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1.
Article in Chinese | WPRIM | ID: wpr-928375

ABSTRACT

OBJECTIVE@#To assess the value of re-sampling for patients who had failed non-invasive prenatal testing (NIPT) due to low cell-free fetal DNA (cffDNA) fraction.@*METHODS@#Clinical data of 20 387 patients undergoing NIPT test was reviewed. The patients were re-sampled when initial blood test did not yield a result due to cffDNA fraction. The results were analyzed, and the outcome of pregnancy was followed up.@*RESULTS@#Among all samples, 17 (0.08%) had failed to yield a result due to low cffDNA fraction, all of which accepted re-sampling. A result was attained in 16 cases, with a success rate of 94.12%. Only one sample had failed the re-test.@*CONCLUSION@#For patients who had failed the initial NIPT due to low cffDNA fraction, re-sampling should be considered with gestational week and ultrasound results taken into consideration.


Subject(s)
Aneuploidy , Cell-Free Nucleic Acids/genetics , DNA/genetics , Female , Fetus , Humans , Pregnancy , Prenatal Diagnosis
2.
China Pharmacy ; (12): 1220-1224, 2022.
Article in Chinese | WPRIM | ID: wpr-924075

ABSTRACT

OBJECTIVE To establish a met hod for the determination of amentoflavone ,bilobetin,ginkgetin,isoginkgetin and sciadopitysin in Ginkgo biloba leaves tablets. METHODS After extracted with methanol ,ultra-performance liquid chromatography (UPLC)was adopted to determine G. biloba leaves tablets. The determination was performed on Waters Acquity UPLC HSS T 3 column with acetonitrile- 0.4% phosphoric acid as mobile phase (gradient elution )at the flow rate of 0.4 mL/min. The column temperature was set at 35 ℃,and the detection wavelength was 340 nm. The sample size were 1 μL(substance control )and 10 μL (test sample ). The relative correction factors (RCFs)of bilobetin ,ginkgetin,isoginkgetin and sciadopitysin were calculated by quantitative analysis of multicomponents by single marker (QAMS)using amentoflavone as control. The chromatographic peak was located with the relative retention time method. Then the contents of the above components were calculated ,and the results were compared with those of external standard method (ESM)(except for amentoflavone ). RESULTS The linear ranges of amentoflavone,bilobetin,ginkgetin,isoginkgetin and sciadopitysin were 0.10-8.21,0.24-19.34,0.16-12.98,0.22-17.66,0.06-4.86 ng,respectively(all r>0.999). The quantitation limits were 0.10,0.24,0.16,0.22,0.06 ng,respectively. RSDs of precision , repeatability and stability tests (36 h)were all lower than 3.00%. The average recoveries were 99.77%-102.85%,and RSDs were 1.90%-4.40%(n=6). The average RCFs of bilobetin ,ginkgetin,isoginkgetin and sciadopitysin were 0.91,0.93,0.96 and 0.95, respectively. The average relative retention times were 1.08,1.18,1.19 and 1.30,respectively. The relative deviation between the calculation result of QAMS and ESM was within ±3.00%. CONCLUSIONS The established method is accurate and stable ,and can be applied to the determination of Ginkgo biflavones in G. biloba leaves tablets and control the quality.

3.
Chinese Journal of Trauma ; (12): 373-378, 2021.
Article in Chinese | WPRIM | ID: wpr-909878

ABSTRACT

The thermal environment increases the risk of thermal injury for persons under high temperature environment. A full understanding of the effects and hazards of the thermal environment on the human body is of great significance to improve the awareness of persons under high temperature environment and reduce occupational heat damage during work. The authors mainly review the thermal environment from aspects of the definition, mechanism of its influence on main functional systems of the human body, influencing factors of heat stress and progress of protection, so as to provide references for the identification and protection of heat-induced diseases for workers under high temperature environment.

4.
Article in Chinese | WPRIM | ID: wpr-922024

ABSTRACT

OBJECTIVE@#To carry out genetic testing and prenatal diagnosis for a Chinese couple whom had conceived two fetuses featuring multiple malformations including polycystic kidney, polydactyly and encephalocele.@*METHODS@#Following elective abortion, the fetus from the second pregnancy was subjected to whole exome sequencing. Suspected pathogenic variants were verified by Sanger sequencing of the fetus and its parents.@*RESULTS@#The fetus was found to harbor compound heterozygous variants of the CEP290 gene, namely c.2743G>T (p.E915X) and c.2587-2A>T, which were respectively inherited from its father and mother. The same variants were not detected among 100 healthy controls nor reported previously. Bioinformatic analysis suggested both variants to be deleterious. The fetus was diagnosed with Meckel-Gruber syndrome. Prenatal diagnosis for the couple during their next pregnancy suggested that the fetus did not carry the above pathogenic variants.@*CONCLUSION@#The compound heterozygous variants of the CEP290 gene probably underlay the pathogenesis of Meckel-Gruber syndrome in the second fetus. Above finding has provided a basis for genetic counseling and prenatal diagnosis for the couple, and also enriched the mutational spectrum of the CEP290 gene.


