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1.
Chinese Journal of Geriatrics ; (12): 216-220, 2021.
Article in Chinese | WPRIM | ID: wpr-884871

ABSTRACT

Objective:To investigate the value of atropine administration before tracheal intubation under general anesthesia in the elderly patients undergoing endobronchial ultrasound-guided transbronchial needle aspiration(EBUS-TBNA)biopsy.Methods:This was a case-control study.A total of 87 elderly hospitalized patients receiving chest enhanced CT test suggesting the risk of lung cancer with enlargement of mediastinal lymph nodes in 7 regions were scheduled to undergo endobronchial ultrasound-guided transbronchial needle aspiration(EBUS-TBNA)biopsy under general anesthesia.The patients were randomly divided into two groups by flipping a coin: the atropine group(n=40)and the control group(n=47). The indicators for evaluating the application values of atropine included preoperative, intra-operative and postoperative systolic blood pressure(SBP), diastolic blood pressure(DBP), heart rate, oropharyngeal and airway secretion volume, oxygen saturation, operation time, positive diagnosis rate and postoperative adverse reactions.Results:SBP and DBP were lower in the atropine group than in the control group before endotracheal intubation(131.7±15.3 mmHg vs.140.7±13.7 mmHg, 79.1±7.6 mmHg vs.85.6±7.4 mmHg, t=2.885 and 4.061, P<0.05). There was no significant difference in SBP and DBP 10 min after endoscopic operation and 10 min after tracheal extubation between the atropine group versus the control group(SBP: 109.1±11.2 mmHg vs.105.0±12.2 mmHg, 136.9±23.0 mmHg vs.129.9±11.2 mmHg, DBP: 66.9±7.5 mmHg vs.68.0±8.3 mmHg, 77.6±10.9 mmHg vs.78.5±6.4 mmHg, t=-1.617, 0.687, -1.751 and 0.448, P>0.05). There was no significant difference in HR between the two groups before endotracheal intubation( t=1.416, P>0.05), while HR was higher in the atropine group than in the control group 10 min after endoscopic operation and 10 min after tracheal extubation( t=-3.323 and -2.181, P<0.01 and P<0.05). The change rates of SBP and DBP were lower in the atropine group than in the control group 10 min after endoscopic operation and 10 min after tracheal extubation( t=7.947, -6.962, -3.187 and -3.232, P<0.01). The change rate of HR was lower in the atropine group 10 min after endoscopic operation and was higher 10 min after tracheal extubation than in the control group( t=-6.467 and -4.131, P<0.01). There were significant differences in the volume of oropharyngeal and airway secretions and fingertip oxygen saturation between the two groups before endotracheal intubation and 10 min after tracheal extubation( t=-2.334, 2.759, -3.314 and -2.767, P<0.01). The endoscopic operation time was less in the atropine group than in the control group with no statistically significant difference[(25.9±5.7)min vs.(26.4±4.7)min, t=0.391, P>0.05]. There was no significant difference in postoperative adverse reactions between the atropine group versus the control group(34 patients or 85.0% vs.43 patients or 91.5%, χ2=1.247, P>0.05). Conclusions:The application of atropine before tracheal intubation under general anesthesia is beneficial to stabilizing the intraoperative blood pressure and heart rate, and can reduce the production of postoperative oropharyngeal and airway secretions in elderly patients undergoing endobronchial ultrasound-guided transbronchial needle aspiration biopsy.

2.
Article in Chinese | WPRIM | ID: wpr-884317

ABSTRACT

Objective:To explore the application of speckle tracking imaging (STI) stratification strain technique in the assessment of circumferential myocardial function and the myocardial protection of ATP-postconditioning (ATP-PostC) in a rabbit model of acute myocardial infarction.Methods:A total of 40 rabbits were randomly divided into 2 groups: pure ischemia reperfusion group (IR group)and ATP-PostC group. STI images were recorded before and 45 min after occlusion of coronary artery, post low-dose dobutamine stress echocardiography, 60 and 120 min after reperfusion, respectively. The following parameters were obtained: left ventricular ejection fraction(LVEF), heart rate (HR), endocardial circumferential systolic strain (CSsys-endo), mid-myocardial circumferential systolic strain (CSsys-mid) and epicardial circumferential systolic strain (CSsys-epi) at left ventricular short-axis level. At different time points after occlusion and reperfusion, 5 experimental rabbits were killed in each group for pathological examination.Results:①Forty-five min after coronary artery occlusion in both groups, the values of LVEF and HR were decreased( P<0.05), and the absolute values of CSsys-endo, CSsys-mid and CSsys-epi were significantly reduced( P<0.01). After LDDSE, the absolute values of CSsys-endo, CSsys-mid and CSsys-epi were increased, which were different from those after blockade( P<0.05). ②After reperfusion, the circumferential strains were not significantly different from those after blockade in IR group ( P>0.05). After blockade, the absolute values of circumferential strains were increased significantly in the ATP-PostC group compared with IR group( P<0.05). In the ATP-PostC group, the absolute values of CSsys-endo at different time points after reperfusion increased significantly compared with that after blockade ( P<0.05). The absolute values of CSsys-endo and CSsys-mid 120 min after reperfusion continued to increase significantly compared with those 60 min after reperfusion( P<0.05). ③Pathological examination: After 60 min of blockade, there was no significant difference in myocardial infarction area between the IR group and the ATP-PostC group( P>0.05). The percentage of infarct areas at each time point of reperfusion in the ATP-PostC group was decreased compared with that after blockade( P<0.05). Compared with the IR group, the percentage of infarct area in the ATP-PostC group was smaller after 120 minutes of reperfusion and the difference was statistically significant ( P<0.05). Conclusions:The applications of STI stratification strain technique and LDDSE can assess left ventricular circumferential strains at each of myocardial layers before and after reperfusion in rabbit myocardial ischemia ATP-PostC model, identify and evaluate the function of viable myocardium, and exhibit the significant protective effects of ATP-PostC on myocardial reperfusion injury.

