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1.
Article in Chinese | WPRIM | ID: wpr-908497

ABSTRACT

Objective:To investigate the clinical value of gadolinium ethoxybenzyl diethy-lanetriaminepentaacetic acid (Gd-EOB-DTPA) enhanced magnetic resonance imaging (MRI) in the preoperative diagnosis of macrotrabecular-massive hepatocellular carcinoma (MTM-HCC).Methods:The diagnostic test was conducted. The clinicopathological data of 150 HCC patients who were admitted to the First Affiliated Hospital of Army Medical University from January 2019 to December 2020 were collected. There were 116 males and 34 females, aged (53±10)years. There were 38 MTM-HCC patients and 112 non-macrotrabecular-massive hepatocellular carcinoma (nMTM-HCC) patients. All patients received Gd-EOB-DTPA enhanced MRI examination. Observation indicators: (1) clinicopathological features of MTM-HCC and nMTM-HCC; (2) imaging features of MTM-HCC and nMTM-HCC; (3) imaging features for diagnosis of MTM-HCC. The normality test of continuous data was analyzed by the Kolmogorov-Smirnov test. Measurement data with normal distribution and homoscedasticity were represented as Mean± SD, and comparison between groups was analyzed using the independent sample t test. Measurement data with skewed distribution were represented as M( P25, P75), and comparison between groups was analyzed using Mann-Whitney U test. Count data were described as absolute numbers, and comparison between groups was analyzed using the chi-square test. Multivariate analysis was conducted using the Logistic regression model. The receiver operating characteristic (ROC) curve was used to evaluate diagnostic value of indicators, and Delong test was used for comparison. Results:(1) Clinicopathological features of MTM-HCC and nMTM-HCC: the alpha-fetoprotein and cases with microvascular invasion were 329 μg/L(20 μg/L,1 034 μg/L) and 24 for MTM-HCC patients, versus 25 μg/L(8 μg/L,200 μg/L) and 31 for nMTM-HCC patients, showing significant differences between the two groups ( Z=-3.306, χ2=15.380, P<0.05). (2) Imaging features of MTM-HCC and nMTM-HCC: cases with regular morphology of tumor, intra-tumoral fat, arterial phase peritumoral enhancement, complete capsule, intratumoral necrosis or ischemia, peritumoral hypointense at hepatobiliary phase (HBP) were 6, 4, 20, 5, 28, 17 for MTM-HCC patients, versus 44, 40, 21, 43, 26, 11 for nMTM-HCC patients, showing significant differences between the two groups ( χ2=7.049, 8.684, 16.399, 8.303, 31.368, 22.783, P<0.05). (3) Imaging features for diagnosis of MTM-HCC. ① Results of multivariate analysis showed that intratumoral fat, intratumoral necrosis or ischemia were independent predictors for MTM-HCC ( hazard ratio=4.033,0.215, 95% confidence interval as 1.196-13.603, 0.079-0.588, P<0.05). ② Diagnostic efficacy: the arear under ROC curve, sensitivity and specificity of intratumoral fat combined with intratumoral necrosis or ischemia for diagnosis of MTM-HCC were 0.799(95% confidence interval as 0.718-0.880, P<0.05), 73.7%, 76.8%. The above indicators of intratumoral fat for diagnosis of MTM-HCC were 0.626(95% confidence interval as 0.530-0.721, P<0.05), 89.5%, 35.7%. The above indicators of intratumoral necrosis or ischemia for diagnosis of MTM-HCC were 0.752(95% confidence interval as 0.659-0.845, P<0.05), 73.7%, 76.8%. There were significant differences in the diagnostic efficacy between the intratumoral fat combined with intratumoral necrosis or ischemia and single intratumoral fat, between the intratumoral fat combined with intratumoral necrosis or ischemia and single intratumoral necrosis or ischemia, respectively ( P<0.05). Conclusions:Intratumoral fat, intratumoral necrosis or ischemia on Gd-EOB-DTPA MRI are independent predictors for MTM-HCC. The two combined features has higher diagnostic efficacy. Gd-EOB-DTPA MRI can be used for pre-operative diagnosis of MTM-HCC.

2.
Article in Chinese | WPRIM | ID: wpr-908133

ABSTRACT

Objective:To understand the perceptions and suggestions of emergency medical staff on the evaluation of nursing quality in the resuscitation room, and to provide reference for the construction of nursing quality evaluation standards in the resuscitation room.Methods:Phenomenological research methods in qualitative research were used to conduct semi-structured personal in-depth interviews with 15 physicians and nursing staff from August to October 2020 using a purposive sampling method, and the results of the interviews were organized and themes were refined using the Colaizzi 7-step analysis.Results:Three themes related to the evaluation criteria of nursing quality in the structure category of the resuscitation room were extracted, namely, nursing management system, nursing human resources, and environment and facilities; three themes related to the evaluation criteria of nursing quality in the process category of the resuscitation room were extracted, namely, sterile isolation/nosocomial infection, quality of specialty care, and standard of nursing documentation; and three themes related to the evaluation criteria of nursing quality in the outcome category of the resuscitation room were extracted, namely, patient health outcome, satisfaction, and incidence of adverse events.Conclusions:At present, the evaluation of the quality of emergency room care needs to be further standardized, and the themes related to the evaluation of the quality of emergency room care extracted based on the perspective of medical and nursing staff can provide a reference basis for the construction of a reasonable, scientific and comprehensive evaluation standard of nursing quality of emergency room.

