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ObjectiveTo qualitatively analyze the chemical constituents and their tissue distribution in Lujiao formula based on ultra performance liquid chromatography-quadrupole-electrostatic field orbitrap high resolution mass spectrometry(UPLC-Q-Orbitrap-MS). MethodThe separation was performed on an ACQUITY UPLC® BEH C18 column(2.1 mm×100 mm, 1.7 μm) with the mobile phase of 0.1% formic acid aqueous solution(A)-methanol(B) in a gradient elution(0-2 min, 4%B; 2-6 min 4%-12%B; 6-38 min, 12%-70%B; 38-38.5 min, 70%B; 38.5-39 min, 70%-95%B; 39-43 min, 95%B; 43-43.1 min, 95%-4%B; 43.1-45 min, 4%B), the flow rate was 0.3 mL·min-1 with the column temperature of 40 ℃ and the injection volume of 5 µL. The data were acquired by an electrospray ionization(ESI) in the full scanning mode of positive and negative ions, the scanning rang was set at m/z 100-1 500, the collision energies were 10, 20, 40 eV. Retention time, precise relative molecular mass and secondary mass spectrometry fragment ions were used to identify the compounds in Lujiao formula and analyze their tissue distribution, combing with self-established database and comparing with standard substances and published literature data. ResultA total of 260 compounds, including 156 flavonoids, 43 terpenoids, 18 coumarins, 13 organic acids, 7 phenylethanoids, 7 alkaloids and 16 others, were identified or hypothesized from Lujiao formula, 68 of which were identified by comparison with standard substances. And the results of tissue distribution showed that 100, 143, 129 and 126 prototype components were detected in blood, heart, liver and kidney, respectively. ConclusionThe chemical composition of Lujiao formula and their tissue distribution were systematic analyzed, which can provide reference for the quality control, clinical application, pharmacokinetics and pharmacodynamic material basis of Lujiao formula and its medicinal materials.
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Immune factors play an important role in recurrent spontaneous abortion(RSA),and immune imbalance affects embryo implantation,growth,and development.There is currently no consensus on the etiology and pathogenesis of RSA caused by immune factors.Based on the theory of latent toxic in TCM and combined with the pathological mechanism of the dynamic changes of immune abnormal substances in the body,this article proposed that latent toxic is the key cause of RSA caused by immune factors.Furthermore,it expounded the pathogenic characteristics of latent toxic:combination of heat and blood stasis hidden in the womb,and latent toxic plays a role in embryo formation under qi deficiency conditions.It is established that latent toxin stagnation in the membrane is the pathogenic mechanism.Moreover,this article revealed the variable pathological changes such as the blockage of the inner membrane system and the outer membrane system.Treatment should be based on the basic methods of tonifying qi and nourishing blood,tonifying kidney to secure the Thoroughfare Vessel,clearing heat and cooling blood,promoting blood circulation and removing blood stasis.This article could provide a theoretical basis for TCM syndrome differentiation and treatment of RSA caused by immune factors.
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Objective:To explore the application of list nursing management combined with different artificial liver treatment modes in patients with liver failure.Methods:Fifty-three patients with liver failure hospitalized in Bethune Hospital of Shanxi Province from July 2020 to July 2021 were selected as the control group, 63 patients with liver failure hospitalized in Bethune Hospital of Shanxi Province from July 2021 to July 2022 were selected as the intervention group. According to the different treatment modes of artificial liver for patients, plasma exchange (PE), double plasma molecular adsorption system (DPMAS) and PE + DPMAS treatment were set up in the two groups. The control group received routine nursing care, while the intervention group received checklist nursing care in addition. The changes of albumin (ALB) and prothrombin time (PT) indexes before and after the different treatment modes were compared, together with the occurrence of complications between the two groups after the intervention.Results:The baseline data between the two groups was balanced, the difference had no statistical significant ( P>0.05). After the therapy, the level of ALB of patients who had accepted DPMAS and PE + DPMAS in the intervention group were 25.3(24.0, 27.9) and 23.2(22.4, 26.3) g/L, which were lower than the 28.2(26.3, 29.7) and 29.4(27.2, 30.0) g/L in the control group, the differences were significant ( Z = 2.47, 3.55, both P<0.05). After the therapy, the level of PT of patients in the intervention group under all three treatment modes were 15.8(14.8, 16.8), 22.7(19.2, 26.2) and 6.0(14.6, 20.0) s, which were lower than the 17.4(15.9, 20.9), 26.3(21.4, 36.4) and 21.2(16.9, 23.4) s in the control group, the differences were significant ( Z = 2.10, 2.07, 2.21, all P<0.05). In the intervention group, there were 6 cases of hypotension, anaphylaxis, bleeding, coagulation and infection under the DPMAS treatment mode, which was significant lower than the 11 cases in the control group ( χ2 = 4.97, P<0.05). There were 4 cases in the intervention group with the PE + DPMAS treatment mode occurred complications in above, which were significant lower than the 11 cases in the control group ( χ2 = 6.87, P<0.01). Conclusions:Artificial liver treatment can improve patients′ liver function and coagulation, and list nursing management may help to improve the effect of artificial liver treatment. It can improve nurses′ awareness of risk prejudgement, reduce various risks in the treatment process, reduce the incidence of adverse reactions, and enhance health care and patient satisfaction.
