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1.
Journal of Clinical Hepatology ; (12): 322-327, 2022.
Article in Chinese | WPRIM | ID: wpr-920878

ABSTRACT

Objective To investigate the value of urinary α1-microglobulin (α1-MG) and N-acetyl-β-D-glucosaminidase/urinary creatinine (NAG/UCr) in monitoring renal injury in patients with chronic hepatitis B virus (HBV)-related liver diseases. Methods A total of 85 patients with HBV-related liver diseases who attended The Second Affiliated Hospital of Kunming Medical University from August 2019 to August 2020 were enrolled, and according to the history of treatment with nucleos(t)ide analogues (NUC), they were divided into NUC treatment group with 57 patients and non-NUC treatment group with 28 patients; according to the type of NUC used, the NUC treatment group was further divided into entecavir (ETV) treatment group with 32 patients and tenofovir disoproxil fumarate (TDF) treatment group with 25 patients; according to the results of HBV serum antigen and antibody markers, the patients were divided into HBeAg-negative group with 57 patients and HBeAg-positive group with 28 patients; according to the results of serum HBV DNA quantification, the patients were divided into HBV DNA-negative group with 47 patients and HBV DNA-positive group with 38 patients; according to abdominal imaging findings, the patients were divided into non-liver cirrhosis group with 47 patients and liver cirrhosis group with 38 patients. The data on medical history and laboratory markers were collected for comparison between two groups. The t -test was used for comparison of normally distributed continuous data between two groups, and the Mann-Whitney U test was used for comparison of data with skewed distribution between two groups; the chi-square test was used for comparison of categorical data between two groups. The McNemar test was used to compare the diagnostic merit of each index; a Spearman correlation analysis was used to investigate the correlation of each factor with α1-MG, and NAG/UCr; the multiple linear regression analysis was used to analyze the independent influencing factors for α1-MG and NAG/UCr. Results The non-NUC treatment group, the HBeAg-positive group, and the HBV DNA-positive group had significantly higher levels of urinary α1-MG than the NUC treatment group ( Z =-2.054, P =0.04), the HBeAg-negative group ( Z =-2.293, P =0.022), and the HBV DNA-negative group ( Z =-2.229, P =0.026), respectively. The HBV DNA-positive group and the liver cirrhosis group had significantly higher levels of NAG and NAG/UCr than the HBV DNA-negative group ( Z =-2.908 and -2.824, both P < 0.05) and the non-liver cirrhosis group ( Z =-3.204 and -3.412, both P < 0.05), respectively. There was a significant difference in the proportion of patients with abnormal α1-MG and that of patients with abnormal estimated glomerular filtration rate (eGFR) (31.8% vs 20.0%, χ 2 =7.178, P =0.007), and the proportion of patients with abnormal α1-MG and NAG/UCr was significantly higher than that of patients with abnormal eGFR (35.3% vs 20.0%, χ 2 =8.049, P =0.005). There was a significant difference in diagnostic merit between α1-MG+NAG/UCr and eGFR ( P =0.015). Age ( β =0.246, P < 0.05), positive HBeAg ( β =0.284, P < 0.01), and liver cancer ( β =0.291, P < 0.01) were independent risk factors for the increase in α1-MG, while the increase in FIB-4 value ( β =0.352, P < 0.05), ascites ( β =0.260, P < 0.05), esophagogastric varices( β =-0.248, P < 0.05), positive HBV DNA ( β =0.197, P < 0.05), and high total bilirubin ( β =0.257, P < 0.05) were independent risk factors for the increase in NAG/UCr. Conclusion In patients with chronic HBV-related liver diseases, renal injury may occur during the whole course of active viral replication, liver cirrhosis, and deterioration of liver function. Antiviral therapy with NUC can alleviate renal impairment caused by HBV and is safe and reliable within a certain course of treatment. Combined measurement of urinary α1-MG and NAG/UCr has more advantages over eGFR in the diagnosis of early renal injury, and it is an effective method for renal function monitoring in patients with chronic HBV-related liver diseases.

2.
Article in Chinese | WPRIM | ID: wpr-884218

ABSTRACT

Objective:To evaluate the efficacy of posterior subtotal vertebrectomy in the treatment of thoracolumbar vertebral refractures after vertebroplasty.Methods:A retrospective analysis was conducted in the 28 patients with refracture after percutaneous vertebroplasty(PVP) or percutaneous kyphoplasty(PKP) who had been treated at Department of Spinal Surgery, Henan Provincial People's Hospital from June 2017 to October 2019. They were 7 males and 21 females, with an average age of 62.4 years(from 61 to 76 years). A total of 28 vertebrae were involved, including 5 T11s, 9 T12s, 11 L1s and 3 L2s. Their previous operations were PKP in 17 cases and PVP in 11. After the spinous process, vertebral plate, articular process and transverse process were resected by posterior approach, the vertebral body, bone cement and upper and lower intervertebral discs were partially resected by trans-vertebral lateral approach. At the same time, nerve decompression was performed. Finally, the inter-vertebral support was fixated followed by the posterior screw-rod orthopedic fixation. The operation time and intraoperative bleeding volume were recorded. The cobb angles of kyphosis were compared on the X-ray films of the whole spine between preoperation and the last follow-up to evaluate correction. Functional improvement of the spine was evaluated by comparison of the visual analogue scale (VAS) and JOA(Japanese Orthopedics Association) scores between preoperation and the last follow-up.Results:The operation time averaged 182.1 min and intraoperative bleeding volume 996.2 mL. All the 28 patients were followed up for 8 to 29 months (mean, 19.8 months). No obvious neurological lesions or other serious complications were observed. The cobb angle was improved from preoperative 41.3°±10.3° to 6.4°±2.5° at the last follow-up, the VAS score from preoperative 7.3±1.8 to 2.5±1.0 at the last follow-up, and the JOA score from preoperative 8.4±2.3 to 21.3±2.5 at the last follow-up, showing a significant difference in all the comparisons ( P<0.05). Conclusion:The posterior subtotal vertebrectomy is effective for thoracolumbar vertebral refractures after vertebroplasty because it can remove bone cement, decompress the spinal canal, fuse the inter-vertebral graft and reconstruct the spinal stability in one stage.