3.
Article in Chinese | WPRIM | ID: wpr-882661

ABSTRACT

Objective:To investigate the effects of recombinant adenovirus with human vascular endothelial growth factor 165 (Ad-hVEGF 165) and recombinant adenovirus with human tissue inhibitor of metalloproteinase 1 (Ad-hTIMP-1) on rats with myocardial infarction (MI) and its mechanism. Methods:A total of 30 healthy 8-week-old male Wistar rats were randomly divided into 5 groups: sham-operated group (sham), virus control group (Ad-Track), Ad-hVEGF 165 group, Ad-hTIMP-1 group and Ad-hVEGF 165+Ad-hTIMP-1 group (hVEGF 165+hTIMP-1) ( n=6 per group). Except the sham group, all rats were ligated the left anterior descending coronary artery to induce MI model with ST-segment elevation and Q waves or T-wave inversion on electrocardiogram and local myocardial whitening. The corresponding recombinant adenovirus comprising 100 μL (1×10 10 VP/100 μL) combined with NaCl solution was injected into the myocardial infarction area at four points respectively. The sham group received no treatment. After 4 weeks, all rats were sacrificed after echocardiography was completed and heart tissues were collected. The expression of hVEGF 165 and hTIMP-1 were detected by immunohistochemistry. The mRNA expression of apoptosis-related factors were detected by real-time PCR. The protein expression of apoptosis-related factors were detected by immunohistochemistry. Differences between groups were determined by One-way analysis of variance. Multiple comparisons between groups were performed using the least significant difference t-test. Results:(1) Both heart rate (HR) (480.83±24.09) beats/min, left ventricular end-diastolic dimension (LVEDD) (6.88±0.44) mm and left ventricular end-systolic dimension (LVESD) (4.85±0.42) mm were increased in the Ad-Track group than those in the sham group (433.16±17.86) beats/min, (6.20±0.45) mm, (4.06±0.70) mm (all P<0.05), and left ventricular ejection fraction (LVEF) (62.70±3.17) % and left ventricular fractional shortening (LVFS) (29.52±1.88) % were significantly decreased in the Ad-Track group than those in the sham group (72.78±5.44)%, (29.52±1.88) % (both P<0.01). Compared with the Ad-Track group, LVEF (71.50±6.23) % and LVFS (36.17±5.27) % in the hVEGF 165-hTIMP-1 group were significantly increased (both P<0.01), and LVEDD (6.22±0.39) mm and LVESD (4.13±0.23) mm were decreased (both P<0.05). LVEF and LVFS in the hVEGF 165-hTIMP-1 group were increased significantly than those in the Ad-hVEGF 165 group (64.65±4.00) %, (30.95±2.57) % (both P<0.05). The mRNA expression of BCL2-associated X protein (Bax), cysteine aspartate specific proteinase 3 (Caspase-3) and BCL-xL/BCL-2-associated death promoter (Bad) in the hVEGF 165-hTIMP-1 group were decreased than those in the Ad-Track group ( P<0.01 or P<0.05), and B-cell lymphoma/leukemia-2 (Bcl-2) in the hVEGF 165-hTIMP-1 group were increased than those in the Ad-Track group ( P<0.01). The mRNA expression levels of Bax and Caspase-3 in the hVEGF 165-hTIMP-1 group were decreased than those in the Ad-hVEGF 165 group (both P<0.05). There was no statistically difference in the mRNA expression of Bax, Caspase-3, Bad, and Bcl-2 between the hVEGF 165-hTIMP-1 group and the sham group (all P>0.05). The protein expression of Bax and Caspase-3 in the hVEGF 165-hTIMP-1 group were significantly decreased than those in the Ad-hVEGF 165 group, the Ad-hTIMP-1 group and the Ad-Track group (all P<0.01), and the protein expression of Bcl-2 in the hVEGF 165-hTIMP-1 group was increased than those in the Ad-hVEGF 165 group, the Ad-hTIMP-1 group and the Ad-Track group (all P<0.05). There were no statistically differences in the protein expression of Bax, Caspase-3 and Bcl-2 between the hVEGF 165-hTIMP-1 group and the sham group (all P>0.05). Conclusions:Ad-hVEGF 165 and Ad-hTIMP-1 can improve cardiac contractile function of MI rats and the beneficial effects are largely attributable to inhibiting myocyte apoptosis. The combination of hVEGF 165 and hTIMP-1 may have a synergistic effect on MI.

4.
Article in Chinese | WPRIM | ID: wpr-799087

ABSTRACT

Objective@#To assess the clinical value of uterine curettage ultrasound in the evaluation of cesarean section scar pregnancy (CSP) after uterine arterial chemoembolization (UAE).@*Methods@#Retrospective analysis were performed in 42 patients who took uterine curettage within 24-48 hours after UAE treatment in the Second Affiliated Hospital of Harbin Medical University from January 2015 to June 2018. The ultrasonic manifestations were graded and classified before UAE. The intraoperative and postoperative complications, time of β-human chorionic gonadotrophin declined to normal limits were evaluated, and the formation of hematoma and hematoma absorption time were followed up by ultrasound.@*Results@#UAE was performed successfully in all patients. The ultrasound-guided scar pregnancy was successfully completed. The uterus was successfully retained in all patients.Among the 42 patients, 18 cases were 3 scores group, and 24 cases were 4 scores group according to the ultrasonic scoring system. Two cases were type Ⅰgroup, 25 cases were type Ⅱ group, and 15 cases were type Ⅲ group according to the ultrasonic classification. The amount of intraoperative complications, postoperative mass formation and absorption time were significantly different between 3 scores group and 4 scores group (P<0.05). No significant differences were found in intraoperative complications, postoperative complications, postoperative mass formation and β-human chorionic gonadotropin (β-hCG) value among different ultrasonic classification groups (P>0.05).@*Conclusions@#Ultrasonography has clinical application value in evaluating the prognosis of CSP treated with UAE. Ultrasonic scoring system can evaluate the efficacy and is helpful for predicting clinical outcome of CSP.

