of femoral neck fractures, both FNS and DHS may lead to fine short-term outcomes. However, compared with DHS, FNS exhibits advantages of simplicity, minimal invasion, less surgical trauma and intraoperative fluoroscopy frequency, and reduced operation time and hospital stay.

5.
Journal of Chinese Physician ; (12): 1538-1541, 2021.
Article in Chinese | WPRIM | ID: wpr-909741

ABSTRACT

Objective:To explore the relationship between residual amniotic fluid volume and perinatal outcomes in preterm premature rupture of membranes (PPROM).Methods:The clinical data of each 68 PPROM patients with normal amniotic fluid (group A), less amniotic fluid (group B) and oligohydramnios (group C) were retrospectively analyzed. The delivery modes, perinatal complications, survival of perinatal infants and Apgar score at 1 min and 5 min after birth of live-born neonates were compared among the three groups. Pearson correlation analysis was used to evaluate the correlation between Apgar score of surviving neonates and residual amniotic fluid.Results:There was no significant difference in the incidence of vaginal midwifery and placental abruption among the three groups ( P>0.05). There were significant differences in natural delivery rate, cesarean section rate, incidence of some perinatal complications (amniotic cavity infection, chorioamnionitis, amniotic fluid fecal staining) and perinatal survival rate among the three groups ( P<0.05); There was no significant difference in natural delivery rate and cesarean section rate between group B and group C ( P>0.05); The natural delivery rate in group A was significantly higher than that in group B and C ( P<0.05), and the cesarean section rate was lower than that in group B and C ( P<0.05); There was no significant difference in the incidence of perinatal complications and perinatal survival between group A and group B ( P>0.05); The above perinatal complications in group C were significantly higher than those in group A and group B ( P<0.05), and the perinatal survival rate was lower than that in group A and group B. Using amniotic fluid volume as the independent variable (normal=0, less=1, too little=2) and the above perinatal complications as the dependent variable, logistic regression analysis showed that there was no significant correlation between amniotic fluid volume and the above perinatal complications ( OR=1.029, 1.117, 1.004, 1.045, P>0.05). There were significant differences in Apgar scores at 1 min and 5 min after birth among the three groups ( P<0.05), and the change trend was group A>group B>group C ( P<0.05). Pearson correlation analysis showed that there was a significant positive correlation between Apgar score at 1 min and 5 min after birth and the residual amniotic fluid of pregnant mothers ( r=0.402, 0.371, P<0.05). Conclusions:Residual amniotic fluid volume in PPROM patients is closely related to the degree of neonatal hypoxia, and the reduction of residual amniotic fluid can also increase the cesarean section rate, and oligohydramnios can also affect maternal-infant outcomes, thus it is necessary to pay attention to clinical practice.

6.
Article in Chinese | WPRIM | ID: wpr-908836

ABSTRACT

Objective:To explore the effectiveness of blended learning in the clinical teaching of wound care clinic.Methods:Blended learning based on WeChat and offline CBL teaching method was constructed by applying evidence-based nursing. Totally 125 interns from the wound care clinic of our hospital were selected as subjects, among which 62 didn't receive the blended learning (control group), and 63 received the blended learning (observation group). At the end of the two-week practice, the effectiveness of the two teaching methods was compared. The objective evaluation was carried out in the forms of theory test, practice evaluation and comprehensive quality questionnaire combined with online self-test and offline practice. All data were analyzed by SPSS 20.0 statistical software.Results:The scores of theory test, practice evaluation and comprehensive quality assessment in the observation group were all higher than those in the control group ( P<0.001). Conclusion:The blended learning with WeChat as the medium can guide student active learning, consolidate the basic knowledge, improve the efficiency of teaching, stimulate the enthusiasm of practice, and improve the comprehensive quality. It's a clinical teaching method that can be used for reference.

