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1.
Chinese Journal of Radiology ; (12): 274-281, 2023.
Article in Chinese | WPRIM | ID: wpr-992959

ABSTRACT

Objective:To explore the value of quantitative parameters of enhanced MRI in predicting the establishment of inferior vena cava collateral circulation in patients with renal cell carcinoma and inferior vena cava tumor thrombus.Methods:Sixty-seven patients with renal cell carcinoma and inferior vena cava tumor thrombus who underwent radical resection and inferior vena cava venography in First Medical Center, PLA General Hospital from May 2006 to January 2021 were included retrospectively. According to the results of inferior vena cava venography, the patients were divided into two groups: the well-established collateral circulation group ( n=41) and the poor-established collateral circulation group ( n=26). Quantitative parameters were measured on preoperative enhanced MRI images, including tumor size, the maximum diameter of bilateral lumbar veins, the length of tumor thrombus, and the long and short diameters of tumor thrombus. Student′s t test or Mann-Whitney U test was used for comparison between the two groups. The independent risk factors related to the establishment of collateral circulation were obtained by binary logistic regression analysis and the model was established. The receiver operating characteristic curve was employed to evaluate MRI quantitative parameters and the logistic model, and the area under the curve (AUC) was compared by the DeLong test. Results:Between the well-established collateral circulation group and the poor-established collateral circulation group, the maximum diameter of the right lumbar vein, the maximum diameter of the left lumbar vein, the length of the tumor thrombus, the long diameter of the tumor thrombus, and the short diameter of the tumor thrombus were different significantly ( P<0.05). There was no significant difference in the tumor size between the two groups ( t=0.30, P=0.766). The AUC of the maximum diameters of the right lumbar veins and left lumbar veins, length of tumor thrombus, long and short diameters of tumor thrombus in predicting the collateral circulation were 0.917 (95%CI 0.824-0.971), 0.869 (95%CI 0.764-0.939), 0.756 (95%CI 0.636-0.853), 0.886 (95%CI 0.785-0.951), and 0.906 (95%CI 0.809-0.963). The AUC of the maximum diameter of the right lumbar vein and the short diameter of the tumor thrombus were larger than those of the length of the tumor thrombus, and the differences were statistically significant ( Z=2.25, 2.04, P=0.025, 0.041), but the AUC between other parameters had no significant difference ( P>0.05). The maximum diameter of the right lumbar vein (OR 24.210, 95%CI 2.845-205.998), the maximum diameter of the left lumbar vein (OR 20.973, 95%CI 2.359-186.490), and the length of the tumor thrombus (OR 23.006, 95%CI 2.952-179.309) were independent risk factors for predicting the establishment of inferior vena cava collateral circulation. The AUC of logistic model was 0.969 (95%CI 0.931-1.000). Conclusion:Quantitative parameters of tumor thrombus and lumbar vein based on enhanced MRI have a good ability in predicting the establishment of inferior vena cava collateral circulation in patients with renal cell carcinoma and inferior vena cava tumor thrombus. The maximum diameter of bilateral lumbar veins and the length of the tumor thrombus were independent risk factors for inferior vena cava collateral circulation.

2.
Chinese Journal of Radiology ; (12): 306-310, 2023.
Article in Chinese | WPRIM | ID: wpr-992964

ABSTRACT

Objective:To investigate the histopathological and immunohistochemical changes of gastric fundus and duodenum after bariatric embolization of left gastric artery and gastroduodenal artery in obesity New Zealand rabbit models.Methods:Twenty obesity New Zealand rabbit models were successfully established and divided into two groups using stratified randomization. Left gastric artery and gastroduodenal artery were embolized with gelatin sponge (350-560 μm) in experimental group, left gastric artery and gastroduodenal artery were perfused with normal saline in control group. All animals were sacrificed for pathological, immunohistochemical examination and Western Blot analysis 4 weeks post embolization, the density of ghrelin producing cells and the gray ratio of ghrelin protein band were measured and compared by the independent sample t test. Results:Macropathological examination showed ulceration in the anterior wall of the gastric body in one rabbit, histopathological examination showed mucosa ulceration in the gastric body in 3 rabbits in experimental group. Immunohistochemical examination showed that the ghrelin producing cells of gastric fundus and duodenum in the experimental group were significantly less than those in the control group (10.0±5.1 vs.27.7±3.4, t=12.35, P<0.05;5.6±2.6 vs. 12.3±2.1, t=4.73, P<0.05). Western Blot analysis showed that the gray ratio of ghrelin bands of gastric fundus and duodenum in the experimental group were significantly lower than that in the control group (0.65±0.05 vs.1.12±0.09, t=9.62, P<0.05;0.55±0.03 vs. 0.94±0.08, t=7.98, P<0.05). Conclusions:Immunohistochemical and Western Blot analysis showed that the ghrelin-producing cells of gastric fundus and duodenum in the experimental group were significantly less than those in the control group after bariatric embolization, histopathologic analysis indicated that bariatric embolization was a safe technique.

