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OBJECTIVES@#To investigate the prevalence of diabetes mellitus (DM) among Uygur children in Hotan Prefecture of Xinjiang, China, as well as the factors influencing the development of DM.@*METHODS@#The cluster random sampling method was used to select 5 308 children, aged 4-18 years, from the middle and primary schools and kindergartens in Hotan Prefecture of Xinjiang. The survey methods included questionnaire survey and the measurement of height and weight. All subjects were tested for fasting fingertip blood glucose to investigate the prevalence of DM and impaired fasting glucose (IFG).@*RESULTS@#A total of 5 184 valid questionnaires were collected. Fourteen children (0.27%) were found to have DM, among whom 8 had type 1 DM, 2 had type 2 DM, and 4 had unclassified DM. Twenty-nine children (0.56%) were found to have IFG. There was no significant difference in the prevalence rate of DM and IFG between boys and girls (P>0.05). The prevalence rate of DM was 0.18% in the 4-<10 years group, 0.47% in the 10-<15 years group, and 0.07% in the 15-18 years group (P=0.072).The prevalence rate of IFG in the above three age groups was 0.18%, 0.94%, and 0.42%, respectively, with a significant difference among groups (P=0.007). The proportion of family history of DM and the proportion of overweight/obesity in children with DM were significantly higher than those in children without DM (P<0.05), while the proportion of children with DM who preferred coarse grains was significantly lower than that in children without DM (P<0.05).@*CONCLUSIONS@#The prevalence of DM and IFG in Uyghur children in Hotan Prefecture of Xinjiang is relatively low. There is no significant difference in the prevalence of DM among children of different genders or age groups, but the prevalence of IFG in children of different age groups is different. A family history of DM, overweight or obesity, and low intake of coarse grains might be associated with the development of DM.
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Adolescent , Blood Glucose , Child , Child, Preschool , China/epidemiology , Female , Humans , Male , Pediatric Obesity , Prediabetic State/epidemiology , Prevalence , Risk FactorsABSTRACT
Common bile duct stones (CBDSs) are a common biliary tract disease, and endoscopic therapy is the first-line treatment modality for this disease; however, some CBDSs are difficult to remove by conventional endoscopic techniques and are thus called difficult CBDSs. Therapies for difficult CBDSs include endoscopic papillary large balloon dilation, mechanical lithotripsy, choledochoscopy-assisted lithotripsy, and extracorporeal shockwave lithotripsy. This article reviews the advances in the above mentioned techniques for the treatment of difficult CBDSs, including indications, clinical effect, and adverse events.
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Background/Aims@#Single-balloon enteroscopy (SBE) has been widely used in diagnosing small bowel disease. We conducted this study to systematically appraise its technical and clinical performance. @*Methods@#Studies on SBE published by September 2018 were systematically searched. Technical and clinical performance data were collected and analyzed with descriptive or meta-analysis methods. @*Results@#In total, 54 articles incorporating 4,592 patients (6,036 procedures) were included. Regarding technical parameters, the pooled insertion depths (IDs) for anterograde and retrograde SBE were 209.2 cm and 98.1 cm, respectively. The pooled retrograde ID in Asian countries was significantly greater than that in Western countries (129.0 cm vs 81.1 cm, p<0.001). The pooled anterograde and retrograde procedure times were 57.6 minutes and 65.1 minutes, respectively.The total enteroscopy rate was 21.9%, with no significant difference between Asian and Western countries. Clinically, the pooled diagnostic yield of SBE was 62.3%. Obscure gastrointestinal bleeding (OGIB) was the most common indication (50.0%), with a diagnostic yield of 59.5%. Vascular lesions were the most common findings in Western OGIB patients (76.9%) but not in Asian ones (31.0%). The rates of severe and mild adverse events were 0.5% and 2.5%, respectively. @*Conclusions@#SBE is technically efficient and is clinically effective and safe, but total enteroscopy is relatively difficult to achieve with this technique. Etiologies of OGIB in Asian countries differ from those in Western countries.
