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1.
Acta Pharmaceutica Sinica ; (12): 13-24, 2022.
Article in Chinese | WPRIM | ID: wpr-913164

ABSTRACT

Tumor immune checkpoint therapy is a clinical treatment strategy developed based on the new principle of the inhibition of negative immune regulation. In this article, the tumor immune checkpoint therapy and the drug delivery strategies were reviewed, mainly including immunity and tumor therapy, tumor immune checkpoint therapy and its mechanism of action, clinical application of tumor immune checkpoint therapy and therapeutic drugs, immune resistance of programmed cell death protein 1 (PD1)/programmed cell death ligand 1 (PDL1) treatment and countermeasures, drug delivery strategies for tumor immune checkpoint therapeutic agents, etc. As a revolutionary new immunotherapy strategy, tumor immune checkpoint therapy has shown obvious superior therapeutic efficacy in a variety types of tumor. However, tumor immune checkpoint therapy is also faced with a big challenge, namely, immunotherapy resistance. With the discovery of new mechanism, the continuous development of new therapeutic drugs and delivery strategies, tumor immune checkpoint therapy is expected to further improve the clinical efficacy of tumor.

2.
Article in Chinese | WPRIM | ID: wpr-927349

ABSTRACT

OBJECTIVE@#To observe the effect of electroacupuncture on motor function and muscle state in patients with primary osteoporosis (POP).@*METHODS@#A total of 60 female patients with POP were randomized into an observation group (30 cases, 1 case dropped off) and a control group (30 cases, 1 case dropped off). On the basis of adjusting lifestyle, caltrate was given orally in the control group, 2 pills a day for 4 weeks. On the basis of the treatment in the control group, electroacupuncture was applied at Zusanli (ST 36), Yanglingquan (GB 34), Ganshu (BL 18), Pishu (BL 20), Shenshu (BL 23), etc. in the observation group, with disperse-dense wave of 2 Hz/10 Hz in frequency, once every other day, 3 times a week for 4 weeks. The time of timed up-and-go test (TUGT) and the value of 10 m maximal walking speed (10 m MWS) before and after treatment were compared in the two groups, and the Young's modulus values of bilateral multifidus muscles in prone position and sitting position before and after treatment were compared by real-time shear wave elastography (SWE) in the two groups.@*RESULTS@#After treatment, the TUGT time was decreased compared before treatment in the observation group (P<0.01), and that in the observation group was shorter than the control group (P<0.01). After treatment, the value of 10 m MWS test was increased compared before treatment in the observation group (P<0.05). After treatment, the Young's modulus values of bilateral multifidus muscles in prone position and sitting position were increased compared before treatment in the observation group (P<0.01); except for the left side in sitting position, the Young's modulus values of multifidus muscles in the observation group were higher than those in the control group (P<0.01, P<0.05).@*CONCLUSION@#On the basis of oral caltrate, electroacupuncture can improve the motor function and muscle state in patients with POP.


Subject(s)
Acupuncture Points , Electroacupuncture , Female , Humans , Life Style , Osteoporosis/therapy , Paraspinal Muscles
3.
Article in Chinese | WPRIM | ID: wpr-880061

ABSTRACT

OBJECTIVE@#To establish quantitative surface plasmon resonance (SPR) assay for antibodies against human platelet antigen-1a (HPA-1a).@*METHODS@#Recombinant protein was fixed on the chip surface by amino coupling method. SPR assay was used to detect the standard antibodies against HPA-1a at different conceatration. The optimal experimental parameters were determined, and standard curves were constructed with linear regression. Moreover, the sensitivity, specificity, accuracy and precision of the assay were evaluated.@*RESULTS@#The quantitative SPR assay for HPA-1a antibodies was established. The determination ranges were 0-20 IU, with accuracy (recovery rate) was 97.75%-103.08%. The intra-assay precision [coefficients of variation (CV)] was 3.53%-4.29%, and the inter-assay precision (CV) was 2.08%-4.40%. For specificity test, several kinds of monoclonal and human antibodies against platelet membrane protein were tested and no positive result was observed.@*CONCLUSION@#The established quantitative SPR assay for HPA-1a antibodies shows good sensitivity, specificity, accuracy and precision, and this rapid and simple method provides a new reference method for scientific research and clinical antibody detection.


