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1.
Chinese Journal of Contemporary Pediatrics ; (12): 98-102, 2024.
Article in Chinese | WPRIM | ID: wpr-1009900

ABSTRACT

Multisystem inflammatory syndrome in children (MIS-C) is a complex syndrome characterized by multi-organ involvement that has emerged in the context of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak. The clinical presentation of MIS-C is similar to Kawasaki disease but predominantly presents with fever and gastrointestinal symptoms, and severe cases can involve toxic shock and cardiac dysfunction. Epidemiological findings indicate that the majority of MIS-C patients test positive for SARS-CoV-2 antibodies. The pathogenesis and pathophysiology of MIS-C remain unclear, though immune dysregulation following SARS-CoV-2 infection is considered a major contributing factor. Current treatment approaches for MIS-C primarily involve intravenous immunoglobulin therapy and symptomatic supportive care. This review article provides a comprehensive overview of the definition, epidemiology, pathogenesis, clinical presentation, diagnosis, treatment, and prognosis of MIS-C.


Subject(s)
Child , Humans , COVID-19 , SARS-CoV-2 , Pandemics , Systemic Inflammatory Response Syndrome/therapy
2.
Acta Pharmaceutica Sinica ; (12): 469-482, 2023.
Article in Chinese | WPRIM | ID: wpr-965609

ABSTRACT

Ribonucleic acid (RNA) medicines have strong therapeutic potential for numerous rare genetic illnesses and malignancies because of its exact programmability based on Watson-Crick base pairing principle and unique ability to regulate gene expression. However, RNA medicines still have limitations in many areas, including stability, half-life time, immunogenicity, organ selectivity, cellular uptake and endosomal escape efficiency despite their great therapeutic potentials. This review briefly introduced numerous RNA medications [mostly messenger RNA (mRNA), small interfering RNA (siRNA), microRNA (miRNA) and antisense oligonucleotide (ASO)] that have intrigued of researchers in recent years, as well as their action mechanism in vivo. A number of delivery techniques, such as chemical modification, ligands coupling and nanocarriers have been proposed. The manufacture and applications of lipid nanoparticle, polymer nanoparticle and exosomes were discussed in depth. The goal of this work is to give a theoretical foundation and design concepts for the development of effective and safe RNA delivery technology, as well as to facilitate RNA therapeutic clinical translation.

3.
Chinese Journal of Anesthesiology ; (12): 535-539, 2023.
Article in Chinese | WPRIM | ID: wpr-994224

ABSTRACT

Objective:To evaluate the effect of dexamethasone combined with aminophylline on perioperative airway responses in COVID-19 convalescent patients undergoing gynecological laparoscopic surgery.Methods:Sixty-eight COVID-19 convalescent patients, aged 25-57 yr, of American Society of Anesthesiologists Physical Status classification Ⅰ or Ⅱ, undergoing gynecological laparoscopic surgery, were divided into experimental group ( n=34) and control group ( n=34). In experimental group, dexamethasone 10 mg was intravenously injected at the beginning of anesthesia induction, and aminophylline 0.25 g (in 100 ml of normal saline) was intravenously infused for 10 min starting from 15 min before the end of surgery. In control group, the equal volume of normal saline was administrated instead at the same time point. Airway secretions, laryngospasm and bronchospasm were recorded from the time point before operation to 24 h after operation, and coughing was also recorded from emergence to 3 min after extubation. The blood eosinophils (EOS) count, percentage of EOS (EOS%), and neutrophil to lymphocyte ratio were determined, and plasma C reactive protein level was measured by enzyme-linked immunosorbent assay before operation and at 24 h after operation. The serum levels of interleukin-6, tumor necrosis factor-α and interferon-γ were measured before operation, at 5 and 10 min after extubation and at 24 h after operation. Results:Compared with control group, the incidence of coughing, severity of coughing, incidence of increased airway secretion, and grade of airway secretion were significantly decreased, the levels of EOS, EOS%, neutrophil to lymphocyte ratio and plasma C reactive protein in peripheral blood and serum levels of interferon-γ, interleukin-6 and tumor necrosis factor-α were significantly decreased after operation ( P<0.05), and no significant change was found in the incidence of bronchial spasm in experimental group ( P>0.05). No laryngeal spasm occurred in both groups. Conclusions:Dexamethasone combined with aminophylline can relieve the perioperative airway responses by inhibition of inflammatory responses in COVID-19 convalescent patients undergoing gynecological laparoscopic surgery.

