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1.
Journal of Chinese Physician ; (12): 563-567, 2021.
Article in Chinese | WPRIM | ID: wpr-884091

ABSTRACT

Objective:To discuss the computed tomography (CT) and magnetic resonance (MR) imaging features of primary adrenal cortical carcinoma (PACC) and improve the imaging diagnostic level of primary adrenocortical carcinoma.Methods:The imaging features of 15 patients with biopsy or pathology confirmed PACC were retrospectively analiezed. There were 12 patients underwent CT examination, 7 patients underwent MR examination, and 4 patients underwent CT and MR exminations.Results:All of 15 PACCs were unilateral (10 on the right, 5 on the left). The maximum diameters of the lesions ranged from 4.4 to 15.1 (8.9±3.3)cm. The shape of the tumor was oval in 6 cases and irregular in 9 cases. CT findings: 1 cases showed homogeneous density and 11 cases were heterogeneous attenuation (including 2 cases with hemorrhage and 1 case with fat) on plain scan. The CT values of triple-phase of PACC ranged from 28.8 to 62.0(39.2±8.5)HU, 32.7 to 83.4(52.5±14.4)HU and 43.4 to 86.4(61.1±15.0)HU respectively. All cases showed mild (7 cases) and moderate (4 cases) gradual enhancement, only one case excluded. MRI findings: inhomogeneous mild and moderate enhancement were detected in 6 cases and homogeneneous enhancement was found in 1 case. The solid parts of PACC showed iso-signal intensity in T1WI, hyper-signal intensity in T2WI and diffusion limited in the diffusion weighted imaging (DWI). There were 14 cases of vascular shadow in 15 patients, and 3 cases of involvement and metastasis of surrounding tissues and organs.Conclusions:PACC often present as a big solitary heterogenous mass with necrotic area, hemorrhage and intratumoral vascular. The mild to moderate heterogenous gradual enhancement can be seen after the contrast.

2.
Chinese Medical Journal ; (24): 2810-2817, 2021.
Article in English | WPRIM | ID: wpr-921217

ABSTRACT

Low-level viremia (LLV) was defined as persistent or intermittent episodes of detectable hepatitis B virus (HBV) DNA (<2000 IU/mL, detection limit of 10 IU/mL) after 48 weeks of antiviral treatment. Effective antiviral therapies for chronic hepatitis B (CHB) patients, such as entecavir (ETV), tenofovir disoproxil fumarate (TDF), and tenofovir alafenamide (TAF), have been shown to inhibit the replication of HBV DNA and prevent liver-related complications. However, even with long-term antiviral therapy, there are still a number of patients with persistent or intermittent LLV. At present, the research on LLV to address whether adversely affect the clinical outcome is limited, and the follow-up treatment for these patients is open to question. At the same time, the mechanism of LLV is not clear. In this review, we summarize the incidence of LLV, the association between LLV and long-term outcomes, possible mechanisms, and management strategies in these patient populations.


Subject(s)
Antiviral Agents/therapeutic use , DNA, Viral , Hepatitis B virus/genetics , Hepatitis B, Chronic/drug therapy , Humans , Nucleosides/therapeutic use , Tenofovir/therapeutic use , Treatment Outcome , Viremia/drug therapy
3.
Journal of Leukemia & Lymphoma ; (12): 483-486, 2021.
Article in Chinese | WPRIM | ID: wpr-907204

ABSTRACT

Objective:To observe the therapeutic efficacy and prognosis of daratumumab combined with chemotherapy bridging to allogeneic hematopoietic stem cell transplantation (allo-HSCT) followed by daratumumab and lenalidomide maintenance treatment for primary plasma cell leukemia (PCL).Methods:The clinical data of a patient with primary PCL admitted to the First People's Hospital of Yunnan Province in January 2020 were retrospectively analyzed, and relevant literatures were reviewed.Results:The patient was diagnosed with primary PCL and treated with daratumumab combined with BD (bortezomib + dexamethasone) for 1 course and BCDD (bortezomib + cyclophosphamide + liposomaldoxorubicin + dexamethasone) for two courses. The patient was treated with daratumumab combined with allo-HSCT after complete remission. The donor cells were successfully implanted and the chimerism rate of donor cells was 94.36% without acute graft-versus-host disease reaction. And then the patient received intermittent maintenance therapy of daratumumab combined with low dose lenalidomide after transplantation, and the current remission period after transplantation reached 4 months.Conclusions:Daratumumab combined with chemotherapy bridging to allo-HSCT followed by daratumumab and lenalidomide may improve the prognosis of primary PCL and prolong survival time.