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Purpose@#An underlying factor for the failure of several clinical trials of anti-epidermal growth factor receptor (EGFR) therapies is the lack of an effective method to identify patients who overexpress EGFR protein. The quantitative dot blot method (QDB) was used to measure EGFR protein levels objectively, absolutely, and quantitatively. Its feasibility was evaluated for the prognosis of overall survival (OS) of patients with gastric cancer. @*Materials and Methods@#Slices of 2×5 μm from formalin-fixed paraffin-embedded gastric cancer specimens were used to extract total tissue lysates for QDB measurement. Absolutely quantitated EGFR protein levels were used for the Kaplan-Meier OS analysis. @*Results@#EGFR protein levels ranged from 0 to 772.6 pmol/g (n=246) for all gastric cancer patients. A poor correlation was observed between quantitated EGFR levels and immunohistochemistry scores with ρ=0.024 and P=0.717 in Spearman's correlation analysis. EGFR was identified as an independent negative prognostic biomarker for gastric cancer patients only through absolute quantitation, with a hazard ratio of 1.92 (95% confidence interval, 1.05–3.53; P=0.034) in multivariate Cox regression OS analysis. A cutoff of 208 pmol/g was proposed to stratify patients with a 3-year survival probability of 44% for patients with EGFR levels above the cutoff versus 68% for those below the cutoff based on KaplanMeier OS analysis (log rank test, P=0.002). @*Conclusions@#A QDB-based assay was developed for gastric cancer specimens to measure EGFR protein levels absolutely, quantitatively, and objectively. This assay should facilitate clinical trials aimed at evaluation of anti-EGFR therapies retrospectively and prospectively for gastric cancer.
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Objective:To study the value of metastatic lymph node radio (rN) and pathological lymph node stage (pN) in evaluating the prognosis of patients after radical gastric cancer.Methods:The clinicopathological data of 491 patients who underwent radical gastrectomy in Tantai Yantaishan Hospital from Jan. 2013 to Dec. 2017 were retrospectively analyzed. X-tile software was used to group the metastatic lymph node radio by rN. According to the number of lymph node metastasis, pN stage was performed. The correlation between metastatic lymph node radio and other clinicopathological factors was assessed. The metastatic lymph node radio and the pathological lymph node stage in evaluating the prognosis of patients after radical gastric cancer were compared.Results:(1) X-tile analysis showed that the best cut-off values for the metastatic lymph node radio in this study were 0.14 (14%) and 0.63 (63%) . (2) According to the cut-off value, the 491 patients included in the study were divided into rN1 (256 cases) , rN2 (160 cases) , and rN3 (75 cases) three subgroups. The results of the analysis of differences showed that there were significant differencesbetween the groups in terms of tumor diameter, tumor location, surgical resection range, stage, lauren classification, degree of differentiation, pT, pN, vascular cancer emboulus, nerve invasion, and pathological TNM staging groups. (3) Comparison of rN and pN staging in evaluation of the prognosis of patients after radical gastric cancer: ①Kaplan-Meier survival analysis results showed that rN was better than pN. ② Both single factor and multivariate cox analysis showed that rN was an independent risk factor for the prognosis of gastric cancer. In univariate analysis, rN group HR=3.18 (95% CI 2.63-3.84, P<0.001) , pN stage HR=1.88 (95% CI 1.66-2.15, P<0.001) ; rN group HR=2.21 in multivariate analysis (95% CI 1.73-2.82, P<0.001) , pN staging HR=1.31 (95% CI 0.95-1.79, P=0.095) . ③The time-dependent ROC analysis showed that the prognostic ability of rN was better than pN staging before 52 months of postoperative follow-up, and pN staging was more advantageous after 52 months. ④The Lauren classification was used as a stratification factor for stratified analysis. The Kaplan-Meier survival curve indicated that rN was better than pN staging in intestinal, mixed and diffuse gastric cancer, and the AUC curve showed the prediction of rN in patients with mixed and diffuse gastric cancer was better than pN staging, while pN staging performance was slightly better in patients with intestinal gastric cancer. Conclusions:rN is an independent factor affecting the prognosis of patients after radical gastric cancer surgery. When judging the prognosis of patients within 52 months after radical gastric cancer, rN has a better prognostic value than pN. In patients with mixed and diffuse gastric cancer in the Lauren classification, rN shows better prognostic value.