4.
Chinese Journal of Ultrasonography ; (12): 129-135, 2023.
Article in Chinese | WPRIM | ID: wpr-992816

ABSTRACT

Objective:To study the value of sound touch elastography (STE) linear combined with ultrasound score (US) in the diagnosis of chronic hepatitis B (CHB) liver fibrosis, and to investigate whether their combination can improve the diagnostic efficiency of subdividing the degree of CHB liver fibrosis. Furthermore, a comparison with STE linear combined with the serological model was performed to seek the optimal linear combination model.Methods:A total of 313 subjects were enrolled from September 2018 to December 2021 in Shenzhen Third People′s Hospital Affiliated to Guangdong Medical University, including 259 patients with CHB who had completed liver biopsy and 54 healthy volunteers. CHB patients were divided into liver fibrosis group (F1-F4 group) according to METAVIR classification standard, and healthy volunteers were used as the control group. All subjects underwent liver ultrasound examination, STE and blood biochemical indexes of liver function. The US was performed according to the liver ultrasound examination, and the liver stiffness measurement (LSM) was measured by STE, aspartate aminotransferase and platelet ratio index (APRI) was calculated by blood biochemical index. Fisher discriminant analysis was used to establish the linear combination (LC) diagnostic marker of US and LSM, and the linear combination (LC2) diagnostic marker of LSM and APRI, successively. Spearman rank correlation coefficient was used to analyze the correlations between US, LSM, APRI, LC2, LC and pathological results. The ROC curves of US, LSM, APRI, LC2 and LC for diagnosing CHB liver fibrosis were plotted, and the diagnostic efficiency of above diagnostic markers was evaluated according to the accuracy, sensitivity, specificity and area under the ROC curve (AUC).Results:The formula for the linear combination of US and LSM was LC=0.986 0×US+ 0.166 7×LSM, and LC was highly positively correlated with pathological findings ( rs=0.851, P<0.001), higher than US, LSM, LC2 and APRI ( rs=0.825, 0.775, 0.802, 0.586, all P<0.001). LC showed the best diagnostic efficiency. The AUCs for diagnosing ≥F1, ≥F2, ≥F3 liver fibrosis and =F4 cirrhosis were 0.945, 0.911, 0.954, 0.955, respectively, which superior to the AUCs of US (0.913, 0.879, 0.934 and 0.916, respectively), the AUCs of LSM (0.860, 0.871, 0.934 and 0.952, respectively) and the AUCs of LC2(0.899, 0.883, 0.941, 0.946, respectively). Compared with US, the AUC of LC diagnosis of ≥F1, ≥F2, ≥F3 liver fibrosis and =F4 cirrhosis increased by 3.2%, 3.2%, 2.0% and 3.9%, respectively, with all significant differences ( P<0.05). Compared with LSM, the AUC of LC increased by 8.5%, 4.0%, 2.0% and 0.3%, respectively, with significant difference ( P<0.05) except for stage =F4 cirrhosis.Compared with LC2, the AUC of LC increased by 4.6%, 2.8%, 1.3% and 0.9%, respectively, and there were significant differences in the diagnosis of ≥F1 and ≥F2 liver fibrosis ( P<0.05). Moreover, the overall efficiency of LC2 was not significantly improved than LSM, the difference was not significant ( P>0.05). Conclusions:US, LSM, LC2 and LC can be used to diagnose the degree of CHB liver fibrosis, but LC is better than US or LSM and LC2 alone, especially in the subdivision of mild liver fibrosis, which is a promising new diagnostic marker to subdivide the degree of CHB liver fibrosis.

5.
Chinese Journal of Endocrinology and Metabolism ; (12): 495-502, 2022.
Article in Chinese | WPRIM | ID: wpr-957580

ABSTRACT

Objective:To investigate the effects of maternal subclinical hypothyroidism (SCH) on preschoolers′ behavioral problems.Methods:Based on the Ma′ anshan Birth Cohort, pregnant women who had their first antenatal checkup in Maternal and Child Health Center in Ma′ anshan were recruited from May 2013 to September 2014. Data on demographic, obstetric information, and maternal exposure were collected. Women′s fasting venous blood in the first, second, and third trimesters of pregnancy was collected. The levels of thyroid hormones [thyrotropin (TSH), free thyroxine (FT 4)] and thyroid autoantibodies [thyroid peroxidase antibody (TPOAb), thyroglobulin antibody (TgAb)] in maternal blood were retrospectively detected by electrochemiluminescence immunoassay. Preschoolers′ behavioral problems were assessed by Achenbach Child Behavior Checklist (CBCL/1.5-5). Poisson regression models were adopted to examine the effect of maternal SCH on preschoolers′ internalizing and externalizing problems and the critical period. Results:In this study, the reference of maternal thyroid indexes was established (between 2.5 th and 97.5 th percentile). The reference of TSH in the first, second, and third trimester of pregnancy was 0.04-4.90 μIU/mL, 0.75-6.08 μIU/mL, and 0.58-5.59 μIU/mL respectively; and the reference of FT 4 was 13.19-23.27 pmol/L, 9.14-15.32 pmol/L, and 9.53-17.45 pmol/L respectively. In the first, second, and third trimester of pregnancy, the prevalence of SCH was found to be 2.0% (25/1 224), 1.6% (19/1 218), and 1.7% (21/1 220), respectively. After adjusting for confounding factors, maternal SCH in the first trimester was associated with the risk of anxiety and depression in preschool children ( OR=3.06, 95% CI 1.05-8.98). Maternal SCH in the second trimester was found to be associated with the risk of overreaction in preschool children ( OR=2.65, 95% CI 1.13-6.21). Conclusions:The establishment of thyroid hormones reference range for pregnant women in Ma′ anshan area is beneficial to the screening, diagnosis, and treatment of thyroid diseases during pregnancy in this area. Maternal SCH during pregnancy is associated with increased risk of behavioral problems in preschool children. In the first trimester, maternal SCH was associated with preschoolers′ anxiety and depression, and in the second trimester, maternal SCH was associated with preschoolers′ emotional reactivity.