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Objective:To survey on the status quo of the role cognition and job burnout among family doctor team members in Shenzhen Futian district.Methods:A survey on the role cognition and job burnout of family doctor members was conducted in October 2022. One family doctor team was randomly selected from each of the 92 community health service centers in Futian district of Shenzhen city, and all members of the selected family doctor teams were included in the survey. The Chinese version of the Maslach Burnout Inventory-Human Services Survey was used in the study, and the influencing factors of role cognition and job burnout, as well as the impact of role cognition on job burnout were analyzed.Results:A total of 361 family doctor team members were included in the survey, The scores of the Role Ambiguity and Role Conflict Scale were (35.25±5.21) and (27.03±13.73), respectively. In the Occupational Burnout Scale, the scores of Emotional Exhaustion, Dehumanization, and Personal Achievement Scale were (17.89±6.82), (6.51±2.54), and (30.95±5.70), respectively. There were significant differences in role ambiguity and job burnout among family doctor team members with different ages, professions, and years of work ( P<0.05). Team members aged≤30, general practitioners, and working time ≤5 years had higher scores for role ambiguity, emotional exhaustion, dehumanization, and lower personal achievement ( P<0.05). The score of role ambiguity was negatively correlated with the degree of emotional exhaustion and dehumanization ( r=-0.544, -0.352), and positively correlated with personal achievement ( r=0.473). The score of role conflict was positively correlated with the degree of emotional exhaustion and dehumanization ( r=0.352, 0.376), and negatively correlated with personal achievement ( r=-0.440). Regression analysis showed that the role cognition was significantly associated with the emotional exhaustion, dehumanization, and personal achievement ( F=10.28-85.12, P<0.01). Conclusion:Active and effective measures should be taken to improve the role cognition and reduce job burnout of family doctor team members in primary health care institutions.
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ObjectiveTo observe the regulation of Qigongwan on the expression of proliferation and apoptosis-related factors programmed cell death 4 (PDCD4) and proliferating cell nuclear antigen (PCNA) in ovarian granulosa cells (GCs) in patients with polycystie ovarian syndrome (PCOS) infertility with phlegm-dampness syndrome, and to explore the effect of Qigongwan on the quality of oocytes and embryonic development potential. MethodSixty-six patients with PCOS with phlegm-dampness syndrome who underwent in vitro fertilization and embryo transfer (IVF-ET) were randomly selected and divided into an observation group (Qigongwan + western medicine) and a control group (western medicine), with 33 patients in each group. Antagonist regimen was used to promote ovulation in the two groups. The observation group was given Qigongwan one cycle before IVF based on the treatment of conventional western medicine, while the control group was not given Chinese medicine. The improvement of phlegm and dampness syndrome, the dosage and the number of days of using gonadotropins (Gn), the levels of luteinizing hormone (LH), estradiol (E2), and progesterone (P) on the day of human chorionic gonadotropin(HCG) injection, the 2PN fertilization rate, and the high-quality embryo rate of patients in the two groups were compared. Real-time polymerase chain reaction (Real-time PCR) and Western blot technology were used to detect the expression of PCNA and PDCD4 in GCs. ResultAs compared with groups before treatment, the score of phlegm-dampness syndrome in both groups was significantly lower (P<0.01). The score of phlegm and dampness syndrome in the observation group was significantly lower than that of the control group (P<0.01). As compared with the control group, the levels of LH, E2, and P in the observation group was higher, but only the difference in the level of E2 was statistically significant (P<0.01). The 2PN fertilization rate [82.25% (556/676) vs 69.92% (365/522), χ2=25.172, P<0.01] and high-quality embryo rate [44.19% (190/430) vs 34.23% (102/298), χ2=7.266, P<0.01] in the observation group were significantly higher than that of the control group (P<0.01). As compared with the control group, the mRNA and protein expression of PDCD4 in ovarian GCs was down-regulated in the observation group and that of PCNA was up-regulated (P<0.05). ConclusionBy down-regulating the expression of PDCD4 and up-regulating the expression of PCNA, Qigongwan may interfere with follicle development, adjust hormone levels, improve the symptomatic manifestations of patients with PCOS with phlegm-dampness syndrome, inhibit the apoptosis of GCs, and promote growth, thus improving the quality of oocytes and embryonic development potential.
