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1.
Acta Pharmaceutica Sinica ; (12): 419-427, 2022.
Article in Chinese | WPRIM | ID: wpr-922924

ABSTRACT

GC-MS metabolomics was used to investigate the effects of fudosteine on lung cancer A549 cells in an inflammatory microenvironment. Eleven metabolites (malic acid, isoleucine, lactose, galactinol, creatinine, gluconic acid, oleic acid, phosphate, S-carboxymethyl-L-cysteine, uridine and tagatose) were identified in the metabolomics results and could be used as biomarkers of fudosteine treatment. Pathway enrichment analysis showed that the metabolic pathways of amino acids including isoleucine, valine, leucine, glycine, serine and threonine were significantly altered, as were the metabolic pathways of carbohydrates such as galactose and pentose phosphate. Fudosteine significantly reduced the level of inflammatory factors in A549 cells and corrected the inflammatory microenvironment by interfering with the effects of amino acid metabolites and amino acid metabolism pathways. This study reveals that fudosteine may be able to inhibit the continuous inflammatory response and prevent the further progression of lung cancer by suppressing the inflammatory microenvironment.

2.
Article in Chinese | WPRIM | ID: wpr-920784

ABSTRACT

Objective To investigate the resistance dynamics of Blattella germanica to commonly used insecticides in Yangpu District of Shanghai during 2014‒2020, and to provide the basis for the rational use of insecticides against cockroaches. Methods Blattella germanica was captured in two farmer’s markets in 2014, 2017 and 2020. The residual film method recommended by WHO was used to test resistance of Blattella germanica to the insecticides. Results In 2014, 2017 and 2020, the resistance ratio of Blattella germanica in Yangpu District was 6.96, 4.39, 7.26 to beta-cypermethrin, 10.41, 6.71, 5.24 to permethrin, and 2.28, 3.16, 1.01 to propoxur. Conclusion The resistance of Blattella germanica to permethrin and propoxur decreases, and the resistance to beta-cypermethrin keeps at low level. Comprehensive management and rotation of insecticides should be implemented to delay the increase of resistance.

3.
Chinese Critical Care Medicine ; (12): 826-831, 2021.
Article in Chinese | WPRIM | ID: wpr-909412

ABSTRACT

Objective:To investigate and evaluate if pulse oxygen saturation/fraction of inhaled oxygen (SpO 2/FiO 2) can be used, as replacement of arterial partial pressure of oxygen/fraction of inhaled oxygen (PaO 2/FiO 2), to assess oxygenation in acute respiratory distress syndrome (ARDS) patients at different high altitudes in Yunnan Province, and to find a rapid and non-invasive method for the diagnosis of ARDS at different altitudes. Methods:Patients with ARDS at different high altitudes in Yunnan Province from January 2019 to December 2020 were enrolled. The patients were divided into three groups according to different altitudes, and received different oxygen therapies according to their respective medical conditions. Group 1 consisted of patients with moderate to severe ARDS from the department of critical care medicine of the First Affiliated Hospital of Kunming Medical University (average altitude approximately 1 800 m), and received mechanical ventilation to maintain SpO 2 of 0.90-0.96 with a low FiO 2 for more than 30 minutes, and SpO 2, FiO 2, PaO 2 were recorded. Group 2 consisted of patients with moderate to severe ARDS at the department of critical care medicine of People's Hospital of Diqing Tibetan Autonomous Prefecture (mean altitude about 3 200 m), and received oxygen with an attached reservoir mask to maintain SpO 2 of 0.90-0.96 for 10 minutes, and then SpO 2, FiO 2, and PaO 2 were recorded. Group 3 consisted of patients with mild to moderate-severe ARDS who admitted to the emergency department of the People's Hospital of Lijiang (average altitude approximately 2 200 m); when SpO 2 < 0.90, patients received oxygen with the oxygen storage mask, and the FiO 2 required to maintain SpO 2 ≥ 0.90 was recorded, and SpO 2, FiO 2, PaO 2 were recorded after oxygen inhalation for 10 minutes. Spearman coefficient was used to analyze the correlation between SpO 2/FiO 2 and PaO 2/FiO 2 in each group. Linear analysis was used to derive the linear equation between SpO 2/FiO 2 and PaO 2/FiO 2, and to evaluate arterial pH, arterial partial pressure of carbon dioxide (PaCO 2), FiO 2, tidal volume (VT), positive end-expiratory pressure (PEEP) and other related factors which would change the correlation between SpO 2/FiO 2 and PaO 2/FiO 2. The receiver operator characteristic curve (ROC curve) was plotted to calculate the sensitivity and specificity of using SpO 2/FiO 2 instead of PaO 2/FiO 2 to assess oxygenation of ARDS patients. Results:Group 1 consisted of 24 ARDS patients from whom 271 blood gas analysis results were collected; group 2 consisted of 14 ARDS patients from whom a total of 47 blood gas analysis results were collected; group 3 consisted of 76 ARDS patients, and a total of 76 blood gas analysis results were collected. The PaO 2/FiO 2 (mmHg, 1 mmHg = 0.133 kPa) in groups 1, 2 and 3 were 103 (79, 130), 168 (98, 195) and 232 (146, 271) respectively, while SpO 2/FiO 2 were 157 (128, 190), 419 (190, 445) and 319 (228, 446) respectively. Among the three groups, patients in group 1 had the lowest PaO 2/FiO 2 and SpO 2/FiO 2, while patients in group 3 had the highest. Spearman correlation analysis showed that PaO 2/FiO 2 was highly correlated with SpO 2/FiO 2 in groups 1, 2 and 3 ( r values were 0.830, 0.951, 0.828, all P < 0.05). Regression equation was fitted according to linear analysis: in group 1 SpO 2/FiO 2 = 58+0.97×PaO 2/FiO 2 ( R2 = 0.548, P < 0.001) ; in group 2 SpO 2/FiO 2 = 6+2.13×PaO 2/FiO 2 ( R2 = 0.938, P < 0.001); in group 3 SpO 2/FiO 2 = 53+1.33×PaO 2/FiO 2 ( R2 = 0.828, P < 0.001). Further analysis revealed that PEEP, FiO 2, and arterial blood pH could affect the correlation between SpO 2/FiO 2 and PaO 2/FiO 2. ROC curve analysis showed that the area under ROC curve (AUC) was 0.848 and 0.916 in group 1 with moderate to severe ARDS; based on the regression equation, the corresponding SpO 2/FiO 2 cut-off values at a PaO 2/FiO 2 of 100 mmHg and 200 mmHg were 155, 252 with a sensitivity of 84.9% and 100%, specificity of 87.2% and 70.6%, respectively. Patients with moderate to severe ARDS in group 2 (AUC was 0.945 and 0.977), the corresponding SpO 2/FiO 2 cut-off values at PaO 2/FiO 2 of 100 mmHg and 200 mmHg were 219 and 432 with the sensitivity of 100% and 85.2%, specificity of 82.5% and 100%, respectively. Patients with mild to moderate-severe ARDS in group 3 (AUC was 0.903 and 0.936), the corresponding SpO 2/FiO 2 cut-off values at a PaO 2/FiO 2 of 200 mmHg and 300 mmHg were 319 and 452 with the sensitivity of 100% and 100%, specificity of 80.9% and 86.2%, respectively. Conclusion:SpO 2/FiO 2 and PaO 2/FiO 2 in ARDS patients at different high altitudes in Yunnan Province have a good correlation, and non-invasive SpO 2/FiO 2 can be used to replace PaO 2/FiO 2 to assess the oxygenation in ARDS patients.