6.
International Journal of Traditional Chinese Medicine ; (6): 1221-1226, 2022.
Article in Chinese | WPRIM | ID: wpr-954456

ABSTRACT

Objective:Effects of pole-specific acupuncture combined with Bobath on upper limb function, daily life ability and nerve function after traumatic brain injury were observed.Methods:A total of 142 patients with cerebral hemiplegia after traumatic brain injury from January 2019 to December 2020, were divided into the Bobath group (47 cases), the pole-specific acupuncture group (47 cases) and combination group (48 cases) by the random number method. Bobath group received Bobath rehabilitation, the pole-specific acupuncture group received pole-specific acupuncture rehabilitation, and combination group was given pole-specific acupuncture rehabilitation and Bobath treatment. The overall rehabilitation efficiency, limb function Fugl-Meyer scale score, Barthel index of daily life ability, nerve function, and other indicators were observed and compared.Results:After treatment, the overall recovery efficiency (86.96%) in combination group was significantly higher than that of the Bobath group (65.96%) and acupuncture group (64.44%)( χ2=5.84, P=0.016). After treatment, the limb function Fugl-Meyer scale (including upper limb and lower limb function scores)( F=19.38, 24.83, all Ps<0.01), daily life ability Barthel index (including cognitive ability situation score, language ability score, self-care ability score, social adaptability score and total score) of combination group were significantly higher than those in the Bobath group and acupuncture group ( F=14.91, 15.87, 18.71, 18.88, 32.62, all Ps<0.001), while the NIHSS score of combination group was significantly lower than that of the Bobath group and acupuncture group ( F=31.71, P<0.01). After treatment, the NE[(58.29±9.82)μg/L vs. (86.29±12.35)μg/L, (88.34±12.87)μg/L, F=33.39], DA[(204.29±20.26)μg/L vs. (278.72±27.56)μg/L, (281.14±27.82)μg/L, F=55.50], 5-HT[(231.27±20.12)μg/L vs. (294.74±29.34)μg/L, (298.19±28.73)μg/L, F=13.86], E[(21.85±3.19)μg/L vs. (28.37±4.07)μg/L, (28.26±4.14)μg/L, F=9.34] of combination group were significantly lower than those in the Bobath group and acupuncture group ( P<0.01). Conclusion:Magnetic pole-specific acupuncture combined with Bobath can improve the function of limbs, daily quality of life and nerve function of the patients with traumatic craniocerebral injury with cerebral palsy.

7.
Chinese Journal of Otorhinolaryngology Head and Neck Surgery ; (12): 136-141, 2022.
Article in Chinese | WPRIM | ID: wpr-936186

ABSTRACT

Objective: To explore the types and clinical characteristics of chronic rhinosinusitis with nasal polyps (CRSwNP) based on artificial intelligence and whole-slide imaging (WSI), and to explore the consistency of the diagnostic criteria of the Japanese epidemiological survey of refractory eosinophilic chronic rhinosinusitis (JESREC) in Chinese CRSwNP patients. Methods: The data of 136 patients with CRSwNP (101 males and 35 females, aging 14 to 70 years) who underwent endoscopic sinus surgery from 2018 to 2019 in the Department of Otorhinolaryngology Head and Neck Surgery, the Third Affiliated Hospital of Sun Yat-sen University were analysed retrospectively. The preoperative clinical characteristics of patients were collected, such as visual analogue scale (VAS) of nasal symptoms, peripheral blood inflammatory cell count, total immunoglobulin E (IgE), Lund-Kennedy score and Lund-Mackay score. The proportion of inflammatory cells such as eosinophils, lymphocytes, plasma cells and neutrophils were calculated on the WSI of each patient through artificial intelligence chronic rhinosinusitis evaluation platform 2.0 (AICEP 2.0), and the specific type of nasal polyps was then obtained as eosinophilic CRSwNP (eCRSwNP) or non-eosinophilic CRSwNP (non-eCRSwNP). In addition, the JESREC diagnostic criteria was used to classify the nasal polyps, and the classification results were compared with the current gold standard for nasal polyps diagnosis (pathological diagnosis based on WSI). The accuracy, sensitivity and specificity of the diagnostic criteria of JESREC were evaluated. The data were expressed in M (Q1, Q3) and statistically analyzed by SPSS 17.0. Results: There was no significant difference between eCRSwNP and non-eCRSwNP in age distribution, gender, time of onset, total VAS score, Lund-Kennedy score or Lund-Mackay score. However, there was a significant difference in the ratio of nasal polyp inflammatory cells (eosinophils 40.5% (22.8%, 54.7%) vs 2.5% (1.0%, 5.3%), neutrophils 0.3% (0.1%, 0.7%) vs 1.3% (0.5%, 3.6%), lymphocytes 49.9% (39.3%, 65.9%) vs 82.0% (72.8%, 87.5%), plasma cells 5.1% (3.6%, 10.5%) vs 13.0% (7.4%, 16.3%), χ2 value was 9.91, 4.66, 8.28, 5.06, respectively, all P<0.05). In addition, eCRSwNP had a significantly higher level of proportion of allergic symptoms (nasal itching and sneezing), asthma, peripheral blood eosinophil and total IgE (all P<0.05). The overall accuracy, sensitivity and specificity of the JESREC diagnostic criteria was 74.3%, 81.3% and 64.3%, respectively. Conclusions: The eCRSwNP based on artificial intelligence and WSI has significant high level of allergic symptoms, asthma, peripheral blood eosinophils and total IgE, and the percentages of inflammatory cells in nasal polyps are different from that of non-eCRSwNP. The JESREC diagnostic criteria has good consistency in our research.