Subject(s)
China , Ciliary Motility Disorders , Encephalocele/genetics , Female , Genetic Testing , Humans , Pedigree , Polycystic Kidney Diseases/genetics , Pregnancy , Prenatal Diagnosis , Retinitis Pigmentosa
5.
Article in Chinese | WPRIM | ID: wpr-921997

ABSTRACT

OBJECTIVE@#To analyze the clinical manifestations and gene variants of patients with blepharophimosis, ptosis and epicanthus inversus syndrome (BPES).@*METHODS@#Clinical data of 7 pedigrees affected with BPES were collected, and genomic DNA was extracted from peripheral blood samples of the probands and their relatives. All exons of the FOXL2 gene were subjected to Sanger sequencing. Those with negative findings were further screened by targeted capture and next generation sequencing (NGS) and microarray analysis. Pathogenicity of candidate variants were predicted by search of PubMed and related databases, and the impact of the variants was interpreted by protein prediction software. Diagnosis was confirmed by clinical phenotype, medical history and mutation analysis.@*RESULTS@#A pathogenic variant was identified in six of the 7 pedigrees, which included four known pathogenic variants and one novel FOXL2 c.299dupA variant. A heterozygous 3q22.3q23 deletion, which encompassed the FOXL2 gene, was identified in another pedigree.As predicted, the c.299dupA frameshift mutation of FOXL2 gene can lead to the premature termination of protein translation, which is pathogenic.@*CONCLUSION@#A novel and 5 known pathogenic variants have been identified in six pedigrees affected with BPES by the combined Sanger sequencing, target capture NGS and microarray analysis. Above findings have enabled genetic counseling and prenatal diagnosis for these pedigrees.


Subject(s)
Blepharophimosis/genetics , Forkhead Box Protein L2/genetics , Forkhead Transcription Factors/genetics , Humans , Mutation , Pedigree , Phenotype , Skin Abnormalities , Urogenital Abnormalities
6.
Article in Chinese | WPRIM | ID: wpr-921958

ABSTRACT

OBJECTIVE@#To identify the etiology of a patient with severe symptoms of DMD and to trace its pathogenic gene, so as to provide a basis for genetic counseling and clinical intervention.@*METHODS@#Multiple ligation-dependent probe amplification (MLPA) technique was used to analyze exon deletion/repetitive variant of DMD gene, and further analysis was performed by chromosome G-banding, fluorescence in situ hybridization (FISH) and SNP array analysis.@*RESULTS@#The MLPA results of the proband showed that the exon 1-79 of DMD gene were deleted, the G-banding karyotype of blood sample was 46, XY, and the deletion of the short arm of X chromosome was found by FISH. SNP array results showed that 5.8Mb (29 628 158-35 434 714) deletion occurred in the Xp21.2p21.1 region of X chromosome, and the patient was diagnosed as the contiguous deletion syndrome involving the genes of IL1RAPL, MAGEB1-4, ROB, CXorf2, GM, AP3K7IP, FTHL1, DMD, FAM47A, TMEM47, and FAM47B.@*CONCLUSION@#The exact pathogenic site of this family is the deletion of 5.8 Mb (29 628 158-35 434 714) in the Xp21.2p21.1 region of X chromosome, which can be used for prenatal diagnosis. High resolution SNP array technique plays an important role in detecting potential chromosome abnormalities in patients.


Subject(s)
Dystrophin/genetics , Exons , Female , Gene Deletion , Humans , In Situ Hybridization, Fluorescence , Muscular Dystrophy, Duchenne/genetics , Pregnancy , Prenatal Diagnosis
7.
Chinese Journal of Dermatology ; (12): 920-922, 2020.
Article in Chinese | WPRIM | ID: wpr-870384