4.
Article in Chinese | WPRIM | ID: wpr-909156

ABSTRACT

Objective:To investigate the clinical efficacy of alprostadil injection in the treatment of acute cerebral infarction.Methods:A total of 300 patients with acute cerebral infarction who received treatment in The First People's Hospital of Jiashan, China between August 2016 and August 2018 were included in this study. They were randomly divided into a control group and an observation group ( n = 150/group). Based on conventional treatment, patients in the control group received Xueshuantong power injection treatment and those in the observation group received alprostadil injection treatment. All patients were treated for 14 days. Clinical efficacy was compared between the control and observation groups. Results:In the observation group, infarct volume, plaque area, lumen area, intima-media thickness of the common carotid artery, Crouse score, recanalization rate, Barthel Index, National Institutes of Health Stroke Scale (NIHSS) score, hematocrit and plasma viscosity in the observation group were (3.16 ± 1.19) cm 3, (0.21 ± 0.05) mm 2, (0.30 ± 0.06) mm 2, (1.05 ± 0.23) mm, (2.18 ± 0.61) points, 98.67% (148/150), (96.38 ± 1.75) points, (6.31 ± 1.08) points, (41.03 ± 4.28)%, (1.12 ± 0.03) mPa/s, respectively, which were superior to those in the control group [ (2.25 ± 1.37) cm 3, (0.68 ± 0.46) mm 2, (0.89 ± 0.54) mm 2, (1.76 ± 0.85) mm, (3.29 ± 0.78) points, 72.00% (108/150), (85.22 ± 1.56) points, (10.18 ± 1.43) points, (50.76 ± 5.31)%, (1.54 ± 0.34) mPa/s, t = 1.869, 1.231, 1.452, 1.326, 2.285, χ2 = 12.528, t = 11.428, 4.28, 17.473, 15.071, all P < 0.05]. Conclusion:Based on conventional treatment, alprostadil injection exhibits good clinical efficacy in the treatment of acute cerebral infarction.

5.
Article in Chinese | WPRIM | ID: wpr-908718

ABSTRACT

Objective:To investigate the clinical efficacy of Yixin tang in patients with chronic pulmonary heart disease (CPHD).Methods:The clinical data of 72 patients with CPHD in Shanghai Tenth People′s Hospital from April 2018 to April 2020 were retrospectively analyzed. Among them, 36 patients were treated with conventional western medicine therapy (control group), and 36 patients were treated with Conventional western medicine therapy and Yixin tang (observation group). The left ventricular ejection fraction (LVEF), forced expired volume in one second to forced vital capacity ratio (FEV 1/FVC), D-dimer (D-D), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), St. George respiratory questionnaire (SGRQ) score and Chinese medicine syndrome score before and after treatment were compared between 2 groups. Results:There were no statistical differences in the indexes before treatment between 2 groups ( P>0.05). The FEV 1/FVC and LVEF after treatment in observation group were significantly higher than those in control group: (89.01 ± 3.24)% vs. (78.13 ± 3.52)% and (60.32 ± 2.36)% vs. (52.80 ± 3.23)%, the TNF-α, IL-6, D-D, Chinese medicine syndrome score and SGRQ total score, limitation of activity score, symptom score, disease impact score were significantly lower than those in control group: (6.95 ± 2.67) pg/L vs. (10.45 ± 4.07) pg/L, (4.36 ± 1.24) pg/L vs. (6.90 ± 7.42) pg/L, (0.32 ± 0.13) pg/L vs. (1.07 ± 0.43) pg/L, (14.50 ± 3.00) scores vs. (16.43 ± 3.08) scores, (20 ± 12) scores vs. (50 ± 20) scores, (21 ± 15) scores vs. (45 ± 14) scores, (22 ± 11) scores vs. (65 ± 16) scores and (17 ± 10) scores vs. (47 ± 14) scores, and there were statistical differences ( P<0.05). Conclusions:The conventional western medicine treatment combined with Yixin tang can effectively improve cardiopulmonary function, inflammatory reaction and quality of life.

