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1.
Article in Chinese | WPRIM | ID: wpr-922048

ABSTRACT

A 3D printing based wrist orthosis device was developed. After collecting the contour information of the carpal and metacarpophalangeal joints of the patients with a 3D scanner, the wrist orthotics were designed to meet the individual needs of the patients according to the relevant requirements of biomechanics. Choose TPU (thermoplastic polyurethanes) materials for preparation of 3D printing. It can functionally assist the smart brace after stroke patients with hemiplegia early rehabilitation training, the use of orthoses carry MPU6050 inertial sensor, magnetometer, time module device such as a sensor and monitor its movements and record the training time, ensure safe efficient rehabilitation training, help patients return to a normal life as soon as possible.


Subject(s)
Humans , Orthotic Devices , Printing, Three-Dimensional , Stroke , Wrist , Wrist Joint
2.
Chinese Journal of Nephrology ; (12): 795-802, 2021.
Article in Chinese | WPRIM | ID: wpr-911901

ABSTRACT

Objective:To evaluate the effect of preoperative plasma D-dimer level on the risk of cardiac surgery-associated acute kidney injury (CSA-AKI). Methods:The clinical data of patients who underwent cardiac surgery with cardiopulmonary bypass in the First Affiliated Hospital of Nanjing Medical University from January 2017 to December 2018 were collected retrospectively. All patients were distributed into two groups (normal D-dimer group with D-dimer level≤0.55 mg/L and elevated D-dimer group with D-dimer level>0.55 mg/L) according to the D-dimer threshold of 0.55 mg/L and the differences of clinical data between the two groups were compared. Kaplan-Meier survival analysis method was used to analyze the difference of the cumulative incidence of CSA-AKI between the two groups. Logistic regression analysis and restricted cubic splines analysis were used to analyze the association between serum D-dimer and the incidence of CSA-AKI. Results:There were 871 patients enrolled in the study with 427 females (49.0%) and age of (56.6±12.3) years, including 215 patients (24.7%) with high D-dimer and 259 patients (29.7%) with CSA-AKI. Compared with the normal D-dimer group, patients with elevated D-dimer had higher baseline serum creatinine, proportion of chronic kidney disease stage 3, international normalized ratio, fibrinogen, proportion of receiving renal replacement therapy and incidence of CSA-AKI (all P<0.05). The prothrombin time, operation time, extracorporeal circulation time, aortic occlusion time and hospital stay in the elevated D-dimer group were longer (all P<0.05), and the preoperative estimated glomerular filtration rate (eGFR) and hemoglobin levels were lower than those in the normal D-dimer group (both P<0.05). There was no statistical difference between the two groups in terms of age, gender, comorbid diseases, cardiac function classification, and hospital mortality (all P>0.05). Kaplan-Meier survival curve results showed that compared with the normal D-dimer group, the risk of CSA-AKI in the elevated D-dimer group was significantly increased (Log-rank χ2=14.227, P<0.001). The multivariate logistic regression showed that after adjusting variables including gender, age, diabetes mellitus, preoperative eGFR, cardiopulmonary bypass time and so on, the higher level of preoperative D-dimer (>0.55 mg/L) was still related to CSA-AKI ( OR=1.476, 95% CI 1.038-2.098, P=0.030). Restricted cubic splines analysis showed that the incidence of CSA-AKI raised when preoperative serum D-dimer concentration increased (non-linear P=0.262). Conclusion:Patients with high preoperative serum D-dimer have an increased risk of CSA-AKI.

3.
Article in Chinese | WPRIM | ID: wpr-910350

ABSTRACT

Objective:To investigate the effect of different additional filters on the image quality and radiation dose in abdominaldigital radiography (DR).Methods:Retrospective analysis was performed on 10 cases of abdominal DR from December 2020 to January 2021 in Fuxing Hospital, and the average mAs was calculated. Using automatic exposure control (AEC) technology, a polymethyl methacrylate (PMMA) slab of the corresponding thickness (18 cm) at the same output of above mAs was confirmed and used as the attenuator to simulate the abdomen. The phantom of CDRAD 2.0 and 17 slices of 10 mm thick PMMA plates (total thickness 18 cm) were placed on the bed. The additional filters were selected as no additional filter, 2 mmAl, 0.1 mmCu+ 1 mmAl, 0.1 mmCu+ 2 mmAl respectively. The AEC levels were selected at -2, -1, 0, 1, and 2 respectively. The images were collected and analyzed by using CDRAD 2.0 software to obtain the image quality factor (IQF inv). The incident air kinetic energy on the surface of the PPMA was measured for each exposure, and PCXMC software was used to estimate the organ dose and effective dose, and a comparative analysis was made. Results:The skin incident doses at no additional filter, 2 mmAl, 0.1 mmCu+ 1 mmAl, 0.1 mmCu+ 2 mm Al were (0.546 1±0.200 8), (0.376 2±0.133 8 ), (0.285 3±0.100 1) and (0.289 9±0.099 2) mGy, respectively. The estimated effective doses were (79.63±29.24)×10 -3, (71.05±25.56)×10 -3, (63.58±22.18)×10 -3 and (67.64±23.11)×10 -3 mSv, respectively. The gonadal doses were (0.058 1±0.020 8), (0.050 0±0.018 0), (0.044 8±0.015 6) and (0.047 7±0.016 3) mGy.The IQF inv values were 4.70±0.61, 4.80±0.84, 4.60±0.55, 4.60±0.60, respectively. There were linear correlations between the effective dose and the skin incident dose under different additional filtration, and the effective doses increased with the increase of the incident doses. The dose was lowest at the addition filtration of 0.1 mmCu+ 1 mmAl. There was no significant difference in the IQF inv between groups( P>0.05). Conclusions:The optimal additional filtration for abdominal DR was 0.1 mmCu+ 1 mmAl with the image quality meeting the requirements of clinical diagnosis, the radiation dose reduced reasonably, and the objective of the optimization of radiographic parameters achieved.