3.
Article in Chinese | WPRIM | ID: wpr-904763

ABSTRACT

Objective To investigate the relationship between cystatin C level and the plasma trough concentration of teicoplanin, so as to provide a reference for the rational application of teicoplanin in clinical practice. Methods The clinical data of the patients receiving teicoplanin, who admitted to our hospital from October 2017 to July 2020 were retrospectively analyzed. The distribution of teicoplanin concentration, the difference of teicoplanin concentration under different cystatin C level, and influence factors for teicoplanin concentration (<15 µg/ml) were analyzed. Results A total of 98 patients including 65 males and 33 females, aged 19 to 94 (52.2±16.2) years old, with 141 trough concentrations were enrolled. The trough concentration of teicoplanin was 11.51 (8.35, 19.07) µg/ml, and the range was 3.57-41.93 µg/ml. 95 cases (67.38%) had teicoplanin concentration <15 µg/ml. When the concentration of cystatin C was >1.05 mg/L, the trough concentration of teicoplanin were 11.37 (8.96, 20.52) µg/ml, significantly higher than those when the concentration of cystatin C was in normal [8.68 (6.34, 11.79) µg/ml, Z=−2.636, P<0.05]. Logistic regression analysis showed that cystatin C level was the influencing factor for teicoplanin trough concentration does not meet the standard (OR=1.529, 95%CI=1.001-2.336, P<0.05). Conclusion The concentration of teicoplanin is significantly increased when the cystatin C level is higher than the normal. Cystatin C level is the influence factor for teicoplanin trough concentration not meeting the standard. The cystatin C level may be considered as a reference for teicoplanin dosage adjustment in clinical practice.

4.
Journal of Experimental Hematology ; (6): 1109-1118, 2021.
Article in Chinese | WPRIM | ID: wpr-888525

ABSTRACT

OBJECTIVE@#To investigate the effect and involved mechanism of RSL3 on ferroptosis action in acute leukemia cells MOLM13 and its drug-resistant cells.@*METHODS@#After MOLM13 treated with RSL3, CCK-8 assay was performed to detect cell viability, flow cytometry was used to detect the reactive oxygen species (ROS) level of the cells, RT-qPCR and Western blot were used to detect the expression of glutathione peroxidase 4 (GPX4). After MOLM13/IDA and MOLM13/Ara-C, the drug-resistant cell lines were constructed, the ferroptosis induced by RSL3 was observed. Bone marrow samples were collected from patients with acute monocytic leukemia. RT-qPCR and Western blot were performed to detect the expression of related genes and proteins involved in ferroptosis pathway.@*RESULTS@#RSL3 significantly inhibited the cell viability of MOLM13 and increased the intracellular ROS level, which were partially reversed by ferrostatin-1. The mRNA and protein expression of GPX4 decreased in MOLM13 treated with RSL3. RSL3 inhibited the viability of MOLM13/IDA and MOLM13/Ara-C cells more strongly than that of non-drug resistant cells, also increased the intracellular ROS level . The cytotoxic effects were partially reversed by ferrostatin-1. The mRNA and protein expressions of GPX4 in MOLM13/IDA and MOLM13/Ara-C cells were higher than those in non-drug resistant cells. The mRNA and protein levels of GPX4 in bone marrow of relapsed/refractory acute mononuclear leukemia patients were higher than those of ordinary acute mononuclear leukemia patients.@*CONCLUSION@#RSL3 can induce non-drug resistant cells MOLM13 ferroptosis by inhibiting GPX4 activity. MOLM13/IDA and MOLM13/Ara-C are more sensitive to RSL3 compared with non-drug resistant cells MOLM13, which may be caused by the differences in GPX4 expression. The expressions of GPX4 mRNA and protein in relapsed/refractory acute mononuclear leukemia are higher than those in ordinary acute mononuclear leukemia.


Subject(s)
Carbolines , Cell Line , Child , Ferroptosis , Humans , Leukemia, Myeloid, Acute , Pharmaceutical Preparations
5.
China Pharmacy ; (12): 2520-2524, 2021.
Article in Chinese | WPRIM | ID: wpr-887434