Subject(s)
Antigens, Human Platelet , Blood Platelets , Humans , Isoantibodies , Surface Plasmon Resonance
4.
Journal of Integrative Medicine ; (12): 460-466, 2021.
Article in English | WPRIM | ID: wpr-888768

ABSTRACT

There is currently no drug or therapy that can cure the coronavirus disease 2019 (COVID-19), which is highly contagious and can be life-threatening in severe cases. Therefore, seeking potential effective therapies is an urgent task. An older female at the Leishenshan Hospital in Wuhan, China, with a severe case of COVID-19 with significant shortness of breath and decrease in peripheral oxygen saturation (SpO


Subject(s)
Acupuncture Therapy , COVID-19/therapy , Drugs, Chinese Herbal , Female , Humans , Treatment Outcome
5.
Chinese Journal of Traumatology ; (6): 273-279, 2021.
Article in English | WPRIM | ID: wpr-888416

ABSTRACT

PURPOSE@#Low-velocity penetrating brain injury (LVPBI) caused by foreign bodies can pose life-threatening emergencies. Their complexity and lack of validated classification data have prevented standardization of clinical management. We aimed to compare the trans-base and trans-vault phenotypes of LVPBI to help provide guidance for clinical decision-making of such injury type.@*METHODS@#A retrospective study on LVPBI patients managed at our institution from November 2013 to March 2020 was conducted. We included LVPBI patients admitted for the first time for surgery, and excluded those with multiple injuries, gunshot wounds, pregnancy, severe blunt head trauma, etc. Patients were categorized into trans-base and trans-vault LVPBI groups based on the penetration pathway. Discharged patients were followed up by outpatient visit or telephone. The data were entered into the Electronic Medical Record system by clinicians, and subsequently derived by researchers. The demography and injury characteristics, treatment protocols, complications, and outcomes were analyzed and compared between the two groups. A t-test was used for analysis of normally distributed data, and a Mann-Whitney U test for non-parametric data. A generalized linear model was further established to determine whether the factors length of stay and performance scale score were influenced by each factor.@*RESULTS@#A total of 27 LVPBI patients were included in this analysis, comprised of 13 (48.1%) trans-base cases and 14 (51.9%) trans-vault cases. Statistical analyses suggested that trans-base LVPBI was correlated with deeper wounds; while the trans-vault phenotype was correlated with injury by metal foreign bodies. There was no difference in Glasgow Coma Scale score and the risk of intracranial hemorrhage between the two groups. Surgical approaches in the trans-base LVPBI group included subfrontal (n = 5, 38.5%), subtemporal (n = 5, 38.5%), lateral fissure (n = 2, 15.4%), and distal lateral (n = 1, 7.7%). All patients in the trans-vault group underwent a brain convex approach using the foreign body as reference (n = 14, 100%). Moreover, the two groups differed in application prerequisites for intracranial pressure monitoring and vessel-related treatment. Trans-base LVPBI was associated with higher rates of cranial nerve and major vessel injuries; in contrast, trans-vault LVPBI was associated with lower functional outcome scores.@*CONCLUSION@#Our findings suggest that trans-base and trans-vault LVPBIs differ in terms of characteristics, treatment, and outcomes. Further understanding of these differences may help guide clinical decisions and contribute to a better management of LVPBIs.

6.
Article in Chinese | WPRIM | ID: wpr-921803

ABSTRACT

A sensitive and efficient method was established and validated for qualitative and quantitative analysis of total alkaloids from the extract of Eurycoma longifolia by high-performance liquid chromatography coupled with quadrupole time-of-flight mass spectrometry(HPLC-Q-TOF-MS) combined with ultra-performance liquid chromatography coupled with triple quadrupole tandem mass spectrometry(UPLC-QQQ-MS/MS). The HPLC-Q-TOF-MS conditions are as follows: Welch Ultimate XB-C_(18) column(4.6 mm×250 mm, 5 μm) with acetonitrile(containing 0.1% formic acid)-0.1% formic acid in water as mobile phase for gradient elution. The UPLC-QQQ-MS/MS conditions are as below: Agilent Eclipse Plus C_(18) column(2.1 mm×50 mm, 1.8 μm) with acetonitrile(containing 0.1% formic acid) and 0.1% formic acid in water as mobile phase for gradient elution. MS data were collected by electrospray ionization in positive ion mode. According to the comparison with reference standards and the accurate masses of molecules, a total of 17 alkaloids in E. longifolia extract were identified by HPLC-Q-TOF-MS. The UPLC-QQQ-MS/MS quantitative analysis result of 3 alkaloids showed that the linear ranges of them were good(r≥0.999 7) and the overall recoveries ranged from 108.8%-110.2%, with RSDs of 2.9%-5.3%. The method is accurate, reliable, and efficient, which can comprehensively reflect the constituents and content of alkaloids in E. longifolia. The result can serve as a reference for further elucidating its therapeutic material basis and quality control.