ABSTRACT

A female patient aged 3 years and 1 month developed poikilodermatous patches on the right forearm at the age of 6 months, which spread to bilateral cheeks, buttocks and limbs at the age of 1 year and 4 months. Skin examination showed multiple brown and off-white poikilodermatous patches on the bilateral cheeks, buttocks and limbs, which were intermingled with normal skin and did not merge with each other. The trunk and oral mucosa were not involved. The fifth toenail of the right foot was thickened. Blood routine examination showed that the neutrophil count fluctuated between 1.70 × 10 9/L and 9.32 × 10 9/L. Histopathological examination of the brown patches on the left upper limb showed hyperpigmentation in the basal layer of the epidermis, and a few melanophages around the dermal vessels. Next-generation sequencing of peripheral blood genomic DNA revealed two compound heterozygous mutations c.798A>G in exon 7 and c.479delT in exon 3 of the USB1 gene in the child, which were inherited from her father and mother respectively. Neither of the two mutations was identified in 100 unrelated healthy controls. The patient was diagnosed with poikiloderma with neutropenia.

8.
Chinese Journal of Dermatology ; (12): 875-879, 2020.
Article in Chinese | WPRIM | ID: wpr-870375

ABSTRACT

Objective:To report a case of autosomal recessive dyskeratosis congenita, and to detect mutations in its causative genes.Methods:Peripheral blood samples were collected from the proband and her parents, genomic DNA was extracted, and 100 unrelated healthy individuals served as controls. The Illumina Nextseq500 sequencer was used to detect sequence variations in coding regions of exons of the skin disease-related genes in the proband′s family, and the causative mutation was verified by PCR-Sanger sequencing. The conservation and pathogenicity of gene mutation sites and corresponding protein structure changes were predicted by using bioinformatics softwares Clustalw2.0, PyMOL, PolyPhen-2, SIFT and FATHMM.Results:The proband clinically presented with reticular poikilodermatous patches on the neck and chest, punctate pigmentation on the axilla, atrophy of some toenails, rough skin and oral leukoplakia, accompanied by abnormality in some indicators of routine blood tests and liver function. Genetic testing showed that the proband carried compound heterozygous mutations c.2452G>A (p.Val818Met) and c.2594G>A (p.Arg865His) in the TERT gene, and the c.2452G>A mutation was not included in the Human Gene Mutation Database. The proband′s mother carried a heterozygous mutation c.2452G>A, and no mutation was identified in the TERT gene of her father or 100 healthy controls. Bioinformatics analysis showed that the amino acid positions 818 and 865 of TERT proteins in multiple species were highly conserved and completely conserved respectively, and the corresponding protein structures changed after the above gene mutations. Based on the clinical manifestations, genetic testing, auxiliary examinations, and bioinformatics analysis results, the patient was finally diagnosed with autosomal recessive dyskeratosis congenita.Conclusion:The compound heterozygous mutations c.2594G>A (p.Arg865His) and c.2452G>A (p.Val818Met) in the TERT gene may be responsible for the clinical phenotype of the proband.

9.
Article in Chinese | WPRIM | ID: wpr-869174

ABSTRACT

Objective:To investigate the predictive value of stimulated thyroglobulin (sTg) before the first 131I therapy for children and adolescents with differentiated thyroid carcinoma(DTC). Methods:Between January 2009 and December 2018, a total of 166 children and adolescents DTC patients (28 males, 138 females; age (16.5±3.0) years) from West China Hospital of Sichuan University were retrospectively analyzed. All patients underwent total thyroidectomy and 131I therapy. According to the treatment response evaluated 6-12 months after 131I therapy, patients were divided into excellent response (ER) group and incomplete response (non-ER) group. Clinical and pathological characteristics of 2 groups were compared using independent-sample t test, Mann-Whitney U test, χ2 test or Fisher′s exact test. The independent predictors for 131I treatment response were analyzed by logistic regression analysis. The cut-off value of sTg for predicting ER was determined by receiver operating characteristic (ROC) curve analysis. Results:Sixty-one patients achieved ER, while treatment response in 105 patients was non-ER. The level of sTg in non-ER group was significantly higher than that in ER group (52.5(11.8, 259.1) and 3.0(1.5, 9.7) μg/L; z=6.508, P<0.001). In addition, age, risk stratification, N stage, M stage, ratio of invaded lymph nodes and activities of 131I administered were also significantly different between those 2 groups ( t=2.611, 3.000, z=2.678, χ2=11.432, 16.299; all P<0.05). The level of sTg (odds ratio ( OR)=1.156, P=0.002) and administered activity of 131I ( OR=0.958, P=0.048) were independent predictors for the responses. ROC curve analysis showed that the best cut-off value of sTg for predicting ER was 16.1 μg/L with the sensitivity of 72.4%(76/105) and the specificity of 96.7%(59/61). Conclusions:sTg has the capability of predicting the response to the first 131I therapy in children and adolescents with DTC. When sTg is lower than 16.1 μg/L, the probability of ER increases.