3.
Article in Chinese | WPRIM | ID: wpr-882503

ABSTRACT

Radiation-induced brain injury is a serious untoward effect of radiotherapy for malignant tumors. Patients received radiotherapy frequently occur cognitive dysfunction which seriously affects the quality of life. Although the exact mechanisms regarding radiation-induced cognitive dysfunction remain unclear, prevention strategies targeting cognitive dysfunction are increasingly applied to clinical intervention, including whole brain radiotherapy with hippocampus avoidance, stereotactic radiosurgery in patients with multiple brain metastases, and pretreatment with neuroprotective drugs such as memantine and donepezil. In addition, measures including appropriate radiotherapy management models, regular cognitive tests, and therapeutic measures at the appropriate time are critical to improve the quality of life for brain tumor patients.

4.
Chinese Journal of School Health ; (12): 737-741, 2021.
Article in Chinese | WPRIM | ID: wpr-877141

ABSTRACT

Objective@#To explore the relationship between dietary patterns and central precocious puberty in children, and to provide a scientific basis for dietary prevention of precocious puberty.@*Methods@#A case-control study was conducted, among 35 newly diagnosed central precocious puberty girls from May to December 2019 as the case group, and 70 healthy girls with normal development as the control group. Physical development examination, parent questionnaire survey and child interview were carried out. Dietary information was assessed using a simplified food frequency questionnaire(FFQ). Principal component analysis was used to identify children s dietary patterns, and multiple Logistic regression was used to assess the association between dietary patterns and precocious puberty.@*Results@#Three different dietary patterns have been established, namely "snack and processed food type", "animal protein type" and "nutritional tonic type" dietary patterns, respectively. After adjusting for covariates such as age and BMI, Logistic regression analysis showed that the "snack and processed food type" dietary pattern was positively correlated with precocious puberty(OR=10.81, 95%CI=2.59-45.15, P<0.01). There was a negative correlation between "animal protein type" and precocious puberty(OR=0.24, 95%CI=0.06-0.91, P=0.04), while the association between "nutritive tonic" and precocious puberty was not statistically significant(OR=0.28, 95%CI=0.07-1.05, P=0.06).@*Conclusion@#Children s dietary patterns were related to precocious puberty." Snack and processed food "dietary pattern with a high intake of fried foods, puffed foods, foods containing preservatives or pigments, western fast foods, chocolate and products, was closely related to central precocious puberty.

5.
Chinese Journal of Trauma ; (12): 37-43, 2021.
Article in Chinese | WPRIM | ID: wpr-909830

ABSTRACT

Objective:To investigate the effect in lumbar mobility and stress of the facet joint and end plate after implantation of the movable artificial lumbar spine so as to lay a biomechanical foundation for its clinical application.Methods:Total lumbar CT data of a healthy adult male were selected to construct a finite element analysis model and its effectiveness was validated (physiological group). Two groups were replicated after removing the L 3 vertebral body and adjacent discs of the model in physiological group. One group was placed with each component of the movable artificial lumbar spine to construct the non-fusion model (non-fusion group). The other group was placed with titanium cage, titanium plate and other to construct the fusion model (fusion group). The models in the three groups were loaded with 500 N axial load and 10 Nm axial load, and the torque load was used to simulate the movement in six directions: forward flexion, backward extension, left and right lateral bending, and left and right torsion. The lumbar mobility and stress peak and distribution of the proximal facet joints (J 1-2, J 4-5), L 2 inferior endplate and L4 superior endplate at the three model operating sites (L 2-3, L 3-4) and adjacent segments (L 1-2, L 4-5) under the same conditions were compared. Results:The range of motions of the surgical site in flexion, extension, left bending, right bending, left torsion and right torsion were L 2-3of 3.9°-8.7° and L 3-4 of 3.6°-8.4° in non-fusion group, significantly increased compared with fusion group (L 2-3 0.1°-0.2°, L 3-4 0.1°-0.1°) and slightly increased compared with physiological group (L 2-3 2.3°-6.0°, L 3-4 2.3°-7.1°). The range of motions of the adjacent segments in the above six directions were L 1-2 of 1.4°-4.3° and L 4-5 of 1.4°-6.0° in non-fusion group, smaller than those in fusion group (L 1-2 2.1°-6.1°, L 4-5 3.3°-8.6°) and similar to those in physiological group (L 2-3 2.3°-6.0°, L 3-4 2.3°-7.1°). The peak values of von Mises stress in the proximal facet joints were J 1-2 of 7.07-19.21 MPa and J 4-5of 6.12-12.99 MPa in non-fusion group, similar to those in physiological group (J 1-2 8.42-18.53 MPa, J 4-5 7.49-11.70 MPa) and smaller than those in fusion group (J 1-2 10.54-21.16 MPa, J 4-5 10.63-16.13 MPa). The maximum von Mises stress of the L 2 inferior endplate and L 4 superior endplate in the above six directions was 29.39-54.72 MPa and 32.31-47.87 MPa in non-fusion group, significantly increased compared with the L 2 inferior endplate (21.20-42.07 MPa), L 4 superior endplate (22.50-36.76 MPa) and L 2 inferior endplate (11.04-29.55 MPa) in fusion group and the L 4 superior endplate (13.12-21.32 MPa) in physiological group. Conclusion:Compared with the traditional fusion prostheses, the placement of the movable artificial lumbar spine can reconstruct the range of motion of the surgical site in the direction of flexion, extension, lateral bending and torsion, greatly reduce the impact on the stress of adjacent facet joints and the range of motion of adjacent segments, and theoretically reduce the incidence of prosthesis subsidence.