4.
Journal of Leukemia & Lymphoma ; (12): 461-465, 2021.
Article in Chinese | WPRIM | ID: wpr-907199

ABSTRACT

Objective:To investigate the significance of Th1/Th2 cytokines in prognostic stratification of acute myeloid leukemia (AML).Methods:A total of 83 patients with newly diagnosed AML from June 2017 to April 2019 in the First People's Hospital of Yunnan Province were collected. According to the Chinese guidelines for diagnosis and treatment of adult acute myeloid leukemia (non-acute promyelocytic leukemia) (2017 edition), AML patients were divided into poor prognosis group (45 cases), moderate prognosis group (19 cases), and good prognosis group (19 cases); moderate prognosis plus poor prognosis was treated as the not good prognosis. Mann-Whitney U test and Kruskal-Wallis H test were used to compare the expression differences of Th1/Th2 cytokines in peripheral blood of different prognosis groups; cytokines with statistical differences among different prognosis groups were selected, and the cut-off value of AML patients with different prognostic stratification distinguished by cytokines was determined by using receiver operating characteristic (ROC) curve. Finally, patients were divided into ≥ cut-off value group and <cut-off value group according to the cut-off value, and then the association of both groups with the prognostic stratification in guideline was also analyzed. Results:The median expression level of tumor necrosis factor (TNF)-β of patients in moderate prognosis group [3.80 pg/ml (2.75 pg/ml, 15.32 pg/ml)] was higher than that of patients in poor prognosis group [2.78 pg/ml (1.28 pg/ml, 3.36 pg/ml)] and good prognosis group [1.61 pg/ml (0.83 pg/ml, 3.04 pg/ml)] ( U=216, P=0.02; U = 312, P < 0.05); the median expression level of TNF-β in good prognosis group was lower than that in poor prognosis group ( U = 562, P = 0.048). There were no statistically significant differences in the expression levels of Th1/Th2 cytokines of AML patients with different prognostic stratification (all P>0.05).The cut-off value of TNF-β was 3.23 pg/ml in good prognosis group and moderate prognosis group, the area under the ROC curve was 0.866 (95% CI 0.753-0.978, P < 0.05); among 26 patients with TNF-β≥ 3.23 pg/ml, 25 (96.2%) patients had not good prognosis. The cut-off value was 3.62 pg/ml for distinguishing between moderate prognosis group and poor prognosis group, the area under the ROC curve was 0.747 (95% CI 0.610-0.884, P = 0.02); 18 (100%) patients with TNF-β≥ 3.62 pg/ml had not good prognosis. The cut-off value was 2.19 pg/ml for distinguishing between good prognosis group and not good prognosis group, the area under the ROC curve was 0.719 (95% CI 0.595-0.842, P = 0.04); among 53 patients with TNF-β≥2.19 pg/ml, 46 (86.8%) patients had not good prognosis. Conclusions:The high expression of TNF-β may indicate that the prognosis of AML patients is not good. When the level of TNF-β was equal or greater than 3.62 pg/ml, it may contribute to the prognostic stratification of AML patients.

5.
Chinese Journal of School Health ; (12): 404-407, 2021.
Article in Chinese | WPRIM | ID: wpr-875708

ABSTRACT

Objective@#To understand the prevalence and influencing factors of Children s Dental Fear (CDF) among 12-15 year-old children in Shenzhen city, so as to provide a framework to alleviate CDF and promote oral health.@*Methods@#Multi-stage stratified random sampling was used to select 5 509 children, aged 12-15 years, to participate in this study, which was carried out from October to November, 2018. The Children s Fear Survey Scheduling-Dental Subscale (CFSS-DS) and oral health examinations were conducted in Shenzhen.@*Results@#The prevalence of dental fear in children aged 12, 13, 14, and 15 years in Shenzhen was 30.3%, 30.5%, 33.6%, and 26.9%, respectively(χ 2=11.97, P=0.01). The CFSS-DS scores were(29.86±13.23)(29.72±13.59)(31.23±14.47)(29.79±13.24), respectively(F=3.60, P=0.01). The CFSS-DS scores of male and female participants were (27.92±13.69) and (32.62±13.12)(t=-12.97, P<0.01), respectively, and the CDF prevalence rates were 23.8% and 38.8%, respectively(χ 2=159.29, P<0.01). Multivariate Logistic regression analysis showed that gender, brushing frequency, visiting experience, oral knowledge level, oral health attitude, oral health and general health status were correlated with CDF (P<0.05).@*Conclusion@#Attention should be paid to the prevalence of dental phobia among children aged 12-15 years in Shenzhen, and comprehensive intervention measures should be taken to improve children s oral health.

