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1.
Article in Chinese | WPRIM | ID: wpr-934404

ABSTRACT

Objective:To investigate the expression of hsa_circ_0000437 in the serum of patients with gastric cancer and its clinical value.Methods:The serum samples from 80 patients (57 males and 23 females) with pathologically confirmed gastric cancer (GC), 50 gastric benign disease (28 males and 22 females) and 80 healthy controls (46 males and 34 females) were collected from October 2018 to December 2020 in Affiliated Hospital of Nantong University.Serum samples from 35 of 80 gastric cancer patients after operation were collected. The expression of serum hsa_circ_0000437 was determined by real-time fluorescent quantitative PCR (RT-qPCR). Serum carcinoembryonic antigen (CEA), carbohydrate antigen 199 (CA 199) and carbohydrate antigen 724 (CA724) were determined by chemiluminescence method.Comparisons of serum hsa_circ_0000437 between groups were performed by Mann-Whitney U test.The correlation between serum expression of hsa_circ_0000437 in gastric cancer patients and its clinical pathological characteristics was performed by χ 2 test.Receiver operating characteristic (ROC) curve and the area under the curve of ROC (AUC) were used to evaluate their diagnosis efficiency. Kaplan-Meier survival curve analysis was used to analyze the relationship between the expression level of serum hsa_circ_0000437 and the prognosis of patients. Results:The relative expression of hsa_circ_0000437 in GC, gastric benign disease, healthy controls were 2.252 (1.235, 4.765), 1.598(1.139, 1.982) and 1.000 (0.818, 1.385) respectively.The relative expression of hsa_circ_0000437 in GC was significantly higher than that in gastric benign disease ( P<0.001) and healthy controls ( P<0.001). The difference between gastric benign disease and healthy controls was also statistically significant ( P<0.001).The differences of serum hsa_circ_0000437 expression in GC patients between T stage, N stage, and tumor differentiation were statistically significant. The AUC of hsa_circ_0000437, CEA, CA199 and CA724 in GC patients were 0.863, 0.619, 657 and 0.608 respectively compared with healthy controls. The AUC of above four-parameter panel was 0.892 and the sensitivity was up to 97.5% (78/80). Kaplan-Meier survival curve showed that the overall survival rate of patients with high serum hsa_circ_0000437 expression was significantly lower than that of patients with low expression ( P=0.008). Conclusion:Serum hsa_circ_0000437 could be a biomarker for the auxiliary diagnosis and prognosis of GC.

2.
Article in Chinese | WPRIM | ID: wpr-934084

ABSTRACT

Objective:To evaluate the endoscopic therapeutic effect on Barrett esophagus (BE) with special intestinal metaplasia.Methods:A retrospective analysis was performed on data of 56 patients of BE with special intestinal metaplasia who were diagnosed in Renmin Hospital of Wuhan University from January 2017 to December 2019 and treated with endoscopic radiofrequency ablation (ERFA) or endoscopic mucosal resection (EMR). The postoperative bleeding rate, feeding obstruction rate, operative time, hospital stay and residual or recurrent intestinal metaplasia lesions were studied.Results:There were no significant differences between the ERFA group ( n=43) and the EMR group ( n=13) in terms of age, gender, length of BE, preoperative gastrointestinal symptoms and comorbidity ( P>0.05). The postoperative bleeding rate [23.1% (3/13) VS 0, P=0.010] and feeding obstruction rate [30.8% (4/13) VS 4.7% (2/43), P=0.022] were higher in the EMR group compared with those in the ERFA group, and the operative time [6.0 (5.6, 6.2) min VS 5.4 (5.2, 5.5) min, Z=4.95, P<0.001] and hospital stay [6.0 (5, 7) d VS 3.5 (3, 4) d, Z=5.76, P<0.001] were longer in the EMR group. There were no significant differences in the incidences of postoperative pain or fever between the two groups ( P>0.05). No residual or recurrent intestinal metaplasia lesions were observed during the follow-up in any EMR patient, and follow-up biopsies after the first treatment in the ERFA group revealed residual intestinal metaplasia lesions in 41.9% (18/43) patients, with a significant difference ( P=0.005). Conclusion:EMR is more thorough in the treatment of BE with special intestinal metaplasia, while ERFA is more widely used in clinical practice for simpler operation, shorter operative time, and less postoperative complications.