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Objective:Explore the predictive value of body composition and related factors in early detection of gestational diabetes mellitus (GDM).Methods:949 pregnant women (142 cases in GDM group and 807 cases in normal group) in early pregnancy were selected from March 2019 to March 2020 in Suzhou Municipal Hospital, subject's clinical data were recorded. Body composition was measured by bioelectrical impedance method before the 13th week of pregnancy, and the relationship between age, protein, basal metabolic rate, body mass index (BMI) before pregnancy, body fat percentage, fat mass index (FMI), pregnancy times and the screening results of glucose tolerance in the second trimester of pregnancy were analyzed. The risk factors of GDM were further identified by multivariate regression analysis. Finally, the ROC curve was drawn to determine the diagnostic value of GDM, and the best boundary value was found to calculate the sensitivity and specificity of the indicators.Results:The age (20.82±2.60 vs 22.35±3.64), BMI before pregnancy (20.82±2.60 vs 22.35±3.64), percentage of body fat (29.37±5.63 vs 32.14±5.77), FMI [6.06(5.00, 7.30) vs 6.87(5.60, 8.60)] and pregnancy times [1(1, 2)vs 2(2, 3)] in GDM group were higher than those in normal group. Pregnancy times ( OR=1.232, 95% CI: 1.033-1.471) and FMI ( OR=1.228, 95% CI: 1.057-1.426) are independent risk factors of GDM. When FMI was used to predict the incidence of GDM, the area under the curve (AUC) was 63.0%. Conclusion:Pregnancy times and FMI in early pregnancy can be used as independent predictors of GDM. They provide a basis for scientific adjustment of diet and reasonable exercise, thereby preventing the GDM as early as possible. FMI can be reduced by adjusting the dietary structure and engaging in reasonable exercise, to reduce its risk among pregnant women.
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Coronary artery disease (CAD) is a chronic disease but causes the highest mortality and morbidity among the cardiovascular diseases worldwide. Correlations between CAD and gut microbiota have been observed. This suggests that the gut microbiota could become a vital diagnostic marker of CAD, and restoring the gut habitat may become a promising strategy for CAD therapy. The elevated level of trimethylamine-N-oxide (TMAO), a gut microbiota-derived metabolite, was found to be associated with the increased risk of cardiovascular disease and the all-cause mortality. Preclinical studies have shown that it has pro-arteriosclerosis properties. It is likely that regulating the production of TMAO by gut microbiota may become a promising strategy for anti-atherosclerosis therapy. This review summarizes the clinical and preclinical researches on the intervention of CAD by regulating the gut microbiota and the microbiota-derived metabolite TMAO, with the aim to provide new target for the therapy of CAD.
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Humans , Coronary Artery Disease , Gastrointestinal Microbiome , Methylamines , OxidesABSTRACT
OBJECTIVE@#To explore the genetic basis for a child with spondyloepimetaphyseal dysplasia type 1 and joint laxity.@*METHODS@#High-throughput sequencing and Sanger sequencing were used to analyze potential variant of the B3GALT6 gene.@*RESULTS@#DNA sequencing has identified 2 variants of the B3GALT6 gene in the patient, namely c.694C>T and c.539_540insCCT, which were respectively derived from his father and mother.@*CONCLUSION@#The c.694C>T and c.539_540insCCT variants of the B3GALT6 gene probably underlie the disease in the patient. The result has enabled molecular diagnosis, genetic counseling and prenatal diagnosis for his family.