6.
Article in Chinese | WPRIM | ID: wpr-908941

ABSTRACT

In order to meet the social demand for ultrasound talents, a layered training system of ultrasound medical talents suitable for China's national conditions has been explored. The department of ultrasound of West China Hospital of Sichuan University has formulated and implemented a "three-layers" ultrasound education and training system in combination with its own reality. The first layer mainly refers mastering the basic ultrasound examination ability mainly through relevant ultrasound theoretical knowledge and basic operation skills training. The second layer is based on the first level to further master the ability of ultrasound diagnosis and differential diagnosis of common and frequently occurring diseases in various systems, and to be capable of engaging in basic ultrasound teaching and scientific research. The third layer means mastering the ability of ultrasound diagnosis, evaluation and interventional diagnosis and treatment of difficult and specialized diseases, grasping the latest development direction of the sub-specialty, and having the ability to engage in ultrasound teaching and clinical research. The results show that the "three-layers" ultrasound education and training system conforms to China's national conditions and is worthy of reference and promotion.

7.
Article in Chinese | WPRIM | ID: wpr-848047

ABSTRACT

BACKGROUND: Avascular necrosis of the femoral head is mainly caused by insufficient blood supply of the femoral head. Core decompression is a common clinical treatment, enriched autologous bone marrow stem cell transplantation can improve hip function, and combined application can promote early recovery of patients. OBJECTIVE: To investigate the therapeutic effects of enriched autologous bone marrow stem cell transplantation combined with core decompression on serum levels of fibroblast growth factor-2, hypoxia-inducible factor-1α and vascular endothelial growth factor in patients with early avascular necrosis of femoral head. METHODS: Sixty-two cases of early avascular necrosis of femoral head treated from January 2016 to January 2018 were selected, and were divided into study group (n=31) and control group (n=31) according to the random number table method. The control group was treated with fine-needle porous-channel core pulp decompression, while the study group was treated with enriched autologous bone marrow stem cell transplantation on the basis of the control group. Harris score, Visual Analogue Scale score, serum fibroblast growth factor-2, hypoxia-inducible factor-1α and vascular endothelial growth factor levels and adverse reactions were observed before and after treatment. RESULTS AND CONCLUSION: (1) The Harris scores at 3, 6 and 12 months after treatment in the two groups were higher than those before treatment (P 0.05). (5) These results suggest that enriched autologous bone marrow stem cell transplantation combined with core decompression in the treatment of early avascular necrosis of femoral head can effectively improve hip joint function, promote the repair of femoral head necrosis area, alleviate pain, increase the level of fibroblast growth factor-2, and reduce the levels of hypoxia-inducible factor-1α and vascular endothelial growth factor.

8.
Chinese Journal of Trauma ; (12): 885-891, 2020.
Article in Chinese | WPRIM | ID: wpr-867800

ABSTRACT

Objective:To investigate the processing accuracy and biomechanical properties of 3D printed artificial bone trabeculae with different porosity generated by the Voronoi Tessellation algorithm, and to provide a reference for improving the biomechanical properties of titanium alloy implants in orthopedics.Methods:A healthy adult male volunteer (aged: 30 years, tall: 175 cm and weight: 70 kg) was selected to collect CT scan data of the lumbar spine. Five kinds of biomimetic artificial bone trabeculae with different porosity were generated using the Voronoi Tessellation algorithm, and divided into Tra_A (73.7%), Tra_B (74.1%), Tra_C (80.0%), Tra_D (80.2%) and Tra_E (85.7%) groups according to the porosity. Selective laser melting (SLM) 3D printing technology was used to process trabecular bone structures with different porosity into titanium alloy prosthesis with a diameter of 18 mm and a height of 20 mm. Each group had 3 samples. The internal structure of each sample was observed by industrial microscope, and the actual porosity of artificial bone trabecular of each group was calculated and compared with the theoretical porosity to evaluate the machining accuracy of artificial bone trabecular with different porosity. Finally, the ultimate load, yield strength and elastic modulus of each sample were evaluated by in vitro mechanical test, and the biomechanical properties of artificial bone trabeculae with different porosity were evaluated.Results:There were no cracks, fracture of connecting rod or accumulation of titanium alloy powder in all specimens. The average actual porosity of the five groups of artificial bone trabecular specimens was 66.0%, 65.5%, 71.8%, 72.5% and 78.1%, respectively. Compared with the theoretical porosity, it was smaller by 10.5%, 11.6%, 10.2%, 9.7% and 8.8%, respectively. In the in vitro mechanical tests for the five groups of artificial bone trabecular specimens, the mean value of ultimate load was 23.6 kN, 18.9 kN, 17.0 kN, 16.3 kN, 10.7 kN, respectively; the mean value of yield strength was 72.2 MPa, 58.7 MPa, 54.9 MPa, 52.2 MPa, and 36.1 MPa, respectively; the mean value of the actual elastic modulus was 7.5 GPa, 6.3 GPa, 4.5 GPa, 4.3 GPa and 2.4 GPa, respectively. With the increase of the porosity of artificial bone trabeculae, all three indicators above showed a decreasing trend. Conclusions:The artificial bone trabeculae generated by the Voronoi Tessellation algorithm and printed by SLM 3D have better machining quality. With the increase of porosity, the processing precision of the titanium alloy artificial bone tray specimens is better. Limit load, yield light and elastic modulus of artificial bone trabecula decrease with the increase of porosity.