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Objective:To investigate the safety and reliability of endoscopic mucosal resection (EMR) in the treatment of gastrointestinal neuroendocrine tumors (GI-NETs) with a diameter of ≤10mm.Methods:From February 2015 to June 2019, 40 cases of gastrointestinal neuroendocrine tumors with a diameter of ≤10mm underwent EMR in Yantaishan Hospital of Yantai City were retrospectively analyzed to evaluate the safety and reliability of EMR surgery.Results:All 40 cases were performed endoscopically by EMR. The en bloc resection rate and RO resection rate reached 100%. The lesions were all confined to the submucosa and did not infiltrate the muscularis propria. Postoperative pathological classification: NET G1: 35 cases, NET G2 grade: 5 cases, no NET G3 grade cases. There were no complications such as bleeding and perforation during and after the operation. Follow-up: 1 case was lost to follow-up, 1 patient died of other diseases, and the remaining 38 cases were followed up for an average of 27.8 months (5-46 months) without local recurrence or distant metastasis.Conclusion:For well-differentiated G1 and G2 gastrointestinal neuroendocrine tumors with a diameter ≤10mm, EMR is a safe and reliable treatment.
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Esophageal cancer is a common malignant tumor of the upper gastrointestinal tract. Early symptoms of the disease are inconspicuous and the disease is often diagnosed at a later stage, leading to higher morbidity and mortality. Esophageal cancer morbidity and mortality in both genders ranks among the top 10 most common cancers. Early detection and early treatment are effective means to reduce the incidence and mortality of esophageal cancer. Tumor markers play an important role in early diagnosis, treatment monitoring and prognosis evaluation of esophageal cancer. This paper reviews the clinical application of tumor markers related to esophageal cancer and the exploration and application progress of new tumor markers for esophageal cancer.
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OBJECTIVE: To investigate the prognostic factors of esophageal cancer with brain metastasis. METHODS: SEER Stat 8.3.5 was used to collect 39 cases of esophageal cancer with brain metastasis from 2010 to 2015 in the Surveillance, Epidemiology and End RESULTS:(SEER) database. X-tile software was used to determine the best cut-off value of the age. Prognostic factors were analyzed with log-rank and Cox proportional hazard model by SPSS(v25.0). RESULTS: The median survival time of patients with esophageal cancer with brain metastasis was 7.0 months, the 6-month survival rate was 53.3%, and the 1-year survival rate was 16.3%. Only age(χ~2=4.045, P=0.044)was the prognostic factor, while there was insufficient evidence to show whether gender, marriage, race, primary site, histological grade,surgery, pathological type, T stage or N stage was associated with the prognosis of the patients. CONCLUSION: Brain metastasis is a rare metastatic type of esophageal cancer. Age is associated with worse prognosis, while the influences of other risk factors are not clear.Active treatment can lead to better prognosis.
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OBJECTIVE: To construct a model for predicting the prognosis of esophageal cancer bone metastasis. METHODS: The clinical data of 183 patients with esophageal cancer bone metastasis were analyzed retrospectively, and the prognostic factors of patients were analyzed by log-rank method and Cox proportional hazard model. Nomogram was constructed with the accelerated failure-time model.RESULTS: The average survival time(10.0 months, 95% CI:7.758-12.338) of patients aged 28-70 years was longer than that of patients aged 71-91(6.4 months, 95% CI:4.365-8.428)(χ~2=4.077, P=0.043). The prognosis of unmarried patients(average 7.0 months) was worse than that of the married(10.5 months on average)(χ~2=12.841, P<0.001). As for prognoses of different pathological types, the differences between adenocarcinoma(average 10.2 months, 95% CI:7.797-12.548), squamous cell carcinoma(average 6.4 months,95%CI:3.895-8.899) and other types(average 4.0 months, 95% CI:4.000-4.000) were statistically significant(χ~2=7.171, P=0.028).There were also significant differences between the prognoses of patients with different T stage(χ~2=8.833, P=0.032). Nomogram was constructed with the risk factors above and the C-index reached 0.675(95%CI: 0.626-0.725). CONCLUSION: The prognosis of esophageal cancer bone metastasis was poor. Marriage, T stage, histological grade and pathological types were risk factors affecting prognosis, while N stage didn't appear to show obvious effect on prognosis. The nomogram was tested to have a good predictive capacity.