7.
Article in Chinese | WPRIM | ID: wpr-908188

ABSTRACT

Objective:To determine the application effect of the "full chain" information-based health management model in the home care of children with bronchial asthma.Methods:Sixty children with bronchial asthma who were hospitalized in the Respiratory Department of Xuzhou Children's Hospital from January to June 2020 were selected and divided into a control group and an observation group according to a random number table with 30 cases in each group. The control group received routine nursing care, and the observation group implemented a "full-chain" informatized health management on the basis of the control group.The intervention time was 6 months. The condition control, medication compliance, self-management and airway function were observed and compared between the two groups.Results:After 6 months of intervention, the frequency of attacks, emergency cases, the medication compliance, the maximum expiratory flow rate, symptom days and peak expiratory flow days were 6.67%(2/30), 3.33%(1/30), 93.33%(28/30), (1.83±0.23) L, (163.00±6.74) d, (168.00±3.78) d in the observation group, and 26.67%(8/30), 20.00%(6/30), 66.67%(20/30), (1.67±0.24) L, (144.00±5.88) d, (157.00±4.08) d in the control group. The differences were statistically significant (χ 2 values were 4.320, 4.043, 6.667, t values were 2.636, 11.635, 10.833, P<0.05). There was no significant difference in the ratio of forced expiratory volume and forced expiratory volume in forced vital capacity in the first second after 6 months of intervention between the two groups ( P>0.05). Conclusions:"Full chain" information health management can reduce the number of attacks and emergency visits of children with asthma, effectively improve medication compliance, thus improving airway function and improving the quality of life of children.

8.
Article in Chinese | WPRIM | ID: wpr-907861

ABSTRACT

Objective:To investigate the clinical characteristics, endoscopic features and management of acquired tracheoesophageal fistula (TEF) by esophageal foreign bodies in children.Methods:The clinical data and follow-up data of 21 children with acquired TEF who were treated in Children′s Hospital Affiliated to Zhengzhou University from January 2008 to January 2019 were retrospectively analyzed.Results:A total of 21 cases with esophageal foreign bodies were button batteries, irregular iron sheets, game coins, jujube seed, animal bone sheets, and fish thorn.The statistical results suggested that the cases of button batteries were 7 cases (33.33%), 4 cases of jujube pit (19.05%), 3 cases of irregular iron (14.29%) and 3 cases of animal bone (14.29%), 2 cases of game coin (9.52%), 2 cases of fish thorn (9.52%). All foreign bodies were removed by endoscopy.Esophageal perforation with TEF was discovered in 17 cases (80.95%) during the operation.Esophageal perforation with TEF was found in 4 cases (19.05%) within 2 week after the operation, and no death occurred.A total of 13 case fistula size ≤5 mm (61.90%), 4 case fistula size>5 mm and ≤10 mm (19.05%) and 4 case fistula size >10 mm (19.05%). The treatment methods included gastrointestinal decompression and nasojejunal nutrition tube support in 10 cases (47.61%), gastrostomy and jejunostomy in 4 cases (19.05%), surgical repair in 4 cases (19.05%) and endoscopic titanium clip suture in 3 cases (14.29%). Five cases (23.81%) were healed in 3 months, 6 cases (28.57%) in 5 months, 4 cases (19.05%) in 8 months, and 2 cases (9.52%) in 12 months.Conclusions:Acquired TEF in children are mostly caused by special foreign bodies embedded in the esophagus, and endoscopic management is effective for fistulas with less trauma.Appropriate operation and intervention should be taken as early as possible.