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Objective To explore the significance of the cut point of peak level of luteinizing hormone (LH) in gonadotropin-releasing hormone (GnRH) agonist test in the diagnosis of precocious puberty in obese girls.Methods According to the diagnostic criteria of children's central precocious puberty diagnosis consensus (2015),796 cases of precocious puberty (peak level of LH ≥3.3 IU/L) in Children's Hospital of Zhejiang University School of Medicine from January 2014 to December 2015 were divided into normal weight group (573 cases),overweight group (170 cases) and obesity group (53 cases).The 3 groups were compared in terms of basic level of LH,basic level of follicle stimulating hormone (FSH),peak level of LH and FSH,ratio of LH (peak)/FSH (peak),sex hormone binding protein (SHBG),and children with 3.3 IU/L ≤peak level of LH <5.0 IU/L were followed up.The accuracy of the diagnosis of central precocious puberty using peak level of LH was analyzed by using receiver operating characteristic (ROC) curve.Results The median of LH (peak) in the obese group was 6.92 IU/L,the median of SHBG was 46.52 nmol/L,the median of LH (peak) in normal weight group was 8.92 IU/L,and the median of SHBG was 87.28 nmol/L.There were significant differences between the 2 groups (P < 0.05,0.001).A total of 89 cases in normal weight group and 65 cases of obesity/overweight group (3.3 IU/L ≤peak level of LH <5.0 IU/L) were followed up for 1 year,and 18 cases in normal weight group and 33 cases in obesity/overweight group developed to central precocious puberty,while the number of cases in the 2 groups was significantly different (P <0.001).The ROC curve analysis showed that the cut point of peak level of LH was 4.16 IU/L,the sensitivity was 0.606,the specificity was 0.656,and the Jordan index was the largest (0.344).Conclusions The peak level of LH in GnRH agonist test is important for the diagnosis of central precocious puberty in girls,but the effect of body mass index on its cut point needs to be considered.
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Objective@#To explore the effect of enterostomy on analgesic pattern in advanced digestive tract cancer.@*Methods@#A retrospective cohort study was carried out, which was approved by the Ethics Committee of the Sixth Affiliated Hospital of Sun Yat-sen University (E2018026). Inclusion criteria were as follows: (1)age and gender were not limited; (2) all the gastrointestinal malignancies were confirmed histologically, and local recurrence or metastasis were confirmed by CT or MR; (3) numerical rating scale (NRS) ≥4 points, opioid analgesic drugs were required; (4) informed consents were signed by patients of their own. Exclusion criteria were as follows: (1) malignancies of early stage; (2) suspicious adverse mental states which might lead to poor administration compliance; (3) hypersensitivity or allergic reactions to opioids. Clinical data of patients with advanced gastrointestinal cancer receiving comprehensive treatment at the Medical Oncology Department of the Sixth Affiliated Hospital of Sun Yat-sen University from September 2016 to April 2017 were retrospectively collected. The patients were divided into the stoma group and the non-stoma group. The clinical findings of two groups were analyzed, including age, sex, ostomy status, pain location, presence or absence of intestinal obstruction, pain characteristics, selection of opioid analgesic agents, treatment of side effects of analgesics. Pain was assessed using brief pain inventory(BPI) table and NRS score. Strong opioids were prescribed for patients of NRS ≥4. Patients who were intolerant to opioids required opioid titration. The titration drugs included oral or IV morphine and oxycodone. After achievement of adequate pain control, long-acting opioids were administered, which included sustained-release morphine tablets, controlled release oxycodone and transdermal fentanyl. Criteria for pain relief included NRS≤3, breakthrough pain <3 times/day and duration of adequate pain control >3 days. The χ2 test and the Wilcoxon signed rank sum test (nonparametric test) were used to analyze the clinical features of patients in the stoma and non-stomach groups. In order to find the factors associated with maintenance therapy and the use of laxatives, the variables were compared as well as in multivariate analysis with multiple regression models. For all the statistical tests, a value of P<0.05 in a two-tailed test was established as the alpha significance level.