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OBJECTIVE: To analyze the prognostic factors related to liver metastasis of esophageal cancer and establish an effective prediction model. METHODS: The data of 464 cases of esophageal cancer with liver metastasis from 2010 to 2015 was collected from the National Cancer Institute SEER database by SEER stat 8.3.5 software. SPSS(v25.0) was used to analyze the prognostic factors of esophageal cancer liver metastasis and Kaplan-Meier curve was used for survival analysis. We introduced the meaningful variables of single factor analysis in Cox proportional hazard model and multivariate analysis and obtained the independent influencing factors of prognosis.Independent factors were then included in the accelerated failure time model to construct the nomogram. RESULTS: The mean survival time of patients in this study was 11.6 months(95%CI: 10.075-13.209), and their 1-, 3-, and 5-year survival rates were 29.4%, 5.5%, and 0,respectively. Age(HR=1.452, 95% CI: 1.175-1.795), marriage(HR=0.753, 95%CI: 0.611-0.927) and surgery(HR=0.428, 95% CI: 0.227-0.807) were independent prognostic factors for patients. We constructed the nomogram with risk factors of prognosis, and the C-index value was 0.614. CONCLUSION: The prognosis of esophageal cancer liver metastasis is poor. being young, Being married, and surgery are associated with better survival, and the nomogram we have constructed is proved to have good predictive ability.
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OBJECTIVE: To establish a prediction model for the prognosis of patients with esophageal cancer lung metastasis.METHODS: Data from 194 patients with esophageal cancer lung metastasis from 2010 to 2015 was collected from the National Cancer Institute Surveillance, Epidemiology and End RESULTS:(SEER) database. The best cutoff value for age was determined by X-tile software.Prognostic factors were analyzed by SPSS(v25.0) with the log-rank method and the Cox proportional hazard model. Risk factors from univariate analysis were used to construct prediction nomogram with R studio software(version 3.5.1). RESULTS: The median survival time of 194 patients with esophageal cancer lung metastasis was 7.0 months, the 3-month survival rate was 69.9%, and the 1-year survival rate was 27.7%. Age(HR=1.51, 95% CI: 1.066-2.140) and pathological type(HR=0.736, 95% CI: 0.543-0.998) were independent prognostic factors for patients with esophageal cancer lung metastasis. The value of C-index was 0.634(95% CI=0.585-0.683). CONCLUSION: For patients with esophageal cancer lung metastasis, being young and adenocarcinoma are associated with a better prognosis. The prediction of the nomogram is good.
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OBJECTIVE: To investigate the prognostic factors of esophageal cancer with multiple organ metastases and establish a prognostic prediction model. METHODS: Patients data were extracted from the SEER database. The clinical data of 388 patients with esophageal cancer with multiple organ metastases were retrospectively analyzed. Risk factors were analyzed by log-rank method and survival curves were drawn by K-M method. Multivariate analysis was performed by Cox proportional hazard model to obtain independent prognostic factors for multi-organ metastasis of esophageal cancer. A prediction nomogram was further established.RESULTS: The mean survival time of patients in this study was 7.3 months, and the survival rates for 1-, 3-, and 5-year were 15.5%,1.2%, and 0, respectively. Age was an independent prognostic factor. The value of C-index was 0.618. CONCLUSION: The prognosis of esophageal cancer with multiple organ metastases is poor. Age at the diagnosis and patterns of multiple organ metastases are related to the survival time of patients. The prediction nomogram provided a good prognosis prediction.
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OBJECTIVE@#The purpose of this study was to assess the association between triglycerides (TG), total cholesterol (TC) at baseline, and type 2 diabetes mellitus (T2DM) incidence in a general Chinese population. Further, it aimed to evaluate the ability of TG and TC to predict T2DM incidence.@*METHODS@#Qingdao Diabetes Prevention Program participants recruited between 2006 and 2009 were followed up in 2012-2015. TG, TC, and T2DM status were measured. Cox proportional hazards models were used to estimate the association between TG, TC, and T2DM incidence. The receiver operating characteristic (ROC) curve was used to evaluate the ability of TG and TC to identify T2DM participants.@*RESULTS@#The incidence of T2DM significantly increased with TG in women and TC in both men and women (Ptrend 1.15 and > 1.23 mmol/L in men and women, respectively. For TC, they were > 5.17 and > 5.77 mmol/L in men and women, respectively. The area under the ROCs of TG and TC were 0.54 (0.51-0.57) and 0.55 (0.52-0.58), respectively, in men, and 0.60 (0.58-0.62) and 0.59 (0.56-0.61), respectively, in women.@*CONCLUSION@#Elevated TG and TC were risk factors for T2DM incidence. However, no predictive capacity was found for both factors to identify T2DM incidence in Chinese men and women. Hence, TG and TC levels in both Chinese men and women might be used for decreasing the incidence of T2DM but no clinical predictive capacity for T2DM.