9.
Article in Chinese | WPRIM | ID: wpr-906147

ABSTRACT

Objective:To investigate the regulatory mechanism of Bushen Zhuyun prescription(BSZYP) on endoplasmic reticulum stress (ERS) in rats with luteal phase defect (LPD) induced by mifepristone. Method:Fifty SD rats were randomly divided into a blank group, a model group, a positive control group (dydrogesterone,0.02 g·kg<sup>-1</sup>), and low-(0.08 g·kg<sup>-1</sup>)and high-dose (0.24 g·kg<sup>-1</sup>) BSZYP groups. Western blot and Real-time fluorescence-based quantitative polymerase chain reaction (Real-time PCR) were used to detect the mRNA and protein expression levels of immunoglobulin binding protein (BIP), protein kinase R-like endoplasmic reticulum kinase (PERK), inositol-requiring enzyme 1 (IRE-1), activating transcription factor 6 (ATF6), and C/EBP homologous protein (CHOP). The enzyme-linked immunosorbent assay (ELISA) was used to detect the serum progesterone (P) and estradiol (E<sub>2</sub>) levels. Result:Compared with the blank group, the model group showed the elevated protein expression of BIP, PERK, and CHOP (<italic>P</italic><0.01) and the dwindled mRNA expression of PERK and CHOP (<italic>P</italic><0.05), while no significant difference was observed in the protein expression of IRE-1 and ATF6, mRNA expression of IRE-1, BIP, and ATF6, and serum E<sub>2</sub> and P levels. Compared with the model group, the positive control group displayed diminished protein expression of CHOP (<italic>P</italic><0.01), while no significant difference was observed in the protein expression of PERK, IRE-1, BIP, and ATF6, mRNA expression of PERK, IRE-1, BIP, ATF6, and CHOP, and serum levels of E<sub>2</sub> and P. The protein expression of CHOP decreased (<italic>P</italic><0.01) and the mRNA expression of CHOP increased (<italic>P</italic><0.05) in the low-dose BSZYP group, while no significant difference was observed in the mRNA and protein expression of PERK, IRE-1, BIP, and ATF6, and serum E<sub>2</sub> and P levels. In the high-dose BSZYP group, the protein expression of PERK, BIP, and CHOP was down-regulated (<italic>P</italic><0.01), and the mRNA expression of CHOP was up-regulated (<italic>P</italic><0.01), while no significant difference was observed in the protein expression of IRE-1 and ATF6, mRNA expression of PERK, IRE-1, BIP, and ATF6, and serum E<sub>2</sub> and P levels. Conclusion:BSZYP can treat LPD by relieving ERS.

10.
Article in Chinese | WPRIM | ID: wpr-888079

ABSTRACT

The present study aimed to explore the effect of nuclear factor erythroid 2 related factor 2(Nrf2)/heme oxygenase-1(HO-1) signaling pathway in intestinal protection by Sishen Pills against ulcerative colitis(UC). After the UC model was induced by 3% dextran sodium sulfate(DSS), experimental animals were randomly divided into control group, model group, salazosulfapyridine(SASP) group, and low-and high-dose Sishen Pills groups. Drug intervention(ig) was performed for seven consecutive days during modeling. On the 7 th day, the mice were euthanized. The body weight and colon length were recorded, and the histopathological changes of the colon were observed by HE staining. Serum interleukin-6(IL-6), tumor necrosis factor-α(TNF-α), total antioxidant capacity(T-AOC), malondialdehyde(MDA), and reactive oxygen species(ROS) were detected by ELISA. The protein and mRNA expression of Nrf2, HO-1, and NADPH quinine oxidoreductase-1(NQO-1) was determined by Western blot and reverse transcription-polymerase chain reaction(RT-PCR). Compared with the normal group, the model group exhibited reduced body weight, colon length, and T-AOC, increased IL-6, TNF-α, MDA, and ROS, and diminished protein and mRNA expression of Nrf2, HO-1, and NQO-1 in the colon tissues. Compared with the model group, the SASP group and high-dose Sishen Pills group showed elevated body weight, colon length, and T-AOC, lowered IL-6, TNF-α, MDA, and ROS levels, and increased protein and mRNA expression of Nrf2, HO-1, and NQO-1 in the colon tissues. As assessed by HE staining, Sishen Pills could improve the pathological changes of the colon. The findings suggested that Sishen Pills could protect the colon against UC induced by 3% DSS. The specific mechanism of action may be related to the anti-inflammatory and anti-oxidative stress effects by the activation of the Nrf2/HO-1 signaling pathway.


Subject(s)
Animals , Colitis, Ulcerative/genetics , Dextran Sulfate , Heme Oxygenase-1/metabolism , Mice , NF-E2-Related Factor 2/metabolism , Signal Transduction
11.
Chinese Journal of School Health ; (12): 1336-1339, 2021.
Article in Chinese | WPRIM | ID: wpr-886903