9.
Chinese Journal of School Health ; (12): 276-278, 2019.
Article in Chinese | WPRIM | ID: wpr-819332

ABSTRACT

Objective@#To understand the situation of school medical staff in Guangzhou after adopting multichannel medical model, and to provide reference for school medical team construction.@*Methods@#A total of 1 099 primary and secondary schools in Guangzhou participated in this study through questionnaire survey regarding school medical personnel, basic situation of school medical personnel and work situation.@*Results@#Among the 1 099 primary and secondary schools surveyed, 638(58.05%) of them consisted of 707 full-time school doctors, the eligible rate was 28.20%. The recruitment of school doctors was still based on independent recruitment(55.87%), and 44.13% of the purchase service modes (community deployment, hospital purchase services, and school clinic custody) were deployed. Most of school medical professionals majored in nursing(56.86%), followed by clinical medicine (26.03%) and preventive medicine (9.76%); In terms of professional titles, junior, intermediate and senior certificates accounted for 52.47%, 37.34%, and 1.27%, respectively; More than 68.74% of school doctors worked for less than 5 years; On average, 68.60% of training were provided every six months. About 33.95% of the school doctor were satisfied with salary, 20.79% were not satisfied. Compared with the year 2016, no significant changes were noticed in academic qualifications, professional titles, and working conditions of school medical team, however, increased proportion of staffs with nursing certificate instead of clinical medicine certificate increased, workload and satisfaction towards salary decreased(P<0.01).@*Conclusion@#After adopting the multi-channel deployment model, the construction of school health workforce in Guangzhou has made breakthrough progress. It is proposed to improve the guidelines for the standardization of school doctors, to strengthen the professional skills training of school doctors, and to better improve the overall level of school health work in the city.

10.
Article in Chinese | WPRIM | ID: wpr-796542

ABSTRACT

Objective@#To explore whether the pro-inflammatory effect of endoplasmic reticulum stress in placental tissues involves in the genesis of gestational diabetes mellitus (GDM).@*Methods@#Forty gravidas who underwent regular prenatal examinations and delivered at Tongji Hospital were recruited from January to December, 2016. Among them, 20 were GDM women (GDM group), and the remaining twenty were served as the control, which were selected from those without GDM and matched for age and gestational weeks to the GDM group. Placental tissues were collected from the two groups. The ultrastructure of endoplasmic reticulum in trophoblast cells was observed under transmission electron microscope. The expression of glucose-regulated protein-78 (GRP-78), a marker protein for endoplasmic reticulum stress, and C/EBP homologous protein (CHOP) were detected using Western blotting. Five placental tissue samples were collected from normal gravidas for explant culture. Three subgroups were set up according to different culturing methods including culturing with IL-1β (5 ng/ml) for 20 h (IL-1β model group), 30 μmol/L thapsigargin (TG, an endoplasmic reticulum stress agonist) for 2 h after treating with IL-1β (5 ng/ml) for 18 h (IL-1β+TG intervention group) or with no stimulation (blank control group). Western blotting was used to detect the expressions of GRP-78, CHOP and glucose transporter 4 (GLUT4) in placenta explants. The mRNA expressions of interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) were determined by real-time fluorescence quantitative polymerase chain reaction (RT-PCR). Statistical analysis was performed using one-way analysis of variance, LSD and t test.@*Results@#(1) In the GDM group, increased number and size of endoplasmic reticulum cisternae were observed in trophoblast cells. Moreover, obviously dilated endoplasmic reticulum and different size of fragments and vesicles were also seen under electron microscope. While the endoplasmic reticulum in the placental tissues of the control group showed no obvious swelling. (2) The expression of GRP-78 and CHOP protein in the GDM group were higher than those in the control group (0.90±0.17 vs 0.48±0.08, t=2.24; 0.85±0.13 vs 0.46±0.12, t=2.10; both P<0.05). (3) Compared with the blank control group, the expression of GRP-78 and CHOP protein in the IL-1β model group increased significantly (0.87±0.18 vs 0.36±0.07, t=2.67; 1.14±0.09 vs 0.78±0.06, t=3.20; both P<0.05); but the expression of GLUT4 protein significantly decreased (1.00±0.14 vs 2.21±0.49, t=2.40, P<0.05); the expressions of IL-6 and TNF-α mRNA significantly increased (0.89±0.23 vs 0.30±0.06, t=2.31; 0.62±0.16 vs 0.17±0.09, t=2.29; both P<0.05). Compared with the IL-1β model group, the expression of GRP-78 and CHOP protein significantly increased in IL-1β+TG group (2.02±0.32 vs 0.87±0.18, t=3.11; 2.18±0.31 vs 1.14±0.09, t=3.16; both P<0.05); the expression of GLUT4 protein significantly decreased (0.39±0.19 vs 1.00±0.14, t=2.66, P<0.05); the expression of IL-6 and TNF-α mRNA increased significantly (1.67±0.25 vs 0.89±0.23, t=2.26; 1.42±0.27 vs 0.62±0.16, t=2.51; both P<0.05).@*Conclusions@#Endoplasmic reticulum stress may be associated with increased release of pro-inflammatory cytokines in placental tissues of some GDM women and involved in the onset and development of GDM.