6.
Article in Chinese | WPRIM | ID: wpr-908702

ABSTRACT

Objective:To analyze the efficacy of dienogest combined with traditional Chinese medicine(TCM) in the treatment of endometriosis (EMs) and its influence on pregnancy and recurrence.Methods:A total of177 patients with EMs admitted to Affiliated Hospital of Shandong University of Chinese Medicine and Linyi Hospital of Traditional Chinese Medicine from December 2018 to June 2019 were divided into the observation group (88 cases) and the control group (89 cases) according to the random number table method. The control group was treated with dienogest 25 mg once a day, and the observation group was treated with dienogest combined with TCM decoction. They all were treated for 6 months. The clinical efficacy, pregnancy and recurrence of the two groups were compared, and EMs health profile-5 (EHP- 5) of the Chinese version was used to evaluate patients′ quality of life of the two groups.Results:The total effective rate in the observation group was higher than that in the control group: 92.04%(81/88) vs. 79.78%(71/89), and the difference was statistically significant ( χ2 = 5.492, P<0.05). The time of ovulation recovery and menstrual recovery in the observation group were shorter than those in the control group: (13.38 ± 3.60) d vs. (14.69 ± 3.15) d, (26.48 ± 4.23) d vs. (28.72 ± 3.40) d, and the differences were statistically significant ( P<0.05). There was no statistically significant difference in the 1-year pregnancy rate between the two groups ( P>0.05). The 1-year recurrence rate in the observation group was lower than in the control group: 1.14%(1/88) vs. 10.11%(9/89), and the difference was statistically significant ( P<0.05). The scores of pain, emotional state, sense of control, sexual life, doctor-patient relationship , infertility, and treatment effect in EHP-5 in the observation group after the treatment were lower than those in the control group, and the differences were statistically significant ( P<0.05). Conclusions:Compared with dienogest treatment alone, the combination of TCM treatment can further improve the efficacy. It is beneficial to pregnancy. It can reduce the recurrence rate, improve the quality of life more significantly, and has great safety.

7.
Article in Chinese | WPRIM | ID: wpr-908403

ABSTRACT

Objective:To investigate the effects of therapeutic plasma exchange(TPE)as adjuvant therapy in children with myasthenia gravis(MG)in pediatric intensive care unit(PICU).Methods:A retrospective study was conducted in 7 children with MG admitted to PICU at Shanghai Children′s Hospital from January 2016 to December 2019.TPE was performed on unsatisfactory effect of acetylcholinesterase inhibitors, glucocorticoids or IVIG.The TPE dose was 50-70 mL/kg for 2 to 3 times for each case.The clinical symptoms, anti-acetylcholine antibody(AChR-Ab)level and prognosis were measured before and after TPE.Results:Seven children with myasthenia gravis admitted to PICU from January 2016 to December 2019, including 4 cases of systemic myasthenia gravis(1 case of myasthenia crisis with respiratory failure)and 3 cases of ocular myasthenia gravis.The AChR-Ab level decreased from 1.66(0.99, 3.33)nmol/L before TPE to 0.66(0.40, 10.97)nmol/L after TPE( Z=-2.545, P=0.011). The symptoms of muscle weakness and blepharoptosis were partially or completely relieved in 7 cases.There were no significantly changes in the levels of circulating immune complex, complement C3, CD4 + , CD8 + and NK cells before and after TPE(all P>0.05). During the process of TPE, 2 cases had mild rash, and 1 case had hypotensive shock, which were recovered after timely treatment.After TPE, the fibrin levelsdecreased from 1.90(1.40, 2.40)g/L to 1.10(1.00, 1.30)g/L( Z=-3.092, P=0.002). Conclusion:TPE reduce the AChR-Ab levels and improve the short-term symptoms in children with myasthenia gravis who have failed conventional treatment.TPE may be an optional therapy for pediatric severe MG.

8.
Article in Chinese | WPRIM | ID: wpr-907773

ABSTRACT

Objective:To evaluate the predictive value of lung ultrasound on mortality in children with severe acute respiratory distress syndrome (ARDS) undergoing extracorporeal membrane oxygenation (ECMO) support.Methods:A prospective observational study was used to enroll patients with severe ARDS who met the Berlin criteria in the Pediatric Intensive Care Unit of Children’s Hospital of Shanghai Jiao Tong University from January 2016 to December 2019. Patients with ECMO support <3 d, lack of appropriate acoustic windows, with severe pneumothorax, and secondary to congenital heart disease or chronic lung disease were excluded. ECMO parameters, respiratory mechanics parameters and outcome were collected and analyzed. Lung ultrasound score (LUS) was measured at the initiation of ECMO as LUS-0 h, then at 24 h, 48 h, 72 h, and 7 d after ECMO support as the value of LUS-24 h, LUS-48 h, LUS-72 h, LUS-7 d, as well as after weaning ECMO as LUS-w. The patients were divided into survivors and non-survivors according to hospital survival status. Receiver operating characteristic (ROC) curve and Kaplan-Meier survival analysis curve were performed to explore the predictive value of lung ultrasound on mortality in patients with severe ARDS undergoing ECMO.Results:A total of 26 patients were enrolled in this study, of which 18 patients survived and 8 died. There were no significant differences in PRISM Ⅲ, dynamic pulmonary compliance (Cdyn), oxygenation index, PaO 2/FiO 2, and PaCO 2 on PICU admission between the two groups (all P>0.05). The values of LUS-72 h and LUS-w in non-survivors were significantly higher than those in survivors [26 (24, 29) vs16 (13, 19), P<0.01] and [30 (26, 35) vs11 (10, 13), P<0.01]. The values of Cdyn-72 h, Cdyn-7 d and Cdyn-w in survivors were significantly higher than those in non-survivors [0.48 (0.42, 0.54)mL/cmH 2O·kg vs 0.36 (0.29, 0.40) mL/cmH 2O·kg, P<0.01; 0.60 (0.52, 0.67) mL/cmH 2O·kg vs 0.27 (0.13, 0.30) mL/cmH 2O·kg, P<0.01, and 0.66 (0.62, 0.70) mL/cmH 2O·kg vs 0.30 (0.13, 0.35) mL/cmH 2O·kg, P<0.01]. ROC curve analysis showed that an area under ROC curve (AUC) of LUS-72 h for predicting PICU mortality was 0.955 (95% CI: 0.864-1.000; P<0.01). The cutoff value of LUS-72 h was 24 with a sensitivity of 87.5% and a specificity of 100.0%. Kaplan-Meier survival analysis showed that PICU mortality of patients with LUS-72 h≥24 was significantly higher than that in patients with LUS-72 h < 24 ( P<0.01) . Conclusions:Lung ultrasound is an effective tool for monitoring progress of children with severe ARDS received ECMO support. LUS-72 h >24 is an index to predict the worsen outcome in children with severe ARDS under ECMO support.