10.
Article in Chinese | WPRIM | ID: wpr-865311

ABSTRACT

Objective:To compare the difference of the ocular surface and efficacy of orthokeratology lenses wearing after using sodium hyaluronate eye drops, rewetting drops and saline solution.Methods:A randomized single-blind controlled trial was conducted.A total of 90 right eyes from 90 myopic patients were recruited from June 2017 to April 2018 in Hainan Eye Hospital.All the subjects received vision correction by orthokeratology lens, and were randomly divided into three groups by random number table method, with 30 eyes in each group.The sodium hyaluronate group was given preservative-free sodium hyaluronate eye drops (1 g/L), the rewetting drops group was given rewetting drops, and the saline solution group was given nonpreserved 0.9% NaCl.The vision, subjective refraction, corneal topography, non-invasive first tear film break-up time(NIKf-BUT) and fluorescein stain of corneal epithelium (FL) were detected before and 1 day, 1 week, 1 month, 3 months after the lens wearing.This study adhered to the Declaration of Helsinki and was approved by the institutional Ethical Committee Review Board of Hainan Eye Hospital.Results:The NIKf-BUT in the sodium hyaluronate group at 1 day, 1 week, 1 month and 3 months after wearing orthokeratology lens was (7.13±1.71), (6.61±1.49), (6.37±1.82) and (7.01±1.63) seconds, respectively, which was obviously higher than (6.32±1.71), (5.53±1.42), (5.57±1.50) and (6.17±1.63) seconds in the rewetting drops group at the corresponding time points and (6.36±1.58), (5.81±1.49), (5.74±1.77) and (6.28±1.53) seconds in the saline solution group at the corresponding time points (all at P<0.05). There was no statistically significant difference in FL score between the rewetting drops group and saline solution group at 1 day, 1 week, 1 month and 3 months after wearing the orthokeratology lens (all at P>0.05). Lower FL scores were observed in the sodium hyaluronate group compared to the the rewetting drops group and saline solution group after wearing the orthokeratology lens (all at P<0.05). No differences were found in uncorrected visual acuity, spherical equivalent and average K value among the groups (all at P>0.05). Conclusions:Compared with the rewetting drops and saline solution, the preservative-free sodium hyaluronate eye drops can stabilize the tear film and have less effect on corneal epithelium at the early stage of orthokeratology lens wearing.However, there is no significant difference in the improvement of visual acuity and the rate of corneal shaping.

11.
Article in Chinese | WPRIM | ID: wpr-781301

ABSTRACT

OBJECTIVE@#To explore the genetic basis of an infant featuring congenital cataract, developmental delay and proteinuria.@*METHODS@#Clinical data and peripheral blood samples of the family were collected. Potential variants were screened by using targeted capture and high-throughput sequencing on a NextSeq 500 platform. Suspected variant was verified by quantitative PCR. Pathogenicity of the candidate variant was predicted based on clinical presentation and laboratory tests.@*RESULTS@#The infant's phenotypes included brain development retardation and proteinuria. Cranial MRI indicated widening of cerebral fissure, bilateral frontal and temporal subarachnoid cavities, and dysplasia of white matter myelination in posterior angular of ventricle. A novel duplication of exons 5 to 16 of the OCRL gene was found in the patient. His mother has carried the same duplication variant.@*CONCLUSION@#The duplication variant of the OCRL gene probably underlies the oculo-cerebro-renal syndrome in the infant. Due to the heterogeneity of its clinical manifestation, pertinent genetic detection is essential for acurrate diagnosis of patients who have the related phenotypes.


Subject(s)
Exons , Genetics , Genetic Testing , Humans , Infant , Oculocerebrorenal Syndrome , Genetics , Phenotype , Phosphoric Monoester Hydrolases , Genetics
12.
Chinese Journal of Oncology ; (12): 133-138, 2020.
Article in Chinese | WPRIM | ID: wpr-799554