11.
Article in Chinese | WPRIM | ID: wpr-791970

ABSTRACT

Objective To explore whether the pro-inflammatory effect of endoplasmic reticulum stress in placental tissues involves in the genesis of gestational diabetes mellitus (GDM). Methods Forty gravidas who underwent regular prenatal examinations and delivered at Tongji Hospital were recruited from January to December, 2016. Among them, 20 were GDM women (GDM group), and the remaining twenty were served as the control, which were selected from those without GDM and matched for age and gestational weeks to the GDM group. Placental tissues were collected from the two groups. The ultrastructure of endoplasmic reticulum in trophoblast cells was observed under transmission electron microscope. The expression of glucose-regulated protein-78 (GRP-78), a marker protein for endoplasmic reticulum stress, and C/EBP homologous protein (CHOP) were detected using Western blotting. Five placental tissue samples were collected from normal gravidas for explant culture. Three subgroups were set up according to different culturing methods including culturing with IL-1β (5 ng/ml) for 20 h (IL-1β model group), 30 μmol/L thapsigargin (TG, an endoplasmic reticulum stress agonist) for 2 h after treating with IL-1β (5 ng/ml) for 18 h (IL-1β+TG intervention group) or with no stimulation (blank control group). Western blotting was used to detect the expressions of GRP-78, CHOP and glucose transporter 4 (GLUT4) in placenta explants. The mRNA expressions of interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) were determined by real-time fluorescence quantitative polymerase chain reaction (RT-PCR). Statistical analysis was performed using one-way analysis of variance, LSD and t test. Results (1) In the GDM group, increased number and size of endoplasmic reticulum cisternae were observed in trophoblast cells. Moreover, obviously dilated endoplasmic reticulum and different size of fragments and vesicles were also seen under electron microscope. While the endoplasmic reticulum in the placental tissues of the control group showed no obvious swelling. (2) The expression of GRP-78 and CHOP protein in the GDM group were higher than those in the control group (0.90±0.17 vs 0.48±0.08, t=2.24; 0.85±0.13 vs 0.46±0.12, t=2.10; both P<0.05). (3) Compared with the blank control group, the expression of GRP-78 and CHOP protein in the IL-1β model group increased significantly (0.87±0.18 vs 0.36±0.07, t=2.67; 1.14±0.09 vs 0.78±0.06, t=3.20;both P<0.05); but the expression of GLUT4 protein significantly decreased (1.00±0.14 vs 2.21±0.49, t=2.40, P<0.05); the expressions of IL-6 and TNF-α mRNA significantly increased (0.89±0.23 vs 0.30±0.06, t=2.31;0.62±0.16 vs 0.17±0.09, t=2.29; both P < 0.05). Compared with the IL-1β model group, the expression of GRP-78 and CHOP protein significantly increased in IL-1β+TG group (2.02±0.32 vs 0.87±0.18, t=3.11;2.18±0.31 vs 1.14±0.09, t=3.16; both P < 0.05); the expression of GLUT4 protein significantly decreased (0.39±0.19 vs 1.00±0.14, t=2.66, P<0.05); the expression of IL-6 and TNF-α mRNA increased significantly (1.67±0.25 vs 0.89±0.23, t=2.26; 1.42±0.27 vs 0.62±0.16, t=2.51; both P < 0.05). Conclusions Endoplasmic reticulum stress may be associated with increased release of pro-inflammatory cytokines in placental tissues of some GDM women and involved in the onset and development of GDM.

12.
Chinese Mental Health Journal ; (12): 232-237, 2019.
Article in Chinese | WPRIM | ID: wpr-744736

ABSTRACT

Objective:To explore the relationship between personality traits and procrastination in young people and the mediating role of self-control.Methods:A total of 344 college students (191 males and 153 females) were assessed with the Mini-IPIP Scale (Mini-IPIP), Dual-Mode of Self-Control Scale (DMSC-S, including control system and impulse system) and General Procrastination Scale (GPS).Results:The GPS scores were negatively correlated with scores of agreeableness subscale and conscientiousness subscale (r=-0.13, -0.53, Ps<0.05), and positively correlated with scores of neuroticism subscales (r=0.27, P<0.01).The structural equation modeling supported the impulse system fully mediated the relationship between neuroticism and procrastination (η2=0.15, 95%CI=0.02-0.25), and those two systems partly mediated the relationship between conscientiousness and procrastination (η2=0.20, 0.20;95%CI=-0.38——0.05, -0.70——0.24).Conclusion:The relationship between youth personality and procrastination may be mediated by a dual system of self-control.Additionally, the degree to how self-control affects the relationship between big five personality trait and procrastination is different under the different types of personality.