3.
Article in Chinese | WPRIM | ID: wpr-932786

ABSTRACT

Pancreatic duct stones are one of the benign pancreatic diseases. It is often combined with chronic pancreatitis. The disease will progress to pancreatic cancer without timely treatment, thus reducing the quality of life of patients and seriously affecting their physical and psychological health. In recent years, with the development of imaging technology, the detection rate of pancreatic duct stones has been increasing year by year. This article reviewed the etiology, diagnosis and treatment strategies for pancreatic duct stones in recent years.

4.
Chinese Journal of Oncology ; (12): 550-554, 2022.
Article in Chinese | WPRIM | ID: wpr-940921

ABSTRACT

Objective: To investigate the survival and influencing factors of unexpected small cell lung cancer following surgery. Methods: We respectively reviewed the clinical characters of 104 patients who underwent surgical treatment and be proved as small cell lung cancer by pathology between January 2000 to October 2020 in Chinese PLA General Hospital. Overall survival (OS) of patients was evaluated using Kaplan-Meier and Cox proportional hazards analysis. Results: Of 104 patients, 27 cases showed central lesions, and other 77 showed peripheral nodules. The margin of nodules was smooth in 42 cases on CT imaging. The median OS was 34.3 months and 5-year OS rate was 45.8%. Postoperative 5-year OS rates for patients were 52.1%, 45.4%, and 27.8% for clinical stages Ⅰ, Ⅱ, and Ⅲ, respectively. Univariate analyses identified the age, surgical access, surgical approach, N stage, TNM stage and vascular cancer emboli were associated with OS (P<0.05). The N stage was an independent factor for the OS of patients (P<0.05). Conclusions: Patients with unexpected SCLC, including Ⅰ, Ⅱ and part ⅢA stage have favorable outcome and can benefit from surgery and systemic postoperative treatment. Standard lobectomy plus systemic lymph node dissection is commended.


Subject(s)
Humans , Lung Neoplasms/pathology , Lymph Node Excision , Neoplasm Staging , Prognosis , Retrospective Studies , Small Cell Lung Carcinoma/surgery , Survival Analysis
5.
Article in Chinese | WPRIM | ID: wpr-912312

ABSTRACT

Objective:To investigate the risk and efficacy of the decortication in treatment of drug-resistant tuberculous empyema.Methods:A retrospective analysis was conducted on the 146 patients with tuberculous empyema, who underwent decortication in Wuhan Pulmonary Hospital from March 2016 to November 2018, according to the drug-susceptibility testing of the pleural effusion or tissue specimens, the patients had been divided into drug-resistant group(29 cases) and control group(117 cases), compared the clinical datas such as operation time, intraoperative blood loss, postoperative drainage duration, pulmonary reexpansion duration, postoperative complications and curative ratio between both groups, and the factors that influence the risk and efficacy of surgery had been analyzed.Results:The operative time, intraoperative blood loss, postoperative drainage duration and postoperative complications in the drug-resistant group were larger than those in the control group, and the differences were statistically significant ( P<0.05). There was no significant difference in pulmonary reexpansion duration and curative ratio in the two groups( P>0.05). Conclusion:Decortication is safety, effective and feasible in the treatment of drug-resistant tuberculous empyema, although the operation is difficult and risky.

6.
Chinese Journal of Neurology ; (12): 943-945, 2021.
Article in Chinese | WPRIM | ID: wpr-911817

ABSTRACT

Neuromyelitis optica spectrum disorders (NMOSD) are a severe autoimmune inflammatory demyelinating disease of the central nervous system. NMOSD complicated with immune thrombocytopenia (ITP) is rare. This paper reports a case of NMOSD who was misdiagnosed as multiple sclerosis for many years, and then developed thrombocytopenia. ITP was diagnosed by perfect examination. After immunosuppression and thrombopoiesis therapy, the platelets returned to normal. The review of the case and literatures can help to improve the understanding of this kind of disease, timely diagnose and treat patients, and avoid serious complications.