Subject(s)
Alkaloids , Chromatography, High Pressure Liquid , Chromatography, Liquid , Eurycoma , Tandem Mass Spectrometry
7.
Article in Chinese | WPRIM | ID: wpr-921719

ABSTRACT

To systematically evaluate the clinical efficacy of 14 oral Chinese patent medicines combined with Azithromycin in the treatment of mycoplasma pneumonia in children with network Meta-analysis. Computer retrieval was performed for such databases as CNKI, VIP, Wanfang, CBM, PubMed, EMbase and Cochrane Library to screen out randomized controlled trials of oral Chinese patent medicines combined with Azithromycin in the treatment of mycoplasma pneumonia in children from the time of database establishment to September 2020. The included studies were evaluated by the Cochrane Risk Assessment tool. Stata 14.0 and Review Manager 5.3 software were used for data statistical analysis. A total of 60 RCTs were included in this study, involving 14 oral Chinese patent medicines. The efficacy ranking based on network Meta-analysis was as follows:(1)in terms of total effective rate, top five Chinese patent medicines in surface under the cumulative ranking curve(SUCRA) were Xiao'er Xiaoji Zhike Oral Liquid, Xiao'er Chiqiao Qingre Granules, Xiao'er Feike Granules, Pudilan Xiaoyan Oral Liquid and Lanqin Oral Liquid;(2)in terms of antifebrile time, top five Chinese patent medicines in SUCRA were Huaiqihuang Granules, Xiao'er Magan Granules, Xiao'er Kechuanling Granules/Oral Liquid, Shuanghuang-lian Oral Liquid for children and Xiao'er Xiaoji Zhike Oral Liquid;(3)in terms of cough disappearance time, top five Chinese patent medicines in SUCRA were Xiao'er Magan Granules, Huaiqihuang Granules, Xiao'er Chiqiao Qingre Granules, Xiao'er Feire Kechuan Oral Liquid and Xiao'er Kechuanling Granules/Oral Liquid;(4)in terms of rale disappearance time, top five Chinese patent medicines in SUCRA were Xiao'er Magan Granules, Huaiqihuang Granules, Xiao'er Feire Kechuan Oral Liquid, Shuanghuanglian Oral Liquid for children and Yupingfeng Granules. The results showed that on the basis of the use of Azithromycin, combined administration with oral Chinese patent medicines could improve the overall clinical efficacy in the treatment of mycoplasma pneumonia in children. However, due to the large differences in the quality and the number of included studies among various therapeutic measures, the ranking results of SUCRA of Chinese patent medicines need to be verified by high-quality multi-center, large-sample, randomized double-blind trials in the future.


Subject(s)
Azithromycin , Child , China , Drugs, Chinese Herbal , Humans , Network Meta-Analysis , Nonprescription Drugs , Pneumonia, Mycoplasma/drug therapy , Randomized Controlled Trials as Topic
8.
Article in Chinese | WPRIM | ID: wpr-912492

ABSTRACT

With the development of the fourth industrial revolution, the influence of automated and artificial intelligence on the pre-analytic-, analytic, and post-analytic processes of laboratory medicine continues to increase. The application of artificial intelligence to large-scale clinical data sets generated through the improvement of automation helps discover new knowledge, develop new models, and explore new fields. Point-of-care testing has the advantages of easy operation, portability, intelligence, and widely application. The application of artificial intelligence in predictive models will promote precision laboratory medicine. In the recent outbreak of the new coronavirus, artificial intelligence has sprouted a new direction in laboratory medicine.