ABSTRACT

Objective@#To study the compliance and associated factors of smartphone application (APP) usage in childhood dietary and exercise intervention.@*Methods@#Based on one childhood intervention of diet and exercise in Beijing, Changzhi of Shanxi Province and Urumqi of Xinjiang Province, 694 children (and their primary caregivers) in the intervention group were investigated regarding usage of APP during the intervention. Compliance of APP usage was evaluated by the click times of APP, and Logistic regression models were used to analyze influencing factors of the compliance.@*Results@#The median (inter quartile range) click times of APP in the four modules (information dissemination, behavior monitoring, homework uploading and feedback) were 10 (5,21), 20 (14,26), 7(4,10), 26 (15,53), respectively. Multivariable logistic regression analysis found that compliance of APP usage was higher among subjects in Changzhi region ( OR =1.67,95% CI =1.12-2.48), whose primary caregiver was mother ( OR =1.55,95% CI =1.09-2.22), or whose mother did not work ( OR =0.47, 95% CI =0.31-0.74).@*Conclusion@#Compliance of APP usage was generally high in the childhood intervention of diet and exercise. Some factors are associated with compliance of APP usage. Findings of the study provide a scientific basis for better implementation of APP based childhood interventions of diet and exercise in the future.

12.
Chinese Journal of Urology ; (12): 116-121, 2021.
Article in Chinese | WPRIM | ID: wpr-884969

ABSTRACT

Objective:To compare the clinical efficacy of transperitoneal robot assisted laparoscopic radical prostatectomy (RARP) versus extraperitoneal single port RARP.Methods:A retrospective analysis was perfoumed on 142 cases of RARP from July 2019 to June 2020 in Robotic Minimally Invasive Center of Sichuan Provincial People's Hospital, including 82 cases(Group A) , aged 70.0(65.6-78.0), undergoing transperitoneal RARP and 60 cases(Group B), aged 68.2 years old(60.1-79.2), undergoing extraperitoneal single port RARP. For group A, PSA was 12.9(5.6-64.0) ng/ml, with 26 cases of less than 10 ng/ml(31.7%), 40 cases of 10-20 ng/ml(48.8%), and 16 cases of more than 20 ng/ml(19.5%), the Gleason score was 7.2(6.0-10.0), with 14 cases(17.1%) of ≤6, 56 cases(68.3%) of 7, and 12 cases(14.6%) of ≥8, and the prostate volume was 61.3(29.0-112.0) ml. There were 49 cases with BMI≤25 kg/m 2, accounting for 59.8%, and 33 cases with BMI>25 kg/m 2, accounting for 40.2%. There were 17 cases(20.7%) of T 1, 44 cases(53.7%) of T 2 and 21 cases(25.6%) of T 3. The proportion of lymph node dissection was 17.1%, and 4 cases(4.9%)had a history of operation. For group B, the PSA was 12.2(1.0-42.6)ng/ml, with 20 cases (33.3%) of <10 ng/ml, 31 cases(51.7%)of 10-20 ng/ml, and 9 cases (15%) of >20 ng/ml. Gleason score was 7.1(6.0-9.0), with 12 cases (20.0%) of ≤6, 42 cases (70.0%) of 7, and 6 cases (10.0%)of ≥8. Prostate volume was 42.4(31.2-72.8)ml on average. There were 37 cases (61.7%) with BMI≤25 kg/m 2, and 23 cases (38.3%)with BMI >25 kg/m 2 . There were 17 cases(28.3%)of T 1, 32 cases(53.3%)of T 2 and 11 cases(18.3%)of T 3.The proportion of lymph node dissection was 11.7% and 4 cases (6.7%) had a history of operation.There was no statistically significant difference in term of age, PSA level, Gleason score, BMI, clinical stage, proportion of lymph node dissection or history of operation between the two groups( P>0.05), but there was statistically significant difference for prostate volume( P<0.05). All operations were performed by the same operator. Four different ways of bladder neck and urethral dissociation was selected according to the intraoperative conditions in Group A, include VIP style, T-shape incision style, VIP plus T-shape incision style or the style along the lateral side of the bladder neck. Small and single anterograde incision stripping of bladder neck was routinely performed in the Group B. Postoperative follow-up was performed to compare the operation time, intraoperative blood loss, bladder neck and urethral anastomosis time, postoperative hospital stay, postoperative exhaust time, postoperative complications, positive rate of surgical margin, indwelling time of urinary catheter, urinary continence satisfaction rate of immediately after operation, 3 months and 6 months after operation, wound healing and aesthetics. Results:All of the operations were successfully completed under robot-assisted laparoscopy, and there was no conversion to open surgery. The operation time was 56.0(45.0-112.0) min in the Group A and 65.4(55.5-96.8) min in the Group B, and there was no statistically significant difference( P>0.05). The intraoperative blood loss was 76.2(30.0-120.5) ml and 55.6(45.5-114.6) ml, respectively, and the difference was not statistically significant( P>0.05). The time of bladder neck urethral anastomosis was 18.9(12.6-25.6) min and 16.2(10.7-19.3) min, respectively, and the difference was not statistically significant( P>0.05). The postoperative hospital stay days were 9.3(8.0-16.0) d and 8.4(7.0-13.0) d, respectively, and the difference was not statistically significant( P>0.05). The postoperative exhaust time was 1.3(0.7-3.0) d and 3.4(2.0-7.0) d, respectively, and the difference was statistically significant( P<0.05). There was 1 case of anastomotic fistula with ureteral injury in Group A, and no serious complication in Group B, and the difference was not statistically significant( P>0.05). The number of positive surgical margin in the two groups was 13(15.9%)and 9(15.0%)respectively, and the difference was not statistically significant( P>0.05). The indwelling time of urinary catheter after operation was 9(7-21) d and 6(4-8) d, respectively, and the difference was statistically significant( P<0.05). The number of patients with satisfactory urinary continence immediately after surgery, 3 months and 6 months after surgery in the two groups were 8(9.8%), 51(62.2%), 62(75.6%) and 17(28.3%), 43(71.7%) and 54(90.0%), respectively. The differences were statistically significant( P<0.05). The total incision lengths in the two groups were 12.1(10.4-13.4) cm and 5.6(5.0-6.0) cm, respectively, and the difference was statistically significant( P<0.05). Conclusions:The extraperitoneal single port RARP is safe and feasible, and the postoperative effect is similar to that of transperitoneal RARP. It has the advantages of shorter recovery time, higher urinary continence satisfaction rate, neater and more beautiful incision. The long-term therapeutic effect needs further confirming by prospective study.