7.
Article in Chinese | WPRIM | ID: wpr-885808

ABSTRACT

Objective:To investigate the diagnosis, surgical methods, perioperative treatment and surgical results of Kommerell's diverticulum with double aortic arch in infants.Methods:From December 2014 to December 2019, 22 cases of double aortic arch combined with Kommerell diverticulum were operated in our hospital, 14 males and 8 females, with an average age of (13.7±11.6) months (1-36 months) and mean body mass of (9.8±3.4)kg (5-20 kg). The children had respiratory symptoms such as asthmatic suffocation, shortness of breath, repeated respiratory tract infection and chronic cough before operation. All patients underwent cardiac CT examination. The average diverticulum was 8 mm×9 mm, in the trachea The average compression degree of the lower segment was 56%±16% (30%-80%). The distal part of the left arch was atresia and Kommerell's diverticulum was found in all patients. The operation methods were left aortic arch separation, ligament separation and diverticulectomy. In one case, tracheal stent was placed simultaneously during the operation because of severe tracheal malacia.Results:The average time in the ward was(1.4±0.8)days (1-4)days, and the average time in hospital was (6.7±2.8)days (4-13 days). The average follow-up period was (25.5±16.9) months (2-60 months). During the follow-up period, 18 children had no persistent respiratory symptoms, and 4 children had only slight respiratory symptoms.Conclusion:Kommerell's diverticulum can also be combined with double aortic arch. The operation method is to separate the aortic arch and ligament at the atresia end and resect the diverticulum at the same time. It has a good early prognosis and may eliminate the residual symptoms and late complications.

8.
Article in Chinese | WPRIM | ID: wpr-885707

ABSTRACT

Data of 55 patients with duodenal mass lesions treated by endoscopic submucosal dissection (ESD) were retrospectively analyzed. Risk factors of delayed bleeding after ESD were explored by univariate analysis and multivariate unconditional logistic regression analysis. Duodenal delayed bleeding occurred in 5 patients (9.09%). No closure treatment under endoscopy( P=0.035) was significantly different between the delayed bleeding group and the non-delayed bleeding group. Multivariate non-conditional logistic regression showed no closure treatment under endoscopy was an independent risk factor for delayed bleeding after ESD in duodenal mass lesions ( P=0.029, OR=0.079, 95% CI: 0.008-0.776). Patients older than 60 years and who did not take endoscopic closure treatment have higher incidences of delayed bleeding after ESD. No closure treatment under endoscopy is directly related to postoperative delayed bleeding.

9.
Chinese Journal of Geriatrics ; (12): 297-300, 2021.
Article in Chinese | WPRIM | ID: wpr-884883

ABSTRACT

Objective:To explore the differences in intravascular ultrasound results in elderly coronary heart disease(CHD)patients with different uric acid levels.Methods:A total of 145 elderly patients diagnosed with CHD in our hospital from December 2017 to May 2020 were included as study subjects.Uric acid levels were measured and intravascular ultrasound examination was conducted in all patients.They were divided into different groups based on uric acid levels: Group A(uric acid≤199 μmol/L), Group B(uric acid 200~399 μmol/L)and Group C(uric acid≥400 μmol/L). Data from intravascular ultrasound-derived indexes were analyzed and compared between the three groups.Results:There was no significant difference in the degree of left main stenosis between Group A and Group B, but it was less severe in both groups than in Group C( F=5.625, P=0.039). Plaque fibrous cap thickness showed no significant difference between Group B and Group C, but it was smaller than in Group A( F=7.825, P=0.020). Group C had the largest plaque area and maximum thickness among the three groups, followed by Group B[(11.12±1.73)mm 2 and(1.76±0.24)mm]and Group A[(8.29±3.14)mm 2 and(1.38±0.09)mm]( F=6.384 and 6.827, P=0.028 and 0.015). Conclusions:Elevated uric acid levels in elderly CHD patients can increase the area and thickness of plaques, and reduce plaque fibrous cap thickness, leading to an increased risk of formation of unstable plaques, which can be life-threatening for these patients.Thus, monitoring and managing uric acid levels should be stressed in elderly CHD patients.