4.
Article in Chinese | WPRIM | ID: wpr-909574

ABSTRACT

Chaetocin is a natural metabolite product with various biological activities and pharmacological functions isolated from Chaetomium species fungi belonging to the thiodiketopyrazines. Numerous studies have demonstrated a wide range of antitumor activities of chaetocin in vitro and in vivo. Several studies have demonstrated that chaetocin sup?presses the growth and proliferation of various tumour cells by regulating multiple signalling pathways related to tumour initiation and progression, inducing cancer cell apoptosis (intrinsic and extrinsic), enhancing autophagy, inducing cell cycle arrest, as well as inhibiting tumour angiogenesis, invasion and migration. The antitumor effects and molecular mechanisms of chaetocin are reviewed and analysed in this paper, and the prospective applications of chaetocin in cancer prevention and therapy are also discussed. Our review provides the theoretical basis for exploiting the clinical applica?tion of chaetocin in cancer treatment.

5.
Chinese Journal of Nephrology ; (12): 95-104, 2021.
Article in Chinese | WPRIM | ID: wpr-885484

ABSTRACT

Objective:To evaluate the value of combined measurement of urinary insulin-like growth factor-binding protein 7 (IGFBP7) and urinary metalloproteinase inhibitor-2 (TIMP-2) in the early diagnosis and prognosis of cardiac surgery-associated acute kidney injury (CSA-AKI).Methods:From March 2018 to June 2018, cardiac surgery patients admitted to the cardiac macrovascular surgery department of the First Affiliated Hospital of Nanjing Medical University were prospectively included, and the blood creatinine was monitored to observe the presence of acute kidney injury (AKI). The prognostic information of the patients was collected, including in-hospital dialysis, in-hospital death, complete recovery of kidney function at discharge, death in one year after surgery, and progression to chronic kidney disease. The levels of urine IGFBP7 and TIMP-2 at 6 h, 24 h and 48 h after cardiac surgery were detected by enzyme linked immunosorbent assay (ELISA), and the urine creatinine (Cr) was also measured. Moreover, receiver operating characteristic curves (ROC) were plotted and the areas under the curves ( AUC) were calculated to evaluate the predictive value and prognostic value of urinary [TIMP-2]·[IGFBP7] (T*I for short) and urine T*I/urine Cr 2 in CSA-AKI. Results:A total of 74 patients with age of (58.43±10.91) years old and 47 males, were enrolled in this study, of which 24 cases (32.4%) had AKI and 10 cases (13.5%) had stage 2-3 AKI. Compared with the non-AKI group, the AKI group had significantly higher levels of urine T*I levels at 6 h and 24 h (both P<0.05). The AUC of T*I at 24 h predicting for AKI was 0.71(95% CI 0.59-0.81, P=0.001, cutoff value 0.020, sensitivity 79.2%, specificity 56.0%), while the AUC for stage 2-3 AKI was 0.85 (95% CI 0.75-0.92, P<0.001, cutoff value 0.083, sensitivity 70.0%, specificity 90.6%). Urinary T*I normalized for urinary creatinine excretion did not show better predictive value. In addition, of T*I at 24 h predicting for poor hospitalization outcome, renal recovery, and one year postoperative death, the AUC was 0.82(95% CI 0.71-0.90, P=0.001), 0.80(95% CI 0.66-0.86, P<0.001), and 0.81(95% CI 0.70-0.89, P=0.047), respectively. Conclusion:The combined detection of TIMP-2 and IGFBP7 in urine is expected to be a biomarker for early diagnosis of CSA-AKI and has certain clinical value in predicting the prognosis of CSA-AKI.