Subject(s)
Female , Humans , Male , Artificial Intelligence , Chronic Disease , Eosinophils/metabolism , Nasal Polyps/pathology , Retrospective Studies , Rhinitis/pathology , Sinusitis/pathology
8.
Journal of Metabolic and Bariatric Surgery ; : 32-41, 2021.
Article in English | WPRIM | ID: wpr-900313

ABSTRACT

Purpose@#Both primary and revisional bariatric surgery are on the rise due to global obesity pandemic. This study aimed to assess the indications for revision after one-anastomosis gastric bypass (OAGB) and the outcomes after laparoscopic conversion of OAGB to roux-en-y gastric bypass (RYGB). @*Materials and Methods@#Retrospective review on patients that had undergone conversion of OAGB to RYGB between June 2007-June 2019 in a tertiary bariatric center, followed by literature review. @*Results@#Out of 386 revisional bariatric surgery, a total of 14 patients underwent laparoscopic conversion of OAGB to RYGB. The mean age was 44.7 with 71% female. The mean pre-revision BMI was 29.2 kg/m2 . The primary indications for revision were bile reflux (n=7), marginal ulcer (n=3), inadequate weight loss or weight regain (IWL/WR) (n=3) and protein-calorie malnutrition (n=1). Conversion of OAGB to RYGB was completed laparoscopically in all cases.The mean length of stay was 4.1 days. There was no intraoperative or early post-operative complication. The mean total weight loss (rTWL%) after revision at year one, year three and year five post-revision were 11.5%, 18.1% and 29.1%, respectively. All patients achieved resolution of bile reflux and marginal ulcer. There was no mortality in this cohort. @*Conclusion@#Bile reflux, marginal ulcer, IWL/WR and malnutrition were the main indications for revision after OAGB in this study. In concordance with the available evidence, laparoscopic conversion of OAGB to RYGB was safe and effective in dealing with late complications of OAGB.

9.
Chinese Journal of School Health ; (12): 867-871, 2021.
Article in Chinese | WPRIM | ID: wpr-881295

ABSTRACT

Objective@#To explore the role of rejection sensitivity in the relationship between the psychological resilience and social adaptability of college students with left behind experience, so as to provide reference for college students to beffer adapt to the society.@*Methods@#Self designed questionnaire, the Conor Davidson Resilience Scale(CD-RISC), the Chinese College Students Adaptation Scale(CCSAS), and the Rejection Sensitivity Questionnaire (RSQ) were administered among 3 418 college students from four universities in Anhui Province with the stratified cluster sampling method. This research investigation used AMOS version 21.0 to construct a structural equation model of rejection sensitivity, psychological resilience, and social adaptability, to analyze the mediation effect.@*Results@#There were 1 324 college students with lefe behind experience. Compared with college students without left behind experience[(64.47±13.79)(197.90±25.57)(10.86±2.98)], students with left behind experience exhibited lower levels of psychological resilience, social adaptability, and rejection sensitivity[(63.26±13.69)(195.14±24.60)(10.45±2.91)](t=-2.50, -3.12, -3.87, P<0.05); Rejection sensitivity was negatively associated with social adaptability, and psychological resilience among college students with left behind experience(r=-0.24, -0.22, P<0.01), while social adaptability was positively correlated with psychological resilience(r=0.64, P<0.01). The results of the mediation model showed that psychological resilience affected the mediation path of social adaptability by rejection sensitivity (mediation effect value=0.02, 95%CI=0.01-0.05, P<0.05).@*Conclusion@#Left behind experience had a negative impact on the psychological resilience and social adaptability of undergraduates. With respect to the psychological resilience of undergraduates with left behind experience, rejection sensitivity played a mediating role in the social adaptability relationship.