3.
Zhonghua Wai Ke Za Zhi ; (12): 461-465, 2022.
Article in Chinese | WPRIM | ID: wpr-935622

ABSTRACT

Objective: To examine the clinical value of routine contrast esophagram (RCE) for the diagnosis of anastomotic leakage (AL) after three-incision esophagectomy with cervical anastomosis. Methods: Clinical data of 1 022 patients with esophageal cancer who underwent McKeown three-incision esophagectomy with cervical anastomosis from January 2015 to December 2019 at Department of Minimally Invasive Esophageal Surgery, Tianjin Medical University Cancer Hospital and Institute were analyzed retrospectively. There were 876 males and 146 females, aging(M(IQR)) 48(16) years (range: 36 to 84 years). There were 253 patients (24.8%) with neoadjuvant therapy, and 817 patients (79.9%) with minimally invasive esophagectomy. According to the diagnosis and treatment habits of the attending surgeons, 333 patients were included in the RCE group, and RCE was performed on the 7th day postoperative, while 689 patients were included in the non-RCE group, and RCE was performed when the patients had suspicious symptoms. Taking clinical symptoms, RCE, CT, endoscopy and other methods as reference to the diagnosis of AL, the sensitivity and specificity were used to analyze and evaluate the efficacy of RCE for the diagnosis of AL. The data were compared by U test or χ² test between groups. Results: The incidence rate of AL after three-incision esophagectomy was 7.34% (75/1 022), including 30 cases in the RCE group and 45 cases in the non-RCE group (9.0%(30/333) vs. 6.5%(45/689), χ²=2.027, P=0.155). The diagnostic time of AL was 9(5) days postoperative (range: 4 to 30 days). Among them, 23 cases showed cervical leakages, 50 cases showed intro-thoracic leakages, and 2 cases both cervical and intro-thoracic leakages. The diagnostic time of patients with intro-thoracic leakages was longer than that of cervical leakages (10(4) days vs. 6(3) days, Z=-2.517, P=0.012). Among the 333 patients in the RCE group, 16 cases of RCE indicated leakages including 11 cases of true positive and 5 cases determined to be false positive, while 317 cases indicated no abnormalities including 19 cases developed leakages. The sensitivity and specificity of RCE to detect AL were 36.7%(11/30) and 98.3%(298/333), respectively. The Youden-index was 0.35, and the diagnostic accuracy was 92.8%(309/333). The positive and negative predictive value were 11/16 and 94.0%(298/317), respectively. Conclusions: Routine contrast esophagram after three-incision esophagectomy with cervical anastomosis has low sensitivity and high specificity in the diagnosis of AL. The diagnostic time of AL is the 9th day after surgery. It is necessary to prolong the observation time clinically, and combine RCE with CT, endoscopy and other inspection methods for diagnosis.


Subject(s)
Female , Humans , Male , Anastomosis, Surgical/adverse effects , Anastomotic Leak/etiology , Esophageal Neoplasms/surgery , Esophagectomy/methods , Retrospective Studies , Surgical Wound/surgery
4.
Zhonghua zhong liu za zhi ; (12): 767-775, 2022.
Article in Chinese | WPRIM | ID: wpr-940937