9.
Article in Chinese | WPRIM | ID: wpr-907714

ABSTRACT

Objective:To summarize the clinical features, imaging changes, treatment, and prognosis of children with severe autoimmune encephalitis (AE).Methods:A retrospective study was conducted on patients with severe AE admitted to PICU of Shanghai Children’s Hospital from June 2017 to May 2020. Clinical features, treatment protocols and follow-up data were collected.Results:A total of 27 children were included, among which 18 cases (66.7%) were girls. The on-set age was (7.9±3.2) years. Eighteen cases were diagnosed with anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis. Fever (77.8%), headache (40.7%) and vomiting (44.4%) were most of prodromal symptoms in children with severe AE. Patients’ neurological symptoms showed seizures (88.9%), mental behavior abnormalities (81.5%), speech disorders (70.4%) and dyskinesia (70.4%). Moreover, epileptic discharge and slow wave activity were critical feature of electroencephalogram (EEG) abnormalities, and the abnormal signal changes on T2-weighted and FLAIR sequence of head MRI were in the posterior horn of the lateral ventricle. In addition, the main comorbidities included refractory status epilepticus (RSE), cardiovascular dysfunction, central hypoventilation syndrome and acute intracranial hypertension syndrome. For patients with central respiratory failure, the median duration of mechanical ventilation was 19.8 (14.8, 29.1) days. According to treatment protocol, the first-line immune treatment included the combination therapies of methylprednisolone, intravenous immunoglobulin (IVIG) and therapeutic plasma exchange (TPE). Eighteen cases were given with methylprednisolone [10-30 mg/(kg. d), 3-5 d] + IVIG (2 g/kg, within 2 d) + TPE, 1 case was treated with methylprednisolone [10-30 mg/(kg·d), 3-5 d] + TPE and 8 cases were given with[10-30 mg/(kg·d), 3-5 d] + IVIG (2 g/kg, within 2 d). Sequential therapy was given with methylprednisolone (1-2 mg/kg), gradually reduced from 3 to 6 months. Finally, 16 children (59.3%) had neurological damages at the first discharge, among which 8 cases (29.6%) were with dyskinesia, 5 cases (18.5%) were with speech disturbance, and 5 cases (18.5%) were with abnormal mental behaviors.Conclusions:The most of first clinical symptom is epileptic seizures in pediatric severe AE, and most of these patients are diagnosed with Anti-NMDA receptor encephalitis. RSE, cardiovascular dysfunction, central respiratory and acute intracranial hypertension syndrome constitute to main organ dysfunctions.

10.
Article in Chinese | WPRIM | ID: wpr-907553

ABSTRACT

Objective:To investigate the expression differences of miR-200c, miR-19a and miR-155 in gefitinib sensitive and resistant non-small cell lung cancer (NSCLC) patients, and to analyze the effects of miR-200c, miR-19a and miR-155 expression differences on the prognosis of patients.Methods:From August 1, 2015 to August 1, 2019, 80 patients with stage Ⅲ-Ⅳ NSCLC who were treated with gefitinib in the Fourth Affiliated Hospital of Nanjing Medical University were selected as the research objects. Among them, 36 cases were sensitive to gefitinib as the sensitive group, and 44 cases were resistant to gefitinib as the drug-resistant group. The general data, serum levels of miR-200c, miR-19a and miR-155 were compared between the two groups, and the sensitive factors of gefitinib in NSCLC patients and the correlations between serum miR-200c, miR-19a, miR-155 and clinicopathological characteristics of NSCLC patients were explored. The survival of the patients was analyzed.Results:Compared with the drug-resistant group, the number of smoking cases in the sensitive group was less ( χ2=5.541, P=0.019), the number of clinical stage Ⅲ cases was more ( χ2=8.984, P=0.003), the number of well-differentiated cases was more ( χ2=8.673, P=0.003), the number of patients with lymph node metastasis was less ( χ2=6.082, P=0.014), and the levels of serum miR-200c, miR-19a and miR-155 were higher ( t=7.249, P<0.001; t=8.222, P<0.001; t=10.467, P<0.001). Multivariate logistic regression analysis showed that smoking ( OR=0.355, 95% CI: 0.149-0.845, P<0.001), clinical stage ( OR=0.494, 95% CI: 0.274-0.892, P=0.021), degree of differentiation ( OR=6.062, 95% CI: 3.258-11.279, P=0.013), lymph node metastasis ( OR=0.422, 95% CI: 0.245-0.726, P=0.019), the levels of serum miR-200c ( OR=5.521, 95% CI: 3.126-9.752, P<0.001), miR-19a ( OR=5.384, 95% CI: 2.947-9.836, P<0.001) and miR-155 ( OR=5.325, 95% CI: 3.058-9.274, P<0.001) were all influencing factors of gefitinib sensitivity in NSCLC patients. The levels of serum miR-200c, miR-19a and miR-155 were significantly correlated with clinical stage ( t=3.230, P=0.002, r=-0.578; t=3.188, P=0.002, r=-0.612; t=3.123, P=0.003, r=-0.594), degree of differentiation ( t=2.586, P=0.012, r=0.610; t=4.009, P<0.001, r=0.632; t=4.773, P<0.001, r=0.594) and lymph node metastasis ( t=2.902, P=0.005, r=-0.587; t=3.721, P<0.001, r=-0.629; t=3.391, P=0.001, r=-0.614) of NSCLC patients. Compared with the patients with low levels of serum miR-200c, miR-19a and miR-155, the 1-year survival rates of the patients with high levels of serum miR-200c (63.19% vs. 4.37%, χ2=32.562, P<0.001), miR-19a (61.01% vs. 4.75%, χ2=37.807, P<0.001) and miR-155 (57.82% vs. 0, χ2=44.454, P<0.001) were higher, with statistically significant differences. Conclusion:The levels of serum miR-200c, miR-19a and miR-155 are significantly increased in gefitinib-sensitive NSCLC patients, which are important influencing factors of gefitinib sensitivity, and are closely related to clinicopathological characteristics such as clinical stage, differentiation degree and lymph node metastasis of NSCLC patients, and the prognosis is better in patients with high serum levels.