ABSTRACT

OBJECTIVE:To explo re the clinical characteristics of voriconazole-induced neurological ADR and the occurrence of hypokalemia and hyponatremia before ADR. METHODS :The medical records of 411 patients receiving voriconazole therapy , who admitted to our hospital from January 2018 to November 2020,were retrospectively analyzed. The general information of all patients,including sex ,age,body weight ,type of infection ,underlying disease ,type of pathogenic fungal infection and administration route of voriconazole ,maintenance dose ,blood drug concentration ,were collected. The basic information of patients with neurological ADR ,including sex ,age,types of infection ,underlying disease ,drug combination ,occurrence time and clinical manifestations ,were collected . The levels of blood potassium ,blood sodium and liver function indexes (ALT,AST, γ-GT,ALP,total bilirubin ,direct bilirubin )within 3 days before the neurological ADR were also collected. The relationship of neurological ADR with voriconazole trough concentration ,blood potassium and blood sodium levels was analyzed. RESULTS : Among 411 patients,31(7.54%)patients suffered from neurological ADR ,which were higher in male (64.52%)than in female (35.48%),mainly in patients aged 50 and over (74.20%). The major infection type was lung infection (96.77%). Among 31 patients with neurological ADR ,26 patients suffered from neurological ADR after 1-7 days after voriconazole administration , accounting for 83.87%. Thirty patients received intravenous drip ,accounting for 96.77%. The incidence of neurological ADR in patients with voriconazole trough concentration >5.0 μ g/mL (8.99%)was significantly higher than that in patients with trough concentration ≤5.0 μg/mL(3.42%,χ2=4.91,P=0.027). The clinical manifestations of the patients were mainly 023-68766797。E-mail:cheng7zhu@163.com hallucinations(32.35%),irritability(32.35%)and poor sleep (17.65%),etc. Within 3 days before 30 patients,receiving related indexes test ,suffered from neurological ADR ,16 patients(53.33%)had hypokalemia and 12 patients(40.00%) had hyponatremia ,which w ere significantly higher than the incidence of hypokalemia (24.74%,P=0.001)and hyponatremia (12.89%,P<0.001)in those without neurological ADR . There were 8,10,7,13,7 and 10 patients with ALT ,AST,ALP, γ-GT,total bilirubin and direct bilirubin increased. In 31 patients with neurological ADR ,the neurological ADR were relieved or disappeared after reducing the dosage or discontinuing voriconazole. CONCLUSIONS :The neurological ADR of voriconazole mostly occurs 1-7 days after voriconazole administration ,mainly by intravenous drip ,mostly in male and people aged 50 and over. The occurrence of neurological ADR may be related to trough concentration of voriconazole ,and most patients suffer from hypokalemia or hyponatremia before the occurrence of ADR .

6.
Article in Chinese | WPRIM | ID: wpr-879906

ABSTRACT

OBJECTIVE@#To study the effect of dexamethasone (DEX) on the expression of Dynein heavy chain (DHC) and Dynactin in the cytoplasm of fetal rat cerebral cortical neurons cultured @*METHODS@#Primary cerebral cortical neurons of fetal rats were cultured @*RESULTS@#There was no significant difference in the mRNA expression levels of DHC and Dynactin among the three groups at all time points (@*CONCLUSIONS@#DEX affects the protein expression of DHC and Dynactin in the fetal rat cerebral cortical neurons cultured


Subject(s)
Animals , Cytoplasm , Dexamethasone/pharmacology , Dynactin Complex/genetics , Dyneins , Neurons , Rats
7.
Article in Chinese | WPRIM | ID: wpr-887980

ABSTRACT

The effects of water regulation on the biosynthesis of calycosin-7-O-β-D-glucoside in 2-year-old Astragalus membranaceus var. mongholicus were studied,and the mechanism was explained from the aspects of key enzyme gene expression and antioxidant enzyme system. The content of calycosin-7-O-β-D-glucoside was determined by HPLC,and the expression levels of six key enzyme genes( PAL,4 CL,CHS,CHI,IFS,13'H) in the synthesis pathway were analyzed by q RT-PCR. The activities of protective enzymes and contents of osmoregulation substances and malondialdehyde were also determined. In the water deficit group,the maximum concentration of calycosin-7-O-β-D-glucoside was 0. 49 mg·g-1 on the 24 th day of treatment. In the whole water regulation,the water deficit group outweighed the water adequate group in osmoregulation substance and MDA contents. The activities of A. membranaceus var.mongholicus antioxidant enzymes SOD,POD,and CAT increased during the initial period of water regulation,but decreased with time.The expression of PAL,CHS,and 13'H in the water deficit group was at a low level,and the 4 CL had active expression,slightly lower than that in the water adequate group. The expression of CHI and IFS elevated rapidly when water deficit occurred. Correlation analysis showed that the content of calycosin-7-O-β-D-glucoside was positively correlated with CHI expression( P<0. 01) and IFS expression( P<0. 05). Therefore,water regulation can change the accumulation pattern of calycosin-7-O-β-D-glucoside,and water deficit may be an effective way to increase its content. CHI and IFS are the key genes in response to water deficit.


Subject(s)
Astragalus propinquus/genetics , Biosynthetic Pathways , Glucosides , Isoflavones , Water
8.
Article in Chinese | WPRIM | ID: wpr-863205