ABSTRACT

Objective: To investigate the value of predicting the degree of differentiation of pulmonary invasive adenocarcinoma (IAC) based on CT image radiomics model and the expression difference of immunohistochemical factors between different degrees of differentiation of lesions. Methods: The clinicopathological data of patients with pulmonary IAC confirmed by surgical pathology in the Affiliated Huai'an First People's Hospital to Nanjing Medical University from December 2017 to September 2018 were collected. High-throughput feature acquisition was performed for all outlined regions of interest, and prediction models were constructed after dimensionality reduction by the minimum absolute shrinkage operator. Receiver operating characteristic curve was used to assess the predictive efficacy of clinical characteristic model, radiomics model and individualized prediction model combined with both to identify the degree of pulmonary IAC differentiation, and immunohistochemical expressions of Ki-67, NapsinA and TTF-1 were compared between groups with different degrees of IAC differentiation using rank sum test. Results: A total of 396 high-throughput features were extracted from all IAC lesions, and 10 features with high generalization ability and correlation with the degree of IAC differentiation were screened. The mean radiomics score of poorly differentiated IAC in the training group (1.206) was higher than that of patients with high and medium differentiation (0.969, P=0.001), and the mean radiomics score of poorly differentiated IAC in the test group (1.545) was higher than that of patients with high and medium differentiation (-0.815, P<0.001). The differences in gender (P<0.001), pleural stretch sign (P=0.005), and burr sign (P=0.033) were statistically significant between patients in the well and poorly differentiated IAC groups. Multifactorial logistic regression analysis showed that gender and pleural stretch sign were related to the degree of IAC differentiation (P<0.05). The clinical feature model consisted of age, gender, pleural stretch sign, burr sign, tumor vessel sign, and vacuolar sign, and the individualized prediction model consisted of gender, pleural stretch sign, and radiomic score, and was represented by a nomogram. The Akaike information standard values of the radiomics model, clinical feature model and individualized prediction model were 54.756, 82.214 and 53.282, respectively. The individualized prediction model was most effective in identifying the degree of differentiation of pulmonary IAC, and the area under the curves (AUC) of the individualized prediction model in the training group and the test group were 0.92 (95% CI: 0.86-0.99) and 0.88 (95% CI: 0.74-1.00, respectively). The AUCs of the radiomics group model for predicting the degree of differentiation of pulmonary IAC in the training group and the test group were 0.91 (95% CI: 0.83-0.98) and 0.87 (95% CI: 0.72-1.00), respectively. The AUCs of the clinical characteristics model for predicting the degree of differentiation of pulmonary IACs in the training and test groups were 0.75 (95% CI: 0.63-0.86) and 0.76 (95% CI: 0.59-0.94), respectively. The expression level of Ki-67 in poorly differentiated IAC was higher than that in well-differentiated IAC (P<0.001). The expression levels of NapsinA, TTF-1 in poorly differentiated IAC were higher than those in well-differentiated IAC (P<0.05). Conclusions: Individualized prediction model consisted of gender, pleural stretch sign and radiomics score can discriminate the differentiation degree of IAC with the best performance in comparison with clinical feature model and radiomics model. Ki-67, NapsinA and TTF-1 express differently in different degrees of differentiation of IAC.


Subject(s)
Humans , Adenocarcinoma of Lung/pathology , Ki-67 Antigen , Lung Neoplasms/pathology , Retrospective Studies , Tomography, X-Ray Computed/methods
5.
Chinese Journal of Dermatology ; (12): 610-611, 2022.
Article in Chinese | WPRIM | ID: wpr-957706

ABSTRACT

Objective:To investigate clinical efficacy of curved fenestration and drainage procedure for the treatment of nail root abscess.Methods:From June 2018 to October 2020, 72 patients with nail root abscess were included in Department of Dermatology, Henan Armed Police Corps Hospital. According to the size, location and severity of the abscess, minimally invasive curved fenestration and drainage procedure was performed under nerve block anesthesia to reduce the pressure and drain the pus. Dressing change was strengthened after surgery, and wound healing was monitored.Results:Among the 72 patients, there were 37 males and 35 females, and their ages varied from 39 to 80 years (average: 63 years) . They all received curved fenestration and drainage procedure. Fifteen days after surgery, 66 cases were cured, 6 obtained marked improvement, and the response rate was 100%. Lesions did not completely subside in 1 patient due to poor blood glucose control and small exposure area at the fenestration site, while the condition of other patients was effectively controlled. Telephone follow-up was conducted 3 months after surgery, and no obvious nail defects or deformed appearance was observed in any of the cases.Conclusion:Curved fenestration and drainage procedure is a simple approach for nail root abscess, with satisfactory efficacy.

6.
Article in Chinese | WPRIM | ID: wpr-884648

ABSTRACT

Objective:The study aimed to study the efficacy and safety of combined dual therapy using anti-programmed death (PD)-1 and tyrosine kinase inhibitor (TKI) with combined triple therapy using anti-PD-1, TKI and locoregional intervention triple therapy in patients with postoperative refractory recurrent liver cancer.Methods:Patients with postoperative refractory recurrent liver cancer who had undergone either anti-PD-1 and TKI dual therapy or anti-PD-1, TKI and locoregional intervention triple therapy between July 2016 and March 2019 at the First Medical Center, Chinese PLA General Hospital were retrospectively studied. Tumor responses were assessed by the modified response evaluation criteria in solid tumors and overall survival and progression free survival were compared. Adverse events were evaluated according to the National Cancer Institute Common Terminology Criteria for Adverse Events.Results:Of 63 patients who were included in this study, there were 25 patients in the dual therapy group (16 males and 9 females, aged 54.3±8.8 years) and 38 patients in the triple therapy group (31 males and 7 females, aged 55.5±8.4 years). The 1-year survival rate of the triple therapy group was significantly higher than the dual therapy group (94.5%vs 54.9%) ( P<0.01). The disease control rate was 64.0% (16/25) in the dual therapy group and 84.2% (32/38) in the triple therapy group, and the difference was not significant ( P>0.05). The incidence of treatment-related adverse events in the triple therapy group and the dual therapy group were 78.9% (30/38) and 80% (20/25), respectively. There was no treatment-related death in the 2 groups. Conclusions:Anti-PD-1 and TKI dual therapy and anti-PD-1, TKI and locoregional intervention triple therapy were effective and tolerable treatments for postoperative refractory recurrent liver cancer. The latter treatment had a significantly better clinical benefit on survival outcomes.