11.
International Journal of Surgery ; (12): 444-451,F1, 2021.
Article in Chinese | WPRIM | ID: wpr-907460

ABSTRACT

Objective:To explore the efficacy of precision hepatectomy in the treatment of single hepatocellular carcinoma with microvascular invasion (MVI) of and the risk factors of positive incisal margin after operation.Methods:The clinical data of 212 patients with single hepatocellular carcinoma with MVI treated in Affiliated Hospital of Panzhihua University from July 2016 to July 2019 were analyzed retrospectively. 152 patients were treated with precision hepatectomy and 60 patients with traditional hepatectomy. According to the pathological results of postoperative liver resection, the patients treated with precision hepatectomy were divided into two groups: negative group ( n=129) and positive group ( n=23). The operation-related indexes, postoperative complications and disease-free survival rate of precision hepatectomy and traditional hepatectomy were compared, and the general data of patients with negative and positive liver cutting edge were compared. multivariate analysis of the factors affecting the positive liver cutting edge after operation; to construct a line chart prediction model to predict the positive liver cutting edge after operation, and to evaluate its predictive efficiency. Normally distributed measurement data are represented by mean±standard deviation ( Mean± SD), independent t-test is used for comparison between groups; count data are represented by the number of cases and percentages, and χ2 test is used for comparison between groups. Results:The operative time, intraoperative blood loss, postoperative hospital stay, positive rate of surgical margin, total incidence of postoperative complications, AFP negative conversion rate 6 months after operation, and 1-year disease-free survival rate of precision hepatectomy were (328.62±38.74) min, (496.83±59.76) mL, (15.28±3.61) d, 15.13% (23/152), 3.95% (6/152), 81.58% (124/152), 67.11% (102/152), respectively. The mean values of traditional hepatectomy were (315.29±40.95) min, (681.46±58.27) mL, (23.87±4.65) d, 28.33% (17/60), 21.67% (13/60), 66.67% (40/60) and 46.67% (28/60), respectively, the difference was statistically significant ( P<0.05). Univariate analysis showed that the positive liver resection margin after precision liver resection was related to the maximum diameter of the tumor, vascular tumor thrombus, TNM staging, BCLC staging, liver cirrhosis, AFP 2 months after surgery, and the distance between the tumor and the resection margin ( OR=3.645, 5.248, 4.285, 4.462, 3.883, 3.964, 3.872; 95% CI: 2.875-4.415, 4.426-6.070, 3.271-5.299, 3.354-5.570, 3.062-4.704, 3.248-4.680, 2.987-4.757; P<0.05). Maximum tumor diameter >5 cm, vascular tumor thrombus, TNM stage Ⅲ, BCLC stage C, liver cirrhosis, postoperative AFP ≥20 μg Uniql, the distance between the tumor and the resection margin was <1 mm were the risk factors of positive incisal margin after precision hepatectomy in patients with single liver cancer with MVI( OR=6.685, 8.425, 7.758, 7.854, 7.124, 7.246, 6.926; 95% CI: 5.828-7.542, 7.6385-9.212, 6.926-8.590, 7.062-8.646, 6.583-7.665, 6.618-7.874, 6.028-7.824; P<0.05). The constructed line chart prediction model had better differentiation and higher accuracy. Conclusions:Precision hepatectomy in the treatment of single hepatocellular carcinoma with MVI has the advantages of less intraoperative bleeding, faster postoperative recovery, less postoperative complications, low positive rate of liver incisal margin and high disease-free survival rate. The construction of a risk prediction model with positive surgical margin provides a reference for improving the survival rate of patients in clinic.

12.
International Journal of Surgery ; (12): 423-427, 2021.
Article in Chinese | WPRIM | ID: wpr-907456

ABSTRACT

Carotid body tumor is a chemoreceptor tumor originated from the carotid body. It is the most common paraganglioma in the head and neck with special location, abundant blood supply and close relationship with carotid artery and peripheral nerves. Therefore, carotid body tumor has the characteristics of difficult diagnosis, lack of specificity and high risk of operation. This article reviews the progress in the diagnosis and treatment of carotid body tumor.