ABSTRACT

Objective:To evaluate the biosafety of medical injectable carboxymethyl glycosaminoglycan gel.Methods:Ames test, chromosome aberration test in vitro and gene mutation test in vitro were used to detect the genotoxicity of the medical carboxymethyl glycosaminoglycan gel. The gel saline extract (50 ml/kg) was injected slowly through the marginal vein of the ear into Japanese big-eared rabbits. The body temperature was measured and the temperature rise was calculated. The gel saline extract (50 ml/kg) and normal saline (control) were injected intraperitoneally and intravenously into the Kunming mice, respectively. The toxicity response in mice was observed after injection, and bodyweight change was valued. The gel saline extract, normal saline and distilled water were added into the rabbit anti-clotting, to detect the rate of hemolysis.Results:Under active and inactive conditions, the number of spontaneous revertants of the 4 strains of gel saline extract group and gel DMSO extract group did not reach 2 times of that of the corresponding negative control group. The rate of chromosome aberration of the three dose groups were 0. There was no significant increase in the large colony mutation frequency, small colony mutation frequency and total mutation frequency in three dose groups (all P>0.05). After injection of gel saline extract for 24, 48 and 72 h, no toxic reaction was found in each group of mice. With the extension of time after injection, the body weight of mice in the sample group and the control group increased, but the difference was not statistically significant ( P>0.05). After injection of gel saline extract, the temperature rise of 3 Japanese big-eared rabbits were 0.0, 0.3 and 0.2 ℃ respectively. The results of hemolysis test showed that the hemolysis rate of the polycarboxymethyl glucosamine gel was 0.1%. Conclusions:No genetic toxicity changes were found in carboxymethyl glycosaminoglycan to induce gene mutation or chromosome damage in bacteria and cells, and no pyrogenicity, acute systemic toxicity and hemolysis were observed. These results indicate that thecarboxymethyl glycosaminoglycan gel has good biosafety.

9.
Article in Chinese | WPRIM | ID: wpr-872670

ABSTRACT

The long-term existence of hyperglycemia leads to the occurrence of metabolic memory effect, which is an important reason for the formation of diabetic macrovascular disease, so the early control of metabolic memory is the key to the prevention and treatment of diabetes and its complications. The excessive formation of advanced glycation end products (AGEs) is not only an important factor to cause metabolic memory, but also the core mechanism for diabetic macrovascular disease. It is believed in traditional Chinese medicine(TCM) that Fu-xie (incubative pathogen) is the key pathogenesis of the formation of diabetic vascular diseases, and it is necessary to adopt the principle of removing pathogenic factors and opening collaterals as early as possible to prevent and cure the disease. During the Spring and Autumn Period and the Warring States Period, the theory of Fu-xie was germinated, and got mature in the Ming and Qing dynasties after the continuous development. The so-called Fu-xie means that the pathogens are of a potential nature but not cause diseases immediately. The theory of Fu-xie first appeared in Huangdi Neijing, with an original meaning of epidemic febrile disease occurring after incubation, and then its meaning continues to expand, now referring to all potential pathogenic factors that would not immediately cause diseases. As the cause and pathogenesis of many diseases, the theory of Fu-xie is widely used in clinical practice to guide the treatment of diseases. In the body, the accumulation of AEGs can induce the subsequent cascade effect in the body, and finally promote the formation and development of diabetic macrovascular diseases. This is very similar to the process of inducing metabolic disorder and disease in TCM due to the accumulation of phlegm and silt. Therefore, under the guidance of Fu-xie theory, the mechanism of AEGs in blocking metabolic memory and preventing and treating diabetic macrovascular disease was analyzed in this paper. On the one hand, it will provide a scientific basis for the exploration of Fu-xie theory affecting the disease course of diabetic macrovascular disease by regulating the generation of AEGs. On the other hand, it can also provide the material change basis for the development of Fu-xie theory in the occurrence and development of diabetic macroangiopathy.

10.
Chinese Medical Journal ; (24): 1639-1648, 2020.
Article in English | WPRIM | ID: wpr-827570

ABSTRACT

BACKGROUND@#The efficacy of entecavir (ETV) add-on peg-interferon therapy compared with ETV monotherapy in treatment-naïve hepatitis B virus (HBV) patients remains controversial. We investigated whether adding peg-interferon to ongoing ETV treatment leads to a better curative effect or not.@*METHODS@#All patients have been recruited between August 2013 and January 2015 from the Shanghai Public Health Clinical Center and Zhongshan Hospital (China). Eligible HBV patients (n = 144) were randomly divided (1:1) to receive either ETV monotherapy (n = 70) or peg-interferon add-on therapy from week 26 to 52 (n = 74). Patients were followed-up for at least 2 years. Indexes including hepatitis B surface antigen (HBsAg) and hepatitis B e antigen (HBeAg) seroconversion rate, sustained virologic response, transient elastography value, and histological scores were evaluated every 3 months until the end of the study. The rate of patients with HBsAg loss was defined as the primary endpoint criteria.@*RESULTS@#At week 26, no patient achieved HBsAg seroconversion in either group. At week 52, one patient in the monotherapy group was HBsAg-negative but there was none in the combination therapy group. The monotherapy group showed significantly better liver function recovery results than the combination therapy group. At week 78, one patient in the combination group had HBsAg seroconverted. At week 104, only three patients in the combination therapy group were HBsAg-negative compared with one patient in monotherapy. The mean alanine aminotransferase and aspartate aminotransferase levels and transient elastography values decreased significantly compared with baseline. Both groups showed a favorable decrease in alpha-fetoprotein (monotherapy: 4.5 [2.8, 7.1] vs. 2.2 [1.8, 3.1] ng/mL, P < 0.001; combination therapy: 5.7 [3.0, 18.8] vs. 3.2 [2.0, 4.3] ng/mL, P < 0.001) and an improved result of liver biopsy examination scores. The combination group showed a better improvement in histology compared with the monotherapy group (mean transient elastography value 6.6 [4.9, 9.8] vs. 7.8 [5.4, 11.1] kPa, P = 0.028). But there was no significant difference in HBsAg conversion rate (1.8% [1/56] vs. 4.1% [3/73], P = 0.809) and HBeAg conversion rate (12.5% [7/56] vs. 11.0% [8/73], P = 0.787), as well as HBV-DNA, sustained virologic response (93.2% vs. 98.5%, P = 0.150) between the two groups.@*CONCLUSIONS@#Both therapies supported liver function recovery and histology improvement. Combination therapy did not show better anti-viral efficacy in HBsAg or HBeAg seroconversion compared with monotherapy. However, combination therapy played a more positive role in reversing hepatic fibrosis compared with monotherapy.@*TRIAL REGISTRATION@#ClinicalTrials.gov: NCT02849132; https://clinicaltrials.gov/ct2/show/NCT02849132.