6.
Article in Chinese | WPRIM | ID: wpr-826388

ABSTRACT

To investigate the risk factors associated with acute renal failure (ARF) after thoracoabdominal aortic aneurysm (TAAA) surgery. A total of 156 patients underwent TAAA repair between January 2009 and December 2017. Renal failure was defined based on the Kidney Disease Improving Global Outcomes criteria. The patients were divided into ARF group and non-ARF group based on the presence/absence of postoperative ARF. The risk factors of ARF were analyzed by univariate analysis and multivariate logistic analysis. The subjects included 111 males and 45 females aged (40.4±10.9) years (range:19-65 years). The surgical reasons included aortic dissection (=130,83.3%),aneurysm (=22,14.1%),and pseudoaneurysm (=4,2.6%). The degrees of repair included Crawford extent I in 6 patients (3.8%),extent Ⅱ in 128 patients (82.1%),extent Ⅲ in 20 patients (12.8%),and extent Ⅳ in 2 patients(1.3%). There were 3 patients presented with aortic rupture and 6 patients received emergent operations. Nine patients (5.8%) died within 30 days after surgery,and 8 patients (5.1%) suffered from permanent paraplegia. Thirty-six patients (23.1%) had ARF after surgery,and 18 of them needed dialysis. Multivariate logistic analysis showed that smoking ( =2.637,95%=1.113-6.250,=0.028),packed red blood cell usage in operation (≥6 U) ( =5.508,95%=2.144-11.930,=0.000),reoperation for bleeding (=3.529,95%=1.298-9.590,=0.013) were independent risk factors for ARF after TAAA repair. Smoking,packed red blood cell usage in operation (≥6 U),reoperation for bleeding are the independent risk factors of ARF after TAAA surgery.


Subject(s)
Acute Kidney Injury , Adult , Aged , Aortic Aneurysm, Thoracic , General Surgery , Blood Transfusion , Blood Vessel Prosthesis Implantation , Female , Humans , Male , Middle Aged , Postoperative Complications , Reoperation , Retrospective Studies , Risk Factors , Smoking , Treatment Outcome , Young Adult
7.
Article in Chinese | WPRIM | ID: wpr-865097

ABSTRACT

Objective:To investigate the application value of artificial neural network in laparoscopic surgery training.Methods:The prospective cohort study was conducted. A total of 158 trainees from the First Hospital Affiliated to Army Medical University between Semptember and November, 2019 who had no experience in laparoscopic technology were selected for laparoscopic surgery training, including 52 graduate students of surgery from grade 2019, 2018 and 2017, 58 surgeons receiving standardized residency training, 12 interns and 36 refresher physicians. The 158 trainees were divided into two groups using the random number table. Trainees trained by artificial neural network laparoscopic simulator were allocated into artificial neural network group, and trainees trained by box laparoscopic simulator were allocated into general laparoscopic simulator group. Trainees in both groups were trained using the laparoscopic simulator for 10 hours (5-day continuous training, 2 hours per day) on fundamentals of laparoscopic surgery. Observation indicators: (1) comparison of operation grades on laparoscopic simulator before and after training in the two groups; (2) comparison of improvement of the operation grades on laparoscopic simulator after training between the two groups. Measurement data with normal distribution were represented as Mean± SD, comparison within groups was analyzed using the paired t test and comparison between groups was analyzed using the independent sample t test. Measurement data with skewed distribution were represented as M (range). Results:A total of 158 trainees were selected for eligibility, including 140 males and 18 females, aged from 23 to 34 years, with a median age of 27 years. Of the 158 trainees, 79 were in the artificial neural network group and 79 were in the general laparoscopic simulator group. (1) Comparison of operation grades on laparoscopic simulator before and after training in the two groups: operation grades of the nails transferring, pattern cutting, ligation, sewing knots in vivo and sewing knots in vitro for the artificial neural network group before training were 51.2±4.9, 45.6±3.7, 43.0±3.6, 42.1±3.1, and 39.6±3.1, respectively. The above indicators for the artificial neural network group after training were 78.6±3.0, 76.4±3.9, 79.9±2.5, 78.3±3.5, and 84.1±3.8, respectively. There were significant differences in the above indicators for the artificial neural network group before and after training ( t=-42.490, -56.256, -80.373, -70.802, -79.742, P<0.05). The above indicators for the general laparoscopic simulator group before training were 50.1±2.9, 45.4±3.9, 42.7±3.0, 42.3±3.4, and 39.2±4.7, respectively. The above indicators for the general laparoscopic simulator group after training were 70.4±5.0, 69.8±4.0, 72.3±3.3, 72.3±3.5, and 72.8±3.2, respectively. There were significant differences in the above indicators for the general laparoscopic simulator group before and after training ( t=-28.942, -42.436, -58.357, -52.322, -53.098, P<0.05). (2) Comparison of improvement of the operation grades on laparoscopic simulator after training between the two groups: improvement of the operation grades in the nails transferring, pattern cutting, ligation, sewing knots in vivo and sewing knots in vitro for the artificial neural network group after training were 27.4±5.7, 30.8±5.0, 36.9±4.1, 36.2±4.5 and 39.5±5.4, respectively. The above indicators for the general laparoscopic simulator group after training were 20.3±6.2, 24.4±5.1, 29.6±4.5, 29.9±5.1 and 33.5±5.6, respectively. There were significant differences in the above indicators between the two groups ( t=7.597, 7.946, 10.638, 8.200, 6.969, P<0.05). Conclusion:The introduction of artificial neural network in laparoscopic surgery training can improve the training effects.