13.
Article in Chinese | WPRIM | ID: wpr-884222

ABSTRACT

Objective:To evaluate the curative effects of Masquelet technique and 3D printing in repair of Cierny-Mader type Ⅳ long bone osteomyelitis.Methods:A retrospective study was conducted of the 8 patients who had been treated at Department of Orthopaedics, The Third Affiliated Hospital to Peking University for Cierny-Mader type Ⅳ osteomyelitis of the lower extremity from June 2017 to December 2019. They were 6 males and 2 females, aged from 27 to 79 years (average, 54.6 years). The defects involved femoral shaft in 5 cases, femoral metaphysis in one, tibia shaft in one, and tibial metaphysis in one. The defect lengths ranged from 7.7 to 15.5 cm, averaging 10.2 cm. Stage one was local infection control and temporary stability reconstruction using Masquelet technique, stage two design and 3D printing of the prosthesis and stable pattern design, and stage three prosthesis implantation and rehabilitation. The ranges of motion of the knee and ankle were recoded postoperatively and the functions evaluated using the Johner-Wruhs scores.Results:The average follow-up time for the 8 patients was 12.6 months (from 6 to 18 months). The total treatment time from the first admission to the last discharge ranged from 62 to 125 days (average, 91.0 days), the time for stage one from 13 to 57 days (average, 28.7 days), that for stage two from 30 to 87 days(average, 48.3 d), and that for stage three from 28 to 84 days (average, 63.0 days). The infection was controlled and there was no recurrence, implant loosening or breakage. Seven patients were capable of full weight-bearing at 14.7 days (from 4 to 42 days) after surgery. One patient recovered full weight-bearing 6 months after surgery due to severe osteoporosis. Fine functional recovery was achieved in the 8 patients, with a range of motion from 0° to 100° for the knee and a range from 35° dorsal flexion to 40° toe flexion for the ankle. The Johner-Wruhs scores at the last follow-up showed 2 excellent, 5 good and one moderate cases.Conclusion:In repair of Cierny-Mader type Ⅳ long bone osteomyelitis, Masquelet technique and 3D printing can shorten the treatment process and allow for early recovery.