11.
Neuroscience Bulletin ; (6): 570-584, 2020.
Article in English | WPRIM | ID: wpr-826793

ABSTRACT

Methyl-CpG binding protein 2 (MeCP2) is a basic nuclear protein involved in the regulation of gene expression and microRNA processing. Duplication of MECP2-containing genomic segments causes MECP2 duplication syndrome, a severe neurodevelopmental disorder characterized by intellectual disability, motor dysfunction, heightened anxiety, epilepsy, autistic phenotypes, and early death. Reversal of the abnormal phenotypes in adult mice with MECP2 duplication (MECP2-TG) by normalizing the MeCP2 levels across the whole brain has been demonstrated. However, whether different brain areas or neural circuits contribute to different aspects of the behavioral deficits is still unknown. Here, we found that MECP2-TG mice showed a significant social recognition deficit, and were prone to display aversive-like behaviors, including heightened anxiety-like behaviors and a fear generalization phenotype. In addition, reduced locomotor activity was observed in MECP2-TG mice. However, appetitive behaviors and learning and memory were comparable in MECP2-TG and wild-type mice. Functional magnetic resonance imaging illustrated that the differences between MECP2-TG and wild-type mice were mainly concentrated in brain areas regulating emotion and social behaviors. We used the CRISPR-Cas9 method to restore normal MeCP2 levels in the medial prefrontal cortex (mPFC) and bed nuclei of the stria terminalis (BST) of adult MECP2-TG mice, and found that normalization of MeCP2 levels in the mPFC but not in the BST reversed the social recognition deficit. These data indicate that the mPFC is responsible for the social recognition deficit in the transgenic mice, and provide new insight into potential therapies for MECP2 duplication syndrome.

12.
Article in Chinese | WPRIM | ID: wpr-828864

ABSTRACT

OBJECTIVE@#To understand the distribution patterns and the factors influencing the interval between entry of mainland China and diagnosis in imported COVID-19 cases in Guangdong Province to provide evidence for formulating and implementing effective control measures.@*METHODS@#We collected the data of imported COVID-19 cases from March 1st to April 10th, 2020 published on the official websites of Health Commission of Guangdong Province and local government of the cities in Guangdong Province for epidemiological analysis. Descriptive statistical methods were used to analyze the distribution patterns of the interval between entry of mainland China and diagnosis of the imported cases, and multivariate logistic regression was used to analyze the factors influencing the interval.@*RESULTS@#A total of 179 imported cases were reported in Guangdong by April 10th, 2020. The average interval between entry of mainland China and diagnosis was 4.21 days with a median of 2 days. The interval was between 1 and 3 days in 69.8% of the cases. Multivariate logistic regression analysis showed that a negative result of the initial nucleic acid test (OR=5.205, 95% : 1.100-24.640, =0.038) and interval between entry of mainland China and a positive diagnosis >2 days (OR=85.654, 95%: 24.569-298.615, < 0.001) were risk factors for the finding delay.@*CONCLUSIONS@#The results of initial nucleic acid detection and the interval between entry of mainland China and a positive diagnosis of COVID-19 are the major contributing factors of delayed case detection. This finding suggests that strict quarantine and detection measures should be carried out for the personnel entering China to accurately and quickly identify the cases.


Subject(s)
Betacoronavirus , China , Clinical Laboratory Techniques , Coronavirus Infections , Diagnosis , Delayed Diagnosis , Humans , Pandemics , Pneumonia, Viral , Diagnosis
13.
Rev. bras. anestesiol ; 69(5): 517-520, Sept.-Oct. 2019. graf
Article in English | LILACS | ID: biblio-1057462

ABSTRACT

Abstract Objective and background: Erector spinae plane block is a novel analgesic truncal block that has been popularized due to its ease of performance and perceived safety. Erector spinae plane block has been postulated to target the ventral rami and rami communicates of spinal nerves, thus providing somatic and visceral analgesia. In this case series, we describe our experience of bilateral erector spinae plane block placed at the low thoracic level in open gynecologic oncology surgery in three patients. Method: Under ultrasound guidance, erector spinae plane blocks were done, preoperatively, at the 8th thoracic transverse process bilaterally. Numeric rating scale for pain and opioid consumption of the first 48 postoperative hours were recorded. Results: Pain scores ranged from 0 to 4 among the three patients and 48 h opioid consumption in oral morphine equivalents of 4, 6 and 18 mg. No adverse events were recorded up to patient discharge from the hospital. Conclusions: Erector spinae plane block provided effective analgesia in our case series. While its true mechanism of action remains obscure, the available case reports show encouraging analgesic results with no adverse events recorded. Formal prospective randomized trials are underway to provide further evidence on its efficacy, failure rate and safety.