ABSTRACT

Objective@#To evaluate the long-term effect and safety of chrono-chemotherapy combined with intensity modulated radiotherapy (IMRT) in locally advanced nasopharyngeal carcinoma (NPC).@*Methods@#160 patients with locally advanced NPC were randomly divided into a chrono group and conventional group according to random number table. In the first stage, all patients underwent two cycles of induced chemotherapy, consisting of docetaxel, cisplatin and 5-Fu every 21 days. Notably, patients received chrono-moduated chemotherapy according to circadian rhythm in the chrono group, and conventional chemotherapy in the conventional group. Then, 21 days after the completion of first stage, three cycles of concurrent cisplatin chemotherapy every 21 days were given to all patients during IMRT. The median follow-up after the completion of radiotherapy was 31 months. Long-term side effects and the survival of patients were observed.@*Results@#Patients in the chrono group had significantly lower rates of hearing loss (22.72%), dysphagia (0) and neck fibrosis (4.54%) compared with those in the conventional group (39.13%、8.69%, 15.94%, respectively, all P<0.05). Meanwhile, the 1- year overall survival rates (97.0% vs 92.8%), 3-year overall survival rates (80.3% vs 81.2%), 1-year progression free survival rates (95.5% vs 87.0%), 3-year progression free survival rates (71.2% vs 73.9%), 1-year locoregional relapse-free survival rates (97.0% vs 95.7%), 1-year locoregional relapse-free survival rates (92.4% vs 92.8%), 1-year distant metastasis-free survival rates (97.0% vs 98.6%) and 3-year distant metastasis-free survival rates (90.9% vs 91.3%) between the chrono group and the conventional group were not statistically significant (all P>0.05).@*Conclusions@#Compared with conventional chemotherapy, chrono-chemotherapy combined with IMRT didn′t affect long-term survival, but reducing the incidence of adverse events in patients with locally advanced NPC.

13.
Article in Chinese | WPRIM | ID: wpr-798650

ABSTRACT

Objective@#To explore the genetic basis of an infant featuring congenital cataract, developmental delay and proteinuria.@*Methods@#Clinical data and peripheral blood samples of the family were collected. Potential variants were screened by using targeted capture and high-throughput sequencing on a NextSeq 500 platform. Suspected variant was verified by quantitative PCR. Pathogenicity of the candidate variant was predicted based on clinical presentation and laboratory tests.@*Results@#The infant’s phenotypes included brain development retardation and proteinuria. Cranial MRI indicated widening of cerebral fissure, bilateral frontal and temporal subarachnoid cavities, and dysplasia of white matter myelination in posterior angular of ventricle. A novel duplication of exons 5 to 16 of the OCRL gene was found in the patient. His mother has carried the same duplication variant.@*Conclusion@#The duplication variant of the OCRL gene probably underlies the oculo-cerebro-renal syndrome in the infant. Due to the heterogeneity of its clinical manifestation, pertinent genetic detection is essential for acurrate diagnosis of patients who have the related phenotypes.

14.
Article in Chinese | WPRIM | ID: wpr-826500

ABSTRACT

OBJECTIVE@#To determine the spectrum of pathological genetic variants among 405 Chinese pedigrees affected with oculocutaneous albinism (OCA).@*METHODS@#A total of 405 OCA patients were collected. High-throughput sequencing (The panel included TYR, OCA2, TYRP1 and SLC45A2 genes), Sanger sequencing and multiplex ligation-dependent probe amplification (MLPA) were used to analyze the genetic variants and patterns of each subtype.@*RESULTS@#The overall detection rate of genetic variants was 79.9% (647/810), and the variants included missense variants (57.3%, 371/647), frameshift variants (22.9%, 148/647), nonsense variants (13.9%, 90/647), splicing variants (5.6%, 36/647), and microdeletions (0.3%, 2/647). Thirty-six novel variants were detected. Of the 405 patients, 306 have carried 2 variant alleles (75.6%, 306/405), 35 carried 1 variant alleles (8.6%, 35/405), while no variant was detected in 64 patients. Among the 306 genetically diagnosed OCA patients, OCA1 was the most common form (74.5%, 228/306), compared with OCA2 (15.0%, 46/306), OCA3 (0.7%, 2/306) and OCA4 (9.8%, 30/306), respectively. One patient was found to harbor homozygous c.1262-4_c.1262-3insTAGA variant of the TYRP1 gene. Another patient was found to carry compound heterozygous variants of c.1214C>A (p.T405N) and c.1338delinsCG(p.V447Gfs*19) of the TYRP1 gene.@*CONCLUSION@#High-throughput sequencing in combination with Sanger sequencing and MLPA can effectively detect genetic variants associated with OCA. Above finding has expanded variant spectrum of OCA, which can facilitate genetic and prenatal diagnosis of this disease in China.