6.
Article in Chinese | WPRIM | ID: wpr-882208

ABSTRACT

Objective:To investigate the current situation of suicidal self-injurious behavior in teenagers and analyze its influencing factors. Methods:From January to November 2020, a stratified sampling method was used to investigate 707 teenagers in Guangdong. The “questionnaire of health-related behaviors of Chinese teenagers” compiled by the Chinese Center for Disease Control and Prevention was used anonymously to investigate the current situation of suicidal self-injurious behavior of the teenagers. The chi-square test was used for univariate analysis, and logistic regression was used for multivariate analysis. Results:The incidence rate of suicidal self-injurious behavior was 14.57% (103/707). It was 13.31% (45/338) in males, 15.72% (58/369) in females, 13.83% (48/347) in junior high school students and 15.28% (55/360) in senior high school students. There was no statistical significance in the incidence of suicidal self-injurious behavior of teenagers between different genders, different learning stages, smoking or not, asexual behavior or not, gambling or not, and fighting or not (all P>0.05). The incidence of suicidal self-injurious behaviors in teenagers from single parent family, drunkenness, runaway, loneliness, under great study pressure, lovelorn, and mobile phone addiction was significantly higher (χ2=13.809, 10.852, 14.279, 11.451, 12.893, 22.905, 19.473, respectively. All P<0.001). Logistic regression analysis showed that the following were main risk factors affecting the incidence of suicidal self-injurious behavior in teenagers: single parent family (OR=3.826, 95%CI: 1.402-7.501), drunkenness (OR=3.903, 95%CI: 1.512-7.368), runaway (OR=3.447, 95%CI: 1.669-7.715), loneliness (OR=3.613, 95%CI: 1.504-7.697), great study pressure (OR=3.712, 95%CI: 1.387-7.604), lovelorn(OR=4.125, 95%CI: 1.516-8.117) and mobile phone addiction(OR=4.027, 95%CI: 1.499-7.984 (all P<0.001). Conclusion:The incidence of suicidal self-injurious behavior in teenagers is not low in Guangdong, and targeted measures should be developed to screen and intervene based on the influencing factors.

7.
Article in Chinese | WPRIM | ID: wpr-880163

ABSTRACT

OBJECTIVE@#To explore the influencing factors in children with chronicity immune thrombocytopenia (ITP), and to provide basis for judging the prognosis and treatment in children with ITP.@*METHODS@#The clinical data of children with ITP admitted to The Second Affiliated Hospital of Anhui Medical University in the past 5 years were retrospectively analyzed and followed up for more than 1 year. According to the inclusion criteria, the eligible cases (328 cases in total) were selected and collected through medical record system retrieval, outpatient clinic and telephone follow-up. Independent influencing factors affecting the prognosis of children with ITP were obtained through single-factor and multi-factor logistic analysis, and their predictive value for the prognosis of ITP in children were evaluated.@*RESULTS@#Of 328 children with ITP, 208 were newly diagnosed with ITP (64%), 54 were persistent ITP (16%), 66 were chronic ITP (20%), and the remission rate within 1 year was 79.9%. The results of univariate analysis showed that, age, pre-morbidity history of infection and vaccination, antinuclear antibodies, initial absolute lymphocyte count(ALC) and treatment options were related to the prognosis of the children (P<0.05). Multivariate analysis showed that the history of infection and vaccination before onset, initial treatment options, and ALC at the time of initial diagnosis were independent factors affecting the prognosis of children with ITP (P<0.05). The time for platelet recovery to 100×10@*CONCLUSION@#The initial treatment plan combined with IVIG can reduce the occurrence of chronicity in children with ITP, and its efficacy is better than that of the single corticosteroids group (the platelet recovery time is shorter); history of preceding infection or vaccination, ALC at the time of initial diagnosis are independent factors affecting the prognosis of children with ITP, and the combination of the two shows a better predictive value for the prognosis.


Subject(s)
Child , Humans , Immunoglobulins, Intravenous , Prognosis , Purpura, Thrombocytopenic, Idiopathic , Retrospective Studies , Thrombocytopenia
8.
Article in Chinese | WPRIM | ID: wpr-905211

ABSTRACT

Objective:To observe the relationship of ventilatory efficiency to cardiac function, especially heart rate recovery after exercise for patients with chronic obstructive pulmonary disease (COPD). Methods:From January, 2019 to December, 2020, 190 patients with COPD were recruited for Cardiopulmonary Exercise Testing. The general condition, medical history and medication history, lung function test and parameters of Cardiopulmonary Exercise Testing were recorded. They were divided into normal group and delay group according to whether the heart rate decline more than twelve beats within a minute after Cardiopulmonary Exercise Testing. Results:There were 89 patients (46.84%) in the delay group. Compared with the normal group, the delay group were older (Z = 2.282, P < 0.05), with less ratio of force exiratory volume in the first second in prediction (FEV1.0%) (Z = 3.626, P < 0.001), maximum power (t = 5.547, P < 0.001), breath reserve (BR) (t = 2.122, P < 0.05) and higher minimum ventilation equivalent of carbon dioxide (VE/VCO2nadir) (Z = 3.296, P = 0.001). Logistic regression showed that the COPD severity, VE/VCO2nadir and BR correlated with heart rate recovery. After adjusting for gender, age, body mass index and COPD severity, VE/VCO2nadir was an independent risk factor for delayed heart rate recovery (OR = 1.203, 95%CI 1.032 to 1.873, P = 0.004), and the best cut-off point was 33.15 (AUC = 0.6387, 95%CI 0.5595 to 0.7178, P = 0.001). Conclusion:The ventilatory inefficiency may increase the risk of abnormal heart rate recovery after exercise in COPD patients.