Resumo Justificativa e objetivo: O bloqueio do plano do músculo eretor da espinha é um novo bloqueio troncular analgésico popularizado devido à sua facilidade de aplicação e segurança percebida. O bloqueio do plano do músculo eretor da espinha foi postulado para atingir os ramos ventrais e os ramos comunicantes dos nervos espinhais, proporcionando analgesia somática e visceral. Nesta casuística, descrevemos nossa experiência com o bloqueio do plano do músculo eretor da espinha bilateral depositado no nível torácico inferior em cirurgia oncológica ginecológica aberta em três pacientes. Método: Os bloqueios do plano do músculo eretor da espinha guiados por ultrassom foram administrados no pré-operatório, entre o 8° e o 10° processo transverso do tórax bilateralmente. Os valores de uma escala de classificação numérica para dor e consumo de opioides nas primeiras 48 horas de pós-operatório foram registrados. Resultados: Os escores de dor variaram de 0-4 entre as três pacientes e o consumo de opioide em 48 horas equivaleu à morfina oral (4, 6 e 18 mg). Nenhum evento adverso foi registrado até a alta hospitalar das pacientes. Conclusões: O bloqueio do plano do músculo eretor da espinha proporcionou analgesia efetiva em nossa casuística. Embora o mecanismo de ação verdadeiro permaneça obscuro, os relatos de casos disponíveis mostram resultados analgésicos encorajadores, sem eventos adversos registrados. Ensaios prospectivos randômicos formais estão em andamento para fornecer mais evidências sobre sua eficácia, taxa de falha e segurança.


Subject(s)
Humans , Female , Aged , Salpingo-oophorectomy , Hysterectomy , Nerve Block/methods , Paraspinal Muscles
14.
Article in Chinese | WPRIM | ID: wpr-777482

ABSTRACT

The study is aimed to explore the effect of different water on the content of total saponins,astragaloside Ⅳ and gene expression in the growth of Astragalus membranceus. In this study, one-year-old A. membranaceus was used as the experimental material, by pot culture different water treatments were simulated at herbal garden in Jilin Agricultural University. The content of astragaloside Ⅳ was determined by HPLC and the total saponins by UV spectrophotometry. With 18 S RNA as a reference gene, fluorescent quantitative PCR was applied to analyze the eight key enzymes in astragalus saponin synthesis pathway AACT,HMGS,HMGR,IDI,FPS,SS,SE,CAS expression. With the decrease of soil water, the content of astragaloside Ⅳ in the root tissue of A. membranaceus showed an increasing trend, up to 1.46 mg·g~(-1). The total saponin content tended to increase, up to 6.80 mg·g~(-1). The results of relative expression of genes showed that the eight genes showed different effects at different water. With the change of soil water content, the amount of(AACT,IDI,SS) relative expression in drought stress group firstly increased and then decreased, then increased, and then decreased. The amount of(HMGS,HMGR,FPS) relative expression in drought stress group increased firstly and then decreased. The amount of(SE,CAS) relative expression in drought stress group increased firstly and then decreased, and continued to decrease after rehydration. The expression of key enzyme genes involved in the synthesis of astragaloside was influenced by each other, and the expression of key enzyme in roots showed a correlation with the content of astragaloside. Correlation analysis showed that there was a very significant positive correlation between HMGR gene and total saponins content in drought stress group and a significant negative correlation between content of CAS and total saponins. The contents of FPS,SE,CAS and astragaloside Ⅳ were very significantly and negative correlated. The relationship between other genes and quality was positive. Therefore, HMGR, FPS, SE and CAS genes have significant effects on the regulation of saponin content under water control. On the 15 th day after water regulation, the total amount of astragaloside and total saponins reached the highest value and could be harvested.


Subject(s)
Astragalus Plant , Metabolism , Chromatography, High Pressure Liquid , Droughts , Saponins , Stress, Physiological , Triterpenes , Water
15.
Article in Chinese | WPRIM | ID: wpr-775089