@*Result@#A total of 123 patients were enrolled in this study, including 79 males (64.2%) and 44 females (35.8%) with a median age of 51 years. Fifty-two patients were in stoma group, including 30 (24.4%) of ileostomy and 22 (17.9%) of colostomy, and 71 patients were in non-stoma group. Pain of 40 (76.9%) patients in stoma group located in abdomenopelvic site while the pain of 44 (62.0%) patients in non-stoma group located in other sites. Compared with non-stoma group, cases in stoma group complained more abdominopelvic pain (73% vs. 62.0%, P<0.001).The median NRS pain score before treatment in the stoma group and the non-stoma group was 5.7 and 5.6, respectively, without statistically significant difference (P=0.741). After analgesic management, the above scores reduced to 2.1 and 2.3, respectively, without statistically significant difference as well (P=0.092). Analgesic treatment was effective in 111 cases (90.2%), including 49 cases (94.2%) in the stoma group, and 62 cases (87.3%) in the non-stoma group, and there was no statistically significant difference between the two groups (P=0.202). There was more application of fentanyl transdermal patch [34.6%(18/52) vs. 9.8%(7/71)] in the stoma group, while more application of lactulose laxative [78.9%(56/71) vs. 61.5%(32/52)](χ2=10.023, P=0.002) in the non-stoma group. Multivariate analysis revealed that ostomy (OR=0.290, 95%CI: 0.102-0.824, P=0.009) and pain site (OR=5.691, 95%CI:1.709-18.948, P=0.005) were independent factors affecting the choice of the first line opioid sustained release agent. Of the 123 patients with maintaining analgesia, 98 had available data of laxative use, of whom 46 used laxatives to prevent or treat constipation, and the proportion of laxatives in stoma group (21.2%, 11/52) was significantly lower than that in non-stoma group (49.3%, 35/71) (χ2=6.957, P=0.008). Multivariate analysis of the application of laxative use showed that age (OR=0.281, 95% CI: 0.123-0.684, P=0.010) and ostomy (OR=2.621, 95% CI: 1.033-6.687, P=0.045) were independent factors affecting the use of lactulose laxatives.@*Conclusions@#Enterostomy may affect the analgesic pattern in advanced digestive tract cancer. Patients with stoma are more likely to use fentanyl transdermal patches and younger patients with stoma do not need prophylactic use of laxatives.
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Objective@#To understand the current situation of blood-borne occupational exposure among health care workers and evaluate the intervention effect of PDCA.@*Methods@#Retrospective survey was adopted to investigate and analyze the blood-borne occupational exposure incidents in a hospital from January 2015 to December 2018, and to compare the intervention effects after PDCA management.@*Results@#A total of 82 cases of occupational exposure occurred from 2015 to 2017, and only 9 cases happened after the implementation of PDCA intervention. The exposed population was mainly consisted of nurses (59 cases, 64.83%) , and mainly with low-working age (1-5 years) (56 cases, 61.54%) , and the main source of exposure was hepatitis B (34 cases, 37.36%) . In addition, after the implementation of PDCA, the vaccination rate of personnel was 77.78%, the standardized field treatment rate was 100%, the preventive drug use rate was 88.89%; The qualified rate of occupational protection assessment was higher than that before intervention, which all shows the difference was statistically significant (P<0.05) .@*Conclusion@#With the guide of PDCA management, Strengthen the training of new employees or ones with low working years as well as their awareness of protection, and standardize the relevant operational procedures, which can significantly improve the prevention of blood-borne occupational exposure and stress management of medical staff.