10.
Environmental Health and Preventive Medicine ; : 3-3, 2021.
Article in English | WPRIM | ID: wpr-880322

ABSTRACT

BACKGROUND@#Previous studies have suggested that screen time (ST) has a negative effect on children's emotional and behavioral health, but there are few longitudinal studies that have been conducted with infants and toddlers. This study sought to examine the effect of ST in early childhood on emotional and behavioral problems in children aged 4 years, based on a birth cohort study in China.@*METHODS@#A total of 2492 children aged 4 years were enrolled in this study. The parents and guardians of each child completed a questionnaire that included items eliciting information on children's birth information, socio-demographic information at baseline, and ST at each follow-up. Emotional and behavioral problems were assessed using the Strengths and Difficulties Questionnaire (SDQ) at 4 years of age. Multivariate logistic analysis was used to explore the effects of ST on emotional and behavioral problems.@*RESULTS@#The percentages of children with ST > 0 h/day at age 0.5 years, ST > 2 h/day at age 2.5 years, and ST > 2 h/day at age 4 years were 45.7, 55.5, and 34.5% respectively. The prevalence of emotional and behavioral problems was 10.8%. ST at 6 months was a risk factor for emotional symptoms and hyperactivity at the age of 4 years. ST at age 2.5 years was a risk factor for hyperactivity at the age of 4 years. However, ST at age 4 years was a risk factor for total difficulties, conduct problems, peer problems, hyperactivity, and prosocial behavior.@*CONCLUSIONS@#Higher ST exposure at early childhood is associated with later emotional and behavioral problems. In particular, sustained high ST exposure is a risk factor for behavioral problems. These findings suggested the importance of controlling ST to prevent the occurrence of emotional and behavioral problems in the early years.


Subject(s)
Child, Preschool , Female , Humans , Male , Altruism , China/epidemiology , Cohort Studies , Emotions , Prevalence , Problem Behavior/psychology , Psychomotor Agitation/psychology , Screen Time
11.
Chinese Journal of Medical Education Research ; (12): 1211-1214, 2021.
Article in Chinese | WPRIM | ID: wpr-908990

ABSTRACT

Objective:To explore the application effect of ADDIE (analyze, design, develop, implement, evaluate) teaching model in the nursing teaching of intensive care medicine.Methods:The data of 89 intern students who studied intensive care medicine in Cancer Hospital of Xinjiang Medical University between January 2016 and July 2020 were retrospectively analyzed. Intern students between January 2016 and December 2017 were included in control group ( n=43), and intern students between January 2018 and July 2020 were selected as observation group ( n=46). The interns in the control group were given regular teaching, and the interns in the observation group implemented ADDIE teaching model. The scores of core competence (comprehensive evaluation scale of core competence of intensive care nurses, CICCN), autonomous learning ability (assessment scale for autonomous learning ability of nursing college students), critical thinking ability (critical thinking disposition inventory-Chinese version, CTDI-CV) and evidence-based practice ability (Chinese version of evidence-based practice ability assessment scale for nursing students) were compared between the two groups of interns at the end of teaching. SPSS 19.0 was used for chi-square test and t test. Results:At the end of the teaching, the scores of CICCN scale, assessment scale for autonomous learning ability of nursing college students, CTDI-CV scale, and Chinese version of evidence-based practice ability assessment scale for nursing students were higher in observation group than those in control group (all P<0.05). Conclusion:The application of ADDIE teaching model in nursing teaching of intensive care medicine can effectively improve the core competence, autonomous learning ability, critical thinking ability and evidence-based practice ability of students.

12.
Journal of Metabolic and Bariatric Surgery ; : 32-41, 2021.
Article in English | WPRIM | ID: wpr-892609

ABSTRACT

Purpose@#Both primary and revisional bariatric surgery are on the rise due to global obesity pandemic. This study aimed to assess the indications for revision after one-anastomosis gastric bypass (OAGB) and the outcomes after laparoscopic conversion of OAGB to roux-en-y gastric bypass (RYGB). @*Materials and Methods@#Retrospective review on patients that had undergone conversion of OAGB to RYGB between June 2007-June 2019 in a tertiary bariatric center, followed by literature review. @*Results@#Out of 386 revisional bariatric surgery, a total of 14 patients underwent laparoscopic conversion of OAGB to RYGB. The mean age was 44.7 with 71% female. The mean pre-revision BMI was 29.2 kg/m2 . The primary indications for revision were bile reflux (n=7), marginal ulcer (n=3), inadequate weight loss or weight regain (IWL/WR) (n=3) and protein-calorie malnutrition (n=1). Conversion of OAGB to RYGB was completed laparoscopically in all cases.The mean length of stay was 4.1 days. There was no intraoperative or early post-operative complication. The mean total weight loss (rTWL%) after revision at year one, year three and year five post-revision were 11.5%, 18.1% and 29.1%, respectively. All patients achieved resolution of bile reflux and marginal ulcer. There was no mortality in this cohort. @*Conclusion@#Bile reflux, marginal ulcer, IWL/WR and malnutrition were the main indications for revision after OAGB in this study. In concordance with the available evidence, laparoscopic conversion of OAGB to RYGB was safe and effective in dealing with late complications of OAGB.