ABSTRACT

OBJECTIVE@#To investigate the pathogen composition and clinical features of preterm infants with sepsis, and to provide a basis for early identification and treatment of sepsis in preterm infants.@*METHODS@#A retrospective analysis was performed for the clinical data of 371 preterm infants with sepsis who had a positive blood culture between January 2014 and May 2018. According to the time of onset, the preterm infants were divided into an early-onset group (an age of onset of <7 days) with 73 preterm infants and a late-onset group (an age of onset of ≥7 days) with 298 preterm infants. The two groups were compared in terms of pathogen composition and clinical features (initial symptoms, laboratory examination results at the time of onset, comorbidities, and prognosis).@*RESULTS@#There was a higher proportion of infants with Klebsiella pneumoniae infection in the late-onset group (P<0.05), while there was a higher proportion of infants with Escherichia coli, Streptococcus agalactiae or Listeria infection in the early-onset group (P<0.05). The early-onset group had a significantly higher proportion of infants with dyspnea than the late-onset group (P<0.05). Compared with the late-onset group, the early-onset group had significantly shorter time to negative conversion of blood culture, duration of antibiotic use before infection, and indwelling time of deep venous catheterization (P<0.05), and the late-onset group had a significantly higher incidence rate of neonatal necrotizing enterocolitis than the early-onset group (P<0.05). The early-onset group had a significantly higher rate of treatment withdrawal than the late-onset group (P<0.05).@*CONCLUSIONS@#Preterm infants with sepsis lack typical clinical manifestations and laboratory examination results at the time of onset. There are certain differences in pathogen composition and clinical features between preterm infants with early- and late-onset sepsis. Possible pathogens for sepsis should be considered based on age in days at the time of onset and related clinical features.


Subject(s)
Enterocolitis, Necrotizing , Humans , Infant , Infant, Newborn , Infant, Premature , Retrospective Studies , Sepsis , Streptococcus agalactiae
16.
Article in Chinese | WPRIM | ID: wpr-816140

ABSTRACT

OBJECTIVE: To investigate the expression changes of human galectin 3(Gal-3)in patients with acute myocardial infarction undergoing emergency PCI and to assess the relationship between Gal-3 level and myocardial infarction range,coronary thrombotic load and ventricular remodeling.METHODS: Totally 62 patients with AMI who underwent emergency PCI in the department of cardiology of our hospital from January to August of 2018 were selected. Blood samples were taken for Gal-3 determination immediately after admission, 3 and 5 days after PCI. Troponin I was measured in 24 hours after PCI.Echocardiography was completed 24 hours after PCI. The patients were divided into three groups according to the results of coronary angiography: the single-vessel disease group, the two-vessel disease group and the three-vessel disease or the left main disease group.Gensini cumulative index was calculated. According to the imaging of coronary angiography, the coronary thrombus load was divided into 0-5 grades. The changes of Gal-3 level on admission to hospital,and at 3 and 5 days after PCI were analyzed and their relationship with troponin, coronary artery diseaseand thrombus load was analyzed.RESULTS: 1. Gal-3 levels were gradually reduced on admission, at 3 days after PCI and 5 days after PCI,which were respectively(93.38 ± 9.37)ng/L,(82.76 ± 7.43)ng/L and(72.71 ± 7.58)ng/L, and there were statistically significant differences among the three groups(F=99.17,P0.05). No correlation was found between Gal-3 levels and Gensini cumulative index(P>0.05). 3. The patients were divided into the group with thrombus level 0(T0 group)and the group with thrombus level 1-5(T1-5 group). Compared to the T0 group,the admission level of Gal-3 was significantly higher in the T1-5 group,which was(95.6±7.31)g/L vs.(89.62±11.3)ng/L,and the difference between the two groups was statistically significant(P=0.014). Similarly, the Gal-3 level of the T1-5 group was significantly higher than that of the T0 group on the 3 days after PCI and 5 days after PCI(P=0.017,P=0.006). Pearson correlation analysis showed that the level of Gal-3 on admission, 3 days after PCI and 5 days after PCI were all positively correlated with troponin I(CTNI)at 24 hours after PCI;there was a negative correlation with left ventricular ejection fraction(LVEF).CONCLUSION: Gal-3 is released in the acute phase of AMI,and decreases gradually within 5 days after emergency PCI. The level of Gal-3 is associated with the coronary thrombus load in patients with acute myocardial infarction. The heavier the thrombus load, the higher level the Gal-3. Gal-3 level is positively correlated with the extent of myocardial infarction, and negatively correlated with LVEF, reflecting that Gal-3 is involved in ventricular remodeling after actue myocardial infarction.

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Chinese Journal of Rheumatology ; (12): 247-254, 2019.
Article in Chinese | WPRIM | ID: wpr-745202