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<p><b>OBJECTIVE</b>To evaluate the safety and preliminary efficacy of dose-modified regimen of 5-fluorouracil plus oxaliplatin and irinotecan (mFOLFOXIRI) for patients with advanced colorectal cancer (CRC).</p><p><b>METHODS</b>Data of 312 CRC patients confirmed by pathology receiving triplet drug alone or combined with target therapy between October 2012 and December 2016 at the Sixth Affiliated Hospital of Sun Yat-sen University were retrospectively analyzed. CRC patients who had previously completed adjuvant therapy (or neoadjuvant therapy) within 6 months or palliative chemotherapy were excluded, meanwhile those with poor general condition (ECOG score > 2) or grade 2 neuropathy and allergy to oxaliplatin were excluded as well. Regimen of mFOLFOXIRI: oxaliplatin 85 mg/m² dissolved in 5% glucose solution 500 ml by intravenous infusion for 2 h; irinotecan 150 to 165 mg/m² dissolved in 0.9% sodium chloride 250 ml by intravenous infusion for 90 min; following intravenous infusion of leucovorin 400 mg/m² for 2 h, day 1; 5-FU 2800 mg/m², 48-h continuous intravenous infusion; once every 2 weeks. Therapy could be combined with a targeted drug, bevacizumab 5 mg/kg every two weeks; cetuximab 500 mg/m² every two weeks. Side effect was graded using the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE 4.0.3). The objective response rate was evaluated according to the Response Evaluation Criteria in Solid Tumors (RECIST 1.1) after administering at least four cycles of chemotherapy.</p><p><b>RESULTS</b>The median age was 52 years (range 16-73) in the whole group; 113 patients (36.2%) had locally advanced CRC, and 199 (63.8%) had metastatic CRC. Most patients (274/312, 87.8%) did not receive any treatment earlier. There were a total of 1651 chemotherapy cycles in the whole group, with a median of 6(1-19) cycles. Of these 1651 cycles, 124 cycles of chemotherapy(7.5%) were dose-adjusted; 176 cycles of chemotherapy(10.7%) were delayed for median 5(3-13) days; 124 cycles(7.5%) required dose decrease. The overall relative dose intensity was >90%; the specific drug dose intensity was 93.6%(2620 mg×m⁻²×d⁻¹) for fluorouracil, 97.8%(83 mg×m⁻²×d⁻¹) for oxaliplatin, and 94.2%(155 mg×m⁻²×d⁻¹) for irinotecan. Twenty-three patients (7 of intestinal perforation, 7 of intestinal obstruction, 1 of grade 4 hematologic toxicity, and 8 of grade 3 fatigue) refused subsequent chemotherapy due to intolerable toxicity. Main grade 3 or 4 adverse events in patients were neutropenia in 69 cases (22.1%), fatigue in 35 cases (11.2%), and anemia in 28 cases (8.9%). Twenty serious adverse events (6.4%) occurred, including 13 patients of febrile neutropenia (4.2%), 7 patients of intestinal perforation (2.2%, 4 patients in upper rectum, 2 in sigmoid colon, and 1 in transverse colon cancer), and 9 of them had subsequent sepsis (2.9%). All the patients with intestinal perforation underwent emergency operation. No treatment-related deaths occurred. In 199 patients with metastatic CRC, because 22 patients did not receive image evaluation, the preliminary efficacy of 177 patients was actually evaluated. A total of 113 objective response events were observed. The overall response rate was 63.8%(113/177), partial response rate was 61.6%(109/177), clinically complete response rate was 2.3%(4/177), stable disease was 29.9% (53/177), progressive disease was 6.2%(11/177), and the disease control rate was 93.8%(166/177). In 127 patients receiving triplet drug, objective response rate was 40.9% for those with less than four cycles and 81.1% for those with more than four cycles (P<0.001).</p><p><b>CONCLUSION</b>The mFOLFOXIRI regimen with reduced dose can be safely used in advanced CRC and has achieved promising results in terms of short-term efficacy.</p>
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Adolescent , Adult , Aged , Humans , Middle Aged , Young Adult , Antineoplastic Combined Chemotherapy Protocols , Therapeutic Uses , Camptothecin , Colorectal Neoplasms , Drug Therapy , Fluorouracil , Leucovorin , Organoplatinum Compounds , Retrospective Studies , Treatment OutcomeABSTRACT
Objective To investigate the Allele and genotype frequency distribution of four single nucleotide polymorphisms(SNPs)sites (rs4917,rs491 8,rs1071592,rs2248690) in Fetuin A gene with type 2 diabetes and type 2 diabetes complicated by atherosclerosis of lower limb arteries(ALLA) in Yi Nationality of Chuxiong,and evaluated for association of Fetuin A polymorphisms with ALLA in type 2 diabetes.Methods Four SNPs in Fetuin A were genotyped in One hundred twenty normal controls,sixty one T2DM cases and sixty seven ALLA in type 2 diabetes by polymerase chain reaction-restricted fragment length polymorphism (PCR-RFLP) and allelic specific primer-polymerase chain reaction(ASP-PCR).Results The CC genotype and Allele C of rs1071592 in normal controls was lower than those which ALLA in type 2 diabetes(P < 0.01),and there were no significant differences in frequency of genotype and allele distributions in the polymorphism analysis of rs4917 (C/T),rs4918 (C/G),rs2248690 (A/T) in these three groups (P > 0.05).Logistic regression analysis showed:the CC genotype of rs1071592 in Fetuin A were nominally associated with atherosclerosis of lower limb arteries of T2DM.Conclusion There existed polymorphism of4917(C/T),rs4918(C/G),rs2248690(A/T),rs1071592(C/A) of Fetuin A in Yi nationality of chuxiong.The CC genotype of rs1071592 might be genetic risk factors of type 2 diabetes complicated by ALLA.