9.
Article in Chinese | WPRIM | ID: wpr-829045

ABSTRACT

OBJECTIVE@#To study the risk factors and infection characteristics of nosocomial infection in children with acute lymphoblastic leukemia (ALL) and analyze the relationship between different nutritional status and nosocomial infection, early treatment response.@*METHOD@#The clinical data of 133 children with ALL treated with CCCG-ALL-2015 from June 2016 to June 2019 (chemotherapy stage, risk level, MRD), infection during hospitalization (course of infection, laboratory indicators, sites of infection, outcome) and nutritional status (sex, age, height/ length, weight) were enrolled. The Chi 2 test and Logistic regression analysis were used for statistical analysis.@*RESULTS@#The rate of nosocomial infection was 19.9% in 133 children with ALL, in which 3 were infection-related death. Sex, immunophenotype and risk showed no significantly affect on the occurrence of nosocomial infection (P>0.05), but neutrophil count, hemoglobin level, platelet count, chemotherapy stage, length of stay in hospital and nutritional status showed affect on the occurrence of nosocomial infection (P<0.05). Logistic multivariate regression analysis showed that chemotherapy stage, length of hospital stay, neutrophils and nutritional status were the independent risk factors, in which the respiratory tract infection was the most common. Gram-positive bacteria, Gram-negative bacteria and fungi accounted for 44.1%, 52.9% and 2.9% respectively. The negative rate of MRD in day 19 and day 46 between different nutritional status groups showed statistically significant (P<0.05).@*CONCLUSION@#Neutrophil count, chemotherapy stage, length of stay in hospital and nutritional status are independent risk factors for nosocomial infection. Among of them, nutritional status negatively correlated with nosocomial infection, and the poorer nutritional status, the higher risk of nosocomial infection. Malnutrition, overweight and obesity can affect the early treatment response of ALL children. The level of nutrition at first diagnosis can be used as a bad factor to evaluate the early treatment response of ALL children.


Subject(s)
Child , Cross Infection , Gram-Negative Bacteria , Humans , Nutritional Status , Precursor Cell Lymphoblastic Leukemia-Lymphoma , Retrospective Studies
10.
Chinese Journal of Urology ; (12): 590-596, 2020.
Article in Chinese | WPRIM | ID: wpr-869710

ABSTRACT

Objective:To validate gender-related differences in patients with upper tract urothelial carcinoma (UTUC).Methods:We used a method of combination of SEER database analysis and validation in our center. We selected 2 125 men (57.8%) and 1 552 (42.2%) women who underwent radical nephroureterectomy (RNU) for UTUC between 1995 and 2015 within the surveillance, Epidemiology, and End Results registries (SEER). In male cases, the median age was 71(22-99)years old, median follow-up time was 53.0 (0-227) months, 902 (89.5%) cases were Caucasian, 1 384 cases (65.1%) were located in the renal pelvis, and 810(38.1%) cases were T 3-T 4. For female cases, the median age was 73.6(25-99)years old, median follow-up time was 53.1(0-226) months, 1 417(91.3%) cases were Caucasian, 1 043 cases (67.2%) were located in the renal pelvis, and 508 (32.7%) cases were T 3-T 4. The analysis of SEER database showed that female patients were older compared to male patients ( P=0.002), the proportion of T 3-T 4 was even lower ( P=0.028). There were no statistically significant differences in race, tumor location, and follow-up time between males and females (all P>0.05). We also enrolled 131 men (55.3%) and 106 women (44.7%) who underwent RNU for non-muscle invasive (T a/T is/T 1) UTUC between January 2000 and January 2015. These patients had no history of bladder cancer, UTUC and kidney transplantation. Preoperative cystoscopy was performed to confirm the absence of bladder tumor. The male group was (65.8±12.4)years old, with history of aristolochic acid medications in 7(5.3%) cases, 98 smoking cases (74.8%), and estimated glomerular filtration rate (eGFR) of (64.2±29.4)ml/(min·1.73 m 2). In the female group, mean age was (66.7±11.9)years, 14 (13.2%) cases had history of aristolochic acid medications, 16(15.1%) had history of smoking, eGFR (56.3±27.9) ml/(min·1.73m 2). Compared with female patients, male patients tended to had less aristolochic acids exposure (5.3% vs.13.2%, P<0.001), frequent smoking (74.8% vs. 15.1%, P<0.001) and better renal function ( P=0.036). The Kaplan-Meier test was used for time-to-event analysis. Univariate and multivariate logistic regression models were adopted to examine the effect of gender on the development of T 3-T 4 tumor. Univariate and multivariate Cox regression analyses were used to assess the roles of factors on overall survival (OS) in both SEER and cases in our center, and competing-risks regression model was used to assess the roles of factors on cancer-specific survival (CSS) in both SEER and cases in our center. Results:Multivariate logistic analysis showed that gendere represented an independent risk factor of T 3-T 4 UTUC development( OR=0.86, P=0.02). Kaplan-Meier analysis showed that better OS and CSS for females only existed in the non-muscle invasive stages(5-year OS rates were 80.4% vs.87.3%, χ 2=31.0, P<0.001; 5-year CSS rates were 82.6% vs.89.2%, χ 2=31.2, P<0.001). In multivariate competing-risks regression models, no statistically significant differences in survival were observed between males and females ( HR=0.83, P=0.115). For the patients in our center, there were also no statistically significant differences existed in the non-muscle invasive stage between two genders on OS and CSS ( HR=0.93, P=0.071; HR=0.87, P=0.064). Conclusions:Females were less likely to have advanced pathological T stage. The differences on OS and CSS between males and females only existed in non-muscle invasive stage. However, after accounting for gender related factors, gender no longer had effects on UTUC prognosis.

