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1.
Article in Chinese | WPRIM | ID: wpr-912044

ABSTRACT

Objective:To explore the effect of a pelvis-assisting rehabilitation robot on lower limb function and knee proprioception after cerebral infarction.Methods:Forty hemiplegic cerebral infarction survivors were randomly divided into an experimental group and a control group, each of 20. Both groups were given routine neurological medication and rehabilitation training, while the experimental group was additionally provided with 20 minutes of robot-assisted gait training daily, five times a week for four weeks. Before and after the intervention, motor function, balance, walking function and knee joint proprioception were assessed using the simplified Fugl-Meyer lower limb assessment, the Berg balance scale, functional ambulation categorization and the Humac Norm isokinetic tester.Results:After the treatment, significant improvement was observed in all of the above measurements in both groups, but the improvements were significantly greater in the experimental group.Conclusions:Robotic pelvic assistance can effectively improve lower limb motor function, balance, knee proprioception and walking after cerebral infarction.

2.
Article in Chinese | WPRIM | ID: wpr-912024

ABSTRACT

Objective:To explore the effect of robot-assisted training and repetitive transcranial magnetic stimulation (rTMS) on the lower limb function of hemiplegic stroke survivors.Methods:Forty hemiplegic stroke patients were randomly divided into a treatment group ( n=20) and a control group ( n=20). Both groups were given routine rehabilitation training and robot-assisted walking training, but the treatment group was additionally treated with rTMS at 1Hz applied to the primary motor cortex M1 area at an intensity of 80% of the resting motor threshold. The stimulation time was 5 seconds at 5-second intervals, 600 pulses each time, five times a week for 8 weeks. Lower limb motor function, balance and walking function were assessed before and after the intervention using the Fugl-Meyer assessment for the lower extremities, the Berg balance scale and the Holden walking function scale. Results:There was no significant difference between the two groups in any measurement before the training, but after the intervention all of the measurements had improved significantly in both groups, with the average Fugl-Meyer score, Berg score and Holden grading significantly better in the treatment group.Conclusion:Repetitive transcranial magnetic stimulation can improve the effectiveness of robot-assisted walking training in improving lower limb motor function, balance and walking after a stroke.

3.
Article in Chinese | WPRIM | ID: wpr-888346

ABSTRACT

OBJECTIVE@#To observe the changes of erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and nerve function in patients with spinal tuberculosis before and after surgery, explore the timing of surgical intervention, and evaluate its influence on surgical safety.@*METHODS@#A retrospective analysis was conducted on 387 patients with spinal tuberculosis who received surgical treatment from March 2012 to March 2017, including 278 males and 109 females, aged 12 to 86 years old with an average of (49.9±19.1) years. There were 64 cases of cervical tuberculosis, 86 cases of thoracic tuberculosis, 76 cases of thoracolumbar tuberculosis and 161 cases of lumbar tuberculosis. There were 297 patients with single segmental involvementand 90 patients with multiple segmental involvement. Among them, 62 cases presented neurological damage, and preoperative spinal cord neurological function depended on ASIA grade, 5 cases of grade A, 8 cases of grade B, 39 cases of grade C, and 10 cases of grade D. According to the duration of preoperative antituberculosis treatment, the patients were divided into group A (256 cases, receiving conventional quadruple antituberculosis treatment for 2-4 weeks before surgery) and group B (131 cases, receiving conventional quadruple antituberculosis treatment for more than 4 weeks before surgery). The two groups were compared in terms of gender, age, preoperative complicated pulmonary tuberculosis, lesion site, lesion scope, surgical approach, drug resistance and other general clinical characteristics. ESR, CRP, visual analogue scale(VAS), Oswestry Disability Index (ODI), Frankel grade and postoperative complications were observed.@*RESULTS@#All 387 patients were followed up for 12 to 36 (18.3±4.5) months. There were no significant differences in gender, age, preoperative pulmonary tuberculosis, lesion site, lesion range, surgical approach, preoperative drug resistance and other characteristics between two groups. A total of 32 patients in two groups did not heal after surgery, with an incidence rate of 8.27%. The VAS and spinal cord dysfunction index of the two groups were significantly improved after surgery (@*CONCLUSION@#After 2-4 weeks of anti tuberculosis treatment before operation, patients with spinal tuberculosis could be operated upon with ESR and CRP in a descending or stable period. In principle, patients with spinal tuberculosis and paraplegia should be treated as soon as possible after active preoperative management of the complication without emergency surgery.