13.
Chinese Journal of Gastrointestinal Surgery ; (12): 327-334, 2021.
Article in Chinese | WPRIM | ID: wpr-942890

ABSTRACT

Objective: Postoperative sexual and urinary dysfunctions are common in rectal cancer patients. This study was conducted to compare the short-term efficacy and the impact of surgery on urinary and erectile functions between laparoscopy and robotic-assisted total mesorectal excision (TME) with partial preservation of Denonvilliers fascia. Methods: A retrospective cohort study was carried out. Clinical data of 276 patients with low rectal cancer who underwent TME with partial preservation of Denonvilliers fascia in our department between January 2016 and March 2019, including 143 in robotic group and 133 in laparoscopic group, were analyzed. All the patients were positioned by rigid rectoscope, and the distance between the tumor and the anal verge was ≤7 cm. The urinary and erectile functions were followed up at postoperative 12-month and evaluated by IPSS score (0-7 points as mild symptoms, 8-19 points as moderate symptoms, 20-35 points as severe symptoms; the excellent rate was defined as the rate of mild symptoms) and IIEF-5 score (score ≥ 22 as no dysfunction, 12-21 as mild, 8-11 as moderate, and 5-7 as severe) respectively. Results: There were no significant differences in operation ways between the two groups (P>0.05). The operation time of the robotic group was longer than that of the laparoscopic group [(312.5±75.4) minutes vs. (273.9±65.6) minutes, t=4.514, P<0.001]. However, in patients with higher body mass index (BMI ≥25 kg/m(2)), there was no significant difference in operation time between the two groups [(309.3±78.5) minutes vs. (276.1±75.3) minutes, t=1.751, P=0.085]. The time to postoperative flatus [(1.3±0.4) days vs. (1.5±1.0) days, t=-2.037, P=0.046], defecation [1 (1-5) days vs. 1 (1-12) days, Z=-2.209, P=0.008] and liquid diet [(1.0±0.1) days vs. (1.2±0.1) days, t=3.195, P=0.002] in the robotic group were all shorter than those in the laparoscopic group. While postoperative length of hospital stay in the robotic group was longer than that in the laparoscopic group [(8.5±5.5) days vs. (7.2±3.3) days, t=2.419, P=0.016]. There were no significant differences between the two groups in intraoperative blood loss, conversion rate, morbidity of postoperative complications, positive rate of distal resection margin, positive rate of circumferential resection margin, and the number of resected lymph nodes (all P>0.05). At postoperative 12 months, none of the robotic group nor the laparoscopic group had severe urinary dysfunction, and the overall excellent rate of urinary function reached 97.6% (83/85) and 98.4% (61/62) respectively. The rate of normal and mild erectile dysfunction in the robotic group and the laparoscopic group were 92.2% (47/51) and 92.6% (38/41) respectively (P>0.05). There was no significant difference between the two groups was found regarding the urinary and erectile function (both P>0.05). Conclusions: Compared with laparoscopic, the robotic TME with partial preservation of Denonvilliers fascia has no significant differences in surgical safety and short-term efficacy. They have similar advantages in the protection of urinary and erectile function. Meanwhile the robotic surgery presents faster postoperative recovery of gastrointestinal function.


Subject(s)
Humans , Male , Erectile Dysfunction , Fascia , Laparoscopy , Rectal Neoplasms/surgery , Retrospective Studies , Robotic Surgical Procedures , Treatment Outcome
14.
Chinese Acupuncture & Moxibustion ; (12): 749-755, 2020.
Article in Chinese | WPRIM | ID: wpr-826660

ABSTRACT

OBJECTIVE@#To observe the impacts of electroacupuncture (EA) on neurological function, the pathological morphology in brain tissue, apoptosis level and the protein expressions of apoptosis-related cytochrome C (Cyt-C) and cysteine aspartic acid protease-9 (Caspase-9) in the rats with traumatic brain injury (TBI) and explore the potential mechanism of EA in treatment of TBI.@*METHODS@#A total of 70 clean-grade SD mice were randomized into a blank group (8 rats), a sham-operation group (8 rats), a model group (27 rats) and an EA group (27 rats). In terms of interventions of 3, 7 and 14 days, 3 subgroups were divided in the model group and the EA group successively, 9 rats in each subgroup. The modified Feeney free-fall percussion method was adopted to establish TBI models of rats. In the sham-operation group, only the skull was exposed and drilled and no free-fall percussion was exerted. One day after modeling, EA was given in the rats of EA group at "Shuigou" (GV 26), "Baihui" (GV 20) and "Neiguan" (PC 6) and "Zusanli" (ST 36) on the affected side, with intermittent wave, 2 Hz in frequency, once daily, 10 min each time, for 3, 7 and 14 days successively. Separately, on the day 3, 7 and 14 of intervention, the modified neurological severity scale (mNSS) was used to evaluate the degree of neurological function injury in the rats, HE staining and Nissl staining were to observe the pathological and morphological changes in brain tissue, TUNEL method was to observe the level of apoptosis in brain tissue and immunohistochemistry (IHC) method and Western blot were to determine the protein expressions of Cyt-C and Caspase-9 in brain tissue.@*RESULTS@#Compared with the sham-operation group, on the day 3, 7 and 14 of intervention, mNSS scores were increased obviously in the rats of the model group respectively (<0.01). Compared with the model group, on the day 3, 7 and 14 of intervention, mNSS scores were reduced in the rats of the EA group respectively (<0.05). On day 3 of intervention, in brain injury region of the rats in the model group and the EA group, gross tissue necrosis, nuclear fragmentation, consolidation and obvious vacuolar changes, reduced Nissl bodies and scattered arrangement were found. On day 7 and 14 of intervention, in the model group and the EA group, the new connective tissue filling and normal cells were visible and Nissl bodies increased. The overall repair and Nissl body quantity in the EA group were better than the model group. Compared with the sham-operation group, on day 3, 7 and 14 of intervention, the numbers of apoptotic cells were increased obviously in the model group (<0.01) and they were reduced in the EA group as compared with the model group (<0.05). Compared with the sham-operation group, on day 3, 7 and 14 of intervention, the protein expressions of Cyt-C and Caspase-9 in damaged brain tissue were all increased obviously in the model group (<0.01) and they were all reduced in the EA group as compared with the model group successively (<0.05).@*CONCLUSION@#Electroacupuncture remarkably improves the condition in the neurological function injury and reduces apoptosis degree in TBI model rats, which is likely related to the down-regulation of the protein expressions of Cyt-C and Caspase-9 in damaged brain tissue and further to bring the impacts on mitochondria mediated apoptosis process.