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Objective To explore the effects of ring finger protein 43 (RNF43) on fibroblast-like synoviocytes (FLS) from patients with rheumatoid arthritis (RA).Methods Synovial tissues from patients with RA treated by knee arthroplasty were used to isolate FLSs by type 2 collagenase.RNF43 lentivirus overexpressing plasmid was constructed and transfected in to RA-FLS.After successful transfection,RNA and super natant of RA-FLS were extracted.QRT-polymerase chain reaction (PCR) and enzyme linked immunosorbent assay (ELISA) were used to detect the mRNA and protein expression levels of matrix metalloproteinase (MMP)-1,MMP-3 and MMP-13.Data were analyzed with Student's t test.Results Transfection efficiency could meet the test requirements when the multiplicity of infection was 40 and was in conjunction with appropriate concentration of polybrene.The mRNA of RNF43 increased for 26158-fold than the control group.In vitro,compared with the control group,RNF43 could significantly inhibit the mRNA of MMP-1,MMP-3 and MMP-13 and MMP-13 [(0.19±0.06),t=28.314,P＜0.05;(0.28±0.07),t=23.413,P＜0.05;(0.21±0.09),t=18.365,P＜0.05]and the protein of MMP-1,MMP-3 and MMP-13 and MMP-13 [(31.0±9.4) pg/ml,(17.1±2.1) pg/ml,t=3.198,P=0.029],MMP-3 [(38.7±8.1) pg/ml,(24.9±3.5) pg/ml,t=3.514,P=0.015],MMP-13 [(35.9±5.4) pg/ml,(20.6±2.9) pg/ml,t=5.632,P=0.001].Conclusion The results of study suggest that RNF43 could inhibit the secretion of MMPs in RA-FLS by suppressing the activity of Wnt signal pathway.
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Objective To study the proliferation and inflammatory phenotypes of human fibroblast-like synoviocytes (FLS) induced by tumor necrosis factor-α(TNF-α). Methods The rheumatoid arthritis (RA)-FLS were cultured in vitro, then treated with different concentrations of diallyl trisulfide (DATS). The proliferation activity was detected by CCK-8 method. Then TNF-α was used to stimulate the RA-FLS, mRNA and protein expression of interleukin (IL)-6, matrix metalloproteinases (MMP)-1 and vascular endothelial growth factor (VEGF) were detected by quantitative real time polymerase chain reaction (qPCR) and enzyme linked immunosorbent assay (ELISA). Differences among groups were determined by one-way analysis of variance (ANOVA), LSD-t test was used for comparison between 2 groups. Results RA-FLS was successfully is-olated and cultured in vitro. The positive rate of CD90 and CD29 in the RA-FLS was more than 90％. The proli-feration activity of RA-FLS treated with 100 μmoL/L, 200 μmol/L and 300 μmol/L DATS was (98.92 ± 0.40)％, (95.91±0.32)％, (94.05±0.24)％, respectively. As Compared with the normal control group, the pro-liferation activity of RA-FLS was lower, and the statistically significant difference is between normal control group 200 μmol/L and 300 μmol/L DATS (t=-4.46, P<0.05; t=-7.98, P<0.05). After TNF-α stimulation, the expression of IL-6's mRNA in experiment group (100μmol/L DATS) is higher compared with the model control group (t=5.74, P<0.05), but the change of IL-6's protein is no significant difference (t=-0.49, P=0.627). The differences of mRNA and protein expression levels of MMP-1 and VEGF between the experiment group (100μmol/L DATS) and the model control group were not statistically significant. The relative mRNA level [(0.42 ± 0.06), t=-23.47, P<0.05;(0.14±0.039), t=-36.59, P<0.05;(0.36±0.09), t=-13.1, P<0.05)] and the protein levels [(108.0±4.7) ng/L, t=-63.79, P<0.05, (26.0±1.0) ng/L, t=-9.68, P<0.05;(57.9±0.7), t=-34.59, P<0.05] of IL-6, MMP-1, VEGF in experiment group (200μmol/L DATS) were significantly decreased. And the relative mRNA level [(0.041 ±0.027), t=-38.48, P<0.05; (0.027 ±0.027), t=-41.22, P<0.05; (0.131 ±0.047), t=-17.74, P<0.05] and the protein levels [(24.2 ±2.3) ng/L , t=-88.69, P<0.05; (22.7 ±1.0) ng/L , t=-14.13, P<0.05; (34.5 ±1.7), t=-48.45, P<0.05] of IL-6, MMP-1, VEGF in the experiment group (300 μmol/L DATS) were also significantly decreased. The difference between the two groups was significant (t=-24.89, P<0.05; t=-4.45, P<0.05; t=-13.87, P<0.05). Conclusion DATS can inhibit the proliferation and the effect of TNF-αinduced secretion of IL-6, MMP-1 and VEGF in RA-FLS. The effect is dose-dependent.