5.
Article in Chinese | WPRIM | ID: wpr-781459

ABSTRACT

OBJECTIVE@#to explore the value of capillary electrophoresis in screening β- thalassemia of children, and to establish the cutoff values of HbA2 and HbF in our laboratory.@*METHODS@#The data of hemoglobin capillary electrophoresis and genetic diagnosis of β- thalassemia from 886 examined children were retrospectively analyzed. The cutoff values of HbA2 and HbF were determined by ROC curve.@*RESULTS@#The cutoff value of HbA2 screening minor β- thalassemia was 3.65%, the specificity was 0.996, and the sensitivity was 0.995. The cut-off value of HbF for screening minor β- thalassemia was 1.45%, specificity was 0.751 and sensitivity was 0.675. Thus, 1 case with codon5 (CCT→C) mutation, 1 case with SEA -HPFH β deletion, 1 case with - 28 (A→G) merger IVS-Ι-128 (T→G) double heterozygous mutations yet were found out, 1 case with 47 bp β gene missing has not yet been reported in literature.@*CONCLUSION@#Capillary electrophoresis has more high sensitivity and specificity in the screening of β- thalassemia in children, especially for the detection of rare β- thalassemia.

6.
Article in Chinese | WPRIM | ID: wpr-872810

ABSTRACT

Platycodonis Radix, which was first recorded in the Agriculture God's Canon of Materia Medica. It is a multi-functional drug with a wide range of applications. The processing of Platycodonis Radix has been recorded as early as in the Jin dynasty, and has a long history of processing. Today, in addition to the washing, cutting and stir-frying with honey, there have also been more than 20 kinds of processing methods, such as stir-frying with wine, stir-frying with bran, stir-frying with Lilii Bulbus juice and so on. The ancients believed that Platycodonis Radix could enhance the effect of diffusing the lung, promoting pharynx and relieving cough by processing. In terms of the chemical compositions in Platycodonis Radix, more than 100 compositions, like triterpenoid saponins, flavonoids, phenols, sterols, polysaccharides and polyacetylenes, have been isolated and identified from it. Among them, triterpenoid saponins are the essential compositions. In addition, Platycodonis Radix has the pharmacological effects of expectorant, antitussive, anti-inflammatory, anti-tumor, etc. The medicinal ingredients of Platycodonis Radix are mainly triterpenoid saponins and polysaccharides. Among them, triterpenoid saponins have diverse biological activities, which lead it to be one of the hotspots of current researches. Platycodonis Radix has a good role in promoting lung and removing phlegm. After being processed, its medicinal effects are enhanced. It is complex and diverse in compositions of Platycodonis Radix so that has rich pharmacological activities. On the basis of sorting out the literature, this paper discusses the processing history, chemical composition and pharmacological effect of Platycodonis Radix, in order to provide reference for the special processing and modern research of Platycodonis Radix. Furtherly, it provides a theoretical basis for the research of its processing mechanism and quality control.

7.
Article in Chinese | WPRIM | ID: wpr-868031

ABSTRACT

Objective:To evaluate the myocardial reserve effect in rabbits′ model of myocardial inshemia-reperfusion by layer-specific strain of speckle tracking imaging and low dose dobutamine stress echocardiography(LDDSE).Methods:Forty rabbits were randomly divided into two groups: ischemia-reperfusion group (IR group) and pharmacological postconditioning group (ATP-PostC group). Echocardiography examinations were performed at baseline, 60 min after ligation (before and after dobutamine stress), and 120 min after reperfusion (before and after dobutamine stress). The size of each chamber was measured and the left ventricular ejection fraction(LVEF) was calculated and the heart rate was recorded. The longitudinal strain of endocardium(SLsys-endo), longitudinal strain of myocardium(SLsys-mid), longitudinal strain of epicardium(SLsys-epi) were acquired. Triphenyl tetrazolium chloride(TTC) and Evans blue staining were applied in two rabbits randomly selected from each group at 60 min after ligation, dobutamine stress and 120 min after reperfusion, respectively.Results:①After coronary artery ligation, LVEF decreased in both groups( P<0.05), SLsys-endo, SLsys-mid, and SLsys-epi decreased in two groups( P<0.01). After low dose dobutamine stress, the SLsys-endo, SLsys-mid and SLsys-epi in the two groups increased, which was different from that after lagation( P<0.05). ②After 120 min reperfusion, the longitudinal strain of the myocardium of both groups increased compared with that after lagation( P<0.01, P<0.05), and the increase in ATP-PostC group was significantly higher than that in IR group( P<0.01). There was no significant difference between the IR group and the first LDDSE( P<0.05). After LDDSE again, the SLsys-endo and SLsys-mid in the two groups further increased, which was different from that after reperfusion ( P<0.05). And the SLsys-endo and SLsys-mid were higher in ATP-PostC group than those in IR group ( P<0.05). ③Pathological results showed that there was no significant difference in myocardial infarct size between IR group and ATP-PostC group at 60 min after ligation ( P>0.05). After 120 min reperfusion, the percentage of myocardial infarct size in the IR group was significantly higher than that in the ATP-PostC group ( P<0.05). Conclusions:Layer-specific strain of STI combined with LDDSE can early detect regional myocardial dysfunction and accurately assess myocardial reserve function, and with endocardial longitudinal strain being more sensitive.