11.
Article in Chinese | WPRIM | ID: wpr-828303

ABSTRACT

OBJECTIVE@#To explore the related factors of fever of unknown causes before operation of intertrochanteric fracture of femur in the elderly.@*METHODS@#From August 2015 to August 2018, 156 cases of intertrochanteric fracture of femur were treated by intramedullary nail fixation. According to the preoperative measurement, whether there was fever was divided into fever group and non fever group. There were 80 cases in fever group, 26 males and 54 females, aged 60 to 93 (75.063±13.082) years; 76 cases in non fever group, 39 males and 37 females, aged 60 to 96 (74.763±13.692) years. All patients' sex, age, basic diseases, WBC, NE%, Hb, CRP, D dimer and ALB were observed for single factor analysisand multi factor analysis.@*RESULTS@#Single factor analysis showed that gender, Hb, CRP had influence on preoperative fever, but other indexes had no influence; multi factor analysis showed that gender and CRP might have influence on fever. The probability of fever increased by 1.2%(=0.050) for every increase of CRP, and there was no significant difference between female and male in the probability of fever (=0.061).@*CONCLUSION@#CRP is an independent risk factor of preoperative fever in the elderly patients with intertrochanteric fracture of femur. The abnormality of CRP indicates that patients are more likely to have preoperative fever. Perioperative management should pay attention to the monitoring of CRP and early intervention.


Subject(s)
Aged , Aged, 80 and over , Bone Nails , Female , Femur , Fracture Fixation, Intramedullary , Hip Fractures , General Surgery , Humans , Male , Middle Aged , Retrospective Studies , Treatment Outcome
12.
Article in Chinese | WPRIM | ID: wpr-823989

ABSTRACT

To examine the feasibility of using a computer tool for stratifying the severity of Coronavirus Disease 2019 (COVID-19) based on computed tomography (CT) images. We retrospectively examined 44 confirmed COVID-19 cases. All cases were evaluated separately by radiologists (visually) and through an in-house computer software. The degree of lesions was visually scored by the radiologist, as follows, for each of the 5 lung lobes:0, no lesion present;1,<1/3 involvement;2,>1/3 and<2/3 involvement;and 3,>2/3 involvement. Lesion density was assessed based on the proportion of ground-glass opacity (GGO), consolidation and fibrosis of the lesions. The parameters obtained using the computer tool included lung volume (mL), lesion volume (mL), lesion percentage (%), and mean lesion density (HU) of the whole lung, right lung, left lung, and each lobe. The scores obtained by the radiologists and quantitative results generated by the computer software were tested for correlation. A Chi-square test was used to test the consistency of radiologist- and computer-derived lesion percentage in the right/left lung, upper/lower lobe, and each of the 5 lobes. The results showed a strong to moderate correlation between lesion percentage scores obtained by radiologists and the computer software (r ranged from 0.7679 to 0.8373, P < 0.05), and a moderate correlation between the proportion of GGO and mean lesion density (r=-0.5894, P<0.05), and proportion of consolidation and mean lesion density (r=0.6282, P<0.05). Computer-aided quantification showed a statistical significant higher lesion percentage for lower lobes than that assessed by the radiologists (x2 = 8.160, P = 0.004). Our experiments demonstrated that the computer tool could reliably and accurately assess the severity and distribution of pneumonia on CT scans.