Subject(s)
Adolescent , Adult , Aged , Aged, 80 and over , Blood Sedimentation , Child , Female , Humans , Male , Middle Aged , Retrospective Studies , Spinal Fusion , Thoracic Vertebrae , Tuberculosis, Spinal/surgery , Young Adult
4.
Article in English | WPRIM | ID: wpr-881068

ABSTRACT

Angelicae Sinensis Radix (Danggui) and Ligusticum Chuanxiong Rhizoma (Chuan Xiong) herb-pair (DC) have been frequently used in Traditional Chinese medicine (TCM) prescriptions for hundreds of years to prevent vascular diseases and alleviate pain. However, the mechanism of DC herb-pair in the prevention of liver fibrosis development was still unclear. In the present study, the effects and mechanisms of DC herb-pair on liver fibrosis were examined using network pharmacology and mouse fibrotic model. Based on the network pharmacological analysis of 13 bioactive ingredients found in DC, a total of 46 targets and 71 pathways related to anti-fibrosis effects were obtained, which was associated with mitogen-activated protein kinase (MAPK) signal pathway, hepatic inflammation and fibrotic response. Furthermore, this hypothesis was verified using carbon tetrachloride (CCl

5.
Article in Chinese | WPRIM | ID: wpr-879409

ABSTRACT

OBJECTIVE@#To compare the clinical effects of three different methods of binding multi-fold rib graft, iliac bone graft and titanium mesh graft in tuberculosis of thoracic vertebra by approach of transverse rib process.@*METHODS@#A hundred and seven patients with tuberculosis of thoracic vertebra received surgical treatment from January 2010 to December 2016 were retrospectively analyzed. The patients were divided into three groups according different methods of bone graft. The surgical approach of the transverse rib process was used in all 107 patients, after thoroughly remove the necrotic tissue of tuberculosis, three different bone grafts were used respectively including iliac bone graft (36 cases, group A), binding multi-fold rib graft (35 cases, group B), titanium mesh bone graft (36 cases, group C). Perioperative indexes, the time required for bone graft during operation, intraoperation blood loss, the loss rate of the anterior edge of the lesion, Cobb angle, postoperative bone graft fusion time, spinal nerve recovery and Oswestry Disability Index were compared among three groups.@*RESULTS@#All the patients were followed up for 13 to 24 months, and the operation time required for bone graft was (23.2±4.1) min in group A, (23.8± 4.4)min in group B, and (25.5±4.2) min in group C, with no statistically significant difference among three groups (@*CONCLUSION@#The approach of transverse rib process for debridement of lesions can effectively treat tuberculosis of thoracic vertebra by binding multi-fold rib graft, iliac bone graft and titanium mesh graft, but binding multi-fold rib graft can effectively avoid iliac bone donor complications, and is an effective alternative to iliac bone graft, which is worth popularizing.


Subject(s)
Bone Transplantation , Humans , Lumbar Vertebrae , Retrospective Studies , Ribs/surgery , Spinal Fusion , Surgical Mesh , Thoracic Vertebrae/surgery , Titanium , Treatment Outcome , Tuberculosis, Spinal/surgery
6.
Chinese Medical Journal ; (24): 524-531, 2021.
Article in English | WPRIM | ID: wpr-878080

ABSTRACT

BACKGROUND@#Reduced application of percutaneous coronary intervention (PCI) is associated with higher mortality rates after ST-segment elevation myocardial infarction (STEMI). We aimed to evaluate potential factors contributing to the refusal of PCI in STEMI patients in China.@*METHODS@#We studied 957 patients diagnosed with STEMI in the emergency departments (EDs) of six public hospitals in China. The differences in baseline characteristics and 30-day outcome were investigated between patients who refused PCI and those who underwent PCI. Multivariable logistic regression was used to evaluate the potential factors associated with refusing PCI.@*RESULTS@#The potential factors contributing to refusing PCI were older than 65 years (odds ratio [OR] 2.66, 95% confidence interval [CI] 1.56-4.52, P 12 h) (OR 3.31, 95% CI 1.83-6.02, P < 0.001) and not being hospitalized in a tertiary hospital (OR 0.45, 95% CI 0.27-0.75, P = 0.002). Compared to men, women were older, were less often married, had a lower BMI and were less often hospitalized in tertiary hospitals.@*CONCLUSIONS@#Patients who were older, had lower economic or social status, and had poorer health status were more likely to refuse PCI after STEMI. There was a sex difference in the potential predictors of refusing PCI. Targeted efforts should be made to improve the acceptance of PCI among patients with STEMI in China.