7.
Article in Chinese | WPRIM | ID: wpr-817642

ABSTRACT

@#【Objective】To investigate the expression of FosB in invasive breast cancer and its correlation to the ultrasound findings and clinical significance.【Methods】Immunohistochemical and ultrasound examination were performed for 155 cases with invasive breast cancer,36 cases with paracancerous tissue and 30 cases with normal breast tissue. To investigate the correlations between the different expression of FosB with histological grade ,lymph nodes,and ultrasound findings.【Results】①The expression of FosB in paracancerous tissue and normal breast tissue was higher than that in invasive breast cancer(P<0.01). ②Based on immunohistochemical staining,high positive expression rate of FosB was associated with low histological grade,ER positive and PR positive(P<0.05). There was no correlation between FosB and age,tumor diameter,lymph nodes,Her2 and clinical stages(P>0.05)③The expression of FosB was higher in microcalcification positive and lymph nodes bigger tissues(P<0.05). There was no correlation between FosB and tumor size, regular shape,boundary,posterior attenuation ratio and blood flow(P>0.05).【Conclusion】The expression of FosB in invasive breast cancer was lower than that in paracancerous tissue and normal breast tissue. The different expression of FosB was correlated with histological grade,ER positive and PR positive. To study the expression of FosB in invasive breast cancer may be helpful for differential diagnosis and targeted treatment. The different expression of FosB was correlated with microcalcification,lymph nodes,and combined FosB with ultrasound findings may contribute to prognostic evaluation of breast cancer.

8.
Chinese Journal of Radiology ; (12): 980-985, 2020.
Article in Chinese | WPRIM | ID: wpr-868357

ABSTRACT

Objective:To explore the value of quantitative parameters of dynamic contrast-enhanced MRI(DCE-MRI) in evaluating the biological behavior of soft tissue tumors.Methods:The clinical data of 69 patients with soft tissue tumors confirmed by pathology in the Affiliated Hospital of Qingdao University from January 2017 to December 2019 were analyzed retrospectively, including 29 benign tumors and 40 malignant tumors. All patients were examined by routine MRI and DCE-MRI before the operation. The DCE-MRI parameters including volume transfer constant (K trans), rate constant (K ep) and extracellular space volume fraction (V e) were acquired by post-processing software analysis. Microvessel density (MVD) and Ki-67 labeling index (Ki-67 LI) were detected using immunohistoche mical method. Spearman correlation test was used to analyze the correlation between DCE-MRI quantitative parameters and MVD and Ki-67 LI.Independent sample t-test or Mann-Whitney U test was used to compare the difference of parameters between benign and malignant group, and the receiver operating characteristic (ROC) curves were performed to evaluate the diagnostic value. Results:There was positive correlation between K trans, K ep and MVD ( r=0.633, 0.727, P<0.0l), and positive correlation between K trans, K ep and Ki-67 LI ( r=0.557, 0.612, P<0.01). There was no correlation between V e and MVD, Ki-67 LI ( P>0.05). The K trans, K ep, MVD and Ki-67 LI in the malignant group were higher than those in the benign group, and the differences were significant ( P<0.05).There was no significant difference in V e value between malignant group and benign group. When K trans value of 0.169/min was used, the sensitivity, specificity and area under the ROC curve (AUC) for differentiating benign and malignant soft tissue tumors were 84.6%, 85.8% and 0.859, respectively. When K ep value of 0.367/min was used, the sensitivity, specificity and AUC were 92.3%, 83.3% and 0.846, respectively. Conclusion:The DCE-MRI quantitative parameters K trans and K ep can be used to evaluate the biological behavior of soft tissue tumors.