9.
Article in Chinese | WPRIM | ID: wpr-910548

ABSTRACT

Objective:To evaluate the prognostic factors and the value of definitive pelvic radiotherapy in patients with stage Ⅳ B hematogenous metastatic cervical squamous cell carcinoma. Methods:Clinical data of 80 patients with Ⅳ B stage squamous cell carcinoma admitted to Zhejiang Cancer Hospital from 2006 to 2016 were retrospectively analyzed. The survival analysis was conducted by Kaplan- Meier method. Prognostic factors were analyzed by Cox models. Results:The 1-, 2-and 5-year overall survival (OS) and progression-free survival (PFS) rates were 52.5%, 26.3%, 16.8% and 25%, 13.8%, 8.8%, with a median OS of 13.8 months and a median PFS of 5.6 months, respectively. The most common site of metastasis was bone (51.3%), followed by lung (36.3%) and liver (26.3%). Univariate analysis revealed that chemotherapy combined with definitive pelvic radiotherapy and ≥6 cycles of chemotherapy were positively correlated with OS and PFS, whereas ECOG performance status score of 3-4 and liver metastasis were negatively correlated with OS and PFS. In multivariate analysis, liver metastasis ( HR=2.23, 95% CI: 1.01-4.91, P=0.048) and ECOG performance status score of 3-4( HR=2.01, 95% CI: 1.03-3.91, P=0 0.040) were significantly correlated with poor OS. Subgroup multivariate analysis showed that compared with chemotherapy±palliative radiotherapy, systemic chemotherapy combined with definitive pelvic radiotherapy significantly improved OS ( HR=0.39, 95% CI: 0.18-0.84, P=0.016). Compared with double drugs combined with<4 cycles of chemotherapy, double drugs in combination with ≥4 cycles of chemotherapy significantly improved OS ( HR=0.32, 95% CI: 0.15-0.68, P=0.003). Conclusions:Patients with low ECOG performance status score or liver metastasis obtain poor prognosis. Definitive pelvic radiotherapy combined with chemotherapy can enhance clinical prognosis of patients with Ⅳ B stage hematogenous metastatic cervical squamous cell carcinoma.

10.
Article in Chinese | WPRIM | ID: wpr-910542

ABSTRACT

Objective:To evaluate the efficacy of intensity-modulated radiation therapy (IMRT) combined with chemotherapy for treating patients with T 1-2N 1M 0 nasopharyngeal carcinoma (NPC). Methods:343 patients diagnosed with T 1-2N 1M 0 NPC in Zhejiang Cancer Hospital and Sun Yat-sen University Cancer Center from January 2008 to December 2016 were recruited in this study. All patients received IMRT and divided into the radiotherapy (RT) and chemoradiotherapy (CRT) groups. Patients in the CRT group were further assigned into the concurrent chemoradiotherapy (CCRT), induction chemotherapy+ CCRT (IC+ CCRT) and CCRT+ adjuvant chemotherapy (AC) groups. Locoregional failure-free survival (LRFFS), distant metastasis-free survival (DMFS), progression-free survival (PFS), cancer-specific survival (CSS) and overall survival (OS) were estimated by Kaplan- Meier method. Multivariate prognostic analysis was performed by Cox models. Results:The median follow-up time for surviving patients (303/343) was 91(range: 49-138) months. The 5-year OS, CSS, PFS, LRFFS, and DMFS rates in the CRT group were not superior to those of the RT group (93.7%: 93.9%, 93.7%: 93.9%, 89.0%: 87.7%, 93.8%: 92.8%, 93.8%: 91.2%, all P>0.05). No significant difference was found in treatment outcomes of patients with T 1N 1 or T 2N 1 NPC between two groups (all P>0.05). In multivariable analyses, only age was an independent prognostic factor for OS, PFS, CSS and DMFS, and negative correlation was found between them. No survival benefits were achieved in the CCRT, IC+ CCRT, CCRT+ AC and RT groups, and no significant differences were found in clinical efficacy among the three combined (all P>0.05). Conclusions:IMRT alone yields comparable clinical efficacy to CRT in treating patients with T 1-2N 1M 0 NPC. However, whether CT can be eliminated in the T 1-2N 1M 0 population still needs further confirmation by prospective, randomized and controlled clinical trials.