15.
Journal of Leukemia & Lymphoma ; (12): 419-422, 2020.
Article in Chinese | WPRIM | ID: wpr-862856

ABSTRACT

Objective:To observe the efficacy of the serial treatment with autologous hematopoietic stem cell transplantation after bortezomib and dexamethasone-based triple chemotherapy regimen and followed by lenalidomide and intermittent intensive therapy in primary plasma cell leukemia.Methods:A retrospective analysis was made on the clinical data of one patient who was diagnosed as primary plasma cell leukemia with complex karyotype in April 2018 in Henan Cancer Hospital, and the relevant literature was reviewed.Results:The patient received multiple cycles of bortezomib and dexamethasone-based triple chemotherapy regimen, then received autologous hematopoietic stem cell transplantation, lenalidomide and intermittent intensive therapy. The patient eventually achieved complete remission and the progression-free survival time was 18 months until the day before the deadline for this article.Conclusion:The treatment with autologous hematopoietic stem cell transplantation after bortezomib and dexamethasone-based triple chemotherapy regimen and followed by lenalidomide and intermittent intensive therapy may improve the prognosis of patients with primary plasma cell leukemia and prolong the survival time.

16.
Chinese Journal of Pathology ; (12): 846-850, 2019.
Article in Chinese | WPRIM | ID: wpr-801207

ABSTRACT

Objective@#To investigate the clinicopathological characteristics and prognosis of renal cell carcinoma (RCC) in patients with end-stage renal disease (ESRD).@*Methods@#The clinicopathological data of patients of renal cell carcinoma arising in end-stage renal disease were collected from the Affiliated Hospital of Qingdao University (ten cases) and 971 Hospital of PLA Navy (five cases) from January 2009 to August 2018.@*Results@#Among 15 patients, 14 were male and 1 was female, and the age ranged from 38 to 78 years (mean 51 years, median 49 years). All patients had history of chronic renal failure (7-192 months), including 9 patients treated with hemodialysis for 6 to 132 months. In 12 cases the tumor border was distinct and the tumor size ranged from 1.8 to 11.0 cm. Two cases were multifocal and one case showed extensive renal hemorrhage with an inconspicuous tumor mass. Microscopically, 9 cases were clear cell reanl cell carcinoma including one with sarcomatoid differentiation, 4 were acquired cystic kidney disease-associated(ACKD-RCC) and two were papillary renal cell carcinoma. All patients had a follow-up of 3 to 120 months. Four patients died during a follow-up of 6 to 60 months (mean 30 months) as a result of extensive distant metastases (two cases) and renal failure (two cases), while other eleven patients were alive without tumor recurrence or metastasis (median 40.8 months of follow-up ranging from 3 to 120 months).@*Conclusions@#ESRD-RCC is more often seen in younger male patients. The time intervals from the onset of chronic renal failure to the diagnosis of renal cell carcinoma differ and tumors are frequently incidental findings. The histological types can be sporadic renal cell carcinoma or unique ACKD-RCC. Tumors are often hemorrhagic and necrotic. Routine physical examination and early detection could benefit ESRD-RCC patients. ESRD-RCC may have a favorable prognosis despite of a large tumor size or the presence of sarcomatoid differentiation.

17.
Article in Chinese | WPRIM | ID: wpr-754537

ABSTRACT

Objective To observe the effect of low-dose dabigatran etexilate on the clinical efficacy of elderly patients with venous thromboembolism (VTE). Methods Seventy-five elderly (≥ 80 years old) VTE patients admitted to Cangzhou Central Hospital from October 2016 to June 2018 were enrolled, they were treated according to the VTE guidelines, and low dose dabigatran etexilate was the anticoagulant therapy selected, 110 mg once daily for 6 months. After treatment for 6 months, the thrombus regression situation with color Doppler ultrasonography;clinical efficacy was evaluated by clinical symptoms and ultrasonographic results, the changes in platelet count (PLT), coagulation parameters [international normalized ratio (INR), activated partial thromboplastin time (APTT), fibrinogen (Fib)] before and after treatment were detected and the occurrence of adverse reactions were recorded and safety of drug was evaluated. Results There were no significant differences in PLT, INR and Fib before and after treatment [PLT (×109/L): 197.88±58.00 vs. 199.88±65.15, INR: 1.02±0.10 vs. 1.05±0.13, Fib (g/L): 2.89±0.67 vs. 2.84±0.70, all P > 0.05], the APTT after treatment was significantly prolonged compared with that before treatment (seconds:40.9±7.34 vs. 26.2±3.16), the difference being statistically significant (P < 0.05), the amount of APTT prolongation after treatment did not exceed 2 times [average (1.75±0.24) times] of the baseline value before treatment. The total effective rate of low-dose dabigatran etexilate for treatment of elderly patients with VTE for 6 months was 90.7% (68/75);no obvious adverse reactions occurred during the treatment. Conclusion Low-dose dabigatran etexilate for treatment of elderly patients with VTE is safe and effective without any obvious adverse reactions, and is worthy to be promoted for clinical use.