9.
Chinese Journal of Orthopaedics ; (12): 902-910, 2020.
Article in Chinese | WPRIM | ID: wpr-869042

ABSTRACT

Objective:To explore the effect of minimally invasivetransforaminal lumbar interbody fusion (MIS-TLIF) on lumbar multifidus muscle using MRI techniqueandits clinical significance.Methods:From September 2016 to July 2019, 23 patients who underwent MIS-TLIF surgery for unilateral symptomatic disc herniation in unilateral segments (L 3,4, L 4,5, L 5S 1) of Qingdao University Affiliated Hospital were studied. Their lumbar MR examination was performed 1 week before surgery, and 3 and 6 months after surgery. The axial section of multifidus muscle cross section area (AxCSA) was measured on the axial T2WI image of each intervertebral disc level before and after the operation. The ratio of long and short lines (RLS) was calculated, andthe ratio of axial section of muscle fat infiltration cross section area (FLSA) and AxCSAwasrecorded as FLSA/AxCSA. The changes of various indexes of multifidus muscle in the affected side and the healthy side of the lumbar spine before and after the operation were compared, and the effect of the MIS-TLIF procedure on the morphology of the multifidus muscle was observed. Magnetic resonance spectroscopy (MRS) measurements of the muscle cross-section of the affected side were performed before and 6 months after the operation. The integral value of intracellular lipid (IMCL) and extracellular lipid (EMCL) of 1H spectrum muscle cells was compared, while the degree of fat infiltration was measured. Results:Patients with single-segment lumbar disc herniation had larger AxCSAin the healthy side than the affected side before surgery in surgical level ( t=6.611, P<0.05), and the muscle AxCSAin the healthy side was larger than the affected side in non-surgical levels ( t=-6.682, P<0.05), both suggested preoperative muscle volume advantage in the healthy side; no difference in bilateral AxCSA at 3 months was found after surgeryin surgical levels ( t=0.197, P> 0.05)and non-surgical levels ( t=-1.631, P> 0.05), which suggested bilateral muscle volume equal advantageat short-term follow-up. The FLSA/AxCSA of affected segment before and after 3 months was 9.5%±3.8% and 8.7%±1.5%, and the difference was statistically significant ( t=3.163, P<0.05); the RLS of affected segment before and after 3 months was 3.3%±0.24% and 2.7%±0.83%, and the difference was statistically significant ( t=3.42, P<0.05). The medians of EMCL/IMCL before and after 6 months of MRS were 2.010 and 1.475, respectively, and EMCL decreased after 6 months ( Z=0.48, P<0.05). Conclusion:Patients with single-segment lumbar disc herniation have different morphology of bilateral multifidus muscle before surgery. MIS-TLIF has little effect on the multifidus muscle of the surgical side. MIS-TLIF significantly reduces extracellular lipid accumulation, promotes intracellular transfer, and increases intracellular fat metabolism. Its retention of muscle attachment points and limited fixation can also reshape compensatory muscle atrophy.

10.
Article in Chinese | WPRIM | ID: wpr-817769

ABSTRACT

@#【Objective】ToinvestigatetheexpressionandclinicalsignificanceofJunDinmolecularsubtypesofinva⁃ sivebreastcarcinoma,benignandmalignantbreastlesions.【Methods】Immunohistochemicalexaminationwasperformed for160patientswithinvasivebreastcarcinoma,191patientswithbreastintraductalproliferativelesionsand20patients withnormalbreasttissue.【Results】①ComparisonwithothersubtypesshowedthattheexpressionofJunDwassignificantly increasedinTBNCsubtype(P<0.05)anddifferencesbetweenothersubtypeswerenotstatisticallysignificant(P>0.05) . ②TheexpressionofJunDininvasivebreastcarcinomawaslowerthanthatinbreastintraductalproliferativelesionsand normalbreasttissuse(P <0.01) .③Basedonimmunohistochemicalstaining,highpositiveexpressionrateofJunDwas associatedwithlowhistologicalgrade(P <0.01).ThereisnocorrelationbetweenJunDandtumordiameter,age,lymph nodes,ER,PRandhistologicalgrade(P >0.05) .【Conclusions】TheexpressionofJunDwassignificantlyincreasedin TBNCsubtype.TostudytheexpressionofJunDinTBNCsubtypeofinvasivebreastcarcinomamayprovideanevaluation intargetedtreatment.ThedifferentexpressionofJunDinbenignandmalignantbreastlesionsmaybehelpfulfortheir differentialdiagnosis.

11.
Article in Chinese | WPRIM | ID: wpr-802126

ABSTRACT

Objective: To explore the possible mechanism of Duhuo Jisheng Tang in relieving knee osteoarthritis based on protein kinase R-like endoplasmic reticulum kinase (PERK)/immunoglobulin-binding protein (Bip) signaling pathway.Method: A model of knee osteoarthritis was established by cold stimulation.Rats were randomly divided into blank group,model group,celecoxib group (0.021 g·kg-1),low,medium and high-dose Duhuo Jisheng Tang groups (8.37,16.72,33.48 g·kg-1).Blank group and model group were given equal volume of physiological saline.The changes of knee joint diameter were recorded.The pathological changes of rat articular cartilage were observed by hematoxylin-eosin (HE) staining.The expressions of tumor necrosis factor-alpha (TNF-α),interleukin-1β(IL-1β) and hyaluronic acid (HA) in serum were detected by enzyme-linked immunosorbent assay (ELISA).The mRNA and protein expression levels of PERK,Bip and cysteinyl as parates pecific protein-9(Caspase-9) in cartilage were detected by Real-time PCR and Western blot.Result: The knee joint redn ess and the joint diameter of celecoxib group and high-dose Duhuo Jisheng Tang group were improved,and the joint diameter was reduced significantly (Pα,IL-1β and HA were increased in model group (PPPα,IL-1β and HA in serum of celecoxib group and high-dose Duhuo Jisheng Tang group were decreased (PPPPConclusion: Duhuo Jisheng Tang can alleviate the symptoms of knee osteoarthritis model rats,and its mechanism may be related to the regulation of PERK/Bip signaling pathway in rat cartilage.