Subject(s)
Animals , Rats , Apoptosis , Brain Injuries, Traumatic , Therapeutics , Caspase 9 , Metabolism , Cytochromes c , Metabolism , Electroacupuncture , Random Allocation , Rats, Sprague-Dawley
15.
Chinese Journal of Preventive Medicine ; (12): 913-918, 2019.
Article in Chinese | WPRIM | ID: wpr-798031

ABSTRACT

Objective@#To analyze the correlation between elective cesarean delivery and duration of breastfeeding in Ma′anshan city from 2013 to 2014.@*Methods@#From May 2013 to September 2014, a total of 3 474 pregnant women with the first prenatal checkup were recruited from Ma′anshan maternal and child health care hospital. Finally, 3 109 pregnant women were included after exclusion of those with terminated pregnancies, adverse birth outcomes, twin or multiple pregnancies, breech traction, breech midwifery and loss of delivery information. Demographic data of pregnant women, mode of delivery and breast feeding of children were collected through questionnaires and hospital records. Logistic regression model was used to analyze the relationship between elective cesarean delivery and duration of breastfeeding in children, with the mode of delivery as independent variable and the duration of breastfeeding as dependent variable.@*Results@#The age of 3 109 subjects was (26.6±3.6) years old, the rate of vaginal delivery was 51.1% (1 589), and the rate of elective cesarean delivery was 46.4% (1 443), among which the rate of non-indicative elective cesarean delivery was 26.4% (820), the rate of indicative elective cesarean delivery was 20.0% (623), and the rate of emergency cesarean delivery was 2.5% (77). The proportion of breastfeeding lasting until 4, 12 and 18 months was 45.0% (1 348/2 998), 23.7% (702/2 962) and 5.2% (154/2 944), respectively. After adjusting the confounding factors, compared with vaginal delivery, the OR (95%CI) values of breastfeeding for 4 months in indicative elective cesarean delivery and non-indicative elective cesarean delivery women were 0.870(0.714-1.059), 0.795(0.665-0.949), and the OR (95%CI) values of breastfeeding for 12 months were 0.772(0.611-0.975), 0.755(0.610-0.934), respectively.@*Conclusion@#Elective cesarean delivery may result in shorter duration of breastfeeding in children.

16.
Chinese Traditional and Herbal Drugs ; (24): 457-461, 2019.
Article in Chinese | WPRIM | ID: wpr-851419

ABSTRACT

Objective To observe the effect of Acanthus ilicifolius alkaloid A (HBOA) on PI3K/AKT/mTOR/p70S6K signaling pathway in rats with hepatic fibrosis induced by carbon tetrachloride (CCl4), and to explore the mechanism of action of HBOA against liver fibrosis. Methods Rats were randomly divided into normal group, model group, high, medium; and low-dose HBOA groups (100, 50, 25 mg/kg), and colchicine group (0.4 mg/kg). Except for the normal group, the rats in other groups were given with a 50% CCl4 olive oil solution twice a week for 12 weeks to induce a rat model of liver fibrosis. From the ninth week of modeling, the drug-administered group was given the corresponding test drug once daily for 4 weeks. After the experiment, the body mass change and liver index were calculated. The levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) in the liver homogenate of each group were detected. The protein expression of p-PI3K, p-Akt, p-mTOR, and p-p70S6K in liver tissue was detected by Western blotting. Results Compared with the model group, the body weight of mice of each drug-administered group was significantly increased, and the liver index, and ALT and AST levels were decreased in liver tissue. In addition, HBOA high and medium-dose groups significantly inhibited the protein expression of p-PI3K, p-Akt, p-mTOR, and p-p70S6K. Conclusion HBOA has a protective effect on hepatic fibrosis rats, and its mechanism may be related to the inhibition of PI3K/Akt/mTOR/p70S6K signaling pathway.