18.
Article in Chinese | WPRIM | ID: wpr-754528

ABSTRACT

Objective To investigate the clinical efficacy and mechanism of rosuvastatin combined with telmisartan in the treatment of persistent atrial fibrillation. Methods One hundred and twenty patients with persistent atrial fibrillation admitted to Cangzhou Central Hospital from February 2015 to February 2018 were enrolled and they were divided into study group and control group by random envelope method, with 60 patients in each group. The patients in study group were treated with rosuvastatin combined with telmisartan; and in control group they were treated with telmisartan, and after treatment for 6 weeks the clinical efficacy was observed. Resting heart rates were observed in two groups. The left atrial inner diameter, left atrium left and right diameter, left atrial sphericity index and left ventricular end diastolic volume, left ventricular end systolic volume, left ventricular posterior wall thickness of two groups were detected by ultrasond before and after treatment; the levels of serum tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) were tested by enzyme linked immunosorbent assay (ELISA) in two groups before and after treatment; and the level of serum hypersensitive C-reactive protein (hs-CRP) was detected by immunoturbidimetry;the level of plasma N-terminal pro-brain natriuretic peptide (NT-proBNP) was tested by immunoluminometric assay. Results Resting heart rate was significantly decreased in study group after treatment compared with that before treatment (bpm: 76.37±7.25 vs. 89.76±8.79, P < 0.05), while in control group, the comparison of resting heart rate before and after treatment was of no statistical significant differences (bpm: 90.71±8.56 vs. 87.80±6.26, P > 0.05), resulting that the post-treatment resting heart rate of study group was significantly lower than that of control group (bpm:76.37±7.25 vs. 87.80±6.26, P < 0.05). After treatment, the left atrial inner diameter, left atrium left and right diameter, left atrial sphericity index and left ventricular end diastolic volume were increased compared with those before treatment in both groups; after treatment, above various index levels in study group were lower than those of control group [left atrial inner diameter (mm): 40.68±3.86 vs. 41.99±3.97, left atrium left and right diameter (mm): 41.07±2.85 vs. 42.69±2.90, left atrial sphericity index: 0.77±0.08 vs. 0.86±0.07, left ventricular end diastolic volume (mL): 107.48±32.90 vs. 118.98±35.75, all P < 0.05]. There were no statistical significant differences between the two groups in left ventricular end systolic volume and posterior wall thickness of left ventricle after treatment [study group: left ventricular end systolic volume (mL) was 38.59±12.37 vs. 39.81±12.03, posterior wall thickness of left ventricle (mm) was 11.34±2.39 vs. 12.80±3.27, control group: left ventricular end systolic volume (mL) was 39.90±11.54 vs. 40.65±11.50, posterior wall thickness of left ventricle (mm) was 11.90±2.57 vs. 12.99±3.16, all P > 0.05]. Besides, the serum levels of TNF-α, IL-6 and hs-CRP were obviously decreased in two groups after treatment (all P < 0.05), after treatment, above indexes in study group were significantly lower than those in control group [TNF-α (ng/L): 29.76±5.31 vs. 36.63±5.11, IL-6 (ng/L): 14.37±3.36 vs. 22.65±4.58, hs-CRP (mg/L): 13.68±2.75 vs. 20.63±2.69, all P < 0.05]. Plasma NT-proBNP was increased in control group after treatment compared with that before treatment (μg/L: 431.80±42.54 vs. 365.89±39.81, P < 0.05), whereas there was no significant difference in the study group between pre- and post-treatment (μg/L: 351.80±38.76 vs. 346.89±35.82, P > 0.05), resulting in post-treatment plasma NT-proBNP significantly lower in study group (P < 0.05). Conclusions Rosuvastatin combined with telmisartan can prevent left atrial remodeling in patients with persistent atrial fibrillation and delay the dysfunction of left ventricular pump. The therapeutic mechanism was related to the decrease in the levels of serum inflammatory factors in patients treated with such therapy.