8.
Article in Chinese | WPRIM | ID: wpr-868023

ABSTRACT

Objective:To classify the ultrasound features of ovarian tumors by modified gynecology imaging reporting and data system(mGI-RADS), and explore the clinical value of mGI-RADS in differentiating of benign and malignant tumors.Methods:The 242 ultrasound images of the adnexal mass from 221 patients with ovarian tumor who underwent ultrasound scan and proceeded surgeries in the Second Affiliated Hospital of Harbin Medical University from September 2017 and December 2019 were involved in the retrospective analysis and compared with the pathological results. According to the latest ultrasound terminology for adnexal masses proposed by the International Ovarian Tumor Analysis (IOTA), the adnexal masses were classified. The suspeted malignant sings were screened for mGI-RADS. Using GI-RADS and mGI-RADS classification systems, all the adnexal masses were double-blindly classified by two senior doctors and their diagnostic efficiencies were evaluated.Results:Among the suspected malignant signs proposed by IOTA, resistance index (RI)<0.5, central blood flow signal, ascites, irregular cystic wall with uneven thickness separation, mass composition (solid component ≥30% and silent shadow attenuation), and papillary structure≥7 mm, showed retatively higher OR values(14.282, 10.372, 9.653, 8.832, 5.851, 4.506, respectively. Using GI-RADS and mGI-RADS classification systems, the diagnostic consistency by the two senior doctors in differentiating benign and malignant ovarian neoplasms was good(Kappa=0.767, P<0.05). Grade Ⅳ was divided into three subtypes (Ⅳa, Ⅳb, Ⅳc) by the mGI-RADS, and their positive predictive values for malignant ovarian masses were 69.0%, 90.4% and 92.9% respectively. When a cut-off value >mGRⅣ was used to distinguish the benign and malignant adnexal tumors, the AUC was the largest, and its sensitivity, specificity, positive predictive value, negative predictive value and accuracy were 93.4%, 93.1%, 90.4%, 95.2% and 93.2%, respectively. Conclusions:The mGI-RADS has a high clinical value in the differential diagnosis of ovarian tumors.

9.
Article in Chinese | WPRIM | ID: wpr-867975

ABSTRACT

Objective:To assess the clinical value of uterine curettage ultrasound in the evaluation of cesarean section scar pregnancy (CSP) after uterine arterial chemoembolization (UAE).Methods:Retrospective analysis were performed in 42 patients who took uterine curettage within 24-48 hours after UAE treatment in the Second Affiliated Hospital of Harbin Medical University from January 2015 to June 2018. The ultrasonic manifestations were graded and classified before UAE. The intraoperative and postoperative complications, time of β-human chorionic gonadotrophin declined to normal limits were evaluated, and the formation of hematoma and hematoma absorption time were followed up by ultrasound.Results:UAE was performed successfully in all patients. The ultrasound-guided scar pregnancy was successfully completed. The uterus was successfully retained in all patients.Among the 42 patients, 18 cases were 3 scores group, and 24 cases were 4 scores group according to the ultrasonic scoring system. Two cases were type Ⅰgroup, 25 cases were type Ⅱ group, and 15 cases were type Ⅲ group according to the ultrasonic classification. The amount of intraoperative complications, postoperative mass formation and absorption time were significantly different between 3 scores group and 4 scores group ( P<0.05). No significant differences were found in intraoperative complications, postoperative complications, postoperative mass formation and β-human chorionic gonadotropin (β-hCG) value among different ultrasonic classification groups ( P>0.05). Conclusions:Ultrasonography has clinical application value in evaluating the prognosis of CSP treated with UAE. Ultrasonic scoring system can evaluate the efficacy and is helpful for predicting clinical outcome of CSP.

10.
Article in Chinese | WPRIM | ID: wpr-804612

ABSTRACT

Objective@#To investigate the genotype and genetic characteristics of the pathogens associated with the epidemic outbreak of acute gastroenteritis(AGE) in Guangyuan city, Sichuan province.@*Methods@#Eighteen stool samples and 15 anal swab samples from 4 AGE outbreaks were collected from Feb 2017 to May 2017. Norovirus (NoV) nucleic acid was detected by Real-time PCR method , and the positive samples were amplified by conventional reverse transcription-polymerase chain reaction (RT-PCR) and nucleotide sequencing.@*Results@#Four AGE outbreaks were all caused by NoV. And 20 (60.6%) samples were positive for NoV GⅡ. Gene sequence comparison and phylogenetic analysis showed that 4 AGE outbreaks were all caused by GⅡ.P16/GⅡ.2 NoV. All the strains of GⅡ.P16/GⅡ.2 NoV shared high homology in nucleotides. One of the outbreaks was caused by GⅡ.P16/GⅡ.2 and GⅡ.P7/GⅡ.14 NoV co-infection.@*Conclusions@#The 4 outbreaks of AGE in Guangyuan city, Sichuan province were major caused by GⅡ.P16/GⅡ.2 NoV, meanwhile GⅡ.P16/GⅡ.2 and GⅡ.P7/GⅡ.14 NoV co-infection existed.