12.
Chinese Journal of Radiology ; (12): 121-126, 2019.
Article in Chinese | WPRIM | ID: wpr-745219

ABSTRACT

Objective To evaluate the safety and efficacy of transcatheter arterial embolization (TAE) in the management of refractory hematuria of prostatic origin (RHPO). Methods This retrospective study from 6 hospitals in china consisted of 31 patients (mean age 75.0±7.5 years, range 58 to 84 years) who underent transcatheter arterial embolization (TAE) for RHPO between February 2011 and January 2017. Patients with RHPO who had complete imaging and clinical data were enrolled. Patients with incomplete clinical data, inability to assess hemostasis, and contraindications to TAE were excluded. The cause of RHPO was benign prostatic hyperplasia (BPH) in nine patients, prostate cancer in twelve, transurethral resection of prostate in four, open prostatectomy in two and prostatic sarcoma in four. Superselective arterial embolization, non-superselective arterial embolization or intra-arterial infusion chemotherapy was performed according to the etiology and angiography. Angiographic findings, technical success rate, clinical success rate, complications were recorded. Results Of the 31 patients, 6 patients (19.4%) were with active bleeding, 4 (12.9%) with aneurysm and 27 (87.1%) with abnormal neovascularization on the angiogram. The 31 patients underwent a totle of 37 TAE, the technical success rate was 100.0%(37/37) and the recent hemostasis success rate was 90.3%(28/31). The incidence of mild complications was 38.7%(13/31), there was no serious complication associated with TAE. Conclusion TAE is a safe and effective method for the treatment of refractory hematuria of prostatic origin.

13.
Article in Chinese | WPRIM | ID: wpr-753942

ABSTRACT

Objective: To analyze the change in community first diagnosis and two-way referral rate under the condition of the regional longitudinal medical consortium implementation in the country at large. According to the simulation results,some suggestions for hierarchical medical system were put forward. Methods : The community first diagnosis and two-way referral rates were determined using the literature meta-analysis, and were simulated under different conditions by means of the system dynamics. Results :The analysis results confirmed that simply increasing the financial subsidies can increase the community first diagnosis rate within a range from 0.08% to 0. 17%. For in case increases are made by the government in technical financial input to enhance the technical level of the community health service centers and in compensatory financial input to reduce the higher hospitals dependence on the light disease, results showed that the lower conversion rate increased within the range of 0.33%~0.45% in terms of the two-way referral rating. On the contrary, when technical financial input is increased to improve the technical level of community health service centers, the rate of change was in the range of 7.52% '- 12.61% - Conclusions : Firstly, the diversified strategy should be used to promote the achievement of graded diagnosis and treatment. Secondly, the Health Commission plays a key role in the promotion of themedical consortiumconstruction. Thirdly, medical insurance reimbursement differential strategy should be implemented and the supply-side reform should be strengthened. At last,attention should be paid to the rational development of existing referrals, especially the upper and lower ones.

14.
Article in Chinese | WPRIM | ID: wpr-701114

ABSTRACT

AIM:To investigate the effect of sodium hydrosulfide(NaHS)on cardiac function and activity of renin-angiotensin(Ang)-aldosterone(ALD)system(RAAS)in the rats with chronic heart failure(CHF).METHODS:The CHF rat model was established by abdominal aortic coarctation.SD rats were randomly divided into sham operation group,model group,low dose of NaHS group and high dose of NaHS group(n=6).The left ventricular end-diastolic di-ameter(LVEDD), left ventricular end-systolic diameter(LVESD)and left ventricular ejection fraction(LVEF)were measured before and after treatment by echocardiography in each group.The levels of renin,AngⅡand ALD in the plasma were measured by ELISA.The expression of angiotensin-converting enzyme(ACE)and angiotensin Ⅱ type 1 receptor (AT1R)at mRNA and protein levels in the myocardium tissues was determined by qPCR and Western blot,respectively. RESULTS:After treatment with NaHS,compared with model group and before treatment,LVEDD and LVESD in low dose of NaHS group and high dose of NaHS group were decreased significantly, while LVEF was increased significantly(P<0.05).Compared with low dose of NaHS group,LVEDD and LVESD were decreased,while LVEF was increased in high dose of NaHS group(P<0.05).Compared with sham operation group,the levels of renin,AngⅡand ALD in the plasma of model group were significantly increased(P<0.05),and the expression of ACE and AT1R at mRNA and protein levels in the myocardium tissues of model group were significantly increased(P<0.05).Compared with model group,the plas-ma levels of renin,AngⅡand ALD in low dose of NaHS group and high dose of NaHS group were significantly decreased (P<0.05),and the myocardial expression of ACE and AT 1R at mRNA and protein levels was significantly down-regulated (P<0.05).The plasma levels of renin,AngⅡand ALD,and the myocardial expression of ACE and AT 1R at mRNA and protein levels in high dose of NaHS group were significantly lower than those in low dose of NaHS group(P<0.05). CONCLUSION:NaHS inhibits the activation of RAAS,thus improving the cardiac function of CHF rats,and the effect of high-dose NaHS is better than that of low-dose NaHS.