19.
Article in Chinese | WPRIM | ID: wpr-754500

ABSTRACT

Objective To observe the effects of recombinant human B-type natriuretic peptide (rhBNP) on cardiac function and heart rate variability (HRV) in patients with heart failure after acute myocardial infarction (AMI). Methods One hundred and twenty patients with heart failure after AMI admitted to the Department of Cardiology of Cangzhou Central Hospital of Hebei Province from January 2015 to January 2018 were enrolled. The patients were divided into a conventional treatment group and an rhBNP treatment group according to random number table method, with 60 cases in each group. The two groups were treated according to the AMI guidelines, the conventional treatment group received west medicine anti-myocardial ischemia and anti-heart failure treatment; the rhBNP treatment group received rhBNP on the basis of routine treatment; the first load dose was 2 μg/kg intravenous injection impact treatment, followed by maintaining dose 8.5 ng·kg-1·min-1 intravenous drip for 7 days. The changes of hypersensitivity C-reactive protein (hs-CRP), N-terminal B-type natriuretic peptide precursor (NT-proBNP), left ventricular ejection fraction (LVEF) and HRV index were observed before and after treatment in the two groups [HRV indexes including the changes of average normal RR interval standard deviation (SDNN), the average value of the normal RR interval standard deviation (SDANN), the root mean square (RMSSD) of the adjacent RR interval difference, and the percentage of adjacent RR interval difference > 50 ms (PNN50)]; the incidences of adverse reactions in the two groups were observed. Results After treatment, the levels of hs-CRP and NT-proBNP in the two groups were significantly lower than those before treatment (all P < 0.05). LVEF, SDNN, SDANN, RMSSD and PNN50 were higher than those before treatment, and the changes of the above indicators in the rhBNP treatment group were more significant than those in the conventional treatment group [hs-CRP (mg/L): 6.2±3.3 vs. 11.8±5.5, NT-proBNP (ng/L): 2.5±2.0 vs. 6.4±4.3, LVEF: 0.49±0.02 vs. 0.44±0.04, SDNN (ms): 93.3±18.1 vs. 79.1±16.0, SDANN (ms): 87.3±17.8 vs. 70.9±14.9, RMSSD: 30.3±11.0 vs. 23.8±10.4, PNN50: (15.9±7.3)% vs. (9.6±5.5)%, all P < 0.05]; No significant adverse reactions occurred during the treatment of the two groups. Conclusion rhBNP can significantly improve the heart function of patients with heart failure after AMI, reduce the levels of inflammatory response indicators and improve HRV;since its clinical efficacy is good, and its application safe, it is worthy to promote its clinical use.

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Article in Chinese | WPRIM | ID: wpr-742742

ABSTRACT

Objective:To explore the change in the cerebral natriuretic peptide (BNP) levels in the premature infants with hemodynamically significant patent dectus arteriosus (hsPDA) and its relationship with hemodynamics, and to further clarify the clinical significance of BNP in the judgement of illness condition and treatment in the premature infants with hsPDA.Methods:A total of 106cases of premature infants within 6hof birth whose gestational age was no more than 32weeks were selected and divided into hsPDA group (43cases) and PDA with no hemodynamic significance group (nhsPDA group, 27cases) and no PDA group (nPDA group, 36cases) .The patients in HsPDA group were divided into hsPDA treatment group (33cases) and hsPDA non-treatment group (10cases) according to whether ibuprofen was administrated or not.Echocardiography was performed in the patients in hsPDA treatment group, 7dafter oral ibuprofen administration, and the patients in hsPDA treatment group were divided into hsPDA close group (15cases) and hsPDA non-close group (18cases) .The left atrium (LA) /aortic root diameter (VO) value, diameter of patent arterial duct, left ventricular ejection fraction (LVEF) , shortening fraction, left ventricular end-diastolic diameter (LVEDD) and left ventricular end-systolic diameter (LVESD) were recorded at 1, 3, 7dafter birth of the premature infants in various groups with echocardiography.The level of BNP in plasma was determined by electrochemiluminescence.The correlation analysis was performed between the hemodynamic indexes of echocardiography and the level of BNP in plasma.Results:Compared with nhsPDA group, the LA/VO value, arterial catheter diameter and LVEDD were significantly increased (P<0.05) .The plasma BNP levels of premature infants in hsPDA close and non-close groups at 1and 3dafter birth were significantly higher than those in nPDA group (P<0.05) ;the plasma BNP level of the premature infants in hsPDA close group at 7dafter birth was significantly lower than that at 3dafter birth (P<0.05) .Compared with hsPDA non-treatment group, the LA/VO value, arterial catheter diameter, LEVDD and the plasma BNP level of the premature infants in hsPDA treatment group at 7dafter birth were significantly decreased (P<0.05) .The plasma BNP level was positively correlated with the LA/VO value and arterial catheter diameter (r=0.727, P<0.05;r=0.780, P<0.05) of the premature infants in hsPDA group at 3dafter birth.Conclusion:The level of plasma BNP of premature infants 3 dafter birth is positively correlated with the hemodynamic indexes, and the detection of the changes of the plasma BNP levels is helpful to judge the condition of preterm infants with hsPDA and to provide basis for its diagnosis.

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