13.
Journal of Medical Postgraduates ; (12): 732-736, 2020.
Article in Chinese | WPRIM | ID: wpr-822592

ABSTRACT

ObjectiveTo explore the value of MSCT for differentiating the hypovascular pancreatic neuroendocrine tumors (Hypo-PNETs) from mass-forming pancreatitis.Methods21 patients with histological-confirmed MPFs and 19 patients with Hypo-PNETs who underwent preoperative dynamic contrast-enhanced CT were included. The CT images were analyzed including tumor size,density, border, CT values in each phase, dilatation of pancreatic duct and bile duct and metastases. The clinical data included age, sex and clinical symptoms.ResultsMFPs often occurred in male patient compared with Hypo-PNETs (85.7% vs 52.6%, P<0.05), and the difference is statistically significant; Metastases only occurred in Hypo-PNETs (P<0.05), and the difference is drastically significant. The well-defined margin often occurred in Hypo-PNETs (52.4% vs 47.6%, P=0.032). Solid tumor more happened in MFPs(95.2% vs 47.4%, P<0.05). The CT values in the portal of MFPs were higher than Hypo-PNETs(P<0.05). The combined features showed accepted diagnostic performance for differentiating Hypo-PNETs from MFPs (89.5% of sensitivity and 95.2% of specificity).ConclusionMFPs often occurred in male patient, and CT values of portal phase, density, border and metastases may be valuable for differentiating Hypo-PNETs from MFPs.

14.
Article in English | WPRIM | ID: wpr-896961

ABSTRACT

Purpose@#The objective of the current study was to examine the potential effects of surgery start times (morning vs. afternoon) on the long-term prognosis of patients after hepatic resection (HR) for hepatocellular carcinoma (HCC). @*Methods@#All eligible patients were divided into 2 groups according to the start time of surgery: group M (morning surgery, 8 AM–1 PM) and group A (afternoon surgery, 1 PM–6 PM). Clinicopathologic and surgical parameters, as well as oncologic outcomes were compared between the 2 groups. @*Results@#In total, 231 patients were included in the study. There was no difference in age, body mass index, comorbidities, tumor size, tumor location, tumor stages, surgical procedures, or surgical margin between morning and afternoon surgery (all P > 0.05). In contrast, patients in group M experienced longer operation duration than those in group A (median, 240 minutes vs. 195 minutes, P = 0.004). However, no differences of overall survival were observed between morning and afternoon surgery groups in the whole cohort or stratified by surgical margin (all P > 0.05). @*Conclusion@#Surgery start times during the work day have no measurable influence on patient outcome following curative HR for HCC, indicating good self-regulation and professional judgment of surgeons for progressive fatigue during surgery.

15.
Article in English | WPRIM | ID: wpr-889257

ABSTRACT

Purpose@#The objective of the current study was to examine the potential effects of surgery start times (morning vs. afternoon) on the long-term prognosis of patients after hepatic resection (HR) for hepatocellular carcinoma (HCC). @*Methods@#All eligible patients were divided into 2 groups according to the start time of surgery: group M (morning surgery, 8 AM–1 PM) and group A (afternoon surgery, 1 PM–6 PM). Clinicopathologic and surgical parameters, as well as oncologic outcomes were compared between the 2 groups. @*Results@#In total, 231 patients were included in the study. There was no difference in age, body mass index, comorbidities, tumor size, tumor location, tumor stages, surgical procedures, or surgical margin between morning and afternoon surgery (all P > 0.05). In contrast, patients in group M experienced longer operation duration than those in group A (median, 240 minutes vs. 195 minutes, P = 0.004). However, no differences of overall survival were observed between morning and afternoon surgery groups in the whole cohort or stratified by surgical margin (all P > 0.05). @*Conclusion@#Surgery start times during the work day have no measurable influence on patient outcome following curative HR for HCC, indicating good self-regulation and professional judgment of surgeons for progressive fatigue during surgery.

16.
Acta cir. bras ; 34(11): e201901105, Nov. 2019. graf
Article in English | LILACS | ID: biblio-1054679

ABSTRACT

Abstract Purpose: To evaluate the effects of Dexmedetomidine (Dex) on spinal pathology and inflammatory factor in a rat model of Diabetic neuropathic pain (DNP). Methods: The rats were divided into 3 groups (eight in each group): normal group (N group), diabetic neuropathic pain model group (DNP group), and DNP model with dexmedetomidine (Dex group). The rat model of diabetes was established with intraperitoneal streptozotocin (STZ) injections. Nerve cell ultrastructure was evaluated with transmission electron microscopy (TEM). The mechanical withdrawal threshold (MWT) and motor nerve conduction velocity (MNCV) tests documented that DNP rat model was characterized by a decreased pain threshold and nerve conduction velocity. Results: Dex restored the phenotype of neurocytes, reduced the extent of demyelination and improved MWT and MNCV of DNP-treated rats (P=0.01, P=0.038, respectively). The expression of three pain-and inflammation-associated factors (P2X4, NLRP3, and IL-IP) was significantly upregulated at the protein level in DNP rats, and this change was reversed by Dex administration (P=0.0022, P=0.0092, P=0.0028, respectively). Conclusion: The P2X4/NLRP3 signaling pathway is implicated in the development and presence of DNP in vivo, and Dex protects from this disorder.