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Objective To analyze the optimal timing of endoscopic stone extraction combined with extracorporeal shock wave lithotripsy (ESWL) in the treatment of chronic pancreatitis (CP) with pancreatic stones. Methods Data regarding 170 pancreatic stone patients receiving ESWL and endoscopic stone extraction at Shanghai Changhai Hospital from February 2014 to February 2015 were retrospectively analyzed. Based on the the prior history of endoscopic treatment,patients were divided into group A and B,and then sub-divided into three groups according to the timing of endoscopic intervention after ESWL including <12 h,12~36 h and >36 h subgroup. The success of pancreatic ductal cannulation, clearance of stone in the main pancreatic duct, and ERCP-related complications were evaluated. Results Among all the enrolled 170 patients,107 previously received ERCP(group A) while the others didn't(group B). The overall success rate of cannulation and clearance rate of stones at different times showed no significant difference. The success rate and clearance rate in group A in <12 h,12~36 h and >36 h subgroup were 91.7%,95.2%,78.0%,and 91.7%,95.2%,80.0%,and no significant difference existed. In group B, the success rate and clearance rate in <12 h, 12~36 h and >36 h subgroup were 66.7%, 71.4%, 96.3%, and 60.0%, 76.2%, 92.6%, and the differences were statistically different. The success rate and clearance rate of >36 h subgroup in group B were obviously higher than that in <12 hours (P=0.025) and 12~36 h subgroup (P=0.04). The timing of endoscopic stone extraction did not influence ERCP-related complications. Conclusions Early endoscopic stone extraction after ESWL can be considered in patients with pancreatic stones who previously underwent ERCP. Delayed endoscopic stone extraction after ESWL is recommended in patients without prior ERCP,which can help promote the therapeutic efficacy.
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Objective@#To evaluate the predictive value of MRI features and pathological parameters on local recurrence, metastasis and progression free survival (PFS) for locally advanced rectal cancer after neoadjuvant chemoradiotherapy and subsequent total mesorectal excision surgery.@*Methods@#A retrospective analysis of 95 patients with locally advanced rectal adenocarcinoma who underwent total mesorectal excision after neoadjuvant chemoradiotherapy was performed. Univariate and multivariate analyses were performed to evaluate the predictive value of MRI features before chemoradiation and postoperative pathological parameters on progression free survival.@*Results@#Among the 95 cases, 5 cases occured local recurrence, 21 cases developed, 3 cases including both locally recurrence and distant metastasis, 19 died and 47 had no recurrence or metastasis at the last of follow-up. Univariant analysis showed that MRI signs before chemoradiation, namely, mr circumferential resection margin, mr levator ani muscle invasion, mr lymphatic vessel invasion, mr tumor deposition and postoperative pathological parameters, yp circumferential resection margin, yp lymphatic vessel invasion were related to PFS (P<0.05). Multivariate analysis of Cox proportional hazard model showed that mr lymphatic vessel invasion and mr tumor deposition were independent factors for PFS (OR=2.774 and 3.029, P<0.05).@*Conclusions@#Lymphatic vessel invasion and tumor deposition on MRI are independent prognostic factors for progression free survival of locally advanced rectal cancer after neoadjuvant chemoradiotherapy and TME surgery. To some extent, MRI signs can assess local recurrence and distant metastasis in locally advanced rectal cancer patients after neoadjuvant chemoradiotherapy and mesorectal excision.