10.
Article in Chinese | WPRIM | ID: wpr-883469

ABSTRACT

Objective:To investigate the effect of tegafur combined with oxaliplatin on the life cycle and serum alpha-fetoprotein (AFP) and carbohydrate antigen 242 (CA242) levels in patients with advanced gastric cancer.Methods:A total of 100 patients with advanced gastric cancer admitted to Hefei Third People′s Hospital from October 2016 to October 2019 were selected and divided into two groups according to randomization, with 50 cases in each group. The patients in the control group received calcium leucovorin and fluorouracil and oxaliplatin, and the patients in the observation group was treated with tegafur combined with oxaliplatin. The remission rate, disease control rate, median progression-free survival (PFS), median overall survival (OS), side effects and serum tumor markers AFP, CA242, carcinoembryonic antigen (CEA), carbohydrate antigen 125 (CA125), carbohydrate antigen 19-9 (CA19-9), tumor growth promoting indicators vascular endothelial growth factor (VEGF), matrix metalloproteinase (MMP)-2, MMP-9, insulin-like growth factor-1 (IGF-1), platelet endothelial cell adhesion molecule-1 (PECAM-1), microRNA (miR) 216a, miR95, miR4286 before and after treatment of the two groups were compared.Results:The remission rate in the observation group was higher than that in the control group: 42.0%(21/50) vs. 22.0%(11/50), and the difference was statistically significant ( P<0.05). After treatment, the levels of AFP, CA242, CEA, CA125, CA19-9 in the observation group were lower than those in the control group: (15.04 ± 3.65) μg/L vs. (20.65 ± 4.17) μg/L, (20.88 ± 6.37) kU/L vs.(35.46 ± 7.33) kU/L, (8.65 ± 2.13) μg/L vs.(15.39 ± 3.25) μg/L, (26.15 ± 8.49) kU/L vs. (34.16 ± 7.50) kU/L, (22.29 ± 5.80) kU/L vs. (38.81 ± 6.79) kU/L, and the differences were statistically significant ( P<0.05). The levels of VEGF, MMP-2, MMP-9, IGF-1 and PECAM-1 in the observation group were lower than those in the control group; the level of miR216a in the observation group was higher than that in the control group, and the levels of miR95 and miR4286 were lower than those in the control group, and the differences were statistically significant ( P<0.05). The median PFS in the control group was 3.0 months, the median OS in the control group was 6.6 months, the median PFS in the observation group was 3.3 months, the median OS in the observation group was 7.0 months, and the differences were no statistically significant ( P>0.05). The incidences of myelosuppression and skin damage toxicity in the observation group were lower than those in the control group: 6.0%(3/50) vs. 24.0%(12/50), 4.0%(2/50) vs. 18.0% (9/50), and the differences were statistically significant ( P<0.05). Conclusions:Tegafur combined with oxaliplatin in the treatment of advanced gastric cancer can improve the anti-cancer effect and promote the relief of the disease, and has high safety. The mechanism may be related to the inhibition of tumor growth promotion indexes and the regulation of miR.