8.
Protein & Cell ; (12): 565-583, 2020.
Article in English | WPRIM | ID: wpr-828772

ABSTRACT

The anterior pituitary gland drives highly conserved physiologic processes in mammalian species. These hormonally controlled processes are central to somatic growth, pubertal transformation, fertility, lactation, and metabolism. Current cellular models of mammalian anteiror pituitary, largely built on candidate gene based immuno-histochemical and mRNA analyses, suggest that each of the seven hormones synthesized by the pituitary is produced by a specific and exclusive cell lineage. However, emerging evidence suggests more complex relationship between hormone specificity and cell plasticity. Here we have applied massively parallel single-cell RNA sequencing (scRNA-seq), in conjunction with complementary imaging-based single-cell analyses of mRNAs and proteins, to systematically map both cell-type diversity and functional state heterogeneity in adult male and female mouse pituitaries at single-cell resolution and in the context of major physiologic demands. These quantitative single-cell analyses reveal sex-specific cell-type composition under normal pituitary homeostasis, identify an array of cells associated with complex complements of hormone-enrichment, and undercover non-hormone producing interstitial and supporting cell-types. Interestingly, we also identified a Pou1f1-expressing cell population that is characterized by a unique multi-hormone gene expression profile. In response to two well-defined physiologic stresses, dynamic shifts in cellular diversity and transcriptome profiles were observed for major hormone producing and the putative multi-hormone cells. These studies reveal unanticipated cellular complexity and plasticity in adult pituitary, and provide a rich resource for further validating and expanding our molecular understanding of pituitary gene expression programs and hormone production.

9.
Article in Chinese | WPRIM | ID: wpr-828646

ABSTRACT

OBJECTIVE@#To study the regulatory mechanism of MS275, a histone deacetylase inhibitor, on the p38 MAPK signaling pathway in rats with convulsion in the developmental stage.@*METHODS@#Thirty-two male rats were randomly divided into four groups: control, pentylenetetrazol (PTZ), PTZ+3 mg/kg MS275, and PTZ+6 mg/kg MS275 (n=8 each). A rat model of convulsion in the developmental stage was prepared by an intraperitoneal injection of PTZ. The rats in the control group were given an injection of normal saline alone. MS275 was given by an intraperitoneal injection at 2 hours before PTZ injection. At 24 hours after successful modeling, 6 rats were taken from each group. Western blot and qRT-PCR were used to measure the protein and mRNA expression of p38, MK2, cAMP response element-binding protein (CREB), and interleukin-6 (IL-6) in the hippocampus. Hematoxylin-eosin (HE) staining was used to observe brain pathological changes. Western blot was used to measure the expression of CD11b as a marker for the activation of microglial cells.@*RESULTS@#Compared with the control group, the PTZ group had significant increases in the mRNA and protein expression of p38, MK2, CREB, and IL-6 (P<0.05). MS275 significantly inhibited the mRNA and protein expression of the above markers in the rats with convulsion in the developmental stage (P<0.05), and 6 mg/kg MS275 had a significantly better inhibitory effect on the mRNA and protein expression of IL-6 and CREB than 3 mg/kg MS275 (P<0.05). HE staining showed that the PTZ group had marked neuron apoptosis, cellular edema, and inflammatory cell infiltration, while MS275 intervention alleviated neuron apoptosis and cellular edema and reduced inflammatory cell infiltration in the rats with convulsion. The PTZ group had a significant increase in the activation of microglial cells, while MS275 significantly inhibited the activation of microglial cells in the rats with convulsion (P<0.05); 6 mg/kg MS275 had a significantly better inhibitory effect than 3 mg/kg MS275 (P<0.05).@*CONCLUSIONS@#In rats with convulsion in the developmental stage, the histone deacetylase inhibitor MS275 can inhibit the p38 MAPK signaling pathway, the apoptosis of hippocampal neurons, and the activation of microglial cells and thus reduce inflammatory response and convulsion-induced brain injury in a dose-dependent manner.