14.
Article in Chinese | WPRIM | ID: wpr-883205

ABSTRACT

Objective:To summarize and analyze the clinical characteristics of different treatment in children with esophageal foreign bodies.Methods:This study collected 246 children with esophageal foreign bodies in our hospital from January 2016 to January 2020, which was divided into endoscopic group and operative group.The general and clinical data of children treated with different treatment were collected and statistical analyzed.Results:There were 222 children in endoscopic group and 24 children in operative group, respectively.The rate of surgery was 9.75%.There were no significant differences in gender and location of esophageal foreign bodies.However, the average age of operative group was(2.92±2.67) years, which significantly younger than that in endoscopic group(4.12±3.37)years( P=0.049). The residence time in operative group(median 29.10 h)was remarkable longer than that in operative group(median 11.80 h)( P<0.001). The proportion of sharpness(50.00%) and corrosive(45.83%) foreign bodies in operative group were more than those in endoscopic group[16.22% and 8.11%( P<0.001)]. Moreover, the occurrence rate of major complication in operative group was 83.33%, which was dramatically higher than that in endoscopic group(0.90%)( P<0.001). Conclusion:The younger and longer residence time of esophageal foreign bodies in children contribute to the rate of operative treatment.Additionally, the sharpness and corrosive foreign bodies increase the risk of surgery and serious complications.

15.
China Occupational Medicine ; (6): 241-246, 2021.
Article in Chinese | WPRIM | ID: wpr-923157

ABSTRACT

OBJECTIVE: To investigate the effects of nuclear transcription factor-κB(NF-κB)/amide adenine dinucleotide phosphate oxidase 1(NOX1) signaling pathway in tumor necrosis factor-α(TNF-α) induced apoptosis of A549 cells. METHODS: i) A549 cells were stimulated with TNF-α at the concentrations of 0.00, 0.25, 0.50, and 1.00 nmol/L. CCK-8 assay was used to detect the cell viability to screen the optimal stimulating concentration of TNF-α. ii) A549 cells at logarithmic growth stage were randomly divided into four groups, the control group, the TNF-α group, the BAY11-7082(NF-κB inhibitor) group and the TNF-α+BAY11-7082 group. The cells in the control group were not treated. The TNF-α and BAY11-7082 groups were stimulated with 0.50 nmol/L TNF-α and 5 μmol/L BAY11-7082, respectively. The TNF-α+BAY11-7082 group was stimulated by both TNF-α and BAY11-7082. After 24 hours of culture, the cell survival rate was detected by CCK-8 assay. Flow cytometry was used to detect cell apoptotic rate, and Western blotting was used to detect the relative expression of NF-κB(p65) and NOX1 proteins. RESULTS: i) When A549 cells were stimulated with TNF-α at the concentration of 0.50 nmol/L, the cell proliferative activity was reduced and the cell apoptosis was promoted. This concentration was selected as the stimulation dose of TNF-α in subsequent experiments. ii) The survival rate of A549 cells in the TNF-α group decreased(P<0.05), the apoptotic rate and the protein expressions of NF-κB(p65) and NOX1 increased in TNF-α group(all P<0.05) compared with the control group. In BAY11-7082 group, the survival rate and the relative expression of NF-κB(p65) and NOX1 of A549 cells were decreased(all P<0.05), and the apoptotic rate of A549 cells was increased(P<0.05) compared with the control group. A549 cells in TNF-α+BAY11-7082 group changed from a long spindle shape to an irregular one. The cell survival rate increased(P<0.05), the apoptotic rate and the relative expression of NF-κB(p65) and NOX1 decreased(all P<0.05) compared with the TNF-α group. CONCLUSION: NF-κB/NOX1 signaling pathway is involved in A549 cells apoptosis induced by TNF-α.

16.
Acta Pharmaceutica Sinica B ; (6): 4020-4031, 2021.
Article in English | WPRIM | ID: wpr-922457

ABSTRACT

Events including antibody‒antigen affinity, internalization, trafficking and lysosomal proteolysis combinatorially determine the efficiency of antibody-drug conjugate (ADC) catabolism and hence the toxicity. Nevertheless, an approach that conveniently identifies proteins requisite for payload release and the ensuing toxicity for mechanistic studies and quality assessment is lacking. Considering the plethora of ADC candidates under development, we developed a target-responsive subcellular catabolism (TARSC) approach that examines ADC catabolism and probes changes in response to targeted interferences of proteins of interest. We firstly applied TARSC to study the commercial T-DM1 and the biosimilar. We recorded unequivocal catabolic behaviors regardless of the absence and presence of the targeted interferences. Their negligible differences in TARSC profiles agreed with their undifferentiated anti-tumoral efficacy according to further