13.
Article in Chinese | WPRIM | ID: wpr-906333

ABSTRACT

Objective:To observe and evaluate the efficacy and safety of Ganduqing Granules in the treatment of common cold due to qi deficiency and pathogen invasion. Method:A multi-center, randomized, double-blind, and placebo-controlled clinical trial was conducted. One hundred and twenty patients were randomly divided into an experimental group (<italic>n</italic>=60) and a control group (<italic>n</italic>=60). Patients in the experimental group were treated with oral Ganduqing Granules, 6 g per time, 3 times per day, while those in the control group received placebo, 6 g per time, 3 times per day. After treatment for 5 successive days in both groups, the overall remission rate, total score of primary symptoms, total score of secondary symptoms, total score of all symptoms, time required for overall symptom remission, and therapeutic efficacy against traditional Chinese medicine (TCM) syndrome in the two groups were analyzed in both full analysis set (FAS) and per-protocol set (PPS), followed by the evaluation of safety in the safety set (SS). Result:No drop-out was found in the experimental group, whereas 3 cases in the control group dropped out. After 5 days of treatment, the overall remission rate of the experimental group was significantly higher than that of the control group (<italic>P</italic><0.01). The analysis in FAS and PDS revealed identical results. The experimental group was obviously better than the control group in improving the total scores of primary symptoms, secondary symptoms, and all symptoms (<italic>P</italic><0.01). The analysis results in FAS and PDS were consistent. There was no significant difference in overall remission time between the two groups. The experimental group was remarkably superior to the control group in alleviating such symptoms as aversion to wind and cold, nasal congestion, runny nose, fatigue, shortness of breath, laziness to speak, dry throat, sore throat, cough, and expectoration (<italic>P</italic><0.05,<italic>P</italic><0.01). The analysis results in FAS were the same as those in PDS. All the patients did not present with significant abnormalities in vital signs, blood routine test, or liver and kidney function tests after medication. There was no significant difference in the incidence of adverse events between the experimental group and the control group. Conclusion:Ganduqing Granules effectively alleviate the symptoms of patients with common cold and shorten the course of disease, without inducing obvious side effects.

14.
Article in Chinese | WPRIM | ID: wpr-906303

ABSTRACT

Objective:To evaluate the clinical efficacy of Qingkailing injection in the treatment of children with sepsis and heat syndrome, and investigate its anti-inflammatory, anticoagulant and protective effects. Method:Eighty patients were randomly divided into control group and observation group with forty cases in each group according to the number table. Both groups received comprehensive treatment measures such as fluid resuscitation, anti-infection, anti-inflammatory, anticoagulation, vasoactive drugs, and protection of vital organ functions. While patients in observation group additionally took Qingkailing injection, 5-10 mL each time, intravenous drip after dilution, 1 time/day. Treatment course was five days in both groups. Before and after treatment, the scores of quick sequential organ failure assessment (qSOFA), pediatric critical illness score (PCIS) and acute physiology and chronic health evalution Ⅱ (APACHEⅡ) were graded; procalcitonin (PCT), serum amyloid A protein (SAA) before and after treatment, heparin-binding protein (HBP), tumor necrosis factor-<italic>α</italic> (TNF-<italic>α</italic>), high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), IL-10, N-terminal brain sodium Peptide precursor (NT-proBNP), high-sensitivity cardiac troponin T (hs-cTnT) level, cardiac troponin I (cTnI), creatine kinase isoenzyme (CK-MB), <italic>D</italic>-dimer (<italic>D-</italic>D ), fibrinogen (FIB) and antithrombin Ⅲ (AT-Ⅲ) levels were detected. Result:The APACHEⅡ and qSOFA scores in the observation group were lower than those in the control group (<italic>P</italic><0.05), while the PCIS score was higher than that in the control group (<italic>P</italic><0.05). The levels of PCT, SAA,HBP,TNF-<italic>α</italic>, hs-CRP and IL-6 in the observation group were lower than those in the control group (<italic>P</italic><0.01), while the IL-10 level was higher than that in the control group (<italic>P</italic><0.01). The levels of NT-proBNP, hs-cTnT, cTnI, CK-MB, <italic>D</italic>-D and FIB in the observation group were lower than those in the control group (<italic>P</italic><0.01), while the AT-Ⅲ activity was higher than that in the control group (<italic>P</italic><0.01). Conclusion:Qingkailing injection as the adjuvant therapy in children with sepsis and fever syndrome, can play the role of anti-inflammatory, anticoagulant, reducing infection and myocardial damage, thereby reducing the severity of the disease and improving the prognosis.