13.
Article in Chinese | WPRIM | ID: wpr-754405

ABSTRACT

Objective: To explore the clinicopathological characteristics and prognostic factors of gastric neuroendocrine neoplasm (NEN). Methods: Clinicopathological parameters and follow-up data collected from 117 patients with gastric NEN at Tianjin Medical University Cancer Institute and Hospital from March 2011 to December 2017 were reviewed, classified, and graded according to World Health Or-ganization (WHO) 2010 classification. Clinicopathological characteristics of different types and grades of gastric NEN were compared and survival analysis was performed. Results: Among the 117 cases confirmed as gastric NEN, this entire cohort comprised 13 cases (11.1%) of neuroendocrine tumor (NET) G1, 6 cases (5.1%) of NET G2, 57 cases (48.7%) of neuroendocrine carcinoma (NEC), and 41 cases (35.1%) of mixed adenoneuroendocrine carcinoma (MANEC). Gastric NET G1 and G2 typically consisted of multiple small tumors with shallow invasion and infrequent lymphatic and distant metastases at early stages at the time of diagnosis. The treatment of patients with gastric NET included endoscopic submucosal dissection and radical surgical resection. Precursor neuroendocrine lesions were detected in most cases. The patients with gastric NET G1 and G2 had a good prognosis. Gastric NEC and MANEC mostly consisted of single large tumors with deep infiltration, and common lymphatic and distant metastases at advanced stages when the diagnoses were confirmed. All the patients with gastric NEC and MANEC underwent surgical resection, and most received adjuvant therapy. Histopathological changes of gastric NEC were characterized by large cells and poorly differentiated tumors, while gastric MANEC had various forms of neuroendocrine and adenocarcinoma components. The prognosis of patients with gastric NEC and MANEC was poor for both; however, the predictors of progression-free survival and overall survival were different between gastric NEC and MANEC. Conclusions: Gastric NEN are a group of heterogeneous tumors with different clinicopathological features and prognosis. More multicenter studies with large sample sizes are still needed to improve the classification of gastric NEN and explore the prognostic factors.

14.
Herald of Medicine ; (12): 152-156, 2018.
Article in Chinese | WPRIM | ID: wpr-700977

ABSTRACT

Objective To investigate the inhibition of rutaecarpine (Rut) on left ventricular hypertrophy rat induced by abdominal aorta coarctation (AAC) and further explore the potential mechanisms. Methods Left ventricular hypertrophy was induced by AAC in male Sprague-Dawley rats.Fifty rats were randomly divided into five groups:model control group,sham operation group,low-,middle- and high-dose (10,20,40 mg?kg-1?d-1 ) Rut group,with 10 rats of each group.Rut was administrated by gavage once daily from the first day after operation for consecutive 4 weeks.The sham operation and model groups were administrated with equal volume of 0.9% sodium chloride solution.The hemodynamics parameters were detected by BL-420 E biology function laboratory system,and the left ventricular hypertrophy index (LVHI,left ventricular weight/ body weight) was measured at 8 h after administration of the last dose.The pathological changes of left ventricular hypertrophy were evaluated by HE staining.To elucidate the mechanism of protection,the mRNA expressions of atrial natriuretic factor ( ANF),extracellular signal-regulated kinase 2 (ERK2) and MAPK phosphatase-1 (MKP-1) were analyzed by real time RT-PCR,and the protein expressions of MKP-1 and phosphorylated ERK2 (p-ERK2) were examined by Western blotting. Results Left ventricular hypertrophy induced by AAC was evidenced by the increased left ventricular weight (LVW) and LVHI (P<0.01),the decreased± dp/ dt max (P<0.01),and the elevated expression of ANF (P<0.01).Compared with model control,Rut (20,40 mg?kg-1?d-1 ) treatment significantly attenuated AAC-induced rat left ventricular hypertrophy,decreased the LVHI (P<0.05),left ventricular systole pressure (LVSP),and left ventricular end diastolic pressure ( LVEDP ) ( P < 0. 05), and increased ± dp/ dtmax ( P < 0. 01). In addition, Rut ( 20, 40 mg?kg-1?d-1 ) downregulated the expression of ANF,ERK2 mRNA,and ERK2 protein,but upregulated the MKP-1 mRNA and protein expression.However,Rut low-dose (10 mg?kg-1 ?d-1 ) was ineffective (P> 0.05). Conclusion Rut alleviates left ventricular hypertrophy induced by abdominal aorta coarctation,and the protection appears to be due,at least in part,to its inhibitory effects on the MAPK/ ERK signal pathway.

15.
Yonsei Medical Journal ; : 611-623, 2018.
Article in English | WPRIM | ID: wpr-715901

ABSTRACT

PURPOSE: Results on the clinical utility of cell therapy for ST-elevated myocardial infarction (STEMI) are controversial. This study sought to analyze the efficacy of treatment with intracoronary bone marrow mononuclear cells (BMMC) on left ventricular (LV) function and remodeling and LV diastolic and systolic function in patients with STEMI. MATERIALS AND METHODS: Literature search of PubMed and EMBASE databases between 2004 and 2017 was performed for randomized controlled trials in STEMI patients who underwent successful percutaneous coronary intervention and received intracoronary BMMC therapy. The defined end points were left ventricular ejection fraction (LVEF), left ventricular end-diastolic volume (LVEDV), and left ventricular end-systolic volume (LVESV). Also, sensitivity analysis and several subgroup analyses based on follow-up duration, timing of injection, doses of cells, and imaging modalities were conducted to strengthen the statistic power of the study. RESULTS: A total of 22 trials with 1360 patients were available for the current meta-analysis. The pooled statistics showed a significant improvement in LVEF {2.58 [95% confidence interval (CI), 1.32, 3.84]; p < 0.001}, LVEDV [−3.73, (95% CI, −6.94, −0.52), p=0.02], and LVESV [−4.67, (95% CI, −7.07, −2.28), p < 0.001] in the BMMC group, compared with the control group. However, in sensitivity analysis, a significant reduction in LVEDV disappeared, while the outcomes of LVEF and LVESV remained unchanged. The same results were presented in the subgroup analysis adjusting for imaging modalities and timing of cells injection. CONCLUSION: BMMC transplantation in patients with STEMI was found to lead to improvement in LVEF, LVEDV, and LVESV parameters, indicating that cell therapy has a potential beneficial effect on LV remodeling and function.