Subject(s)
Animals , Male , Pentylenetetrazole , Rats , Rats, Sprague-Dawley , Seizures , Signal Transduction , p38 Mitogen-Activated Protein Kinases
10.
Protein & Cell ; (12): 565-583, 2020.
Article in English | WPRIM | ID: wpr-828608

ABSTRACT

The anterior pituitary gland drives highly conserved physiologic processes in mammalian species. These hormonally controlled processes are central to somatic growth, pubertal transformation, fertility, lactation, and metabolism. Current cellular models of mammalian anteiror pituitary, largely built on candidate gene based immuno-histochemical and mRNA analyses, suggest that each of the seven hormones synthesized by the pituitary is produced by a specific and exclusive cell lineage. However, emerging evidence suggests more complex relationship between hormone specificity and cell plasticity. Here we have applied massively parallel single-cell RNA sequencing (scRNA-seq), in conjunction with complementary imaging-based single-cell analyses of mRNAs and proteins, to systematically map both cell-type diversity and functional state heterogeneity in adult male and female mouse pituitaries at single-cell resolution and in the context of major physiologic demands. These quantitative single-cell analyses reveal sex-specific cell-type composition under normal pituitary homeostasis, identify an array of cells associated with complex complements of hormone-enrichment, and undercover non-hormone producing interstitial and supporting cell-types. Interestingly, we also identified a Pou1f1-expressing cell population that is characterized by a unique multi-hormone gene expression profile. In response to two well-defined physiologic stresses, dynamic shifts in cellular diversity and transcriptome profiles were observed for major hormone producing and the putative multi-hormone cells. These studies reveal unanticipated cellular complexity and plasticity in adult pituitary, and provide a rich resource for further validating and expanding our molecular understanding of pituitary gene expression programs and hormone production.

11.
Article in Chinese | WPRIM | ID: wpr-867648

ABSTRACT

Objective:To predict the epitopes of the spike protein of 2019 novel coronavirus (2019-nCoV) and to analyze the mutation characteristics of this protein.Methods:The gene sequences of 2019-nCoV was downloaded from GenBank and Global Initiative on Sharing All Influenza Data database (as of March 4, 2020). ClustalW, MEGA 7.0, Immune Epitope Database and other software were used for predicting potential B lymphocyte and T lymphocyte epitopes of spike protein, and then mutations were compared in epitope and non-epitope regions. Statistical analysis was performed with chi-square test.Results:There were 130 potential epitopes, including 25 linear B lymphocyte epitopes, 18 non-linear B lymphocyte epitopes, 71 human leukocyte antigen (HLA) class-Ⅰ restricted T lymphocyte epitopes, and 16 HLA class-Ⅱ restricted T lymphocyte epitopes in spike protein. S 404-426displayed the higher antigenicity-score, and its population coverage was 73.4% in China. Compared with the spike protein before January 31, the mutation frequencies of spike protein were increased both in non-epitope (15.4% vs 21.7%) and epitope regions (6.2% vs 8.7%) after January 31, but the differences were not statistically significant (both P>0.05). Conclusions:The study identifies several epitopes of 2019-nCoV spike protein, which provides a preliminary basis for the study of 2019-nCoV vaccine. Mutations in spike protein have an increasing trend which needs more attention and research in the future.

12.
Article in Chinese | WPRIM | ID: wpr-824049

ABSTRACT

Objective To explore the application effect of mixed reality technology in the teaching of hepatobiliary surgery.Methods A total of 120 professional postgraduates majored in surgery who had received the four-month standardized training of residents in hepatobiliary surgery department of the First Affiliated Hospital of Army Military Medical University and the First Affiliated Hospital of Chongqing Medical University during 2016-2018 were selected and were equally allocated into the control group and the research group via random number table method.Students in the control group were trained with traditional surgical teaching mode and in the research group were trained with three-dimensional visualization model which was constructed by mixed reality.Students in both groups received assessment and questionnaires at the end of training.Results Scores of theoretical examination and surgical operation assessment of students in the research group were higher than those in the control group(P<0.05).The error rate for separating gallbladder artery and bile duct in the laparoscopic simulated system of students in the research group was significantly lower than that in the control group(P<0.05).Students-teacher satisfaction degree in the research group was higher than that in the control group(P<0.05).Conclusion Using mixed reality technology to construct a three-dimensional visualization model and to implement hepatobiliary surgery teaching enables the trainees to better master anatomical key points in the hepatobiliary system and the hepatobiliary surgical approach,with good feedback.