Subject(s)
Animals , Male , Spine/drug effects , Dexmedetomidine/pharmacology , Diabetic Neuropathies/drug therapy , Receptors, Purinergic P2X4/analysis , Adrenergic alpha-2 Receptor Agonists/pharmacology , NLR Family, Pyrin Domain-Containing 3 Protein/analysis , Sural Nerve/drug effects , Time Factors , Random Allocation , Blotting, Western , Pain Threshold , Microscopy, Electron, Transmission , Diabetes Mellitus, Experimental/pathology , Diabetes Mellitus, Experimental/drug therapy , Diabetic Neuropathies/pathology , Disease Models, Animal , Interleukin-1beta/analysis , Interleukin-1beta/drug effects , NLR Family, Pyrin Domain-Containing 3 Protein/drug effects , Neural Conduction/drug effects
17.
China Pharmacy ; (12): 2722-2726, 2019.
Article in Chinese | WPRIM | ID: wpr-817510

ABSTRACT

OBJECTIVE: To provide reference for reducing the rate of outpatient/emergency intravenous infusion in paediatric and improving the safety of drug use in children. METHODS: The comprehensive intervention of outpatient/emergency intravenous infusion in paediatric by pharmacists of our hospital though multiple measures was introduced, such as education training, system construction and management, multi-party monitoring and intervention. Related data were selected before (Jan-Jun. 2018) and after intervention (Jul.-Dec. 2018) to evaluate intervention effects, involving paediatric outpatient/emergency intravenous infusion rate, antibiotics intravenous infusion rate, the rate of intravenous infusion prescription, total cost of antibiotics, TCM injection, adjunctive drugs and key monitoring drugs in infusion prescriptions. RESULTS: Through the comprehensive intervention of pharmacists, related indexes of outpatient/emergency intravenous infusion in paediatric were decreased greatly in our hospital. The rate of intravenous infusion, the rate of antibiotics intravenous infusion, the rate of intravenous infusion prescription and the rate of antibiotics intravenous infusion prescription were decreased from 19.52%, 15.46%, 20.29%, 11.20% to 10.37%, 8.55%, 10.25%, 6.64%(P<0.001), respectively. Total cost of antibiotics, TCM injection, adjunctive drug and key monitoring drug were decreased respectively in infusion prescriptions (P<0.001). CONCLUSIONS: The comprehensive intervention measures taken by pharmacists in our hospital can reduce the rate of outpatient/emergency intravenous infusion in paediatric and the medical cost, and promote the safety of drug use in children.

18.
Article in Chinese | WPRIM | ID: wpr-744242

ABSTRACT

AIM:To investigate the effect of high-mobility group box-1 (HMGB1) expression knockdown on the invasion ability of breast cancer cells induced by tumor necrosis factor-α (TNF-α).METHODS:HMGB1 siRNA was used to transfect into the breast cancer MDA-MB-231 cells.The expression of HMGB1 at mRNA and protein levels was determined by RT-qPCR and Western blot.After the MDA-MB-231 cells with HMGB1 expression knockdown were treated with TNF-α, the apoptosis rate was analyzed by flow cytometry, the cell invasion ability was measured by Transwell assay, and the cell migration ability was detected by cell scratch test.The protein expression of E-cadherin, MMP-2, N-cadherin, MMP-9 and Bax was determined by Western blot.RESULTS:The expression of HMGB1 at mRNA and protein levels in the MDA-MB-231 cells transfected with HMGB1 siRNA was significantly lower than that in the non-transfected cells (P<0.05).The apoptosis rate in the cells was increased after TNF-αtreatment, and the cell invasion and migration abilities were also increased.The protein level of E-cadherin in the cells was decreased, the protein level of N-cadherin was increased, and the protein levels of MMP-2, MMP-9 and Bax were also increased (P<0.05).After the MDA-MB-231 cells with HMGB1 expression knockdown were induced by TNF-α, the apoptotic rate was increased, the invasion and migration abilities were decreased, the protein levels of E-cadherin and Bax were increased, and the protein levels of N-cadherin, MMP-2 and MMP-9 were decreased, as compared with the cells only induced by TNF-αwithout knockdown of HMGB1 expression (P<0.05).CONCLUSION:Knockdown of HMGB1 expression enhances the apoptosis of breast cancer cells induced by TNF-α, and inhibited the cell invasion, migration and epithelial-mesenchymal transition induced by TNF-α.The mechanism may be related with the changes of protein expression of MMP-2, MMP-9 and Bax.