15.
Article in Chinese | WPRIM | ID: wpr-906266

ABSTRACT

Objective:To explore the possible mechanism of Kaixinsan in improving cognitive impairment in Alzheimer's disease (AD) model rats based on the epichlorohydrin associated protein-1 (Keap-1)/nuclear factor E2 related factor (Nrf2)/manganese superoxide dismutase (MnSOD) signaling pathway. Method:The AD model was established by injecting Amyloid <italic>β</italic><sub>1-42</sub> (A<italic>β</italic><sub>1-42</sub>, 5 μL) into the lateral ventricle. After modeling, the experimental rats were randomly divided into model group, donepezil group, and Kaixinsan low dose, medium dose and high dose groups. Another normal control group was also established. The donepezil group received donepezil tablets (1.8 g·kg<sup>-1</sup>·d<sup>-1</sup>), Kaixinsan low dose, medium dose and high dose groups received corresponding doses of Kaixinsan (10, 20, 40 g·kg<sup>-1</sup>·d<sup>-1</sup>, respectively), and the normal control group and model group were given with equal volume of pure water. Morris water maze was used to test the learning and memory ability of rats. The pathological morphology of hippocampal CA3 area was observed by Nissl staining. The expression levels of myeloperoxidase (MPO), inducible nitric oxide synthase (iNOS) and superoxide dismutase (SOD) in serum were detected by colorimetry, and the protein expression levels of Keap-1, Nrf2 and MnSOD in hippocampus were detected by immunohistochemistry (IHC) and Western bolt. Result:Compared with the normal control group, the escape latency, total swimming distance and first arrival time of the plateau in the model group increased (<italic>P</italic><0.01), while the times of crossing the plateau and the time in target quadrant decreased (<italic>P</italic><0.01). Compared with the model group, the rats in donepezil group and Kaixinsan groups showed less latency, lower total swimming distance and first arrival time on the platform (<italic>P</italic><0.05, <italic>P</italic><0.01), while the times of crossing the platform and time in target quadrant increased (<italic>P</italic><0.05, <italic>P</italic><0.01). Compared with the normal control group, the expression levels of MPO and iNOS in serum of the model group increased (<italic>P</italic><0.01), while the expression levels of SOD decreased (<italic>P</italic><0.01). Compared with model group, the expression of MPO and iNOS in serum of donepezil group and Kaixinsan groups decreased (<italic>P</italic><0.05, <italic>P</italic><0.01), while the expression of SOD increased (<italic>P</italic><0.05, <italic>P</italic><0.01). In the normal control group, the neurons in the hippocampal CA3 of the rats were arranged neatly, without obvious Nissl body shrinkage. The neurons in the CA3 of the hippocampus of the model group were not arranged neatly, with obvious neuron loss and pyknosis of Nissl body. The neurons in the CA3 of the hippocampus of the rats in the donepezil group and Kaixinsan groups were arranged neatly, with increased number of neurons and decreased Nissl body shrinkage. Compared with the normal control group, the integrated optical density (<italic>IA</italic>) and protein level of Keap-1 in the hippocampus of the model group decreased(<italic>P</italic><0.01), while the <italic>IA</italic> and protein level of Nrf2 and MnSOD increased (<italic>P</italic><0.01). Compared with model group, <italic>IA</italic> and protein levels of Keap-1 and MnSOD in hippocampus of rats in donepezil group and Kaixinsan groups increased (<italic>P</italic><0.05, <italic>P</italic><0.01), while <italic>IA</italic> and protein levels of Nrf2 decreased (<italic>P</italic><0.05, <italic>P</italic><0.01). Conclusion:Kaixinsan could alleviate memory impairment in AD rats, and its mechanism may be related to its regulation of Keap-1/Nrf2/MnSOD signaling pathway.

16.
Article in Chinese | WPRIM | ID: wpr-906065

ABSTRACT

Objective:To explore the group modules of Chinese medicine and western medicine for the treatment of bronchitis patients with Xiyanping injection based on the real world to provide references for the clinical treatment of bronchitis with Chinese medicine and western medicine. Method:Medical records of 13 874 patients with bronchitis treated by Xiyanping injection were extracted from 29 hospital information systems (HISs) in China,and complex network analysis was carried out using Tabu Search algorithm to obtain the substructure and associated information of core drug combination of Xiyanping injection for the treatment of bronchitis and to analyze clinical medication protocols. Result:Medication protocols for the pathogens of bronchitis are listed below: Xiyanping injection + cefuroxime for bacterial infection. Xiyanping injection + interferon for viral infection. Xiyanping injection + azithromycin for mycoplasma infection. According to the clinical symptoms and complications of bronchitis, the appropriate medication protocols were as follows: Xiyanping injection + ambroxol + Feilike mixture + ibuprofen for uncomplicated bronchitis. Xiyanping injection + ipratropium bromide + budesonide + salbutamol for asthmatic bronchitis. Xiyanping injection + mannitol + furosemide + phenobarbital + gangliosides + immunoglobulin for bronchitis complicated with viral encephalitis. Xiyanping injection + creatine phosphate sodium + vitamin C for bronchitis complicated with viral myocarditis. The combined medication of Chinese medicine for the treatment of bronchitis was adopted based on its characteristics of traditional Chinese medicine. Conclusion:The data of this study were derived from the real world. The combined medications protocols of Xiyanping injection targeting the clinical symptoms and complications of bronchitis were extracted and summarized. However, it is necessary to formulate an individualized medication protocol according to the specific condition.

17.
Article in Chinese | WPRIM | ID: wpr-905194

ABSTRACT

Objective:To explore the effect of placing drainage or not on rapid rehabilitation after total knee arthroplasty (TKA). Methods:From January, 2018 to September, 2020, 80 patients with knee osteoarthritis who underwent primary TKA in our hospital were analyzed retrospectively, and they were divided into groups A and B, with 40 cases in each group. Drainage was placed routinely in group A and not in group B. The postoperative serum inflammatory factors, postoperative pain score, postoperative complication rate, postoperative time out of bed, hospital stay, knee function score, range of motion of knee and World Health Organization Quality Of Life-abbreviated version score (WHOQOL-BREF) were compared between two groups. Results:There was no significant difference in the levels of C-reactive protein between two groups on the 1st to 3rd day after operation (t < 0.410, P > 0.05). There was no significant difference in Visual Analogue Score between two groups from 12 h to 48 h after operation (t < 0.300, P > 0.05). The incidences of postoperative complications were 5.0% in group A and 2.5% in group B, with no significant difference between two groups (χ2 = 0.346, P > 0.05). The time of getting out of bed and hospital stay was significantly shorter in group B than in group A (t > 4.863, P < 0.001). The scores of knee joint function, range of motion of knee and WHOQOL-BREF significantly increased after operation in both groups (t > 6.099, P < 0.001), however, there was no significant difference between two groups (P > 0.05). Conclusion:Placement or non-placement of drainage after primary TKA does not affect postoperative complications, knee joint function and quality of life of patients with knee osteoarthritis, however, non-placement of drainage can promote postoperative recovery and discharge.