11.
Article in Chinese | WPRIM | ID: wpr-910507

ABSTRACT

Objective:To establish a radiomics-based biomarker for predicting pathological response after preoperative neoadjuvant chemoradiotherapy (nCRT) in locally advanced esophageal cancer.Methods:From 2008 to 2018, 112 patients with locally advanced esophageal cancer who received nCRT were enrolled. All patients were treated with preoperative nCRT combined with surgery. Enhanced CT images and clinical information before nCRT were collected. A lesion volume of interest was manually delineated. In total, 670 radiomics features (including tumor intensity, shape and size, texture and wavelet characteristics) were extracted using the pyradiomics package in PYTHON. The stepwise regression combined with the best subset were employed to select the features, and finally the Logistic regression model was adopted to establish the prediction model. The performance of the classifier was evaluated by the area under the ROC curve (AUC). Results:The pathological complete remission (pCR) rate was 58.0%(65/112). 10 radiomics features were included in the final model, The most relevant radiomics feature was the gray feature (the texture information of the image), followed by the shape and voxel intensity-related features. In the training set, the AUC was 0.750 with a sensitivity of 0.711 and a specificity of 0.778, the corresponding values in the testing set were 0.870, 0.757 and 0.900, respectively.Conclusions:Models based on radiomics features from CT images can be utilized to predict the pathological response to nCRT in esophageal cancer. As it is efficient, non-invasive and economic model, it could serve as a promising tool for individualized treatment when validated by further prospective trials in the future.

12.
Article in Chinese | WPRIM | ID: wpr-910492

ABSTRACT

Objective:To evaluate the application of a multi-task learning-based light-weight convolution neural network (MTLW-CNN) for the automatic segmentation of organs at risk (OARs) in thorax.Methods:MTLW-CNN consisted of several layers for sharing features and 3 branches for segmenting 3 OARs. 497 cases with thoracic tumors were collected. Among them, the computed tomography (CT) images encompassing lung, heart and spinal cord were included in this study. The corresponding contours delineated by experienced radiation oncologists were ground truth. All cases were randomly categorized into the training and validation set ( n=300) and test set ( n=197). By applying MTLW-CNN on the test set, the Dice similarity coefficients (DSCs) of 3 OARs, training and testing time and space complexity (S) were calculated and compared with those of Unet and DeepLabv3+ . To evaluate the effect of multi-task learning on the generalization performance of the model, 3 single-task light-weight CNNs (STLW-CNNs) were built. Their structures were totally the same as the corresponding branches in MTLW-CNN. After using the same data and algorithm to train STLW-CNN, the DSCs were statistically compared with MTLW-CNN on the testing set. Results:For MTLW-CNN, the averages (μ) of lung, heart and spinal cord DSCs were 0.954, 0.921 and 0.904, respectively. The differences of μ between MTLW-CNN and other two models (Unet and DeepLabv3+ ) were less than 0.020. The training and testing time of MTLW-CNN were 1/3 to 1/30 of that of Unet and DeepLabv3+ . S of MTLW-CNN was 1/42 of that of Unet and 1/1 220 of that of DeepLabv3+ . The differences of μ and standard deviation (σ) of lung and heart between MTLW-CNN and STLW-CNN were approximately 0.005 and 0.002. The difference of μ of spinal cord was 0.001, but σof STLW-CNN was 0.014 higher than that of MTLW-CNN.Conclusions:MTLW-CNN spends less time and space on high-precision automatic segmentation of thoracic OARs. It can improve the application efficiency and generalization performance of the models.

13.
Article in Chinese | WPRIM | ID: wpr-910459

ABSTRACT

With the advancement of imaging diagnosis and the development of modern radiotherapy, the survival of cancer patients has been prolonged and the incidence rate of brain metastases (BM) has been significantly increased. The quality of life of patients and potential radiotherapy-induced neurocognitive impairment have gradually captivated widespread attention. Whole brain radiotherapy (WBRT) is one of the common local therapies for BM patients. However, the application of WBRT is controversial because it may lead to neurocognitive impairment. The incidence of metastatic tumors in hippocampus and radiation-induced neurocognitive impairment can accelerate the implementation of hippocampal-avoidance WBRT (HA-WBRT). In this article, the feasibility of HA-WBRT was discussed and research progress in recent years was reviewed.