11.
Article in Chinese | WPRIM | ID: wpr-883424

ABSTRACT

Objective:To compare the clinical characteristics and prognosis of children with necrotizing pneumonia (NP) infected by bacteria and Mycoplasma pneumoniae (MP). Methods:The clinical data of 69 children with NP from January 2012 to June 2019 in Dalian Central Hospital Affiliated to Dalian Medical University were retrospectively analyzed. Among them, there were 27 cases of bacterial infection NP (bacterial infection group) and 42 cases of MP infection NP (MP group). The clinical symptoms and signs, extrapulmonary complications, laboratory examination, imaging examination, treatment, outcome and follow-up were compared between 2 groups.Results:There were no significant differences in the rale rate, respiratory tone reduction rate and total fever time between 2 groups ( P>0.05); the incidence of shortness of breath in bacterial infection group was significantly higher than that in MP group: 77.8% (21/27) vs. 14.3% (6/42), and there was statistical difference ( P<0.01). There were no significant differences in the incidence of extrapulmonary complications between 2 groups ( P>0.05). The white blood cell, C-reactive protein (CRP), procalcitonin (PCT) and interleukin (IL) -10 in bacterial infection group were significantly higher than those in MP group, the tumor necrosis factor (TNF)-α and interferon (IFN) -γ in bacterial infection group were significantly lower than those in the MP group, and there were statistical differences ( P<0.05). There were no significant differences in neutrophils, lactate dehydrogenase (LDH) and IL-6 between 2 groups ( P>0.05). The time of necrosis in bacterial infection group was significantly earlier than that in MP group: (14.5 ± 4.2) d vs. (21.7 ± 6.4) d, and there was statistical difference ( P<0.05); there was no significant difference in the incidence of pleural effusion between 2 groups ( P>0.05), but the incidence of pleural effusion separation in bacterial infection group was significantly higher than that in MP group: 70.4% (19/27) vs. 2.4% (1/42), and there was statistical difference ( P<0.01). There were no significant differences in antibiotic application time, CRP recovery time and hospital stay between 2 groups ( P>0.05); the oxygen uptake rate and closed thoracic drainage rate in bacterial infection group were significantly higher than those in MP group: 88.9% (24/27) vs. 35.7% (15/42) and 25.9% (7/27) vs. 11.9% (5/42), the recovery times of WBC and PCT in bacterial infection group were significantly longer than that in MP group: (12.8 ± 4.1) d vs. (9.2 ± 2.0) d and (10.5 ± 2.5) d vs. (7.6 ± 1.9) d, the bronchoalveolar lavage rate was significantly higher than that in MP group: 25.9% (7/27) vs. 76.2% (32/42), and there were statistical differences ( P<0.01 or <0.05). There was no significant difference in the absorption time of necrotic lesions between 2 groups ( P>0.05). Conclusions:Compared with MP infection, the clinical process of bacterial infection NP is serious, the necrosis time appears earlier, and the course of disease is longer. However, most of the children with NP can obtain a good prognosis after active symptomatic and antiinfective treatment.

12.
Article in Chinese | WPRIM | ID: wpr-883213

ABSTRACT

Objective:To analyze the causes, influencing factors and trends of dead on arrival cases in children′s Hospital in the past 5 years, aiming to provide direction and basis for reducing the dead on arrival cases of children.Methods:We collected the dead on arrival cases in the department of emergency at Shanghai Children′s Hospital from January 2015 to December 2019, classifed and analysed the gender, age, native place, death season, time of death, and possible causes of death, and then studied the correlation between above factors and the cases.Results:A total of 151 dead on arrival cases were collected.The annual number decreased year by year, and boys were more than girls in gender.Most of them were infants under 1 year old, and nonlocal children were more than Shanghai native.The above differences were statistically significant, but there was no significant difference in the distribution of death season and death time.In terms of the cause of death, perinatal diseases accounting for 33.8%(51/151), those accompanied with severe underlying diseases accounting for 39.1%(59/151), accidental death accounting for 14.6%(22/151), unexplained deaths accounting for 12.6%(19/151). Those distribution differences were statistically significant( χ2=32.497, P<0.001). Meanwhile, there were statistic differences in gender and age of the cases with severe underlying diseases( χ2=4.898, P=0.027; χ2=32.169, P<0.001), and the year and age distributions of the accidental death cases also had significant differences( χ2=16.636, P=0.002; χ2=14.727, P=0.002). Conclusion:To reduce dead on arrival cases of children, we should do a good job in perinatal health care and screening, reduce premature birth and birth defects, actively conduct propaganda to prevent children′s accidental injuries, popularize medical first aid knowledge, and strengthen children′s transport system.