Subject(s)
China , Female , Humans , Male , Myocardial Infarction , Percutaneous Coronary Intervention , Risk Factors , ST Elevation Myocardial Infarction/surgery , Time Factors , Treatment Outcome
7.
Acta Pharmaceutica Sinica B ; (6): 3527-3541, 2021.
Article in English | WPRIM | ID: wpr-922422

ABSTRACT

Nonalcoholic fatty liver disease (NAFLD) has become one of the most prominent causes of chronic liver diseases and malignancies. However, few therapy has been approved. Radix Bupleuri (RB) is the most frequently used herbal medicine for the treatment of liver diseases. In the current study, we aim to systemically evaluate the therapeutic effects of saikosaponin A (SSa) and saikosaponin D (SSd), the major bioactive monomers in RB, against NAFLD and to investigate the underlying mechanisms. Our results demonstrated that both SSa and SSd improved diet-induced NAFLD. Integrative lipidomic and transcriptomic analysis revealed that SSa and SSd modulated glycerolipid metabolism by regulating related genes, like

8.
Article in Chinese | WPRIM | ID: wpr-846666

ABSTRACT

Objective: To screen the main hepatotoxic components, predict the target of active components, and explore the mechanism of liver toxicity of Euodiae Fructus (EF). Methods: According to TCMSP database, PubChem database Pharmmapper server and Uniprot KB database information, active constituents of EF were screened, and targets of hepatotoxicity were predicted. The active component-acting target network of EF was constructed by Cytoscape software, while the function and metabolic pathways of target genes were analyzed by KOBAS 3.0 database. Results: Network analysis results demonstrated that 147 potential hepatotoxic components from EF, accompanied with 49 targets like F2, PIM1, MMP13 and MAOB, connecting with cell metabolism, catalytic activity, stimulate the reaction pathways may be associated with EF’s liver toxic effects. Conclusion: Based on network pharmacology methodology, this paper disclosed that many potential toxic components in EF may interact with cell metabolism, catalytic activity and other pathways through multiple targets, leading to produce hepatotoxicity in vivo as a result, which can provide new clues for further researches of the hepatotoxicity mechanism study of EF.

9.
Article in English | WPRIM | ID: wpr-829009

ABSTRACT

Objective@#To explore the protective effects of dexmedetomidine (Dex) against high glucose-induced epithelial-mesenchymal transition in HK-2 cells and relevant mechanisms.@*Methods@#HK-2 cells were exposed to either glucose or glucose+Dex for 6 h. The production of ROS, morphology of HK-2 cells, and cell cycle were detected. Moreover, the expression of AKT, p-AKT, ERK, p-ERK, PI3K, E-Cadherin, Claudin-1, and α-SMA were determined and compared between HK-2 cells exposed to glucose and those exposed to both glucose and Dex with or without PI3K/AKT pathway inhibitor LY294002 and ERK pathway inhibitor U0126.@*Results@#Compared with HK-2 cells exposed to high level of glucose, the HK-2 cells exposed to both high level of glucose and Dex showed: (1) lower level of ROS production; (2) cell morphology was complete; (3) more cells in G1 phase; (4) lower expression of p-AKT, p-ERK and α-SMA, higher expression of E-Cadherin and Claudin-1. PI3K/AKT inhibitor LY294002 and ERK inhibitor U0126 decreased the expression of p-AKT, p-ERK and α-SMA, and increased the expression of E-Cadherin and Claudin-1.@*Conclusion@#Dex can attenuate high glucose-induced HK-2 epithelial-mesenchymal transition by inhibiting AKT and ERK.