11.
Journal of Experimental Hematology ; (6): 1232-1235, 2019.
Article in Chinese | WPRIM | ID: wpr-775736

ABSTRACT

OBJECTIVE@#To analyze the genotype and hematological characteristics of children with αβ-thalassemia in Shenzhen area of China.@*METHODS@#The erythrocyte parameters and hemoglobin components of the children were determined by blood routine examination and capillary electrophoresis (CE). Reverse dot blot (RDB) -polymerase chain reaction (PCR) was used to determine gene mutations in α- and β-thalassemia children. The Gap-PCR was used to determine the gene deletion of α-thalassemia children,while specimens suspected HKαα were determined with nested PCR.@*RESULTS@#Total of 29 complex genotypes were detected from 74 cases of αβ-thalassemia, among which 1 case was determined as β-thalassemia with αααanti4.2/αα and 5 cases were double heterozygous β-thalassemia combining α-thalassemia with intermediate phenotype. 1 case of β-28/βcap+40-43 double heterozygotes combined with --/αα and the other 62 cases were characterized by light β-thalassemia, 2 cases ofβCAP+40-43/βN with --/αα showed light α-thalassemia.@*CONCLUSION@#The genotypes of αβ-thalassemia in Shenzhen area of China are complex and diverse. The common complex genotypes are similar to those of simple β-thalassemia. If the genotype and phenotype are not consistent, the existence of rare genotype should be considered.


Subject(s)
Child , China , Genotype , Humans , Phenotype , alpha-Thalassemia , beta-Thalassemia
12.
Article in Chinese | WPRIM | ID: wpr-775086

ABSTRACT

OBJECTIVE@#To investigate the serum level of soluble transferrin receptor (sTfR) and its association with the degree of anemia in children with hemoglobin H (HbH) disease.@*METHODS@#A total of 55 children with HbH disease were enrolled as the HbH group, and 30 healthy children were enrolled as the control group. The HbH group was further divided into a deletional HbH disease group and a non-deletional HbH disease group. A retrospective analysis was performed for hematological parameters and serum sTfR level in all groups.@*RESULTS@#Of the 55 children with HbH disease, 39 had deletional HbH disease and 16 had non-deletional HbH disease. Compared with the control group, the deletional and non-deletional HbH disease groups had significantly lower hemoglobin (Hb), mean corpuscular volume (MCV), and mean corpuscular hemoglobin (MCH) and a significantly higher serum level of sTfR. Compared with the deletional HbH disease group, the non-deletional HbH disease group had significantly lower red blood cell count (RBC) and Hb level and significantly higher MCV, MCH, and serum sTfR level. In children with HbH disease, serum sTfR level was negatively correlated with RBC and Hb level (r=-0.739 and -0.667 respectively, P<0.05) and positively correlated with MCV and MCH (r=0.750 and 0.434 respectively, P<0.05).@*CONCLUSIONS@#Serum sTfR level is associated the degree of anemia in children with HbH disease, and sTfR may be a target for the treatment of HbH disease.


Subject(s)
Child , Erythrocyte Count , Hemoglobin H , Humans , Receptors, Transferrin , Retrospective Studies , alpha-Thalassemia
13.
Chinese Journal of Pathology ; (12): 215-219, 2019.
Article in Chinese | WPRIM | ID: wpr-810512

ABSTRACT

Objective@#To investigate the clinicopathologic features and prognosis of ALK-positive Spitz tumors.@*Methods@#Thirteen patients with ALK-positive Spitz tumors diagnosed at Shanghai Cancer Center, Fudan University from October 2016 to December 2017 were collected. All cases were routinely evaluated histopathological features in HE staining and detected ALK protein expression by immunohistochemistry. The ALK fusions of 7 cases were confirmed by fluorescence in situ hybridization (FISH).Follow-up data was collected.@*Results@#The age of patients including 2 males and 11 females ranged from 4 to 47 years (mean 25 years). 12 patients were diagnosed with atypical Spitz tumors and 1 patient was diagnosed with Spitz nevus. Clinically, most lesions presented as papules or nodules, while a few lesions presented as plaques. Histologically, most tumors were exophytic (9/13). More than half of the tumors were amelanotic and the junctional component was mainly composed of melanocytic nests. Kamino bodies were not found. The bases of the tumors were mainly wedge-shaped (5/13) and flat (7/13). Eight tumors displayed mixed cell types, while 5 tumors were composed of only spindle cells. All the tumors showed a plexiform and/or intersecting fascicular growth pattern, and perineural extension was observed in 3 tumors. ALK immunohistochemistry showed diffuse and intense cytoplasmic staining in 13 cases, and 7 of them were detected by FISH to confirm the presence of ALK fusions. All patients were followed up for 7 to 21 months (median=12), with no recurrence or lymph node dissemination.@*Conclusions@#Spitz tumors with ALK fusions have their special histopathologic features.ALK fusions mainly occur in Spitz nevi and atypical Spitz tumors. The follow-up data of the existing literatures and our research indicates that the prognosis of ALK-positive Spitz tumors may be good.