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Objective@#To study the clinicopathologic characteristics, immunophenotype and ALK gene alterations of gastrointestinal inflammatory myofibroblastic tumor.@*Methods@#Clinical data, histological features and immunohistochemical results were analyzed in 7 cases of gastrointestinal inflammatory myofibroblastic tumor at Zhejiang Province Taizhou Hospital from January 2005 to December 2016. ALK gene status was investigated by ALK fluorescence in situ hybridization.@*Results@#There were 4 female and 3 male patients. The age of patients ranged from 1 to 72 years (median age=53 years and mean age=40 years). The tumor was located in stomach (n=4), left hemicolon (n=1), right hemicolon (n=1) and rectum (n=1). Histologically, the tumors consisted of spindle fibroblast and myofibroblast cells growing in bundles with inflammatory infiltration primarily composed of plasma cells and lymphocytes. Immunohistochemical study showed spindle tumor cells were positive for vimentin (7/7), SMA (7/7), but were negative for CD34, CKpan, CD117, DOG1, S-100 and desmin. Two cases expressed ALK protein and fluorescence in-situ hybridization revealed the presence of ALK gene rearrangement in the both cases.@*Conclusions@#Gastrointestinal inflammatory myofibroblastic tumor is a rare neoplasm that is easily misdiagnosed. Its surgical removal is a reliable treatment. ALK may be a potential novel therapeutic target for inflammatory myofibroblastic tumor.
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Objective To assess the prognostic benefits of intraoperative radiotherapy (IORT) with electron beam among patients with unresectable locally advanced pancreatic cancer.Methods Between January 2009 and December 2014,167 patients with unresectable locally advanced pancreatic cancer received IORT with electron beam (10-20 Gy) in our hospital.After surgery,12 patients were treated with external beam radiotherapy,56 patients with chemoradiotherapy (CRT),and 17 patients with chemotherapy.Overall survival (OS),local recurrence,and toxicities were retrospectively analyzed.The Kaplan-Meier method was used to calculate survival rates,the log-rank test was used for survival difference analysis and univariate prognostic analysis,and the Cox model was used for multivariate prognostic analysis.Results The follow-up rate was 100%.The median OS time was 10.3 months,and the 2-year OS rate was 22%.The median progression-fiee survival (PFS) time was 6.3 months,and the 2-year PFS rate was 9.9%.The cancer-specific survival (CSS) time was 11.2 months,and the 2-year CSS rate was 23.6%.In the patients treated with IORT alone at doses of<15 Gy,15 Gy and>15 Gy,the median OS times were 6.2 months vs.9.1 months vs.22.2 months,and the 1-year OS rates were 10.0% vs.39.6% vs.74.4% (P=0.000).Among the patients receiving postoperative adjuvant therapy,those treated with IORT+CRT had the best survival,with a median OS time of 11.6 months (P=0.033).The univariate analysis showed that IORT dose (P =0.000),tumor size (P =0.006),and IORT applicator diameter (P =0.007) were prognostic factors.The multivariate analysis showed that IORT dose (P=0.000) and IORT combined with CRT (P=0.006) were independent prognostic factors.Conclusions IORT with electron beam is an effective and safe treatment strategy for unresectable locally advanced pancreatic cancer.After protecting surrounding organs,increasing the IORT dose can improve the survival.IORT combined with CRT should be recommended because it improves survival for unresectable locally advanced pancreatic cancer without increasing toxicities.