Subject(s)
Bone Marrow Transplantation , Bone Marrow , Cell- and Tissue-Based Therapy , Follow-Up Studies , Humans , Myocardial Infarction , Percutaneous Coronary Intervention , Stroke Volume , Ventricular Dysfunction, Left
16.
Article in Chinese | WPRIM | ID: wpr-707562

ABSTRACT

Objective To introduce a classification of infection interfaces associated with existing implants which was used to guide the treatment algorithms for implants and infection.Methods From January 2006 to April 2016,197 patients were treated at Department of Bone Tumor Osteopathology,Zhengzhou Orthopaedics Hospital for early infection associated with an existing implant.They were 147 males and 50 females,aged from 12 to 63 years (average,47.3 years).After bacterial cultures and drug sensitive tests and other laboratory examinations,their infection interfaces were classified into 3 types.In type Ⅰ of 89 cases,the infection was confined to the soft tissue and spread to only part of the implant;in type Ⅱ of 75 cases,the infection spread to the internal implant but ended at the implant and bone surface,involving no intramedullary cavity;in type Ⅲ of 33 cases,the infection spread to the intramedullary cavity with defects at broken ends.In primary surgery,plating was performed in 126 cases,external fixation in 48 and intramedullary nailing in 23.Type I cases were treated by systemic intravenous infusion combined with local antibiotic therapy and/or limitedly extended debridement while the implants were reserved,type Ⅱ cases by extended debridement while the implants were reserved,and type Ⅲ cases by extended debridement and external fixation while the implants were removed.Antimicrobial therapy was conducted before and after surgery according to their pathogen examination results.Antibiotics were used after surgery according to their pathogen examination results.Their therapeutic outcomes were evaluated according to their systemic and local symptoms,signs,blood routine indexes,erythrocyte sedimentation rate and level of C reactive protein.Results All the patients were followed up for 2 to 5 years (mean,3.4 years).After antibiotic therapy,debridement and vacuum sealing drainage,the implants were reserved in 150 cases,of which 84 were type I and 66 type Ⅱ,and removed in 47 cases,of which 5 were type Ⅰ,9 type Ⅱ and 33 type Ⅲ.By the criteria described in Surgery for Pyogenic Infection of Bone and Joint,the therapeutic outcomes were rated as cured in 185 cases,as effective in 7 and ineffective in 5.Conclusions A classification of infection interfaces associated with existing implants is significant for scientific,reasonable,standardized and individualized treatment algorithms for implants and infection,avoiding not only incidence of osteomyelitis but also unnecessary removal of implants with effective control of inflammation.

17.
Article in Chinese | WPRIM | ID: wpr-706794

ABSTRACT

Objective:To explore the clinicopathological characteristics and prognostic factors of neuroendocrine neoplasms(NENs)at different sites in the digestive system.Methods:The clinicopathological parameters and follow-up data were collected from 284 pa-tients with NENs in the digestive system in Tianjin Medical University Cancer Institute and Hospital from March 2011 to December 2015.The incidence and clinicopathological features were compared between the cases of NENs at different sites and survival analysis was performed.Results:In this study,NENs were detected mostly frequently in the pancreas,followed by the colorectum and stom-ach.In the pancreas,neuroendocrine tumor(NET)G1(51.8%)and G2(35.8%)accounted for a large proportion of NENs.World Health Organization(WHO)grades were related to lymph node metastasis,adjacent organ invasion,and nerve invasion(P<0.05 for all)but were not associated with the overall survival time of the patients.The patients with pancreatic NENs with distant metastasis had poor overall survival(P<0.05).Regarding colorectal NENs,most patients had NET G1(82.5%),and the majority of patients were cured with endoscopic or transanal resection.Patients with NENs,lymph node metastasis,and distant metastasis had poor overall survival(P<0.05 for all).The ratio of male-to-female patients,proportion of patients aged older than 40 years,prevalence of neuroendocrine carci-nomas(NECs)and mixed adenoneuroendocrine carcinomas(MANECs),presence of lymph node and distant metastasis,and presence of advanced stage tumors were greater in patients with gastric NENs than in patients with pancreatic and colorectal NENs(P<0.05 for all).WHO grades and lymph node metastasis were associated with the overall survival time of patients with gastric NENs(P<0.05 for both).Conclusions:NENs in the digestive system are a group of heterogeneous tumors with different clinicopathological features at different sites.The distribution and clinicopathological features of Chinese patients with NENs in the digestive system are different from those of European and American patients.More multicenter studies with large sample sizes are still needed to understand the bi-ological behaviors and prognostic factors of NENs at different sites in the digestive system.