14.
Article in Chinese | WPRIM | ID: wpr-910457

ABSTRACT

Objective:To investigate the expression changes at the transcriptional level in normal lung tissues of mice after exposure to heavy ion radiation for different durations at different doses, aiming to provide evidence for exploring sensitive genes of heavy ion radiation, heavy ion radiation effect and the damage mechanism.Methods:Experiments on the temporal kinetics: the whole thorax of mice was irradiated with 14.5Gy carbon-ions and the total RNA of lung tissue was extracted at 3days, 7days, 3 weeks and 24 weeks. In dose-dependent experiment, the total RNA of lung tissue was extracted at 1 week after irradiated with a growing thoracic dose of 0, 7.5, 10.5, 12.5, 14.5, 17.5 and 20Gy. Protein-to-protein interaction (PPI) analysis and gene-ontology biological process enrichment analysis were performed on significant differentially expressed genes (DEGs).Results:A clearly differential expression patterns were observed at 3-day (acute stage), 1-week (subacute stage), 3-week (inflammatory stage) and 24-week (fibrosis stage) following 14.5Gy carbon-ions irradiation. Among those, the 3-day time point was found to be the mostly different from the other time points, whereas the 7-day time point had the highest uniformity with the other time points. Cellular apoptosis was the main type of cell death in normal lung tissues following carbon-ions exposure. The interactive genes of Phlda3, GDF15, Mgmt and Bax were identified as the radiosensitive genes, and Phlda3 was the center ( R=0.76, P<0.001). Conclusion:The findings in this study provide transcriptional insights into the biological mechanism underlying normal lung tissue toxicity induced by carbon-ions.

15.
Article in Chinese | WPRIM | ID: wpr-910446

ABSTRACT

Objective:To investigate the correlation between the changes of oral bacterial flora during head and neck radiotherapy and radiation-induced oral mucositis (ROM).Methods:The oral bacterial samples of patients with nasopharyngeal carcinoma and accompanying family members were obtained before and at the end of radiotherapy and subjected to high-throughput sequencing. C57BL/6 mice were used to establish the ROM models. On the 9 th day after radiotherapy, oral bacterial samples were collected in the radiotherapy group and the negative control group. On the 3 rd, 5 th, 7 th, and 9 th days post-radiotherapy, the tongue tissues were obtained from another batch of mice in the negative control and radiotherapy groups. Inflammatory factors were detected with PCR and HE staining was performed. Results:The oral bacterial diversity of patients after radiotherapy significantly differed from that of patients before radiotherapy and their accompanying family members before and after radiotherapy in Observed species, Chao1, Simpson index (all P<0.05). There was a significant difference in Shannon index between the severe and mild ROM patients ( P=0.036). LEfSe analysis showed that patients with severe ROM had higher levels of g_ Streptococcus and f_ Streptococcus, and lower levels of f_ Familyxl, g_ Gemini and o_ Bacillus. The Simpson index and PCoA results in the oral bacterial samples significantly differed between the negative control and radiotherapy groups (all P<0.05). Conclusions:Radiotherapy can disrupt the balance of bacterial flora. The dysregulated oral bacterial flora is closely associated with the aggravation of ROM.

16.
Article in Chinese | WPRIM | ID: wpr-910042

ABSTRACT

Objective:To evaluate antegrade interlocking intramedullary nails combined with less invasive stabilization system (LISS) in the treatment of femoral fractures (Lambiris type Ⅲ or Ⅳ).Methods:The clinical data of 27 patients were retrospectively analyzed who had been treated for femoral fractures of Lambiris type Ⅲ or Ⅳ at Department of Orthopedic Surgery, Wuhan Fourth Hospital from February 2015 to May 2019. They were 21 males and 6 females, aged from 22 to 57 years (average, 41.3 years). According to the Lambiris classification, 24 cases were classified as type Ⅲ (17 as type Ⅲa, 5 as type Ⅲb and 2 as type Ⅲc) and 3 cases as type Ⅳ. The time from injury to operation ranged from 2 to 9 days (average, 4.3 days). All the fractures were fixated with anterograde femoral interlocking nails and femoral LISS. Recorded were operation time, intra-operative blood loss, hospital stay, bone healing time, and Harris hip score, Hospital for Special Surgery (HSS) knee score and complications at the final follow-up.Results:In this cohort, operation time averaged 2.1 h (from 1.8 to 2.5 h), intraoperative blood loss 361 mL (from 310 to 480 mL), and hospital stay 15.1 d (from 11 to 18 d). All the 27 patients were followed up for 13 to 38 months (average, 25.3 months) after operation. All the fractures united well after an average duration of 29.2 weeks (from 28 to 36 weeks). By the Harris hip scores at the final follow-up, the hip function was evaluated as excellent in 18 cases, as good in 6 and as acceptable in 3, giving an excellent and good rate of 88.9%(24/27); by the HSS knee scores at the final follow-up, the knee function was excellent in 16 cases, good in 7 and acceptable in 4, giving an excellent and good rate of 85.2%(23/27). Follow-ups observed no fracture nonunion, malunion, refracture, internal fixation failure or other complications.Conclusion:In the treatment of femoral fractures of Lambiris type Ⅲ or Ⅳ, antegrade interlocking intramedullary nails combined with LISS has advantages of rigid fixation, a high rate of fracture union, limited complications, and good functional recovery.