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Chinese Journal of Nephrology ; (12): 507-514, 2019.
Article in Chinese | WPRIM | ID: wpr-756081

ABSTRACT

Objective To investigate the predictive value of nutritional and fluid status measured by bioelectrical impedance methods for the prognosis of acute kidney injury (AKI) patients undergoing continuous renal replacement therapy (CRRT). Methods Patients with severe AKI received CRRT in the First Affiliated Hospital of Nanjing Medical University from September 2016 to September 2018 were enrolled, and divided into death group and survival group according to 28-day survival. Cox regression was used to analyze the association between 28-day survival and lean tissue index (LTI), fat tissue index (FTI), the ratio of extracellular water (ECW) and body cell mass (BCM) (ECW/BCM), and overhydration (OH), respectively. Results A total of 156 patients were included, including 101 males and 55 females. The age was (62.7 ± 15.4) years, with sequential organ failure assessment (SOFA) score of 9.9±3.9. The 28-day mortality rate was 46.2%. The pre-CRRT OH values in the 28-day survival group and death group were 2.95(1.80, 5.50) L and 4.20(2.95, 5.70) L(P=0.016), and ECW/BCM values were 1.00(0.76, 1.18) and 1.07(0.88, 1.25) (P=0.033), respectively. Univariate Cox regression analysis showed that pre-CRRT high OH values (HR=1.08, 95%CI 1.00-1.17, P=0.040) and high ECW/BCM values (HR=3.02, 95%CI 1.46-6.22, P=0.003) were associated with 28-day death. The changes of OH values (HR=0.83, 95%CI 0.72-0.95, P=0.008) and ECW/BCM values (HR=6.79, 95%CI 1.72-26.82, P=0.006) between pre - CRRT and the 7th day after CRRT initiation were significantly associated with 28-day mortality in patients who survived 7 days after CRRT initiation. After adjusting for age, gender, and SOFA scores, multivariate Cox regression analysis showed that the high OH value (HR=1.16, 95%CI 1.06-1.27, P=0.002) and the high ECW/BCM value (HR=2.80, 95%CI 1.30-6.06, P=0.003) before CRRT, the change of OH value (HR=0.82, 95%CI 0.72-0.95, P=0.008) and ECW/BCM value (HR=2.79, 95%CI 1.30-5.98, P=0.009) between the 7th day after CRRT initiation and pre-CRRT, were independently associated with 28-day death, while LTI (HR=0.93, 95%CI 0.86-1.02, P=0.113) and FTI (HR=0.98, 95% CI 0.92-1.04, P=0.475) before CRRT were uncorrelated with 28-day death. Conclusions In bioelectrical impedance analysis, the high OH value and high ECW/BCM value before CRRT are associated with 28-day mortality in patients with AKI, while the nutritional indicators LTI and FTI before CRRT are not significantly related. The correction of fluid overload by CRRT within 7 days may reduce the risk of 28-day mortality.

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Article in Chinese | WPRIM | ID: wpr-779415

ABSTRACT

Objective To investigate the association of smoking status with incident cardiovascular disease (CVD) and its subtypes among the middle-aged and older male populations. Methods This study included 13 940 males from Dongfeng-Tongji (DFTJ) cohort who were free of coronary heart disease (CHD), stroke, cancer or severely abnormal electrocardiogram (ECG) at baseline. All participants completed baseline questionnaires, physical examinations, clinical biochemical tests and blood sample collection. Cox proportional hazard models were used to estimate the hazard ratios (HRs) and 95% confident intervals (CI) for the association analyses. Results Compared with never smokers, current smokers had significant higher risks of CVD, CHD and stroke, the adjusted HRs of current smokers who smoked for more than 40 pack-years were 1.49 (95% CI: 1.32-1.68, Ptrend=0.001), 1.40 (95% CI: 1.22-1.62, Ptrend=0.026) and 1.59 (95% CI: 1.26-2.00, Ptrend=0.029) for CVD, CHD and stroke, respectively; and the adjusted HRs of current smokers who started smoking before 20 years old were 1.29 (95% CI: 1.06-1.58, Ptrend=0.007) and 1.30 (95% CI: 1.03-1.64, Ptrend=0.010) for CVD and CHD, respectively. Former smokers who had quitted smoking for 10 or more years had significant lower risks of CVD (HR: 0.80, 95% CI: 0.71-0.91, Ptrend=0.017) and stroke (HR: 0.65, 95% CI: 0.50-0.84, Ptrend=0.207) when comparing to current smokers. Conclusions Smoking is significantly associated with higher risks of CVD, CHD and stroke, and greater amount of smoking and earlier age at smoking initiation are associated with a higher risk of CVD. Smoking cessation can reduce the risk of CVD.

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