Subject(s)
Adrenergic alpha-2 Receptor Agonists , Pharmacology , Cell Line , Dexmedetomidine , Pharmacology , Epithelial-Mesenchymal Transition , Glucose , Metabolism , Humans , MAP Kinase Signaling System , Proto-Oncogene Proteins c-akt , Signal Transduction
10.
Chinese Medical Journal ; (24): 1409-1414, 2020.
Article in English | WPRIM | ID: wpr-827637

ABSTRACT

BACKGROUND@#The relationship of uric acid (UA) with the thyroid function among healthy individuals remains unclear. We aimed to examine the relationship between UA contents and thyroid hormone levels in healthy Chinese individuals.@*METHODS@#This was a cross-sectional study of 1186 Chinese adults (736 men and 450 women) who underwent a health check-up at the Huadong Hospital Affiliated to Fudan University (Shanghai, China) between January 1, 2010 and July 31, 2018. Clinical and thyroid hormone levels were compared in different UA groups (in male and menopause women groups, MG1: UA < 5 mg/dL; MG2: 5 mg/dL ≤ UA< 7 mg/dL; and MG3: UA ≥ 7 mg/dL; in female groups, FG1 to FG3 represent the UA levels of <4 mg/dL, 4 mg/dL ≤ UA< 6 mg/dL, and ≥6 mg/dL, respectively). In addition, natural cubic spline regression, together with Pearson correlation analysis, was performed in investigating the correlation of UA with thyroid hormones.@*RESULTS@#After adjusting for confounding factors, low levels of UA (for males, UA < 5.30 mg/dL; for females, UA < 4.05 mg/dL) were negatively correlated with free triiodothyronine (FT3) both in men and women. UA levels between 4.83 and 6.06 mg/dL may act to protect FT3 in women, while UA levels between 6.39 and 7.09 mg/dL may protect FT3 in men. FT3 levels of low-range UA group reduced compared with mid-range UA and the high-range UA groups in both men and women.@*CONCLUSIONS@#Our results provide epidemiologic evidence to support the negative correlation between low UA contents and FT3 in the Chinese Han population, suggesting that the reduced UA contents may serve as the risk factor to predict poor thyroid function in Chinese individuals.

11.
Journal of Experimental Hematology ; (6): 1189-1196, 2020.
Article in Chinese | WPRIM | ID: wpr-827141

ABSTRACT

OBJECTIVE@#To investigate the prognosis prediction value of PET/CT in DLBCL patients treated with CAR-T therapy.@*METHODS@#The effects of PET/CT were retrospectively explored on 13 R/R DLBCL patients who were treated with CAR-T therapy. Parameters reflecting tumor metabolic burden, such as metabolic tumor volume (MTV) and total lesion glycolysis (TLG) were measured before and after CAR-T treatment.@*RESULTS@#Patients with larger baseline MTV or longer sum of longest diameters showed shorter overall survival (OS) time than those with low tumor burden. Patients achieved complete remission (CR), partial remission (PR) and minor remission (MR) determined by response evaluation criteria in lymphoma (RECIL) in 12 weeks showed progression-free survival and OS time superior to those of patients with no remission. In addition, it was found that 2 patients with residual masses classified as PR by contrast-enhanced CT of patients were evaluated as complete metabolic response by PET/CT imaging.@*CONCLUSION@#PET/CT shows a great value in the evaluation of prognosis and response in CAR-T-treated R/R DLBCL patients.


Subject(s)
Cell- and Tissue-Based Therapy , Fluorodeoxyglucose F18 , Humans , Lymphoma, Large B-Cell, Diffuse , Positron Emission Tomography Computed Tomography , Positron-Emission Tomography , Prognosis , Receptors, Chimeric Antigen , Retrospective Studies
12.
Journal of Clinical Hepatology ; (12): 1909-1912, 2020.
Article in Chinese | WPRIM | ID: wpr-825056

ABSTRACT

Severe acute pancreatitis (SAP) is a common critical disease of the digestive system with rapid progression, multiple clinical outcomes, and high mortality rate. With the development of minimally invasive technology, the surgical intervention strategies for SAP have changed greatly, and the mode of surgical intervention is developing towards minimal invasiveness, multidisciplinary cooperation, and individualization. At present, the treatment concepts of “step-up approach” and delayed intervention have been widely accepted by clinicians. Accurately grasping the indications for surgical intervention, emphasizing the timing of surgical intervention, and selecting a reasonable mode of surgical intervention have become the key to successful surgical intervention for SAP in clinical practice. Emphasis on the principles of multidisciplinary cooperation and individualization and a correct understanding of the role and status of surgical intervention may help to further improve the overall cure rate of SAP patients.