14.
Article in Chinese | WPRIM | ID: wpr-743361

ABSTRACT

Purpose To describe the clinicopathologic features, diagnosis and differential diagnosis, and prognosis of secretory breast carcinoma (SBC). Methods Clinicopathological and follow-up data of six SBC patients were collected. Histopathologic analysis was performed on hematoxylin and eosinstained (HE) section. Immunohistochemical staining was performed by En Vision two-step method and ETV6 gene detected by fluorescence in situ hybridization (FISH), then relevant literatures were reviewed. Results The ages of the patients ranged from 6 to 76 years with a mean age of 38.7 years, including one male and five female patients. The right breast was involved in 4 cases, and the left, in 2 cases. Five cases showed painless breast mass while one presented with a nipple discharge. The tumor size ranged from 1.0 to 3.1 cm with a mean size of 2.0 cm. Most of the tumors were circumscribed, solid gray white to light brown. Histologically, tumor showed solid nested microcystic, glandular or papillary pattern separating by hyaline fibrous tissue and growed in multiple nodular from. The cytoplasm contains abundant eosinophilic secretions or secretory vesicles. Immunhistochemistry, all cases were positive for CK7, S-100 and CEA, but negative for estrogen and progesterone receptors (ER and PR) and HER-2, and the proliferation index Ki-67 ranged from 10% to 40%. Molecular testing confirmed the presence of the EVT6 gene translocation in one case. Lumpectomy was performed in 2 cases and modified radical mastectomy in 4 cases, two of them had lymph node metastasis (3/15, 1/16). Five cases were followed up for 6 months to 20 years, 1 case had lung metastasis. Conclusion SBC is a rare breast tumor with relatively indolent clinical and good prognosis. It can be diagnosed according to typical pathological morphology and immunohistochemical characteristics. The characteristic EVT6 gene translocation also has important differential diagnostic value.

15.
Article in Chinese | WPRIM | ID: wpr-756199

ABSTRACT

Objective To explore the effect of bilateral hand function training on the hand function of stroke survivors.Methods Thirty-one patients with unilateral hand dysfunction after stroke were randomly divided into an experimental group of 16 and a control group of 15.Both groups were given 60 minutes of hand function training of their affected hands daily,five days a week for 4 weeks.The experimental group was additionally provided with 40 minutes of bilateral hand training on the basis of the aforementioned intervention.Before the treatment and after the 4 weeks,integrated surface electromyography (iEMG) signals were recorded from both hands' flexor and extensor muscles.Both groups were also assessed using the Fugl-Meyer motor assessment for the upper extremities (FMA-UE).Results After the treatment,the average iEMG of the flexor and extensor muscles during flexion and extension were significantly better than before the treatment in both groups.There was no significant difference between the two groups in their average iEMGs before the treatment,but afterward significant differences were observed in all the iEMG measurements.After the treatment the average total FMA-UE score of the experimental group was significantly higher than that of the control group.Conclusion Bilateral hand function training is significantly more effective than unilateral training in promoting the recovery of flexor and extensor muscle function after a stroke.

16.
Article in Chinese | WPRIM | ID: wpr-754841

ABSTRACT

To evaluate the changes of myocardial viability and systolic function in rabbits with different ischemic periods by layer‐specific strain of ultrasound speckled tracking imaging ( ST I) and low dose dobutamine stress echocardiography ( LDDSE ) . Methods T hirty‐six rabbits were randomly divided into 3 groups( n =12) : ①myocardial infarction group Ⅰ :coronary artery occlusion for 45 min ; ②myocardial infarction group Ⅱ :coronary artery occlusion for 60 min ; ③ myocardial infarction group Ⅲ :coronary artery occlusion for 90 min . Echocardiography examinations were performed at baseline ,after ligation and low dose dobutamine stress . After the experiment ,rabbits were killed and the hearts were taken to assess viable or nonviable mycardium , triphenyl tetrazolium chloride and Evans blue staining were applied . Results ①After coronary artery ligation ,left ventricular ejection fraction( LVEF) decreased in 3 groups ( all P < 0 .05 ) , the ventricular global endocardial longitudinal strain ( GSLsys‐endo ) , global myocardial longitudinal strain( GSLsys‐mid) ,and global epicardial longitudinal strain( GSLsys‐epi) decreased in 3 groups ( all P < 0 .05 ) ,the longitudinal strain of endocardium ( SLsys‐endo ) ,longitudinal strain of myocardium ( SLsys‐mid) ,longitudinal strain of epicardium ( SLsys‐epi) decreased in viable myocardial ( all P<0 .05) ; ②While low dose dobutamine stressing ,the GSLsys and SLsys increased in each groups ,and the GSLsys‐endo ,GSLsys‐mid ,GSLsys‐epi and SLsys‐endo of viable segments in each group were increased ( P<0 .05) ; ③After ligation and low dose dobutamine stress ,the GSLsys in endocardium in three groups were different( P <0 .05) ,and the SLsys in endocardium of viable segments in three groups were different ( P<0 .05) . Conclusions Layer‐specific strain of STI combined with LDDSE can accurately evaluate the changes of myocardial viability and systolic function in different ischemic periods ,and the longitudinal strain of endocardium is more sensitive ;moreover ,with the increase of coronary artery occlusion time ,the infarcted myocardium increases ,myocardial viability and systolic function decrease .