17.
Journal of Sun Yat-sen University(Medical Sciences) ; (6): 546-553, 2019.
Article in Chinese | WPRIM | ID: wpr-817704

ABSTRACT

@#【Objective】To investigate the predictive value of blood eosinophil in eosinophilic chronic rhinosinusitis with nasal polyps(eosCRSwNP)by analyzing the characteristics of eosCRSwNP adult patients in Guangdong Province, China.【Method】From Oct.2017 to Sep.2018,a total of 108 eosCRSwNP adult inpatients scheduled for surgery in Department of Otorhinolaryngology,Head and Neck Surgery,The Third Affiliated Hospital,Sun Yat-sen University were enrolled. They were divided into eosCRSwNP(n = 39) and non-eosCRSwNP(n = 69) group by the pathologic features. The demographic and clinical features were collected and compared.【Results】The eosCRSwNP group accounted for 36.1% while non-eosCRSwNP group accounted for 63.9% in our study. A higher prevalence of allergic rhinitis,asthma and higher blood IgE level,bilateral Lund-Mackay score of posterior ethmoid sinus,ethmoid to maxillary Lund-Mackay score ratio, peripheral blood eosinophil absolute count and percentage and peripheral blood basophil absolute count and percentage were found in eosCRSwNP patients. Only peripheral blood eosinophil absolute count and percentage were independent predictors of eosCRSwNP. The cutoff absolute value of 0.275×109/L demonstrated a sensitivity of 74.4% and a specificity of 72.5% while the cutoff relative value of 4.32% demonstrated a sensitivity of 74.4% and a specificity of 73.9%.【Conclusion】Non-eosCRSwNP was predominant in Guangdong. EosCRSwNP differs from non-eosCRSwNP in many clinical features,while peripheral blood eosinophil count and percentage were independent predictors of eosCRSwNP.

18.
Chinese Journal of Contemporary Pediatrics ; (12): 676-679, 2019.
Article in Chinese | WPRIM | ID: wpr-775125

ABSTRACT

OBJECTIVE@#To compare the levels of short-chain fatty acids in enterobacteria-related metabolites in feces between infants with cholestatic hepatopathy and healthy infants.@*METHODS@#Thirty infants with cholestatic hepatopathy were enrolled in this study as the disease group, while 30 healthy infants were enrolled as the control group. Fecal specimens were collected from the disease group before and after treatment and from the control group. Gas chromatography was used to quantitatively determine the content of short-chain fatty acids in the feces of both groups including acetic acid, propionic acid, butyric acid, isobutyric acid, and isovaleric acid.@*RESULTS@#There were no significant differences in the concentrations of acetic acid and propionic acid between the control and disease groups before and after treatment, as well as no significant changes in the two markers in the disease group after treatment (P>0.05). The disease group had a significantly increased concentration of butyric acid after treatment (P<0.05). The concentrations of isobutyric acid and isovaleric acid in the control group were significantly higher than those in the disease group before and after treatment (P<0.05).@*CONCLUSIONS@#Intestinal protein metabolites in infants with cholestatic hepatopathy are significantly different from those in healthy infants, whereas there is no significant difference with respect to carbohydrate metabolites.


Subject(s)
Humans , Infant , Acetates , Butyric Acid , Enterobacteriaceae , Fatty Acids, Volatile , Feces
19.
Chinese Journal of Preventive Medicine ; (12): 633-637, 2019.
Article in Chinese | WPRIM | ID: wpr-805581

ABSTRACT

The role of microbes in regulating the metabolism and immune function of the body has been highlighted. The interactions of host-microbe and microbial-microbe have existed before the birth. However, the existence of placental microbiota and their regulatory effects on pregnancy are still controversial. It was found that placental microbes might be implanted into the placenta via urogenital-placental, gastrointestinal-placental, and oral-placental routes. Microbiome may play a role in promoting the outcome of benign pregnancy, and the placental microbiota in pathological pregnancy may be associated to adverse pregnancy outcome. Placenta and amniotic fluid microbes have been linked to abortion, chorioamnionitis, premature rupture of membranes, premature delivery and stillbirth in Cultivation-dependent and Cultivation-independent studies. Obesity, gestational diabetes mellitus, probiotics and antibiotics during pregnancy may be the main factors affecting placenta microbiology.

20.
Chinese Journal of Experimental Traditional Medical Formulae ; (24): 103-107, 2019.
Article in Chinese | WPRIM | ID: wpr-802341

ABSTRACT

Objective:To observe the effect of alkaloid A from Acanthi Ilicifolii Herba seu Radix(AAIA) on liver injury model caused by acetaminophen. Method:Mice were randomly divided into normal group, model group, positive drug group (bifendate, 150 mg·kg-1) and high, medium and low-dose AAIA groups (200, 100, 50 mg·kg-1), with 10 in each group. They were given drugs by gavage for 10 days, and fasted for 8 hours after the last administration. Except the normal group, the other groups were intraperitoneally injected with 275 mg·kg-1 acetaminophen to induce acute liver injury model in mice. Six hours later, blood was taken from the eyeball. The body, liver, spleen, kidney and thymus were weighed, and then the corresponding organ indexes were calculated. The kits were used to detect the contents of aspartate aminotransferase (AST) and alanine aminotransferase (ALT) in serum. The contents of nitric oxide (NO) and inducible nitric oxide synthase (iNOS) in liver homogenate were determined by ultraviolet spectrophotometry, and the expressions of extracellular regulated protein kinases (ERK1/2) and phosphorylated extracellular regulatory protein kinase (p-ERK1/2) were determined by Western blot. Result:Compared with the normal group, the liver index, serum AST and ALT levels, the production of NO and iNOS in liver homogenate, the expression of p-ERK1/2 protein in liver of the model group increased significantly (PPConclusion:AAIA may protect mice from drug-induced liver injury by reducing AST and ALT levels, down-regulating the expressions of NO and iNOS, and reducing the expression of protein p-ERK1/2.

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