13.
Article in Chinese | WPRIM | ID: wpr-911707

ABSTRACT

Sixty general practitioners of in-service training undertaking rotation in gastroenterology department of Qingdao Municipal Hospital from July 2017 to July 2019 were randomized assigned in trial group ( n=30) and control group ( n=30). The problem-oriented mode was applied in trial group and conventional mode was applied in control group for teaching of two typical digestive diseases (upper gastrointestinal bleeding and acute pancreatitis). The formative evaluation and questionnaire survey were used to compare the teaching effects and the results of evaluation were compared with χ 2 test by SPSS 17.0 between two groups. The excellent and good rates of evaluation for the clinical psychological quality, clinical reasoning ability, doctor-patient communication ability and practice-based learning and improvement ability in trial group were significantly higher than those in the control group(χ2=7.38, P=0.03; χ2=12.96, P<0.01; χ2=23.33, P<0.01; χ2=16.14, P<0.01). Questionnaire survey showed more satisfaction towards teaching method in trial group was higher than that in control group(χ2=12.86, P<0.01); and the clinical reasoning ability, learning initiative and self-confidence in trial group were improved more markedly than those in control group(χ2=8.26, P=0.02; χ2=19.48, P<0.01; χ2=21.46, P<0.01). The problem-oriented clinical thinking teaching model demonstrates good effects on clinical comprehensive ability for general practitioners of in-service training during gastroenterology rotation, which is worth further promotion.

14.
Article in Chinese | WPRIM | ID: wpr-882913

ABSTRACT

Objective:To investigate the morphological characteristics and operative methods of mixed total anomalous pulmonary venous connection (TAPVC), and to analyze the risk factors of postoperative death.Methods:From January 2011 to January 2019, 17 cases of mixed TAPVC were operated in Department of Cardiovascular Surgery, Beijing Children′s Hospital, Capital Medical University, with 10 males and 7 females.The average age was (4.4±3.8) months (1-15 months) and the average body mass was (5.6±1.7) kg (3.5-10.0 kg), including 1 case of ventricular septal defect, 17 cases of atrial septal defect and 15 cases of ductus arteriosus.Preoperative pulmonary vein stenosis was discovered in 4 cases and severe pulmonary hypertension was in 10 cases.A total of 5 cases needed ventilator support before operation, and 2 cases needed emergency operation.The diagnosis was confirmed by color Doppler ultrasound and CT before operation.There were 2 cases of type Ⅰ (type 2+ 2), 13 cases of type Ⅱ (type 3+ 1), and 2 cases of type Ⅲ (anatomic variant).Results:All the patients were treated through operation.The principle of operation was to correct all pulmonary veins to the left atrium.The cardiopulmonary bypass time was (182.3±122.8) min, the aortic occlusion time was (84.3±15.9) min, the postoperative ventilator support time was (92.9±70.0) h, and the monitoring room time was (6.9±4.9) d. In this group, 3 cases died in hospital (17.6%) and 1 case died out of hospital (5.9%).Conclusions:The mortality of mixed TAPVC type Ⅲ was high, while preoperative pulmonary vein stenosis, severe pulmonary hypertension and the combination of sub-cardiac type were the important risk factors of death.The operation mode depends on the anatomic drainage mode, so individualized operation is recommended.

15.
Article in Chinese | WPRIM | ID: wpr-871682

ABSTRACT

Objective:To evaluate the inpatient PE incidence and thromboprophylaxis after thoracic surgery according to adjusted Caprini VTE risk assessment model.Methods:The study selected consecutively 500 patients who received thoracic surgery from first of June in consecutive three years of 2015, 2016 and 2017. We retrospectively assessed these 1 500 patients using Caprini VTE risk model and recorded baseline characteristics, postoperative prophylaxis, and PE incidence.Results:Only 19.4% of 2015-year patients received pharmacologic prophylaxis, while the rate reached up to 65.2% in 2016 and 77.2% in 2017. PE occurred on 4 cases in 2015, 1 case in 2016, and 0 case in 2017. The overall incidence of PE was 0.3%(5/1 500). The PE incidence negatively correlated with the implementation of prophylaxis( r=-0.04, P=0.07). The PE risk(odds ratio) increased 4.68 times(95% CI: 0.525-41.800) when patients did not receive prophylaxis in PE cohort. Postoperative pharmacologic prophylaxis with current dosing did not affect the drainage of chest tube after surgery. Conclusion:Implementation of an adjusted Caprini risk assessment protocol can be useful for the thoracic postoperative patients to receive appropriate thromboprophylaxis. Current pharmacologic prophylaxis protocol should be safe and enough to prevent PE after thoracic surgery.