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Objective To investigate the value of magnetic resonance diffusion-weighted imaging (DWI) in combination with peripheral serum tumor markers in the diagnosis and therapeutic evaluation of small cell lung cancer (SCLC) brain metastases.Methods Retrospective analysis of 368 SCLC cases diagnosed by histopathology or cytology from February 2009 to February 2012 in Shanxi Provincial Cancer Hospital was made.All patients underwent pathological examination of progastrin-releasing peptide (ProGRP),neuron-specific enolase (NSE) and brain DWI,and measured the apparent diffusion coefficient (ADC) of DWI sequences of brain metastases.The difference between the positive rates of ProGRP and NSE in patients with or without brain metastases was compared by the X2 test,and the diagnostic efficiency of ProGRP,NSE,DWI and combined detection for brain metastases were analyzed.The Kruskal-Wallis H test was used to compare the changes of ADC value,ProGRP and NSE before and after brain irradiation therapy in brain metastases of SCLC.Pearson correlation analysis was made to evaluate the correlation between the changes of ADC value and the levels of ProGRP and NSE in SCLC patients with brain metastases before and after treatment.Results The median expression of serum ProGRP in 169 SCLC patients was 2 664.7 pg/ml (98.4-4 876.8 pg/ml),with a positive rate of 98.2 ％ (166/169).The median expression of NSE was 41.9 μg/L (9.4-264.3 μg/L),with a positive rate of 70.4 ％ (119/169).The median expression of serum ProGRP level was 514.3 pg/ml (3.9-2 899.3 pg/ml) in 199 SCLC patients without brain metastasis,the positive rate was 89.4 ％ (178/199).The median expression of NSE was 40.4 μg/L (0.3-176.1 μ,g/L),with a positive rate of 64.8 ％ (129/199).The difference of ProGRP level between the two groups was statistically significant (u =121.47,P ＜ 0.001),but there was no significant difference in NSE level (u =1.35,P =0.12).The sensitivities of ProGRP,NSE,DWI,ProGRP+DWI and NSE+DWI were 68.4 ％,41.2 ％,66.7 ％,92.2 ％,and 82.4 ％,and the specificities were 52.9 ％,35.3 ％,76.5 ％,94.1％,and 88.2 ％.The sensitivity and specificity of ProGRP+DWI and NSE+DWI were higher than those of single test,and the differences were statistically significant (all P ＜ 0.001).One hundred and fifty-six SCLC patients with brain metastases were treated with whole brain radiotherapy.Pearson correlation analysis showed that ADC values were negatively correlated with ProGRP and NSE levels (r =-0.945,P ＜ 0.001;r =-0.995,P ＜ 0.001).Conclusion DWI combined with ProGRP and NSE can provide objective evidence and clinical guidance for the diagnosis of SCLC brain metastases and the evaluation of whole brain radiotherapy.
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Objective@#To explore the effect of anterior alveolar bone reconstruction achieved through autogenous block bone from the wisdom teeth extraction zone in onlay grafting technique. @*Methods@#The 20 patients with bone defect of anterior teeth area were selected. They all had impacted teeth with no infection factors of pericoronitis to be removed. They were treated with autogenous block bone grafts from wisdom teeth extraction zone in onlay grafting technique respectively. The changes of thickness and the height of the bone measured from CBCT before and after 6 months of the surgery were carefully compared. Questionnaire from the patients opinion of acceptance was also be collected. @*Results@# Acceptance questionnaire showed an average score of 55 points (60 full score). Among them, 75% of paitients showed totally supportion and 25% showed basically supportion. The thickness was 6.73 ± 0.28 mm after the surgery compared with 2.26 ± 0.57 mm before the surgery which illustrated a significant difference (F = 6.32, P<0.001). The height didn't change obviously before 14.32 ± 0.31 mm and after 14.56 ± 0.35 mm the surgery. The technique of using autogenous block bone from the wisdom teeth extraction zone improved the compliance of patients with surgery. It can provide good osteogenesis effect and solve other oral diseases at the same time. @*Conclusion@#The Onlay grafting technique which using autogenous block bone from the wisdom teeth extraction zone was a simple and effective techniques for anterior alveolar bone augmentation.
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Objective To observe the clinical efficacy of acupoint thread embedding plus Western medication in treating major epilepsy.Method Sixty epilepsy patients were randomized into a thread embedding group and a Western medication group, 30 cases each. The Western medication group was intervened by Western medication; the thread embedding group was given acupoint thread embedding based on the same Western medication treatment. Seizure frequency, seizure score, general efficacy and the improvement of adverse reactions due to Western medications were analyzed.Result Compared to the Western medication group, the thread embedding group was more effective in controlling seizure frequency (P<0.01), and reducing seizure score (P<0.05) and adverse reactions of Western medications (P<0.05); the general efficacy of the thread embedding group was superior to that of the Western medication group in treating epilepsy (P<0.05).Conclusion Acupoint thread embedding plus Western medication is effective in treating epilepsy, and is superior to the use of Western medication alone.