17.
Chinese Journal of Trauma ; (12): 926-931, 2021.
Article in Chinese | WPRIM | ID: wpr-909958

ABSTRACT

Objective:To investigate the effect of robot-assisted percutaneous retrograde screw fixation in the treatment of acetabular fractures involving the posterior column.Methods:A retrospective case series study was conducted to analyze the clinical data of 13 patients with acetabular fractures involving the posterior column admitted to Wuhan Fourth Hospital from January 2019 to December 2020. There were 8 males and 5 females,aged 62-78 years[(69.7±1.5)years]. According to Judet-Letournel classification,fractures involved the posterior column in 4 patients,anterior column plus posterior semi-transverse column in 3 and double column in 6. According to AO classification,type 62-A2.1 was found in 2 patients,62-A2.2 in 2,62-B3 in 3 and 62-C in 6. All patients were treated with retrograde percutaneous screws assisted by orthopaedic surgery robot. The operation time,intraoperative blood loss,length of hospital stay and time of bone healing were recorded. The incision healing and complications were detected. Matta reduction standard was used to evaluate the fracture reduction quality at 2 days after operation,and Majeed function score was used to evaluate the functional recovery preoperatively,at 3 months after operation and at 6 months after operation.Results:All patients were followed up for 6-12 months[(9.3±1.7)months]. The operation time was 1.1-1.5 hours[(1.3±0.2)hours]. The intraoperative blood loss was 110-200 ml[(161.3±21.1)ml]. The length of hospital stay was 8-13 days[(10.7±1.3)days]. The time of bone healing was 14-18 weeks[(15.4±1.1)weeks]. All incisions were healed by first intention. One patient with sciatic nerve injury was treated with mecobalamin and recovered 3 months later. One patient with advanced heterotopic ossification had no obvious clinical symptoms. All patients had no complications such as incision infection,deep venous thrombosis of lower limbs,fat embolism,screw penetration into hip joint,fracture displacement after failure of internal fixation,traumatic arthritis,or necrosis of femoral head,etc. According to Matta reduction standard,there were 10 patients with anatomical reduction and 3 with satisfactory reduction. Majeed function score was(15.0±1.3)points before operation,(76.5±2.0)points at 3 months after operation and(85.1±1.9)points at 6 months after operation( P<0.01),and there were 9 patients with excellent results,2 with good results and 2 with fair results,showing the excellent and good rate of 85%. Conclusion:For acetabular fractures involving the posterior column,robot-assisted percutaneous retrograde screw fixation has advantages of less surgical trauma,higher fracture healing rate,fewer complications,satisfactory anatomical reduction and good functional recovery.

18.
Article in Chinese | WPRIM | ID: wpr-906247

ABSTRACT

Objective:To observe the short-term effect of modified Kaijie Huatantang on chronic rhinosinusitis with nasal polyp due to qi stagnation phlegm syndrome. Method:A total of 90 cases were divided into control group and observation group,with 45 cases in each group. The control group was given mometasone furoate,and the observation group was given modified Kaijie Huatantang after nasal endoscopy surgery for 4 weeks. After treatment and follow-up for 1 years,the sino-nasal outcome test-20(SNOT-20),Lund-Kennedy and traditional Chinese medicine(TCM) syndrome were observed. The serum and nasal secretions tumor necrosis factor-alpha(TNF-<italic>α</italic>),interleukin(IL)-1<italic>β</italic>,IL-8,IL-17,eosinophilic cationic protein(ECP) and immunoglobulin E(IgE) were detected before and after treatment. The safety,clinical efficacy after treatment and follow-up for 1 years were compared between two groups. Result:After treatment and follow-up for 1 years,the total control rates were 97.7%,93.0% in observation group, which were higher than 87.8%,75.6% in control group(<italic>P</italic><0.05). Compared with the control group after treatment and follow-up for 1 years,SNOT-20,Lund-Kennedy and TCM syndrome scores in the observation group decreased in the same period(<italic>P</italic><0.05). Compared with the control group after treatment,the serum and nasal secretions TNF-<italic>α</italic>,IL-1<italic>β</italic>,IL-8,IL-17,ECP and IgE in the observation group were significantly decreased(<italic>P</italic><0.05). The incidence of postoperative complications was 2.3% in the observation group, which was lower than 17.1% in the control group(<italic>P</italic><0.05). The incidence of adverse reactions was 4.7% in the observation group, which was lower than 41.5% in the control group(<italic>P</italic><0.05). Conclusion:Modified Kaijie Huatantang can significantly improve the short-term clinical efficacy of patients with chronic rhinosinusitis and nasal polyp due to Qi stagnation phlegm obstruction,with a low incidence of adverse reactions.