18.
Journal of Clinical Hepatology ; (12): 2092-2096, 2021.
Article in Chinese | WPRIM | ID: wpr-904850

ABSTRACT

Objective To investigate the influencing factors for rebleeding after gastroscopy in patients with liver cirrhosis and esophagogastric variceal bleeding. Methods A retrospective analysis was performed for the clinical data of the patients with liver cirrhosis and esophagogastric variceal bleeding who were hospitalized in Tianjin Third Central Hospital from January 1, 2017 to December 31, 2018, and according to the presence or absence of rebleeding and bleeding time, the patients were divided into non-bleeding group ( n =148) and bleeding group ( n =119). The risk factors for rebleeding after gastroscopy were analyzed. The t -test or the Mann-Whitney U test was used for comparison of continuous data between two groups, and the chi-square test was used for comparison of categorical data between two groups. The Cox regression model was used for univariate and multivariate analyses. The receiver operating characteristic (ROC) curve was used to evaluate the accuracy of Child-Turcotte-Pugh (CTP), fibrosis-4 (FIB-4), and albumin-bilirubin (ALBI) scores in predicting rebleeding after gastroscopy, and MedCalc was used to compare the area under the ROC curve (AUC). Results A total of 267 patients with liver cirrhosis and esophagogastric variceal bleeding were enrolled, among whom 53 (19.9%) had liver cancer. A total of 119 patients suffered from rebleeding, with an overall rebleeding rate of 44.6% and a median time to rebleeding of 11.0 (0-39.0) months. The univariate Cox regression analysis showed that liver cancer (hazard ratio [ HR ]=0.377, P 0.05). Conclusion Liver cancer, AST, PT, CTP score, FIB-4 score, and ALBI score are associated with rebleeding after gastroscopy in patients with liver cirrhosis and esophagogastric variceal bleeding, among which CTP, FIB-4, and ALBI scores have a good value in predicting rebleeding outcome, while there is no significant difference in predictive ability between them.

19.
The Korean Journal of Pain ; : 176-184, 2021.
Article in English | WPRIM | ID: wpr-903790

ABSTRACT

Background@#Diabetes-related neuropathic pain frequently occurs, and the underpinning mechanism remains elusive. The periaqueductal gray (PAG) exhibits descending inhibitory effects on central pain transmission. The current work aimed to examine whether inflammatory cytokines regulate mechanical allodynia and thermal hyperalgesia induced by diabetes through the phosphoinositide 3-kinase (PI3K)-mammalian target of rapamycin (mTOR) pathway in the PAG. @*Methods@#Streptozotocin (STZ) was administered intraperitoneally to mimic allodynia and hyperalgesia evoked by diabetes in rats. Behavioral assays were carried out for determining mechanical pain and thermal hypersensitivity. Immunoblot and ELISA were performed to examine PAG protein amounts of interleukin-1β (IL-1β), IL-6, and tumor necrosis factor-α (TNF-α), as well as their corresponding receptors in STZ rats, and the expression of PI3K/protein kinase B (Akt)/mTOR signaling effectors. @*Results@#Increased PAG p-PI3K/p-Akt/p-mTOR protein amounts were observed in STZ-induced animals, a PI3K-mTOR pathway inhibition in the PAG attenuated neuropathic pain responses. Moreover, the PAG concentrations of IL-1β, IL-6, and TNF-α and their receptors (namely, IL-1R, IL-6R, and tumor necrosis factor receptor [TNFR] subtype TNFR1, respectively) were increased in the STZ rats. Additionally, inhibiting IL-1R, IL-6R, and TNFR1 ameliorated mechanical allodynia and thermal hyperalgesia in STZ rats, alongside the downregulation of PI3K-mTOR signaling. @*Conclusions@#Overall, the current study suggests that upregulated proinflammatory cytokines and their receptors in the PAG activate PI3K-mTOR signaling, thereby producing a de-inhibition effect on descending pathways in modulating pain transmission, and eventually contributing to neuropathic pain.

20.
The Korean Journal of Pain ; : 176-184, 2021.
Article in English | WPRIM | ID: wpr-896086

ABSTRACT

Background@#Diabetes-related neuropathic pain frequently occurs, and the underpinning mechanism remains elusive. The periaqueductal gray (PAG) exhibits descending inhibitory effects on central pain transmission. The current work aimed to examine whether inflammatory cytokines regulate mechanical allodynia and thermal hyperalgesia induced by diabetes through the phosphoinositide 3-kinase (PI3K)-mammalian target of rapamycin (mTOR) pathway in the PAG. @*Methods@#Streptozotocin (STZ) was administered intraperitoneally to mimic allodynia and hyperalgesia evoked by diabetes in rats. Behavioral assays were carried out for determining mechanical pain and thermal hypersensitivity. Immunoblot and ELISA were performed to examine PAG protein amounts of interleukin-1β (IL-1β), IL-6, and tumor necrosis factor-α (TNF-α), as well as their corresponding receptors in STZ rats, and the expression of PI3K/protein kinase B (Akt)/mTOR signaling effectors. @*Results@#Increased PAG p-PI3K/p-Akt/p-mTOR protein amounts were observed in STZ-induced animals, a PI3K-mTOR pathway inhibition in the PAG attenuated neuropathic pain responses. Moreover, the PAG concentrations of IL-1β, IL-6, and TNF-α and their receptors (namely, IL-1R, IL-6R, and tumor necrosis factor receptor [TNFR] subtype TNFR1, respectively) were increased in the STZ rats. Additionally, inhibiting IL-1R, IL-6R, and TNFR1 ameliorated mechanical allodynia and thermal hyperalgesia in STZ rats, alongside the downregulation of PI3K-mTOR signaling. @*Conclusions@#Overall, the current study suggests that upregulated proinflammatory cytokines and their receptors in the PAG activate PI3K-mTOR signaling, thereby producing a de-inhibition effect on descending pathways in modulating pain transmission, and eventually contributing to neuropathic pain.

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