15.
Article in Chinese | WPRIM | ID: wpr-703546

ABSTRACT

Objective:To compare and analyze the choice and application of policy tools in the construction of hierarchical medical system in different provinces of china, and to provide advice for improving the effectiveness of the hierarchical medical policy implementation. Methods:Retrieve the policy documents of provincial governments on hierarchical medical policy through internet search;sort names and categories of policy tools based on the classifica-tion of policy tools by Rothwell&Zegveld after consulting the expert,and analyze the use of policy tools by calculating the frequency of different policy tools. Results:This study has summed up 15 types of policy tools in 3 categories in-cluding demand,supply,and environment of provincial hierarchical medical policy. Supply policy tools accounted for 32.92%,demand policy tools accounted for 20.58%, and environmental policy tools accounted for 46.50%. The most widely used policy tool is the regulatory control, and the least used policy tool is the disease catalog. Conclu-sions:Among the choice of policy tools,the category of environmental policy tools are the most widely used,and de-mand policy tools are applied the least. The use of three types of policy tools in the eastern region are balanced,the demand policy tools in Central China are relatively few, and the environmental policy tools are widely used in the western region,while the demand oriented policy tools are scarce.

16.
Article in Chinese | WPRIM | ID: wpr-706325

ABSTRACT

Objective To observe the value of three-dimensional constructive interference in steady state (3D-CISS) sequence for displaying anterolateral ligament (ALL) of knee joint.Methods MR scans of right knee joint were performed on 30 healthy volunteers,and the protocol included axial and coronal fat saturation proton density weighted imaging (FS-PDWI) and 3D-CISS sequence.MRP and CPR (reconstructive angles including 0°,30°,60°,90°,120°,150° and 180°) images were generated from of 3D-CISS sequence.The visibility rates of the femoral part,meniscal part,tibial part,meniscal insertion,femoral footprint and tibial footprint of ALL were compared among different protocols.Results The visibility rates of tibial footprint and femoral footprint of ALL on 3D-CISS CPR images were both 96.67% (29/30),and on 3D-CISS MPR images were both 93.33% (28/30),all of them were higher than those on FS-PDWI images (all P<0.017).The visibility rates of tibial part,meniscal part and meniscal insertion of ALL on 3D-CISS CPR images were 96.67% (29/30),83.33% (25/30) and 83.33% (25/30),respectively,and all of them were higher than those on FS-PDWI images (all P<0.05).There was no statistical difference of visibility rate of femoral part between 3D-CISS CPR images and FS-PDWI images (P=0.095).Conclusion 3D-CISS sequence with CPR can significantly enhance the ability to identify ALL.

17.
Chinese Journal of Trauma ; (12): 754-758, 2018.
Article in Chinese | WPRIM | ID: wpr-707365

ABSTRACT

Objective The incidence of traumatic brain injury (TBI) has been on the rise year by year around the globe.According to the latest Guidelines for the Management of Severe Traumatic Brain Injury (Fourth Edition) released by the Brain Trauma Foundation (BTF),there is no sufficient evidence that related medicine can promote the repairment of neural injury in the treatment of central nerve damage.The clinical treatment of TBI is facing multiple difficulties.In recent years,brain computer interface (BCI) technology has developed rapidly and shown enormous potential in TBI repairment,especially in visual and auditory restoration,neural function recovery,and cognitive restoration.BCI provides a new approach to improve the quality of life for patients.This paper reviews the application and prospect of BCI in sense,motion,and cognitive function repairment after TBI,so as to provide new insights for the treatment of TBI nerve function.

18.
Article in Chinese | WPRIM | ID: wpr-773806

ABSTRACT

OBJECTIVE@#To establish an animal model for loaded swimming, so as to investigate the energy metabolism effects of soybean isoflavones (SI) on swimming mice.@*METHODS@#Thirty male Kunming mice were randomly divided into three groups:normal control, swimming group, and swimming+SI group. The normal control group mice were fed a basic AIN-93M diet, the SI groups were supplied with soybean isoflavones(4 g/kg).Two weeks later, the mice were forced to swim for an hour,and then all the mice were killed, the samples of blood, liver and muscles of hind were collected.The serum contents of lactic acid(Lac), the activities of lactic dehydrogenase (LDH), succinate dehydrogenase (SDH), creatine kinase (CK) and ATPase were measured.@*RESULTS@#Compared with normal control,the serum content of Lac was significantly improved in the group of the swimming control and SI(<0.05),the activity of LDH in the serum was obviously improved in the group of the swimming control and SI, and the activity of CK and SDH were both significantly improved in the group of the swimming control and SI except the activity of SDH in the liver of the group SI; compared with the swimming control,the serum contents of Lac,the activities of LDH, ATPase, SDH, CK were obviously improved(<0.05).@*CONCLUSIONS@#Soybean isoflavones can improve the energy metabolism,antioxidant capacity of the swimming mice.