13.
Article in Chinese | WPRIM | ID: wpr-865087

ABSTRACT

Cholecystectomy is currently the most important surgical treatment for gallbladder disease, however, the complications of cholecystectomy, especially the occurrence of intestinal tumors has gradually aroused attention of scholars. In recent years, scholars have found that bile acid metabolism changes significantly after cholecystectomy, which may be the main cause of colorectal cancer induction, but the specific mechanism of colorectal cancer induced by cholecystectomy has not been clarified. In this article, the changes of bile acid metabolism after cholecystectomy (the size and composition of bile acid pool) and the mechanism of colorectal cancer induction after cholecystectomy were summarized and discussed based on the research progress at home and abroad, aiming at providing theoretical basis for the exploration of the prevention and treatment of colorectal cancer.

14.
Article in Chinese | WPRIM | ID: wpr-862679

ABSTRACT

Objective::To identify the main active components of Coptidis Rhizoma and Euodiae Fructus for the treatment of gastric cancer, predict the targets of the common active components in these two herbs, establish the network of active drug components-target genes, and further explore the potential mechanism and effect of Coptidis Rhizoma-Euodiae Fructus for the treatment of gastric cancer. Method::The active components of Coptidis Rhizoma-Euodiae Fructus were screened by Traditional Chinese Medicine Systems Pharmacology Database (TCMSP), gastric cancer targets were predicted and screened by Genecard database platform, " drug-active ingredient-disease-targets" networks were built by Cytoscape (3.7.1) software, and protein interaction networks were built by String database platform. Finally, Gene Ontology (GO) analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis were performed by using Bioconductor platform and R language. Result::The 14 potential active components of Coptidis Rhizoma and 15 potential active components of Euodiae Fructus were obtained, involving 127 targets related to gastric cancer. There were 33 common targets for Coptidis Rhizoma-Euodiae Fructus-gastric cancer, which played a therapeutic role in gastric cancer mainly by regulating target genes such as PTGS2, PTGS1, AR, RXRA and NOS2, as well as cell apoptosis, p53 signaling pathway and interleukin (IL)-17 signaling pathway. Conclusion::The therapeutic mechanism of Coptidis Rhizoma-Euodiae Fructus reflects the multi-component, multi-target and multi-pathway characteristics of traditional Chinese medicines and provides the scientific basis for further study and the material basis of Coptidis Rhizoma-Euodiae Fructus against gastric cancer.

15.
Article in Chinese | WPRIM | ID: wpr-792974

ABSTRACT

OBJECTIVE@#To investigate the clinical effect of One-stage posterior debridement combined with lumbar-ilium fixation and bone graft fusion for the treatment of lumbosacral tuberculosis.@*METHODS@#The clinical data of 31 patients with lumbosacral tuberculosis treated by one-stage posterior debridement combined with lumbar-ilium fixation and bone graft fusion from January 2013 to February 2018 were retrospectively analyzed. There were 18 males and 13 females, aged from 18 to 77 years old with an average of (45.9±9.1) years. The lesion segment was form L to S. The preoperative ASIA grading showed that 2 cases were grade B, 17 cases were grade C, 12 were grade D. Pre- and post-operative C reactive protein (CRP), visual analogue scale (VAS), erythrocyte sedimentation rate (ESR), ASIA grade, lumbosacral angle and intervertebral space height were analyzed, the surgery complications, stability of internal fixation, bone fusion were observed.@*RESULTS@#All the 31 patients were followed up for 10 to 24 months with an average of (16.0±3.1) months. One patient with local infection and subcutaneous hydrops was cured by dressing change. Other 30 cases got primary healing without sinus formation and no recurrence of spinal tuberculosis. All the patients were cured, no internal fixation loosening and breakage were found. All bone fusion was successful with an average fusion time of (4.7±1.1) months. At the final follow-up, ESR and CRP were normal, the VAS was decreased from (6.13±1.21) points preoperatively to (1.92±0.57) pioints, the ASIA grading showed that 2 cases were grade C, 6 cases were grade D, and 23 cases were grade E. The lumbosacral angle and intervertebral space height was increased from preoperative (21.42±3.75) °, (7.84±0.41) mm to (27.21±3.12) °, (9.80±0.38) mm at the final follow-up, respectively.@*CONCLUSION@#One-stage posterior debridement combined with lumbar-ilium fixation and bone graft fusion is a practicable, effective and safe method for the treatment of lumbosacral tuberculosis. It can be recommended in clinical application.