17.
Article in Chinese | WPRIM | ID: wpr-754825

ABSTRACT

Objective To investigate the incidence of abnormalities and adverse reactions of intrauterine device ( IUD) by three‐dimensional transvaginal ultrasound ,and guide the correct selection of IUD . Methods Female volunteers who came to our hospital for health check‐up from July 2016 to February 2018 were selected as subjects to obtain information of the belt loop time and number of loops . T hree‐dimensional transvaginal ultrasound was used to observe and record the IUD types and positions . T he incidence of location abnormalities ,adverse reactions and cervical lesions of differnet types of IUD were retrospectively analyzed . Results T wo thousand one hundred and thirteen eligible subjects were included in the study ,including 423 cases of McuIUD ,506 cases of circular ring ,405 cases of uterine ring ,372 cases of T‐ring and 407 cases of γ ring . T he statistical analysis showed that the incidence of adverse reactions after wearing rings was as high as 34 .07% ,and the adverse reaction rate of different IUD was different . McuIUD had the highest incidence of adverse reactions ,compared with the circular ring ,the uterine ring ,the T‐ring , and the γ ring ( 47 .99% vs 25 .88% ,27 .41% ,37 .10% ,33 .66% ; all P < 0 .05 ) . Different IUD had different incidence of adverse reactions . T he low back pain rate in McuIUD and γ ring were higher than the other 3 IUDs . T he low back pain rate of McuIUD was higher than the circular ring ,the uterine ring and the T‐ring ( 23 .4% vs 15 .71% ,14 .07% ,13 .7 1% ; all P < 0 .01 ) . Different types of IUD had different incidence of location anomalies . T he descending rate of the circular ring was higher than that of the McuIUD and γ ring ( 6 .32% vs 3 .30% ,3 .19% ; all P< 0 .05 ) ,and no statistically significant difference compared with the uterine ring and T‐ring ( 6 .32% vs 3 .45% ,4 .30% ; all P >0 .05 ) . T he incarceration rate of the mother ring was higher than that of the circular ring ,uterine ring and T‐ring ( 3 .07% vs 0 ,0 .25% ,0 .54% ;all P <0 .01) . T he intrauterine rotation rate of uterine ring and γ ring were higher than that of McuIUD , circular ring and T‐ring ( all P <0 .01) . Pregnancy >1 and ring times ≥2 were related with the occurrence of adverse reactions of IUD ( P < 0 .05 ) . T he incidence of cervical erosion in the T‐ring was the highest compared with the McuIUD ,circular ring ,uterine ring ,and γ ring ( 30 .65% vs 16 .78% ,16 .80% ,18 .02% , 17 .69% ; all P <0 .01) . Conclusions The incidence of adverse reactions is higher in women with different types of IUD . T he incidence of different types of abnormal IUD position is different . T he frequency of pregnancy and band ring are related to the occurence of adverse veactions to IUD .

18.
Chinese Critical Care Medicine ; (12): 588-593, 2019.
Article in Chinese | WPRIM | ID: wpr-754015

ABSTRACT

Objective To explore the relationship between serum levels of osteoprotein (OPG), soluble nuclear factor-κB receptor activator ligand (sRANKL), inflammatory factors and coronary heart disease (CHD) and its severity. Methods The patients who underwent coronary angiography (CAG) due to chest pain admitted to department of cardiology of Tianjin Chest Hospital from April 2017 to December 2018 were enrolled, and they were divided into CHD group and non-CHD group according to the CAG results. The gender, age, history of hypertension, smoking history, diabetes, the levels of cholesterol (TC), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), apolipoprotein AI (apoAI), apolipoprotein B (apoB), lipoprotein (a) [Lp (a)], MB isoenzyme of creatine kinase (CK-MB) and other clinical data of patients were collected. The serum levels of OPG, sRANKL, matrix metalloproteinase-9 (MMP-9), monocyte chemotactic protein-1 (MCP-1), insulin-like growth factor-1 (IGF-1) and interleukin-6 (IL-6) were determined by enzyme-linked immunosorbent assay (ELISA). According to the results of CAG, the patients with CHD were divided into single-, double-, triple-branch coronary artery lesion groups, and the relationship between the levels of serum OPG, sRANKL, inflammatory factors and the degree of coronary artery lesions was observed. Multivariate Logistic regression was used to analyze the risk factors of CHD, and receiver operating characteristic (ROC) curve was plotted to analyze the predictive value of main risk factors for CHD. Results A total of 472 patients were enrolled in the final analysis during the study period, including 264 patients in the CHD group, 208 patients in the non-CHD group, 79 patients in the CHD group with single-branch disease, 75 patients with double-branch disease, and 110 patients with three-branch disease. ① Compared with the non-CHD group, the CHD group had more older male patients, as well as higher proportion of hypertension and diabetes, the levels of serum Lp (a) and CK-MB were significantly increased, and the levels of serum HDL-C and apoAI were significantly lowered. There was no statistically significant difference in serum TC, LDL-C, or apoB between the two groups. The levels of serum OPG, MMP-9, MCP-1, IGF-1 and IL-6 in the CHD group were significantly higher than those in the non-CHD group [OPG (μg/L): 1.79±0.50 vs. 1.50±0.30, MMP-9 (μg/L): 57.91 (33.50, 130.46) vs. 38.33 (29.43, 109.78), MCP-1 (μg/L):298.30 (207.96, 537.16) vs. 252.73 (165.22, 476.01), IGF-1 (μg/L): 734.03±486.11 vs. 217.75±126.45, IL-6 (ng/L):64.76±40.25 vs. 48.60±15.80, all P < 0.05], and the levels of serum sRANKL was significantly lower than that in the non-CHD group (ng/L: 344.31±122.14 vs. 378.74±109.27, P < 0.05). ② The serum OPG level showed a slight upward tendency with the increase in the number of coronary artery lesions, and the sRANKL level showed a slight downward tendency [OPG (μg/L) in the single-, double-, triple-branch coronary artery lesion groups was 1.74±0.49, 1.76±0.50, 1.85±0.52, and sRANKL (ng/L) was 354.96±116.64, 340.05±124.24, 339.57±125.03, respectively) without statistically significant differences (all P > 0.05). The levels of IGF-1 and IL-6 were increased with the number of coronary artery lesions [IGF-1 (μg/L) in the single-, double- and triple-branch coronary artery lesions groups was 372.13±258.42, 676.06±350.29, 1 033.47±468.06, and IL-6 (ng/L) was 48.87±16.72, 65.36±18.84, 75.76±22.72, respectively], and the differences among different lesion groups were statistically significant (all P < 0.01). Correlation analysis showed that IGF-1 level was significantly positively correlated with the number of coronary artery lesions (r = 0.612, P < 0.01), while IL-6 was not correlated with the number of coronary artery lesions (r = 0.185, P > 0.05).③ Multivariate Logistic regression analysis showed that elevated serum OPG and IGF-1 levels were risk factors for CHD [OPG: odds ratio (OR) = 1.995, 95% confidence interval (95%CI) = 1.936-2.067, P = 0.012; IGF-1: OR = 1.009, 95%CI = 1.004-1.015, P = 0.001]. ④ ROC curve analysis showed that the area under ROC curve (AUC) of OPG and IGF-1 was 0.716 and 0.867, respectively. When the cut-off value of OPG was 1.13 μg/L, the sensitivity was 81.7%, the specificity was 58.1%; when the cut-off value of sRANKL was 401.20 μg/L, the sensitivity was 69.7%, the specificity was 95.7%. Conclusions CHD was associated with increased in OPG, related inflammatory cytokines including MMP-9, MCP-1, IGF-1 and IL-6, and decreased in sRANKL. The level of IGF-1 was positively correlated with the severity of CHD. The serum levels of OPG and IGF-1 were risk factors for CHD, which had good predictive value for CHD.