16.
Article in Chinese | WPRIM | ID: wpr-871635

ABSTRACT

Objective:The Corona Virus Disease 2019 (COVID-19), caused by a novel virus (2019-nCoV), is a current epidemic throughout the world. Widespread discussion has been going on about the suitability of lung transplantation for critically-ill patients as an emergent treatment. So far lung transplantation has been performed sporadically in China; however, the relevant treatment and prognosis after transplantation are inconclusive. This article mainly reviews the literature in terms of transplantation and viral infection, indications of lung transplantation, postoperative complications, ethics, and health economics, to elaborate this argument and to further explore the future of lung transplantation for COVID-19.

17.
Article in Chinese | WPRIM | ID: wpr-824960

ABSTRACT

Objective: To observe the effect of moxa-stick moxibustion plus recombinant human granulocyte-colony stimulating factor (rhG-CSF) in preventing chemotherapy infection in gastric cancer and its effect on immune function. Methods: A total of 70 patients with gastric cancer treated by chemotherapy were randomly divided into an observation group and a control group, with 35 cases in each group. The control group was given rhG-CSF, and the observation group was given additional moxa-stick moxibustion on the basis of rhG-CSF. Both groups were treated for 2 chemotherapy cycles, totally 6 weeks. The number of patients with infection, the duration of infection and the duration of continuous use of antibiotics were observed. The leukocytes and granulocytes counts, the levels of tumor necrosis factor-α (TNF-α) and interferon-γ (IFN-γ) were measured before and after treatment, and the levels of CD4, CD8 and natural killer (NK) cells were analyzed. Results: The infection rate of the observation group was significantly lower than that of the control group (P<0.05), and the duration of infection and the duration of continuous use of antibiotics were also shorter (P<0.05). After treatment, the leukocytes and granulocytes counts in the two groups were higher than those before treatment (all P<0.05). After treatment, the levels of TNF-α and IFN-γ of the patients in the two groups were improved (all P<0.05), and there were significant differences between the observation group and the control group (P<0.05). After treatment, the numbers of CD4, CD8, and NK cells in the observation group increased significantly (all P<0.05), but the changes in the control group were not significant (P>0.05). Conclusion: Moxa-stick moxibustion plus rhG-CSF can significantly reduce the incidence and severity of chemotherapy infection in gastric cancer, increase the leukocytes and granulocytes counts, and regulate the levels of inflammatory factors, which may be related to the improvement of the immune function of the patients.

18.
Article in Chinese | WPRIM | ID: wpr-865939

ABSTRACT

Objective:To evaluate the application of digital memory in abdominal physical examination teaching in cultivating gastroenterology professional postgraduates during the course of clinical rotations.Methods:Sixty clinical specialty postgraduates from Qingdao Municipal Hospital practicing in gastroenterology department from September, 2016 to September, 2018 were selected as subjects, and were randomized into experimental group ( n=30) and control group ( n=30). They were respectively received digital memory mode and traditional mode for clinical practice. The teaching effect was evaluated by comparing the scores of theory examination, skill results and clinical assessment at the end of training stage. Statistical analysis was performed using t test and chi-square test by SPSS 17.0. Results:There was no significant difference in the scores of theory examination and skill operation results between the experimental group and the control group, however, the number of excellent postgraduates and the average scores in clinical assessment were significantly higher than those in control group ( χ2=9.14, P=0.01). Questionnaire survey showed good evaluation of digital memory model in the experimental group. The recognition rate of learning interest and initiative, theoretical knowledge, systematic memory, clinical thinking ability as well as operational skills are 56.67%, 63.33%, 66.67%, 63.33% respectively. Conclusion:The digital memory mode in abdominal physical examination teaching demonstrates good effects on cultivating professional postgraduates' clinical comprehensive ability during the course of rotation in gastroenterology department, which worth further popularization.