13.
International Journal of Surgery ; (12): 810-814,封3, 2019.
Article in Chinese | WPRIM | ID: wpr-823532

ABSTRACT

Objective To analyze the consistency of gastroscopic biopsy in the diagnosis of high grade intraepithelial neoplasia (HGIN) and postoperative pathological diagnosis,and explore the risk factors associated with missed diagnosis of HGIN.Methods From January 2012 to December 2018,the clinical data of 63 patients who were diagnosed with HGIN by gastroscopic biopsy prior to operation and underwent complete resection in the Union Hospital,Tongji Medical College,Huazhong University of Science and Technology were retrospectively analyzed.There were 55 males and 8 females,with a median age of 60 (35 to 76) years old.The gender,age,endoscopic lesion shape,longest diameter,CT image and inflammatory markers were analyzed,to investigate the correlation between them and pathological upgrading after operation.Receiver operating characteristic (ROC) curve was drawn to analyze the cut off value of measurement data,and the comparison of count data was performed by chisquare test or Fisher exact probability method.Univariate analysis was used to screen potential risk factors,and multivariate logistic regression analysis was futher utilized to analyze the independent risk factors of postoperative pathological upgrading.Results A total of 63 patients were enrolled,including 47 cases underwent surgical resection and 16 cases underwent endoscopic submucosal dissection(ESD).Among them,19 patients(30.2%) were pathologically diagnosed with HGIN,while 44 patients(69.8%) were pathologically diagnosed with invasive cancer after resection.Preoperative contrast-enhanced CT showed that 11 patients (17.5%) with perigastric fat spiculation around the lesion,all of which were confirmed as invasive carcinoma after operation.Univariate analysis showed that the longest diameter of the lesion ≥2 cm (P =0.002),ulcer lesions under gastroscopy (P =0.013),platelet to lymphocyte ratio (PLR) ≥ 103 (P =0.030),lymph node enlargement (P =0.046) and spiculation of the perigastric fat (P =0.025) were significant differences between the groups.Logistic regression analysis showed that the longest diameter of the lesion ≥2 cm (P =0.033) and ulcer lesions under gastroscopy (P =0.007) were independent risk factors for predicting postoperative pathological upgrading.Conclusions Gastroscopy biopsy in the diagnosis of high-grade intraepithelial neoplasia of the stomach has poor consistency with pathological diagnosis after operation.Clinicians should take active surgical intervention,especially for cases with the longest diameter of the lesions ≥2 cm,ulcer or perigastric fat spiculation on CT.

14.
Chinese Journal of Hepatology ; (12): 533-540, 2019.
Article in Chinese | WPRIM | ID: wpr-810761

ABSTRACT

Objective@#To analyze non-alcoholic steatohepatitis (NASH)-related differentially expressed genes (DEGs) by bioinformatics methods to find key pathways and potential therapeutic targets for NASH.@*Methods@#GSE61260 chip was downloaded from the public microarray database and liver biopsy samples from 24 NASH cases and 38 healthy controls were included. The Limma software package in R language was used to screen DEGs under the condition of difference multiple > 1.5 and adj. P < 0.05. The clusterProfiler software package was used for GO analysis and KEGG analysis. The STRING online database was used for protein-protein interaction analysis, and the L1000 and DrugBank databases were used for drug prediction.@*Results@#Compared with healthy control group, 857 DEGs were screened out in NASH group including 167 up-regulated genes and 690 down-regulated genes. GO analysis showed that DEGs were mainly involved in inflammation and cholesterol metabolism. KEGG analysis showed that DEGs were mainly enriched in PPAR, non-alcoholic fatty liver disease, oxidative phosphorylation and other signaling pathways. Among them, eight genes of ACSL4, CYP7A1, FABP4, FABP5, lipoprotein lipase, ME1, OLR1 and PLIN1 were enriched in PPAR signaling pathway, and 165 interaction nodes were formed with 47 DEGs-encoded proteins. Lipoprotein lipase interacted with 21 DEGs, and its up-regulated expression had improved lipid metabolism, insulin resistance and anti-inflammatory effects. Four drugs (gemfibrozil, bezafibrate, omega-3 carboxylic acid and glycyrrhizic acid) were screened by L1000 and DrugBank to activate lipoprotein lipase. Presently, these four drugs are clinically used to treat hypertriglyceridemia or to improve inflammation. In this regard, we speculated that the pharmacological effects of these four drugs had improved NASH by activating lipoprotein lipase to promote liver lipid metabolism and alleviate inflammation.@*Conclusion@#PPAR signaling pathway is closely associated to the occurrence and development of NASH, and thereby lipoprotein lipase agonist is a new attempt to treat NASH.

15.
Article in Chinese | WPRIM | ID: wpr-776009

ABSTRACT

Objective To evaluate the early and midterm results of surgical repair of thoracoabdominal aortic aneurysm(TAAA)in patients with Marfan syndrome(MFS). Methods The clinical data of patients with MFS undergoing TAAA repair in Fuwai Hospital between January 2009 and December 2017 were retrospectively analyzed.These patients were divided into two groups:MFS group(=58)and non-MFS group(=98).The baseline data,early postoperative results,and midterm follow-up outcomes were compared between these two groups. Results MFS patients were significantly younger(32 years old 45 years old,=9.603,=0.000)and more frequently had a history of aortic aneurysm or dissection(19% 0,=19.996,=0.000)than non-MFS patients.However,the proportions of males and smokers were significantly lower when compared with non-MFS patients(55.2% 80.6%,=11.489,=0.001;13.8% 46.9%,=17.686,=0.001).There was no significant difference in proportion of emergency operation,prophylactic cerebrospinal fluid drainage,operation time,intra-operative circulation management,and intra-operative blood transfusion(all >0.05).The 30-day mortality rate was significantly lower in MFS group than in non-MFS group(0 9.2%, [Formula: see text]=5.034,=0.025). Conclusions For patients with MFS,TAAA repair provides lower 30-day mortality and comparative middle-term survival.However,the re-intervention rate is higher among MFS patients,highlighting the importance of close follow-up.