16.
Article in Chinese | WPRIM | ID: wpr-772589

ABSTRACT

OBJECTIVE@#To explore the clinical effects and advantages of percataneous endoscopic focal cleaning and drainage combined with posterior internal fixation in the treatment of tuberculosis of lumbar spine in elderly.@*METHODS@#The clinical data of 32 patients with tuberculosis of lumbar spine received percataneous endoscopic focal cleaning and drainage combined with posterior internal fixation from May 2013 to May 2016 were retrospectively analyzed. There were 13 males and 19 females, aged from 62 to 85 years old with an average of 75 years. Lesion segmental Cobb angle was 13° to 21° with an average of (16.52±3.20)°. Tuberculosis focal involved L₁-L₂ of 1 case, L₂-L₃ of 4 cases, L₃-L₄ of 15 cases, L₄-₅ of 10 case, L₅-S₁ of 2 cases. Cobb angle, VAS score, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and ASIA grade were compared before and after operation. The stability of the spine and the recurrence of tuberculosis were evaluated.@*RESULTS@#All patients were followed up for 12-36 months with the mean of 24 months. Three patients complicated with giant paravertebral psoas abscess occurred sinus tract in canal orifice of drainage tube after irrigation, and healed in 3 months after operation. Other 29 patients obtained healing of phase I without sinus tract formation. The clinical symptoms of all patients obvious improved at 2 weeks to 3 months after operation and no complications such as severe heart and lung, liver and kidney dyfunction were found. VAS scores and Cobb angles were improved from preoperative(6.77±1.23) points and(16.52±3.20)° to(4.71±0.69) points and (4.24±1.22)° at 1 week after operation. No infection and tuberculosis recurrence were found at follow-up period. ESR and CRP were normal at final follow-up and ASIA grade had obvious improved.@*CONCLUSIONS@#Percataneous endoscopic focal cleaning and drainage combined with posterior internal fixation is a simple, effective and safe method for tuberculosis of lumbar spine in elderly, and is worthy to recommend its clinical use.


Subject(s)
Aged , Aged, 80 and over , Debridement , Drainage , Female , Fracture Fixation, Internal , Humans , Lumbar Vertebrae , Male , Middle Aged , Retrospective Studies , Spinal Fusion , Thoracic Vertebrae , Treatment Outcome , Tuberculosis, Spinal
17.
Article in Chinese | WPRIM | ID: wpr-772585

ABSTRACT

OBJECTIVE@#To explore the clinical effect of cortical bone trajectory screw technology combined with anterior mini-open debridement and prop graft for lumbar tuberculosis in elderly.@*METHODS@#The clinical data of 22 patients with lumbar tuberculosis treated by cortical bone trajectory screw technology combined with anterior mini-open debridement and prop graft from February 2015 to December 2016 were retrospectively analyzed. There were 13 males and 9 females with an average age of (73.3±7.1) years old. The pre-operative Frankel grading showed that 2 cases were grade B, 5 cases were grade C, 6 were grade D, and 9 were grade E. Pre- and post-operative kyphosis Cobb angle, visual analogue scale (VAS), erythrocyte sedimentation rate(ESR) and the Frankel grade were analyzed, the conditions of complication, stability of internal plants, graft fusion were observed.@*RESULTS@#All 22 patients were follow-up for 12 to 24 months with an average of (18.7±4.6) years. Two patients with contralateral psoas major muscle abscess enlarged at 3 months after operation and were cured by drainage under the guidance of type-B ultrasonic. Other 20 cases got primary healing without sinus formation and recurrence of spinal tuberculosis. At the final follow-up, the Frankel grading showed that 3 cases was grade C, 5 cases were grade D, and 14 cases were grade E. The Cobb angle, visual analogue scale (VAS), ESR were respectively decreased from preoperative(17.68±3.86)°, (6.95±2.26) points, (47.14±20.85)mm/h to (4.77±2.47)°, (2.18±1.59) points, (16.77±11.42) mm/h at final follow-up. X-ray and CT scan showed bone union for 3 to 8 months after operation, with a mean time of(4.9±1.2) months.@*CONCLUSIONS@#It is effective method to treat lumbar tuberculosis with cortical bone trajectory screw technology combined with anterior mini-open debridement and prop graft.