18.
China Pharmacy ; (12): 1162-1166, 2018.
Article in Chinese | WPRIM | ID: wpr-704755

ABSTRACT

OBJECTIVE:To promote the realization of information management for hospital pharmacy. METHODS:The practice of pharmacy information management pathway in our hospital was introduced in respects of drug supply,rational drug use monitoring,pharmacy information dissemination,etc. The effects of information management were evaluated in respects of work efficiency,the rate of drug dispensing error and rational drug use index,etc. RESULTS:The information management pathway of our hospital included drug purchase,warehousing and keeping system,drug distribution management system,reasonable drug use monitoring information module,etc. It realized automatic generation and issue of purchase plan,acceptance bar code of drug warehousing,real-time drug stocking and location changing,drug guarantee delivery in advance,window drug delivery and check barcode scanning,drug distribution quality information management,whole process temperature and humidity monitoring, unreasonable prescription after the event,in the event,in advance,early warning of drug use,real-time monitoring of drug use and administration of drugs for chronic diseases,etc. After the implementation of information management,the time of drug warehousing invoice input and drug stocking were shortened.Among drug dispensing error,the percentage of type error decreased from 0.005 2% during Jun.-Dec. 2015 to 0.001 6% during Jan.-Jun. 2016;that of number error decreased from 0.006 9% to 0.001 6%;that of other error dropped to zero. During 2014-2016,the ratio of drug cost to treatment cost decreased gradually;those of inpatient were 26.62%,24.91%,24.36%,respectively;those of outpatient were 44.06%,42.10%,41.32%, respectively. Utilization rates of antibiotics in the inpatients decreased gradually,and were 44.82%,44.14%,43.91%, respectively. CONCLUSIONS:Information construction plays an important role on hospital pharmacy,can effectively improve work efficiency,reduces medication error and promotes rational drug use.

19.
Article in Chinese | WPRIM | ID: wpr-806290

ABSTRACT

Objective@#To evalate the effectiveness and suitability of a wearable health monitoring device for community-based management of hypertension.@*Methods@#In December 2015, 400 patients with hypertension were enrolled from Beijing, Chaoyang. Subjects were divided into an experimental group (220 cases) and control group (180 cases), and baseline data were collected. The control group received follow-up with general planning while the experimental group received wearable health devices. Follow-up was performed three times using a questionnaire (April, August, and December 2016), and medical staff provided feedback and guidance. The experimental group was also classified according to risk factors and intervention measures were individually designed, and included monitor and medication compliance, self-management ability, and social support. Communication between patients and medical staff was recorded to form a case system. Evaluation indexes included accuracy and reliability, blood pressure management efficacy, behavior intervention efficacy, satisfaction, and disease burden. A t-test, non-parametric test, and chi-square test were used to compare the experimental and control groups before and after intervention.@*Results@#At 1-year follow-up, after correcting for differences in baseline information between the two groups, statistically significant differences in numerical indexes were observed for number of visits within 1 month [1(1) vs. 1(1), Z=5.42], payment within 1 month [85(141) yuan vs. 40(70) yuan, Z=-2.66], visiting time [20(20) min vs. 20(15) min, Z=-2.82], exercise times [4.79(2.24) times/week vs. 4.09(2.00) times/week, Z=9.27], medication compliance score [7.33(5.77) vs. 8.70(5.24), Z=6.86], satisfaction [9.27(0.08) vs. 8.88(0.10), Z=11.77], diastolic pressure [(78.93±0.56) mmHg vs. (81.32±0.61)mmHg, F=8.70] (1 mmHg=0.133 kPa), and body mass index [(25.55±0.27) kg/m2 vs. (27.74±0.43) kg/m2, F=-2.24]. In addition, classification indexes adjusted for normalized blood pressure and habitus were different between experimental and control groups (χ2=3.89, 8.38, P≤0.05). The equipment worked well, with performance rates of over 90% (90.9%, 97.3%, and 92.7%).@*Conclusion@#The wearable health monitoring equipment showed good stability and reliability, and was able to effectively support health management in patients with hypertension in the community. At the same time, the equipment can improve healthy lifestyle compliance and awareness or self-management of blood pressure. In this manner, the burden of disease is reduced and the quality of life is improved.

20.
Article in Chinese | WPRIM | ID: wpr-609710

ABSTRACT

Objective To explore the effect of self-control deficit on ego depletion in patients with type 2 diabetes mellitus (T2DM) on the basis of ego-depletion theory.Methods Dual-Task Paradigms were used to manipulate self-control depletion.This study employed 2×2 between-study design.T2DM patients were chosen as the study group,and healthy volunteers were selected as normal control group,with 30 cases in each group.They were randomly assigned to depleted group (30 cases) or non-depleted group (30 cases).Depleted group completed classical Stroop task,whereas,non-depleted group completed conformant Stroop task.Finally,the ego-depletion effects were investigated by Simon Task.Results The number of reaction errors in the T2DM group was significantly greater than that in the normal group under the compatible condition ((8.73±6.09) vs (5.10±4.35),F(1,58)=7.125,P=0.010),and the incompatible condition((10.60±10.10)vs (3.97±3.97),F(1,58) =10.890,P=0.002).The reaction time in the T2DM group was longer than that in the normal group under the compatible condition ((673.33 ± 83.54) ms vs (663.18± 123.27) ms,F(1,58) =0.139,P=0.711) and the incompatible condition ((691.83± 107.75) ms vs (644.07± 106.69) ms,F(1,58) =2.964,P=0.091),however,the differences were not statistically significant.The number of reaction errors in the depleted group was more than that in the non-depleted group under the compatible condition (F(1,58) =0.821,P=0.369),and the incompatible condition (F(1,58) =0.231,P=0.632),but the difference was not statistically significant.The reaction time in the depleted group was longer than that in the non-depleted group under the compatible condition(F(1,58) =1.623,P=0.208),and the incompatible condition (F(1,58) =0.806,P =0.373),the differences were not statistically significant.The interactions between participants type and experimental conditions were not significant.Conclusion The patients with T2DM are in a state of chronic depletion and self-control will potentially aggravate ego depletion,which leads to decline in self-control ability and difficulties in self-management.

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