Subject(s)
Adult , Aneurysm, Dissecting , Aortic Aneurysm, Thoracic , General Surgery , Blood Vessel Prosthesis Implantation , Female , Humans , Male , Marfan Syndrome , Middle Aged , Retrospective Studies , Treatment Outcome
16.
Article in Chinese | WPRIM | ID: wpr-746347

ABSTRACT

Objective To examine the operation efficiency of hospital clinical departments and explore ways to improve inefficient units from an input-output perspective.Methods We used the data envelopment analysis(DEA) to analyze the panel data in 2013-2017 from 30 clinical departments of a hospital,applying the CCR model and the BCC model.Results The overall operation efficiency of the hospital was as high as 26.32% of its clinical departments showed the increasing returns to scale.The scale efficiency was found to be high when the bed size in clinical departments ranged from 1 to 20,from 41 to 80,or from 91 to 100.There was an irrationality in fixed assets and staff deployment.Conclusions Size and input of clinical departments should be carefully planned to increase resource utilization efficiency.

17.
Chinese Journal of Radiology ; (12): 305-309, 2019.
Article in Chinese | WPRIM | ID: wpr-754925

ABSTRACT

Objective To investigate the differences in magnetic resonance imaging characteristics between perianal?fistulas of Crohn disease (P?FCD) and perianal?fistulas of non?Crohn disease (P?FNCD). Methods A retrospective analysis was made of 109 patients with perianal fistula who were confirmed by clinical examinations and surgery and had complete preoperative pelvic MRI data from sir run run shaw hospital affiliated to Zhejiang University from June 2015 to March 2017. Patients were divided into P?FCD and P?FNCD groups according to whether the patient was clinically diagnosed with Crohn disease (CD). There were 59 cases in group P?FCD and 50 cases in group P?FNCD. All patients underwent pelvic MRI plain scan and enhanced scan. the classifications of perianal fistula (St. James University Hospital classification and improved Parks classification) were evaluated. The number of branches, the number of abscesses, the number of internal opening, the height of the internal opening were measured and recorded. The incidence of proctitis and anal inflammation were recorded. Van Assche score was evaluated. Measured data between patients in the P?FCD and P?FNCD groups were compared using independent sample t test (normal distribution) or non?parametric test (skewed distribution).The quantitative data were compared using cross?sectional Pearson χ2 test. Results There were significant differences in the number of branches, the number of abscesses, the number of internal opening, the height of the internal opening, the positive rate of proctitis, the positive rate of anal canalitis, and the Van Assche score between the P?FCD group and the P?FNCD group (all P<0.05). There was no significant difference in the modified Parks classification between the P?FCD group and the P?FNCD group (P>0.05).There was significant difference in the classification of St. James University Hospital between the P?FCD group and the P?FNCD group (P<0.05). Conclusions P?FCD is mainly composed of high complex anal fistula, which is significantly different from P?FNCD. We used St. James University Hospital classification and Van Assche score to diagnose perianal fistula in combination with clinical examinations, which was helpful for the diagnosis of P?FCD.