19.
Chinese Critical Care Medicine ; (12): 319-324, 2019.
Article in Chinese | WPRIM | ID: wpr-753962

ABSTRACT

Objective To explore the polymorphisms of T149C and T950C gene in osteoprotectin (OPG) promoter sites and the levels of serum OPG and soluble nuclear factor-κB receptor activator ligand (sRANKL) and the incidence of coronary heart disease (CHD). Methods 528 patients in Tianjin suspected of CHD and underwent coronary angiography (CAG) who admitted to the department of cardiology of Tianjin Chest Hospital from April 2017 to December 2018 were enrolled. According to the CAG results, they were divided into two groups: CHD group (n = 302) and non-CHD group (n = 226). The gender, age, history of hypertension, family history of CHD, diabetes, levels of blood lipid parameters in serum and other clinical data of patients were recorded. The levels of serum OPG and sRANKL were measured by enzyme-linked immunosorbent assay (ELISA). T149C and T950C gene polymorphisms were analyzed by polymerase chain reaction-restriction endonuclease fragment length polymorphism (PCR-RFLP) methods. Hardy-Weinberg genetic balance test was performed for alleles. Binomial classification multivariate non-conditional Logistic regression method was used to analyze the relationship between T149C and T950C gene polymorphisms, serum levels of OPG and sRANKL and CHD. Results All patients were enrolled in the final analysis. The serum level of OPG in CHD group was significantly higher than that in non-CHD group (μg/L: 1.76±0.49 vs. 1.47±0.29, P < 0.01), the serum level of sRANKL was significantly lower than that in non-CHD group (ng/L: 342.14±121.38 vs. 376.63±108.66, P < 0.05). Logistic regression analysis showed that after adjusting for age, gender, blood lipid parameters, diabetes and other factors, the increase in serum OPG level was an independent risk factor for CHD [odds ratio (OR) = 1.995, 95% confidence interval (95%CI) = 1.935-2.066, P = 0.012]. PCR-RFLP results showed that TT, TC and CC genotypes were found in T149C and T950C of OPG promoter. According to Hardy-Weinberg equilibrium test, the polymorphisms of OPG T149C and T950C accorded with Hardy-Weinberg law, achieving genetic balance with representative of the population. The frequencies of TT, TC, CC and alleles T and C in T149C genotypes of non-CHD group were 53.5%, 42.9%, 3.6%, 75.0% and 25.0%, respectively, and they were 43.1%, 50.3%, 6.6%, 68.2% and 31.8%, respectively in CHD group. There were statistically significant differences in genotype and allele frequencies between the two groups (all P < 0.05). It was shown by Logistic regression analysis that the risk of CHD in TC+CC genotype of T149C was 1.86 of TT genotype (OR = 1.86, 95%CI = 1.24-2.78, P = 0.003). It was suggested that C allele might be a susceptible gene for CHD. In non-CHD group, the frequencies of TT, TC, CC, and alleles T and C in T950C genotypes were 39.8%, 46.5%, 13.7%, 63.1% and 36.9%, respectively. They were 39.4%, 43.4%, 17.2%, 61.1% and 38.9%, respectively in CHD group. There were no significant differences in genotype and allele frequencies between the two groups (all P > 0.05). Logistic regression analysis showed that TC+CC genotype of T950C was not related with CHD. Conclusions The increased level of serum OPG was closely related with CHD and could be used as a risk factor for CHD. The cases carried OPG T149C TC+CC genotype might have the risk suffering CHD. C allele is might be a susceptible gene.

20.
Article in Chinese | WPRIM | ID: wpr-695521

ABSTRACT

Objective To evaluate the value of different surgical methods in the repair of huge chest wall defect after breast malignant tumor operation.Methods The clinical data of 22 patients with chest wall defect after chest operation were retrospectively analyzed.All patients received one-stage repair for the chest wall defect with different surgical methods.Of the patients,9 cases got repair with latissimus dorsi myocutaneous flap,4 cases received repairment with internal mammary perforator flap of contralateral breast,and the others received dermatoplasty.Results All the 22 cases were successfully repaired.Two cases of dermatoplasty got mild edema who was healed after acitive dressing change.No one got effusion,infection or necrosis.No recurrence or distant metastasis happened except one case of liver metastasis in the follow-up of 6 to 24 months.Conclusions Application of different surgical methods in repair for the chest wall defect can improve patients' life quality.It is easy,safe and effective.We should choose the most suitable surgical method according to individual situation.

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