Subject(s)
Aged , Aged, 80 and over , Bone Screws , Bone Transplantation , Cortical Bone , Debridement , Female , Fracture Fixation, Internal , Humans , Lumbar Vertebrae , Male , Retrospective Studies , Spinal Fusion , Thoracic Vertebrae , Treatment Outcome , Tuberculosis, Spinal
18.
Article in Chinese | WPRIM | ID: wpr-734982

ABSTRACT

Objective To evaluate the value of endoscopic ultrasonography ( EUS) combined with conventional endoscopy for prediction of invasion depth of early gastric cancer and its therapeutic decision-making. Methods Patients with biopsy-proven gastric cancer underwent EUS and conventional endoscopy from July 2011 to January 2018 in Ningbo No. 2 Hospital. A total of 129 patients with early gastric cancer confirmed by postoperative pathology were enrolled in the study. The sensitivity, specificity, positive predictive value, negative predictive value, consistency ( the value of Kappa ) and area under receiver operating characteristic curve ( AUC) of EUS, conventional endoscopy and combination of two methods to assess the accuracy of tumor infiltration depth were analyzed. The accuracy of therapeutic decision-making based on the EUS, conventional endoscopy and combination of two methods were assessed. Results In intramucosal cancer, the sensitivity, specificity, positive predictive value, negative predictive value, the value of Kappa and AUC of EUS were 75. 00%, 82. 22%, 88. 73%, 63. 79%, 0. 536 and 0. 797, respectively, and for conventional endoscopy, these statistical values were 61. 9%, 93. 33%, 94. 55%, 56. 76%, 0. 481, and 0. 801, respectively. For the combination of two methods, these statistical values were 85. 71%, 82. 22%, 90. 00%, 75. 51%, 0. 666 and 0. 850, respectively. In submucosal cancer, the sensitivity, specificity, positive predictive value, negative predictive value, the value of Kappa and AUC of EUS were 51. 11%, 86. 91%, 67. 65%, 76. 84%, 0. 403 and 0. 697, respectively, and for conventional endoscopy, these statistical values were 57. 78%, 73. 81%, 54. 17%, 76. 54%, 0. 311 and 0. 678, respectively. For the combination of two methods, these statistical values were 71. 11%, 90. 48%, 80. 00%, 85. 39%, 0. 632 and 0. 817, respectively. The accuracies of therapeutic decision-making of EUS, conventional endoscopy and the combination of two methods were 83. 72%, 68. 22% and 92. 25%, respectively. Conclusion Patients who are diagnosed as intramucosal caner by conventional endoscopy should not be recommended to undergo EUS. For those whose invasion depth is unclear, or diagnosed as submucosal cancer or deeper by conventional endoscopy, EUS should be performed for reassessment. The combination of two methods can improve the accuracy of distinguishing intramucosal and submucosal caners and therapeutic decision-making. Trial registration Chinese Clinical Trial Registry, ChiCTR-DDT-13003299.