18.
Chinese Critical Care Medicine ; (12): 1004-1007, 2019.
Article in Chinese | WPRIM | ID: wpr-754098

ABSTRACT

To investigate the risk factors and prognosis of acute kidney injury (AKI) in children with sepsis in pediatric intensive care unit (PICU). Methods A retrospective analysis of clinical data of PICU sepsis children in Anhui Children's Hospital from May 2015 to May 2018 was performed. The children were divided into AKI group and non-AKI group according to whether AKI occurred within 48 hours of PICU [referring to the diagnostic criteria for Kidney Disease: Improving Global Outcomes (KDIGO)]. The general data, physiological data and clinical outcomes of the two groups were compared; Logistic regression analysis was used to analyze the risk factors of AKI in children with sepsis and the prognostic factors. Results AKI occurred in 55 of 127 children with sepsis, the incidence of AKI was 43.3%, and the overall mortality was 28.3% (36/127), with 41.8% (23/55) in AKI group and 18.1% (13/72) in non-AKI group.① Compared with non-AKI group, oxygenation index, albumin, the pediatric critical illness case score (PCIS) and urine volume in AKI group were significantly decreased, while cystatin C, procalcitonin (PCT), prothrombin time (PT), activated partial thromboplastin time (APTT), pediatric multiple organ dysfunction score (P-MODS), the proportions of mechanical ventilation, vasoactive drug use, shock, septic shock and mortality were significantly increased, while there was no difference in age, gender, mean arterial pressure (MAP), white blood cell count (WBC) and C-reactive protein (CRP) between the two groups. Multivariate Logistic regression analysis showed that low serum albumin [odds ratio (OR) = 0.627, 95% confidence interval (95%CI) = 0.495-0.794, P = 0.000] and homocystatin C (OR = 2.641, 95%CI = 1.157-6.032, P = 0.021) were risk factors for AKI in children with sepsis. ② Compared with the survival group of children with sepsis AKI, the proportion of mechanical ventilation, septic shock, vasoactive drug use, positive balance ratio of liquid for 72 hours, 6-hour lactate clearance rate < 10%, and AKI 3-stage patients in the death group of children with sepsis AKI were significantly increased. Multivariate Logistic regression analysis showed that 72-hour positive liquid balance (OR = 8.542, 95%CI = 1.956-37.307, P = 0.004) and 6-hour lactate clearance rate < 10% (OR = 5.980, 95%CI = 1.393-25.676, P = 0.016) were risk factors for the death of children with sepsis AKI. Conclusions Serum albumin and cystatin C should be closely monitored in children with sepsis. Early detection and intervention of positive fluid balance and low lactate clearance rate can reduce the mortality of AKI in children with sepsis.

19.
Chinese Journal of Hepatology ; (12): 838-841, 2019.
Article in Chinese | WPRIM | ID: wpr-801305

ABSTRACT

Alanine aminotransferase (ALT) is the most abundant enzyme in human liver cells. When liver lesions occur, the permeability of liver cell membrane is enhanced and ALT is released into the blood. Clinically, the nature and degree of liver lesions are understood by measuring the level of ALT in peripheral blood. Serum ALT levels after chronic hepatitis B virus (HBV) infection are associated with the risk of hepatocellular carcinoma (HCC), while the normalization of ALT in antiviral therapy for chronic hepatitis B (CHB) patients is an independent surrogate indicator for predicting HCC development.

20.
International Journal of Surgery ; (12): 810-814, 2019.
Article in Chinese | WPRIM | ID: wpr-800677

ABSTRACT

Objective@#To analyze the consistency of gastroscopic biopsy in the diagnosis of high grade intraepithelial neoplasia(HGIN) and postoperative pathological diagnosis, and explore the risk factors associated with missed diagnosis of HGIN.@*Methods@#From January 2012 to December 2018, the clinical data of 63 patients who were diagnosed with HGIN by gastroscopic biopsy prior to operation and underwent complete resection in the Union Hospital, Tongji Medical College, Huazhong University of Science and Technology were retrospectively analyzed. There were 55 males and 8 females, with a median age of 60 (35 to 76) years old. The gender, age, endoscopic lesion shape, longest diameter, CT image and inflammatory markers were analyzed, to investigate the correlation between them and pathological upgrading after operation. Receiver operating characteristic (ROC) curve was drawn to analyze the cut off value of measurement data, and the comparison of count data was performed by chi-square test or Fisher exact probability method. Univariate analysis was used to screen potential risk factors, and multivariate logistic regression analysis was futher utilized to analyze the independent risk factors of postoperative pathological upgrading.@*Results@#A total of 63 patients were enrolled, including 47 cases underwent surgical resection and 16 cases underwent endoscopic submucosal dissection(ESD). Among them, 19 patients(30.2%) were pathologically diagnosed with HGIN, while 44 patients(69.8%) were pathologically diagnosed with invasive cancer after resection. Preoperative contrast-enhanced CT showed that 11 patients(17.5%) with perigastric fat spiculation around the lesion, all of which were confirmed as invasive carcinoma after operation. Univariate analysis showed that the longest diameter of the lesion ≥2 cm (P=0.002), ulcer lesions under gastroscopy (P=0.013), platelet to lymphocyte ratio (PLR) ≥103 (P=0.030), lymph node enlargement (P=0.046) and spiculation of the perigastric fat (P=0.025) were significant differences between the groups. Logistic regression analysis showed that the longest diameter of the lesion ≥2 cm (P=0.033) and ulcer lesions under gastroscopy (P=0.007) were independent risk factors for predicting postoperative pathological upgrading.@*Conclusions@#Gastroscopy biopsy in the diagnosis of high-grade intraepithelial neoplasia of the stomach has poor consistency with pathological diagnosis after operation. Clinicians should take active surgical intervention, especially for cases with the longest diameter of the lesions ≥2 cm, ulcer or perigastric fat spiculation on CT.

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