Subject(s)
Animals , Male , Mice , Adenosine Triphosphatases , Blood , Creatine Kinase , Blood , Energy Metabolism , Isoflavones , Pharmacology , L-Lactate Dehydrogenase , Blood , Lactic Acid , Blood , Random Allocation , Glycine max , Chemistry , Succinate Dehydrogenase , Blood , Swimming
19.
Article in Chinese | WPRIM | ID: wpr-705208

ABSTRACT

OBJECTIVE To explore the antitumor effects of combined tanshinoneⅠ(TanⅠ),metformin (Met) and aspirin (Asp) on malignant melanoma in mice and the possible mechanisms. METHODS C57BL/6 mice were injected with 0.1 mL B16F10 cells(2.8×109L-1)to establish the subcutaneous trans-plantation tumor model at the right forelimbs axillary.Then,the mice were divided into 8 groups according to body mass,including model group, TanⅠgroup(20 mg·kg-1,ip),Asp group(210 mg·kg-1,orally in drinking water), Met group (70 mg·kg-1, orally in drinking water), Asp+Met group, TanⅠ+Asp group, TanⅠ+Met group and TanⅠ+Asp+Met group,10 mice in each group.Each mouse drank about 7 mL of water every day for a total of 18 d.The mouse body mass was measured every other day and the tumor diameter was calculated every day. The mice were sacrificed after treatment, the tumor mass was measured and the tumor inhibitory rates were counted. The histopathological changes of the liver and spleen were observed with HE staining. The percentage of lymphocytes in the tumor tissue such as CD8+T,CD4+T and Treg cells was detected by flow cytometry.Inflammatory factors such as interleukin-6 (IL-6),IL-1β and tumor necrosis factor-α (TNF-α) were detected by ELISA. RESULTS The body mass (including tumor mass)of mice in different groups increased during the experiment,but that of TanⅠ+Asp+Met group increased more slower than in model group(P<0.01).At the end of the experiment,no lesions were seen in any liver or spleen tissue by pathological observation,and the number of survivors was 8/10(model group),8/10(TanⅠgroup),7/10(Asp group),7/10(Met group),8/10(TanⅠ+Asp group), 8/10 (TanⅠ+Met group), 7/10 (Asp+Met group) and 5/10 (TanⅠ+Asp+ Met group), respectively. Compared with model group,there were no obvious changes in tumor volume or tumor mass in TanⅠ, Asp and Met groups and other two-two joint groups,but the tumor volume and tumor mass in TanⅠ+Asp+ Met group were significantly decreased (P<0.01, P<0.05), and the tumor inhibitory rate in this group was 46.2%.Compared with the model group,the percentage of CD8+T cells increased(P<0.05) in TanⅠ+Asp+Met group,but there were no significant changes in other groups.The contents of IL-6, IL-1β and TNF-α in tumor tissue of TanⅠ+Met group were much higher than in model group(P<0.01, P<0.05,P<0.05)and the content of IL-6 increased in TanⅠ+Asp+Met group(P<0.01).CONCLUSION Combination of TanⅠ,Asp and Met can effectively inhibit the growth of melanoma in mice,which may be related to the increasing percentage of CD8+T lymphocytes and IL-6 in tumor tissue.However there are possibly some side effects.

20.
Article in Chinese | WPRIM | ID: wpr-665492

ABSTRACT

Objective To explore MSCT optimal examination time window for patients with occult rib fracture, and provide objective evidence for forensic injury. Methods Totally 105 cases with chest trauma were retrospectively analysed. They were examined in the first week after trauma and re-examined in different time windows by MSCT. The quantities of occult rib fractures in the first examination were compared to those in re-examinations. Results The quantities of occult rib fractures at different inspection time windows were mostly different. There was no statistically significant between the quantities of rib fractures in the first week and the second week, the first week and the sixth week later, the fourth week and the fifth to sixth weeks (P>0.05). There was statistically significant between the quantities of rib fractures in the first week and the thrid to sixth weeks, the second week and the third to sixth weeks, the third week and the fourth to sixth weeks (P<0.05). Conclusion The result of the study imply that the fourth to sixth week is the optimal time window of MSCT examination in the occult rib fracture.

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