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Objective To comprehensively analyze the effect and various detection indicators of leucocyte depletion suspended red blood cells(RBC) prepared by different storage time and different manufacturers of leucocyte depletion instrument to provide some decision-making basis for peers .Methods Two hundreds and forty bags of suspended RBC(1 ,1 .5 ,2 U) prepared from whole blood by 4 manufacturers were randomly collected and preserved in (4 ± 2)℃ dedicated refrigerator according to different specifica-tions .Then the sterile quick-release connector was used to take 240 leucocyte depletion suspended RBC samples of same specifica-tions and different shelf lives of 0 ,7 ,14 ,21 ,28 ,35 d by different manufacturers .Their capacity ,hematocrit ,leukocyte residues ,plas-ma free hemoglobin content and hemoglobin content were detected ,and the hemolysis rate at the end of shelf life was calculated .Re-sults The effect of leucocyte depletion suspended RBC by the same manufacturer had no statistical difference among different spec-ifications (P>0 .05);the capacity and plasma free hemoglobin content in the same specification had statistical difference among difference among different manufacturers (P<0 .05);the free hemoglobin and hemolysis rate at the end of shelf life in the same manufacturer had statistical difference among different preserving time (P<0 .05) .Conclusion By comprehensive considering the results of indexes of capacity ,hematocrit ,filter time ,free hemoglobin content and hemolysis rate ,our station chose the Shandong Weigao and Fresenius disposable leucocyte depletion plastic bags for ensuring the leucocyte depletion effect ,and safety and efficacy of RBC transfusion .
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Objective To explore the value of tracheal intubation guided by fiberoptic bronchoscopy in children snoring disease operation.Methods A total of 50 patients underwent tracheal intubation guided by fiberoptic bronchoscope or laryngoscope from August 2015 to June 2016.There were 25 cases of fiberoptic bronchoscopy assigned into group A, 25 cases of laryngoscopy into group B.The intubation time, success rate and adverse reactions of the two groups were compared and analyzed.Results All the intubation in group A succeed at the first time.The intubation time was (20.1±4.3) s and the position was right.There was no need for replacement during the operation.Three cases in group B succeed at the second time because the tonsil was too big to expose the pharynx.The intubation got out of the pharynx in 3 cases in group B and were adjusted to the right position.The intubation time was (50.7±6.9) s and the success rate at the first time was 76% (19/25).Groups A behaved better than group B in aspects of the success rate of signal intubation and intubation time (Fisher''s Exact Test, P=0.022;t=-18.725, P=0.000).There were no adverse reactions in group A, such as pharyngorrhagia, odontoseisis or loss of tooth, laryngospasm and so on.There were 3 cases of hemorrhage from throat after intubation, 3 cases of loss of tooth in different degrees and 1 case of laryngospasm at second intubation time in group B.There was no significant difference in adverse reactions between the two groups (P>0.05).ConclusionFiberoptic bronchoscopy can be used for children snoring disease with good safety as well as rare adverse reactions.
ABSTRACT
Objective To evaluate the feasibility and safety of thoracoscopic lung cancer surgery under non-tracheal intubation anesthesia. Methods Twenty patients with peripheral lung cancer were enrolled in experimental group and control group. Then monitored and recorded Systolic pressure (SBP), diastolic pressure (DBP), mean arterial pressure (MAP), heart rate (HR), electrocardiogram (ECG), heart rate (HR), Oxygen saturation (SpO2), Final moisture CO2 partial pressure (PETCO2), central venous pressure, invasive arterial blood pressure and blood glucose and the related complications like sore throat, hoarse voice, nausea and so onin such time points: before induction (T0), induction of intubation (T1), operation (T2), and sudden removal (T3) of the two groups. Results The laryngeal mask group was given a smaller stimulus to the cardiovascular system during anesthesia.The time of feeding, the exhaust, the time of getting out of bed, the average hospitalization day, the reduction of hospitalization expenses, pharynx, respiratory and cardiovascular complications were shorter and less than intubation group. Conclusion The laryngeal mask ventilation intravenous anesthesia with thoracic vagal nerve block in the thoracoscopic lobectomy is simple, safe, no intubation-related complications and single lung ventilation lung injury, in line with surgery -anesthesia overall minimally invasive development concept, worthy of clinical promotion.