17.
National Journal of Andrology ; (12): 892-898, 2021.
Article in Chinese | WPRIM | ID: wpr-922172

ABSTRACT

Objective@#To assess the feasibility and validity of the establishment of a modified channel for extraperitoneal robot-assisted laparoscopic radical prostatectomy (RARP) through single incision.@*METHODS@#From November 2020 to January 2021, 35 cases of localized PCa were treated by extraperitoneal RARP through single incision in our center. All the operations were performed by the same surgeon, none via the multichannel port for the establishment of the channel. We recorded and analyzed the intra- and postoperative parameters, operation cost, complications, pathological findings and follow-up data.@*RESULTS@#All the operations were successfully completed, without conversion to open surgery or additional channels, or serious postoperative complications, the time for establishing the extraperitoneal space averaging 25.4 (20.0-45.0) min, the operation time 67.3 (35.0-125.0) min, intraoperative blood loss 75.5 (60.0-150.0) ml, time to first postoperative anal exhaust 26 (8-48) h, and postoperative hospital stay 7.89 (7-10) d. Postoperative pathology showed adenocarcinoma in all the cases, with Gleason score (GS) 3+3 in 9 (25.7%), GS 3+4 in 9 (25.7%), GS 4+3 in 8 (22.9%), and GS ≥ 8 in 9 (25.7%) of the cases, 23 (65.7%) in the

Subject(s)
Blood Loss, Surgical , Humans , Laparoscopy , Male , Prostatectomy , Robotic Surgical Procedures , Robotics
18.
Article in Chinese | WPRIM | ID: wpr-921809

ABSTRACT

The present study investigated the effect of Modified Dihuang Decoction in improving ovarian reserve in mice through the Bcl-2-related mitochondrial apoptosis pathway. Forty-eight adult female BALB/c mice were randomly divided into the following six groups with eight mice in each group: a blank group, a model group, a femoston group(three cycles of treatment with 0.13 mg·kg~(-1) estradiol tablets for 2 days and 1.43 mg·kg~(-1) estradiol and dydrogesterone tablets for 3 days), and high(64.74 g·kg~(-1))-, medium(43.16 g·kg~(-1))-, and low-dose(21.58 g·kg~(-1)) Modified Dihuang Decoction groups. Mice in other groups except the blank group received a single intraperitoneal injection of 12 mg·kg~(-1) cyclophosphamide and 1.2 mg·kg~(-1) busulfan to induce a model of diminished ovarian reserve(DOR), while those in the blank group received an equal volume of normal saline. Mice were treated with corresponding drugs for 15 d from the 36 th day, once per day, and the mice in the blank group and the model group were treated with an equal volume of normal saline. The general condition and oestrous cycle were observed. The serum hormone levels were detected with the enzyme-linked immunosorbent assay(ELISA). The morphological changes of ovaries were observed by HE staining. Western blot was used to detect the protein expression of cysteinyl aspartate specific proteinase-9(caspase-9), cleaved caspase-3, Bcl-2 associated X protein(Bax), Bcl-2, superoxide dismutase-2(SOD-2), and glutathione peroxidase-1(GPx-1). The mRNA expression of Bax and Bcl-2 was detected by real-time fluorescence-based quantitative polymerase chain reaction(real-time PCR). The results showed that compared with the blank group, the model group showed body weight loss, disordered oestrous cycle, elevated serum levels of follicle-stimulating hormone(FSH) and luteinizing hormone(LH), reduced serum levels of estradiol(E_2), anti-mullerian hormone(AMH), and inhibin B(INHB), the declining number of ovarian follicles and granulosa layers, increased number of atretic follicles, up-regulated protein expression of caspase-9, cleaved caspase-3, and Bax and Bax mRNA expression in ovaries, and down-regulated protein expression of Bcl-2, SOD-2 and GPx-1, and Bcl-2 mRNA expression. Compared with the model group, the Modified Dihuang Decoction groups displayed restored body weight and oestrous cycle, decreased serum levels of FSH and LH, elevated serum levels of E_2, AMH, and INHB, increased number of ovarian follicles, thickened granulosa layers, and declining number of atretic follicles. Additionally, the protein expression of caspase-9, cleaved caspase-3, and Bax, and Bax mRNA expression was down-regulated, and the protein expression of Bcl-2, SOD-2, and GPx-1, and Bcl-2 mRNA expression was up-regulated. The results suggest that Modified Dihuang Decoction can regulate endocrine hormone, promote follicle growth and improve ovarian reserve by enhancing ovarian anti-oxidant capacity, inhibiting the Bcl-2-related mitochondrial apoptosis pathway, and further inhibiting cell apoptosis.