19.
Article in Chinese | WPRIM | ID: wpr-906212

ABSTRACT

Objective:To observe the effect of modified Shuzhong Huatantang replace hormone on children with rhinosinusitis and adenoid hypertrophy due to spleen deficiency and phlegm obstruction after operation. Method:Eighty cases were randomly divided into control group and observation group,40 cases in each group. After nasal endoscopy,the control group was given mometasone furoate,and the observation group was given modified Shuzhong Huatantang for 6 week. The nasal situation Lund-Kennedy assessment scal(Lund-Kennedy),adenoid thickness /nasopharyngeal cavity width (A/N),TCM syndrome were observed for before treatment,6,24,and 48 weeks after operation. The contents of immunoglobulin E(IgE),eosinophilic cationic protein(ECP),eosinophilic granulocyte(EOS),tumor necrosis factor-alpha(TNF-<italic>α</italic>),interleukin-1<italic>β</italic>(IL-1<italic>β</italic>),interleukin-17(IL-17) in serum and nasal secretions were detected before and 48 weeks after operation. The clinical efficacy,complications,recurrence 48 weeks after operation were compared between the two groups. Result:Three cases of abscission in the control group and one case in the observation group during the study period. The total control rate was 94.9% in the observation group higher than that 75.7% in the control group six weeks after the operation(<italic>χ</italic><sup>2</sup>=6.972,<italic>P</italic><0.05). The recurrence rate was 2.6% in the observation group lower than that 18.9% in the control group 48 weeks after operation(<italic>χ</italic><sup>2</sup>=4.137,<italic>P</italic><0.05). To compared with the control group at 6,24 and 48 weeks after operation,Lund-Kennedy,A/N,TCM syndromes in the observation group decrease in the same period (<italic>P</italic><0.05). To compared with the control group 48 weeks after operation,The TNF-<italic>α</italic>,IL-1<italic>β,</italic>IL-17,IgE,ECP,EOS in serum and nasal secretions in the observation group were reduced (<italic>P</italic><0.05). The incidence of adverse reactions was 2.7% in the observation group lower than that 29.7% in the control group. Conclusion:Modified Shuzhong Huatantang can significantly improve the postoperative clinical symptoms with chronic rhinosinusitis and adenoid hypertrophy due to spleen deficiency and phlegm obstruction,and the recurrence rate is lower.

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Article in Chinese | WPRIM | ID: wpr-905206

ABSTRACT

Objective:To investigate the changes of gray matter volume in patients with chronic nonfluent aphasia after cortical cerebral infarction and the relationship between gray matter volume and language function. Methods:From June, 2016 to June, 2019, 19 patients with chronic nonfluent aphasia after cortical cerebral infarction from the First Affiliated Hospital of Ji'nan University and 28 healthy subjects (controls) were scanned with structural magnetic resonance imaging. The data were analyzed using voxel-based morphological measurement to measure the gray matter volumes of the brain regions, and the differences between patients and controls were compared. The correlation between volumes of brain regions with difference and scores of items of Aphasia Battery of Chinese (ABC) was analyzed. Results:The gray matter volumes increased in the brain regions of right inferior frontal gyrus triangle, right inferior frontal gyrus island cover, right angular gyrus, the right medial frontal gyrus, left insula, left medial frontal gyrus in the patients; while decreased in right globus pallidus. The volumes of left insular lobe correlated with the scores of repeating (r = 0.665, P = 0.001) and naming (r = 0.638, P = 0.003); and the volumes of right inferior frontal gyrus triangle correlated with the scores of hearing comprehension (r = 0.493, P = 0.031), repeating (r = 0.576, P = 0.009) and naming (r = 0.674, P = 0.001) in the patients. Conclusion:The cortex volumes of left insula and right inferior frontal gyrus triangle increase in patients with chronic nonfluent aphasia after cerebral infarction, which may play a role in the language dysfunction.

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