ABSTRACT

Objective To investigate the correlation between synovial inflammatory changes (synovial blood signals,synovial thickness,joint effusion) and cartilage injury,meniscus prominence of knee osteoarthritis (KOA) under energy Doppler ultrasound and further to assess the value of ultrasound for prognostic judgment in KOA.Methods A total of 291 KOA patients from our hospital from 2016 to 2018 were collected.The patients with rheumatoid arthritis (RA) with knee joints involved were recruited as control group.The data that conform to the normal distribution were expressed by mean±SD,and others were represented by M (P25,P75).The t test,the rank test and Chi-square test were used between the two groups,and ANOVA or K-W test was used to compare the data between the multiple groups,Spearman correlation analysis was used for correlation analysis.Results ① The proportion of synovial blood flow signal in KOA group was lower than RA group (19.6% vs 47.7%,x2=286.2,P<0.01),as well as the typical synovial thickness [2.6(0,3.95) mm vs 3.43 (1.85,6) mm,Z=-3.674,P<0.01] and popliteal cyst (11.5% vs 18.5%,x2=4.484,P=0.04).② In KOA group,no significant difference was found between ESR and hs-CRP among different synovial blood signals (H=7.213,H=0.883,all P>0.05).ESR from KOA group were both significantly lower than controls but the synovial blood signals was the same except for power Doppler signal-2 group (Z=-8.414,Z=-4.991,t=-3.428,all P<0.05);hs-CRP from KOA group were both significantly lower than controls but the synovial blood signals was the same.③ A total of 489 knee joints were detected in 291 patients with KOA,of which synovial blood flow signals were found in 96 joints,the power Doppler signal-I group was the most frequent in KOA (80/96,83.3%).In addition,joint effusion and synovial thickening were positively correlated with the synovial blood signals,(r=0.277,r=0.411,all P<0.05).④ At last,the degrees of ultrasound blood flow signal in KOA group was positively associated with the WOMAC score,the Lequsne index and US-1 score (r=0.352,r=0.424,r=0.59,all P<0.05).Conclusion Energy Doppler ultrasonography can be used to detect the KOA synovitis.Synovitis is not rare in KOA patients,and which is associated with disease activity.However,KOA and RA cannot be differentiated by energy Doppler ultrasonography.

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Article in Chinese | WPRIM | ID: wpr-755844

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Objective To evaluate the oncological safety of axillary reverse mapping in patients with breast cancer.Methods Patients with sentinel lymph node biopsy(SLNB) or axillary lymphnode dissection (ALND) between Oct 2015 and Feb 2016 were enrolled in this study prospectively.Axillary reverse mapping (ARM) procedure was done using a radioisotope before the surgery.All the ARM nodes were identified and sent separately for histologic analysis.Results 78 patients underwent 78 axillary operations.Of 53 patients with SLNB,33 (62.3%)had ARM nodes identified.22 (41.5%)had the crossover of the ARM nodes with the SLNs,and one (4.5%) had positive ARM node.Of 36 patients with ALND,33 (91.7%) had ARM nodes identified.9(25%)had positive ARM nodes.Positive ARM node status was significantly associated with advanced axillary disease(P =0.036).Conclusion Preserving ARM nodes in SLNB is oncologically safe to reduce upper extremity lymphedema.

19.
Article in Chinese | WPRIM | ID: wpr-751597

ABSTRACT

Objective To synthesize and characterize four acryl acetyl glucosamine (DA-NAG), and to determine its biocompatibility and cell membrane binding properties, so as to provide basis for its application in medical self agglutination gels. Methods DA-NAG was synthesized by esterification reaction. The products were characterized by mass spectrometry and hydrogen spectrum. Cytotoxicity test and subcutaneous implantation test were performed on the synthesized DA-NAG. The binding properties of DA-NAG to mouse fibroblast L929 cell membrane were detected using high performance liquid chromatography (HPLC). Results The characterization of mass spectrum and hydrogen spectrum are consistent with the characteristics of DA-NAG. The product has no cytotoxicity, and the subcutaneous implantation shows that the DA-NAG can be degraded at 4 weeks without obvious stimulation to the surrounding tissues. The result of HPLC shows the binding effect between the DA-NAG and cell membrane. Conclusions DA-NAG is successfully synthesized, and it has good cytocompatibility and binding ability to cell membrane.

20.
Article in Chinese | WPRIM | ID: wpr-743832

ABSTRACT

BACKGROUND: The injectable carboxymethyl glycosaminoglycan anti-adhesion gel prepared in the previous study combines the advantages of anti-adhesion membrane and anti-adhesion liquid. It can form soft gel in situ in a relatively short time, which is not affected by body position, bear the pressure of surrounding tissues and can be used without compression. OBJECTIVE: To evaluate the biocompatibility of medical injectable carboxymethyl glycosaminoglycan anti-adhesion gel. METHODS: Logarithmic growing L929 cells were used as test cells, and the cytotoxicity of injectable carboxymethyl glycosaminoglycan anti-adhesion gel extract was detected by MTT method. The intradermal stimulation test of injectable carboxymethyl glycosaminoglycan anti-adhesion gel extract was carried out in Japanese big ear rabbits. Guinea pigs were used as experimental animals to carry out intradermal induction and local induced delayed hypersensitivity test of injectable carboxymethyl glycosaminoglycan anti-adhesion gel extract. Wistar rats were used as experimental animals to carry out the subchronic toxicity test of injectable carboxymethyl glycosaminoglycan anti-adhesion gel extract. RESULTS AND CONCLUSION: The cytotoxicity of injectable carboxymethyl glycosaminoglycan anti-adhesion gel extract was grade 1, meeting the standard requirements. Injectable carboxymethyl glycosaminoglycan anti-adhesion gel extract had no potential intradermal stimulation and no potential skin sensitization. In the subchronic toxicity test, the rats were subjected to the tail vein injection of injectable carboxymethyl glycosaminoglycan anti-adhesion gel extract for 28 continuous days, and there was no obvious subchronic systemic toxicity in body mass, hematology, coagulation function, blood biochemistry and visceral pathology. These results indicate that the injectable carboxymethyl glycosaminoglycan anti-adhesion gel has good biosafety.

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