Subject(s)
Animals , Apoptosis , Female , Mice , Mice, Inbred BALB C , Ovarian Follicle , Ovarian Reserve , Ovary
19.
Chinese Medical Journal ; (24): 2776-2787, 2021.
Article in English | WPRIM | ID: wpr-921154

ABSTRACT

Many seminal advances have been made in human immunodeficiency virus (HIV)/AIDS research over the past four decades. Treatment strategies, such as gene therapy and immunotherapy, are yielding promising results to effectively control HIV infection. Despite this, a cure for HIV/AIDS is not envisioned in the near future. A recently published academic study has raised awareness regarding a promising alternative therapeutic option for HIV/AIDS, referred to as "selective elimination of host cells capable of producing HIV" (SECH). Similar to the "shock and kill strategy," the SECH approach requires the simultaneous administration of drugs targeting key mechanisms in specific cells to efficiently eliminate HIV replication-competent cellular reservoirs. Herein, we comprehensively review the specific mechanisms targeted by the SECH strategy. Briefly, the suggested cocktail of drugs should contain (i) latency reversal agents to promote the latency reversal process in replication-competent reservoir cells, (ii) pro-apoptotic and anti-autophagy drugs to induce death of infected cells through various pathways, and finally (iii) drugs that eliminate new cycles of infection by prevention of HIV attachment to host cells, and by HIV integrase inhibitor drugs. Finally, we discuss three major challenges that are likely to restrict the application of the SECH strategy in HIV/AIDS patients.


Subject(s)
CD4-Positive T-Lymphocytes , HIV Infections/drug therapy , HIV-1 , Humans , Virus Latency
20.
Article in Chinese | WPRIM | ID: wpr-879044

ABSTRACT

L~*, a~* and b~* values of prepared slices of Curcumae Rhizoma were measured by spectrophotometer. SPSS 21.0 was used for discriminant analysis to establish the color range and mathematical prediction model of prepared slices of Curcumae Rhizoma. The values of L~*, a~* and b~* of kwangsiensis ranged from 58.09-62.40, 4.53-5.66 and 23.61-24.29, while the values of L~*, a~* and b~* of phaeocaulis were between 64.02-70.71,-0.89-4.13 and 44.59-54.52, respectively. The values of L~*, a~* and b~* of wenyujin were 68.55-70.99,-0.11-1.47 and 28.26-32.19, respectively. The mathematical prediction model was proved to be able to realize 100% identification of Curcumae Rhizome of different origins through original and cross validation and external samples validation. A dual wavelength HPLC was established; the contents of 9 sesquiterpenoids and 3 Curcumae Rhizomes were determined simultaneously; and the contents of Curcumae Rhizome of different origins were determined. The results showed that kwangsiensis had higher contents of neocurdione, β-elemene and isocurcumaenol, phaeocaulis curcumin, furadienone, demethoxycurcumin and curcumin; and wenyujin mainly contained curdione, furadienes and guimarone. Pearson correlation analysis on L~*, a~*, b~* value and content of 12 components showed that curcumin, furadienone, demethoxycurcumin and curcumin had a significant positive correlation with b~* value(P<0.01). There was a significant negative correlation between neocurdione, β-elemene and isocurcumaenol and L~* value(P<0.01). Curdione, furadienes and guimarone were significantly correlated with L~* value(P<0.01),indicating that the appearance co-lor of Curcumae Rhizoma could reflect the change of the content of the internal components. This study provided reference for the rapid recognition of Curcumae Rhizoma and the establishment of quality evaluation system.


Subject(s)
Chromatography, High Pressure Liquid , Color , Curcuma , Curcumin , Rhizome
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