19.
China Pharmacy ; (12): 2532-2538, 2020.
Article in Chinese | WPRIM | ID: wpr-829363

ABSTRACT

OBJECTIVE:To evaluate the safety of PARP inhibitors in hematological system ,and to provide evidence-based evidence for rational drug use in the clinic. METHODS :Retrieved from PubMed ,Embase,Cochrane Library ,ScienceDirect, CNKI,CBM,VIP and Wanfang data from May 2014 to June 2019,randomized controlled trials (RCTs)about PARP inhibitors or PARP inhibitors combined with chemical treatment drugs (trial group )versus chemical treatment drugs alone ,placebo alone or chemical treatment drugs combined with placebo (control group )were collected. After literature screening ,data extraction and quality evaluation with bias risk assessment tool recommended by Cochrane systematic evaluator manual 5.1.0,and Meta-analysis was performed by using Rev Man 5.3 software,and sensitivity analysis and publication bias analysis. RESULTS :A total of 10 RCTs were included ,involving 3 129 patients. Meta-analysis showed that the incidence of anemia ≥grade 3 [RR=7.27,95%CI (2.74,19.27),P<0.000 1],neutropenia≥grade 3 [RR=2.46,95%CI(1.43,4.24),P=0.001],and leukopenia ≥grade 3 in trial group [RR =1.71,95%CI(1.15,2.54),P=0.008] in trial group were significantly higher than control group. There was no statistically significant difference in the incidence of thrombocytopenia ≥grade 3 between two groups [RR =3.54,95%CI(0.66, 19.05),P=0.14]. Results of sub-group analysis showed that the incidence of an emia≥grade 3 and neutropenia ≥grade 3 in the patients receiving PARP inhibitors alone ,PARP inhibitors combined with chemical treatment dr ugs as well as the incidence of leukopenia≥grade 3 in the patients receiving PARP inhibitors (No.2018FH001-096) combined with chemical treatment drugs were significantly higher than those receiving placebo alone ,chemical treatment com drugs alone or chemical treatment drugs combined with placebo (P<0.05). Sensitivity analysis supported the above results howerer,publication bias was possibility. CONCLUSIONS :PARP inhibitor in the treatment of cancer can cause hematological system adverse drug reaction ,mainly manifesting as anemia ,neutropenia and leukopenia. These results should be interpreted with caution.

20.
Chinese Journal of Pathology ; (12): 537-542, 2019.
Article in Chinese | WPRIM | ID: wpr-810749

ABSTRACT

Objective@#To investigate the clinicopathological characteristics of SMARCA4- deficient thoracic sarcomas.@*Methods@#The clinical features and CT scans of SMARCA4-deficient thoracic sarcomas (n=5) diagnosed at Fudan University Cancer Hospital from December 2016 to October 2018 were reviewed. Hematoxylin-eosin staining, immunohistochemistry and targeted next generation sequencing were performed in available cases along with a literature review.@*Results@#All 5 patients were males with age ranging from 32 to 65 years (average 54 years; median 61 years). Four patients were smokers except one with unknown smoking history. The average maximum diameter of tumor was 5.6 cm. Tumor primary sites included thoracic wall,thoracic cavity,lung and mediastinum. Histologically,tumor cells formed solid sheets or anastomosing islands with brisk mitotic figures accompanying with large areas of necrosis. Three cases focally exhibited rhabdoid morphology and vesicular chromatin. Immunohistochemically, SMARCA4, SMARCA2 and Claudin-4 were negative in all cases and all tumors demonstrated SOX2 and SMARCB1 nuclear positive staining. Among 3 cases analyzed by targeted next generation sequencing, concurrent SMARCA4 and p53 mutation was detected in all three cases. Mutations of STK11, ERBB4, NF2, GNAS, MTOR,MET and FGFR1 amplification were also detected among the three cases. The follow-up information was available in all 5 cases. Two patients died of the tumor. One relapsed multiple times after surgeries but was alive with disease. Two patients received radical excisions without relapse.@*Conclusions@#SMARCA4-deficient thoracic sarcoma is a rare but highly-aggressive tumor with dismal prognosis. The tumor is featured by rhabdoid morphology histologically and distinctive immunohistochemical and molecular phenotype.

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