19.
Chinese Journal of Digestion ; (12): 98-104, 2018.
Article in Chinese | WPRIM | ID: wpr-711578

ABSTRACT

Objective To analyze the predictive value of combination of endoscopic ultrasound (EUS)and 64-slice dual-source computed tomography(DSCT)in regional clinical staging and peritoneal metastases of gastric cancer.Methods From July 2011 to May 2017,365 patients with gastric cancer diagnosed by endoscopic biopsy were enrolled.The patients received EUS and DSCT examination with the gold standard of postoperative pathological diagnosis,the accuracies of EUS alone,DSCT alone and the combination of EUS and DSCT were evaluated in original gastric tumor,regional lymph nodes and peritoneal metastases.The accuracy,sensitivity,specificity,the positive predictive value,the negative predictive value,consistency(the value of K ap pa)and area under curve(AUC)of receiver operating characteristic(ROC)curve were calculated.Results A total of 263 patients were enrolled into the study on the depth of tumor invasion and clinical staging of regional lymph nodes and 289 patients were recruited into the clinical prediction study on peritoneal metastasis.The accuracy of EUS in clinical staging of the depth of tumor invasion was 75.29% and the sensitivity,specificity,the value of Kappaand AUC of EUS in clinical staging of regional lymph nodes were 86.26%,81.81%,0.681 and 0.840,respectively.The sensitivity,specificity,the value of Kappaand AUC of DSCT in clinical staging of regional lymph nodes were 74.81%,87.12%,0.620 and 0.813,respectively.The sensitivity,specificity,the value of Kappa and AUC of EUS in the prediction of peritoneal metastases were 38.24%,97.25%,0.432 and 0.668, respectively.The sensitivity,specificity,the value of Kappa and AUC of DSCT in the prediction of peritoneal metastases were 41.18%,100.00%,0.553 and 0.706,respectively.The accuracy and the value of Kappaof the combination of EUS and DSCT in clinical staging of the depth of tumor invasion were 75.29% and 0.639;the sensitivity,specificity,positive predictive value,negative predictive value, Kappa,AUC in clinical staging of regional lymph nodes were 93.13%,87.88%,88.41%,92.80%, 0.810 and 0.905,respectively;and the sensitivity,specificity,positive predictive value,negative predictive value,Kappa,AUC in the prediction of peritoneal metastases were 58.82%,97.25%, 74.07%,94.66%,0.616 and 0.774,respectively.Conclusions The combination of EUS and DSCT which is superior to single examination is very helpful in the depth of gastric cancer invasion and regional lymph nodes,and is helpful in the prediction of peritoneal metastasis. The combination of two complementary examinations can improve the accuracy of the depth of gastric cancer invasion,clinical staging of regional lymph nodes,and the prediction of peritoneal metastasis.

20.
Article in Chinese | WPRIM | ID: wpr-707242

ABSTRACT

Objective To explore the dynamic expressions and clinical significance of toll-like receptor 4 (TLR4)/microRNA (miRNA)-181a in the pathogenesis of hepatic fibrosis (HF) in patients with chronic hepatitis B (CHB) .Methods CHB patients underwent liver biopsy for fibrosis staging HF (S) .Real-time polymerase chain reaction (PCR) was used to detect the expressions of miRNA-181a in both serum and liver tissue and the expression of TLR4 mRNA in liver tissue .Western blot was used to detect the expression of TLR4 protein in liver tissue . The fibrosis-4 (FIB-4 ) index and aspartate aminotransferase-to-platelet ratio index (APRI ) were calculated for noninvasive evaluation of fibrosis staging .One-way ANOVA ,Mann-Whitney U test ,spearman correlation analysis and receiver operating characteristic (ROC) curve were used for statistical analysis .Results Forty CHB patients were includedin this study ,including 7 with S0 ,6 with S1 ,14 with S2 ,7 with S3 and 6 with S4 .Serum levesl of miRNA-181a (2-ΔΔCt ) in paitents with S0-4 were 1 .00 ± 0 .00 ,0 .68 ± 0 .08 ,1 .60 ± 0 .43 ,2 .32 ± 0 .40 , and 1 .81 ± 0 .22 ,respectively ,showing an overall upward trend (F=207 .242 ,P< 0 .01) and a positive correlation with the severity of HF (r= 0 .754 , P< 0 .01) .The expressions of miRNA-181a ,TLR4 mRNA and TLR4 protein in liver tissues showed an overall increasing trend from S 0 to S4 (F=207 .242 , 110 .390 and 57 .030 ,respectively ,all P<0 .01) .The expression of miRNA-181a in liver tissue showed a positive correlation with both the expression of TLR4 protein in liver tissue and the severity of HF (r=0 .673 and 0 .911 ,respectively ,both P< 0 .01) .There was no significant difference of APRI scores between the severe (S3-4) and non-severe (S0-2) HF groups (Z= -1 .401 ,P>0 .05) .The serum level of miRNA-181a was superior to FIB-4 index for evaluation of the severe HF (S3-4) ,with areas under the ROC curve (AUROC ) of 0 .887 and 0 .695 , respectively , and accuracy of 85 .0% and 60 .0% , respectively .Conclusions miRNA-181a may be involved in the regulation of TLR4 signaling pathway so that to affect the progression of HF in CHB patients ,which may be a potential new target for the prevention and early treatment of HF and a non-invasive serum marker for evaluation of HF .

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